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Inside the Lab Digital and computational pathology, Point of care testing, Clinical care, Technology and innovation

Where No Healthcare Device Has Gone Before

Computer – activate emergency medical hologram!” How many medical professionals, whether working in a lab or on a ward, wish they could tap into futuristic technology when workloads become unmanageable? Sadly, holographic doctors are still out of reach – but other medical devices from the world of science fiction are coming ever closer to reality.

You may be aware of the Ansari XPRIZE for suborbital flight, the highly publicized “space race” that provided a US$10 million prize purse to the first team to design and build a reusable, functioning manned spacecraft. Fewer people know that the XPRIZE story didn’t end when SpaceShipOne took to the stars – instead, XPRIZE competitions continue to set lofty goals for new technologies, with a mission to spur “radical breakthroughs for the benefit of humanity.” These competitions differ significantly from other prizes in that, while most are retrospective, XPRIZEs provide the goal and let participants from all disciplines compete to see who can reach it first.

In expanding the scope of competition, one of the current prizes up for grabs is the Qualcomm Tricorder XPRIZE. The goal? To develop a consumer-friendly, noninvasive healthcare device that can diagnose a wide variety of medical conditions and record a range of metrics for general health. The goal is to create innovative technologies for precision diagnostics, so that users can reliably monitor their own or others’ health regardless of time, place or the availability of traditional medical and laboratory equipment. In other words, bringing healthcare to the disadvantaged, the remote, the busy and anyone else who needs it.

The concept of a tricorder comes from the world of Star Trek, where it’s a device used to scan anything and everything – including, in the case of doctors, their patients. On television, the tricorder not only provides its user with a vast array of information about the patient, but even offers instant diagnostic capabilities. The XPRIZE asks: why should such a useful tool be limited to fiction? Why not make it a reality?

That’s the goal for all eight of the teams currently participating as finalists in the competition. Their task is to create the first affordable, portable, wireless, consumer-friendly medical diagnostic device that can be used by physicians and patients alike. The tricorder must be able to assess at least 16 distinct conditions, monitor at least five vital signs, demonstrate safety and user-friendliness, and send data to the cloud, where it can be stored and accessed by the patient or doctor. The three-and-a-half-year competition is approaching its final months, so each of the teams already has a prototype device; their next step is to test it on a consumer group, evaluating both the health and user experience aspects. The solution that performs best will take home the grand prize – but regardless of which team attains the Qualcomm Tricorder XPRIZE, the real winners will be patients and healthcare providers around the world.

We spoke with Grant Campany, Senior Director, Qualcomm Tricorder XPRIZE

The Pathologist: What drove your decision to actually launch an XPRIZE competition in the diagnostics arena?

Grant Campany: When you consider the “big picture”, you can segment the globe into two segments – the developing world, and the developed world. The developing world has a population of millions who have no access to healthcare; not only are there resource constraints in terms of equipment, but there’s a shortage of medical professionals as well. Africa is a good example – the continent has 25 percent of the world’s population, but only one percent of the world’s doctors. Countries like China and India are similar in having hundreds of millions of people without the ability to access medical care. It’s a huge problem, but it’s also a tremendous opportunity.

Then you look at the developed world – and even within the United States, there’s increasing pressure on both the government and private insurers to keep healthcare costs low. A key cost driver in America is that many people just don’t have access to tools and providers that might give them early diagnoses of serious or chronic illnesses, thereby preventing long-term decline. It’s especially true of vulnerable populations like the elderly or those with low incomes, who may be reluctant to go to the doctor simply because of the logistics involved – not just in paying for the visit, but in obtaining transportation, finding the time, arranging assistance or childcare if it’s needed, and all sorts of other complicating factors. So you can imagine that there’s plenty of opportunity, even in the developed world, to look at how we bring healthcare to consumers. If we can prevent the need to actually get into a car, drive or take public transport, and then wait as much as a few hours before the doctor can see you, we’d be improving access for a lot of people.

Now imagine that you have a tool that enables doctors to extend their reach into their patients’ homes and allows them to monitor patients – even high-risk ones – remotely through the Internet. The aim of the Qualcomm Tricorder XPRIZE is to motivate teams from around the world to develop the kinds of tools that will allow doctors, regardless of location, to have access to their patients – which makes life much more convenient for both parties and increases productivity using resources we already have, like cloud computing. The rules of the competition include developing tricorders with the ability to transmit data directly to the cloud, because we don’t just want innovative technology – we want to set the stage for eventual commercial use. By putting both the clinical and the IT infrastructure in place, we can use the XPRIZE competition as a learning experience before scaling up to bring tricorder technology to the world.

TP: Are you worried that such a technology-driven device might be somewhat restrictive in the developing world?

GC: As technology advances, the cost of the sensors and technologies needed for a tricorder continually decreases. For instance, as recently as five years ago, it would have been difficult to make such a sensitive device portable at all, let alone affordable. So when we consider the tools we’ll need to provide tricorder services in the future, I think it’s going to be an opportunity to invest early in providing that infrastructure. Lots of companies are currently creating wireless healthcare for the home, so I think we’ll see tremendous progress in the next five to 10 years.

Cellular service already exists even in many of the poorest and most remote areas of the world – so we know that many people, regardless of where they live, have mobile phones and are able to transmit data to the cloud. For the initial stages, we plan to purchase tablets with data connections to serve as the media bridge between the tricorders and the cloud. It essentially mimics what’s likely to happen in the real world. If you’re using a tricorder in a clinic where patients come for diagnosis, all you really need is a phone to transmit the data – and that transmission might go to a local hospital where staff are remotely monitoring patient readouts on a digital dashboard. That way, they can keep abreast of patients who can’t make it to the hospital, and also get an idea of the general health of the population. It’s true that a lot of infrastructure will be needed in order for governments and insurance providers to manage larger patient populations, but I think that infrastructure is already on the verge of being created.

TP: What kind of work are you doing with governments and national agencies to bring about improvements to their infrastructures?

GC: We're all familiar with the process of regulatory review for medical devices before they can go to market – especially when we’re talking about diagnostic tools. About two years ago, we formed a relationship with the United States Food and Drug Administration (FDA), who created a first-of-its-kind helpdesk for us so that our teams could have direct access to knowledgeable volunteers to ask questions. That not only opens the door to the FDA, but allows everyone involved to start building relationships with key people in the review process – which is important because we want them to get to know the creators of new technologies, but also to understand what those technologies are and how they’re going to be used. The idea is that if the FDA understands what we’re doing, it’ll be easier to identify potential barriers and provide guidance, so that the tricorders can make it through the review process and reach the market – and maybe that will even help to simplify the process in other countries.

TP: Is the primary goal for teams to obtain funds to further develop and market their product?

GC: We've discovered that the prize purse usually isn’t the main incentive for teams to compete. We offer a worldwide stage upon on which teams can be recognized for their achievements, which gives them immediate visibility and allows them to build their brand – a benefit that’s almost priceless. The XPRIZE also creates a lot of awareness about what they’re doing, not just with industry experts, but with the general public. We want to help people around the world also understand what’s being done and how new technologies can improve their quality of life. I think winning the XPRIZE is almost like the Olympics; we even have three prize purses – first, second and third. The grand prize is US$7,000,000, then the runner up is $2,000,000 and the third place is $1,000,000. All three of our winners will be recognized for their performance.

I think competitions like the XPRIZE are a great way of driving innovation, because we’re able to encourage ideas that we know are going to be dramatic breakthroughs. We try to simultaneously push the technological envelope and close an economic gap – because typically these are the kinds of innovations that aren’t getting financed. Without an XPRIZE, these ideas would have nowhere to turn for funding. So we’re creating incentives for people to focus on developing technology that wouldn’t exist any other way.

TP: What do you expect will be the outcome of the Qualcomm Tricorder XPRIZE competition?

GC: I'm expecting to see several things. One is that I think we’ll learn how people behave with these types of devices. In June, the teams are delivering 30 working prototypes to the University of California, San Diego Medical Center’s Clinical and Translational Research Institute. We’re recruiting up to 300 participants from the hospital who have one of the 15 conditions for which we’re going to be testing to volunteer as consumer testers; we’ll be giving each of them a device, which will show us how they use the tricorders at home.

We don’t just want technologies that work, we want technologies that people are going to embrace – in fact 45 percent of each team’s score depends on the user experience. We’ll be conducting surveys following every consumer testing session, so we’ll have specific information on their experiences with the device. That will be invaluable to the teams as they think about the tweaks and refinements they need to make so that their devices are as user-friendly as possible.

I also think it’s very important for the general public to understand the amount of effort that goes into the development of these technologies. It’s all about improving the health of patients worldwide – and what’s often missed in competitions are the real human stories behind the teams. The people who are competing for this XPRIZE are very passionate. People have real, personal reasons for participating. Some team members are emergency room doctors; some have lost loved ones; they all want to stop people from getting sick and dying.

Team DMI

Team SCANADU/Intelesens

Team Aezon

Team CLOUD DX

Team Dynamical Biomarkers Group

Team Danvantri

Team Final Frontier Medical Devices

Team SCANurse

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About the Author
Michael Schubert

While obtaining degrees in biology from the University of Alberta and biochemistry from Penn State College of Medicine, I worked as a freelance science and medical writer. I was able to hone my skills in research, presentation and scientific writing by assembling grants and journal articles, speaking at international conferences, and consulting on topics ranging from medical education to comic book science. As much as I’ve enjoyed designing new bacteria and plausible superheroes, though, I’m more pleased than ever to be at Texere, using my writing and editing skills to create great content for a professional audience.

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