Seeing Into the Future:
Medical Imaging and Diagnostics Guide Advances in Healthcare
By Jenny Bieksha, Bishop & Associates Inc.

Several factors are predicted to influence the growth rate of the medical electronics market: an aging population, rising health care costs, a shortage of healthcare professionals, and the merging of IT with medical devices and technologies. There will be a pronounced need for in-home medical diagnosis and treatment in our homes, especially in remote and emerging regions. In nearly all industries, the technology trend is to build a smaller, faster, higher quality product. In addition, new medical market applications are driving a need for higher resolution, higher density, data security, and miniaturization of connectors.

The medical electronics market for connectors is made up of many different segments, each with its own particularities, growth rates, and trends. To date, most equipment in the healthcare industry has fallen into two categories: medical imaging and diagnostic. The size and footprint of these devices and the technology used becomes increasingly complex. Emerging medical products will be thinner, lighter, and more flexible, with increased emphasis on patient comfort. These next-generation products will combine biological and electronics systems into smarter devices with connectivity and comfort central to their design.

Hospital-based patient monitoring systems are being supplemented by portable versions operating in the home. These devices may feature integrated telemetry capabilities that allow a physician or nurse to continually monitor blood glucose, pulse, and pressure levels. Handheld devices can check blood pressure, blood oxygen, and sugar levels. Wearable monitoring devices not only record data 24/7, but also wirelessly transmit it to a remote doctor for analysis. The use of these consumer devices is driven by insurance companies that are looking for ways to minimize costs and by patients, who are seeking more control and a normal lifestyle.

Technology Driving Market Growth
The medical imaging segment is poised for a major new phase of growth. Coming changes will be fueled by the availability of new technology coming from the digital information segment and by the Baby Boom generation. As this population segment ages, patients will bring new demands to the marketplace. There will be a steady increase in demand for medical imaging services, along with pressures to improve the quality of healthcare delivered in the home. Of course, there will also be pressure to bring down costs. Continuous improvements in technology are resulting in a growing number of new imaging tests that combine high levels of accuracy with rapid, easy-to-use product formats.

There is little doubt that electronic devices have played a major role in the diagnosis and treatment of injury and disease. Doctors are now able to detect tumors at their earliest stages, while precisely controlled beams of radiation can target very specific areas with minimal harm to surrounding tissues. MRI and CT scan equipment can visualize bone and soft tissue with amazing clarity, allowing physicians to diagnose the extent of a problem without invasive surgery. Ultrasound scans can determine the sex of a baby within weeks of conception, as well as identify medical conditions that can benefit from early intervention. Implantable devices such as pacemakers can monitor and correct irregular cardiac rhythms.

Equipment manufacturers are being challenged to design devices that ensure the same clinical functionality but are smaller, easier to operate, simple to maintain, and often portable, and lower costs. Launch of the new fourth-generation network from cellular wireless companies will enable radiologists to upload and download images more than 10 times faster than they have been able to in the past. While wireless mobile applications for imaging are still a distinct minority, the faster speeds could open the door for preliminary reads or image demonstrations on smartphones and iPads. Consumers have come to expect intuitive, user-friendly products, which will require the development of smart devices that automate many of the functions previously provided by trained medical personnel.

The growth in medical imaging can be attributed to its transformational effect on medicine for almost every facet of every disease. The best means to reduce costs and overuse is by creating a more efficient healthcare system through healthcare information technology and to manage medical imaging utilization through physician-driven guidelines. The integration of imaging with therapies to provide more minimally invasive options is also emerging as a major trend. Integrating imaging with the therapy enables patients to leave the hospital faster than ever before. While there is a large investment in technology up front, it decreases costs over the long term.

Today, the continued integration of technology is showing much promise. One interesting development in the diagnostic imaging area is the merging of Positron Emission Tomography (PET) with Computerized Tomography (CT). Advances in MR-PET systems in combination enable images to be seen that have never been seen before simultaneously. Another area showing promise is functional MRI, which can enable advances in diagnostics for diseases such as Alzheimer’s and other diseases that are becoming more prevalent with an aging population.

When processed together, the combined modalities result in a dramatic gain in diagnostic power. The signal processing demands also increase dramatically; necessitating the use of high-performance backplane interconnects. New designs, particularly PET/CT and SPECT systems, employ standards-based, high-performance switch fabrics and embedded multi-core processors. Interface protocol include 10 gigabit Ethernet XAUI, gigabit Ethernet, fiber channel, or IEEE 1394B.

Imaging Equipment and Applications
PET (Positron Emission Tomography) is a non-invasive diagnostic technology that produces physiologic images based on radiation emissions from the body. A PET scan uses radiation, or nuclear medicine imaging, to produce three-dimensional, color images of the functional processes within the human body. The machine detects pairs of gamma rays that are emitted indirectly by a tracer that is placed in the body on a biologically active molecule. The images are reconstructed by computer analysis. While other imaging techniques—such as X-rays or CT scans—provide anatomical information about the way organs or tissues look, a PET scan shows what the cells in those organs or tissues are doing.

CT (Computerized Tomography) is a medical imaging technique that produces three-dimensional images of internal human body parts from a large series of two-dimensional X-rays taken in a single-axis rotating structure called a gantry. The introduction of portable CT scans has enhanced access and availability of the diagnostic imaging modality. The most significant increase in the CT segment can be seen on the cardiac imaging side attributed to increased use in emergency medicine, perfusion studies, and CT angiography.

X-rays consist of high-energy radiation with waves shorter than those of visible light. X-rays possess the properties of penetrating most substances, acting on a photographic film or plate, and causing a fluorescent screen to give off light. Portable X-ray machines are used on battlefields, in rural communities, nursing homes, prisons, and morgues. The units range from handheld units to slightly larger, yet still easy to carry, box-like units that can be transported in the back of a van, to stand-alone units that are wheeled from one place to another in a hospital.

MRI (Magnetic Resonance Imaging) is a non-invasive diagnostic technology that produces physiologic images based on the use of magnetic and radio frequency (RF) fields. Unlike X-rays or CT scan, MRI scan does not use radiation. MRI scans are painless and safe without any major side effects. Small, dedicated orthopedic scanners have developed to scan knees, wrists, feet, and ankles, allowing scans in orthopedic clinics. Connector manufacturers have made excellent use of standard modular inserts to address not only the complex interconnection needs of the MRI patient coil application, but also the important aesthetic needs. Due to the complexity and mix of signals, custom interconnects are often required.

Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures. For several decades now, ultrasound has been one of the mainstays of medical imaging and a major tool for primary diagnosis. The development and evolution of hand-carried ultrasound has had the broadest impact in expanding the clinical applications of ultrasound, by moving ultrasound out of the imaging lab and bringing it to point-of-care applications in a variety of hospital and non-hospital settings. A new area of research is the development of ultrasound imaging combined with heads-up/virtual reality-type displays that allow a doctor to “see” inside you as he/she is performing a minimally invasive or non-invasive procedure, such as amniocentesis or biopsy.

Diagnostic Equipment and Applications
Patient monitoring is vital to care in operating rooms, emergency rooms, intensive care units, and critical care units. Patient monitoring products measure, display, and document physiological information obtained at regular intervals over time from sensors attached to the patient or other input devices. Measured parameters include electrocardiogram (ECG), invasive and noninvasive blood pressure, pulse rate, pulse oximetry, body temperature, respiration rate, end-tidal CO2, and other specialized parameters. There are special patient monitors for several applications, such as anesthesia monitoring, which incorporate the monitoring of brain waves. They are usually incorporated into anesthesia machines. In neurosurgery intensive care units, brain EEG monitors have a larger multichannel capability and can monitor other physiological events.

Technological improvements are helping to meet the demands of an increasing number of patients, and have helped reduce the need for healthcare professionals at the bedside of the patient all the time. By reducing the length of time a patient stays in the hospital, remote patient monitoring helps control healthcare costs. Remote monitoring of older patients in homecare settings will be an important part of keeping future healthcare costs down, not to mention raise quality of life for seniors. 

An important trend is the need to wirelessly network healthcare equipment to provide better information to the clinicians providing care. Patient-monitoring equipment is going the way of most information technology equipment with a focus on networked equipment, rather than standalone monitors and wireless transmission of data. Much of the drive toward wireless networking is related to the increased focus on electronic medical records and paperless record keeping.

ECG (Electrocardiograph) is used to monitor the electrical activity of the heart and is the most common form of monitoring. Monitors are deployed throughout the clinical environment: at the bedside, in operating rooms, ICU/CCU environments, catheter labs, and maternity wards. Portable heart monitors exist in several configurations, ranging from single-channel models for domestic use, which are capable of storing or transmitting the signals for appraisal by a physician, to 12-lead complete, portable ECG machines that can store for 24 hours or more (Holter monitoring devices). There are also portable monitors for blood pressure and EEG.

Another device that has seen great strides in miniaturization is the pulse oximeter. This device is designed to measure the oxygen-carrying status of the blood and is a widely used diagnostic in hospital care. Miniaturization in this area has been greatly aided by the availability of LEDs (light-emitting diodes) with the required wavelengths. Some SpO2 monitors are available with internal memory and/or wireless data transmitters, and may be used easily at home by patients without the help of a caregiver. Monitors are rechargeable via wall plug or USB-port charging.

Large Imaging Devices Require More Computing Power
With so much focus on device miniaturization, there is a tendency to lose sight of other medical technology needs. The opposite end of the medical design spectrum includes hospital records systems, or large imaging applications such as room-sized MRI or scanning machines, which are more sophisticated and powerful than tiny, portable medical devices. These large devices are part of the trend in increasing computing power and remain unaffected by the movement for smaller designs. This trend is especially critical for the growing number of medical applications that rely heavily on image processing.

There is a need to develop more powerful imaging capabilities in order to increase both early diagnosis and diagnostic accuracy. The challenge is to develop devices that can address the immense processing power required for current and future imaging applications. This issue is especially important as images are expected to be clearer and more precise than in the past.

Larger scale systems will also continue to improve performance, with increased computing power, speed, and reliability based on processor advancements. Moving forward, technology will continue to enable a new level of care, playing a key role as service providers’ work to improve both efficiency and standards of care. With backplane performance hitting the limitations of standard architectures, there is a demand for connector technologies that offer higher performance. Connectors must address the I/O density challenge, as well as contact density, signal integrity, shielding effectiveness, ease of use, ease of cleaning, reliability, and aesthetics.

Long-Term Outlook
The medical device market experienced an economic upswing in 2010. Despite pressure to reduce costs on high-tech products and the uncertainty about future reimbursement policies, medical device companies continue to develop new devices and upgrades that allow price increases and sizeable profit margins. Sustaining innovation, delivering stronger value propositions, and fueling long-term growth will challenge the medical industry moving forward. The long-term outlook for the medical electronics market remains highly encouraging for those companies who proactively realign their strategies in recognition of these challenges.

Director, Renewable Energy, Medical, and Test, Measurement, and Instrumentation, Bishop & Associates Inc. Jenny Bieksha joined Bishop & Associates in 2008 as its market segment director for the renewable energy, and the test, measurement, and instrumentation markets. She is currently a management consultant specializing in strategic business planning, with an emphasis on the development of program, market, and product plans. Bieksha has more than 20 years of experience in the electronics industry, with a background in market management, business development, channel sales, product management, and operations for ITT Corporation, Delphi Connection Systems, and Hughes Aircraft Company. Bieksha has a bachelor of science degree in marketing from the University of Wyoming, and has since received her certificate as a project management professional.