Nigel Syrotuck

DIGITAL HEALTH UTOPIA – IS THE TRICORDER FACT OR FICTION?

medical device tricorder

Image credit: The RPF forums

In November 2014, DMI  won the Nokia Sensing XChallenge for a lab on a chip contest by creating a – you guessed it – wearable health monitoring device coupled with a blood testing device. The blood tester can run 22 tests with just a drop of blood, which the wearable monitors health and vital signs. They are also competing in the Tricorder XPRIZE.
The tricorder is the ultimate objective of diagnostic medical device development: an all-in-one package that can immediately diagnose any disease without touching the patient. Is this dream reachable, or is it going to stay in science fiction? If so, what will it look like?

The name ‘tricorder’ comes from Star Trek, and was adopted as a term in the digital health industry by the announcement of the Qualcomm XPRIZE. Though not quite the nearly-magical device used in the show, the goal of the tricorder XPRIZE  is to produce an “automatic non-invasive health diagnostics packaged into a single portable device that weighs no more than 5 pounds (2.3 kg), able to diagnose over a dozen medical conditions, including whooping cough, hypertension, mononucleosis, shingles, melanoma, HIV, and osteoporosis”. If successful, a device like this can and will revolutionize the diagnostic industry. But is it possible? Only time will tell, but here are some major considerations:

Technology

The technology required to diagnose all of these diseases is already available, though commonly they require blood samples, or are far too bulky and slow to be possible in a handheld device. Portable versions are being adapted by many groups right now, but will likely be slow to get to market as typically people (in countries with hospitals) can accept going to the doctor and getting blood taken for these tests… Little do they know what they are missing!

The key technology for such devices will be sensors. The go-to tool for a distanced diagnosis is imaging, which as Photonix notes, is a growing field very related to the tricorder. For example, Philips already offers an iPhone app that can sense heartbeat from a distance using the change in skin temperature, which is really neat, but checking for HIV by using a camera is a different story.

Most likely, in my opinion, a combination of a wearable sensors and diagnostic scanners will be required to create a tricorder. Sweat sensors, UV detectors, and all-in-one devices are already being researched, and coupled with the growing wearable sensors and MEMS market means that these technologies will also be affordable. Whether or not a user wishes to wear one everyday bring us to a second consideration.

 Adoption

More and more, people are willing to include technology in all aspects of their lives. The internet of things – as it is now known – means that soon our coffee maker can turn on when we wake up, and our alarm turns off when we return to our house. Realistically for these to work, people will be required to connect themselves to the internet. For the next decade or two, this may manifest in the form of smartwatches, which can track and share our location to our alarm system, and our heartbeat to our coffee maker. If people are wearing sensors like these every day, integrating a heart attack diagnostic tool or a UV-exposure warning alarm is just a small step away. Integrated digital health tracking will lead to integrated diagnostics, making a tricorder that interfaces with them all the more likely– regulatory concerns (which are a major hurdle) notwithstanding.

The next logical step past smart wearables is implantable sensors. Though you might argue that an implant cannot be part of a tricorder because it is invasive, once they are implanted a daily check for a range of diseases is entirely non-invasive and much more effective that a camera scan. Imagine a future where a device implanted into your body tracks your workout routine in the morning and lets you know you have liver cancer in the afternoon. It’s not as far away as you might think.

Logistics

The last major consideration of the Tricorder is logistical. How much will it cost, and how long will it take to make its diagnosis?  These are certainly major hurdles in the tricorder development, but they will be solved over time. Though it’s not possible to make a cheap personal tricorder today, I have faith that it will be eventually, just by the nature of the market.

One of the more focused-upon logistical considerations of the XPRIZE is the user interface. The tricorder is supposed to be able to be used by anyone, without training, and present simple enough conclusions to be useful. Doctors make diagnostic conclusions based on a quantified values, patient observation, and history. They draw on years of experience to make expert conclusions. Trying to replace their thinking power with computers is a massive challenge, and also a huge legal gamble (imagine suing your robo-doctor over a misdiagnosis). Dave thinks diagnostic devices will never be completely automated, and though I agree, I think this could be the most exciting output from the XPRIZE contestants.

 The Final Word

Regardless of how close the tricorders of the XPRIZE are to the Star-Trek version, I think the device is possible and the prize will yield some amazing results that will remind us that the future is now. Shortly after the winners are announced you may start to hear that at-home tricorder scanners are just around the corner, but don’t be fooled. My prediction is that the first useful tricorders will have to be integrated with digital health devices worn on or inside our bodies to be truly effective. Better start getting used to the idea soon!

[Update 23/03/2015: This week at SXSW the Cloud DX team unveiled a tricorder prototype which uses a collar, wand, blood sampling stick, and base station to perform the suite of tests. Check it out here.] [Update 23/06/2015: Another step towards the tricorder is a non-invasive diagnostic technique being developed to diagnose malaria using lasers.]

Nigel Syrotuck is Mechanical Engineer who currently does not have anything implanted inside him (except that penny he swallowed as a kid). He has worked on a number of medical devices that use sensors to perform diagnostics and he hopes that the tricorder does not put him out of a job one day.

 







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