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Should Medical Devices Multitask?

Yesterday, in Slate, Farhad Manjoo reported on Steve Jobs' snubbing of the Amazon Kindle because it is a single task item. In the piece, Jobs is quoted saying: "I'm sure there will always be dedicated devices, and they may have a few advantages in doing just one thing, but I think the general-purpose devices will win the day." This axiom that consumers want devices that do more than just one thing is certainly has truth to it. But what about devices in the medical field? Should they do more?

And are patients forced to spend more money because insurer's insist that home healthcare devices be for medical use only? That is the question asked today by the New York Times. The article, by Ashlee Vance, describes a patient with ALS (Lou Gehrig's Disease) who uses her iPhone to turn text into speech. She had a dedicated medical device to perform this task, but found the item and its price tag (the Medicare-approved device cost her $8000) rather clunky. In contrast, the patient says her iPhone is portable and works with her lifestyle. The logic for insurance companies is hard to refute. They cover medical devices and the hint that a device could do more (surf the Web, play video games) opens up paths for fraud. But consumers expect functionality to keep up with other technology in their homes and industry has not yet delivered. Further, the medical device industry is slow to lower costs on its products, often because those products are made at low volume, using research that serves a specific patient population. Again, the reasoning is logical. Medical device makers are hampered by regulatory restrictions, and reimbursement requirements. But such arguments, however reasonable, may not translate to a patient who must shoulder some cost or haggle for hours with insurance providers. If a healthy person had the choice to spend $8000 on a single-use machine or $300 (the approximate price of an iPhone) on a machine that performs the same task, plus has additional useful functions, that decision would be considered a no-brainer. Why, then, should we expect sick people to make a different decision? If Steve Jobs is right (and I'm inclined to say he is), then general purpose devices will continue to become more common among consumer devices. I've already talked about the increasing popularity of medical apps on smart phones. So what should industry do? What changes can (or should) it make to appeal to the growing body of patients that, above all, want to feel normal?  If consumer devices can fulfill medical needs and still sport sleek looks, multiple functions, and a lower price tag, where is the motivation to purchase heavily-researched but equally heavily-priced medical products?

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