There were three tracks this afternoon, and I chose the wireless track (of course). The moderator was Stan Kachnowski, Chair of the HIT Lab at Columbia University, who ran a tight ship and provided great context for the various speakers.
Investment banker, Rob McCray of TripleTree, provided a great overview of wireless technologies and the current market situation (its HOT!). He also posited the following questions that must be answered by any investor or company:
- Which wireless and medical technology?
- Who will pay?
- Who regulates and with what restrictions?
- What is the best stratey for marketing and distribution?
- How will the services be delivered?
McCray also noted the need for investors and companies who understand health care, communications technology and consumers. There's little doubt that wireless health will succeed, the question is how many failed attempts will be made before the right success formulas are found.
Next up was Paul Hedtke of Qualcomm. He noted the long life cycles of medical devices when compared to the cell phone or consumer electronics industry. Also mentioned were high reliability requirements, device interfaces and older users as other key factors. Connectivity requirements touched on wireless coverage, and smart data management (no lost or duplicate data). Another big issue is the absence of service level agreements (SLAs) from a wireless carrier, and limited device management tools.
Cell phones are a walled garden, controlled by the carrier - this makes support for deep health care applications tricky to implement. Off-the-shelf considerations are similar to embedded 802.11 radios for medical devices - life cycle, carrier certification and the right feature sets are key issues. Using an embedded radio in an application specific device is the typical approach. You can get a device from ODMs (original device manufacturers), a combination of outsourcing incorporating an OEM cell phone engine, or doing it yourself. You can use carriers services as is, or use a managed wireless data service, like that provided by Qualcomm in their QConnect program.
Jon Darsee of Vitaphone talked about direct to consumer business in telecardiology. The thrust of his presentation was the need for high touch to complement the high tech. His mention of the telehealth myth got a few chuckles: if just the most affluent 5% of sufferers of this disease just bought our telehealth service/product, we'd be successful. He presented Vitaphone as a case study. They developed a cell phone that could acquire and transmit an ECG. The product, that was unique on the market, was a flop. Next they added GPS location data and Bluetooth for an added gateway capability. It still flopped. Next, they provided a health content provider they sell and cobrand with pharmacies in Germany. The also came out with a special 3 button phone (which they partnered with Vodaphone, who distributes the phone and services). This phone enabled very high touch services that include a health conserge service.
Stephen Intille, of MIT, talked about body sensors in the home. They use cell phones as gateways for data transmission. His position is that the key enabler of mobile consumer health care is "just-in-time." Traditional care relys on a nagging doctor who may not see you again for 6 months or a year. Alternatively, a just-in-time sensor-enabled cell phone that can provide immediate feedback and reinforcement. He maintained that the just-in-time capability is more important than the wireless feature. His current research looks at how best to provide micro feedback at teachable moments on mobile devices to encourage sustainable behavior change - very cool stuff that goes to the heart of Mike Barrett's talk about Prospect Theory.
Robert Schwarzenber of Card Guard shared the history of his company as a case study. They started as a remote monitoring device company. They then acquired a company called LifeWatch that provides cardiac arrhythmia monitoring services. Next they acquired Instromedix a manufacturer of monitoring devices. Sensei is a joint venture between Humana and Card Guard, that leverages behavior informatics. Sensei incorporates wireless sensors, expert content, and individualized, just in time actionable messaging using the psychology of behavior informatics.
They currently brand and sell their own products, white lable products ("Card Guard Inside"), and co branded products (Sensei). They've also developed an ASIC (application specific integrated circuit) for interactive mobile platform applications. They have quite a suite of devices, some they developed themselves and some they licensed from cash strapped start ups. All of their devices use standard Bluetooth for communications with any Bluetooth enabled cell phone. He also emphasized that while the technology is important, getting the rest of the business model right is essencial.
Pictured right is the ANT radio designed for wireless sensors - there was lots of discussion of wireless networks at the conference, but it was all focused on connecting a gateway to the wide area network, rather than wireless enablement of sensors.