Doug OrrNow that we are officially into the new millennium, it is easy to overlook the subtle, but relentless technical advances that are incorporated into our daily healthcare lives. This is not meant as a recital for the multitude of leading-edge technologies that live a highly sheltered life at university and academic research centers. I think it is also interesting to look at several building-block technologies that have affected healthcare broadly. Perhaps this will help us to spot substantive change when the vendors show it to us.

CMOS Chips and Batteries
Have you ever wondered why a new cell phone keeps lasting longer between charges? Low power CMOS (complementary metallic oxide semiconductor) chips cost more, but use far less power. Batteries continue to grow smaller, lighter and more powerful, using improved science and exotic materials. These basic benefits are widely incorporated in many new medical devices.

Automatic External Defibrillators — You can’t go very far these days without seeing either a headline or a portable defibrillator. PAD has become the new marketing term: Public Access Defibrillation. You’ll now find these devices much more accessible to the intended target, victims of sudden cardiac arrest (SCA), for whom the only viable treatment is defibrillation within 10 minutes or less. With upwards of 300,000 SCA episodes per year, the demand for these $4,000 systems has become a land-rush, including every airline, airport, shopping mall, police and fire department, corporate office parks, convention centers and even golf courses. The first-person accounts from survivors attest to the real benefit that these devices deliver, now saving lives on almost a daily basis. You won’t find a power cord in AEDs, just batteries, and low-power hardware and software that enables even novice users to intervene successfully.

Implantable Cardioverter Defibrillators — Like the Energizer bunny, these devices last longer all the time, and the applications just keep growing and growing. The power electronics and battery technology include both waveform sensing and shock management. This market exploded in the late 1990s, taking a stagnant bradycardia pacing business into the stratosphere of broad-based cardiac rhythm management. With extensive programming capabilities, these devices can deliver patient optimized therapy, rather than the one-size-fits-all shock. Medtronic Inc. (Minneapolis) and Guidant Corp. (Indianapolis) have delivered both quality of life and shareholder wealth riding this technology wave.

Wireless Communications
Paging Dr. Howard, Dr. Fine, Dr. Howard. Nowadays, the melodious tones of Beethoven’s Fifth announce a call, page, email, stock tip or sports score to your connected physician! It has never been easier or harder to reach the medical specialist — everyone is so connected that you can’t get his or her attention for more than 5 minutes — max. But, if all you need is 5 minutes, the physician is there for you.

PDAs have shrunk the ever-expanding encyclopedia of medical knowledge, and can make it classically cool for M.D.s to look up all sorts of useful information. For those that know it all, they can use this tool and still keep the impression in place. The rest of us are just glad that someone cares enough to check and be certain before proceeding.

The appearance of CT scanners in the 1970s represented a breakthrough in the use of minicomputers in medical imaging devices. Today’s laptop PCs have more than 100 times the capabilities of those systems. While computing power didn’t just show up overnight in the medical devices market, it is easy to see that every medical device has directly incorporated computing power to a high level. Imaging systems earn the award for the most intensive use of advanced computing power. In fact, these systems are so good that radiology’s work has shifted more and more to the specialists, where the patients are managed and imaged directly by the physician.

When bar codes were first printed on groceries, it looked like “1984” had finally arrived. It seems so long ago now, but bar codes and scanners have infected medical devices along with almost every other facet of life. Bar code scanners have the undeniable benefits of accuracy and speed. If you are concerned with the hot topic of medical errors, then bar codes should be of interest to you — it is so easy to eliminate the simplest mistakes in a super-busy environment. So, when you check into the hospital next time, keep an eye out for bar codes in radiology (on the x-ray film), on your wrist (patient ID), your medicine, your chart and maybe even your bedpan.

Coming Attractions
The medical profession soon will hit the wall with a labor shortage — not enough M.D.s for the Baby Boomers entering the prime healthcare years. The current medical care protocols require substantial improvements in speed and accuracy, across all disease categories. Getting the diagnosis right the first time is the solution, and then couple the diagnosis to a patient specific therapy that works the first time as well. The technology that will deliver this medical Holy Grail has not yet been seen, but genetics, clinical diagnostic test kits and substantially improved imaging are certain to play a role.

Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to [email protected].