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Medical Device


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Innovating for the wider world

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The emerging markets of the BRIC countries – Brazil, Russia, India and China – are having a profound effect on the global economy. India and China alone are putting billions of potential consumers into the global marketplace, however, most of these consumers have only a fraction of the income of their Western counterparts.

Often called reverse innovation or frugal innovation, medical device innovators have been embracing the notion of making products simpler, stripping out costs to make devices affordable for those who have very little income, and adapting devices to make them invaluable for healthcare professionals who don’t have the state-of-the-art facilities – or any facilities at all, in some cases – of a Western hospital.

The incredible, shrinking pacemaker

One such device is the mini-pacemaker, developed by Medtronic. Smaller, more efficient, and – perhaps its crowning glory – easier to implant than its traditional cousins, it should be on the market in about five years. The excitement awaiting this tiny device is, you could say, in inverse proportion to its size: huge.

Stephen Oesterle, Medtronic’s Vice President for Medicine and Technology, announced the development of the mini-pacemaker at the 2010 TEDMED conference. “It’s about the size of an antibiotic capsule, it’s got a seven-year battery, a telemetry capability, a memory, it can be interrogated, it can be reprogrammed,” he explained.

“And it’s leadless – I can’t emphasise how important that is, not only because there are issues with leads. But (because) there are lots of places in the world where there isn’t the sophistication to implant pacemakers.”

Currently, a cardiologist creates a pocket in the upper part of the chest to insert the pacemaker and the connecting Leads are threaded through blood vessels into the heart. It’s a complex procedure that requires extensive practice and training– something most of the world’s population don’t have access to. 

The game-changer

The mini-pacemaker is guided through the femeral vein in the leg up to the heart by means of a catheter,  eliminating the need for a surgical procedure . Once it has reached its destination, the mini-pacemaker – about the size of a vitamin pill – fixes itself inside the heart and begins its work.

Since no surgery is required and leads aren’t used, the risks for individual patients with the mini-pacemaker are considerably less. But the real game-changer is that the device doesn’t require the specialist skills of a surgeon to be implanted.

“Right now, in the United States, for our population, we have somewhere in the region of 3,000 cardiologists who are trained in implanting pacemakers,” Oesterle said. By contrast, there are only about 1,000 implanters in India, for a population of more than one billion. By providing a technology that aligns better with the skill sets of more physicians, pacemaker technology can be delivered to more patients.

 Remote monitoring

The life-saving, and life-changing, benefits of the mini-pacemaker extend beyond its innovative implantation, however. The explosion in mobile phone usage in the developing world has made it possible to use mobile technology and networks to disseminate healthcare advice and information, a trend known as mHealth. The mini-pacemaker’s telemetry might facilitate a development in the future that would allow healthcare professionals to control the device and monitor patients using a standard programmer via smartphones, thereby providing individual treatment to patients in the most rural of areas.

The mini-pacemaker is an excellent example of how the challenges of the potential global market, the need for more flexible distribution channels and differing healthcare needs can extend an innovator’s thinking into areas of limitless potential.

18/10/2011 | Posted by Medtronic
Tags: reverse innovation; mini-pacemaker; medical device innovation; pacemaker; pacing; medical engineering; frugal innovation; pill-sized pacemaker; Stephen Oesterle; remote monitoring; mHealth