LAS VEGAS — Samir Qamar, MD, a family physician with big ambitions to transform medicine, stood on a stage here at the Consumer Technology Association 2016 Digital Health Summit and conducted a physical examination of a woman on a giant video screen.

Samantha, the patient for the demonstration, was located 35 miles away. She held what resembled a chubby but sleek spaceship in her hand. Dr Qamar instructed her to aim the device's camera down her throat and say "ahh." The inside of Samantha's upper throat, in all its pinkness, appeared on the video screen. She then attached a speculum cone to the device and inserted it in her ear to take her temperature, and positioned her index finger on top of the device to measure her heart rate and blood oxygen level.

The performance earned Dr Qamar a round of applause. However, the family physician doesn't want what happened in Vegas to stay in Vegas, as the saying goes. He envisions his remote diagnostic device, called MedWand, in millions of homes, workplaces, schools, nursing homes, ships, battlefields, off-shore oil rigs, and any other place where someone requires medical attention but not necessarily the immediate presence of a clinician. The $250 price shouldn't deter the widespread commercialization of the device, he said.

MedWand adds the sorely needed component of a traditional physical exam to telemedicine, Dr Qamar told Medscape Medical News. "You can't examine a patient in merely a video chat," he said. "That's a teleconsult, not telemedicine."

The MedWand demonstration didn't show off all of its capabilities. The device also incorporates a stethoscope, otoscope, and three-lead electrocardiogram. And it wirelessly connects to a blood pressure cuff and glucose meter.

Device to Replace Onsite Clinics

MedWand isn't the only all-in-one remote diagnostic device trying to reach the market, but it seems to be well on its way. Dr Qamar's company, MedWand Solutions, has applied for approval from the US Food and Drug Administration (FDA) under its 510(k) process, which requires that a new product essentially resemble one already on the market. The individual components of MedWand fit that bill, said Dr Qamar. He expects the FDA to grant its blessing in time to launch MedWand in the fourth quarter of 2016.

Confidence in MedWand's eventual debut is high enough that Group Health Cooperative of Eau Claire, an insurer in Wisconsin, announced in October 2015 that it was placing preorders for the device. The insurer said in a joint news release that it would initially distribute MedWand to its employer clients so workers on the job could be examined for health concerns through video conference. MedWand-enabled telemedicine would eliminate the need for businesses to maintain onsite clinics for worker health.

In the second phase of the rollout, Group Health Cooperative of Eau Claire plans to buy the devices for its "higher-need members" with chronic conditions that warrant intensive monitoring.

"We are excited to be the first in the insurance industry to use MedWand's innovative technology, and we look forward to integrating it into our infrastructure as another tool to help improve member health and manage risk," said Peter Farrow, chief executive officer of Group Health Cooperative of Eau Claire. "MedWand's appeal with convenience, access, and cost reduction should make it popular with other industries quickly."

Likely Wielders of MedWand

MedWand Solutions is a partnership between Cypher Scientific, an engineering design firm, and MedLion Management, another of Dr Qamar's companies. MedLion operates a network of some 350 independent physicians in 27 states engaged in direct primary care.

In the MedLion model of direct primary care, physicians charge adult patients a monthly fee of $85 for primary care, and private insurance covers other expenses, such as drugs, specialist care, and hospitalization. MedLion has contracted with dozens of employers that pay all or some of the primary-care monthly fee for upward of 5000 employees and buy wraparound insurance for everything else, according to MedLion President Praveen Mooganur. The idea is to liberate primary care from the nickel-and-dime hassles — some would say tyranny — of third-party reimbursement.

MedLion physicians and their patients are a natural market for MedWand, said Mooganur. For the sake of clinical integration, exam results generated by the device could be relayed through a software interface to a physician's electronic health record system.

Mooganur and Dr Qamar also see an opportunity for MedWand in telemedicine companies that field their own physician networks for video visits. MedWand Solutions is partnering with two of these companies — Doctor on Demand and MYidealDoctor — so customers can get a telemedicine physician along with the device.

Not an Autoexamination

Dr Qamar was quick to point out that although the patient holds the MedWand device, the physician conducts the exam. The physician activates individual components, such as the thermometer, zooms in with the camera, and acoustically focuses the stethoscope on lung and heart sounds.

"I don't believe that technology is advanced enough to allow for autoexaminations by patients," said Dr Qamar. There is also the obvious need for clinical judgment. "There are times when I change the course of my examination based on what I'm getting back."

That said, Dr Qamar wants to make MedWand as easy as possible for patients to use. To that end, the device recently underwent a design change, morphing from the original spaceship look to one that now resembles an oversized computer mouse. "It looks friendlier and it's easier to hold," he said. The new version is also wireless.

In anticipation of demand for his product, Dr Qamar has configured MedWand and its ancillary hardware and software into different packages for the home, the workplace, and what he calls the "global clinic." The last package is designed for remote, tough environments, such as off-shore oil rigs, where ferrying a clinician to an ailing roustabout is very expensive. The global clinic version is housed in an extra-rugged case and features a built-in satellite phone, Wi-Fi hotspot, and a solar power system.

MedWand faces competition from other handheld multipurpose diagnostic tools, such as Tyto and Scanadu Scout, which are also seeking FDA approval.

"I expect and hope that other companies will follow suit with such devices," Dr Qamar said. "We're not just doing this for ourselves. We're trying to introduce the concept of remote examinations."

"There's enough of a market — with 10 billion people on the planet — for everyone to do well."

Consumer Technology Association (CES) 2016 Digital Health Summit. Presented January 7, 2016.


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