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Wednesday, Sep 28, 2022
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High-Tech Health Care

The wireless industry has given us features that allow cell phones to link to the Internet, place calls and take pictures.

Now it wants to give us devices that can keep track of, diagnose and monitor our health.

Picture a medical device that’s used to link wirelessly to a cell phone that can communicate a person’s blood pressure, blood sugar level or heart rate.

Another idea is to use a “disposable wireless sensor” or “smart wireless Band-Aids” that can be used to measure such physiological information as skin temperature and blood oxygen levels, and communicate it to a cell phone.

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“It can provide advice, coaching or dieting, exercise activity levels or create logs or diaries of activity to keep track of how you’re doing and provide warnings when your physiological output is out of range,” said Donald Jones, the vice president of business development of health care at San Diego-based Qualcomm Inc.

The wireless technology giant derives much of its revenue by licensing its chip technology to handset makers and making CDMA , Code Division Multiple Access , chips for phones, according to Wall Street analysts.

“Qualcomm has its tentacles in different areas,” said John Bright, an analyst for Avondale Partners LLC in Nashville, Tenn., who doesn’t own Qualcomm stock.

“They try to create products that use a wireless network. If they create more usage for those networks, their equipment becomes more viable,” he added.

Jones said the emergence of wireless technology in health care is a great opportunity for market growth and investment.

The market for wireless technology for medical uses in the United States was about $300 million as of 2003, with a compounded annual growth rate of 18 percent, said Natesh Kare, who covers health care and life science issues for Frost & Sullivan, a marketing group in San Antonio.

With this kind of growth, the market could reach $637.3 million by 2007, she said.

Jones has a dual role. He heads a group of four engineers focused on internal research and development at Qualcomm while evaluating partnership opportunities with medical device companies looking to adapt CDMA technology for unusual uses.

His primary focus, however, is trying to create opportunities from within the company.

“I’m on the incubator side, which is about incubating new technologies and new business models within Qualcomm,” said Jones, who is 46 years old and lives in Cardiff-by-the-Sea.

The firm also has a research-and-development technologies and ventures fund, which committed $500 million in the United States and $100 million in China, he said.

“Any health care related funds come to me,” Jones said.

It was only two years ago when Qualcomm struck its first health care deal with a local heart rate monitor maker, CardioNet Inc.

CardioNet’s heart device was approved by the Food and Drug Administration in February 2002.

It consists of three sensors that stick to the patient’s abdomen and chest and uses radio frequency transmission to send each heartbeat to a monitor the size of a Palm Pilot.

Qualcomm’s built-in CDMA technology allows the data to be sent to a monitoring center in Philadelphia.

Physicians typically prescribe patients to wear the device continuously for up to 12 days, said Larry Watts, CardioNet’s vice president of marketing.


Immediate Response

“When patients experience an event (irregular heartbeat), we have the wireless technology that can transmit the data immediately,” Watts said.

Twenty technicians stand by 24-7 to analyze the data and look for adverse events, he said.

When problems arise, the technician calls the patient’s physician and immediately directs the patient into the emergency room.

“Untreated atrial fibrillation is one of the leading causes of stroke,” he said. “Untreated ventricular arrhythmia leads to sudden cardiac death, and patients can die within three to five minutes.”

Privately held CardioNet pitches the device to doctors as a tool to help detect heart problems and monitor heart patients.

But getting reimbursement from Medicare, the federally funded health care program for seniors, and private insurers, is the major stumbling block for wider adoption.

Thus far, CardioNet’s business is focused on the East Coast, where the firm managed to negotiate Medicare contracts, Watts said.

Medicare pays CardioNet about $1,200 for up to 21 days of patient monitoring, he said. Doctors get reimbursed “on a case by case basis” without being more specific.

Jones said getting reimbursed is a huge challenge for medical device makers.

The bar is even higher when it comes to converged technologies.

“One of the biggest hurdles is how to make it work,” he said. Other countries tend to adopt new technologies faster.

For instance, a CDMA-enabled medical device that’s embedded in cell phones and sold in Korea is unlikely to be in the hands of American diabetics any time soon.

“The glucometer (a device to test blood sugar levels) is inside the cell phone, so a diabetic will test their blood sugar level by pricking their finger and putting the test strip (with the blood) inside the cell phone,” Jones explained.

“Not only do you see the graphics, but the phone completes a patient log of their blood glucose level and can share the information with others, like a doctor, or let mom know that the child has tested.”

It makes sense to combine the two technologies given that most people own cell phones and always carry them, Jones says.


Hurdles To Overcome

Kare, however, is skeptical that such a device will see U.S. adoption anytime soon.

There are multiple issues that would need to be addressed first.

She listed regulatory hurdles with the FDA, compatibility of technologies, government reimbursement, and technology costs.

Even Jones echoed these concerns.

However, he pointed to the upside. “It becomes a powerful proposition that patients carry around and interact with and share,” he said. “And there is the value proposition , what they pay for a cell phone or medical device, the converged device doesn’t have to be more expensive.”

“Regulatory approval is important, cost and application of technology are too. If these three match, most patients would benefit,” Kare said.

She sees the biggest growth opportunities for wireless technology in medicine inside hospitals and in home health care.

Doctors and nurses are becoming more reliant on wireless devices, such as personal digital assistants, to become more efficient.

For instance, doctors already use PDAs or laptops to browse patient appointments and patients’ medical records, and send prescriptions to pharmacists and e-mail to patients, she said.

Pharmacists also use PDAs to communicate with doctors to confirm prescriptions, and lab technicians use them to order tests, Kare said.

In home health care, these wireless devices are often used to monitor patients.

Given the budget constraints of U.S. hospitals , five or six of every 10 hospitals operate in the “red,” according to Kare , and hospital decision-makers’ known skepticism toward adopting new technologies, you end up with two industries pulling on opposite ends of a string.

That is the rapidly advancing wireless side vs. the slow-moving health arena.

The problem is that “There are rapid changes in the advancement of technologies, but when it comes to health, not all technologies are implemented or widely used,” Kare said.

But Jones finds no shortage of medical device companies’ suitors.

“We have spoken to more than 100 medical device companies,” Jones said. “But if someone has a nice device but no business model around wireless, we’ll pass.”

Jones said he has four engineers dedicated to finding their own solutions in-house.

He projects it won’t be long before the cell phone and wireless medical device walk down the aisle together, even here.

After all, the Koreans aren’t the only ones embracing the converged technology.

Biotronik, a German biomedical firm, also markets a cell phone-interactive wireless heart device in Germany and elsewhere.

And that’ll be just the beginning, Jones said.

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