SD Medtech Industry Making Lasting Impact

For better or worse, technology has permeated nearly every aspect of modern life. It is a large part of both business life and social life, but the area where technology has its greatest impact on life is on maintaining life itself.

Technology is one of the most important and fastest growing segments of healthcare today. The global medical device industry alone is estimated to be worth more than $465 billion this year and is expected to grow to more than $718 billion by 2029, according to a report by Fortune Business Insights.

As a region with an economy steeped in innovation, San Diego has been, and continues to be, a leader in bringing lifesaving and life-changing technology for healthcare to the world.

Innovative Devices

Dexcom Inc. is one San Diego’s leading companies in healthcare technology that is bringing that change to the world. This month, Dexcom announced its  new G7 Continuous Glucose Monitoring (CGM) System is now available in the United Kingdom, Ireland, Germany, Austria and Hong Kong for people with diabetes age 2 years and older; the company is also working to introduce the G7 in New Zealand and South Africa in the weeks ahead, with additional markets planned soon after.

“CGM is becoming the standard of care around the globe – it already is here in the United States and that benefit is being seen around the world,” said Dexcom COO Jake Leach, adding that awareness of the technology was the company’s first hurdle toward mass adoption.

The G7 is the latest advancement of Dexcom’s CGM devices, which first came to market in 1999. Leach said in those early days, Dexcom’s focus was on developing a reliable CGM, which was a large unmet need at the time. After 20 years developing and improving the technology, Dexcom CGMs are focused on including meeting user experience needs, like connecting the CGM to mobile phones.

“We have this patient-first mindset and so we always think about our products as we develop them from a user’s perspective,” Leach said. “The combination of new technologies with medical devices is a great opportunity. We’re seeing connected devices and data becoming such a more important aspect of all our lives and medical devices is just one of those that can really improve user experiences by those integrations.”

Another San Diego company advancing technology in healthcare with a global reach is NuVasive Inc. – a leader in spine technology innovation that is transforming spine surgery in over 50 countries.  The company recently announced the completion of its NuVasive Reline fixation portfolio for complex spinal deformity.

“Our approach is to provide a comprehensive, procedurally integrated set of solutions for the anterior and cervical spine. These cervical solutions help patients that need posterior cervical fusion, anterior cervical discectomy and fusion, and cervical total disc replacement surgeries,” said Michael Farrington, chief people and culture officer at NuVasive.

The global market for the cervical segment of spine devices is over $2.5 billion and growing, Farrington said. He pointed out there are some roadblocks to addressing the market needs, however.

“The biggest challenge is the amount of variability still prevalent in the spine industry, and the lack of standardization when it comes to spine care,” he said. “Intelligent surgery is our vision for NuVasive innovation—making more data-driven solutions to ensure a better outcome for patients around the world. When that’s done, the total market will expand because clinical, operational and financial outcomes will all improve.”

In addition to trailblazing new devices, innovation can also take the shape of improving upon or adapting old technologies, as San Diego-based Vektor Medical has done with its vMap tech.

vMap is the first technology cleared by the FDA to identify potential arrhythmia (irregular heartbeat) source locations in under three minutes, utilizing data from a standard 12-lead ECG (electro-cardiogram). Vektor received FDA clearance for vMap in November 2021 and is currently rolling it out to select centers of excellence across the U.S., including UC San Diego Health and the VA San Diego, ahead of a full commercial launch.

“Cardiac mapping is critical in understanding where an arrhythmia source is located and how much to ablate,” said Vektor Medical CEO Rob Krummen. “Traditional mapping is labor- and time-intensive, expensive and invasive, requiring a catheter to slowly navigate throughout the heart.”

According to the Centers for Disease Control and Prevention, 12.1 million people are predicted to have the most common type of arrhythmia, growing the addressable market for the corrective procedure requiring heart mapping to $11 billion.

“We are proud to be founded by a team who have seen firsthand the unmet needs in their field and identified a potential solution to better treat people suffering from arrhythmias,” Krummen said. “Innovation in medical devices is critical to addressing unmet needs in healthcare. When the healthcare industry follows outdated and inefficient practices, patients ultimately pay the price for the lackluster care and unsatisfactory outcomes they experience.”

Health System Innovation

In addition to leading in technology innovation, San Diego is leading in replacing outdated and inefficient healthcare practices.

Last year, UC San Diego Health launched the Center for Health Innovation. It is “the first such center run from the health system – not a medical school or engineering school,” said Chris Longhurst, M.D., chief information  officer at UC San Diego  Health. The vision for the center is to realize heath at scale and innovate “in a significant way that affects significant portions of the population we serve,” he added.

One example of this innovation at scale is the center’s P1000 program which set out to use remote monitoring on at least 1,000 patients in the Medicare population.

“We’re helping these patients stay healthy by using technology to ensure they’re on as healthy a path as possible between doctor visits,” Longhurst said, adding that the program uses a “disciplined approach to outcomes measurement, both improving outcomes and reducing cost of care, while addressing health equity and improving the patient and provider experience.”

Longhurst likened the center’s work to looking at the various pieces of the healthcare puzzle – technologies, insurance, patients, doctors  – and reimagining how to put them together. Those reimagined processes have already shown progress in addressing health risks like high blood pressure, diabetes, glaucoma and heart failure, “not from medication or expensive biologics – just by rethinking all the workflows.”

Longhurst said the center’s approach differs from other healthcare technology innovators from outside the industry who often come up with ideas for a problem they can solve in healthcare that “in fact is not really a problem for us at all. We’re really trying to flip that script and say, ‘here are the problems we’re trying to solve from a health system standpoint.’”

Providers’ Perspective

From the healthcare provider standpoint, there are several problems providers are looking to technology to solve – and one that technology has created.

“Cybersecurity is a major risk for all health systems and these new devices can become opportunities for hackers to enter your system,” said Omar Khawaja, M.D., chief medical officer at Palomar Health.

Jennifer Dailard, senior communications specialist for Kaiser Permanente, also said that cybersecurity will be a key focus for healthcare providers “for the foreseeable future.

“Security will have larger importance on IT and significantly change the approach to technology delivery because we will have to deliver fast, safely and securely,” she said. “The pace of change, flexibility and the ability to learn new skills have always been requirements within the technology world. IT leaders need to embrace change and be brilliant at the basics, enabling them to have the bandwidth to adapt and take advantage of the latest opportunities.”

Before adopting new technologies or devices for patients or doctors, providers follow rigorous protocols before clearing them for use in hospitals. At Palomar, the process involves sending information about the technology to a Value Analysis Team to study external reviews, safety issues and cost data for the device.

“If it clears the initial hurdle, it is then evaluated by our IT team for compatibility with our current technology and our cybersecurity protocols. Many new devices technology have cloud-based capabilities and Wi-Fi interactions, so this is becoming increasingly important,” Khawaja said. “If all this is good, then we get financial clearance, and the product or technology goes to our all-leader governance meeting where everyone from infection control to education learns about the device and gives feedback about how and when it should be implemented.”

Kaiser Permanente uses a similar review process carried out by national strategic sourcing teams to include assessing the viability of the vendor assessment, using empirical data for ensuring the evidence-based outcomes in using the device or technology, looking at the clinical needs for the device based on the hospital’s frequency of the procedure that would utilize it, and cost, Dailard said.

Khawaja said cost is a major issue with hospital systems that are still struggling after the pandemic.

“Healthcare has not been the most nimble of industries, so changing the culture to accept new technology can [also] be a barrier,” he added.