Wireless technology leader Qualcomm Inc. has some very big ideas about untethered devices for healthcare, and in particular, about using your mobile phone as a health aid. I was lucky enough last week to get a "back stage pass" for a chat with Don Jones, the company's VP of Business Development, who's considered a visionary on the application of wireless technology to the healthcare and medical device sectors.
We choose to define it as wireless health -- not healthcare -- because this includes fitness, wellness, and consumer health. It's basically anywhere that connectivity can be applied to people's health.
Qualcomm is a B2B (enterprise to enterprise) organization, helping companies deliver wireless health services by developing the enabling technologies. We've focused on small computing devices that have connectivity and incorporate into people's lives beyond traditional voice services.
DM) Can you give us some examples?
Wireless pills, for example, are pills with integrated circuits. They're best-known as Given Imaging Pills for looking at the digestive system. You swallow this camera pill and the data is wirelessly received on a recorder. It then passes through your system. Other pills are dissolved in the stomach like regular pills, but before they do, a communication mechanism tells the provider that the medicine has arrived.
Another example is a so-called wireless band aid, or "smart band-aid." This is a transdermal detector that can check your vital signs and even your blood pressure without a cuff. It's peel-and-stick, disposable. This has been used for example to keep tabs on mental health patients taking psychotropic drugs.
Other wireless medical devices might help your Grandma, who's on blood thinner, and had several strokes. Previously, she had to go in to the doctor regularly for adjustments, at first twice a day for up to three months, and then once a week, and then monthly for life. That's a big burden for her. Now this monitoring can be done at home without the time and trouble of going to the doctor. Networked devices are able to report actionable information to her provider.
DM) What will be the biggest impact for people with diabetes?
As you know, diabetes device manufacturers are all turning to wireless connectivity for pumps and monitors. I think we'll see incremental improvements -- more meters that interface with cell phones and have glucose diary functions like the t+ Medical LifeScan meter with wireless connectivity recently introduced in Europe. We've also partnered with HealthPia here in America on the GlucoPhone.
I think going forward, three models will evolve:
1) The 'anywhere-anytime' connected glucose meter -- meters that can communicate wirelessly with an insulin pump or phone. Initially this will be based on Bluetooth technology, although not for the long-term; it's a poor solution as the pairing issues are too difficult and it tends to be 'power-hungry' -- whereas meters now last a long time on coin-cell batteries.
We're working to solve those problems: easy pairing, power management, identifying YOUR device versus other devices, security issues, etc. There are new radio systems on the horizon that look very powerful, but probably won't be commercially available till 2010.
[We're also working on Body Area Network technologies -- devices implanted inside the body, like pacemakers but with wireless connectivity, that can be used for a variety of health conditions.]
2) The meter and phone will converge. The current GlucoPhone is a kind of 'sled' that the meter slides on. In the 2010 timeframe, we'll have meter-phones that are more truly integrated devices.
3) Meters that connect everywhere. Eventually all meters will have cellular radio chips inside, and will be able to interface with web-based systems, back-end systems, and be connected via Wifi to report data back to a PC. This is different from No. 1 because it doesn't require voice (phone) functionality at all. This system may employ reminders, remote coaching, sharing information with caregivers, and the like.
DM) There's always the issue of who's paying doctors to analyze all this data they receive wirelessly. How can the technology help us if the healthcare system isn't set up to support it?
What we're observing is the formation of 'data intermediaries' that manage it, package it, and flag important and actionable events. In other words, a whole niche of new service companies is being built up around this need.
Wireless CardioNet, for example, is an anywhere, anytime, device for electrocardiograms. Patients install it themselves at home, and wear it for 14 days, using a PDA device (that reaches up to 200 feet). The Cardiac Monitoring Center is the intermediary. Each doctor chooses how to receive the information, and what they want to be notified about.
Also, look at what Philips is doing. Historically they were a consumer electronics "box company." They started buying services companies like LifeLine -- the "I'm falling and I can't get up" people. Then they bought Visicu, which provides critical care specialists with 24/7 remote monitoring of numerous ICU beds in hospitals. They also bought Emergin, which provides medical alarm signals throughout hospitals. And they launched the Motiva set-top TV box for remote chronic disease management. So they're building up their profile as a medical services provider.
Reimbursement is still an issue to be worked out. As long as the healthcare ROI (return on investment) can be demonstrated, insurers may be pressured to move faster, especially in areas like diabetes.
DM) So are these wireless healthcare monitoring devices mainly for the elderly and homebound? Or will they become "mainstream"?
Certainly it's useful for everyone, no matter what state of "healthy." One Qualcomm project that will be marketed directly to consumers is called LifeComm. We're working with cell phone manufacturers to design 'Health Phones' — that work like normal cell phones, but also have a condition-related set of management tools on the phone as well. Those can be medication reminders, personal emergency response services, coaching services, fitness or weight management tools, diabetes management or many more. The phones essentially act like 'personal health managers.'
These will be brand new custom phones, kind of Blackberry like, the first of which should launch in late 2009, early 2010. If you think about it, the Blackberry did four things:
- Introduced a custom device with a really good user interface
- Offered new software on those devices
- Set up new server software on the back end to support the system, and
- Provided unique service — they managed to strike deals with Fortune 500 companies to service them internally, behind the firewalls
We're doing all this and interfacing to live services for specific conditions, disease management, and overall health promotion.
Early design health conscious phone -- not from Qualcomm
DM) So are health phones the Next Big Thing? And what about cost?
Consumers just want to know if something is more convenient or if it helps improve their life. We've done a ton of research -- focus groups around the country on storyboards to prototypes -- to understand how wireless connectivity be used to change people's lives in a way that they think is valuable.
For diabetes, research suggests that an integrated meter in a phone is far more appealing to Type 2's than Type 1's -- because the Type 2's test less often, and don't always carry their meter. With the phone, they'd always have it on-hand. They're also more interested in the coaching and convenience of the services.
We think large employers will eventually be willing to subsidize a portion of these phones, that act as health aids. We foresee a day where Flexible Spending and health savings account dollars can be used for a cell phone if it's a health phone.
You choose the phone you buy because it has certain functionality. So we also believe that consumers will be willing to pay a reasonable pricing premium for a phone with the right tools.
The Next Big Thing is really translating these tools into actions: How can we use wireless devices to change behavior —- the social and psychological aspects?
Thank you, Don, for the inside look at the cutting edge.
[OK, I'm a Type 1, but I'd still love to beta test the Diabetes Health Phone some day soon. How 'bout you folks?]