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JAMA

SCIENTIFIC DISCOVERY AND THE FUTURE OF MEDICINE

The human body is soft, curvilinear, and continuously evolving; modern electronic devices are rigid, planar, and physically static. Recent research has yielded a complete set of advanced materials, manufacturing approaches, and design layouts that eliminates this profound mismatch in properties. The resulting devices can intimately integrate onto or into the human body for diagnostic, therapeutic, or surgical function with important unique capabilities in biomedical research and clinical medicine. These emerging technologies have strong potential to improve human health and to enhance the understanding of living systems. They fall into 3 categories—soft, injectable, and bioreabsorbable electronics—each demonstrated in extensive animal studies and several in initial human trials. The Figure presents images of bioelectronic devices.

Figure. Images of Biocompatible Electronic Devices A, Inflated balloon catheter equipped with arrays of sensors for pressure, flow, and contact along with actuators for ablation therapy and light-emitting diodes for optical characterization. B, Three-dimensional membrane wrapped around the entire surface of the heart for cardiac electrotherapy. C, Actively multiplexed sheet of electronics laminated onto the surface of the brain for high-resolution electrocorticography. D, Wireless electronics mounted on the skin for continuous, multimodal monitoring of physiological status. E, Injectable optoelectronic system threaded through the eye of a sewing needle and wrapped around its shaft to highlight the small dimensions and flexible mechanics. F, Bioresorbable electronic circuit, partially dissolving in a drop of water. All of the constituent materials dissolve at controlled rates into harmless end products when exposed to biofluids.

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Stuck in the waiting room

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A long-touted health-care revolution may at last be about to arrive

Oct 11th 2014 | ROME | From the print edition

THE idea of telemedicine—health care provided using telecommunications equipment—has a lengthy history. Radio News, an American magazine, devoted its cover to a patient at home consulting a doctor in his surgery via a television link as long ago as 1924. When NASA began monitoring astronauts in space in the 1960s, fantasy became reality. It has been touted as health care’s future ever since.

But even smartphones and tablets have failed to usher in the telemedicine revolution: most health care still happens face to face. Now, enthusiasts think the wait is nearly over. Governments have been slow to embrace an approach that could improve coverage and outcomes, as well as saving money. But they are under increasing pressure from ageing populations and a surge in chronic diseases, just as public budgets are being squeezed.

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