Medical electronics seeks role in health care debate

High blood pressure in medical electronics
MINNEAPOLIS — The medical electronics sector is under pressure to prove its value in the debate over the high costs of health care—some of the costs driven by expensive diagnostic systems. Many believe the sector's biggest contribution could be developing devices and networks that drive a shift to lower cost care at home, but market hurdles have stymied early efforts.

"We all have a responsibility to be involved in health care reform," said Rebecca Bergman, a vice president of new therapies at Medtronic (Minneapolis), a leading maker of implantable devices. "Tech is not at the core of this issue, but we should make tech part of the solution and not part of the problem--that's the attitude we need to have," she said in a talk at the recent conference of the IEEE Engineering in Medicine and Biology Society (EMBC '09) here.

Medical electronics companies need to set realistic expectations of risks and benefits of new technologies in an environment of rising complexity of systems and increased scrutiny by regulators and the public, she said. "How we deal with that will take very big thinkers," she added.

Cost is quickly becoming the key issue in the health care debate, said Richard Kuntz, recently named as chief science officer of Medtronic.

"Comparative effectiveness research is the buzzword in health care reform," said Kuntz. "So we have to show added costs add benefits," in a market where the lowest-cost therapy wins and where the value of an added year of life is pegged at about $45,000, he added.

"The instruments we construct are part of the solution, but they are often seen as part of the problem," said Joseph Smith, vice president of emerging technologies at Johnson & Johnson Services Inc. (New Brunswick, NJ), which oversees dozens of medical businesses.

Many speakers at EMBC '09 outlined the crisis ahead. An aging, overweight population in the U.S. is seeing a rise in chronic illnesses as the percent of the population paying for health care services decreases.

Two out of three Americans are overweight, 65 million have chronic cardiac problems and 20 million have diabetes, said Smith. The $2.5 trillion spent in the U.S. each year represents 45 percent of all global spending on health care, and the vast majority of it is spent on people 65 and over in the last months of their lives, said Yong-Min Kim, a professor of electrical engineering at the University of Washington.

The top three health care expenses in the U.S. are medications, imaging and other advanced treatments ranging from gene therapy to stents, Kim said. Poor communications often lead to duplicating tests, and each hour of care leads to an hour of paperwork, he added.

In addition, as many as 50 million Americans are uninsured. "They use the emergency room as their normal health care provider which causes a lot of problems," Kim said noting hospitals are the most expensive place to receive care.

The situation has led Kim and others to advocate monitoring health at home via networked consumer and wearable devices, especially for those with chronic illnesses.

"We don't yet have the treatment paradigms for continuous care for chronic diseases, but I think we will get there," said Smith of Johnson & Johnson. "The solution is in embedded or wearable devices linked to therapy," he added.