Fig 1. Revenues from digital health technology-enabled solutions and services in the U.S. will rise from more than $1.5 billion in 2010 to more than $5.5 billion in 2015. (courtesy of Delivering Quality Care to the Digital Home: 2010 Update, Parks Associates)
Fig 2. The Analog Devices AD9278 and AD9279 represent the fourth generation of an ultrasound AFE IC line. They integrate the company’s data conversion technology for low-noise TGC mode performance.
Fig 3. Targeting mission-critical applications, the Microsemi LXMG1645 quad-lamp CCFL backlight invertor will be used in complex LCD panels used in health monitoring.
Fig 4. Using Bluetooth 2.0 technology the Onyx II Model 9560 from Nonin Medical is the world’s first wireless fingertip pulse oximeter. Clinicians can use it to remotely monitor patients with chronic diseases such as chronic obstructive pulmonary disease, congestive heart failure, or asthma.
Fig 5. The Sony Ericsson Xperia is the first commercially available smart phone that can natively communicate with the low-power ANT+ network of health and fitness devices. The Texas Instruments WiLink 6.0 triple-radio single-chip solution enables the ANT+ connectivity.
Medical electronics now represents one of the fastest-growing opportunities for industrial semiconductors. It’s also a very demanding market, but it’s one of the few that vendors consider virtually recession-proof (Fig. 1). None of this has been lost on the major chip vendors and distributors.
Several companies, including Texas Instruments, Analog Devices (ADI), Microsemi, Freescale Semiconductor, Maxim, Vishay, and Honeywell, have created discrete business units with detailed medical solution guides that provide block diagrams and recommended parts for popular medical devices (see “Portable Medical Diagnostic Gear Looks To Analog Designers For Cures,” March 24, 2011, p. 32).
Microchip developed its Medical Design Partner Specialist program as an extension of its Design Partner service. Infineon Technologies has a similar program. The logos of Digi-Key, Mouser Electronics, and Arrow Electronics are also prominent on the medical market-focused literature of their chip vendor clients. And, ADI formed its Healthcare Group nearly three years ago—the first full-time segment organization the company established.
“The medical market continues to be a growing part of ADI’s business,” says Tom O’Dwyer, technology director of ADI’s Healthcare Group. He says the company’s focus is to fully understand its key customers’ design needs and then to leverage ADI’s breadth of core product technologies to provide the best solutions possible.
“We’re investing heavily to develop greater healthcare systems expertise. We want to be able to work more closely with our customers and provide them with the greatest possible benefits of cutting-edge silicon technology in their systems,” O’Dwyer says.
ADI has a range of products for the healthcare sector. Its ADAS1128 current-to-digital converter for CT scanners was unveiled in February 2009, which O’Dwyer points to as an example of the company’s ability to leverage its expertise in converters, amplifiers, and other monolithic technologies in a single chip.
In November 2010, ADI introduced the AD9278 and AD9279, which represent the fourth generation of an ultrasound analog front-end (AFE) IC line and integrate ADI’s data conversion technology for low noise time-gain-control (TGC) mode performance (Fig. 2).
In early March, ADI introduced a highly integrated, low-power RF transceiver for operation in the global 2.4-GHz industrial, scientific, and medical (ISM) frequency band for its ADF7241 portfolio. The device supports the IEEE 802.15.4 physical-layer (PHY) protocol at 250 kbits/s on a single chip.
ADI also recently announced the ADuM6000, which it calls the industry’s smallest isolated dc-dc converter. According to the company, the chip enables designers to free up circuit board real estate and eliminate the time-consuming step of securing medical and other safely approvals.
Future Growth
“The medical sector is one of our growth engines for the future,” says David Niewolny, marketing manager for Freescale Semiconductor’s medical business segment. “We are established players in networking, automotive, and consumer, but medical and metering are two key focus areas for growth in the next 10 years.”
Niewolny says that some medical subsectors and end equipment are expecting double-digit growth over the next two to three years. “We continue to see customer interest in integrated analog functionality within MCUs as well as standalone analog front ends for various applications,” he says.
Wireless technologies are also expected to have a bigger role in medical applications. Like most other major chip companies, ADI is investing in the development of wireless technology for medical applications, recently announcing the ADuCRF101 system-on-a-chip (SoC).
The ADuCRF101 integrates all of the RF transmit and receive functions, data conversion, and processing elements required to enable a fully programmable radio. The new device enables remote, wireless patient monitoring.
Freescale is focusing on two wireless technologies, ZigBee and sub-1-GHz, both of which are prevalent in medical apps. Freescale says it is currently the largest manufacturer of IEEE 802.15.4 silicon, which is the basis of ZigBee wireless technology.
ZigBee-enabled systems already are in place in group care facilities and hospitals. In 2009, the ZigBee Alliance and the American Telemedicine Association (ATA) agreed to establish a liaison relationship that focuses on the abilities of ZigBee Health Care, an open standard, to bring secure wireless monitoring and management to noncritical, low-acuity healthcare and wellness services.
The popularity of the ZigBee Health Care standard has quickly begun to fill the needs of the telehealth and wellness communities. The Continua Health Alliance, a non-profit, open industry organization of more than 240 healthcare and technology companies, adopted ZigBee in June 2009 as its next-generation wireless system (see “Better Medical IC Technology Gets Ready To Make House Calls,” March 24, 2011, p. 24).
Freescale’s sub-1-GHz technology is mainly used in custom MCU solutions where a simple very low-power, low-data-rate connection is needed. Freescale also has devices in the medical implant communications service (MICS) band (402 to 405 MHz) as well as in the ISM band (433 to 434 MHz) for medical device customers. Niewolny says the company will soon be promoting sub-1-GHz standard products.
Microsemi says its products fit best in clinical and diagnostic and imaging applications where small form factors and power savings are essential, using its FPGAs to offload the processor, freeing it to perform other functions to save power. FPGAs are also used in imaging applications such as robotic arm consoles in robot-assisted surgery to perform system monitoring functions like voltage, temperature, and current and feed data back to the processor for decision-making.
Microsemi’s newest medical device, introduced in March, is its LXMG1645 quad-lamp cold cathode fluorescent lamp (CCFL) backlight invertors (Fig. 3). Designed for mission-critical applications, the invertors will be used in complex LCD panels used in health monitoring.
The Distributor’s Role
Increasingly, franchised distributors have set up their own internal groups dedicated to the healthcare market, staffing them with field application engineers with supporting technical literature and webinars.
“We are seeing more manufacturers focusing on the medical industry,” says Kevin Hess, vice president of technical marketing at Mouser Electronics. “The demand for all types of medical devices continues to rise dramatically.”
Several factors are contributing to the demand, says Hess. Besides an aging population and advances in technology, more medical institutions are moving away from single-source solutions to purchasing from multiple suppliers, creating many new opportunities for medical equipment manufacturers.
“Being a broad line distributor, we see all types of products and parts targeted for the medical market,” says Hess. “Even more interesting, not only are chip manufacturers focusing on medical, but sensor, power, resistor, and capacitor suppliers are also recognizing new opportunities” in this market.
In April, Mouser is releasing the first of a four-part series of newsletters and application sites on a variety of medical equipment. These newsletters will feature the latest market information and trends, as well as the newest products from its suppliers directly supporting a specific end equipment category and new applications.
Another key role played by distributors is helping manufacturers avoid costly redesigns, manufacturing delays, or project termination from using end-of-life (EOL) and obsolete components in new designs.
“In fact, obsolescence is a huge issue for medical design engineers,” says Hess. “The design cycles are generally much longer due to stringent regulatory approvals. Keeping them informed of EOL products is an invaluable service that helps in speeding their development process.”
Portable Ultrasound
ADI, like Texas Instruments and several other chip houses, is already an active supplier in medical imaging. “We also see a lot of potential in the medical imaging markets, particularly in the ultrasound area,” says ADI’s O’Dwyer. “There has been a surge in new handheld ultrasound products from companies like GE and Siemens.”
Minal Sawant, product marketer for medical military and avionics in Microsemi’s SoC Product Group, says that in imaging applications, the trends are portability (critical at several levels, including accelerating the turnaround time of diagnostics), speed, accuracy of results, and integration with wireless connectivity.
In February, the U.S. Food and Drug Administration (FDA) cleared a diagnostic radiology application for mobile devices. The new mobile app allows physicians to view medical images on Apple’s iPhone and iPad.
The application is the first cleared by the FDA for making medical diagnoses based on computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine technology, such as positron emission tomography (PET). As the FDA makes clear, this approval is not intended to replace radiology workstations, but the app can be used when there is no access to a workstation.
At about the same time, Fujifilm Medical Systems USA said it was adopting Synapse Mobility to enable remote access to Fujifilm’s suite of Synapse products for mobile devices and Mac or Windows-based PCs.
“These \\[portable ultrasound\\] devices are opening up new modalities for medical treatment. For example, it is conceivable that these devices could be used to give fast feedback on suspected fractures at sports games, without the need to travel to a hospital,” says O’Dwyer.
While admitting that these devices may be less sophisticated than their larger cousins, O’Dwyer expects to see improvement with the Moore’s Law progression of semiconductor processing and increased levels of automation that would reduce the skill level required by the operator to the point where they may become a mainstay tool of the trade for every medical practitioner.
Another important aspect in clinical types of equipment is immunity to single-event upsets in electronics. For example, where there is a radiation source such as in oncology equipment, electronics must be immune to upsets. Sawant says Microsemi’s FPGAs, which are flash- or antifuse-based for configuration or connection elements, are immune to these types of upsets, eliminating any need for redundancy.
Emerging Trends
As healthcare shifts toward home-based applications, ADI expects to see increased computing power and the smaller size of electronic components making it possible to design medical devices for consumers that are smaller, mechanically simpler, and increasingly more powerful. In fact, the need for home-based patient monitoring systems is expanding along with the number of aging baby boomers who require home care.
“We see wireless connectivity within the medical industry as a strong trend,” says Mouser’s Hess. “In fact, we have seen reports that within the next five years, roughly a third of patient body monitors will use some sort of wireless technology.”
There are also emerging developments in power efficiency. “While batteries are the staple for portable power, there are also recent developments in thermal or piezo energy harvesting for powering patient monitoring sensors and low-power RF transmitters,” says Hess.
There’s a growing trend toward joint ventures among chip vendors and medical hardware specialists to develop new systems that meet medical market requirements as well. Intel and General Electric have started a joint venture called Intel-GE Care Innovations to develop home-based healthcare technologies. The venture is already marketing the Intel Health Guide, a home monitoring system that helps doctors remotely management patients’ care.
National Semiconductor is working with Siemens Medical Solutions USA to create ultrasound systems with enhanced image quality and 3D/4D imaging capabilities. Siemens says the emphasis will be on consuming less power to meet the increased demand for portability and performance. And STMicroelectronics very recently announced that it will produce the iChip microprocessor for the LifeNexus Personal Health Card, which uses the iChip for securely maintaining individual personal health records.
Wi-Fi & Bluetooth
The Wi-Fi Alliance and Continua have agreed to facilitate and promote the adoption of Wi-Fi networking technology in connected health applications. The agreement enables cooperative efforts for joint technical review of Wi-Fi Alliance and Continua specifications and guidelines to facilitate interoperability between personal health and fitness applications. It comes as Wi-Fi becomes standard in hospitals, doctor’s offices, and healthcare facilities and as Wi-Fi is increasingly being used to connect patient monitoring devices.
The Bluetooth Special Interest Group (SIG) decided in 2006 there was an opportunity for its technology in healthcare applications.
“When we first started out, I wasn’t sure where we could take this,” says Bob Hughes, chair for the Bluetooth SIG Medical Device Working Group. In fact, the Bluetooth group initially envisioned apps in chronic disease and health and wellness management.
“As it turned out, there was a huge level of interest in consumer health care as opposed to strictly clinical/medical applications, like devices you might see if you were in a hospital. They were concerned about liability issues and didn’t want to interoperate with someone else’s device,” Hughes says.
But many of the group’s members were very interested in laying out some standards for healthcare devices. “They felt that there was a healthcare revolution underway and, with the technology, we were in a position to do a lot of things,” says Hughes.
One of the advantages of Bluetooth is its low-energy requirements. It now has to compete with the iPod and similar products, though, which has redirected Bluetooth toward fitness applications where users can monitor their goals by tracking health data during a workout with a variety of Bluetooth sensors. One sticking point is that the product introduction process has been slowed in clinical applications where companies face regulatory issues, such as FDA approval—or the foreign equivalent.
The Bluetooth SIG medical group is now focused on developing profiles that support different consumer healthcare fitness devices. “That’s the bulk of my work now,” says Hughes. The first product the group will support will be a Bluetooth-based thermometer, which will actually be the jumping off point—a “framework” as Hughes calls it—for several other Bluetooth home healthcare products, such as blood pressure, weight scale, and body composition analyzers.
The products demonstrated at the 2011 International CES’s Digital Health Summit in January included a Bluetooth blood pressure cuff and weight scale from A&D Medical and a Bluetooth pulse oximeter from Nonin Medical (Fig. 4).
Since then, ANT Wireless, a division of Dynastream Innovations Inc., and Texas Instruments have begun promoting their role in the Sony Ericsson Xperia (Fig. 5). According to the companies, the Xperia is the first commercially available smart phone to natively communicate with the low-power ANT+ network of health and fitness devices. The ANT+ connectivity is enabled by the Texas Instruments WiLink 6.0 triple-radio single-chip solution.
Any Downsides?
Despite the medical market’s current strength, industry analysts have a few concerns about potential long-range market issues.
UBM TechIinsights, a professional services and intellectual property (IP) management specialist, warns that the convergence of consumer medical device and smart-phone technologies will impact revenues, design strategies, and IP management for medical devices in the same way it has for many consumer products, including cameras, GPS devices, and personal media players.
“The question for traditional medical device companies is whether the designers, marketers, and IP staff have factored the smart-phone platform into their thinking,” says Jeff Brown, vice president of business intelligence for UBM.
“Smart phones provide medical technology companies with unprecedented access to an enormous consumer market,” Brown says. “To capture this opportunity, they must think carefully about how they develop new technologies and protect their intellectual property innovations. Otherwise, they face the same fate as makers of standalone GPS and MP3 players—a slow decline to obsolescence.”
Brown says that the smart phone’s ability to be always at hand and ready to use at all times gives it a huge market advantage. “Over time, medical technology innovations improve the precision and reliability of implementations on smart phones so that they rival or, when combined with apps, even surpass standalone devices,” he says.
Standardization may be another long-range issue. “Based on my research of healthcare technology, I envision that wireless radios will play big roles in many aspects as consumers pursue healthier options,” says Harry Wang, who studies the consumer electronics sector for Parks Associates.
The underlying challenge that accompanies this vision, he thinks, is the number and different types of radios that will be needed to fill this market space, which Wang says begs the question: “Which radio technology will serve the digital health space?”