Medical MEMS – Understanding the Healthcare IndustryPosted by Sam Bierstock, MD, BSEE on Apr 26, 2013 in MEMS Forum
As Healthcare has been thrust into the digital world, and as the Medical MEMS Technology industry’s interest in healthcare grows exponentially, many issues pertaining to the accumulation of healthcare data have come to light. These include privacy and confidentiality, sharing of data, use of accumulated data for epidemiological purposes, development of quality of care issues, protocols and guidelines, etc.
While the ability of MEMS devices to deliver data is of great value to analysis and quality of care determinations, it is important to define the additional value offered for clinical decision making. Anyone entering the Medical MEMS Technology arena must have a clear understating of the best use of the data to be generated and to whom it will be most useful.
Generating reports is one thing. Receiving, analyzing, selecting key elements and basing decisions on a constant stream of data is something else. Clinicians are busy, pressured and constantly multitasking. While non-clinicians may gain some insight into physician workflow, unless you have been in the trenches of clinical care delivery, it is not possible to understand physician “Thoughtflow™”. I first defined clinical Thoughtflow™ a decade ago as the process by which physicians and other clinicians access, assess, prioritize and act upon data. Thoughtflow™ differs by specialty and indeed, by individual. A cardiac surgeon has little analysis to do when receiving an alert from an intelligent coronary artery stent indicating a drop in flow through the device. On the other hand, an internist may have to take a fair amount of time to review a report with a cascading stream of blood glucose levels over a lengthy period of time, and relate the results to eating and medication patterns for a diabetic patient. The risk of overwhelming the clinician in such an instance is substantial.
While the MEMS technology industry has clearly found the Healthcare Industry, the reverse is not true. The mainstream medical informatics world is just beginning to grasp what is out there — and when a full comprehension of MEMS capabilities is achieved, the demand for medical MEMS devices will be staggering. The medical and research communities are highly creative, and the request for function-specific medical MEMS devices is likely to soon outpace the industry’s ability to produce them. The FDA is likely to make the process of meeting demand even slower — especially for implantable wireless devices. As a medical informaticist with more than 30 years in the informatics world, I am still stunned by how few of my colleagues even know what MEMS devices are.
But I have seen this movie.
I tried to convince people about the potential for Internet-based medical records and the need for security of private healthcare information in the mid-1990’s, but it took another 10 years for information to begin to move on to the Internet and into the cloud. I tried to convince a major (and then very young) cell phone manufacturer of the enormous potential for hand-held devices in healthcare in 1998. I was thanked and wished a good day. Healthcare is a sluggish industry, steeped in stagnation and inertia, and deeply immobilized by the endless crises of the moment. It has a difficult time differentiating fads from trends. Millions are spent and made on fads. Positioning for trends rarely extends to what is coming next — let alone what is coming after what is coming next. Governmental regulation and reimbursement challenges make maneuvering for survival a necessary primary priority.
It is also an industry that wallows in what it has to deal with at any given moment. Spending money on what may be coming is rarely on the radar.
Knowing how to position a medical MEMS device so as to highlight the value of its data-generating capability and its clinical pertinence is of paramount importance to success. This requires an intimate understanding of the issues that keep C-level decision makers awake at night, of healthcare practices, of clinical decision-making, of current policy-shaping legislative mandates, and of the fiscal pressures to which providers are subjected at every level. The healthcare industry is like no other industry, and the side of the road to gaining a foothold is littered with the failed remnants of businesses of all sizes — from start-up companies to multi-billion dollar corporate entities — who thought that their conventional “business smarts” would assure success.