The application of technology in the connected hospital
Professional healthcare has always relied heavily on technology. Medicine went through something of a revolution around 2000 years ago, when observational science started to predominate the way patients were treated. The science of medicine has been developing ever since and, as it has, clinicians have applied technology to help with their treatments.
Today, the medical equipment used in hospitals, clinics and even ambulances is highly advanced, often largely autonomous and, now, likely to be connected to the Internet of Medical Things (IoMT).
As we continue to develop our understanding of human physiology, innovators are able to apply technology to augment and complement the clinician's own skills and experience. Recently, artificial intelligence (AI) has been enrolled in the diagnosis of diseases such as cancer, by using image sensors to examine scans and X-Rays in much the same way as a doctor would. This not only helps speed up the diagnostic process, but also gives doctors a 'second opinion'; one that gets better with experience but never suffers from fatigue.
This is just one example of how healthcare in hospitals is evolving, but clearly there is innovation happening at every level. The use of robotics is increasing rapidly, allowing experts to perform operations remotely. As well as revolutionising the operating theatre, new technologies are now implicitly linked to the diagnosis of chronic diseases, the analysis of cells and the general application of healthcare.
Medical imaging technology
Before any care can be administered, the healthcare professionals need to understand the condition they are treating. Often, the cause is much less obvious than the symptoms and this is one area where imaging equipment makes a real difference. Imaging encompasses techniques that cover almost the entire RF spectrum, from X-ray to visible, to ultrasound.
CT scanners can now use AI to provide deep clinical insight
Medical imaging is a good example of how automation is changing the way patients interact with medical equipment. Repeated exposure to the forms of radiation used can be harmful to clinicians, so it is becoming more common for imaging machines to be semi-autonomous or remotely controlled. In some cases, the patients themselves may be given some level of control over the imaging equipment, allowing them to direct the sensing element to exactly the right area on their body.
The use of robotics is increasing in medical imaging, often in conjunction with greater integration of the imaging modality. This may mean that a single piece of equipment performing one pass can carry out multiple scans using complementary imaging technologies, such as fluoroscopy, angiography and radiography. This kind of technological breakthrough is giving clinicians access to more realistic 3D images, delivered in real-time, using live X-ray imaging that doesn't require the images to be developed or processed offline before they can be analysed.
Medical analysis technologies for diagnostics
As well as imaging, the extent to which cellular analysis is now used to help diagnose conditions is considerable. Many of these techniques involve the analysis of blood, including tolerance tests. Other cells taken from the body can also provide deep insights. The condition of vital organs can be tested in this way, for example.
These assays of cell samples have traditionally been carried out by clinicians using microscopes to physically observe the individual cells. Now, this is an area where high performance image sensors and advanced algorithms (such as AI) are making a massive contribution. The development of cellular health assays using advanced medical imaging and analysis equipment is set to be a vital area of research and development in the near future.
Using technology for care delivery
One of the most critical elements in the provision of care is the administration of drugs. For in-patients, this is often carried out using a device known as a syringe pump. Essentially, these devices regulate the delivery of a drug, via a syringe, over a predetermined period. Since the introduction of schemes such as the Drug Error Reduction System (DERS), which was launched across Europe in 2002, much effort has gone into improving the way these devices operate. As a result, syringe pumps have become 'smarter', using technology to improve the automation of drug delivery. This can help bring down the error rates associated with the prescribing, transcribing and administration of drugs through infusion pumps.
Smart infusion pumps have been around for well over 10 years now, but like everything else in the medical sector, they are evolving. While the working life of an infusion pump (or most other types of medical equipment) may be considerably longer than anything we may find in the consumer sector, the technologies used are remarkably similar, so the opportunity for feature upgrades is definitely present. These smart devices can be designed to allow hardware maintenance and software upgrades, so it is conceivable that smart infusion pumps will be designed in a more modular way, to support a long service without sacrificing in-service upgrades. Of course, they will still be subject to the standards and regulations in place to protect patients and clinicians, but it is technically possible to extend the value of medical equipment through in-service upgrades. This approach will be even more applicable to home health equipment.
Transferable technologies to support the IoMT
The majority of devices intended for use in a medical capacity will need to comply with a number of national and international standards before they can be put into service. It is worth remembering, however, that most of the components used are not, themselves, subject to certification. This means that many of the technologies developed for one sector are equally applicable to the medical market.
In terms of drug delivery, digital motors provide the artificial muscle needed by smart infusion pumps, while sensors form the key component in the closed-loop feedback path that allows the pump to deliver just the right dosage. The same design methodology applies to other types of medical equipment, such as ventilators.
The critical role of power
When a piece of medical equipment is quite literally responsible for monitoring or maintaining a patient's life, its power supply needs to be beyond reliable. Battery packs are often used now to provide the primary or secondary source of power. Suppliers such as RRC offers sealed battery solutions designed for medical applications, including defibrillators, infusion pumps and patient monitors.
When the power source is AC, a dedicated power supply solution will be needed. This is where fanless, intelligent modular power supplies like the CoolX 1000 Series from Advanced Energy are positioned. Because it is fanless it creates no noise or vibration, as it only uses natural convection. In addition, it doesn't require a baseplate, making design-in simpler. With a 1000W output, it is ideal for a number of medical applications, including diagnostic equipment, medical lasers, dialysis machines and radiology imaging.
Providing the human (interface) touch
Medical equipment puts an even greater emphasis on the need for good, functional human-machine interface. Popular technologies here include encoders, pushbuttons and joysticks, all of which can be made to comply with the demands made by medical devices and are available from suppliers such as Grayhill. As a leader in this field, Grayhill has also developed a gesture recognition system that also includes a multi-touch surface, which it has named Instinct Touch Technology. The system's software tracks touches and interprets them as gestures. These gestures can then be used to manipulate 2D or 3D images, for example. Grayhill's solutions are currently used in a number of medical applications, including front-panels for ventilators and portable defibrillators, as well as in bedside keypads and patient monitoring equipment.
Connectivity for the IoMT
The benefits of connectivity are not restricted to any single vertical sector, but the needs of the medical market are perhaps unique. The quality requirements are covered by the standard ISO 13485, so any solution used needs to support compliance to this standard. Often the application will need to support extensive cleaning regimes, so ingression protection requirements are likely to reach IP68. Of course, other industry-wide demands in the form of EMI/EMC will also need to be observed.
For convenience, many new designs will feature wireless connectivity and, here, Wi-Fi is as popular a choice as it is in other markets. Implementing a wireless local area network in a hospital environment, particularly for patient monitoring through bedside equipment. Monitoring equipment is typically portable or mobile, as it will be used when and wherever the patient needs it, so choosing wireless connectivity has clear and inherent benefits. Manufacturers targeting this application space include Panasonic with its dual band (2.4GHz and 5GHz), dual mode (Wi-Fi and Bluetooth) modules.
Familiar technologies, such as touch-sensitive interfaces and wireless connectivity, are already used extensively in medical devices, but we can expect emerging technologies such as AI to have an important role to play here.
The demand for medical equipment remains strong and is an area that welcomes innovation. This presents significant market opportunities for manufacturers who are experienced in development medical devices, but it can also offer an attractive proposition for new market entrants.
This article is taken from the summer 2020 edition of focus. Click here to read the full magazine.