Tech Tackles Health Care

Can technology make humans healthier? If technology investments in this market are any indication, the answer is a firm “yes.”

Massive growth in this market has been predicted for years. In fact, it was the initial driver behind many of the initial IoT devices, which fizzled largely because of insufficiently developed end applications and poor battery life of wearable devices. Much has changed since then, and it’s reflected in the most recent market projections.

Worldwide, the health-care market will grow 4.82% this year to almost $2 trillion, Frost & Sullivan forecasts. Technology’s share in that market will increase. The research firm predicts the global market for health-care cloud computing will be worth nearly $10 billion by 2021 and by 2025, 10% of hospitals around the world will be “smart” facilities, investing more than $11 billion in cloud-based computing and data analytics.

“Even though 2017 was a year full of spectacular advancements in health care, 2018 will be the year of digital health technologies such as artificial intelligence, Internet of Medical Things, big data analytics, and robotics,” said Kamaljit Behera, industry analyst at Frost & Sullivan, in a statement.

Technology is being applied and implemented in health care on numerous fronts, from research and development in brain-machine interfaces to counting your daily steps. Wearable electronics are becoming tools for assessing cardiac health, tracking how much we exercise, and monitoring how well we eat and sleep.

“Non-healthcare companies will continue to collaborate with health-care industry players to transform these technologies into actionable applications that will drive growth opportunities across the globe,” Behera said.

Apple, IBM, Hewlett Packard Enterprise, Intel, Microsoft, Oracle, Philips, Qualcomm, and Samsung are aiming products and services at health care. Google launched Google Health in 2008 and discontinued the service in 2011, but Verily Life Sciences, established in 2015, grew out of Google X’s Life Sciences division and now is a part of Alphabet Inc.’s network of subsidiaries. Temasek of Singapore last year invested $800 million in Verily.

Fig. 1: What else can your phone do? Source: Apple

Amazon, Berkshire Hathaway, and JPMorgan Chase announced in January that they would provide health care for their U.S. employees through a new company. While the details of this joint venture remain unclear, it could provide a not-for-profit alternative to the American health-care system and the health insurance industry that significantly decides what (and how much) health care its customers will receive.

What is digital health?
Digital health, also called eHealth, is often defined as using information and communication technology in health care. The field takes in advanced diagnostic equipment, bioinformatics, computational biology, electronic health records/electronic medical records, insulin pumps for diabetics, mobile health (also known as mHealth), and telehealth/telemedicine (the use of videoconferencing technology for remote checkups and doctor-patient consultations), among other applications.

IBM’s Watson augmented intelligence technology, famous for its victory over two human contestants on the “Jeopardy!” game show in 2011, is now being used in health care as IBM Watson Health, an umbrella group covering IBM Watson for Drug Discovery, IBM Watson for Genomics, and IBM Watson for Oncology. The technology also is deployed in the IBM Watson Care Manager and social program management.

Intel is involved in health care’s digital transformation through predictive clinical analysis, which employs artificial intelligence, data analytics, and machine learning. The chip giant also addresses genomic analytics, pairing data science with DNA to enable genomic sequencing and precision medicine to treat diseases and infections.

Microsoft co-founder Bill Gates is taking on health care around the world through the philanthropic Bill & Melinda Gates Foundation. Meanwhile, Microsoft sells a variety of health solutions and services to aid in care coordination, clinical analytics, cybersecurity in health care, operational analytics, patient engagement, and telehealth. The Microsoft Cloud can be used by health providers to operate their facilities and organizations, while Microsoft Azure helps with the diabetic retinal examination process.

Qualcomm Technologies has its own Qualcomm Life business, using its wireless communications technology for clinical connectivity to share patient data. The chip design company developed a device-neutral, open platform to collect data from medical devices. It offers its medical-grade 2net Connectivity Platform, which complies with FDA quality and HIPAA privacy standards. Qualcomm also provides the Capsule Medical Device Information System.

Fig. 2:Qualcomm’s vision for medical-grade end-to-end connectivity. Source: Qualcomm

Moreover, Qualcomm Ventures has invested in 19 digital health startups. One of its early investments involved Fitbit. (Qualcomm said that it may scale back its investment over time now that the Fitbit has gone public.)

Wherefore wearables
Fitbit, however, is going through a relatively rough patch. Despite spending $343 million on R&D in 2017, the fitness wearables manufacturer posted sales of $1.6 billion in 2017, down from $2.17 billion in 2016 and $1.86 billion in 2015. The company posted a net loss of $277.2 million last year and a $102.8-million net loss in 2016, compared with net income of $175.7 million in 2015.

Early last year, Fitbit initiated a reorganization, including a 6% reduction in force, affecting 110 employees. It didn’t help that Fitbit’s largest customer — the distributor Wynit — filed for Chapter 11 protection from creditors last September.

That’s only part of the picture, though. While the number of devices sold declined in 2017, the company’s active users continued to climb.

In the wearables market, Fitbit counts Garmin and Nokia as competitors in the specialized consumer electronics area, while watch manufacturers Fossil and Movado are rivals. The company also sees competition from Apple, Google, LG Electronics, Samsung Electronics, and Xiaomi. The Apple Watch is a competing product.

The Nokia Health segment is being subjected to a review of strategic options. Nokia got into the wearables business with its 2016 acquisition of Withings, which was rebranded as Nokia Health last year. “The strategic review of the Digital Health business may or may not result in any transaction or other changes. Any further announcements about the Digital Health business will be made if and when appropriate,” Nokia stated in February.

Internet of (healthy) Things
How does the Internet of Things intersect digital health technology? In many ways, both good and bad.

Wearables are given the task of monitoring many things, such as blood-sugar levels, heartbeats, and whether a patient is taking prescribed medications at the right times. IoT devices rightly have a poor reputation for secure operation, especially when it comes to protecting the data they collect and insuring patient privacy. Hackers are targeting MRI machines, drug pumps, and unsecured medical devices in their ceaseless efforts to exploit cybersecurity vulnerabilities, wherever they can be found on the Internet.

ForgeRock, for example, offers a platform for profile and privacy management, identity management, access management, edge security, and directory services. The startup, founded in 2010, has more than $140 million in private funding from such investors as Accel Partners, Foundation Capital, Meritech Capital Partners, and KKR. Its customers include the BBC, GEICO, Morningstar, Pearson, TomTom, Toyota Motor, and Vodafone. The ForgeRock Identity Platform has applications in multiple industries, including health care, and also addresses connected cars and the Industrial IoT.

AI, blockchain, and a parade of investors
Artificial intelligence is making its way into health care and the life sciences, too. The Genpact Cora AI platform includes the Cora PVAI touchless AI-based adverse event reporting tool and the Insight Assistant for AI-driven predictive insights.

Philips Healthcare is implementing AI and machine-learning technology in its products and services. AI’s benefits in health care are improvements in operational efficiency and performance, helping in clinical decision support, enabling population health management, empowering consumers, and improving patient care, according to the company.

And, of course, blockchain technology is coming to health care. The CDX Academy is holding the inaugural Blockchain Brand Innovation Summit on May 11 at Columbia University in New York City.

Investors are flocking to the digital health field. Milpitas, Calif.-based Bigfoot Biomedical, a developer of connected insulin delivery optimization for Type 1 diabetics, just raised $18 million in new Series B funding from Abbott Laboratories and other investors. The round’s total is now $55 million. Janus Henderson Investors and Quadrant Capital Advisors co-led the initial tranche. Bigfoot was founded in 2014 and has raised a total of more than $90 million in private funding.

LetsGetChecked, which provides personal health testing kits, received $12 million in Series A funding co-led by Optum Ventures and Qiming Venture Partners. It also was founded in 2014 and has total funding of €11.2 million (about $13.78 million). The company makes its headquarters in Dublin, Ireland, and has offices in New York, N.Y., and Toronto, Canada. LetsGetChecked will use the new money for worldwide expansion, developing a technology platform for connecting customers to testing laboratories, and increasing its clinical support team.

San Francisco-based Tempest Therapeutics took in $70 million in Series B funding led by Versant Ventures, F-Prime Capital, and Quan Capital. Also participating were Lilly Asia Ventures, Foresite Capital, and Eight Roads Ventures. The startup describes itself as “a development-stage biotechnology company advancing small molecules that modulate anti-tumor immunity pathways.” Tempest was spun off in late 2017 from Versant’s Inception Sciences incubator and has total funding of $92 million.

Research: Pulling data directly from the brain
At the 2018FLEX conference in Monterey, Calif., Rikky Muller of Cortera Neurotechnologies gave a keynote address on “Minimally Invasive Wireless Neural Interfaces.” Dr. Muller also serves as an assistant professor at the University of California, Berkeley.

“Recent advances in brain-machine interfaces have offered hope to 100 million people worldwide, living with paralysis,” she said, showing a video of a paralyzed woman controlling a robotic prosthetic arm with signals recorded directly from the motor cortex of her brain. “This is an incredible scientific achievement. But there may be impediments to the practical translation of this technology to patients.”

Muller and her colleagues rejected the use of electroencephalography (EEG) technology in their research on brain-machine interfaces (BMI), since EEG is applied to the surface of the scalp and doesn’t provide the data needed for BMI tasks of interest. Intracortical recording offers the highest spatial and temporal resolution, yet has its own drawbacks, according to Muller.

The UC Berkeley researchers ultimately resorted to electrocorticography (ECoG), where sensors are placed at the surface of the brain. Those sensors can wirelessly provide their data to physicians and scientists.

“You’re in contact with the brain, and you have higher spatial and temporal resolution than EEG, but you don’t get the same level of cortical scarring. You can interact in a more natural way with the sensitive cortical tissue,” Muller said. “Our solution was to replace the existing large wired sensors with a small wireless implant based on electrocorticography. We used thin, flexible, biocompatible materials that interact much more naturally with the sensitive cortical tissue. This particular electrode array was developed by my colleagues at the Berkeley Sensor and Actuator Center.”

The array has about 200 nanometers of microfabricated thin-film metallization.

Also emerging from UC Berkeley is the BioInspira startup, which is developing a colorimetric sensor platform for air chemical detection. The technology, originating from UC Berkeley and Lawrence Berkeley National Laboratory, could be used in environmental monitoring and health care.

BioInspira got its start in late 2014, during a business conference at UC Berkeley. The company has seed funding from institutional investors and a $100,000 grant from the U.S. Environmental Protection Agency, according to CEO Ray Chou. Its investors are in Asia (where the company has a subsidiary) and the U.S.; one of the investors is a manufacturing partner.

BioInspira late last year had six full-time employees and five contractors, Chou said, with plans to expand its engineering team. The company is also raising new funding to establish a scalable manufacturing line. It has yet to publicly introduce its product.

The MEMS & Sensors Technical Congress held in Monterey along with 2018FLEX heard about several medical applications, such as embedding sensors into wearable devices, smart sensors connected to high-performance health equipment via Bluetooth Low Energy and near-field communication to take advantage of always-on IoT, blood oximeters, and gas sensors.

The 2018FLEX conference had presentations on a wearable patch for continuous monitoring of sweat electrolytes, a flexible oral biosensing platform, “The Birth of the Internet of Skins,” flexible biometric sensor bands, wearable sensing gloves for objective medical assessment, thin-film tactile force sensors for biomedical applications, and the GraftWorx SmartPatch, among other topics.

More to come
Technology is being widely introduced into health care. Safety and security are primary considerations for medical devices. Digital health is a growing field attracting academic and corporate research, along with private investments, while providing potential markets for artificial intelligence, blockchain technology, the Internet of Things, and semiconductors.

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