Biomedical Sensors – Workshop I

This is a summary from the Foresight Workshop “Biomedical Sensors” in Copenhagen October 6th – 7th 2005.
Av Rita Westvik, Seniorrådgiver

A Nordic consortium headed by SINTEF (Norway) and with the participants VTT (Finland), FOI (Sweden), S-SENCE (Sweden), STC (Denmark) and MedCoast-Scandinavia is conducting a foresight study Foresight Biomedical Sensors.

The project is supported by the Nordic Innovation Centre. This workshop was the first in a series of four to be held as parts of the project. The workshop is also supported by the Danish Bio-Photonics network”.

The workshop attracted 40 people from Sweden, Norway, Finland, and Denmark. The participants represented a cross-section of the relevant sectors and industries covering research institutions, granting agencies, companies addressing the health care sector and health care practitioners.

The objective was to establish status, needs and perspectives for sensors in relation to health care and in particular the need for biomedical sensors.

Background

The health care systems of the industrialized countries are expected to undergo major changes within the next 10 – 15 years. The number of elderly people requiring treatment will grow considerably, so-called welfare diseases is increasing, and increasing use of new advanced treatments will occur.

This will require a more efficient health care system offering better services. A number of new health care technologies will emerge and several will be adopted by the health care systems.

The Workshop

This workshop addressed these topics in relation to the possible impact of biomedical sensors. The workshop consisted of two sessions with invited presentations covering needs of the health care system, assessment of health care technology, security and defense, commercialization of sensors and diagnostic equipment, and the technology of the sensors for the health care industry.

Group work was performed in relation to the following topics:

Home care:
What are the possibilities for home care diagnostics at present and in the years to come? (self testing, remote testing and control, the relation patient-doctor-hospital)

**Doctor’s office:**
Current diagnostic techniques at the doctor’s office. What will a doctor’s office offer in 15 years? (doctor’s office/offices, central vs. decentralized diagnosis and sensing, doctor’s office in a high tech health care system etc)

Hospitals:
Central diagnostic units versus decentralized (near patient testing and central labs, hospitals as surveillance centers, hospital vs. doctors office)

Defense and security:
The battlefield: Individual actors, whole theater.
Terrorism: Utilities, transportation, persons

The pharmaceutical Industry was originally included. However, it was found that only very few participants had adequate knowledge about the field and thus it was decided not to have a group assigned to this topic.

Despite this fact, the topic was discussed at the workshop and some conclusions emerged in relation to high-throughput screening.

The Program

Ingrid Storruste Svagård from SINTEF is the project leader. She gave an introduction to the project as a whole and introduced the subject in general.

Lars Lading chaired the workshop and gave an introduction to the workshop and presented a number of hypothesise concerning the future of health care that would have an effect on the need for and application of medical sensors.

Jens F. Rehfeld from Copenhagen University Hospital gave a presentation “The Hospital Laboratory of the future”, which described the current state of affairs and the future role and desired premises.

Two main conclusion emerged:

(1) Detection of molecular structures will become much more important for future diagnostics than what currently is the case, and

(2) the central laboratories are essential to the quality of diagnostics and the laboratories should be closely linked to research.

Especially the latter caused some discussion especially in relation to the subsequent presentation by Hindrik Vondeling from Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark on “Health technology assessment: an introduction with emphasis on the clinical and economic evaluation of diagnostic tests”.

The presentation included a discussion of formal methodology in technology assessments and discussions about how these are applied to the health care sector. The subsequent discussion revealed that many decisions are made in relation to perceived needs in a narrow context and may not comply with the general needs of a health care system.

Åke Sellström from The Swedish Research Defence Agency gave a presentation on needs and possibilities in relation to security and defence. The nuclear, biological and chemical threats were discussed.

The globalisation and the fact that many modern soldiers from affluent countries are and will operate under conditions and in an environment that are very different from those of the home countries.

This poses a number of both physiological and physical problems including exposures to a combination of unknown threats. It was discussed which biological and chemical substances that in this context are and will be necessary to detect and how this would have to be performed.

Both sensors “embedded” in the soldier’s uniform and remote sensing was discussed. It was emphasized that the area is very much controlled by politics and this also included funding of research activities. The US Homeland Security program was mentioned.

Ulf Jönsson is CEO of Cellectricon and former CEO of Biacore. Biacore is an example of a company that successfully has exploited a biosensing concept based on so-called surface plasmon resonance.

Ulf Jönsson gave a presentation on “Marketing Biosensors: Opportunities and Pitfalls based on real world experiences”. He described how the basic concepts had emerged, which applications were addressed and the relation to owners and investors.

An important comment was that current instruments are well suited for research and drug discovery. However, they are not suited for high-throughput screening. This is a costly and time consuming process in connection with drug development.

Lars H. Pedersen from Bioneer (a Danish research and consulting company owned by the Technical University of Denmark) gave a presentation of the technologies of sensors for medical applications. Current applications were presented, research activities were discussed and future scenarios were presented.

It was pointed out that there has been and are great expectations to the field. However, the have only to a very limited extend been materialized. It was pointed out that some of the same validation methods used for technology assessment could also be applied for validation of sensor signals.

The Group Work

In addition to the four main areas the groups were asked to address the following topics:

Market
Technology
Organization
Structure
Logistics
Ethical issues
Political issues

Some of the conclusions of the groups are as follows:

1) Home Care

The need for home care will increase drastically. This will necessitate an increased use of medical sensors, telemedicine, and remote consultation, diagnostics and decision making.

It is not obvious whether this development will increase or decrease the burden on the rest of the health care system.

Implantable devices where sensing and therapy are combined has a great potential, but poses a number of legal and ethical issues.

Equipment must be developed in the form of simple, robust, and reliable kits. The private market for health care services will most likely increase and health care and so-called well being will often merge.

The public system as well as individuals will have to face a number of difficult problems in relation to defining priorities.

The organization and market will most likely become more chaotic than what currently is the case.

Home care is currently the larges market for low-cost medical sensors and this will most likely also be the case in the future.

Cross-validation and consistency will be increasingly important with a growing market for home-care solutions.

2) Doctor’s Office

The General Practitioner medical doctor (GP) will face a more market driven situation. The patients will be more active and demanding. This calls for quicker and more reliable services, which again implies more “on the spot” sensing and diagnostics.

Screening of patients will be an increasingly important task.

Preventive health care will most likely become more important than it currently is. Insurance companies will play an increasingly important role even in countries with “social medicine”.

Tasks that are currently allocated to hospitals will be transferred to GPs.

It was also discussed if the GPs would become obsolete in relation to hospitals and home care. This would be very unlikely.

In relation to medical sensors GPs represents a very large potential market for low-cost reliable medical sensors.

Economic incentives is a main driver for change.

3) Hospitals

They should be more service and production oriented!

It was found that much work could be preferably be performed with dedicated non-research equipment.

Greater attention to individuals would be required in the future.

Point-of-care vs. central laboratories was discussed. Both would be needed in the future. However, more diagnostics must be performed at the point of care.

Increased skills in relation to so-called distributed diagnostics would become more important. Distributed point-of- care systems puts pressure on the user friendliness of the systems.

More…

Presentations from the workshop can be found here.