Vadim Alexeenko
University of Surrey, UK

Anna Shumitskaya
Independent telecommunications journalist

https://doi.org/10.36866/pn.97.12

Physiology is one of the health sciences that embraced the use of computers as soon as they became available, and has heavily relied on digital equipment ever since. As technology progressed, digital devices grew in capability and shrank in size and weight, ultimately becoming portable and connected, at first via wired networks. A recent boom in mobile communications has enabled portable devices to stay online and maintain the link with data processing centres virtually anytime and anywhere. This change has not yet affected the health sciences, but it is the wave of change that seems to be on its way.

Physiology, as the science of body function, has always needed to record the tissue or organ response to stimuli, and almost till the end of the last century every physiology laboratory had an extensive collection of chart recorders and paper rolls used for analogue data collection and storage. Even now, if you go through the laboratory cupboards, very likely you will find one or two such ‘fossilised’ devices. Most likely they are preserved purely for sentimental reasons, while the ‘real science’ went fully digital long ago. The major driving forces were the prospect of easy access to huge volumes of data, the power of numerical data analysis and the ability to automate the experiment.

The determination to use computers was so strong that the first electronic devices, used to control experiments or treat the patient, were bulky, consequently limiting the subject’s movements to the immediate vicinity of the apparatus (Fogt et al. 1978). However, the ultimate aim of life sciences is not to gather physiological data or cure a patient who is tethered by wires and tubes to a computer, but to help them have as normal a life as possible, and this means mobility.

Mobility for a medical device can come in different forms. At its simplest it takes the shape of an external device connected by sensors to a patient, like a Holter heart rate monitor or glucose monitor. More complex technologies that can augment or replace physiological functions include implantable prosthetic devices: pacemakers, defibrillators, cochlear implants, sacral neuromodulators and drug pumps. Such implants do not restrict patient movement and can substantially increase their quality of life. But these implantable digital devices overcome quite a few technological challenges. First, there is a requirement for compact and energy-efficient computers, sporting high precision analogue-to-digital and digital-to-analogue converters to interface the implant. Secondly, an appropriate set of sensors is needed to read the relevant physiological information. The list of such parameters might be long: electric potentials, blood or other liquid pressure, oxygen and glucose concentration; this list is by no means exhaustive. Thirdly, if the implantable device is intended for drug delivery, then a pump is a must. Lastly, and perhaps most importantly, an efficient and compact power source is essential to supply the implant.

Some of these tasks were solved by microfluidics technologies – tiny liquid pumps with the smallest of them being less than a few cubic millimetres. Others were addressed by development of biosensors: for example, it is now possible to detect blood glucose content using optical methods (Ozana et al. 2014). A highly competitive telecommunications market has helped to shrink the size of portable electronic devices, hugely increased the capacity of their batteries, and introduced wireless charging technology to the mass market. Application of the same technologies to implantable devices has brought similar benefits of decreased size and power consumption; wireless charging is now available for devices that are implanted several centimetres deep (Ho et al. 2014).

However, an important feature of implantable devices that has not been mentioned is that they have the ability to collect data and relay it to external data storage centres for further analysis by healthcare professionals. The increased capabilities of portable electronics make it even possible to perform a limited data analysis on the implantable or wearable device. This can restrict the uploaded data to just those segments that report deviations from the normal state and enabling the device to alert medical services and carers of potentially dangerous situations. A review analysing continuous cardiac monitoring devices, piloted in France, indicated a four-times quicker intervention response compared with conventional monitoring strategies (Maillard et al. 2014).

The progress of telecommunications has made the link between an implantable device and a remote data centre much more feasible than was previously possible. During the last decade, considerable effort has been directed towards the development of methods to facilitate data exchange between stationary and mobile digital devices – machine-to-machine technology (M2M). Originally conceived for automation and instrumentation, now it also covers various telematics applications, and buzzwords such as ‘connected revolution’ or ‘internet of things’ became a commonplace in the telecommunications world.

Proper functioning of such technologies requires permanent network connectivity and this might have had an influence on the paradigm shift in the design of mobile networks. The development of all previous standards of mobile communication technologies was aimed primarily at increasing the data transfer rate as the most important parameter, and loss of service in some locations was treated as a valid trade-off for high data transfer rates in the neighbouring places. The upcoming standard of fifth-generation mobile network (5G) is expected to be adopted in early the 2020s and, according to Professor Rahim Tafazolli, the head of the 5G Innovation Centre in the UK, the new standard will focus mostly on availability of digital services, with the ultimate aim of the total elimination of ‘bad reception areas’.

Other important features of 5G devices will include increased energy efficiency, reduced delays and latencies, and better management of portable device resources.

It is still too early to make any assumptions on a final shape of the 5G standard, but one can now make some informed guesses as to the possible uses of its features: mobile phones used as portable remote cardiac monitoring base stations is just one of them. The exciting possibilities for other futuristic medical gadgets may emerge very soon. And one of the key things to make it happen is a tight collaboration of telecommunication scientists and health scientists.

References

Fogt EJ, Dodd LM, Jenning EM & Clemens AH (1978). Development and evaluation of a glucose analyzer for a glucose controlled insulin infusion system (Biostator). Clin Chem 24, 1366–1372.

Ho JS, Yeh AJ, Neofytou E, Kim S, Tanabe Y, Patlolla B, Beygui RE & Poon AS (2014). Wireless power transfer to deep-tissue microimplants. Proc Natl Acad Sci U S A 111, 7974–7979.

Maillard N, Perrotton F, Delage E, Gourraud JB, Lande G, Solnon A, Probst V, Grimandi G & Clouet J (2014). Cardiac remote monitoring in France. Arch Cardiovasc Dis 107, 253–260.

Ozana N, Arbel N, Beiderman Y, Mico V, Sanz M, Garcia J, Anand A, Javidi B, Epstein Y & Zalevsky Z (2014). Improved noncontact optical sensor for detection of glucose concentration and indication of dehydration level. Biomed Opt Express 22, 1926–1940.