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It’s a wireless medical world

Few areas of society are as complex and information-laden as medicine – a fact that makes medical care a perfect candidate for Information and Communications Technology (ICT). Norwegian scientists are developing ways to use the power of ICT to decode...
“The future is closer than many people think,” says Dag Ausen, contact for an initiative called “Wireless Health Care”, and Senior Adviser at SINTEF, Scandinavia’s largest independent research institution.
A portion of Norway’s medical ICT research is conducted with funding from VERDIKT, the Research Council of Norway’s large-scale ICT programme, which directs 8.8 percent of its project funding to health care sector applications. The Research Council also supports health care research through programmes such as Centres of Excellence or Centres for Research-Based Innovation, and through the efforts of researchers at SINTEF and the Simula Research Laboratory, the major universities such as the University of Oslo, the Norwegian University of Science and Technology (NTNU) and the University of Tromsø.
The result of all this research has also led to the foundation of a number of Norwegian spin-off companies, such as Norchip, which makes a credit-card sized diagnostic kit, Alertis Medical, which makes sensors to measure blood gasses, and bioinformation companies such as Interagon and Pubgene, which analyse genetic information.

Medical education may be transformed by the development of new ICT technologies that could change everything from patient record management to the monitoring of patient health after medical procedures. © NTNU Info/Rune Petter Ness

The Heart of the Problem

Heart disease is a major cause of premature death in the Western world. This simple fact is one reason why Norwegian researchers are harnessing the power of ICT to find innovative ways to understand the heart better.
One such research effort is being conducted at the Simula Research Laboratory in the Scientific Computing Department, where the Center for Biomedical Computing has been awarded a Centre of Excellence designation from the Research Council of Norway. Among the projects being undertaken by the centre is a mathematical simulator for the electrical and mechanical behaviour of the heart. By creating this mathematical model, researchers can examine the functioning of the heart in both healthy and stressed conditions.
The centre is now testing some of its data on patients, says Olav Lysne, Research Director at Simula. “The dream is to be able to feed the EKG readings into the computer, and with that compute the status of the heart, if there is ischemia or a cardiac problem,” Lysne says. “They should be able to deduce where the problems are electronically.”
Researchers at NTNU’s Medical Imaging Laboratory (the MI Lab) are using an ultrasound and MR imaging in a different approach to non-invasive ways of examining the heart and other organs. The laboratory was appointed in 2006 as a Centre for Research-Based Innovation by the Research Council. The award involves yearly funding of NOK 40 million over the eight years of the programme.
One of the major strengths of the MI Lab is its strong partnerships with industry leaders, such as GE Vingmed Ultrasound AS, Horten; Fast Search & Transfer (FAST) ASA, Oslo; Medistim ASA, Oslo; SonoWand, Trondheim; Odetect AS, Kongsvinger/Trondheim; Nordic NeuroLab AS, Bergen; and Cortechs Labs, Inc, USA. Non-industry cooperators are St Olav’s Hospital in Trondheim, the Central Norway Regional Health Authority and SINTEF.
One MI Lab project involves improving the visualization and quantification of blood flow, using ultrasound to assess blood flow in vessels, and through the heart chambers and valves. Still another project is designed to put advanced cardiac ultrasound techniques in the hands of non-expert users, such as general practice doctors.

Wireless Health Care

Miniaturization and advances in nanotechnology have made it possible to develop tiny sensors that can measure all kinds of critical changes in a patient’s organs and tissues. That, according to Dag Ausen, Senior Adviser at SINTEF, is the future of medicine. “What will be true is that in five to ten years, doctors can take advantage of existing technologies, to get much more information about a patient from these kinds of sensors and wireless systems,” Ausen says.
These tiny sensors are being evaluated in an initiative called “Wireless Health Care”, which combines the efforts of researchers in Trondheim, Tromsø and Oslo, and is a part of a larger project called “Wireless Future”, initiated in February 2004 by the largest telecom operator in Norway, Telenor, along with SINTEF, and the ICT branch of the Norwegian Trade Association, Abelia. More than 150 Norwegian businesses are now involved.
One of the factors driving projects like Wireless Health Care is the ageing of Western populations, and the projected lack of professional health care workers. In Norway alone, for example, the next 10 years will see a demand for approximately 100,000 health care workers – while the country may only educate one-fifth of that amount.
“ICT makes it possible to work more efficiently,” Ausen says, either by allowing patients to be monitored at home, or by allowing patients to access medical advice via e-mail or mobile phone.
Among the companies established to take advantage of the biosensor market is Alertis Medical AS in Oslo. The company was founded in 2000 to commercialize a unique technology for the early detection of critical conditions related to blood supply and respiration, and was developed by researchers from Rikshospitalet University Hospital, Oslo. The company’s first device is a miniaturized disposable biosensor that provides early warning of blood and oxygen deprivation in tissue, which can be a common complication of surgery, post-operative care and organ/tissue trauma. Another company, NorChip AS, has worked with SINTEF to develop a credit-card sized chip that can conduct diagnostic tests on a droplet of blood in a matter of minutes.

Researchers at the MI Lab at the Norwegian University of Science and Technology are working with a variety of industry cooperators, including GE Vingmed Ultrasound AS in Horten, to bring advances to ultrasound imaging of the heart and other organs. This image of the heart shows current ultrasound technology using a GE Vivid7 Dimension Ultrasound. © GE Healthcare/GE Vingmed Ultrasound

Managing – & Mining – Information

When it comes to patient care, information is everything. Doctors need to find relevant medical details amid the vast sea of a patient’s medical history. A patient has information he or she would like to share with the doctor. And in some cases, that patient-doctor sharing of information has to be bridged over considerable physical distances, as is common in the more rural areas of Norway. These demands have been an important driver in shaping the development of ICT tools for medicine in Norway.
A VERDIKT project coordinated by the Rikshospitalet-Radiumhospitalet Medical Centre in Oslo is developing ways for patients to communicate with their doctor and update their own medical records from a home computer or mobile phone. Researchers have developed a tool called Choice, which allows patients to enter their own symptoms and treatment needs on a computer. The tool has been tested with roughly 1,000 cancer patients at the Rikshospitalet-Radiumhospitalet Medical Centre.
Another VERDIKT project to develop flexible medical files, called POCMAP, is being headed by researchers at NTNU in Trondheim. The goal is to develop a mobile device so health care professionals can bring up a patient’s electronic file no matter the location – whether at the patient’s bedside or from an office computer.
At the University Hospital of North Norway, the Tromsø Telemedicine Laboratory (TTL) has been established as a Centre for Research-based Innovation, funded by the Research Council of Norway at NOK 180 million over the eight years of the project. The TTL’s partners are the University of Tromsø, Norut IT, Telenor, IBM, DIPS, Well Diagnostics, Norwegian Healthnet, and the Northern Norway Regional Health Authority. The goal of the TTL is to develop telemedicine approaches that can be commercialized, with a particular focus on enabling the Norwegian health system to provide the elderly and those with chronic illnesses with safe and effective home care.

Advances in MR imagining, as being developed at the MI Lab at the Norwegian University of Science and Technology, will enable researchers to plan for delicate brain surgery even before the patient enters the operating room. © NNTNU MR Center

A number of Norwegian businesses have also been established in response to the vast amount of medical information now available. For example, a company called Interagon was spun off in 2002 from Fast Search & Transfer to use search technologies to identify drug targets and develop therapeutic methods based on genetic information.
Another company called PubGene also uses search technology in building a database that provides a graphic overview of how genes and their proteins relate to each other. The company has a variety of products, including PubGene Analysis, which is designed for researchers who work with lists of genes – as well as those looking for specialized gene functions, such as searches in the context of chromosomal regions or identification of genetic polymorphism.
Sonitor Technologies, headquartered in Oslo, has developed an ultrasound indoor positioning system that automatically tracks the real-time location of moveable equipment and people. The wireless detectors and tags are linked to a digital file with important information about the item or individual being monitored.
For Ausen, these technology companies are just the tip of the iceberg in the world of Wireless Health Care and the future of medicine. “There are a lot of possibilities,” he says.