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‘Tricorder’ enables patients to diagnose 15 illnesses

By Jerry Zeidenberg

The Qualcomm Tricorder XPrize competition, an international quest to develop a portable device that can diagnose 15 ailments in a package weighing less than 5 lbs., will announce a winner in January 2016 – and a Canadian company is one of the 10 companies in the running.

The competition, named after Star Trek’s famed Tricorder that could diagnose medical problems, was launched three years ago and testing of final products begins this May. The winner will take home $7 million, while those in second and third place will wind up with $2 million and $1 million. (http://tricorder.xprize.org/about/overview)

“We’ve got a very good shot at winning,” said Robert Kaul, CEO of Cloud DX, which does the majority of its research and development in Canada. “But we’re using this competition as a springboard to create usable products.”

The company has a core staff of seven in product development, sales and marketing, and has offices in Kitchener, Ont., and Brooklyn, N.Y. It has also contracted another 40 technologists to help further develop the Tricorder XPrize product.

Cloud DX already produces and sells a $199 health monitor, named Pulsewave, that uploads results into the cloud for easy sharing among caregivers and family members.

The Pulsewave cuff is FDA cleared and licensed by Health Canada to measure blood pressure, heart rate and heart variability. In Canada, over 45 clinicians are using it to screen their patients, and five pilot projects across the country are validating and helping to further refine the technology. The pilots are located in Ontario and New Brunswick.

As part of the XPrize mission, the company is engineering a new, wearable vital sign monitor, called Vitaliti, which goes much further, measuring ECG, heart rate, heart rate variability, oxygen saturation, respiration, core body temperature, blood pressure, movement, steps and calories. It is expected to be commercially available in 2016 at a price of $349.

The company calls it the “most comfortable wearable ever designed. So light you can forget you are wearing it. Designed to be worn continuously for up to three days … and to not make you look like a robot!”

It, too, uploads results to the cloud for processing, storage and easy sharing of the data.

And a third technology combines the Vitaliti necklace with a device capable of analyzing blood and urine specimens in less than 10 minutes. Using a wireless camera and specialized software, it will also be able to detect skin lesions, and by attaching a small instrument, it will be able to assess lung function.

This expanded version of the Vitaliti is now being tested by Cloud DX before sending it off to the Tricorder XPrize competition. “We’ve created software capable of diagnosing all 15 medical problems,” said Kaul. “We’re now refining the prototype and doing the fine-tuning.”

Those 15 medical problems include anemia, atrial fibrillation (AFib), chronic obstructive pulmonary disease (COPD), diabetes, hepatitis A, leukocytosis, pneumonia, otitis media, sleep apnea, stroke, tuberculosis and urinary tract infection.

As well, the device must be able to diagnose three of the following: Allergens (airborne), cholesterol screen, food-borne illness, HIV Screen, hypertension,
hypothyroidism/hyperthyroidism, melanoma, mononucleosis, osteoporosis, pertussis (whooping cough), shingles and strep throat.

Finally, to qualify for the Qualcomm Tricorder XPrize, the device must also be able to determine vital signs: Blood pressure, heart rate, oxygen saturation, respiratory rate and temperature for 72 hours without discomfort to the user.

What sparked the competition?

With skyrocketing medical costs and a shortage of medical professionals in many regions, it’s believed that a point-of-care device capable of accurately measuring vital signs and diagnosing serious ailments would help control costs and improve care.

As well, a portable device would do wonders in war-torn regions and remote countries beset by natural disasters, such as earthquakes and hurricanes. Indeed, Cloud DX was co-founded by Dr. Sonny Kohli, an intensive care physician at the Oakville Trafalgar Memorial Hospital, near Toronto, who volunteered his services in Haiti after the earthquake devastated the country in 2010.

Dr. Kohli found that point-of-care diagnostic devices would have been a godsend in such circumstances. The experience led him to launch Biosign Technologies, a company producing portable medical devices able to deliver quick and accurate vital signs and diagnoses, and the forerunner of Cloud DX.

The organizers of the XPrize competitions came up with the idea of awarding a large sum to a company that could produce an easy-to-use, effective and accurate device that enables consumers to diagnose their own medical problems. The Qualcomm Life Foundation, which is heavily involved in developing e-health solutions and investing in the innovations of others, was enlisted to sponsor the $10 million contest.

While there are myriad point-of-care medical devices on the market today, most are single purpose. For example, a patient must wear a cuff for blood pressure, another device for pulse and blood oxygen, and must turn to other point-of-care devices for analyzing urine and blood. (In truth, portable lab test devices of this sort are just entering the marketplace.)

“Medical devices, whether they’re for the consumer or in hospital, usually do just one thing,” said Kaul. “And they don’t talk to each other.”

Moreover, the results are often not readily available to all healthcare providers, so nurses and doctors tend to take readings over and over again.

By contrast, Kaul believes the cloud-computing approach of his company will solve the communication problem. And by putting 15 or more tests in a single box, it will produce a powerful diagnostic device.

“We’re pushing the boundaries of what can be done in a self-contained system, in a short period of time,” said Kaul.

A key factor is usability, as the Tricorder XPrize organizers insist the device must be easy to use.

And as a consumer device, cost is another big factor. Kaul believes his firm has an edge here, too, as the cloud strategy is a huge advantage. Not only does the cloud enable medical professionals to obtain quick and easy access to results, but the processing of medical data can be done centrally by powerful computers instead of inside each and every point-of-care device.

“If you upload to the cloud, you cut the cost by 90 percent,” said Kaul.

Finally, the results have to be extremely accurate. A good portion of the Tricorder XPrize evaluations will deal with the clinical accuracy of the 10 devices in the competition.

Cloud DX is benefitting from the input of medical advisors and clinical trials. One of the trials is being conducted in Saint John, N.B., where a test is taking place under the direction of Dr. Keith Brunt, an assistant professor at the Dalhousie University School of Medicine and Director of Community Engagement and Innovation Development.

Dr. Brunt explains that most consumer medical devices are not clinically accurate, and instead are for “entertainment purposes only.” With that in mind, the Saint John trial is determining how accurate the Pulsewave cuff is when measuring blood pressure, and how useful it can be in promoting and monitoring the health of patient populations, such as patients with diabetes and hypertension.

“We need to establish whether the accuracy of the cuff can support clinical decision-making,” said Dr. Brunt.

He’s all for the idea of remote monitoring of patients, as it would go a long way towards assisting patients in New Brunswick and across Canada. But it’s crucial to ensure that monitoring devices are of high quality.

He explains that hypertension is often missed at sporadic doctor’s appointments, but can be caught through regular monitoring over a period of several days or weeks.

Moreover, there are tremendous cost savings and health benefits when vital signs can be monitored from a distance.

Many rural patients have trouble getting to their medical appointments, especially those who are elderly or frail, said Dr. Brunt. Moreover, these patients are also more prone to catching nosocomial infections when visiting hospitals and clinics. Keeping them out of medical institutions can actually promote their health.

And of course, if the technology is easy to use, and patients can easily upload their vital signs, it’s possible to keep closer tabs on their health than through a monthly visit to the doctor’s office. For example, if a patient’s blood pressure suddenly soars and an alert is sounded, it can be treated within a matter of days instead of weeks or months.

While Dr. Brunt cannot yet comment on the findings of the trial, which is about half finished, Cloud DX’s Kaul is confident the results will be positive. He not only believes that Pulsewave will rival catheter-based readings in accuracy, but that the technology will in many cases supplant the need for catheters.
“By reducing the number of catheterizations, you can also reduce complications and infections.”

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