In the previous article in this series we had a look at some new and upcoming medtech solutions to support preventative care, with a particular spotlight on wearables. This blog post will highlight some other exciting medtech uses within the field of rehabilitative care and robotics, and also list some exciting innovations in the fields of screening and diagnostics.
Screening and Diagnostics
In accordance with the secondary level of preventative care measures, we can see screening, testing and diagnostic procedures; i.e. activities performed to identify the onset of a condition, to monitor the state of a diagnosed condition, or to verify other types of health statuses and bodily indicators.
Screenings and diagnosis are quintessential to preventative care, and the following are examples of new and in-the-pipeline innovations in these fields:
Viewi – Glaucoma screening
Cambridge Consultants developed a device that consists of a headset, a remote control, a smartphone, and an app (that links all the components) to measure the patient’s responses. The app measures the responses of the patient as they react to lights on their smartphone screens, similar to static perimetry. The results of this 5-minute test can be forwarded immediately to an ophthalmologist for follow-up.
It is not intended to replace existing glaucoma tests. It was specifically created in collaboration with medical stakeholders to boost current screening approaches.
The simplicity of the device reaps immense cost benefits, and the user friendliness allows patients to evaluate their glaucoma in the comfort of their own homes. The inventors believe it can save over €20,000 per patient.
The invention is currently still in the prototype phase.
Cytosponge – Oesophageal cancer testing
Around 8,000 people die annually in the UK due to oesophageal cancer, and 16,000 in the USA. Due to the often belated diagnosis of this particular cancer, the 5-year survival rate is only 18%. Current diagnostics for this cancer are time and resource intensive and require endoscopies.
The Cytosponge is a minimally invasive and cost-effective diagnostic tool to detect malignant cells at a much earlier stage. It initially looks like a pill, to be swallowed by the patient, whilst a string remains attached to it that remains partly exterior to the mouth. After being ingested, the pill-cap dissolves and releases a wiry sponge-like device. The physician then removes the sponge by pulling it out again by the exterior end of the string. As the sponge exits the body, it scrapes and drags with it key cells from along the food pipe.
Accuracy rates in tests so far have been 90-92%. This device needs to be tested further to establish its accuracy outside of case-controlled environments. It is currently on trial in the UK.
Robotics: Across All Levels of Preventative Care
The 1st level of care is the most basic and obvious in many ways: eliminate sources and causes of illness. The following example of innovations target hospital/medical facility-based infection risks:
Xenex – Hospital disinfection robot
The WHO reports that at any given moment 7 in developed (and 10 in developing nations) out of every 100 hospitalized patients will contract a healthcare/hospital-associated infection (HAI). In Europe alone, HAIs represent €6 bn in care costs, and billions of additional hospital-stay days.
Xenex’s Full Spectrum UV Germ-Zapping Robot is a square mobile device the size of a small fridge, that uses flash lamps emitting UV-C rays of the entire disinfecting spectrum (200-320 nm). These UV-Cs penetrate through to the DNA and RNA of bacteria/viruses, damaging and destroying the pathogens at a cellular level.
Currently around 400 hospitals in the USA are using these robots, capable of cleaning over 60 rooms daily.
Speaking of UV-based disinfection, Indigo-Clean has created a lightbulb that emits rays like the Germ-Zapping Robot, but at a different light frequency; one that is not harmful to humans (i.e. 405nm). It serves as a normal light bulb, but has the immense added-value of simultaneously and continuously killing bacteria in the air, and on hard and soft surfaces.
A variety of market values can be found that reflect the lucrative potential of infection-prevention within preventative care. The following are market values as predicted for 2021 (overlaps are possible as some product fall into multiple segments):
- Infection control market – €15.3 bn
- Medical device cleaning market – €1.45 bn
- Surface disinfectant market – €466 m
- Disinfectants and sterilization equipment market -€7.8 bn
Beta Bionics – iLet Bionic Pancreas
The Bionic Pancreas combines continuous glucose monitoring with a responsive insulin and glucagon delivery system. It is minimally invasive and involves placing two little catheters in the body, secured with a patch, connected to a delivery device which fits inside a trouser pocket. A second patch fitted with a chip sends glucose measurements to a smartphone-sized device that continuously calculates the body’s need for glucose adjustments.
Without active involvement from the diabetic patient, the device automatically communicates with the delivery mechanism, and injects glucagon or insulin, depending on the measurements taken in the moment.
This device, which has also been called the robotic pancreas, has been under development for 17 years, and has had several successful clinical trials in recent years. The researchers hope to obtain FDA pre-market approval in 2018.
The diabetes market is a particularly critical one, as this condition brings together many gravely life-impacting and health-affecting conditions, from obesity to limb amputation, blindness, cardiovascular diseases, and kidney damage. Furthermore, diabetes affects all demographics worldwide; prevalence has increased by 30% from 1980-2014, and continues to rise.
The diabetic care market is estimated at €62 bn in 2016, and expected to reach €138 bn by 2021.
It’s nothing new to hear that our human population is greying. With the gift of having a higher life expectancy -unfortunately- come a wider variety of physical ailments that an elderly individual can contract or develop over time. Beyond the physical health risks, there are also mental challenges and deteriorations that we must face, of which the less severe forms are generally termed Mild Cognitive Impairments (MCI).
Studies have shown -and it does not come as a surprise – that an individual, when incapacitated to perform a particular chore which was previously easy and routine to them, will actually be more likely to be triggered into a further and graver physical and cognitive decline as a direct effect of suffering the initial loss of said ability/function.
As a rule: the longer an individual is able to live independently and self-sufficiently, the longer they will be healthy, mentally-sound and happy. Respectively, devices that assist elderly to live independently are an incredibly important preventative care service; i.e. preventing elderly from deteriorating further, preventing the loss of self-esteem, preventing institutionalization, and preventing injuries at home and consequential hospitalization is a benefit to the elderly, and the healthcare system as a whole.
RAMCIP – Robotic Assistant for MCI Patients
This is an EU-funded research project of a 3-year duration, that started in 2015. RAMCIP aims to create robotic solutions that are practical for the elderly and other sufferers of MCI. The project coordinators state: “
These assisted-living robots should complete a variety of tasks and provide:
- Emotional support and intellectual stimulation
- Medication-intake reminders
- Assistance with domestic chores, e.g. cleaning, cooking, etc.
When we recall the 3 categories of preventative care from the previous blog, we see that the 3rd level of preventative care is defined as:
Actions that try to reduce the symptoms and the spreading of a disease after an illness has been diagnosed, e.g. surgical intervention to remove harmful tissue, antidepressants when depression has been diagnosed, rehabilitation to restore physical functions, etc.
Regarding the aforementioned surgical interventions, the first thing that comes to mind when trying to prevent/reduce future demands upon healthcare services, is the rise and essence of minimally invasive techniques.
Novel Surgical Robotic System (NSRS)
A team of scientists, led by the Hong Kong Polytechnic University and sponsored by the Hong Kong government, has created the first minimally invasive robotic system with tactile feedback, that works through a single incision or -even a step further and less invasively- with a natural orifice. One of the most beneficial capabilities, is that it is tactile, allowing high precision whilst communicating the extent of real-time real-life pressure being placed on the internal tissue of the patient.
Currently the da Vinci robot is the sole minimally invasive robot of this caliber that dominates the market.
So far, the NSRS is specifically designed to be used for abdominal and pelvic procedures. Several trial operations have been performed successfully, and the designers report that they hope to have it available for healthcare markets in the near future.
Another exciting component of the NSRS project are the “Transformer vehicles”. These are appendages that attach to the ends of the robotic arms of the NSRS, and that can (in theory) transform, disassemble and reassemble themselves whilst inside of the body, to perform different functions as is needed. This part of the robot is even further down the pipeline, but it’s exciting to contemplate the realm of possibilities.
Restoring bodily functions, reducing the symptoms of an existing condition, and eliminating the need for future demands upon healthcare services is definitively preventative in nature. Exoskeletons are a perfect example of such a restoration of bodily functions.
The following is an example of robotics suiting this tertiary-level of preventative care. We selected this example in particular, because it uses the gamification approach, which is also extremely popular and widely used in healthcare of today.
NEOFECT – RAPAEL (smart glove)
The RAPAEL smart glove This is a highly sensitive exoskeleton-type glove that bends with the fingers, made of elastomer (a polymer that is both resistant as well as flexible). The glove is linked to an elaborate user-friendly application on the computer, which offers a variety of games and gamified virtual tasks (e.g. squeezing an orange). The app also records and feedbacks on the performance of the various tasks and objectives to be reached.
The games target specific rehabilitation, on a per finger basis if desired, and induce a gradual optimization of finger-movements whilst allowing the user to track their progress.
The medical robotics market value, covering all types of robots from surgical to rehabilitative, orthopedic and assistive, is estimated at €4.3 bn in 2016, and projected to reach €11 bn by 2021.
Preventative care is an impressively wide-reaching, diversified, and high-value market with many sectors/sub-segments and a substantial potential for long-term expansion (and revenues). It invites innovation, cost-effectives and minimally invasive solutions.
In the next blog of this three-part investigation, we will explore the growth drivers and the market forces that fuel preventative care’s impressive growth figures.
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About Laura Weynants
Performs primary and secondary market research to create country reports at TforG. Interviews KOLs and medical sector professionals to build on TforG’s healthcare market expertise and competence networks. Complementing five years of sustainability policy and CSR communication, she now focuses on grasping key medical market trends, structures and opportunities in medical sectors worldwide. Coming from an international background of living in Germany, Spain, USA, UK and Belgium, she has gained a keen insight in international organizations and language skills to perform first hand investigations. She graduated from Sussex University Brighton, UK with a BA English Literature and Sociology and achieved a Master Degree in Sustainability and Corporate Social Responsibility in EOI Business School in Madrid, Spain.