IEEE ENGINEERING IN MEDICINE AND BIOLOGY MAGAZINE JANUARY/FEBRUARY 2005 5

inventing the future of medicine

President’s Message

Yongmin Kim

As I watched the student paperand design competition final-ists during our Society’sAnnual Conference (EMBC

2004) in San Francisco, California, lastSeptember, it reminded me of my firstconference in Houston as a finalist inthe 1981 student paper competition.Since then, biomedical engineers havebeen instrumental in developing numer-ous breakthrough diagnostic and thera-peutic technologies that have beencommercialized—ranging from MRIand ultrasound to implantable defibril-lators and drug-eluting stents—con-tributing tremendously to increasing notonly our life expectancy but also thequality of life.

As the baby boomer generation (peo-ple born from 1946 to 1964) ages in thenext several decades, however, thenumber and percentage of the elderly inthe United States and other developedcountries will increase rapidly. Withthis demographic trend, we expect tosee the number of people with nonacuteillnesses (e.g., cardiovascular disease,stroke, diabetes, cancer, arthritis, andobesity) increase accordingly.

Effective management of chronicdisease requires frequent and continu-ous monitoring and proactive treat-ments, which are both time-intensiveand costly; chronic disease presentlyaccounts for more than two-thirds ofhealthcare costs in the United States. Inaddition, the current centralized health-care system requires patients to go to ahospital or clinic for even a simple con-sultation (or biochemical/physiologicaltest), which is costly as well as incon-venient. Moreover, current healthcarefacilities are overloaded with anincreasing number of patients andincessant financial pressures. At thesame time, health insurance premiumshave been rising rapidly, and there aremore than 45 million people in theUnited States without health insurancecoverage. Considering these situationsand other factors, it is clear that the cur-

rent system is not sustainable, and anew paradigm in healthcare delivery iskeenly needed along the line of distrib-uted diagnosis and home healthcare(D2H2).

Advancements in key technolo-gies—e.g., device miniaturization, sen-sors, biomarkers, computing, imaging,software, communications, signal pro-cessing, storage, and biomedical infor-matics—could greatly enhance andfacilitate the D2H2 system. Manyhomes are already equipped with a per-sonal computer with telephone modemor broadband connection. Also, peoplenow feel more comfortable with e-commerce (e.g., purchasing books andtrips online and online banking), due toits convenience, and with typing sensi-tive information (e.g., credit card num-bers) online. With the greaterbandwidth in the future, increasingamounts of information can be stored,accessed, and transferred online quick-ly, e.g., X-ray CT and MR images,video, and even individual genomedata. Microelectromechanical systems(MEMS) and microfluidics-based lab-on-a-chip technologies, with whichlarge clinical laboratory-based assayscould be replaced by a credit-card-sized device (or smaller), wouldincrease the number and capabilities ofhome-based sensors and point-of-carediagnostic devices. These small andlow-cost measurements would enablethe remote data collection needed inmonitoring, screening, and diagnosis.Once all the relevant data have beencollected, computing, signal process-ing, smart software, and biomedicalinformatics would make possible intel-ligent health information processing fordecision support such as medical infor-mation reminders (e.g., medications,guidelines, and appointments), harmfuldrug-drug interactions, and the likeli-hood of an individual developing breastor prostate cancer. Even when fullyrealized, the D2H2 system will notreplace hospitals, clinics, and care

providers but will coexist with them,enabling increased efficiency while sig-nificantly improving the overall qualityof care provided to patients without acorresponding cost increase.

The D2H2 system would lead toimproved prevention, diagnosis, treat-ment, and patient outcomes. Long-term,home-based remote monitoring and apatient-centered system would enablepatients to accumulate comprehensivepersonal health information. Allowingpatients to not only access their medicalrecords but also to manage them wouldmake patients more knowledgeableabout their medical conditions andtreatment options and more activelyinvolved in the decision-makingprocess. There are many challenges(and opportunities) in making the D2H2

system a reality, ranging from systemintegration and privacy to regulatoryissues and clinicians’ acceptance. Ibelieve that biomedical engineers willplay a central role with scientists, careproviders, patients, and policy makersalong with people from governmentagencies, insurance companies, andindustry in planning and facilitating theresearch, implementation, and deploy-ment of this 21st-century healthcare-delivery paradigm.

Many of the key technologies need-ed for the D2H2 system, e.g.,bioMEMS and biosensors, imaging,biorobotics, biomedical and healthinformatics, and their state of the artwill be presented in September 2005 atthe EMBC 2005 in Shanghai, China.As you know, China has been rapidlytransforming itself into an industrialpower. Also, China potentially repre-sents the largest market for healthcareproducts and services in the future. Iencourage you to plan on attending ourSociety’s flagship conference this yearand take a first-hand look at the mod-ern China. I hope to see you inShanghai and be able to welcome youas president of the IEEE Engineeringin Medicine and Biology Society.