Improvements in health care have greatly increased quality of life, but those increases have come at skyrocketing costs since the 19060's, said Yongmin Kim, professor of bioengineering at the University of Washington. The U.S. spends an estimated $2.5 trillion a year on health care, almost half the $5.5 trillion spent worldwide, he said.

Kim charged bioengineers to design lower cost systems that enable "patient-centered care" in the home or local clinic rather than in big hospitals. He described his work on a new ultrasound system that could detect coronary artery disease (CAD) earlier than current angiogram tests at a fraction of their $18,000 costs.

Nearly half a million people die each year from plaque buildup in the heart, despite a number of tests used to detect the disease. "Cardiologists are not happy with their tools because, they say, none of them work well, so this is one of a few areas where there is a he unmet clinical need," Kim said.

Yongmin Kim Professor of Bioengineering, University of Washington

The University of Washington group hopes to introduce an ultrasound system primary care physicians can use to screen patients for CAD in ten minutes. That would reduce the need to send patients to cardiac specialist for the more expensive and invasive angiograms.

The ultrasound system would check vibrations in the 1000-1,000 Hertz range to detect signs of a blockage in an artery. He reported on promising early lab results, but said the project still has a long way to go.

"We have been working on this nearly ten years, and there may be another ten years of work still ahead," he said.

Kim's team is leveraging its history designing ultrasound systems and chips with companies including Hitachi, Philips and Texas Instruments. "Now we have all the digital technology for ultrasound including and front- and back-end processing that can be realized in chips selling for as little as $60," Kim said.

Separately, engineers from the IMEC research center in Leuven, Belgium, showed wearable heart and sleep monitoring devices suitable for use in the home. Both are based on a low power signal amplifier and 2.4 GHz wireless network technology the group has developed.

IMEC's wearable heart monitor delivers a full electrocardiogram in real time with algorithms tuned to filter out noise from body movements. It is geared for sports enthusiasts who crave more data that heart rate meters provide or cardiac patients wanting an alternative to more costly and bulky wired monitors.

IMEC's wearable heart monitor uses a low power amplifier and 2.4 GHz network.

The device can be worn as a necklace, patch or belt recording continuously on a single battery charge for up to seven days thanks to power consumption estimated at 1 milliamp. "Most systems these days are limited to continuous recording for about 24 hours," said Julien Penders, a program manager for wearable medical systems at IMEC.

IMEC's sleep monitor lets consumer screen themselves at home to determine whether they might have sleep disturbances severe enough to warrant treatment. It is designed to be easier to use and less intrusive than lab systems that use wired connections between sensors and a recording device or computer.

In tests, the IMEC system provided sleep profiles similar to existing lab systems at least 80 percent of the time. It provides readings from five wet electrodes for up to 12 hours, and a version using dry electrodes is in development.

The new devices are small pieces of the puzzle of what's needed to lower health care costs and extend coverage. As many as 50 million people in the U.S. have no health care insurance, and as many as 10,000 die every year due to preventable errors such as unforeseen drug interactions, said Kim of the University of Washington.

The health care debate in the U.S. "is a difficult topic," Kim said when asked by a questioner about his opinions.

"I've heard we spend more than 50 percent of health care dollars in last six months of care," Kim said. "We should look at ways to move even just ten percent of that into prevention for children and others," he said.