This appeared
last week:
07 February
2024
By Ivor Campbell
What used to
sound like science fiction is becoming technological reality, with implications
for general practice.
When
two or more people from the world of medical technology meet, talk inevitably
turns to the ongoing, yet elusive, search for an industry-standard,
multi-disciplinary diagnostic device – the fabled tricorder.
Fans
of Star Trek will recall the small, rectangular gadget with a top-mounted,
rotating hood and shoulder strap, routinely carried by Dr Bones McCoy whenever
he was beamed down to a new planet.
Simply
by waving it in the general direction of stricken Starship Enterprise crew
members, Bones was somehow able to diagnose anything from acute
Hutchinson-Gilford Progeria Syndrome to an ingrown toenail. Of course, this was
unnecessary for any crew member wearing a red shirt.
While
the Star Trek tricorder remains the stuff of science fiction, diagnostics
companies globally continue to beaver away behind the scenes in search of a
machine capable of diagnosing the highest number of possible conditions within
a single technology.
Visitors
to global conventions like Medica and Medlab – the latter is in Dubai this week
– will be aware of the now perennial beauty contest among companies showing off
their latest prototypes of devices and software, aimed at facilitating multiple
test capabilities.
A
decade ago, Qualcomm, the San Diego-based communications technology company
offered a $US10 million prize to anyone who could produce a machine that most
closely approximated the tricorder.
The
winner was Final Frontier Medical Devices, based in Paoli, Philadelphia, whose
DxtER device was capable of diagnosing 13 conditions by integrating insights
from clinical emergency medicine and data analysis from actual patients, using
non-invasive sensors to collect vital signs, body chemistry, and biological
function data.
Since
then, the march of artificial intelligence has placed booster rockets under
existing technologies, to create advances that would have seemed unthinkable
only a few years ago.
Devices
such as digital stethoscopes by Clinicloud and Eko Core, and one-channel ECG
monitors like WIWE and AliveCor’s Kardia, reveal a focus on making diagnoses
faster, more accurate, and convenient.
The
availability of multi-channel ECGs, like the ECG Dongle, and multi-sensor
devices such as Viatom Checkme Pro, further demonstrate the evolution of
diagnostic capabilities.
These
devices aim to streamline the diagnostic process, providing users with
real-time data and promoting communication with smartphones for comprehensive
health monitoring.
Last
year a team at the University of California-Santa Cruz announced it had
developed a portable gadget that uses a special laser to analyse tiny particles
in blood samples, to simultaneously identify multiple viruses, DNA, antibodies,
and cancer markers.
Unlike
other chip-based blood test devices that focus on a single target, this
technology integrates optics and microfluidic channels on a chip, allowing it
to identify various particles with different concentrations.
The
device, which is being commercialised by Fluxus Inc, based in Sunnyvale,
California, uses a laser beam to detect particles and adjusts its sensitivity
to accurately measure both high and low concentrations.
The
researchers, led by Dr Holger Schmidt, also applied machine learning to enhance
accuracy in distinguishing different particle types. The technology is being
commercialised by Fluxus Inc. for medical use and holds potential for studying
neurodegenerative diseases and paediatric cancers.
The
reason for the industry’s obsession with such devices is because, in the world
of medical diagnostics, the pursuit of efficiency has become relentless,
particularly since the covid pandemic.
However,
having a fantastic product with brilliant engineering is not enough.
Cost-effectiveness and speed are crucial factors that can make or break a
diagnostic device and the company behind it and, as demands on public health
providers continue to mount, the significance of anything that can save
doctors’ time, and the health service money, cannot be overstated.
An
ongoing review of how to triage and treat general practice patients quickly and
effectively is under way in many countries around the world. The current model,
in which local family doctors’ surgeries are the first port of call for
patients, is seen by many people as no longer fit for purpose – not least
because they don’t currently operate outside of office hours when more people
now want to be seen.
In
future, it is expected that much of the burden of general practice will fall on
out-of-hours clinics and local pharmacies, and that cleverer and more versatile
diagnostic technologies will play an ever greater role.
Limited
shelf space in pharmacies and in confined consulting rooms creates a demand for
ever more compact and multifunctional solutions, hence the search for the
tricorder-like devices.
Yet,
while the physical and cost benefits of such devices are clear, there is a
growing awareness that they might create new and unintended consequences for
medical practitioners.
In
particular there is a recognition of the dilemma GPs face when presented with
immediate and potentially life-altering information about a patient’s
condition.
The
delicate balance between rapid diagnostics and allowing healthcare
professionals the time to carefully analyse and plan treatment is a critical
consideration.
Part
of the review’s remit is to find ways to free GPs from dealing with relatively
minor and less consequential conditions that they currently spend so much time
diagnosing and treating.
Many
countries have a large number of highly qualified pharmacists, with extensive
pharmaceutical education, who could contribute significantly to alleviating
pressures on local doctors’ surgeries, but whose skills are currently
underutilised.
The
lack of automation in pharmacy systems and physical constraints within premises
prevent them realising their full diagnostic potential.
But
things are changing. Similar to the evolution of personal computers in recent
decades, MedTech is now adapting to this demand.
The
commercialisation of the testing devices is primarily being driven by American
computer hardware companies rather than traditional players in the MedTech
sector, with growing competition from China and India which are developing an
ever more prominent role in the industry, driven by the vast markets and a
growing middle-class interest in healthcare.
…..
Ivor Campbell is chief executive of UK-based Snedden Campbell, a
specialist recruitment consultant for the global medical technology industry.
More here:
https://www.medicalrepublic.com.au/to-boldly-diagnose-day-of-the-tricorder-is-at-hand/104882
It is
impressive just how much progress appears to be happening in the technologies
we would need for a tricorder!
Clearly there
is a shrinking job needed to create a hand-held device but I suspect that in
time we will see that issue solved.
Stand by for
some exciting announcements in the next few years!
David.