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Patient-centred technologies abound at Medica

By Andy Shaw

DUESSELDORF, Germany – Greater mobility and freedom for caregiver and patient alike, as well as far greater scalability of healthcare technology systems, were two underlying trends for many of the innovations introduced last November at Medica, the world’s largest annual medical gathering and trade show. Among the 32 Canadian exhibitors, for example, Southmedic Inc., based in Barrie, Ont., introduced to world markets its new OxyMask. It’s an oxygen mask with a revolutionary ‘open’ design that frees the patient to talk with caregivers even while inhaling the gases.

Also in this vein, game-like therapeutic devices aimed at speeding the rehabilitation of stroke patients in their own homes made several appearances at Medica this year. Some were based on the Wii game console from Nintendo. But likely the most innovative and scientific came from the Canadian exhibitor, Quanser in Markham, Ont.

Quanser introduced its “Rehab Robot” in Duesseldorf after extensive research and prototype development in Canada. As a video and handouts at the modest Quanser booth demonstrated, a 73-year-old Canadian stroke victim, Alice Prytula, used the Rehab Robot, which employs “haptic feedback” technology, to recover use of her left arm after months of conventional therapy had failed.

Toronto-based Interfaceware made its first appearance as a Medica exhibitor – but it was no stranger to the medical world. Founded in 1997, its HL7-based software products and services are speeding the exchange of electronic healthcare data at over 6,000 installations world wide.

“What we brought to Medica 2008 was a whole new version of our HL7 Iguana interface engine,” said Andreas Theodosiou, Interfaceware’s executive vice president. “Iguana version 4.0 is not just an upgrade. It runs faster, more efficiently and is highly scalable - from a single interface to increasingly popular ‘hosted services’ that have large data centres hosting hundreds of interfaces.”

Target markets for the company at Medica were equipment vendors, hospitals, and health authorities seeking better integration of their information systems.

For chief Medica organizer, Horst Giesen, Southmedic, Quanser, and Interfaceware were typical of what he saw and liked at his show.

“A lot of the innovation we see here comes from small products and small companies – I believe you call them SMEs in North America. We’re seeing a real trend to smaller, more portable devices being used in almost every field of medicine. They are products that bring healthcare to the patient and not patients to the products, as usually happens,” said Giesen during a wind-up interview at the show.

The compact and multi-talented Mobile Care Unit (MCU) from TMA Medical, a SME located in Fischbach, Austria, was right up that alley – indeed it could roll up the alley. Operated and controlled by a dedicated tablet-PC, the MCU can carry out right at bedside a long list of customizable examinations and functions – ECG, blood pressure, blood monitor, haematology, oxygen saturation, spirometer, urine analysis, audiometer, defibrillator, and ultrasound to name a few. It also can create a homogeneous electronic medical record that can be beamed out wirelessly straight from the cart. Built-in video conferencing also makes the MCU a useful tool for remote clinics needing connection to centralized experts. A similarly sophisticated mobile cart from Devlin Electronics in Britain features new battery technology that gives the cart a run time of six to eight hours before re-charging.

From down under, New Zealand’s Chiptech, an “electronics design and build” company in Christchurch known for its medical alarms, unveiled its small, multi-functional Personal Response Unit (PRU). With programmable and upgradeable “Smartware” software on board, the PRU is much more than the traditional alarms that elderly stay-at-home people are encouraged to wear or keep by their bedside. Current functions of the PRU include medication reminders but also the ability to upload and download other applications including graphics and voice files, all over a standard telephone line. Indeed, according to its makers, the PRU has been designed as a platform that just about any home monitoring device can be linked to.

Though much of Medica is a SME show, the heavyweights of healthcare technology still predominate visually at the event. Two and three level “booths”, some complete with kitchens, tower above the others and attract the biggest crowds. None more than Siemens. On Day 1 of the show, over orange juices, espresso coffees, and morning canapés served high above the madding crowds, Germany’s flagship high tech firm launched a “Molecular CT” diagnostic imaging scanner that promises the finest resolution ever; iGuide CAPPA, a precise GPS-like guidance system for biopsies and other invasive needle procedures; and its Acuson S2000 ultrasound machine with built-in technology that can “feel” the stiffness of liver and other tissue it is peering at.

Not to be outdone, Philips kept in step with the more mobile care theme by unveiling at Medica its Magnotech handheld technology designed to bring lab testing to the bedside. A sample fingerprick drop of blood or saliva is placed in a disposable biosensor cartridge that’s not much larger than a cell phone. Magnetic nano-particles in the cartridge go to work on the sample, binding to target molecules before being attracted to an internal biosensor. Results show up on the Magnotech screen within five to 11 minutes.

According to Marcel van Kasteel, the CEO of Philips Handheld Immunoassays, Magnotech handhelds could bring complex in-vitro diagnostic tests out of the laboratory and into decentralized settings, including the patient’s bedside and even at home.

“Long term, we envisage that different testing stations - both conventional, automated labs, and these new, mobile handheld systems - will be part of a diagnostic network, using wired or wireless connectivity and sophisticated healthcare informatics solutions to store and assist in interpreting the data,” said Mr. van Kasteel.

Meanwhile at GE Healthcare smaller is also better. GE introduced its Centricity Advanced Web distribution engine at Medica for referring physicians who want access to their large RIS/PACS hospital systems fed through the small pipes of their remote or home offices. GE’s patented ‘pixel-on-demand’ fast-streaming technology gives remote physicians, radiologists, or other clinicians fast web-based access to virtually the same advanced applications, clinical tools, and diagnostic-quality image display they would get at the hospital. Even if they are saddled with a low bandwidth back in their offices, says GE, users can still get their hands on a big set of tools including 3D visualization, multi planar reconstruction, integrated ultrasound, mammography, orthopedic tools, second opinion consulting, printing, and CD burning.

Still, Siemens being a Germany company, chooses to put more of its new approaches and gear on display at Medica than the Holland-headquartered Philips or USA-based GE tend to. This year Siemens made its pitch for its “fully integrated medical technology” spanning the entire continuum of care, with solutions that are highly scalable “from the laboratory up to business management and control” – and all in seamless integration. No small task.

To that end, Siemens also introduced at Medica two new MRI machines using its unique TIM (total imaging matrix) technology first introduced in 2003. The Magnetom Essenza is a 1.5-Tesla machine aimed at the demand for high quality but reasonably priced MRI. The Magnetom Verio, on the other hand, is the first 3-Tesla in the world to feature a 70-cm bore. This machine, says Siemens, literally opens the way to MRI examination to obese and or claustrophobic patients who couldn’t or wouldn’t be examined before.

On the CT front, Siemens also introduced the Somatom Definition Adaptive Scanner. It can range in use from a radiologist’s routine diagnostics to complex scans for neurologists and cardiologists. But it is ideal, Siemens claims, for emergency situations. With fine, adaptive control of its dosage at the fingers, caregivers can examine accident or other trauma victims, be they giant Sumo wrestlers or skinny little kids, with just enough, and therefore the safest possible, x-ray exposure.

Other Siemens firsts introduced at Medica included:

Multix Swing, a flat X-ray detector that can be placed underneath or next to a patient’s heard to reach areas making hip examinations, for example, easier

IQ-SPECT, which can generate perfusion (blood flow) data from cardiac CT examinations within five minutes

TubeGuard, a remote monitoring system that continuously measures the life left in X-ray tubes

Improvements to the Syngo portal for radiologists and referring physicians which speed the exchange and workflow of examinations and reports between the two

Advances in Siemens’ Health Information Exchange, a shared communications platform that facilitates co-operative medical care by using Soarian Integrated Care software and its physician-administered electronic patient record.

Esprimo Ma, a 1.3 kg PC tablet in a wireless (WLAN, 3G) pen-based, rugged design.

Despite the deepening economic crisis, Medica 2008 closed its annual four-day run last November with record numbers – 4,313 exhibitors from 66 countries were visited by 137,000 people who clicked through the turnstiles of the sprawling Messe Duesseldorf fairgrounds on the banks of the Rhine River.