Greeting From The Capsule: The Tricorder Is Here

4. July 2013
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"Star Trek" tricorder for all: innovative software solutions that will revolutionise medicine in a similar way to how antibiotics and anaesthesia once did. New products are ready to spring into the marketplace or are already in use. The basic prerequisite is a solid IT infrastructure.

Headaches, malaise or fever: “Star Trek” crew members always know what to do. With their tricorder they determined vital signs, physical quantities or rseached out the area for signs of life. At least one variant of the medical miracle box has now arrived in the present: Scanadu Scout.

Body signals sent through the smart phone

The small, handy device determines blood pressure, body temperature, pulse, respiratory rate and the saturation of the blood with oxygen. Via Bluetooth all the data for analysis and storage travels to a smartphone. Walter De Brouwer, CEO of Scanadu: “We are experiencing in all areas of our lives an ever greater personalisation, just not when visiting a doctor”. Patients ultimately, as soon as they have recovered, dive down again until the next illness. Vital signs are not recorded during this period. And Chief Medical Officer Dr. Alan Greene adds: “With the smartphone you can currently obtain a diverse range of pieces of information – apart from those from your own body”. Together with an interdisciplinary team, the two have now developed tricorder prototypes barely larger than a matchbox. Patients hold their device with two fingers to the forehead and activate sophisticated sensors. “You get the complete data set of a medical emergency facility on your mobile phone within ten seconds”, says De Brouwer. He is certain: “The device will in no way make doctors superfluous. “Rather, new impetus for telemedicine are to be expected – in the doctors clinic data could be evaluated and patients monitored more closely than before. Also, unnecessary consultations could be reduced – and colleagues would have more time for severe cases, explain the two developers.

Using Crowdfunding to Find Success

Economic aspects still remain to be clarified. The U.S. Food and Drug Administration (FDA) reviews medical advance very precisely. For this reason, around 100,000 U.S. dollars were required – no problem: by June 21 the respective call for funds was made on the crowdfunding platform Indiegogo, and the required sum was reached in no time. Meanwhile, users have freed up more than 500,000 U.S. dollars for the project, and FDA approval no longer stands in the way. Devices should be available from 2014, supporters already now receive a pre-production model starting at 199 U.S. dollars. For 269 dollars there are other, as yet unknown, functions added. Only recently the XPrize Foundation and the technology company Qualcomm launched a tender: the winner will receive a whopping ten million dollars to develop a tricorder.

Scanaflu and Scanaflo

In addition, scientists at Scanadu have big plans: Scanaflo is supposed to make high-quality urine tests affordable for all patients – with the accuracy of medical laboratories. The developers are considering as possible parameters glucose measures, proteins, leukocytes, pH value as well as possible pregnancy. Scanaflo would be the ideal early warning system of problems with the liver, the kidney or the genitourinary tract – before early symptoms occur. And Scanaflu detects pathogens such as influenza A, B and streptococci in the saliva. Again, researchers rely on customised interfaces for smartphone apps.

“Liver Explorer” in the Field

German innovation crafters are also splashing out. Researchers at Fraunhofer Institute for Medical Image Computing (MEVIS), for example, want to make liver surgery safer. “This organ is crossed by countless blood vessels and every minute 1.5 litres of blood flow through it”, says MEVIS scientist Andrea Schenk. One wrong cut could have fatal consequences, therefore interventions often take several hours. Doctors using computed tomography studies generated three-dimensional representations of the diseased organ and until now have had to hang prints in the operating room. Using the iPad one is able not only to design better medical interventions. Thanks to the built-in camera operators have the opportunity to “broaden reality” (Augmented Reality): live images of the real body can be overlaid with planning data, and surgeons see exactly where they have to reckon with the nearest blood vessel. If surgeons need to change their planning, the “Liver Explorer” simulates possible consequences. One great success of the new software: “Since 2003, we have been able with more than 60 hepatectomies to accumulate experience with the preoperative 3D simulation software MEVIS. Compared to operations prior to using the software, blood loss has been able to be significantly reduced”, says Itaru Endo of Yokohama City University, a partner of MEVIS.

Brain Surgery: With Social Media live on the spot

Back to the USA: This is where some of our colleagues are investing a lot in the communication of medical interventions to larger audiences. Some time ago the first open-heart and brain surgeries travelled through Twitter – a pioneering achievement of the Memorial Hermann Texas Medical Center. While doctors initially still tweeted individual pictures, now movies are also following on from that. “Whereas clinics in the digital world pay ever more attention to data security, there are more and more patients who are willing to share confidential moments with the world”, comments the Los Angeles Times not without surprise. Thus colleagues and amateurs from all over the world are able to follow along watching short films about how neurosurgeons in ULCA Health implant a brain pacemaker. The Parkinson patient demonstrates his motor skills by playing on his guitar unplugged. Roxanne Yamaguchi Moster from ULCA explained that through the spectacular LiveTweet ULCA intended to make the brain pacemaker and its significance more well known. Behind the brilliant move there was one very different aspect: the App Vine used allows users to spread short videos over social networks and has now also become known in medical circles. The rival Facebook has already paid out 737 million U.S. dollars for photo sharing app Instagram, and now Twitter is successfully following suit with the video sharing service Vine.

Landing Again in Today

Whereas pilot projects in the U.S. show where the journey could go, inpatient facilities have no need to go into hiding right now. HIMSS Analytics records in particular by using the so-called Electronic Medical Record Adoption Model (EMRAM) how far IT infrastructures have already penetrated the hospital routine. In addition to a basic level there were  seven possible expansion modules defined. Since the beginning of the ambitious “Meaningful Use Program”, things in The States have suddenly been on the rise: the number of institutions at the highest level rose all at once by 63 percent and the numbers at the second-or third-highest level by 80 percent. Germany is miles away from that area – in the European leaderboard of “Stage 6 & 7 EMR Adoption Model Awards” only the University Medical Center Hamburg-Eppendorf (UKE) appears.

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