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Thinking about Life Sciences

http://blog.aesisgroup.com

Monday, February 18, 2008

Innovations Galore Spawning From 2008 Medical Design Excellence

Awards (MDEA)

I’m here now in Los Angeles serving as a judge in the 2008 Medical Design Excellence Awards (MDEA),
which is a premier competition for medical products, devices and technologies. I also published a column on
2007’s competition.

We actually haven’t finished our deliberations yet, and even if we had, I wouldn’t be able to tell you about
the winners.

Winning products will be announced in the April edition of Medical Device & Diagnostic Industry (MD&DI)
magazine. The winners will also be presented with gold- or silver-level MDEA trophies at the competition’s
ceremony in June, which will be held in conjunction with the Medical Design & Manufacturing (MD&M) East
Conference & Exposition being held in New York City.

Suppliers to MDEA-winning products are also named as official suppliers to 2008 MDEA winners and are
permitted to use a special logo in association with their products.

We have observed some significant and accelerating trends among the technologies we’re seeing. While we
see these trends embodied in individual products, they also represent significant changes that we’re seeing
in how medicine is being practiced and how health care is being delivered. Among these trends, we see:

Increasing use of wireless technologies

More point of care and home-based technologies
Close integration of diagnostics and therapeutics
”Disintermediation”

Less Wires

There’s no surprise here. Wireless technologies (including Bluetooth in selected cases) are being increasingly
implemented among medical technologies. As a consequence we are going to see less and less wires strung
about the hospital, the OR and the doctor’s office.Again, without giving away details, we are seeing wireless
patient monitors, wireless cardiac monitors, wireless sensors of various sorts. This is not a new trend but
nevertheless one that is accelerating. In addition, we have seen with some of the products submitted an
emphasis on reliability and seamlessness in the wireless connections which appears to have been a problem
in first generation products.More Point of Care, Home-Based TechnologiesWe are seeing more and more
products that bring care directly to the patient instead of requiring transportation of the patient or the
blood/tissue sample, etc. to a centralized, separate facility. We have seen, for example, a truly portable CT
scanner that can literally be pushed around like a frankfurter cart (without the umbrella, of course) around
the streets of New York.

Another (not to be underestimated) advantage of such technology is that it effectively “disintermediates”

(see below) some processes in health care. In other words, the ability to have an intraoperative CT obviates
in some cases the need for a follow-up CT scan and then a potential second operation.

Miniaturization has been the major enabling force behind this trend. Another example we have seen is a
handheld ultrasound machine that makes possible the closer integration of ultrasound into the physical
examination of the patient rather than relegating the ultrasound study to a later time at a different facility.

We also saw another device, for example, that allows clinicians at the bedside to ascertain with a handheld
device (that’s connected to a PDA) the presence of a brain hematoma (bleeding around the brain) without
having to transport the patient to a CT scanner.

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Closing the Loop Between Diagnostics, Therapeutics

We saw a surprisingly large number of products that bring the diagnostic and therapeutic process closer
together and (in some cases) deliver diagnostic and therapeutic capability in one package.

One example was a very sophisticated dental device for producing dental implants in which one component
of the device digitally scans an image of the teeth and the other – as a computer console – designs the
implant. The last component actually fabricates the final implant.

This is one seamless system that truly integrates the evaluation (diagnostic) process with the final
therapeutic implementation. The portable CT scanner mentioned above is yet another example of technology
enabling a closer integration between diagnosis and therapy.

Another example product we saw was a system that allowed brachytherapy (radiation therapy) “seeds” to be
produced directly as a result of the initial ultrasound evaluation. This enables those seeds to be surgically
implanted at the same sitting.

Disintermediation

Many processes in health care involve a fairly involved sequence of steps. “Disintermediation” is a business
term in which one or more of those steps is taken away, rendered irrelevant and/or otherwise substituted.

For example, brachytherapy often involves an initial diagnostic step (utilizing, for example, ultrasound to
map out the diseased tissue) followed by a fabrication step in which the radioactive seeds are fabricated and
then an implantation step in which the seeds are surgically implanted in the cancerous tissues. Having a
device enable all those steps in one seamless operation is an example of disintermediation.

We have seen other examples of this as well. The dental implant scanning, design and fabrication device
noted above also disintermediates several steps in the dental implant process. While having a handheld
ultrasound machine certainly will not eliminate all conventional ultrasound exams, it will certainly substitute
for some of those studies while enhancing the traditional physical exam of the patient.

We saw quite a few other developments: an increased number of home-based medical devices, further
proliferation of “smart” devices and software-driven devices that enhance safety and capabilities. We were
somewhat dismayed at some devices that continued to propagate proprietary technologies rather than
fostering standardization and interoperability.

We were also concerned at some products that didn’t incorporate enough aesthetic design. A very small
number of products also seemed be wildly expensive, and while we recognize the substantial costs involved
in product development and cost is not our leading criteria for prize worthiness, these examples did raise
some concern with respect to their impact on medical cost inflation.

Overall, though, this was an exceptionally strong year for medical design excellence and innovation. The
industry will be very pleased to learn of the winners later this spring.

Iraq, Afghanistan

What does Iraq and Afghanistan have to do with the MDEA? As one famous surgeon once said, the one
indisputable “benefit” of war was in the training of young surgeons.

Indeed, a number of products were brought to the table that have emerged out of combat experience with
injuries and trauma. Without trying to be political, it can be said that at least some good things have come
out of that very difficult and challenging situation.

Ogan Gurel, MPhil

gurel@aesisgroup.com
http://blog.aesisgroup.com/

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