The Future of Battery Powered Medical Devices?
One of the biggest limitations holding back battery powered medical devices is the battery power. Most telemetry units are powered by batteries you buy at Walgreens – not very high tech. Other products, with rechargeable batteries use lithium-ion batteries, an improvement but not a big improvement.
Welch Allyn's Propaq LT and Draeger's TeleSmart (more here, scroll down) take a step in the right direction with bedrails that trickle charge the monitors, so they're always at full charge when they go mobile. But many wireless medical devices (and device use cases) are not suited to the recharging cradle. What we need is new dramatically improved battery technology.
MIT spin-off A123 Systems has taken the lithium-ion battery and applied materials science and nanotechnology to the particles that coat the battery's electrodes and store and discharge energy. Results include a doubling of power density, a fivefold jump in peak energy (the cells pack more
punch than a standard 110-volt wall outlet), and recharging time
plummets – the M1 battery takes 5 minutes to achieve a 90% charge. Sweet. Going nano also improves safety. Regular
high-capacity Li-ion batteries can explode under severe stress,
like if they're dropped from several feet, or crushed. Rocket scientists can check out the spec sheet here (pdf).
A123 Systems has yet to announce any deals with medical device vendors, but let's hope that changes soon. Pictured right is the M1 battery.
[Hat tip: Wired]
Health Wonk Review – Number 12
Welcome to the twelfth edition of the Health Wonk Review. I'm the lucky host this time around, presenting the best of the blogosphere in health policy, infrastructure, insurance, technology, and managed care. So grab a fresh cup of coffee, and enjoy!
First up we have Julie Ferguson, from Workers Comp Insider. In this submission, Jon Coppleman discusses an updated prescription drug study by the
National Council on Compensation Insurance (NCCI) in his post on the drug management learning curve and some snake oil – “snake oil” is mentioned.
Dmitriy Kruglyak of The Medical Blog Network, interviews Andy Kessler author of “End of Medicine” – a book that made Amazon's Top 10. The interview with the author highlights his vision of the future of health care delivery. The post, “The End of Medicine” is a great example of some of the original reporting in the health wonk blogosphere.
At Healthcare Economist, Jason Shafrin reviews a few academic articles which analyze whether or not nurse
practitioners are cost effective in both the hospital and out-patient
setting. Both studies find that nurse practitioners can reduce cost
while not reducing the quality of care to patients. Hmm, lower cost… same quality… The Cost Effectiveness of Nurse Practitioners is interesting stuff.
Hospital Buyer reports shocking news: New Medicare Rules Met with Opposition from Many Parties. Olivier Travers notes that the Deficit Reduction Act includes significant cuts in Medicare
reimbursements set to begin early next year. HospitalBuyer looks in
these two entries
at the current debate involving Congressmen, device manufacturers,
hospitals, imaging centers, and a number of trade associations. Several
parties are trying to delay the new rules by two years to evaluate cost
savings and impact on access.
William Marcus Newberry, MD, writes Fixin' Healthcare, a blog about health promotion, healthy lifestyles and disease prevention. The post, The Lifestyle Chronicles – The Light At The End Of The Tunnel looks at the shift in public opinion to support financial
incentives as a means to promote healthy lifestyle. The change in
public opinion will permit health plans to change their approach, which
might lead to more prevention and improved health status. Public policy
might shift from sickness to health.
Jared Rhoads, of the Lucidicus Project explores the intersection of capitalism and health care. Boston Globe columnist Steven Syre recently asked, “What do each of
this year's 10 worst-performing stocks in Massachusetts have in
common?” The answer is that all ten of the state's biggest losers are
public companies that deal with medicine. If you're a capitalist, or better yet if you're a socialist, check out Shares of medicine.
The blog Wellness Tips, by Vreni Gurd, looks at breathing. One of the most amazing things we do is breathe. From our first breath
as a baby to the last when we die, our breath continues whether or not
we notice. Hyperventilation is a common faulty breathing pattern that
can cause problems in many systems of the body by raising the pH.
Learn to recognize and correct this pattern and improve your health by checking out Breathe – Hyperventilation increases your pH.
At InsureBlog, Bob Vineyard asks the question, “Is simpler, better?” Bob takes a look at Oregon's efforts to
use the power of the state to solve a problem in the market. Alas, the post Health Reform, shows there are not simple answers to improving health care. Hint: the short answer is no – read the post to find out why.
In a classic case of “follow the money,” Gary Mark Levin, MD, of Inland Empire RHIO News asks why payors aren't funding RHIOs (after all, they stand to benefit the most). The post, The Elephant in The Room looks at UnitedHealth Group's latest financial report and draws the obvious conclusions.
Tony Chen of hospital impact digs into the strategy and potential outcomes of the $21 billion HCA buyout. His analysis ends with a warning, “…so, look for the best HCA hospital in the country and start imagining that kind of hospital in your backyard.” Good analysis as always.
The Health Business Blog, written by David Williams, asks, “Is the MA health care reform law built on shaky assumptions?” If it wasn't, would have written this great post? His post revolves around assumptions about ER utilization refuted by a recent Health Affairs paper. The implications are intriguing.
At Managed Care Matters, Joe Paduda asks, Who Is UHC's Customer? He notes a rather questionable business practice between UHC's Golden Rule subsidiary and their providers, resulting in a kind of bait and switch for the insured. Unlike many health care business relationships, the customer relationship in this situation would seem to be pretty clear.
Matthew Holt, of The Health Care Blog, takes on United Healthcare and their Golden Rule subsidiary in, You sleep with scumbags, you expect to catch nasty diseases. Matthew pulls no punches in his scathing review of the payor's current and past business practices. Matthew is like an elephant, he doesn't seem to forget anything.
FCC Announces Regulatory Changes for Wireless Medical Devices
Last week the FCC issued a notice of proposed rulemaking whereby the FCC is proposing certain modifications to their rules to better support new wireless medical devices. The also gave “notice of inquiry,” seeking comment on new implanted and body-worn wireless medical devices (pdf press release). You can read the notice here (pdf).
This site gets lots of visitors using search terms for “wireless medical devices” and “standards” – there seems to be a lot of confusion about what is stipulated by FDA or FCC regulations and the frequencies and RF technologies allowable for certain applications. The short answer to these questions is that neither the FDA nor the FCC proscribe specific frequencies or technologies for medical applications.
The FCC's Medical Implantable Comminications Servic, or MICS, has not gotten much adoption. Many vendors have requested and received waivers (here's a good overview) seeking to use different frequency or apply some subset or variation of the MICS requirements. Less than a hand full of devices have adopted MICS in the 6 years since the band was created.
The latest major salvo from a vendor was the Petition for Rulemaking from Guidant, submitted last February (pdf document here). Titled, “In the Matter of Petition to Amend the Medical Implant Communications Service (MICS) Rules to Add Inductive Telemetry at 90-110 KHz, Expand the MICS Spectrum and Make Other Technical Changes in MICS,” Guidant lays out a variety of proposed changes, some of which make it into the FCC's Notice of Proposed Rulemaking.
You can read a brief intro to MICS here.
Hospitals Told Not to Ban Mobile Phones
The use of cell phones in hospitals seems to be a controversy that just won't go away. Some hospitals ban all cellular phones and have signs to that effect prominently displayed. Other hospitals ban phones, but for some reason don't bother to post any notices to that effect. Some hospitals allow mobile phones everywhere but in critical areas and surgery, and some allow cell phones everywhere (the physicians certainly like this approach).
Well it seems that ongoing controversy has compelled the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK to issue a statement.
[The MHRA's] experts said they should be restricted only where specialist equipment was used, as in intensive care and specialist baby units.
They said there was a small risk of interference. Bans are currently decided on individually by hospitals.
However, many NHS trusts have introduced outright bans and the British Medical Association has called on doctors to be allowed to use phones, but not the public.
The MHRA reports receiving only 10 reports in the past decade of cell phones interfering with infusion pumps. What, no ventilator problems? It's nice to know that mobile phone interference (and resulting outright bans) is a controversy that reaches near-religious proportions some place besides the U.S.
There are many sources of interference that effect medical devices, and these problems crop up quite frequently. To ban cell phones is perhaps not the best solution to what is really a risk management problem.
Cardiopulmonary Gets Nod from Frost
Frost & Sullivan recently named Cardiopulmonary Corp. as the recipient of the 2006 Global
Excellence of the Year Award in centralized patient monitoring technology. Very few hospitals standardize on one vendor's ventilators. This multi vendor requirement, plus the increased ventilation of patients outside critical care areas, has created a need for a system that provides an integrated view into ventilator performance, patient status and common alarms and alarm notification – regardless of vendor or location. Here is Frost's description:
monitoring systems to best-in-class devices that has taken place due to the
convergence of ventilation monitoring, infusion pump monitoring, and core
patient monitoring. Cardiopulmonary continues to demonstrate its dedication to
innovation in information technologies. As patient safety concerns are driving
cooperation, Cardiopulmonary is well poised to take advantage of these new
trends.
Pictured right are some of the ventilators in Cardiopulmonary's lab.
