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Jan Crols Written by Jan Crols
on 12 Jul 2021

Global spending on healthcare is expected to reach $11.5 trillion by 2030 and McKinsey estimates the value of digital technology in healthcare systems to reach $3 trillion by then. The future of healthcare will be further driven by medtech as opportunities in digital health evolve along the patient pathway. Improvements in implantable medical devices in particular will drive significant market traction over the next few years.

To understand the trends and innovations impacting the medical implants and ASICS (Application Specific Integrated Circuits) space, we interacted with Jan Crols, CTO Semiconductor of Ansem, a Cyient company and an expert in integrated wireless communication; and Mayank Maria, Engineering Consultant and Practice Director of the Everest Group. Here are the salient factors having a bearing on the industry’s growth trajectory:

 

Growing investment in Engineering R&D in the medtech vertical

The medical devices sector is growing rapidly at approximately 6% per annum, with spends touching a trillion dollars annually in Engineering R&D (ER&D), according to Everest Group estimates. Implants, active and passive, constitute 19% of the ER&D spends, roughly accounting for $7 billion annually. The primary drivers of growth include greater affordability and the growing popularity of implants, coupled with demographic and lifestyle changes. The key investment areas for implants are two-fold:

  • Enhancement of longevity and efficacy of existing implant offerings
  • Development of new use cases and applications, as well as the enablement of digital healthcare convergence as part of the larger connected healthcare ecosystem

Enhancement of longevity and efficacy of existing implant offerings

Medical device companies are working on implant longevity, including making miniaturized implants to achieve optimized energy consumption, reduced current leakage, and easier placement, especially for active implants. There is increased focus on enhanced stimulation control, which also aids implant longevity. Improved battery technology is another area of ongoing innovation – for instance, enabling battery recharge while an implant is inside the human body. Experiments are also being carried out on battery composition to enable an overall increase in battery capacity. Researchers are working on extending the durability as well as biocompatibility of implants by leveraging new and alternative materials. These will help improve passive implants like orthopedic and dental implants.

 

There is renewed industry focus on innovating to enhance implant efficacy for increased patient benefit, particularly with cardiovascular, neuro-stimulator, cochlear implants and insulin devices. Personalized implants allow patients to make adjustments, as in the case of cochlear implants, where the recipient can use a sound processing level that suits them best. Adaptive implants have rule-based intelligence that can sense patient vitals and make requisite dosage modifications. Programmable implants are connected to applications, and are used by caregivers for enhanced patient care and monitoring. Other innovations include omnidirectional sensing needs, leveraging patches to improve the overall functionality of implants, and enhancement of EMI/EMC resistance of the implant in order to shield from external disturbances.

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New avenues of value creation and industry implications

New avenues of value creation are coming onstream with the connected healthcare system. The Internet of Medical Things (IoMT) can potentially drive significant benefits of healthcare convergence for patients. The five transformation pillars enabling this are - strong connectivity, a robust cloud infrastructure, an API led environment, a strong security layer and intelligence with artificial intelligence (AI) and machine learning (ML) The benefits are immense and manifold, including the use of digital therapeutics, enablement of remote patient monitoring, Real World Evidence (RWE) based engineering, and facilitation of value-based contracting. There are also new use cases around medical implants and patches that are continuously evolving and being adopted, which are positive signs for the industry.

 

However, in fueling innovation, medical companies need to contend with the need for stronger data protection and cybersecurity, the review and revamp of the underlying hardware to ensure compatibility for new use cases, responsible use of critical patient data, and finally, compliance with new and additional regulations.

 

Trends impacting application of implant technology

There is an increasing focus on stimulating and sensing applications. Implants can now be built with rechargeable batteries, supporting new use cases where they can operate without constant connectivity with external applications. Low current leakage and low power consumption are other important criteria. There is also a rise in deep implants, but the classic approach of using magnetic field power transfer is not well suited here. Consequently, research is currently underway to explore the feasibility of ultra sound power transfer or temporary energy storage on micro supercapacitors, and other newer technologies. However, these and other implants connected to applications that require heavy visual inputs continue to have higher battery and power requirements. Across all these use cases, the need for advanced battery chargers for controlled and secure charging is very high, eliminating battery deterioration over time. So, paradoxically, there is increased demand for both lower power consumption and long sleep states for rechargeable implants, higher power consumption for implants for stimulation, and the like.

 

The dichotomy of high power and high data requirement can be resolved with split magnetic communication. This mandates that data encryption protocols be strictly followed to ensure secure communications.

 

The rise in computing, memory storage, and complex operating sequences

With the rise in computing, data processing and data compression in implants, increased requirements may be linked to local data storage. This is especially true of sensing applications where the data needs to be stored locally temporarily before it can be transmitted to an external device. There is also the need for a unique secure ID for every implant to ensure the right sequences are applied to the right implant, for the right patient. A one-time programmable memory function can be used as an for the unique ID; a PUF (Physical Unclonable Function) can be an alternative. As the complexity of implants increase, more flexible microcontrollers will need to be integrated, bringing with them the challenge of software validation and security.

 

Breakthroughs have been made in medical implants and patches, and more specifically semiconductor-based custom ASICS solutions to enable continuous patient monitoring and advanced data analytics. Artificial Intelligence (AI) is an important trend in medical applications, with the potential to save power with fairly small AI engines within the implant. Additional communication requirements consume very high power in a digital medical implant. Therefore, configuration of pre-selected data for the physician to access before moving data to the cloud is one potential way to reduce power consumption. Incorporating an Edge analytics component in the AI engine will also enable more informed and faster decision-making.

 

Implantable devices are becoming smaller and smarter than ever before, driven by a whole new design and development paradigm. The next generation of implantables needs an integrated approach – weaving together greater application connectivity, customized small but powerful integrated circuits, improved functionality, lower battery and power consumption, and greater patient benefit. 

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