THE FUTURE IS HERE WITH DISRUPTIVE TECHNOLOGIES

By Healthovation Team

Cover Story

February 3, 2020

In Bushoro, Uganda, six-year old Gordon Andindagaye watched in awe as Dr. William A. Cherniak moved a small ultrasound scanner on his chest. The doctor plugged the scanner into his iPhone and peered into the clear image on the screen, watching little Gordon’s lungs fill with air and expand as he breathed in.

The reason for Gordon’s persistent cough and swollen lymph nodes was clearly visible on the image. His lungs had fluid in them. The scan was uploaded in the evening so that the diagnosis of early-stage pneumonia could be confirmed by an ultrasound specialist in Toronto.

Medical Innovations

When compared to other industries, innovations in medical technology are few and far between. But when innovations do come, it proves to be life-altering. One such case in point is the Butterfly Network’s new Ultrasound device – the Butterfly iQ – an innovative solution that turns a smartphone into an ultrasound machine. An amazingly compact device that makes people wonder why nobody ever thought of it before, this technology puts medical imaging into the hands of as many people as possible.

“We were told that we can’t build a system like this; it’s too big, too complex.” And while he knew it was not impossible, Jonathan Rothberg, a serial biotech entrepreneur, realized that if it wasn’t difficult it would have been done already. However, he had a vision. A vision that originated from the desire to make an impact in the lives of patients around the world.  For Jonathan, it was more of a personal journey as well. His inspiration to take a closer look at ultrasound machines came from his little daughter, who suffered from tuberous sclerosis (TSC), a rare disease that causes tumours in the organs. While her tumours were, thankfully, non-cancerous, the management of the disease required multiple ultrasound scans to monitor the growth of the tumours affecting her kidney.

The family had to drive to Boston each time for an ultrasound, and this got Jonathan’s brain working on overdrive. The inefficiency of her treatment and the unwieldiness of the ultrasound equipment made him wonder why modern technology could not be used to fundamentally change how we image the body.

The family had to drive to Boston each time for an ultrasound, and this got Jonathan’s brain working on overdrive. The inefficiency of his daughter’s treatment and the unwieldiness of the ultrasound equipment made this biotech entrepreneur wonder why modern technology could not be used to fundamentally change how we image the body.

Making the Right Connections

Rothberg connected with Max Tegmark, an MIT professor of Physics who was undertaking revolutionary work in the field of imagery. Tegmark was working on a project that captured images from thousands of radio telescopes and used it to measure the energy from distant stars. He had developed a system which he called the “butterfly network”, to split the data-processing between the various antennae in an efficient manner in order to capture high-quality images.

Rothberg told Tegmark that he would love to further develop his ideas on imaging and use them to put an ultrasound machine on a chip. He asked him for the brightest and best among his students who could help him do that. Tegmark introduced the idea to Nevada Sanchez, a bright young double degree holder from MIT who was working in his lab at the time.

Birth of an Idea

Sanchez immediately saw the potential in this, and together with Jonathan the duo founded Butterfly Network in 2011. This partnership brought together two of the brightest minds in the industry to redefine the way medical imaging has been carried out for the past 50 odd years.

Sanchez worked on designing a chip that functioned like the crystals in the transducers found in traditional ultrasound machines. In the old models, an electric current that was applied to the crystal would cause it to vibrate and produce sound waves that travelled into the body. Returning echoes that hit the crystals would emit electric currents that were translated into an ultrasound image. Sanchez’s chip functioned in the same manner but could be manufactured at a dramatically lower price point. This $2000 scanner could do all the things that a $50,000 ultrasound device could do, and more!

Revolutionizing the Industry

Several prototypes later, the first handheld ultrasound was born – a pocket-sized ultrasound scanner called Butterfly iQ, equipped with the power to change the very face of healthcare!

Here, traditional hardware is replaced with a semiconductor chip, in a smart device that needs only a single probe that connects to a smartphone. This probe is usable on the whole body, a marked improvement over the multiple probes that were earlier needed. Users can connect to an app that captures images, pulls patient information and sends scans to a secure
Butterfly Cloud. The app can even send images seamlessly to PACS, the radiology software system popularized by leading healthcare organizations.

On September 25, 2018, this revolutionary development in medical technology was formally launched in Europe. Since then, this all-in-one pocket-sized ultrasound system has been winning one award after the other. Not surprising, as it has the vision to democratize healthcare for the world.

“4.7 billion people around the world are in the medical profession today,” Jonathan points out, “and only 1% of them have access to medical imaging”. This invention will turn these statistics around, ushering in a new era in healthcare.

Are the days of the stethoscope numbered? Only time will tell. As yet, the Butterfly iQ is approved for operation in less than 20 countries. Ethical and other issues prevent its use in some countries, where the PCPNDT Act has been firmly in place since 1994 to prevent socially unacceptable practices such as the sex selection of unborn foetuses.

Awards and Accolades

President Obama was one of the first to recognize the potential of this imaging device. He presented Jonathan Rothberg with the National Medal of Technology and Innovation for his “pioneering inventions and commercialization of next-generation DNA sequencing technologies, making access to genomic information easier, faster and more cost-effective for researchers around the world.”  Subsequently, the device has won a slew of awards, ranging from the 2019 Apple Design Award to the Not Impossible Labs 2019 Healthcare Breakthrough Award and the Fast Company 2019 World Changing Ideas Winner for Health and Wellness.

And they are already going global. With a $250 million investment at a $1.25 billion valuation from the likes of The Bill and Melinda Gates Foundation, Fidelity and Fosun Pharma, they are well on their way to realizing their vision. Using Butterfly iQ, even the most remote village in a corner of the world has access to second opinions from distinguished specialists in the global medical community.

We’ve Come a Long Way from the Stethoscope

Experts feel that this pocket-sized ultrasound could very well threaten the existence of the stethoscope which was once considered the hallowed symbol of the medical profession. Although today’s stethoscopes are a far cry from the rudimental model invented in the early 1800s by Frenchman Rene Laennec, they work on the same principles. Laennec’s model used just a hollow wooden tube, about one foot long, to amplify heart and lung sounds. Later on, the rubber tubes, earpieces and cold metal disc that are synonymous with modern stethoscopes were added.

The butterfly iQ has completely turned this method of diagnosis on its head. With every bit as easy to use as stethoscopes (perhaps, easier) this device allows doctors to clearly see what’s going on under the skin rather than just listen to sounds. Moving pictures and readouts allow for accurate and instantaneous detection of valve leaks, heart murmurs, abnormal rhythms, tumours and other problems in the heart, lungs and elsewhere.

Are the days of the stethoscope numbered? Only time will tell. As yet, the Butterfly iQ is approved for operation in less than 20 countries. Ethical and other issues prevent its use in some countries, where the PCPNDT Act has been firmly in place since 1994 to prevent socially unacceptable practices such as the sex selection of unborn foetuses.

Experts feel that this pocket-sized ultrasound could very well threaten the existence of the stethoscope which was once considered the hallowed symbol of the medical profession.

Help for our furry friends too!

And there’s help for our four-legged pals too! Butterfly iQ Vet – the equivalent device for veterinarians can help diagnose your pet minus any incision and without causing the poor animal undue pain. This translates to early diagnosis and improved outcomes for every animal, big or small.

“The iQVet has the potential to change veterinary medicine; it makes the diagnosis more accessible!” As one of the very first users of Butterfly iQ Vet, Valerie Wilson, Aurora Companion Animal Hospital in Gretna, Louisiana says that she uses the device at least once a day to rule out potential tumours.

Unique Selling Points

In the past one year, the Butterfly iQ device has been a game changer for thousands of medical practitioners in the U.S. and abroad. As opined by Dr. John Martin, Chief Medical Officer at Butterfly Network, the selling points that make Butterfly iQ stand apart are its “affordability, portability and versatility”. Priced at just £1,699 ($1,999), Butterfly iQ is available at just a fraction of the cost of other devices currently available.

Besides which, the fact that it can be carried around in a physician’s pocket (the Butterfly is just about the size of an electric shaver) makes it accessible to patients in far-reaching corners of the world. The results can be shared online for educational, referral or discussion purposes. The integrated software platform that uses cloud-based software innovation powered by Amazon’s AWS is what makes it truly unique. As Jimmy Jia, principal scientist at Butterfly Network , says, “Using AWS Cloud services, we can put advanced imaging capabilities in the hands of many more people around the world and empower them with new ways to securely store, share, and collaborate with medical images.” Truly the technology of the future.

But for Jonathan Rothberg and Sanchez Nevada, the greatest reward comes from seeing the impact that this device has already made in the lives of patients around the world. They don’t believe in maximising profits; they believe in maximising impact.

“I got a message from a doctor telling me that he just saved a patient’s life using this. And that was an important moment for me…I was paralysed in my seat. Someone is alive today, because I did this,” Nevada says. “For me, that’s the biggest motivation.”

 

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