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Roman Lysecky is an Associate Professor of Electrical and Computer Engineering at the University of Arizona. He is a speaker at the MedTech Forum 2018 and his session include: Becoming Hackproof in MedTech on Thursday 25th of January. For more information go to the MTF website and follow #MTF2018 on Twitter. ********************************* Security must become the number one concern when developing connected medical devices. Millions of connected devices have already been produced and many of these are implantable. What would happen if these products were compromised by malware? Implantable cardiac devices, such as insulin pumps and other products with wireless connectivity and remote monitoring features, are delivering considerable benefits to patients and health systems. However, without the right protection, this comes with significant risks that hackers might seek to exploit vulnerable devices . The nightmare scenario would be a security breach that could cause cardiac arrest or be used to extract ransom from individuals or institutions. Failure to protect vulnerable patients from cyberattacks could undermine the lifesaving promise of these technologies, potentially breaking the Hippocratic Oath: First Do No Harm. Producing software that is entirely and provably secure is prohibitively costly, time-consuming, and often infeasible. We need resilient systems that automatically detect any security issues and have a built-in way to mitigate any threat this may pose. Threat detection At my lab at the University of Arizona, we believe security should be a fundamental part of the device itself, not an afterthought or a nice-to-have feature. Our team has developed a prototype pacemaker device that detects runtime anomalies – tiny differences in the order or time it takes for the device to perform computational tasks. For example, if it takes 20 milliseconds instead of three milliseconds to send data to the patient’s digital cardiac log, something may be wrong. Currently,...
The range of treatment options for patients with vision problems has expanded dramatically over the past two decades. This has helped to improve outcomes for patients while delivering shorter recovery times. But with so many possibilities available for vision correction, cataract removal and glaucoma surgery, how can patients make informed decisions that give them the best chance of getting the result they expect? While some turn to the internet or rely on the experiences of friends and family, the role of experienced ophthalmologists in demystifying treatment options is now greater than ever, according to Professor Carlos Palomino Bautista, Head of Ophthalmology Services, at the University Hospital of Quirón in Madrid. He says his long career in ophthalmology can be divided into two periods – the era before patients had the internet, and the period thereafter. Each has its own pros and cons. “Patients are increasingly aware of what is possible. We have a lot of patients that come to a consultation with information found online,” he says. “They often have a particular lens or procedure in mind but sometimes, after examining them and discussing the specifics of their case, I help them to change their mind.” Every patient is different. Not only can age, vision and the physical characteristics of the eye vary considerably from one patient to the next, their needs differ depending on the kind of job they do and how they spend their spare time. For example, ophthalmic surgeons can now implant corrective lenses in the eye during cataract surgery. But deciding which one requires a detailed conversation between patient and surgeon. “For a patient with long-sightedness, who has glaucoma or macular degeneration, there is a specific lens that I would choose,” says Prof Palomino who is also Professor of Ophthalmology at the European University of Madrid...
A World Health Organisation report has found that increasing access to hearing devices is ‘a sound investment’. Are decision-makers listening? For individuals, hearing loss can have a profound impact on quality of life: they lose independence, educational opportunities and earning power. Some people also suffer social isolation, lost confidence and a decline in wellbeing. Now consider the fact that over 5% of the world’s population – that’s 360 million people – are living with disabling hearing loss. In addition to the personal burden borne by millions, the global impact on societies and economies is enormous. Many of those 360 million people require support from their families, communities and – where available – social insurance funds. But there are actions that can be taken to address this serious issue. A sound investment The burden of deafness and hearing problems has come into sharp focus in the wake of a WHO report entitled ‘ Action for hearing loss: make a sound investment ’. The report looks at the economic impact of hearing loss and the cost of intervening to restore hearing using devices such as hearing aids and cochlear implants. These technologies require investment. The big question for the WHO experts behind the report was how the cost of treating hearing loss compares to the cost of inaction. The answer was clear: doing nothing is simply not an option . According to the WHO, the cost of hearing loss runs to around $750 billion per year. On the other side of the scales, the total cost of hearing care globally is estimated to be around $15 billion annually. ‘Provision of hearing devices is a cost-effective strategy, especially when used regularly and supported with rehabilitation service,’ according to the report. Screening children and adults aged over 50 is also considered to be a...
People with a rare eye disease known as retinitis pigmentosa (RP) suffer a gradual loss of vision; some become completely blind. Now, an innovative new approach to treatment has given dozens of people the chance to see again. With the help of a retinal implant, special glasses and intensive training, people who were blind have a new way of viewing the world which could one day benefit people with other degenerative eye diseases. We spoke to Professor Marie-Noelle Delyfer, University Hospital of Bordeaux, who has already performed eight such operations. What is retinitis pigmentosa (RP) and what is the prognosis for patients? RP is actually around 300 distinct genetic disorders that lead to the loss of photoreceptors on the retina. Some affected individuals have a reduction in their visual field while others become blind. With such a rare disease, it is difficult to describe a typical patient. Some lose their sight early in life or in early adulthood but there are others who become blind only in their 70s or 80s. Until 20 years ago, there were no treatments at all and the disease was not well understood. The first genetic cause of the disease was identified in 1984 – before that it was thought of as an inflammatory disease. What treatments are available? Some pharmaceutical therapies help to maintain photoreceptors but this only slows the progression of the disease – it’s not a cure. In the longer-term, there is some research on gene therapy targeting the mutations responsible for RP. How can technology help? I have used a new technology, from SecondSight, with eight carefully selected patients living with end-stage RP. These patients have an electrode array implanted in their retina. They wear glasses that are fitted with a camera that ‘sees’ their surrounding environment. This signal is sent...