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August 31, 2006

RFID: is the tag tipping?

rfid-tag.jpgToday there are two reasons to be anxious about RFID: that it may live up to expectations and that it may not.

Civil libertarians are concerned about a wide deployment of RFID and the security of data on tags, and with reason it seems.

In the recent edition of PC Pro, Paul Trotter looks at their concerns. Security experts working with Dutch TV quickly intercepted and cracked encrypted transmissions from a prototype passport’s RFID tag. This allowed access to personal information stored on the tag—a worrying development for the US, where RFID-tagged passports will be available in the next few months.

Food and drinks manufacturers, on the other hand, are concerned that RFID may not be the panacea it seemed. On liquids and metals passive tag read rates can be lower than 40 percent—hardly the basis for comprehensive supply chain management. Similar problems are found in healthcare settings, where signals from tags can also be distorted by the babble of equipment emitting at radio frequency.

Recent enthusiasm for RFID was catalysed by the falling price of passive tags signalling the vision of cheap, ubiquitous tagging. Active RFID tags carrying their own power source could address some of the implementation issues, but they are far more expensive.

As one of a spectrum of wireless techniques, I believe RFID has a role in healthcare. But what role? A few years ago, Gartner placed RFID at the "Peak of Inflated Expectations" on its hype cycle. I think passive RFID is now tipping into the "Trough of Disillusionment", the precursor to new technologies finding their level of practicability. We will see where it ends up.

August 24, 2006

Robot Surgery for Prostatectomies

Picture of RP7 in action.For some procedures robotic surgery is less invasive than open surgery. Its use in prostatectomies, for example, may result in less pain, less bleeding and a quicker recovery. A surgical robot's lenses may also give surgeons a 3D view deep into incisions making it easier to avoid damaging the ureter and the complex of nerves.

But easier viewing isn't the only factor in favour of robotics. Canada is particularly interested in robot surgery because of its vast size and many rural communities. Read the full article.

If you live near London, UK, you may be interested in attending a talk on the use of robots in medicine at a meeting of the British Computer Society's London and South East Healthcare SIG on 21st September 2006. I will be co-presenting with Parv Sains, Clinical Research Fellow and Specialist Registrar at Imperial College, St Mary’s Hospital, Paddington who will discuss his clinical experience of In Touch Technologies Inc's RP7 remote presence robot (pictured).

August 21, 2006

Remote Monitoring: silicon biotechnology

You couldn't fail to notice the interest in remote monitoring and diagnosis. Offerings vary in sophistication: some monitor activity, such as the opening of a fridge door, others blood sugar and pressure.

I spotted "Labs on a Chip" in Fast Company which looks forward to 2008 when portable biosensors based on silicon biotechnology will be developed by an alliance of Genencor and Dow Corning.

Remote testing devices comprise a reader and a disposable biochip. In tiny wells on the layers of silicon making up the biochip, blood molecules from a sample react with reagents, such as an antibodies. Results are read by the handheld reader.

A related press release from the alliance says silicon biotechnology is expected to yield materials for diagnostics, biosensors, personal care products and controlling the delivery of active ingredients. The materials may also be used in developing new biochip-based devices with acute recognition and superior signal transduction capability.

Wireless technologies are sure to be at the core of telemedicine. In an article I wrote while working for PA Consulting "Care on the Airwaves", I proposed Smart Dust—which may comprise tiny, self organizing “motes”—as a future technology for both sensing and transmitting.

I am excited by the convergence of IT and biotechnology, and will be watching to see which of the promising technologies grow into practical healthcare applications.

August 16, 2006

Brawn and Brains in Robots

Picture of inked wrists.Whether you prefer your robots with brawn or brains you are in luck.

In New Scientist (12 August 2006) Dan Cho describes the development of machine muscle aimed at enabling smoother moving robots, producing better prosthetic limbs and even powering artificial organs.

Human muscle relies on a biochemical ballet of sliding actin and myosin filaments. Developing muscle technology resembles human muscle but is powered differently. In some respects, artificial muscle improves on biological muscle: some polymers can extend further and react faster. However, artificial muscle can not regenerate and will eventually wear out.

The contenders for artificial muscle are:

  • Conducting polymer: in response to voltage, ions move into a polymer causing it to swell.
  • Dielectric elastomers: a polymer is sandwiched between layers of film that squeeze together when charged.
  • Polymer metal composites: this time the polymer is squeezed by layers of metal.

I really did mean brains. Japanese M-TRAN has 20 modules each with its own "brain". The robot can lose any of its body parts without breaking down.

August 13, 2006

Your Clothing Cares: wearable computing

If you thought sporting a cell phone wireless earpiece was geeky, just wait. The next must have accessories may be designer clothes woven with electroconductive equipment and IT.

In an article in the UK’s Financial Times, Robin Manning futurologist at BT’s Adastral Park in the UK suggests the close contact of clothes with the body makes them ideal for monitoring our metabolism. Nor need it stop there. External chips in clothes could converse with surgically implanted internal ones.

In another application, a vest fitted with blinking red LEDs can help zap-while-you-scan therapies to target accurately. New Scientist describes how live images of tumours and internal organs are helping surgeons to achieve unprecedented precision.

Surgeons target tumours with an accuracy of less that a millimetre using real-time MRI and CT scanning, which compares with about one centimetre when using pre-operative scans.

Surgeons zap malignancies with conventional X-rays or high-intensity ultrasound. Ultrasound beams 10,000 times more potent than those used in pregnancy scans can heat tissue to 55 degrees Celsius, causing cellular protein to denature and malignant tissue to die.

August 06, 2006

Acute to Primary Care at Tipping Point?

Is it me or is UK healthcare changing faster than we expected?

I mean, we thought a switch from acute and late-stage to primary and prophylactic care was inevitable. But have we reached a tipping point?

We thought it likely that the NHS would be unable to afford to manage predicted levels of chronic illness. After all, about 2 percent of the UK's population is over the age of 85 (about 1.2m) and that is expected to increase to 6.5 percent (about 4.2m) by 2056. The UK also has the fastest growing rate of obesity in the developed world, another predictor of increased levels of chronic illness.

Falling demand for staff seems to presage change. NHS overspending has led to large-scale redundancies and reductions in job vacancies. Two years ago, physiotherapy looked like a safe career bet; however, the Daily Telegraph reports 93 percent of last year's graduates do not have jobs. Demand for doctors and nurses has also fallen.

A shift in emphasis from late-stage care to prophylaxis is inevitable. As a consequence, independent and public sector organisations will almost certainly compete for the opportunity to establish the remote monitoring and management of patients and local facilities like the community hospitals of yesteryear.

But--in my case--predictors of a quick change are offset by experience. A few weeks ago my father-in-law suffered a mild stroke. Being of independent spirit, he was keen to go home, and the hospital into which he was admitted was keen to discharge him to free a bed. Fair enough.

Home he came with the promise of an "immediate" home visit by speech, occupational and physiotherapists. After two weeks he had his first visit, occupied entirely by the therapist filling out a nine-page assessment form. Now three weeks after discharge he is still waiting for his first session of treatment.

Maybe the tipping point is still some way off.

August 05, 2006

Pregnant Robot Teaches Students

The UK's Sheffield Hallam University is using the Noelle birth simulator to teach student midwives.

Noelle simulates hundreds of scenarios, and mother and baby can be individually programmed offering students a rich range of scenarios and complications.

Visit the Gaumard site for more.