The devices continue to shrink, too. A new microactuator
technology could be used to build and control medical devices such as valves
and stents, microsurgical instruments, and miniaturized manufacturing molds; and
even to manipulate proteins and genetic components. And yet another molecular robot could soon be coming to a blood vessel near
you. To prevent their delicate mechanisms from overheating may require nanothermometers to monitor their temperatures, and
to charge the nanobatteries that power their nanocomputer
brains, they will need a ready supply of fuel. Conveniently, they are swimming
in it.

A manufacturing process under development could churn
out wallpaper that lights up a hospital ward, and many other devices we have not
been able to conceive of before. The wallpaper could double as a gigantic video
screen using a new “electrowetting” process. Dull wards
could be transformed into soothing gardens; or, with live video over broadband
Internet links, could transport patients anywhere in the world — Disneyland,
the Leaning Tower of Pisa, Waikiki Beach — and even see and interact with
people there. An alternative to wallpaper video could be thin-air video, where the interactive display is just water
vapor.

Other news of emerging devices:

• Lab chips that analyze proteins could be in use
  within two years. 

   

• RFID chips could help people navigate the complex maze
  that many large hospitals and campuses have become. 

   

• Handheld ultrasound scanners threaten to consign
  the stethoscope to the dustbin. 

   

• Spyglass spectacles sporting a hidden camera
  record everything the wearer sees. They could be useful in surgery, and would be
  handy for getting to know a person for such programs as DARPA’s spooky LifeLog.
  A lifetime of pictures and metadata captured by the spyglasses could be stored
  in an Intel server the size of a matchbox. 

   

• A pharmaceutical company is said to be using a 3-D
  printerto print whole pills. 

   

• Digital paper and pens could give a new lease on life to
  the bed-end patient chart clip-board. 

   

• A nanoengineered bag turns the filthiest,
  disease-ridden cesspit soup into a safe and healthful drink. 

The RFID (radio frequency identification) tags manufacturers and retailers
are starting to use to track products contain small radio transponders that
broadcast unique identification numbers from the product to fixed radio
receivers in the store. By reversing that arrangement — making the receivers
mobile and the transponders fixed — Rochester University researchers have
created a system that provides location information to the visually impaired,
museum visitors, or people visiting a large medical facility.

The user carries a reader/playback device that trips passive transponders
mounted in key locations when the user comes near. The transponder in turn trips
a particular CD track containing information about the location, and transmits
it to the user’s playback device.

The device could be commercialized within two years.

Reference: Unknown (2003). “Radio Tags
Provide Guidance.” Technology Research News, September 24.

Heart Monitor

IBM is muscling in on med tech territory by building, in conjunction with a
European phone network, a heart-rate monitor that will phone for help when
trouble arises. “If an elderly person wants to live alone and has a heart
condition, the cell phone could monitor the heart and if the heart rate exceeds
certain thresholds it would send a message,” said an IBM official. It could also
be used by athletes, joggers, and cyclists.

The engineers are also experimenting with global positioning so the location
and identity of the user could be sent along with the heart-rate measurements.

IBM has already worked with Medtronic to design a portable device that can
communicate wirelessly with a pacemaker implant, allow a doctor to monitor a
patient’s heart and check the battery of the pacemaker without connecting wires.
The wand-like device is waved over the patient’s chest and information from the
pacemaker is automatically downloaded into a laptop computer.

Reference: Fuscaldo, Donna (2003). “IBM Unit
Hatches Heart Monitor.” Wall Street Journal, August 5.

Implants

Implantable sensors to monitor heart pressure, heart rate, blood sugar
levels, and other vital measures are here. The information they send to remote
computers (over the Internet, in at least one case) for analysis and to alert
doctors if necessary, or to other implant devices (such as an insulin pump) can
reduce hospital stays and “free doctors for higher-order tasks.”

And sensor devices are getting rapidly smarter, covering an ever wider range
of measures and conditions (arterial plaque build-up, for instance), and
becoming “forgettable,” with everything happening automatically and
unobtrusively, via wireless. Ultimately, they will be implanted in healthy
people, too.

Leading device maker Medtronic plans to bundle wireless patient-monitoring
capabilities into all its defibrillators and pacemakers. Guidant is developing a
wireless “advanced patient management” system for defibrillators, and other
competitors are developing similar devices.

“The multitude of therapies that will come out of this will be explosive,”
said a Medtronic executive.

Reference: Langreth, Robert (2003). “The Doctor
Is In.” Forbes, September 1.

Heart Pumps – The Next Generation

Within a year or two, two new left ventricular assist devices (LVADs) from
MicroMed and Jarvik are soon to compete with the older and much larger
HeartMate and Novacor LVADs already approved an in thousands of patients.
MicroMed’s C-battery-sized LVAD has already been implanted into 200 patients,
mostly in Europe, and is seeking FDA approval as a temporary device for patients
awaiting heart transplant. The HeartMate has been approved as a
replacement instead of just a bridge to a transplant.

The technology for the Micromed device was derived from a liquid hydrogen
pump developed for the Space Shuttle. Its size makes it easier to implant and it
is small enough for children.

Berger, Eric (2003). “Heart Pumps
Catching On: Houston firm developing devices to replace transplants.”
Houston Chronicle, September 4.

See also “Cost of High Tech Health” in the
Policy section of this issue.

Miniature Surgibots

A US patent has been issued for microactuators that can be operated
wirelessly by focused beams of energy, enabling them to control objects as small
as 100 nanometers. Scanning-probe-microscope atomic manipulators already work at
nanoscale, but they are limited to moving individual atoms and small molecules,
and are slow. The new method combines heat-activated shape memory alloys (SMAs)
with electron-beam or photon-beam heating. Thin-film SMA microactuators return
to a “memory” state when heated by the beams, which eliminate the bulky wires
and batteries formerly required. The scanning electron microscope used to supply
the heat beams also provides visual feedback and control.

Technology Innovations, Inc. (2003). “Breakthrough enables world’s
smallest robots; nanotools capable of manipulating large molecules and cells;
New patented electron-beam ‘micro-robot’ technology based on ‘memory’ metal
helps fulfill Feynman’s nanotech dream.” Press release, July 17,
2003.

Nanobots

The US National Science Foundation is funding the development of a molecular
robot made from viral protein to patrol the bloodstream and repair damaged
cells, tissues, and DNA. The robot will have a gripper that can open and close,
and sensors.

Meanwhile, a California company claims to be less than a year away from
producing nano-scale “nanotools” or “microactuators” to work inside or outside
the body at the intra-cellular level. They are made of a shape-memory alloy
which, when heated by a scanning electron microscope or laser, causes them to
grip and manipulate nanoscale objects.

References: Unknown (2003). “Nanomotor
to Power Bloodstream Robots.” Betterhumans, September 25; Jaques, Robert
(2003) “Honey I shrunk the robots:
Medical ‘nanotools’ just a year away, claim scientists.” VNUnet, August
22.

See also “Doctor in a Cell” in this
issue.

Nanothermometer

Japanese researchers have made nano-thermometers, each about one hundredth
the diameter of a red blood cell. The thermometers (made of magnesium oxide
rather than the more common, and combustible, carbon) can register temperatures
as high as 1,000 degrees Celsius, close to the melting point of gold. Within
three to five years, they could be ready to monitor the temperatures of
nano-motors, or to become structural elements in nano devices.

Reference: Unknown (2003). “Nanothermometer
Withstands Heat.” Technology Research News, September 9.

See also “Exotic Computing” in the
Computing section of this issue, which introduces the similar concept of
a “doctor in a cell.”

Blood-powered Battery

Japanese scientists have developed a method of drawing electric power from
blood glucose, mimicking the way the body metabolizes energy from food. The
“human battery” (or “bio-nano fuel cell” as they prefer to call it) uses an
enzyme to oxidize glucose and strip it of its electrons. It could produce enough
power to run electronic implants, or sugar-fed robots.

Reference: Unknown (2003). “Power from
blood could lead to ‘human batteries’.” Sidney Morning Herald, August
4.

Organic Printing

Helping make RFID tags and very large e-paper video screens inexpensive and
ubiquitous will be the sort of manufacturing process currently being developed
by GE Global Research Energy Conversion Devices, Inc. under a grant from the US
National Institute of Standards and Technology (NIST). The process is to be a
low-cost, roll-to-roll process for the mass production of large-area, thin, and
flexible products such as e-paper, big TV screens and monitors, embedded
sensors, solar powered cells, and high-efficiency lighting devices.

A roll of organic plastic (carbon-based polymer) film goes in one end, and a
roll of working electronic devices comes out the other. In between, low-cost
gravure or screen printing techniques print the circuits and components.
Significant technological challenges face this work-in-progress, but the
potential payoff will be worth the considerable investment; in terms not only of
low-cost, mass-produced conventional products, but also of products never before
thought possible, including “wrap-around lighting,” “lighting wallpaper,”
“lighting curtains,” flexible barcodes and smart cards, disposable RFID tags,
large-area distributed devices for sensing pollutants or biological agents in
building ventilation systems and water treatment areas, and sensor arrays woven
into clothing.

Reference: Unknown (2003). “GE
Global Research and ECD Ovonics Announce Contract with NIST to Manufacture
Groundbreaking Large-Area Organic Electronic Devices: NIST, GE and ECD Ovonics
Collaborate on $13 Million Project.” ECD press release, September
25.

See also “Navigating the Hospital Maze,”
“E-paper,” and “Update on Smart Pens” in the Devices section of this
issue.

Protein Chip

Protein chips are hot on the heels of gene chips, which are already
established in useful, practical, medicine-related applications. A prototype
biochip that sorts protein molecules by properties such as size and type could
be used to sense pathogens. It could be ready for use in practical microfluidic
systems in two years.

Reference: Unknown (2003). “Heated Plastic
Holds Proteins.” Technology Research News, September 19.

Handheld Ultrasound

We first
mentioned the handheld ultrasound device back in February, as one of
Popular Science magazine’s “top picks” in 2002.

CNN’s Christy Feig reminds us that the venerable stethoscope seems likely to
be replaced by that device, because ultrasound can do a better job, at least in
the hands of a doctor trained its use. A regular heart ultrasound done by a
specialist in a hospital can cost between $700 and $1,200. The $15,000 and up
cost of current handheld ultrasound devices may have to come down for it to
proliferate among primary care physicians, but its growing adoption, competition
among device manufacturers, patient demand, and the falling cost of technology
overall, practically ensure that it will, and that the stethoscope is headed for
the museum.

Reference: Feig, Christy (2003). “Ultrasound
may mean end to classic stethoscope.” CNN, August 27.

Spyglasses

A prototype pair of sunglasses with a camera built in to them has been
created by Hewlett Packard researchers. When switched on, the camera — so small
it is practically undetectable — constantly snaps what the wearer sees. The
system also captures information about how and where each picture was taken,
whether a subject was walking or turning, smiling, or looking directly at the
camera lens. That “metadata” is used by the system to quickly locate images or
image sequences. The images can be processed in a handheld computer attached to
the sunglasses or on a conventional home computer.

In field trials, one wearer used them to take images of children playing
catch, while another wore a pair while playing football. An HP executive pointed
out that the technological trend here is the trend to smallness in devices like
cameras, enabling them to be embedded in the fabric of life. Others point out
the trend toward ubiquitous secret surveillance and the loss of privacy.

Be that as it may, one can envision applications in medicine: for example,
surgeons might wear (undarkened versions of) them to relay what they see when
performing surgery, nurses might have to wear them so they can prove what they
did at any given time. Ally this to the technology that stores your every
experience (above).

Reference: Unknown (2003). “Camera specs
take candid snaps.” BBC News, September 18.

The Storage of Your Life

Intel is developing a matchbox-sized “Personal Server” that it says could be
used to store a lifetime of personal information. Storage capacity of three
terabytes would be enough to record a lifetime’s conversations; add 94 terabytes
for video. “I would be very surprised if you don’t see devices like this on the
market in five years’ time,” said an Intel executive. “There could also be a
legal requirement for such a device in some circumstances. It would certainly
make solving arguments a lot easier.” It would have an obvious use with the
“Spyglasses” also covered in this section.

Reference: Thomson, Iain (2003). “Your life in a matchbox.” VNUnet,
September 16.

3-D Printer Update

UC Berkeley researchers are developing a “flextronic” — flexible mechatronic
— device. But the interesting device is not the one they are making; rather, it
is the one they are using to make it: A 3-D printer with multiple print heads
and “ink” cartridges filled with different polymers to lay circuits,
transistors, capacitors, sensors, and casing.

3-D printers are also known as “rapid prototyping” (RP) machines. Fifteen
years ago, RP machines cost $300,000; today, they cost about $30,000 — and
falling. There’s a rumor that Hewlett-Packard is planning to sell one for
$1,000.

“The future,” says Daith� � hAnluain in Wired, “has bewildering
potential. In 10 years, you might be able to fax a toy car to a favorite niece
or nephew.” Or print out your medicine prescription — not the paper order, but
the actual pill. One company is reported to be printing pharmaceutical pills
with RP technology today.

Reference: � hAnluain, Daith� (2003). “3-D Printing’s
Great Leap Forward.” Wired News, August 11. (Related articles in previous
issues of Health Futures Digest can be found by searching on
“printer”).

E-paper

Researchers at the Dutch electronics firm Philips have invented an
“electrowetting” process that enables high-definition video display on
paper-thin foldable screens they invented not so long ago for static displays.
The video is clear and accurate, with reflectivity and contrast approaching
those of paper and “a colour concept which is intrinsically four times brighter
than reflective liquid-crystal displays and twice as bright as other emerging
technologies,” they claim. It works on very low voltages, and is lightweight and
flexible enough to be sewn into clothing, so that one could wear one’s monitor
on one’s sleeve.

Reference: Reuters (2003). “New
E-paper could show moving images too.” Forbes, September 24.

Thin-air Displays

We have said that with the resolutions of two dimensional displays achieving
resolutions better than the human eye can register, 2-D has nowhere to go. We
were wrong.

Not only are they getting vastly bigger, thanks to the E-paper technologies
discussed elsewhere in this issue, but the display substrate itself is literally
disappearing into thin air. IO2 Technology and Finland’s FogScreen have
demonstrated working prototypes of devices that produce two-dimensional images
in thin air. IO2’s Heliodisplay projects images onto a cloud of water
vapor diffused into the air, and observers can control the virtual characters
directly with their hands — no mice or datagloves required. The potential for
medical education and telemedicine is obvious, and indeed IO2’s website featured
(at the time of writing) a photograph of a HelioDisplay image of a human
skeleton.

FogScreen is not interactive but already has a price — $110,000 —
and a foothold in the market. It was a hit at the Siggraph Emerging Technologies
conference in August, where it was used to display a walk-through virtual image
of the Mona Lisa. A Finnish museum is now exhibiting the same image, and a
Finnish mime uses the FogScreen in a performance.

Within ten years, computer monitors and TV screens as we know them today
could well be history. Remaining challenges include improving the resolution,
widening the currently small viewing angle, and eliminating distortion, not to
mention bringing the price down. But with the power of yesterday’s multimillion
dollar mainframes now available in a laptop for a thousand dollars, price is not
likely to remain an issue.

Reference: Batista, Elisa (2003). “Look Ma, No
Projection Screen.” Wired News, September 16.

Update on Smart Pens

A prototype patient charting system combining e-paper and digital pen will be
tested in hospitals in France. The system aligns technology perfectly with
existing physician and nurse practices, and is less expensive than “putting a
tablet PC at the end of every bed.” Information written on the chart is
automatically digitized and uploaded to a central computer system and
automatically time-stamped.

Reference: Unknown (2003). “Smart pens
aim for better health.” BBC News, September 4.

See also article on digital
pens in the February issue of HFD.

Drinking the Undrinkable

Iraq’s current shortage of drinking water could be solved with “a few
planeloads” of small bags, almost empty except for a nutrient powder. Just drop
one in “the dirtiest, most contaminated bilge imaginable. . . full of viruses,
bacteria, poisons, you name it,” writes Jay Bryant; wait for it to fill up with
two liters of “a clean and safe Gatorade-like nutrient drink formulated to
replace critical electrolytes lost during strenuous activity,” and drink from
the attached straw.

The bag is Hydration Technologies, Inc. (HTI)’s HydroPack. It needs no
power, has no mechanical parts, and involves no purifying chemicals. It is
simply an advanced forward osmosis membrane that removes any and all
contaminants. Forward osmosis uses the natural tendency of substances to mix
together when placed in contact. The membrane’s 3 to 5 angstrom (30-50
nanometer) pores can’t clog up. The tiniest (50 angstroms wide) virus is at
least ten time too big to get through, and the smallest (2,000 angstroms wide)
bacterium doesn’t stand a chance. In tests, after 24 hours in a vat of E. Coli,
the bags still contained zero E. Coli.

Bryant points out that a soldier in Baghdad could “fill up right out of the
Tigris without a worry. And a soldier in Liberia could fill up out of a
cholera-laden mud hole.”

Reference: Bryant, Jay (2003). “Just Add Water.” Tech
Central Station, July 31.