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The recent global pandemic redefined well-established paradigms in healthcare. The classic model involving frequent hospital visits is no longer viable due to the risk of contagion. The focus is now on remote and pervasive vital sign monitoring solutions and automated data processing for health assessment. Social-distancing-friendly technologies, such as wearables, implantables, insertables and ingestables that enable long-term monitoring, can help detect medical abnormalities both in individuals and large populations. SEMI spoke with Carlos Agell, program manager and principal member of Technical Staff at imec, about remote vital sign monitoring using innovative form factors and methodologies. imec’s healthcare technology vison for remote care systems will be the focus of Agell’s presentation at the SEMI MedTech Forum, 19 February, as part of the SEMI Technology Unites Global Summit, 15-19 February 2021, online event. Join us to meet experts from imec and other key industry influencers. Registration is open. SEMI: What is driving innovation in diagnostics and what is the role played by the semiconductor industry? Agell: There is a clear need for remote diagnostics triggered by the COVID-19 pandemic. Two examples are respiration monitoring and SARS-CoV2 testing technologies. The fact that some of the more obvious symptoms of COVID-19 are respiratory has revealed a big gap in medtech: the need for low-friction, ambulatory, continuous and pervasive respiratory monitoring solutions. At imec we have been working on bioimpedance-based technologies (from chipsets to smartphone-enabled sensing devices) that can provide feasible solutions in that space. Hence, novel sensing modalities from the semiconductor industry can make a difference when it comes to remote ambulatory respiratory monitoring. On the other hand, SARS-CoV2 diagnostic technologies have become paramount during the health crisis. In this space there is a clear need to simplify, speed up and lower the cost of testing. Additionally, from a practical perspective society needs to prevent virus spreading. imec is spearheading an innovative semiconductor-based solution aimed at simplifying SARS-CoV2 testing by collecting aerosols from subjects’ breath using a silicon-based solution for analysis using the polymerase chain reaction (PCR) method, the gold standard in COVID-19 testing. Determining viral load in exhaled breath is a clear indicator of infectiousness, and detecting subjects with a high viral load is key when developing these rapid tests to facilitate economic recovery. A cost-effective and speedy though reliable SARS-CoV2 testing solution opens up possibilities for its use as gating mechanism (such as testing to allow access to facilities and prior to boarding a plane) to help jump-start some of the hardest-hit sectors in the economy, such as travel and hospitality (hotels and restaurants) by enabling more in-person interactions. SEMI: Please share more about imec’s commitment to improving the healthcare sector. Agell: imec R D is active in the field of remote unobtrusive respiration solutions, which are vital in treating respiratory system conditions such as asthma, chronic obstructive pulmonary disease (COPD) and COVID-19. These solutions rely on a combination of silicon chipsets, sensor integration and algorithms to interpret sensor data. As part of our effort to understand biological fundamentals, imec’s multi-electrode array (MEA) platform for heart-on-chip applications offers unparalleled capabilities to acquire high-density information (4444 electrodes/mm2) to enable extra- and intracellular recordings, electrical stimulation and impedance gauging to study patient-derived cardiomyocytes, cells that make up the heart muscle. imec is developing a rapid, low-cost SARS-COV2 test based on breath analysis (aerosol capture) aimed at a 5-minute analysis. Such tool is a key to economic recovery, and imec is planning large-scale testing of the prototype device at Brussels Airport later in 2021. imec has recently supported spinoffs and external companies that develop social distancing tools for usage during the pandemic. Healthcare is a key strategic area at imec, with multiple departments working on complementary topics, ranging from cell-sorting technologies and multi-electrode arrays, through sensors and systems for non-invasive cardiorespiratory and neurological monitoring, all the way to advanced processing of medical data and tooling for trials. SEMI: How is the pandemic impacting remote diagnostics? What’s new in that field? Agell: The pandemic has accelerated advances in remote diagnostics for healthcare – for example making remote doctor visits possible and launching telehealth into a successful sector. But in my opinion, this is just the starting point. Telehealth doctors will soon need to collect health data points such as body temperature, weight, or blood pressure remotely, the same information they collect during an office visit. Soon thereafter though, doctor’s will need more and more data, sparking the next stage of advances in remote diagnostics as algorithms are developed to analyze sizeable amounts of data. All in all, it will result in a big move from doctor-centric paradigms to more patient-centric solutions. Hopefully that jump will also drive a more proactive approach to health, enabling prevention and keeping people healthy, and leaving behind the era of curing the sick. imec research tools for respiratory monitoring will come in the form of a health patch. SEMI: Besides infectious disease diagnostics, what solutions will enable a paradigm shift? Can you name two global market trends related to the rising need for remote diagnostics? Agell: The paradigm shift in healthcare will be largely fueled by the hyperconnectivity trend. Communications are fast and far-reaching. The pandemic has proven that healthcare, similar to retail, banking, trading and business in general, can also be done partly remotely through a communications line. The need for proof of performance in the case of diagnostics has been proven challenging, due to the highly regulated medical field and the general conservativeness of this market. There is a clear trend underway in which algorithms and automated diagnostics are slowly gaining the trust of the medical community. Trials and regulatory submissions will help here, but the clear proof will be the general trust of the medical community (and general population) in solutions that have been on the market for a while. Similar to what happened with GPS navigation technologies back in the day, it would require a critical mass to reach general acceptance. As far as the healthcare market is concerned, there is a forecast bounce back from telehealth into hybrid models (a mix between in-office visits and telehealth) as a first post-pandemic scenario. Although this is perceived as the best of both worlds, its effectiveness and survival within the market is still to be proven. A clear market trend accelerated by the pandemic is the commoditization of health and wellness features in consumer electronics. A glimpse into consumer electronics venues reveals that watches, smartphones, weight scales and even your office chair or mattress will soon be collecting healthcare information. imec MultiElectrode Array (MEA) chipset SEMI: What is imec’s role in addressing the challenges and trends in healthcare? Agell: As an R D organization, imec offers expertise in the semiconductor, integration, data interpretation, data management and health-specific application domains. Thanks to our experience in horizontal technology and multiple application domain verticals (including healthcare), imec provides solutions to partners that push the boundaries of performance in health-tangential fields such as communications, consumer electronics, automotive and energy. imec is part of big European initiatives aiming to tackle the challenges of the pandemic. For example, we recently started working on the Digipredict project, which aims at early intervention in infectious diseases. We’re working with key players in the research domain within the EU such as École Polytechnique Fédérale de Lausanne, University of Twente and Eidgenössische Technische Hochschule Zürich. Additionally, imec has worked for market leaders in the healthcare sector such as Philips and Biotelemetry (recently integrated in Philips) and can help partners make the next health solution a reality. SEMI: How can technology unite us? What do you expect from your participation at SEMI Technology Unites Global Summit? Agell: I am a big optimistic on this pandemic. I believe technology has played a key role in putting boundaries around damage caused by the global health crisis. Technology does not only unite us, but it arguably saves lives! My personal expectation for the SEMI Technology Unites Global Summit is for us to get a better understanding about how the semiconductor industry reacts to a pandemic and upcoming post-pandemic scenario. I am curious to see if health-related trends emerge, and whether this is a transitory effect. During the last global pandemic, the semiconductor industry was not even existing, so there is no clear precedent for the current situation. Carlos Agell, program manager and principal member of Technical Staff at imec, where he oversees the development of projects and sets strategy directions for research topics. He has a background in wearable device development, having taken leadership roles in development of two FDA-approved medical devices in the field of wearable cardiology. He is member of the Dutch chapter of the standardization committee, which develops next-generation international standards for active medical devices. Carlos Agell holds two MSc degrees in Electronics Engineering and EECS from the Polytechnical University of Catalonia (Spain) and the University of California in Irvine (Irvine, CA, USA). Serena Brischetto is senior manager of Marketing and Communications at SEMI Europe.
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SEMI spoke with Dr. Franz Laermer, Research Fellow (Senior Chief Expert) at Robert Bosch GmbH Stuttgart, Corporate Sector Research and Advance Engineering, about the latest trends in medical diagnostics and personalized treatments. An open platform for the automation of complex molecular diagnostics workflows recently developed by Robert Bosch has proven its ability to take molecular diagnostics to the point of need.To make this happen, miniaturization, microsystems and microfluidics technologies, as well as microelectronics, are crucial. This is critical for the detection of SARS-CoV-2 infections within a rather short development time.Laermer shared his views ahead of his presentation at the SEMI MedTech Forum, 19 February, as part of the SEMI Technology Unites Global Summit, 15-19 February 2021, online event. Join us to meet experts from Robert Bosch and other key industry influencers. Registration is open. SEMI: What is driving innovation in diagnostics and what role does the semiconductor industry play?Laermer: One of the major drivers in diagnostics is the molecular breakdown and detailed analysis of nucleic acids on the level of the individual nucleotide. This reveals the root causes of diseases like cancer, genetic aberrations, infections and therapy resistances. Today’s solutions are mostly PCR-based (that rely on the polymerase chain reaction) or depend on sequencing. The keys to bring these technologies closer to the point of need are automation, miniaturization, low-cost, ease of use, flexibility, reliability, and fast time from sample-to-result. Semiconductor and microsystems technologies are enablers to meet these requirements, thanks to their ever-increasing performance, with Moore’s law pushing the semiconductor side of the story.SEMI: Can you tell us more about the the Bosch VIVALYTIC system? Laermer: VIVALYTIC is a universal and highly flexible diagnostic platform for the integration and automation of a wide variety of molecular diagnostics assays. It consists of the universal laboratory analyzer tool, which operates the application-specific cartridges. All reagents and specific bio contents are contained in the application-specific cartridges in a long-term stable manner at room temperature. The user only has to introduce the patient sample into the cartridge, push the cartridge into the analyzer and start the automatic workflow, which yields a diagnostic result within typically less than one hour. The VIVALYTIC products are manufactured by Bosch Healthcare Solutions GmbH (BHCS) in cooperation with strategic diagnostic partners and bio content owners.SEMI: How is the pandemic impacting automated diagnostics in the medical industry? What is new now?Laermer: The pandemic has clearly shown the importance of fast automated diagnostics at the point of need. Breaking infection chains as early as possible requires fast reliable PCR testing anywhere and anytime. We managed to reduce the time needed for SARS-CoV-2 rapid testing to less than 30 minutes for positive probes, an achievement that is embraced by our customers. Until a sufficiently high level of immunization is reached by vaccination, rapid testing is the only way to limit the number of infections, hospitalizations, and lethal outcomes of the COVID-19 pandemic.SEMI: Besides infectious disease diagnostics, what solutions will enable a paradigm shift in medical treatments?Laermer: Today more and more targeted drugs and therapies are developed in oncology to address certain mutations that are considered drivers of the cancer. This moves away from the one drug fits all approach to precision oncology. As a prerequisite of this personalized therapy, the mutation status of a tumor must be clarified – and monitored precisely and repetitively during therapy. The latter requires molecular diagnostics at the point of need, i.e. at the onco-ambulance. One keyword in this context is liquid biopsy. Another example of personalized therapy is the detection of bacteria type and antibiotics resistances in bacterial infections, and the selection of optimized antibiotics therapy.SEMI: What solutions can Robert Bosch bring to address the needs just mentioned? Laermer: Robert Bosch GmbH is a leader in microsystems, microsensors and semiconductor technologies. Our new 12-inch semiconductor plant in Dresden will strengthen our position in these fields. This encompasses artificial intelligence and the Internet of Things as well. As a technology provider, we generate superior solutions for automation and management of complex workflows, and thus deliver win-win-solutions together with our diagnostic partners.SEMI: How can technology unite us? Laermer: Technology, especially semiconductor and microsystems technology, is a game changer in the medical area. Whenever different disciplines meet each other and cooperate, as are the medical, diagnostics and semiconductor areas, innovation is accelerated strongly. New things happen at the interfaces between different areas of competencies.Franz Laermer, Research Fellow (Senior Chief Expert), Robert Bosch GmbH Stuttgart, Corporate Sector Research Advance Engineering. Dr. Franz Laermer joined the Corporate Research and Technology Center of Robert Bosch GmbH, Stuttgart, Germany, in 1990, where he started the development of new key technologies and sensor functions for the upcoming field of MEMS at Bosch. Today he is a Bosch Research Fellow/Senior Chief Expert for Microsystems, Microfluidics and Molecular Diagnostics. Laermer's work laid the foundation for the VIVALYTIC Diagnostics Platform of the newly founded Bosch Healthcare Solutions (BHCS) Business Division and the SARS-CoV-2 rapid tests from Bosch. Dr. Franz Laermer is the co-inventor of the Bosch Deep Reactive Ion Etching Process (BOSCH-DRIE) for microstructuring silicon. He holds more than 200 patents and was awarded with European Inventor of the Year 2007 – Category Industry prize by the European Commission and the European Patent Office (together with co-inventor Andrea Urban) for the invention, development and sustainable success of the BOSCH-DRIE process. He received the 2014 IEEE Jun-ichi Nishizawa Medal Award from the Institute of Electrical and Electronics Engineers (IEEE), USA. In 2019 he was awarded with the 2019 Technology Prize from the Eduard-Rhein-Foundation in Germany.Serena Brischetto is senior manager of Marketing and Communications at SEMI Europe.
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