In a December 9th, 2009 E-cast on “Point-of-Care Terminals, Lab Equipment, Diagnostic and Therapeutic Devices: Learn How These Low-Power Medical Devices and Others Benefit from Intel® Architecture”, sponsored by the Intel® Embedded Alliance, trends and ideas in medical designs using long-life Intel embedded processors were presented by a panel of guests with a Q&A follow up.
Don Dingee, editorial director of Embedded Computing Design, moderated the event for OpenSystems Media. Panelists presenting were:
- Lisa Miller, Market Development Manager, Intel Embedded & Communications Group
- Joseph Chung, Product Manager, Medical Computing Products, Advantech
- Jack London, Product Manager, Kontron Embedded Modules Division
Don opened the E-cast with ideas from a Dec ‘09 interview with Rick Cnossen, from Intel’s Digital Health Group and the Continua Health Alliance. Cnossen speaks of the trend toward connected healthcare devices and solutions, and not only among healthcare providers trying to reduce costs and improve care. “Connected health solutions also empower individuals to play a greater role in their own health and fitness by giving them the tools, knowledge and motivation required for the success of preventive measures,” he said. Don pointed out the standards are shaping up around Ethernet, Wi-Fi, Bluetooth, USB, and ZigBee as the networking technologies.
Lisa Miller of Intel identified several macro trends: a shortage of healthcare professionals, rapidly rising costs of healthcare, demographic shifts toward aging populations and those with chronic conditions, and the broader adoption of electronic health records (EHRs). “Continuous [patient] monitoring will become more prevalent, and that’s going to translate into real-time, robust, two way communication pathways between an individual and a healthcare practitioner. Devices are going to contain more intelligence, so they can scale and provide efficiency … They will also have more intelligence so they can be used by less-trained practitioners to help address that shortage.” Lisa reinforced the point of connected, portable devices helping improve care, and how Intel Architecture processors can help build those devices.
Joseph Chung of Advantech, a Premier member of Intel® Embedded Alliance, opened by discussing how electronic health records are changing the way solutions are designed and used, with billions of dollars flowing into EHRs over the next five years. Connected devices will be critical to putting records, patients, and healthcare practitioners together. He also spoke of the trend toward more mobile solutions with wireless connectivity, including those for computerized physician order entry (CPOE), and the need for security such as called for by HIPAA to go along with this connectivity. He talked about how Advantech designs to meet IEC and FDA regulations. He then outlined examples of mobile clinical and beside devices designed by Advantech, looking at connectivity, user interface, and battery characteristics – and how these solutions are enabled by Intel technology.
Jack London of Kontron, a Premier member of the Alliance, followed by describing the challenges in designing these new medical devices: new software requirements, higher resolution images and faster frame capture rates, long development and approval processes for devices, and security, integrity, and privacy requirements. He then outlined the digitization of healthcare, and a range of different applications emerging with more intelligent technology inside. He showed an interesting matrix of applications versus enabling Intel processor technology, and showed several proof points of those applications using Kontron modules based on Intel architecture processors.
After these overviews, the Q&A portion of the E-cast began. Following are excerpts from that session.
To see and listen to the entire event:
Register to view the archived event, with slides and audio: http://bit.ly/4Hr16J
Download the podcast with audio only: http://bit.ly/5FLuFh
DD: What’s really the better solution to deliver value into the medical market: is it bedside terminals, is it mobile clinical assistants – what are customers telling you?
LM: I think it really depends on specifically what you are looking for. Bedside terminals offer value in being a “triple play” type of solution, where you can provide patient education, patient entertainment, as well as a clinical aspect. Mobile clinical assistants are really a personal device for a clinician to help enable EMR.
JC: Most of our customers are looking at mobile solutions, for field diagnosis and mobile in-facility applications.
DD: Most hospital or clinic IT systems are running on Intel Architecture. Ethernet and Wi-Fi can integrate hardware, but there’s more than just hardware connectivity – what are you seeing as far as integrating these devices with the rest of the hospital IT systems?
LM: A lot of the integration is based on software. Where I was coming from was if you’ve got more of a common hardware base, your validation and verification may be superior. When you have Intel Architecture, you’re going to get the same implementation of that architecture every time you see it. With Intel Architecture, you’ve got a lot of people using it, testing it, probing it – the probability of finding any issues or vulnerabilities that might exist, and finding them earlier, is higher. From a software perspective, with the common hardware architecture, your investment is somewhat lessened in terms of trying to integrate things together.
DD: Let’s let Kontron and Advantech go a little deeper into that question. We’ve got a question on ETSI compliance, and how maybe it would require recertification of a system depending on what’s going on in a specific application. How does Kontron support customers going through something like ETSI compliance?
JL: We try to pace with our customers to walk through with them and their certification process, providing information about particular modules, whether it has to do with power consumption, EMI, connectivity, whatever is needed from a system standpoint. Sometimes it can take a couple iterations, but we want to try and work with the customer to provide the maximum information for a successful certification.
DD: Advantech has a viewpoint as well …
JC: We have customers doing, for example, anesthesia, diffusion pumps, ventilators – we help them with passing ETSI approval by modifying some circuitry, and providing technical documentation. We also have solutions for EMC with FCC Class B and IEC certifications.
DD: What are you seeing as the operating system trend in medical devices?
LM: There’s a lot of Windows-based devices, there’s a lot of Linux, and more RTOS is coming on. When you’re talking life critical, an RTOS is probably the direction you’re going to go. When you’re talking about a very rich user interface, you may see something else. It depends on the specific application.
JC: Still the majority of our customers are using Windows Embedded, and some customers are trying to look into Windows 7 for embedded. About 30\% of our customers are using Linux, and something like Moblin or Fedora.
JL: We’re seeing a lot in Windows-based applications. We can support Linux and things like QNX as well, but the largest percentages of our customers are in the Windows environment.
DD: We know some of the big iron, like MRI machines, big expensive pieces of gear, have very, very long lifecycles – even longer than 10 years. But I imagine for the smaller mobile, lower powered gear, there is some trend toward shorter lifecycles. Talk about what you are seeing and how you are supporting those trends.
JC: Most of our customers are still looking for longevity, at least 5-7 years, and we select components including those off the Intel embedded roadmap. We do see more and more customers looking for longer lifetimes, and after 5 years we need to consider lifetime buys of components.
JL: We look at the component selections, and key off the Intel embedded roadmap to pick a processor to ensure long life. In parallel, there are other components on our boards, and we partner with other strategic suppliers, stable suppliers who have been around for a long time and also understand the medical environment and the need to support long life. We can extend the life of a product usually beyond component availability through a couple different methods: for example, through our program management, we’re able to extend life upwards of 7-10 years. It has to be a very disciplined effort to ensure long life. We are seeing a faster turnover because of the rapid pace of change in the technology, and for this reason we go with computer-on-module (COM) technology so the computer can scale with the application as the processor performance improves.
LM: There needs to be a balance for designers and manufacturers of medical devices between taking advantage of the latest technology and protecting the investment made in developing a particular device on that platform, and all the regulatory obstacles they need to overcome in getting to market. In some instances, the trend is getting longer, 10+ years. In some instances, where it may not be specifically a clinical device, like something not regulated by the FDA, you’ll see significantly shorter lifecycles.
As healthcare becomes more digital, and more and more devices become connected, the trends looked at today will become the reality of tomorrow’s low power medical devices. Designers can look to Intel and their Alliance partners for solutions and expertise in implementing these devices.
What are your ideas on this topic? We welcome comments and discussion on trends, needs, and unique applications in the medical field.