It’s no secret that wireless technology is in a growth spurt. From WiFi cars on commuter trains to the omnipresent Bluetooth and iPhone devices, as the saying goes, “There’s an app for that.”
The medical industry is no exception. Wireless medical devices are becoming more and more common, with innovations like pacemakers that can send data directly to physicians. GE Healthcare is looking to push the envelope even further, with a vision for wireless medical monitoring systems that would eliminate the rat’s nest of cables that spring up around hospital patients.
In pursuit of that vision, the company petitioned the Federal Communications Commission to create a dedicated, vendor-neutral wireless spectrum for medical devices.
MassDevice spoke with David Freeman, general manager for parameters at GE Healthcare, about the petition, how wireless monitoring devices can improve patient outcomes and his vision for the hospital of the future.
MassDevice: What’s your background? How did you come to find a home in the medical device industry and why is it a good fit for you?
David Freeman: I’ve been in the medical device space for over 20 years. I started my career in Andover, Mass., at Hewlett-Packard’s medical products group and I’ve pretty much been in the medical device and life science space since then. The people who are in the medical device and healthcare space could be in a lot of different fields, but they really want to make a difference and that’s what attracts them and keeps them in this industry.
I’m very fortunate in the work I’ve done, because I’ve felt like over the years we’ve really made a difference, we’ve really made a contribution. It’s very rewarding. Big companies have plenty of things to make you frustrated — matrix management and quality systems, all these wonderful things — but at the end of the day, it’s easy to push through because you know you’re really making a difference to patients and people around the world. That’s pretty motivating, pretty exciting and pretty rewarding.
I was at Hewlett-Packard and then Philips, I was at Becton Dickinson for a while in life sciences, and now at GE, coming up on four years. I can remember the times when we’d get voicemails about someone’s life being saved, or the physician saying, “Where the hell is it, because I could have used it in the OR yesterday!” I’ve had both those calls and it really drives home that sense of purpose and reward. Good stuff.
MassDevice: Why did GE Healthcare decide to take the lead in petitioning the FCC for a dedicated frequency for wireless medical devices? What’s so important about having a vendor-neutral “channel” for devices?
DF: GE’s been involved in working with groups and the FCC for petitioning them in the past, so when television went from analog to digital and there was some spectrum freed up, GE was very involved in petitioning for the white space initiative, which set aside some bandwidth for medical telemetry in the hospital. We feel it’s very important that someone sort of steps out and takes that industry position. It allows us as a individual party, knowing that the spectrum is set aside, it frees us up to make a lot of technical decisions.
These are enabling technologies, so they’re going to allow us to advance how wireless technology is deployed in healthcare. GE’s really been enjoying enormous growth and interest from our customers in wireless telemetry, wireless infrastructure, wireless portable monitors, so we know this is an important area that our customers are looking to us to advance.
MassDevice: What types of devices would use the channel, should the FCC approve its creation?
DF: GE Healthcare is a leader in patient monitoring equipment, which is a broad category. It used to be kind of a box business and now it’s more and more like a systems business, where anywhere in the hospital, whether it’s in the emergency room, ICU, OR, general ward, patients’ clinical measurements need to be taken. So you put a sensor or group of sensors on the body to detect the patient’s condition, and put that information on screen in a central area where clinicians are watching those patients and making sure the right interventions are happening.
A lot of the clinical decision-making that happens happens at that point, where our products are connected to patients and there’s real-time information coming back from the monitors. Nurses and physicians are making treatment decisions on how to maintain and improve patients’ conditions. Our job is to not only generate some of that information, which is the clinical measurements piece, and trend that over time, but also to pull information from the rest of the devices and products in the room and also across the enterprise and integrate that to make it useful for clinicians in that moment of care.
So you’ve got products focused on these high-acute areas like the OR and the ICU. But, increasingly, hospitals, because of patient demographics, are becoming like large ICUS. The safety net that hospitals are wishing to extend around patients is ever-increasing. That’s one of the reasons why wireless monitoring continues to grow so much. It’s a technology that supports stretched clinicians in treating ever-more acute patients in their environment.
That allows for patient mobility, which is really important for recovery period, but also allows [clinicians] to extend their reach. We have not just wireless products that are attached to the patient, but also some of the wireless infrastructure that allows for a single point of entry to manage WiFi, cellular telephones and also medical-grade telemetry, which has obviously high degrees of quality, high resolution and guaranteed delivery point-to-point.
MassDevice: How would a dedicated spectrum improve patient care and outcomes?
DF: There are inherent benefits to getting a patient up and moving and not having them tethered to a box. If you can remove the wires, if the sensors become kind of like little patches on the body and can wirelessly send information into the system, then the patient can move more freely, is more comfortable and hopefully can recover faster.
But there are a lot of benefits beyond just patient comfort. We have regular customer advisory board meetings and at one, one of the representatives slammed his fist on the table and said, “Just get rid of the wires!” Every time you want to transfer a patient — and you have to transfer patients on regular basis — you have to unhook them. Now you’re not actively monitoring them. You then have to transfer them, hook them up to a new piece of equipment, and you have to reverse the process to bring them back. So there’s a nurse productivity issue.
Another issue is the cables that connect the sensors to the devices. Those get re-used, so they’re a vector for infection control and obviously you want to remove as many of those as possible. They need to be cleaned — pretty tough chemicals are used to clean those — so eliminating that procedure would be great.
Then there’s flexible acuity monitoring. As a patient’s condition changes, you can “flex” the monitoring that gets done. In a body-centric network or a wireless sensor world, you could have very basic monitoring when a patient gets into the hospital. If their condition changes, you could add different patch electrodes to monitor other parameters. So it’s very flexible in that way. And you wouldn’t necessarily have to move them to a particular area of the hospital that specializes in that monitoring, because that’s where the equipment is and that’s where you need to hook them up.
For example, if you wanted to monitor someone’s brain activity, you could put EEG electrodes on them and wirelessly get that information over to the neurology department. You wouldn’t necessarily have to transfer the patient to the neurology environment. It just gives the hospital staff a lot more flexibility in how to manage the workflow of those patients.
My sense is that at some point, because of the benefits we talked about — mobility, infection control, transport, flexible acuity monitoring — all sensors are going to become wireless.
MassDevice: So what’s your vision of the fully wireless hospital?
DF: Today about 30 percent of the patients in a hospital are monitored. Most of the patients are not monitored by equipment. Obviously, every patient is monitored by people, but no hospital has that one-to-one ratio with patients. So everyone is stretched to keep track of the status of all the patients in an institution. You see a lot of things happening in hospitals today to try and support very stretched clinicians with very sick patients.
So, for instance, it used to be just “Code Blue.” But now you have emergency response teams whose sole focus is to run to a patient who is in distress. You’ve got sophisticated infrastructure being put in place to route alarms to clinicians. So wireless is happening. Aside from the fact that you have a lot of patients who are really sick and you’ve got stretched staff, it’s because not all of the patients in a hospital are being monitored. That’s one of the reasons you see this enormous growth in wireless technology being deployed.
This is sort of the next step, where patients come in the door and every single one of them is going to get some kind of small sensor. Maybe it’s something like a “life sensor,” where you’re making sure their ECG and respiration is fine and you know where they are, because you can put tracking in [the sensors]. Then, if their condition changes, you can add incremental sensors and they’ll do all the positives that we talked about before, but will also catch a whole lot more patients than are being caught with the systems piece of this.
MassDevice: Would these sensors be disposable?
DF: They will absolutely be disposable. One of the things that’s important about the FCC ruling is that this be some spectrum that supports low-power transmissions. So that means small batteries, small sensors, lower costs being supported.
You have to make trade-off decisions about transmission power and battery size and sensor sizes. This isn’t like the ubiquitous wireless technology like ZigBee or Bluetooth or things with WiFi. These things are high-resolution medical devices. We have to guarantee delivery point-to-point and we have to be able to scale it at an enterprise level for hundreds of patients simultaneously.
GE is well-suited to do this. We’re in this wireless telemetry space, we know about the technologies that are required and we’re fortunate to have the Global Research Center, the equivalent of Bell Labs, that brings kind of a horizontal view of technology. In other words, they bring technology from any industry and think creatively about how we can leverage those technologies — miniaturization, batteries, et cetera — into the medical space.
MassDevice: What’s the status of the FCC petition today?
DF: My understanding is that they’ve received feedback through their website. That’s one of the reasons we went public, to encourage more participation and support from clinicians. We think that they’re going to make a ruling in early 2010, but it’s not like they say, “We’re going to decide by a certain date,” because it could be an iterative process as they go out for comments and respond to comments.
MassDevice: Is there federal stimulus money at stake here, for example any ARRA provisions to support the development of wireless devices and the dedicated frequency in particular?
DF: Not that I’ve heard, but if you’ve got a lead let me know. There’s a lot on IT infrastructure and obviously this could link into that, but to be honest this is still really in the research phase. That’s why the partnership between GE’s monitoring business and global research center and some of these decisions by the FCC really need to get nailed down, so things can advance more toward the technical implementation and prototyping stage. But we’re not there yet.