With health care costs growing without bounds, the medical devices industry and President Obama are hard at work. Not hard at work reducing costs. Hard at work convincing us that the solution to the cost crisis is more technology. Right, Mr. President. And John McCain is a maverick and Sarah Palin is a genius. Almost everyone else believes advanced technology is a significant driver of health care costs and the idea that it will drive down costs is not just a fantasy but steaming pile of crap. That doesn’t mean there’s no room for innovation to lower costs. On the contrary:
Nobody knows precisely why it works, but doctors have known for decades that the healing process for open wounds can be greatly speeded up by applying negative pressure ? that is, suction ? under a bandage sealed tightly over the affected area. The speculation is that it helps by drawing bacteria and fluid away from the wound, keeping it cleaner.
For patients, there is a benefit even beyond the speedier healing. Traditional dressings need to be removed and replaced ? sometimes painfully ? up to three times a day, but with the negative pressure system dressings can be left in place for a few days. But in the developing world, there’s a problem: The systems are expensive, and they need to be plugged in or powered by batteries that last only a few hours. In many developing nations, a reliable source of electricity is rarely available.
The device, a cylinder with accordion-like folds, is squeezed to create the suction, and then left in place, connected to the underside of the wound dressing by a thin plastic tube. At that point, it requires no further attention: “It holds its pressure for as long as there’s not an air leak,” [MIT Masters Degree student Danielle] Zurovcik explains. For that reason, a suitable dressing that can hold the seal is a crucial element of the system. (MIT News Office, h/t Boingboing)
If this is such a good idea, how come some high entrepreneur hasn’t made such a device? Apparently they have. You can rent one for $100 a day, but the batteries have to be recharged every 6 hours. Or you can try something like this, where each unit costs about $3 and doesn’t require and power or attendance. It was designed by a class of student engineers and developed further for a Masters degree by one of them. It’s been field tested and is being refined further to improve the dressing seal. There are already plans to manufacture it locally in Rwanda in an ambulatory version small enough to carry in a pocket.
There is a lot of scope for reduced cost technology, even in the high tech area. Recently we were interested in using x-ray fluorescence (XRF) for exposure estimation in an epidemiological study. We have a device but it costs around $30,000. It seems it isn’t much more than an x-ray source and a detector with suitable ancillary circuitry. Asking around it sounds like something an undergraduate electrical engineering student could build for under $1000. We’re looking into it.
While the difference between $30,000 and $1000 seems an improbable gap, consider the difference between $100 a day and $3 to purchase in perpetuity. Technology might very well drive down costs. But not the way we are going about it via private sector entrepreneurs and venture capitalists hoping to milk the health care cash cow.
How about some open source health care technology projects?