Sunday, November 11, 2007

Bionic Bodies ?

The MIT Club of Northern California held an interesting panel on Semiconductor and Systems Opportunities in Biomedical Technology. The panel was comprised of folks from the semiconductor and biomedical industries and was moderated by Dr. Sudhi Gautam a surgeon turned biomedical engineer. Panelists included Stanford Professor Dr. Atul Butte, Ron Koo from Maxim Technologies, Steve Sapiro from Emotiv, a thought sensor startup and Dr. Rich Withers from Varian Inc. In the interests of full disclosure, I helped set up the panel. My motivation was to understand why the economics of semiconductor companies was not showing up in biomedical devices. The panel discussed this along with many other interesting questions.

Dr. Gautam opened the session with some statistics on the biomedical industry. 50% of all biomedical companies worldwide are in the US and over 2500 of them are in California. The Bay Area including Silicon Valley has over 700 and Sunnyvale is one of the hotspots for biomedical devices ! This is probably logical since the proximity of Silicon Valley's semiconductor industry, the medical research from Stanford, UCSF and other universities coupled with access to venture capital must make for an interesting combination. The panelists gave their view of what the next hot thing was. Dr. Butte suggested that perhaps there was more value in understanding the impact of genetic analysis than in having the analysis itself widely available with lower cost chips. The solutions which used the chips in end applications to improve a particular problem were likely to be more popular. Today this knowledge is limited. The panel considered the question of body reactions to implanted silicon sensors. The view was that much like stents have been designed with coatings which make them less susceptible to rejection, new technologies would be developed to overcome this problem.

The panel considered the question of the best mechanism to foster transfer of technologies between the biomedical and semiconductor industries. Semiconductor companies which target the biomedical space hire experts in the field to understand the space and define products. Similarly biomedical companies also sometimes hire semiconductor experts or acquire teams with this expertise, especially when developing biochips or arrays. However, they pointed to the inability to have access to specific semiconductor process technology to optimize biochips. Not many biomedical companies have the luxury of owning a fab :-)

The panel considered the impact of outsourcing technology in the biomedical industry. Today diagnosis assistance such as reading X-rays is sometimes outsourced, but its far from a perfect situation. There are also regulatory hurdles to such practice. The question of which device areas would be impacted by MEMS was answered by Alissa Fitzgerald and MIT Club officer and MEMS expert, from the audience. The primary areas seem to be in cardiac or cardio-thoracic devices.

The panel did consider the issue of cost of biomedical devices and why they are not impacted by cheaply available technology. The semiconductor component cost of many of these devices is a small fraction of the total cost. The fact that the medical device industry is not an open, competitive space is part of the issue. After the lengthy regulatory approval process, the devices are supplied to patients and are paid by a small group of insurers. The cost is added up among the many layers in the system. So, even if technology scaling of cost and performance were to be applied to these devices there would be no quick reduction in cost. This is partly the reason for the high cost of health care in the US without the commensurate benefit. Strange how a capitalistic society is not so capitalistic in some critical areas :-)

However, with access to technology much better health care is possible. The panel talked about many new advances such as robotic surgery devices which could perform much more complicated surgeries than humans could perform, with far more success. This will drive the growth of a whole new way of praticing medicine, with doctors being trained to use these devices to achieve very high levels of surgical sophistication. Intuitive Surgical and Accuray are two Valley companies which provide such devices today. Clearly, Silicon Valley is going to be at the center of such exciting innovation in the years to come.

Madan

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