Thirty-six thousand feet in the air, Matthew Bromwich, MD, founder of Ottawa, Canada-based Clearwater Clinical and an otolaryngology, head and neck surgery surgeon, had an idea.
Clearwater had previously developed and released the DizzyFix, a medical device that cures vertigo through head movement. A patient puts the device on their head, which temporarily relieves their vertigo symptoms through employing the Epley Maneuver.
It was when he was in a plane that he thought of the idea that would pivot Clearwater Clinical, and launched its exploration into the mobile medical device industry.
Smartphones have built-in accelerometers that track and adapt to direction changes. For example, when a phone turns from portrait to landscape, the accelerometer registers the change and reorients the device. Dr. Bromwich thought the accelerometers could mimic and register the head mounted device for smartphone use.
"We treated patients one at a time (at the start) and that was very time consuming," Dr. Bromwich says. "(I thought) if they knew how to do this maneuver, the most common cause of dizziness could be cured. … We put the whole exercise into the phone. A patient can just pick up their phone, put it on their head and it tells you what to do. Anyone can download DizzyFix and cure their disease."
DizzyFix's success brought Clearwater in a whole new direction.
Instead of making expensive devices that would become outdated, Clearwater devices update every product cycle. When a new smartphone gets released, Clearwater has a stronger camera and processor to work with a new operating system.
"If you use consumer technology and base medical devices on it you can imagine a world where all medical devices are affordable," Dr. Bromwich says. "The core of it could be the mobile device and the outside piece can be custom."
That's when Dr. Bromwich set about trying to fix two industry wide problems: patient privacy and hearing testing.
Providers may take pictures of a patient's symptoms to share with their colleagues if the condition is difficult to diagnose. However, a provider cannot monitor how others share the photo once he presses send, which may teeter on non-HIPAA compliant.
Clearwater developed Modica, a HIPAA-compliant photography app that allows providers to consult each other while respecting patient privacy. Instead of a photo being unsecured, it sits in a secured Dropbox-like app. Allowing access to approved parties anywhere in the world.
Another problem that needed addressing was hearing testing. Without the proper equipment or otolaryngologist training, most patients will go long spans between hearing tests, if having a test at all. This is concerning as hearing loss is one of the top three disabilities throughout North America with the average person having a 30 percent chance of hearing loss by age 60, Dr. Bromwich says.
That's where Clearwater's Shoebox Audiometry came in. Shoebox is a clinically validated audiometer on an iPad.
"We tried to address the problem by saying we can take some of the expertise, the equipment and the support and fit it all into something like a shoebox," Dr. Bromwich said.
Dr. Bromwich said several Canadians in the north flew south to take $40 dollar tests. With all the travel expenses, a routine hearing test added up to a substantial amount. That's why Clearwater made Showbox, a portable test designed to bring testing to the people and eliminating the need to travel to specialists.
Mobile technology is operating in a day and age where these types of medical devices can be accessible to everyone, yet regulation hasn't caught up. Dr. Bromwich said commercialization and deployment of hospital based innovation is a challenge facing the mobile medical device market. Transitioning technology to companies like Clearwater is an important step in getting healthcare technology to the broader community.
"We need to create a clear pathway of engaged commercialization," Dr. Bromwich says. "I use engaged because I don't think you want corporations purely motivated by profit to control this sector. I think you want physicians to solve these problems. It takes a strong collaboration to address these problems."