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Exclusive interview: Dr. R.A. Brest van Kempen, CEO of RS TechMedic

RutgerHere is a treat for all you medical gadget lovers. An exclusive interview with Dr. R.A. Brest van Kempen who just happens to be the CEO of RS TechMedic. His company has produced some amazing high tech medical devices over the years. One of their most revolutionary product on the market today is a telemedicine device called Dyna-Vision. Only for you, Dr. R.A. Brest van Kempen talks about his company’s products and shares news about the development of software which will enable you to monitor your patient in real time using your iPhone.

Could you tell me more about yourself, about your background?

I studied at the Catholic University of Leuven in Belgium and have been a “clinical perfusionist” in cardiovascular surgery for 10 years in 3 leading hospitals in Belgium and the Netherlands. I started my MBA study in 2006. In 1999 we founded RS TechMedic, a company developing medical technologies. I am responsible for marketing and sales, the operation of the company and the machine-to-man interfacing design of the products. With our dedicated hardware and software engineers we’ve developed 9 medical devices and clinical software so far and our latest development is focused on the fast growing telemedicine market.

Please shortly describe the history and milestones of your company, RS TechMedic?

We developed products for Terumo CardioVascular Systems, Maquet, Martil Instruments, and a number of other companies. These products were all high-tech developments and are on the market as we speak. The most advanced product was our automatic micro-air removal device for heart-lung machines. With this technology we are able to significantly reduce the postoperative cognitive dysfunction in heart surgery patients. Out of 160 companies, we were granted the Innovation Award 2002 for this product.

dyna-visionCurrently one of your major products is Dyna-Vision. Tell me a little bit more about it and the ways it differs from similar products on the market?

Dyna-Vision is developed with the latest available technologies. What we often see is that other companies are “upgrading’ existing products to be used for telemedicine. We are convinced that this is not the best solution. We created a wish list of physicians and their patients and developed a new technology based on these requirements. This is a different strategy and makes that we can offer the most recent technology.

We are a bit careful with making comparisons as Dyna-Vision as we really see Dyna-Vision as a new “type” of products and not as one of the existing ones. Our device gives you 3, 5 or 12 lead ECG, Heart Rate, Heart Rate Variability, RR-time, Plethysmogram and Oxygen Saturation.

Basically, the device creates a data file to be used in different software for analyses. Currently we certified 4 packages: Cardio, Monitoring, Health and Fitness and Research. This makes Dyna-Vision a multi-purpose device. Physicians can use Dyna-Vision for different indications optimizing there return-on-investment.

Dyna-Vision is the first and only device in the world with an integrated mobile phone. With this connection the recordings are transmitted to a remote server for analysis by a physician. This process is fully automated so there is no action required by the patient to transfer the data. A physician can download the recordings for analysis from anywhere at any time. Also, we offer the unique feature of real-time remote monitoring. For example, a patient has symptoms and contacts the physician who can simply login to the server to monitor the actual streaming parameters on a computer !

Dyna-Vision is supported by several software packages (Cardio, Health & Fitness, Research , Monitoring) aimed at different types of users. Which one is the most popular so far?

  • Cardio is far ahead of the others as cardiologists are very used to recording and analyzing ECG. That makes that we can offer our Dyna-Vision as the “next generation” holter recorder. The patients are connected to the device in their practice. When the patient leaves the practice, the ECG is continuously transmitted to the cardiologist. The patient can be monitored for longer periods of time and does not have to come back to the practice to “download” data from the device. With Dyna-Vision, the patient has more freedom and can be sure that the cardiologist can always analyze the ECG, also when the patient is at home.
  • Monitoring is closely related to Cardio and it is commonly used to monitor remote patients.
  • Health and Fitness is rapidly growing since the wellness sector is focusing more on preventive medicine lately to expand their offering to their clients. When our test shows underlying health problems they refer their client to a physician for further analysis.
  • Research is used by universities but it is a very specific market. This is a niche which does not grow fast.

If I choose to use Dyna-Vision in my medical practice how much security can I expect regarding my patients’ data?

Dyna-Vision “creates” a data file with the recorded parameters. This data file is encrypted before transmission and it does not contain the name of the patient. The files are transferred from the server to your PC Software after entering a security code. After download, the files are decrypted and attached to the correct patient record. Although it will probably never be possible to design an unbreakable security, we took great care of making our product as safe as possible.

You have announced that your company will be launching the first real-time streaming patient monitor on the iPhone platform. How did you come up with this idea? Did you receive any requests from your customers for such a monitor on iPhone?

Well, when I demonstrate Dyna-Vision to cardiologists they always ask me if it is possible to receive ECG data on their mobile phone for a quick analysis. Until now we were a bit hesitating to develop such a tool as it seems more easy than it actually is. Besides that, there are a number of security issues you have to take care of and finally, the processor speed and screen resolution of the phones are still not really suitable for high-resolution multi-parameter monitoring. But, then the iPhone came with the high resolution screen and some very useful programming tools to graphically optimize the streaming data to make it technically possible.
Now we can offer a true telemedicine system for ambulant patients where patients can call their physician when they experience symptoms. The physician can immediately look at the streaming ECG.

In your opinion how did the iPhone influence the whole telemedicine field? Does it offer anything new regarding the mobile phones already on the market?

I must say that I found only a few interesting applications on the iPhone for medical use. The actual use has to grow I believe and this will take time. The main problem is that Apple made it difficult to distribute applications through the central appstore and this brings uncertainty to commercial developers. We had the same discussion within the company: do we develop an iPhone application with the risk of difficult distribution after development or even removal from the Appstore… or do we develop a “common” web application that we can freely distribute. This is a difficult decision but we choose the iPhone for the technical specifications. On the side, the added value of an iPhone to our own Dyna-Vision must not be forgotten. The graphical interface is fun to use and is relatively fast. The iPhone does offer new features that are not found in other phones yet, but other brands are coming up with new products that have somewhat similar specifications.

Explain some of the key features of the iPhone software for Dyna-Vision?

With the software the physician can login to the server and start a live data streaming session. After authentication, the data stream starts and the software automatically starts in monitoring mode. The user can change the layout of the screen and the colors of the graphs. The application is touch screen controller (obviously) and makes use of “flips” to graphically enhance the interface.

Will iPhone be able to communicate with Dyna-Vision unit only by GPRS or also via bluetooth?

Initially we will launch it with the GPRS connection. However, the next release by the end of this year will also support the Bluetooth connection.

When do you expect that iPhone version of your software will be available?

We are introducing the iPhone Telemedicine Application during the Medica in Dusseldorf, Germany to be held from 19-22 November 2008. Immediately after that it will be commercially available. However, it is only sold to licensed physicians who need to register with our company. We will authorize them in the system so that they are able to use the iPhone application.

Was it difficult for your software engineers to start developing for the iPhone platform using the tools from Apple?

The Software Development Kit from Apple needs some work so to say before you are able to use it to its full extend. On the other hand, if you have an experienced software engineer this is not a problem. Also, you do not have to take care of compatibility with other platforms as is the case when developing JAVA applications. So in the end, it is less difficult than developing for other platforms.

How do you comment on the likely ban of iPhone sales in the Netherlands? Will it in any way interfere with your plans?

Assuming that you are referring to the internal battery I do not worry about it. First of all, Apple is already discussing the new law with the government and it seems that there are three escapes that Apple can use to bypass the law.. The most important one is the use for medical purposes where the battery is an essential part for the correct functioning of the product. When it is easily removed, this creates issues with data storage and patient safety.
By law, medical devices have a waiver for this requirement and as we are selling it as a part of our medical device… probably we are okay. Nevertheless we are facing this challenge not only for the Netherlands as it is a European Law..

We will not only sell the iPhone Telemedicine Application in the Netherlands but all over Europe. As an example we just made an agreement with a telecom provider that has 35 million subscribers. Early next year we will expand to the USA and Asia. We have contracts with different telecom providers for monthly iPhone plans. We just have to wait and see how things will end up but my hopes are that Apple will work hard on solving the battery problem urgently…

Now that you have stepped into Mac arena, can we expect the Macintosh version of your Dyna-Vision software for desktop computers?

Of course it is already possible to use Dyna-Vision Software on Macintosh with a windows emulator but we are working on a OSX version. We have no release date scheduled but I estimate this will be ready Q1 in 2009.

There you have it! Something to look forward to, a new and revolutionary way to monitor your patients on the iPhone is coming soon. We will keep you updated.

A big thanks goes out to Dr. R.A. Brest van Kempen for this interview.


Why is iPhone perfect for doctors

I purchased my iPhone about six months ago and it has in many ways changed my life for the better. This is especially true regarding my work as a medical doctor. I believe that iPhone is a perfect gadget and that it can improve any physician’s performance. That is way I decided to present some of many useful ways you can utilize iPhone in your practice.

Access your Electronic Medical Record

Life Record is a company which produces Life Record Electronic Medical Record (EMR) software. What is interesting about it is that you can access your records form an iPhone. You can also make updates and even write prescriptions.

View medical images

To view your radiology images remotely you can use the Mobile MIM iPhone Application. This application provides multi-planar reconstruction of data sets from modalities including CT, PET, MRI and SPECT, as well as multi-modality image fusion. Using the multi-touch interface, users can change image sets and planes; adjust zoom, fusion blending, and window/level.

Calculate, compute, add, subtract, multiply, divide

Medical Calculator gives quick access to calculations that are too hard to memorize or perform in your head. There are around 50 clinical calculations that you can do with it right now, and more are coming. To not get lost, favorite those you use often.

Medical calculator

Access drug information

Epocrates Rx software for iPhone puts continually updated peer-reviewed drug information at your fingertips. This can improve patient care and safety, save time, reduce administrative burden and enable confident clinical decisions.

Take notes

There are many powerful note taking apps for iPhone out there. But let me just present the two most interesting, Evernote and Jott.

Evernote allows you to take text, snapshot, saved photo and voice notes. When you take for example a voice note, you can add a title to it, some description and tags. The interesting thing happens after you have taken your notes. They synchronize with your online account and what this means is that you can access them from anywhere. From your computer using a desktop application or from any other computer in the World with an Internet connection via the web interface. Everything is always synchronized across all of your devices. One cool thing that Evernote can do is transcribe images, meaning that it is capable to find text inside an image and make it searchable. It doesn’t yet transcribe your voice notes to text, but I believe this feature will be coming in the near future.

There are some advices on how to use Evernote on The Efficient MD blog, but I am sure you can think of many more ways to utilize this app. For example you could take snapshots of your patient’s injuries in the ER or record interviews with your patients.

Well, this other application, Jott is capable of doing what Evernote still can’t. It can capture your to-dos and transcribe your voice into text and place the resulting notes in your lists.

If you like Evernote, but desperately need for your voice notes to be transcribed to text, don’t worry. There is this great hack from Lifehacker that can help you.

Stay on top of your field

As a modern evidence based medicine physician you have to read and follow new developments in your field. Often you find interesting articles on the Internet, but don’t have time to read them. My advice is to save them for latter and read them on your iPhone during your breaks, when you are on call and have some free time or while waiting in some line. Perfect little app that can help you do just that is Instapaper and it is one of my favorite iPhone app ever. When you find something on your computer that you want to read later, simply click Read latter bookmark. Then when you have time, just open Instapaper app on your iPhone and read those articles. You would think that the iPhone’s screen is too small to read, but you would be wrong. It’s high resolution screen and zoom capabilities make reading enjoyable.

Of course you can read whole books on the iPhone too. Use Stanza to transfer and read all your important medical e-books.

Apart from reading, you can do a little bit of watching and listening, to thousands of podcasts in the medicine category. A podcast is a series of audio or video digital-media files which is distributed over the Internet and can be transfered to your iPhone. Listen and watch podcast from The Lancet, The New England Journal of Medicine and many others while you, let say, travel to work.
Podcast directory

Enhance your scientific research

You can use your iPhone to find scientific literature. Download PubSearch and search among the millions of research papers indexed in PubMed. This app has a simple user interface with fast access to the PubMed database, and it lets you concentrate on finding the research articles you need without getting in your way. PubSearch Plus is on the way and it will allow you to not only read abstracts, but full-text articles too.

Convert your iPhone into a wireless external disk, one with a lot of memory. This way you can carry around all the important documents for your undergoing scientific project. Come to a meeting with your colleagues and have all your excel and powerpoint files with you. Also bring some scientific articles in pdf, or other format, related to your research. All these files can easily be opened on your iPhone or access from any PC or Mac in the room. This is all done using AirSharing for iPhone.

Play games

You too deserve to have fun from time to time. There are numerous great games for iPhone and if nothing these can help you relax during an intensive and difficult shift. There have been some results published about video games and their ability to enhance surgeons’ performance. So before your next surgery why not try playing a game like Labyrinth to get you all warmed up and focused.

As you can see there are numerous useful ways you can utilize iPhone as a medical professional. This is not all of course, there are many other interesting apps coming up everyday and I did not mention the obvious things like reading email, surfing the web and contacting people via sms or IM services. I am looking forward to new medical apps that might appear in the future. Also, wouldn’t it be cool if somebody introduced some iPhone medical accessories. I would like to see some pulse oximeter sensors or ECG cables for iPhone. They could plugin-in to it’s 30-pin dock connector to input data which, I am sure, due to it’s processing power iPhone would not have a problem to analyze. Are we getting closer to those great all in one medical devices from Star Trek? 🙂
Star Trek