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Point of Care Medical Technologies Must Blaze New Trails

By Clifford Dacso

The range of wireless-enabled common medical devices is greatly expanding. But simply transmitting healthcare information from the patient to the healthcare provider is not the answer! The user must be brought into the picture as a true collaborator with his or her own healthcare experience. They must be able to, in real-time, make fundamental decisions about their own health.

Point of care medical technologies, loosely construed, consist of a family of devices and interventions focused on bringing healthcare past the “last mile” into the home. Formerly simply the domain of wireless-enabled common medical devices such as pulse oximeters, bathroom scales, and sphygmomanometers, point of care medical technology has now expanded to envelop the entire continuum of care.

It is not enough to put a wireless antenna on a bathroom scale and call it point of care health. In order to add value to the healthcare continuum, it is critical that point of care technologies provide information not only to the medical care establishment but also to the end user. It is critical that these technologies have within them sufficient information processing and algorithmic power that they are able to provide decision level support to the individual user in real time.

It is common in the point of care medical technology field to simply connect common medical devices to “healthcare providers.” But “the providers” do not want this information! Imagine the situation of the physician who cares for hundreds of patients with blood pressure problems all of whom have wirelessly enabled sphygmomanometers. She arrives at the office at 7 o’clock in the morning, pours a hot cup of coffee, and confronts a file of all the blood pressure readings of all of her patients for the last 24 hours. Virtually all of this information will have no diagnostic or therapeutic import. But she will be responsible for detecting the anomalies, acting on them, and will be liable should she miss an important finding. And she will not be paid for this. Where does she sign up?

Thus, in order to provide healthcare value, point of care technologies must exist within an ecosystem of care that includes the ability to have “the human touch,” as well as sophisticated information processing. There must be a reciprocal arrow between the device and its interpretation so that the user is able to, in real-time, make fundamental decisions about his or her own health. Additionally, in order to provide value, point of care healthcare technologies must describe new metrics and new interventions that are not even part of the physician’s current armamentarium. This might include the development of new predictive indices, devices that compel healthy lifestyles, and information generating tools allowing the user to become a true collaborator with his or her own healthcare experience.

Point of care healthcare technologies may find their greatest value in underserved and under resourced areas. These do not by necessity include only emerging economies. Indeed, it is hard to imagine that the current philosophy of training more physicians will do anything more than increase the cost of healthcare. This has been a historical truth. Properly applied, intelligent point of care technologies have the ability to provide leverage to the healthcare establishment allowing an individual practitioner to provide better care for less money to more people.

In order for point of care technologies to take the next step, engineers and healthcare professionals in collaboration need to define new problems and new solutions. Only in this way will this new frontier lead to its desired goal of improving healthcare quality and outcomes without the pernicious effect of increased costs, confusion, and complications.

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January 2013 Contributors

Nitish V. ThakorNitish V. Thakor is a Professor of Biomedical Engineering at Johns Hopkins University, Baltimore, USA, as well as the Director of the newly formed institute for neurotechnology, SiNAPSE, at the National University of Singapore. Read more

Atam DhawanAtam Dhawan, Ph.D. obtained his B.Eng. and M. Eng. degrees in Electrical Engineering from the University of Roorkee, Roorkee, India... Read more

Clifford DacsoClifford Dacso, MD, MPH, MBA is Professor of Molecular and Cell Biology and Medicine at Baylor College of Medicine, John S. Dunn Sr. Research Chair in General... Read more

Ritu KamalRitu Kamal works at Stanford Biodesign Program, Stanford, CA, as a Global Research Project Manager. She has previously worked at Roche Diagnostics as a Scientist and was a 2010... Read more

Christine KuriharaChristine Kurihara is Manager of Special Projects, for the Stanford Biodesign Program, Stanford, CA. In this capacity, she oversees IT, web and infrastructure projects for the program. Read more

Dr. Anurag MairalDr. Anurag Mairal is the Director, Global Exchange Programs, Stanford University, Stanford, CA. In this role, he is responsible for developing an extensive network... Read more

Dr. T. SunderDr. T. Sunder is a Senior Consultant Cardiothoracic and Transplant Surgeon in Apollo Hospitals, Chennai, India with over 20 years' experience in Cardiothoracic Surgery... Read more