While consumers are finding it easier than ever to play an active role in their healthcare by leveraging smartphones and tablets, clinicians are also finding new opportunities to take advantage of mobile devices at the point of care. We had a chance to sit down with Dr. Hak Lee, a Urologic Oncology Fellow at the University of California San Diego, and Dr. William Sohn, a Clinical Instructor at Vanderbilt University, to learn about the Endockscope, a new device that allows a smartphone to capture images during endoscopy procedures.
Michael Batista, Medgadget: How did you transition from practicing medicine to developing the Endockscope?
Drs. Lee and Sohn: Development of the Endockscope resulted from the translation of our combined clinical experiences. As urologists, surgical endoscopy is a common part of our practice and we have always had a keen interest in developing technologies. Endockscope is a combination of both our clinical and technological interests.
Medgadget: How did you come together and who else did you bring on board to create the Endockscope?
Drs. Lee and Sohn: We both trained at the University of California, Irvine for residency in Urology. To launch development of the Endockscope, we teamed up with engineers at Praxis BioSciences led by Dr. Joon You who brought experience developing and designing low-cost solutions for primary care applications and commercializing biomedical devices. Additionally, Dr. Samir Shreim and Renai Yoon are biomedical engineers who have been exceptional at pushing the progress of Endockscope. Dr. Ralph Clayman, our mentor during surgical training, continues to be a valued mentor of the Endockscope team.
Medgadget: Let’s get into your technology. What is the Endockscope?
Drs. Lee and Sohn: The Endockscope is a specialized lens and docking system that is used to couple a smartphone to an endoscopic device. The Endockscope is composed of three key components: a phone adapter to attach an endoscope eyepiece to the camera of a smartphone, a zoom lens for the smartphone camera, and a portable LED white light source. With optical zoom, we avoid issues associated with decreased resolution resulting from digital zoom. The Endockscope completely changes the paradigm of current endoscopy by replacing the bulky, traditional endoscopic monitor, video box, light source, and wires with a more compact, wireless device. By using the smartphone as the imaging device, we can utilize features such as still image capture, video, and wireless capabilities, ultimately leveraging the benefits of mobile technology.
Medgadget: Why would a clinician want to use a smartphone-based endoscope device compared to standard endoscope technology?
Drs. Lee and Sohn: A smartphone-based endoscope offers advantages beyond traditional endoscopy. First, the cost of standard endoscopic technology can be two orders of magnitude more expensive than a smartphone-based endoscope ($349.00). In the era of rising health care costs, cheaper technology translates to money saved for clinicians, hospitals, insurance companies, and most importantly, patients. Second, smartphone-based endoscopes are portable. Current mobile endoscopes can weigh as much as 150 pounds and often requires the use of a van or truck to transport the equipment to remote areas, limiting access to the technology. The Endockscope and smartphone fit in a 13″ x 9″ x 3″ case, slightly bigger in area than a manila envelope, and weigh less than one pound. Ease of transportation provides the opportunity for surgeons to extend their reach beyond geographic limitations. Third, a smartphone allows for functionality that either does not exist or is not well executed with current endoscopic devices. Photos and videos can be easily captured on a smartphone and securely stored and transferred to the cloud. From there, this data can potentially be synced with EMR systems to maintain a multimedia patient record. In contrast, collecting photos or videos is often complicated and cumbersome in existing endoscopy. These technical hurdles often result in surgeons deciding not to collect these important visual records. Smartphones also provide the opportunity to utilize real-time video conferencing. Live consultation between surgeons during an operation can be extremely useful and allows for immediate recommendations that save valuable time for both surgeons and patients. For consultation in remote locations, no good solution exists with standard endoscopy.
Currently available smartphone-based endoscopes are not meant to be a true replacement for standard endoscope technology. While cost savings, portability, and new functionality provide benefits beyond standard endoscopes, image quality is still limited by the smartphone camera. Image quality is comparable, allowing important images and videos to be collected, but is not equivalent to standard operating room endoscopes. As smartphones technology continues to improve, the benefits of smartphone-based medical devices like the Endosckope will only increase. We look forward to the realization of the smartphone as the single integrated platform for any medical technology to be immediately available to any clinician.
Medgadget: What stage is the technology at and where do you see it going in the future?
Drs. Lee and Sohn: We are now in the small volume production stage for the first generation of the Endockscope. For now, compatibility is limited to the iPhone 4S and Galaxy S3/S4 although we are currently working on broader compatibility with other smartphones. Additional development efforts are focusing on brighter LED light sources and a companion smartphone app to make it even easier to capture, store, and share images and videos when using the Endockscope. We are also working to seamlessly sync and transfer images and video to EMRs and allow patient accessibility to the data via the web.
As access to smartphones continues to expand and smartphone technology continues to improve, we expect clinicians to realize even more benefits from the Endockscope. Our mission is to see the Endockscope lower the technical and economic barriers to standard endoscopy and expand access to endoscopy procedures to those medically underserved populations across the world.
Medgadget: Do you have a regulatory plan for Endockscope?
Drs. Lee and Sohn: Currently, Endockscope is not FDA cleared and is distributed solely for educational and research purposes. Users must consult and acquire appropriate approvals from their institutions (i.e. Institutional Review Board) before using Endockscope for human applications. As with any new mobile Health technology, we are currently evaluating our options for regulatory clearance.
Medgadget: What other medical devices would you like to see developed with smartphone or tablet compatibility?
Drs. Lee and Sohn: We look forward to seeing more mobile technology that will increase the accessibility of a test or procedure to the global community through reduced cost, increased portability, and additional functionality. For surgeons, a device or application that incorporates augmented or virtual reality into live procedures and surgeries would be particularly beneficial.
Medgadget: With mHealth technology on the rise, how do you predict mobile (smartphone or tablet-based) medical devices will play a role in clinical spaces like intensive care units (ICUs) in the future?
Drs. Lee and Sohn: While implementation, execution, and overall acceptance of mHealth technology may take some time, it will ultimately play a significant role. With the realization of benefits like those mentioned earlier, we predict the shift towards adoption of these types of tools will be dramatic. More than ever, the responsibilities and duties of the physician are expanding. Mobile health technology has the potential to allow physicians to become more efficient with diagnostics, patient monitoring, and data logging and analysis. We hope mobile technology will continue to develop in a manner that augments the physician’s efforts to improve overall patient care.
Medgadget: If any of our readers are interested in more details or getting in touch how can they reach out?
Drs. Lee and Sohn: Please reach out to us at our website www.endockscope.com.
Here’s a quick video demonstrating how to setup the Endockscope: