The document discusses emerging technologies that enable the next generation of wireless healthcare, including diagnostics, treatment, monitoring and healthy lifestyle support. Key technologies discussed include capsule endoscopy, smart drug delivery systems, digital pill monitoring and mHealth. These technologies leverage advances in processing, sensors, batteries and biomarkers to improve healthcare outcomes while reducing costs.

1. The Next Generation of Wireless Healthcare
MT5009: Analyzing High-Tech Opportunities
Chen Weiming
Alec Liu
Asger Thomsen
Eugene Wang
Zhang Jianliang

3. Overview
•Introduction
–Future Trends
–Enabling Technologies
•Illustrations
–Capsule Endoscopy
–Smart Drug Delivery
–Digital Pill System
–M-Health
•Conclusion

4. Healthcare Future Trends
•Paradigm shifts
•Greater participation of one’s health matters
–Doctor’s office →home
•Mobile devices will play a greater part in welfare
–Desktops → mobile devices
•Greater human-device interaction
–Accuracy: inside body >> outside body
•Medical records → electronic

5. Some Stats
Have access to in the world:
4.2 b 4.8 b
140% greater survival rate for patients with pacemaker with high remote monitoring
Patient Remote Monitoring almost doubles from 2012 to 2014
US will be short of 90,000 doctors next 4 years
30 million wearable health devices shipped in 2012
What if we could harness the potential of IT
for the betterment of healthcare?

6. Enabling Technologies –Processing Capabilities
Advances in integrated circuits drive the reduction of computing devices, and increase their functionality

7. Enabling Technologies –MEMs

8. Enabling Technologies –Power Consumption
Computations per kWh have been increasing by a factor of 1.5 per year

9. 0
100
200
300
400
500
600
700
800
1990
1995
2000
2005
2010
2015
2020
Energy Density (Wh/l)
Year
Li-ion Energy Density
Enabling Technologies –Batteries
New materials continue to help elongate Li ion battery life

10. Enabling Technologies –Biomarkers
Biomarkers have become more important indicators in recent years
•Proteins, DNA, hormones
Increasing number of approved biomarkers
•400%, 2003 -2012

11. Presentation Theme
•Next gen of wireless healthcare is for
–Diagnosis
–Effective regimen
–Healthier lifestyle
–Monitoring
•In corpore, ex corpore, and corpus-silico

12. Capsule Endoscopy
Diagnosis
Effective regimen
Healthier lifestyle
Monitoring

14. What is Capsule Endoscopy

15. Why Capsule Endoscopy -explore the unexplored
5m
0.5m
1.5m
Lower endoscopy
Upper endoscopy

16. Capsule endoscopy
•Photographic capsule
•Collect 2 images per second
•Moves by peristalsis
•Images are collected and stored for later download
•Capsule “working life” ranges 8-10hrs
•Capsule passes from body naturally
•Specific to examination of the Small bowel but other wireless device that exam remainder of GI tract

17. 1)Precheck up to see patient are eligible to take capsule endoscopy
2)Patient are required to fast for 12 hours before taking the capsule
3)Patient are mounted with antenna on the abdomen
4)Patient swallow the capsule
5)Patient bring back the data recorder to workstation for review the images/video
Procedure

18. Technology for Improvement
•Lens
•LEDS
•Camera
•Batteries
•RF transmitter
•Antenna
27mm
11mm

19. Current limitations
•Unable to control the speed of the capsule movement
•Unable to perform biopsy
•Risk of capsule retention
•Time consuming to review thousands of photos download at the end of the inspection

20. Smart Drug Delivery
Diagnosis
Effective regimen
Healthier lifestyle
Monitoring

21. Future drug delivery
•Imagine you automatically will get what you need
•Monitors your body and gives you drug when needed
Biosensor
Drug reservoirs
wireless
Heart rate
Hormones
temperature
Many different drugs
Implant

22. Drug delivery today
•Syringes
•External pumps
•Pens
•Inhalers
•Pills
•Patches
•Labor-intensive!

23. New drug delivery -Benefits
•Lower cost of care
•More data
•Automatic release
–Minimizing patient’s efforts
–No human errors
•Drug doses spread out in time
•Constant monitoring

24. How close are we?
•Not a single device that can do everything
•However, devices are moving in that direction
Biosensor
Drug reservoirs
wireless
Omnipod
Microchip
Apple Watch

25. Example of a device –MicroCHIP (1)
•Implanted by doctor with local anesthesia
•20 reservoirs, each containing 600 nanolitre
•Seal made of thin layer platinum and titanium
–Melts when current are applied
•Timer or wireless command (execute only)
•Not yet any biosensors, no data
<-3 cm ->
<-5 cm ->

26. Example of a device –MicroCHIP (2)
•Successfully tested with drug to treat osteoporosis patient
–Needs daily injections
•Price still to high
–Same as delivered with injections
•$10,000-12,000 per year
<-3 cm ->
<-5 cm ->

27. Example of a device -Omnipod
•Insulin pump
•Attach to skin (lasts three days)
•Manage dose wirelessly
–Intelligent system
•Not an implant, separate controller

28. Example of a device –Apple Watch
•Biosensor and data
–Monitors pulse
–Steps taken
•Connected to smartphone
•Not an implant and no drug
Infrared sensor

29. Barriers
•Reliability
–Complete control of drug delivery
•Security
•Standards
•Size
•Price
•Technology

30. Digital Pill System
Diagnosis
Effective regimen
Healthier lifestyle
Monitoring

31. What is Ingestible Digital Pill System
•Daily tracking of exact medicine intake time
–Noncompliance is a major healthcare issue
•Smartphone app
•Patch
•Ingestible sensor
–Size of a grain of sand (1 x 1 mm)
–Silicon
–Enclosed in pill
–No battery required

32. A system for monitor and record medicine taken.
Why Ingestible Digital Pill System

33. How is Ingestible Digital Pill System Work
•Patient swallows pill
•Stomach fluid activates sensor
•Patch collects data
•Patch sends data to smartphone
•Smartphone notifies in case of non- compliance

34. Wearable patch sensor and Mobile App
Store data in cloud. Loved ones and doctor can access these data.
Wearable Technology
Wireless technology
Mobile App

35. Market Ready
Edible technology for Ingestible sensors
Composition
Common reference
Typical Nutritional Guidelines
Copper: 0.0077 mg
Magnesium: 0.0098 mg
2 mg in Centrum® tablet
50 mg in Centrum® tablet
1.5 mg per day via IV for nutrition
400 mg US RDA
Ingestible Sensor approved as medical device
-Unlimited use by patients ingesting up to 30 sensors per day

36. Improvements
•Ingestible sensor
–Further reduce size while maintain detectable signal
(Current size: 1mm x 1mm)
–Simple marker of ingestion to a multi- functional data collection platform
•Wearable patch
–Batter power efficiency
(Currently lasts 7 days)
–New materials to make patch re- usable
–Be worn during all activities including showering and bathing
–Tattoo type patch for easy use.

37. Potential Cost Savings
$290billion in increased 2009 US medical costs
13% of total US health expenditures
50%do not take medications as instructed
Daily tracks the exact medication taken time
record
monitor
feedback
Provide valuable feedback on effectiveness of pharmaceutical
treatment
Adds visibility into a patient’s actual behaviors for better care
Waste due to missuse
Value Proposition

38. M-Health
Diagnosis
Effective regimen
Healthier lifestyle
Monitoring

39. A recent trip to NUH

40. M-Health
•M-Health uses mobile devices and/or communication networks for the provision of health services
•Monitoring of health data
•Three major dimensions: battery life, device capabilities/functionality, size/aesthetics

41. Basic Monitoring (1)
•ECG, heart rate, respiration rate, activity level, blood pressure, weight, blood glucose
•Remote monitoring of cardiac arrhythmias
•Benefits
–Reduced re-admissions, shortened hospital stays, improved clinical outcomes

42. Basic Monitoring (2)
•Leading health apps do not monitor anything related to menstruation and reproductive health of half the world’s population
•Menstruation patterns can reveal health problems
–Premenstrual syndrome
–Premenstrual dysphoric disorder
–Polycystic ovarian syndrome
–Menorrhagia
–Hysterectomy
•Other reasons for tracking
–functionality of contraceptive methods
–planning work and leisure activities
•Basal temperature as indication for stage menstrual cycle and ovulation

43. Advanced Monitoring
•Portable test kits + smartphone camera
•Molecules to detect
–Influenza A
–Vitamin D (mood, anxiety, sleep quality)
–C-receptive protein (inflammation)
vs.

44. Scale Effects
In biological molecule analysis, reduction in dimensions helps shorten analysis time
This is further compounded by parallelization

45. M-Health Cost Savings
•In Singapore, M-Health can save health costs by S$3 billion per year
–By comparison, venture capital in M-Health reached ~ US$1 billion (2013) in the US
•In the EU, savings of €99 billion in 2017
–Fewer complications: doctors and paramedical staff could save 472,000 doctor days
–Other economic costs: worker absenteeism, early retirement costs

46. New Ways of Powering (1)
•A major limitation to widespread use of mobile health is power with respect to size of device
Power Sustenance
Reduce power consumption
Components
Generation
Human power
Storage
Batteries
Based on 2013 Ultra Low Power Wireless ECG Sensor Tag
340 μW, 2V, 100m range
Based on 2012, ultra low power implantable medical sensor

47. New Ways of Powering (2)
Temporary Biofuel Cell Tattoo
•Electricity from sweat
•Can be twisted and stretched
•Chemically generates electricity
Currently 5 to 70 μW/cm2

48. New Ways of Powering (3)
•Fibre-based nanotechnology generate electricity via piezoelectric effect
•Textile fibers covered with zinc oxide nanowires
•Nanowires generate electricity when stretched
•6mm2generates about 20 mV, 0.8 μA (2.5 mW/mm2)

49. New Ways of Powering (4)
•Implantable hydroelectric generator
•Heart generates about 1-1.5 W of power
•About 1mW power available for devices e.g. Pacemaker requires 10 μW

50. Conclusions

51. Entrepreneurial Opportunities
•Consumer electronics
•IT support
•Healthcare sector
•New software
•Health insurance coverage policies
•Developing countries

52. Conclusion
•Advances in electronic components, biological molecule analysis, batteries signal the dawn for the next generation of wireless healthcare
–New medical procedures (endoscopy)
–Greater control of medicinal release
–Digitizing our healthy habits (digital pill)
–Strengthening patient/doctor dialog (M- Health)
•Greater confidence to both patients and healthcare professionals
•Better integration
–Diagnostics and procedures
–Medication
–Payment
•Wireless technology: 24/7, everywhere

54. Back-up

55. Back-up

56. Back-up
Smartphone cameras are sufficiently specific and sensitive for diagnostics
•Not statistical significant difference between smartphone cameras and conventional lab optic detectors

57. Back-up

58. Examples -Preventice
•Remote monitoring of cardiac arrhythmias via algorithm
•Doctors monitor key biometrics
–Reduced re-admissions, shortened hospital stays, improved clinical outcomes
•Components: bandage patch with battery and monitor sensor, mobile device
•Data collected: ECG, heart rate, respiration rate, activity level, blood pressure, weight, blood glucose
•Cloud-based platform collects real-time data from the mobile device
•Physicians then review data
•Support for numerous device connection types: cellular/smartphone, wi- fi, Bluetooth

59. M-Health Cost Savings (1)
•Traveling to a central lab for testing: $10 per test
•Also considering indirect cost of taking 0.5 day offto do testing: $200
•Transportation cost: $10
•If 10 tests are needed a year, it will cost $2200 per year per patient
•If the testing cost can be halved, and test can be done at home, in Singapore, this can save $3 b per year (assuming 1.5 million people needing tests)
•By comparison, venture capital in M-Health reached $900 million (2012), about $1 billion (2013) in the US

60. M-Health Cost Savings (2)
•Savings of 99 billion EUR in the EU in 2017
•mHealth can help 9.4 million regular users at risk of developing chronic diseases to expedite diagnosis
•815,000 patients can successfully detect chronic diseases early
•These patients could avoid complications and seek medical attention earlier, reducing the need for hospitalization and saving 3.7 billion EUR in treatment costs
•Doctors and paramedical staff could save 472,000 doctor days by having to treat fewer complications
•Chronic diseases could lead to 718 billion EUR in lost wages in 2017
•Healthcare cost savings as a result of improving lifestyles, reducing risk of chronic disease, saving of hospital and doctor days, healthcare providers staying informed, reducing worker absenteeism, and avoiding early retirement costs