In their studies of grand challenges for the global
community in the 21st century, the National Academy of Engineering concluded
that advances in “…the acquisition, management, and use of information in
health…” will greatly enhance the quality and efficiency of medical care and
our ability to respond to public health emergencies. Decisions and preventative
measures informed by real-time data and associated analytics will only become
more urgent as global age demographics shift, particularly as the proportion of
people over 65 rises to near 17% by 2050. Emerging classes of body-integrated
electronic sensors offer unique capabilities for collecting and distributing
continuous, clinical-quality health information and thereby improving the
delivery of treatments to the elderly and other vulnerable populations,
regardless of their location. These new, futuristic bioelectronic devices serve
as the foundations for a range of powerful tools and microsystems that
seamlessly and non-invasively integrate with the skin, in an imperceptible
fashion. Integrated technologies supported by bioelectronic platforms will
automatically capture and share critical physiological data with physicians,
health care officials, family members, and care providers who, in turn, can use
the information to inform and improve health care at individual, community, and
global levels.
Recent progress in
this area was highlighted at a 2018 AAAS symposium entitled “Biomedical Devices
in Service to Society.” There, researchers discussed new concepts and designs
for electronic devices that have the potential to revolutionize the way that we
sense, record, and analyze essential parameters of human health, including
traditional vital signs as well as patterns of motion, sounds of body
processes, and biochemical signatures in sweat, tears, and saliva. Speakers
described studies of new skin-interfaced electronic sensors that provide data
on patients recovering from stroke, managing symptoms of Parkinson’s disease,
or suffering from atrial fibrillation. Other work focused on the development of
epidermal electronic systems as skin-like apparatuses that allow intimate
integration onto nearly any surface of the body, without irritation or
discomfort. The unusual mechanical properties of these technologies are
particularly important: Their miniaturized, lightweight construction and
intimate skin interface eliminates motion artifacts and allows precise
collection of biophysical data in natural contexts, including those outside
clinical or laboratory settings. These essential characteristics differ
markedly from those of conventional, wafer-based integrated circuits and open
totally new opportunities for research and application. In fact, such devices
are already being validated through field studies in major hospitals,
rehabilitation clinics, military settings, and in professional and collegiate
sports.
Electronic Product Designing
Innovations in
biomedical device design such as these are increasingly abundant. Some resemble
tattoos or thin adhesive bandages adhered to the skin, while others take the
form of soft conductive gels that create high-quality electrical-skin
interfaces, able to collect accurate recordings of cardiac, brain, and muscle
activity. Epidermal sensors of mechano-acoustic signals gently mounted on the
base of the neck allow precise measurements of speech and swallowing to
facilitate rehabilitation protocols for patients suffering from aphasia and/or
dysphagia. Soft, thin microfluidic networks bonded to skin can capture, store,
and analyze the chemical constituents in minute volumes of sweat. These
biomedical laminates provide a real-time non-invasive method for assessing body
chemistry in ways that could complement traditional blood analysis techniques,
with the capacity for real-time visual read-out through integrated displays
that present the information directly and intuitively to users.
New bioelectronic
designs extend beyond skin-mounted appliances to implanted, programmable
devices with unique modes of operation, including those that follow from their
ability to bypass the blood–brain barrier. Such systems will interface directly
with internal organs, allowing targeted, personalized, programmed drug
delivery, and, in turn, dramatically reduced possibilities for drug toxicity
and/or side effects. Related bioelectronic implants will deliver electrical
stimulation to the heart and brain to treat arrhythmias and cognitive disorders
in ways not possible today. Such “bioelectronic medicines” will complement
pharmaceuticals in the treatment of disease and healing processes and may one
day replace many of their functions.
These technologies
will also yield high-quality “big data” related to natural body processes,
including those that occur during the full range of daily activities. This type
of information, collected from individuals and across populations, may help to
transform and extend our understanding of human systems and physiology. Future
embodiments will support unprecedented levels of device autonomy, leveraging
advances in deep learning algorithms and artificial intelligence-based
diagnostics, some of which can already outperform highly trained physicians for
certain tasks. Aligning with the sensibilities of users and regulators, such
devices will also integrate secure communication protocols, advanced encryption
schemes, and safe storage mechanisms to ensure sustained privacy and
individualized use of personal and aggregated information.
The examples of new
technologies featured in the AAAS symposium are representative of the
impressive progress in this new domain of interdisciplinary study, where basic
research in engineering science is establishing the foundations for
groundbreaking innovations in medicine and human health care. Just as the field
of consumer electronics developed rapidly in response to the public’s voracious
appetite for devices to improve productivity, communications, and
entertainment, so are similar dynamics propelling advances in biomedical device
design for health care, sports, and military applications. Future advances will
rely on the melding of technology with biology in ways not yet imagined. The
associated areas of scientific challenge are diverse and significant, ranging
from materials and manufacturing science, to sensor design and power supply, to
data communication, analysis, and security. Although testing and
commercialization of early tools and products are already well underway,
interdisciplinary research at the crossroads of invention, material design, and
system innovation will continue to play a critically important role in the
development of technologies that can accelerate global efforts to confront and
conquer growing challenges in global health.
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distribution, and reproduction in any medium, so long as the resultant use is
not for commercial advantage and provided the original work is properly cited.
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