A real-life medical tricorder: XPrize wants to make it so
From CNET Magazine: An XPrize competition aims to turn a 50-year-old science fiction concept into a powerful medical device that's accessible to all.
Jennifer GuevinManaging Editor / Reviews
Jennifer Guevin is managing editor at CNET, overseeing the ever-helpful How To section, special packages, and front-page programming. As a writer, she gravitates toward science, quirky geek culture stories, robots, and food. In real life, she mostly just gravitates toward food.
If you've ever watched "Star Trek," you've probably coveted one of the ingenious gadgets carried by those polyester-wearing space travelers. Much of the sci-fi series' futuristic tech is the stuff of dreams. But one device, in particular, has always seemed to have life-changing potential. In the "Star Trek" universe, the medical tricorder is an indispensable tool -- a handheld portable scanning device that diagnoses medical conditions within seconds.
This fictional device could solve age-old dilemmas. A typical visit to the doctor today isn't easy: drive to the doctor's office, wait up to an hour in the lobby before an assistant checks your vitals, wait for the doctor to come in and ask questions, travel to have your blood drawn, then wait up to a week for results. And this scenario assumes a lot, not the least of which is that you live near a doctor, have health insurance, can afford to pay the bills and a job flexible enough to let you off work. To simplify the onerous process, the XPrize Foundation is attempting to turn the decades-old tricorder dream into a modern medical reality.
XPrize doesn't shy away from an audacious challenge. This nonprofit organization holds competitions designed to make significant technological breakthroughs in a variety of fields -- all with an eye toward addressing major global challenges. XPrize competitions have focused on everything from private space travel or building a lunar lander to finding more effective ways to clean up oil spills. The Qualcomm Tricorder XPrize competition, announced in 2012 and in its late stages now, will award $10 million in prizes to teams that make a real-world medical diagnostic device inspired by the "Star Trek" tricorder.
The goal is to make a lightweight, easy-to-use device that can monitor key health indicators as well as diagnose much more serious problems. To meet the challenge, tricorders must be able to track five basic vital signs -- such as blood pressure, heart rate and temperature -- in real time and for at least 72 hours straight. They must accurately diagnose 13 "core" conditions, including diabetes, Hepatitis A, stroke and tuberculosis. In addition to those, teams are required to pick three "elective" conditions for diagnosis, ranging from HIV or melanoma to whooping cough or strep throat. The devices need to be able to send that data to the cloud so patients and doctors can access and talk about the results. And that all has to happen with one device that weighs less than 5 pounds, including all of its necessary chargers and attachments.
That's an ambitious goal. "We have to create a system that is verifiably safe and that works at a very high, clinical level. And it has to have a very futuristic consumer experience," said Robert Kaul, the president and CEO of Cloud DX, a Toronto-based company that is competing in the XPrize challenge. "Every one of those [goals] is a huge challenge, but creating all of those in six to eight months is crazy."
Another competitor put it more simply: "It's like giving people a bicycle and saying the first one to Mars wins," said Walter De Brouwer, CEO of Scanadu, which is both a company in Silicon Valley and a team participating in the challenge.
But a lot of smart people are giving it a shot. When the challenge was announced at the 2012 Consumer Electronics Show, more than 300 teams registered. A tough selection process whittled down that group to 10 finalists from around the world remained. Now the group is even smaller. In April, two of those teams (Scanadu in California, and Zensor, based in Ireland) combined efforts to work as one team, making a total of nine teams gunning for the top prize.
The teams are making fast progress. They've developed working prototypes that are currently being tested by actual patients at the UC San Diego Medical Center so doctors and the competing teams can learn how these devices might fare in the real world. Those consumer tests work in two ways. First, patients already have known conditions, which allows judges to test the accuracy of the tricorders' diagnoses. Second, they also can offer real-world feedback on how well the products are designed and how easy or hard they are for regular people to figure out.
Not as seen on TV
In concept, the similarities to the medical tricorders on "Star Trek" are apparent. And associating the competition with the franchise was a highly strategic move by XPrize. Part of the purpose of these competitions is to make great technological advances, but another equally important goal is educating the world about critical problems, said Grant Campany, senior director of the Qualcomm Tricorder XPrize Challenge. There are 40 million people in the world who call themselves trekkies, according to Campany. So by creating a real-life version of a prominent "Star Trek" device, the foundation knew they'd catch the attention of a huge audience from the beginning.
But the devices that come out of this competition won't necessarily look like the ones that graced the sick bays of the starship Enterprise. For one thing, teams took different approaches to solving this problem. And because they'll be testing for so many factors, devices need a variety of sensors and attachments.
Measuring heart rate, for example, typically requires attaching sensors to the skin. For blood pressure, an arm cuff or wristband is standard; for bloodwork, a finger prick test. These all might require special components beyond a basic handheld unit like those used on "Star Trek." And the requirement that vital signs have to be monitored continuously for three days means patients would have to sleep with the product attached to them.
Cloud DX considered all their options. "We looked at sleeves, wrist cuffs, gloves, combinations of biosensors adhered to the body," said Kaul.
When measuring heart rate, Cloud DX didn't want to use the sticky adhesive that's typically used to attach sensors to a patient's chest because, well, it gets itchy. After testing many approaches -- and yes, sleeping in them -- their team settled on the idea of a collar that goes around the back of a patient's neck, with weighted sensors that hang down over his chest.
To measure temperature and oxygen saturation, they designed a small device -- reminiscent of a hearing aid or a Bluetooth headset for a mobile phone -- that sits in a patient's ear with a sensor pointing down to the ear drum.
"It's not just about deploying great technology, but it has to be consumer friendly, futuristic and comfortable," said Kaul. And that's not an exaggeration. Nearly half of the teams' final scores will be based on how consumers interacted with the device -- in short, could people figure out how to use it? Did they enjoy using it?
One mission, many sequels
The consumer products that eventually hit store shelves are likely to be diverse. The XPrize competition is essentially a hyper-charged, hyper-focused test bed. Teams are pushing to figure out what works and what doesn't in both long-term health monitoring and disease diagnostics in an insanely short period of time. But when they go on to actually sell these things, it's likely that they'll focus on one area with a more specialized device.
So how will devices like these ultimately fit into people's lives? The initial goal of the XPrize competition was to solve the problem of access, creating inexpensive take-home devices that could make huge strides in rural areas with little access to medical facilities. But they'll do other things too. Once the competition is over, some teams might take their products in different directions.
"In 5 to 10 years, it's very realistic to believe that tricorders will exist in many forms and be available in many places," said Campany. "We're starting out diagnosing 15 conditions. But as teams prepare to go to market, they might just focus on one capability."
Teams are already making those plans, and some have consumer products in the works. Cloud DX is now taking preorders for a vital-signs monitor called Vitaliti. And Scanadu has already announced the Scanadu Scout, a small health monitor designed by Yves Béhar, and the Scanaflo, an at-home urine analysis kit.
Where and how people will buy the tricorders is still a question. Teams envision selling their tricorders in just about any channel that exists, according to Campany. You might go into CVS to buy or rent one. A large healthcare provider like Kaiser Permanente might loan them out to patients who need long-term monitoring. When it comes to products that are more focused on fitness, people might buy them at a big sportswear store, Best Buy or Amazon.
Uncertainties in the prognosis
For all that promise, tricorders have a long way to go. Regulatory approval presents one big hurdle. It's one thing to develop a cool gadget in a lab. But it's another to get legal clearance and bring it to market. Genetics testing startup 23andMe once offered at-home ancestry and genetic health analysis kits but was forced by the Food and Drug Administration to halt the health screenings. In order to avoid similar regulatory snafus, XPrize partnered with the FDA from the very beginning.
"We're pushing the envelope pretty hard here," said Campany. "The last thing in the world we want is to see these devices make profound diagnoses but yet the FDA has no idea how to handle it." At the moment, 18 employees at the FDA volunteer their time to be available for teams with questions along the way. This helps the teams understand how they need to build devices in order to get approval, long before they've gone too far down a road that might turn out to be a dead end. "The access is unprecedented," Campany said.
Another question is how these devices fit in with the doctor-patient relationship. What happens, for example, when the tricorder delivers really bad news? Like, "you've got cancer" news? Normally that news would be delivered by a doctor, who can give immediate advice and information about how they'll tackle the disease. But what happens if a machine is the one making a diagnosis?
And the winner is...
While teams will have to navigate those questions eventually, first they have to make something that works. First-, second- and third-prize winners will be announced in January 2016, on the 50th anniversary of the debut of "Star Trek." Get ready to see a whole new wave of devices designed to help you live long and prosper.
Dara Kerr contributed to this story, which appears in the summer edition of CNET Magazine. For other magazine stories, go here.