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'Consumerism of healthcare is driving semiconductor manufacturers towards medical devices'

Semiconductors have revolutionised the medical device landscape. From a top end hospital CT machine driving for better image quality, to a heart rate monitor talking to a mobile phone, it is semiconductor advances which have enabled the envelope to move forward, and will continue to do so for the foreseeable future. Tom O’Dwyer, Director of Technology, Healthcare Group, Analog Devices explains these concepts to M Neelam Kachhap

Why are semiconductor makers looking at medical devices as the next big opportunity?

Tom O’Dwyer

Traditionally medical devices have been expensive and only sold to clinics and hospitals. The trend today has shifted from healthcare being delivered in hospitals to more home-based care. This is driving the need for smaller and more compact monitoring devices such as vital signs monitors. This migration will drive up unit volumes by several folds and hence justifies IC solutions which are more tailored to the particular application. The phenomenon is also referred to as ‘consumerism of healthcare’.

The rise of the mobile phone as a healthcare platform is a key driver. Several medical device companies have released add-on modules to mobile phones which provide functionality similar to hospital equipment but are targeted for the consumer. Although lower in performance, these devices will also drive up volume.

Thirdly, the move towards ubiquitous wireless connectivity is driving up volume. The advent of Bluetooth 4.0 SMART standard has been a key enabler to new wrist- or arm-worn monitors which talk to mobile phones in a very energy-efficient manner.

Choosing a chip to design a medical device is a complex process. Kindly comment.

The task can certainly be complex, since it depends very much on the function of the medical device, and in particular the grade level under FDA (US) guidelines. Devices which are designed to support life-critical functions require extremely high reliability, and it is important to select a product which matches this need. Failure to do so could result in litigation which could cripple the supplier, or result in halted shipments if problems are found.

Device longevity is another serious consideration. Medical equipment will often have a useful life of 15 years or more, and in today’s fast-changing process migration following the Moore’s Law curve, this can be a problem of ensuring long term supply of the IC solutions used in the medical equipment. So it is important to work with suppliers who can support these life cycles, like those who service into the industrial and avionics markets, which have similar longevity issues.

Size can often be another concern, especially for implanted devices. Very often this drives the medical device designer down the ASIC path, which can be very expensive and takes time. The task is getting easier though as more suppliers develop more targeted healthcare chips, which lower the power and cost for these applications.

What should a designer expect from a semiconductor supplier?

These days, before designing any new equipment, it is worth checking around with all the suppliers focused on the medical market to check for their latest offerings. Newer and more tailored designs are coming on-stream all the time, such as Analog Device’s ADAS1000, complete single chip ECG measurement system. Many of these devices are complete hospital-quality measurement systems, and considerably ease the burden of system design. The ADAS1000, for example, contains fully integrated detection of pacemaker rules, and can even measure respiration, features which are found in high end hospital equipment.

Also with regard to expectations, several suppliers who are focused on the medical market have dedicated applications teams who understand most of the major equipment types to a deep level, and customers can now expect a very high standard of support.

How does advances in precision analog components help medical device manufacturers?

The components are becoming more sophisticated these days, with higher levels of integration, at least for the standard medical functions, and as a result, overall performance can be greatly improved due to removal of parasitics due to PCB routing, cabling, etc. These new generation of devices considerably ease the problem of the hardware design, and result in lower development costs and time to market. It leaves the equipment designer free to focus on the software and algorithms, which is typically the added value in many cases.

On–chip integration of analog functionality provides many system cost benefits. Kindly comment.

The major cost benefits relate to both reduction of development cost and also lower per-unit cost. Typically the devices contain many integrated functions, thus shortening the design time. But in addition, the size, weight and power of the final system design is often smaller, and each of these drive down the per-unit cost. For example, ultrasound systems have been cart-based, and rather clumsy to move around a hospital. Thanks to integration innovations such as Analog Device’s AD9278, ultrasound systems are getting smaller and even handheld versions are now available.

Tell us about ADI’s single chip solutions for integrating front-end A/D functions?

Some of the single chip or single package solutions from Analog Devices that integrate the entire signal chain are:

  • ADAS1000:  Low power , 5-electrode electrocardiogram (ECG) analog front end with respiration measurement and pace detection
  • AD8232:  Single lead heart rate monitor analog front end
  • AD9278/9: Ultrasound AFE
  • ADXL345/62 3- Axis digital accelerometee for fall detection and movement detection as an auxiliary to any physiological measurement

Many other solutions are currently in development and will be announced in the next few quarters.

What do you think about Indian medical device manufacturers?

Our estimate is MNCs today control 70-80 per cent of the market in terms of revenue and Indian manufacturers the rest. While MNCs control a significant portion of the imaging market, patient monitoring systems have stiff competition with strong Indian players, MNCs and cheaper Chinese imports, while home health is controlled by MNCs again. Few Indian manufacturers are strong contenders internationally and there are several across West and North region doing smaller volumes.

Most MNCs now are doing substantial amount of their product development in India. While originally they started re-designing existing equipment to reduce costs for the local market catering to India and other BRIC countries, now they are doing complete designs of their own. We are seeing more and more Indian-designed equipment finding its way into mature markets such as US, Europe and Japan. Design houses in India have emerged strong in the sub-contract design space, particularly for vital signs monitoring equipment. They have matured from a software-only model, to full turn-key solutions providers, and several design houses are now established world players doing more and more of the R&D work for global medical electronics companies.

How is ADI helping shape the medical device landscape in India?

ADI continues to grow in India through its design centre in Bangalore. This group has worked on some of our new generation components aimed at healthcare markets, and is likely to see an expanding role in the future. We continue to monitor the Indian market closely as it is one of the fastest growing in the world, and we continue to build relationships with the key design companies there, with the help seminars, training and direct support to the designers through our medical electronics system experts.


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