Connected health, which can be defined as technology-enabled care and the potential for new strategies in healthcare delivery, is driving growth in embedded design applications. Advanced medical devices that require high performance include both large-scale systems as well as hand-held, portable devices.

Today’s OEMs face complex and demanding regulations and market requirements. From imaging, diagnostics, and therapy to patient monitoring and medical information technology systems infrastructure, designers use an extensive range of products and services to meet international medical standards for hardware, software, and connectivity. Such standards include ISO 13485, EN 60601-1, and UL 60601-1. Many size and performance demands can be addressed with Intel multicore processor architectures that are integrated into either computer-on-modules (COMs) or CompactPCI-based systems.

 

Smaller Devices, Bigger Performance

One of the most important medical design trends is a reduction of device size, driven largely by smaller components to integrate into a design. For example, take an imaging application that has previously run on a cart and now must be developed on a smaller scale. COMs support this particular design path by not only moving from medium-sized devices toward smaller products, but also by providing upgradeability within a single product generation.

For example, high-performance COMs such as the ETXexpress-PC can perform imaging work that previously required a much larger single-board computer. An even smaller footprint can be achieved by using the microETXexpress-PC module based on the same chip set and central processing unit (CPU). In addition, a sister device that doesn’t require the same high image processing capability but needs to be more power efficient could use the microETXexpress-SP module. These options give designers a range of scalable performance within a single medical product line. Further, designers can anticipate that future COMs, such as the recently introduced microETXexpress-XL, will be a good match for sister devices that need to be highly resistant to shock and vibration and can withstand extreme temperature conditions.

The amount of performance that can be squeezed into a small form factor has improved dramatically with the advent of Intel’s 45-nm architecture. Designers can anticipate that recent developments such as Intel’s 32-nm processor technologies will only continue to propel reliable and high performance in medical devices and systems. Specifically developed to address embedded applications limited by space, performance, and thermal constraints, 45-nm technology achieves fast performance with clock speeds between 1.1 and 1.6 GHz in a sub-five-watt thermal power envelope. With power optimization on the frontside bus of up to 533 MHz, the technology enables fast data transfer. This speed is especially suited for on-the-fly imaging tools that scan and transmit images of an injured person en route to the hospital or while at the scene of an accident.

Digital Technology Drives the Medical Market

Digital technology is dramatically evolving medical markets and playing a key role in many aspects of design, as service providers work to improve both efficiency and standards of care. Portable devices, for example, meet and exceed current standards in terms of speed and accuracy of medical data collection and provide an avenue for secure and effective data transmission among medical service personnel. According to a market report by New Venture Research Corp., these and other market conditions are expected to drive significant growth in embedded medical technology.1 The role of COMs is expected to grow to $205.6 million by 2013, up from $78.7 million in 2008. This increase represents a compound annual growth rate of 21.2%.

The COM Express standard, a PCI Industrial Manufacturers Computer Group industry specification (initiated by Kontron Corp. and originally sponsored by Kontron, Intel Corp., PFU Ltd., and RadiSys Corp.), includes defined interfaces that enable a smooth transition from legacy parallel interfaces to low-voltage differential signaling (LVDS) interfaces. Legacy buses such as PCI, parallel advanced technology assessment (ATA), LPC, and HD Audio (or AC’97) can be supported. New high-speed serial interconnects such as PCI Express, serial ATA, or SAS and gigabit Ethernet are also supported. As an evolving standard, COM Express was initially designed to accommodate the next generations of PCI Express (5 GHz) and serial ATA (300 Mb/sec) interfaces, effectively doubling existing data rates to 160 Gb/sec and 1.2 GB/sec. To ensure future scalability and interoperability between COM Express modules and carrier boards, five common signaling configurations (pin-out types) have been defined to ease system integration. Some pin-out types require only a single 220-pin connector, and others require both of the two integrated 220-pin connectors to supply all the defined signaling.

Additionally, the support of PCI Express Graphics (PEG) rather than older AGP graphics has greatly improved images that doctors rely on when evaluating a patient’s condition. Support for advanced communications technologies such as gigabit Ethernet and USB 2.0 also allows medical personnel to view these high-quality images in real time. Serial DVO and LVDS capabilities within COM Express module-based embedded medical applications eliminate a bottleneck in the transmission of data.

 

Customization Doesn’t Expire

As off-the-shelf compact modules, COMs contain all core PC functions including graphics, Ethernet, sound, communications interfaces, USB ports, and other system buses. These functions represent an entire computer host-complex on a small-form-factor module. The module is then mounted onto custom carrier boards containing application-specific I/O and power circuitry customized for specific medical end uses. It is only the custom-designed carrier board that relates to the specific medical application, which adds the required functionality for a number of unique treatment or diagnostic procedures, such as medical imaging or capturing patient data such as blood pressure or heart rate.

The investment in customization can be extended over several end-product generations with various CPU cores that can be swapped out as required for product extensions and line expansions. In contrast, low-volume designs with no custom hardware requirements may be more appropriate for a standard single-board computer solution.

A standard COM implementation might be found in a future application such as a miniature ultrasound machine that is small enough to fit inside a medical technician’s pocket and can wirelessly transmit images to a standard PC for remote diagnosis. First responders could use this new device to communicate with attending doctors, which would enable responders to start the diagnosis and treatment process even before the patient arrives in the emergency room.

Whether end-user expectations are driving device development or the other way around, designers are free to expand their thinking as new technology emerges. For example, micro- and nanosized versions of COMs give portable designs more computing power than previous systems. The microETXexpress module is now accepted into the COM Express standard as the compact form factor, and nanoETXexpress only differs from the official COM Express standard in terms of size. The pin-out definition and connector placement is completely in sync with the standard for pin-out type 1.

Advances in medical imaging illustrate these benefits and offer a much broader application than in previous years. For example, powerful imaging equipment is being used in treatments that include trauma, cardiology, and cancer. Portable devices are no longer limited by low-quality imaging or slow processing. These device improvements are resulting in reduced human error and fast diagnostics. They have made great strides in the concept of preventive medicine.

 

Large Devices Keep High Computing Power

The opposite end of the medical design spectrum includes hospital records systems or large imaging applications such as room-sized MRI or scanning machines that are more sophisticated and powerful than tiny, portable medical devices. These large devices are part of the trend in increasing computing power and remain unaffected by the movement for smaller designs. This trend is especially critical for the growing number of medical applications that rely heavily on image processing. CompactPCIs have a solid role in these applications, based on its robust construction and high-performance PCI-Express computing blades.

Ideal for effectively processing a lot of data via distributed high processing capabilities and high-capacity I/O throughput, CompactPCI is highly applicable to the wealth of medical imaging applications that are improving patient care and delivering detailed data in real time to both patients and healthcare professionals. The challenge for developers of products for the CompactPCI platform is to develop devices that can address the immense processing power required for current and future imaging applications. This issue is especially important as images are expected to be clearer and more precise than in the past.

Intel Core 2 Duo processors with 45-nm technology are being incorporated into the current generation of CompactPCI 6U and 3U products. As a result, designers are seeing significantly greater throughput, up to 8.5 GB/sec, with the use of current Intel chip sets compared with earlier processor generations. With no measurable increase in energy consumption, multicore architectures for CompactPCI equate to 25% faster core speeds (2.53 GHz), 50% more L2 cache (6 MB), and a 60% faster frontside bus (1066 MHz).

Overall, multicore characteristics keep CompactPCI’s performance intact without adding cost to maintain appropriate thermal thresholds. Further, CompactPCI boards integrating CPUs with 32-nm processing technolologies allow more computer performance while consuming less power, delivering greater potential with respect to upgrading and extending the life of implemented systems. For instance, an existing system that uses up to 10 CompactPCI 2.16 single-core, single-slot boards could potentially achieve the same performance with a single dual-slot, quad-core board. With anticipated performance improvements and greater energy savings resulting from Intel’s 32-nm processor technology, atom-based low-power processors, and multicore architectures, CompactPCI’s role in the medical device market is not only strong but also growing significantly.

CompactPCI is rugged for demanding medical applications. With gas-tight, high-density pins and socket connectors, as opposed to card-edge or slot-based connectors, PCI signal reflections are minimal based on low induction and controlled impedance. Although card-edge and slot-based may both be ideal for nonmobile applications, the high-density pins in CompactPCI allow it to perform in more rugged environments.

For example, CompactPCI would be suitable for a rolling cart that might be used in several areas of a hospital and is frequently on the go from patient to patient. Reliability is strong with 220 ground pins (such as defined in the COM Express specification), providing suitable shielding and grounding for low ground bounce and continuous operation in noisy environments. The gas-tight connectors provide strong and reliable mating between the board and the backplane. Furthermore, the high pin density allows for hundreds of ground pins that enable suitable shielding and grounding for low ground bounce and continuous operation in noisy environments. Because medical imaging machines frequently work nonstop, the fundamental design elements of CompactPCI can accommodate a demanding working environment that requires constant high computing power.

 

Medical Devices: Designing for the Long Haul

Overall, medical device designers have a lengthy wish list when it comes to preferences and requirements for the components that they design into their products. Life cycle management, program management, and supply-chain management play key roles in any product’s design and ultimate success. Most medical applications require long-life platforms that are available for 10 years or more. Designers must choose components that will have the appropriate life cycle not only through the 12-month or longer design cycle, but also through a potentially lengthy FDA approval and as many as 10 years of production.

As such, component manufacturers are taking steps to extend life beyond the basic 10 years that is common in medical life requirements. This goal is effectively supported by Intel and its commitment to seven-year life for selected processors and chip sets. COMs such as the microETXexpress-DC manage this requirement by including a CPU and chip set bundle slated to be available through 2015 and potentially further into the future through special arrangements.

Other strides in technology mean further evolution and market growth for medical devices. These advances include new display capabilities, improved design flexibility, and faster I/O such as USB 3.0. With additional pin-out options and lower power features expected, medical OEMs will be challenged to deliver technology and devices geared to specific application areas. The benefits of low-power design can be realized in devices that are smaller, more user-friendly, and more mobile, which enables easy transportation to places where emergency response is needed but where conditions may be more rigorous, such as in third-world countries.

 

Conclusion

Technology advances such as general electronics design and, more specifically, the COMs universe, along with factors such as early availability, long lifespan, quality, and flexibility, can present challenges when it comes to component selection and implementation. Today, component manufacturers are engineering resources and play a more integral role in the design process. However, they must not only understand the technical design requirements but also the trends, industry influences, customer requirements, and regulatory demands. These design elements make the component manufacturer-designer relationship critical to the overall success of the medical device.

 

Reference

Christine Van De Graaf is product manager at Kontron’s Embedded Modules Division (Poway, CA). She can be reached via e-mail at christine.vandegraaf@us.kontron.com. David Pursley is applications engineer of MicroTCA, ATCA, cPCI, VME, and VPX product lines at Kontron. He can be reached at david.pursley@us.kontron.com.