Innovation & Tech Today - Summer 2014 - Sports & Medical Technology

THE ROBOT’S JOURNEY FROM SCI-FI TO

OPERATING ROOMS

SUSTAINABLE STADIUMS NEXT GENERATION DESIGN

THE SUMMIT

SPECIAL FOCUS:

OF SPORTS & MEDICINE

SPORTS & MEDICAL

TECHNOLOGY

GAMING 30 IS THE NEW TEENAGER

NEW TECH PRODUCTS, GIFTS, REVIEWS AND MORE

SUMMER 2013

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Charles Warner cwarner@goipw.com Robert Yehling ryehling@wordjourneys.com Mary Racila raciladesign@aol.com Shane Brisson Loren Wilde Kelsey Elgie Domier Dave Van NIEL Carlos Hernandez Nicholas Guzzo Aaron Halda Kelsey Elgie Domier Lisa Lunney Stephanie Clarke Amanda Leach Fletcher Martin Rosemary O’Brien Dave Batten Aaron Halda Chance Van NIEL Barbara Stahura Darryn Busby Kylee Bulla

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SPECIAL THANKS TO IDG World Expos and Macworld/iWorld, Jessica Venditto, The V Foundation for Cancer Research, INPEX, Randy Manzo, Mark Cuban/Magnolia Pictures, Bjorn Brunvand, Christy Laramy, Chris Voss, Lloyd L. Rich, P.C., Joe Huffstutler, Jan Johnson, CEO Space, 4imprint, Olivia Sellke/CEDIA, Martha Halda, FUJIFILM, Moffitt Cancer Center, Xenith Helmets, I1 Biometrics, Zephyr Technologies, Siemens, John Capurso/Visioneer, Madonna Rehabilitation Hospital, Centre for Neuro Skills, Andrews Orthopaedic & Sports Medicine Center/Dr Joshua G Hackel, Keiser University/Dr. Julie Snyder This publication is dedicated to the dreamers, the innovators, the collaborators and the doers who can’t be bothered by those saying it can’t be done.

This is for Nicholas and Aria.

from the publisher

Nicole McDaniel Photography

N

ow that we have put the finishing touches on this sports and medical technology edition of Innovation and Technology Today, it is our sincere desire that you will enjoy these stories from our finest group of writers and contributors to date, assembled by our amazing editor, Robert Yehling. As this publication, your publication, grows a bigger audience and even wider distribution, our staff is dedicated to providing compelling reports on the topics you want to know about.

Make sure to check out the latest on robots in the operating room (page 58). We have certainly evolved from sci-fi to reality, with robots, iPads, wearable sensors and other cutting-edge technology now an everyday part of the healthcare system. We also present a fascinating look at how far collaboration and integration between sports, medicine, fitness, rehabilitation/therapy and technology can go, with our flagship feature on The Summit Medical Fitness Center (page 30). Treatments are improving and recovery times are speeding up, primarily due to the latest and greatest technology skilled doctors are putting to use.

Speaking of sports, with our national American pastime, football, kicking off, it should give us pause to realize just how little we still know about TBI and the human brain. We cover this subject thoroughly (page 36), thanks to our special guest contributor, Barbara Stahura, a national expert on offering therapy to TBI victims through writing and journaling.

Sadly, it is just now becoming common knowledge that an individual receiving multiple concussions or head injuries while doing their job (even while wearing a helmet) could have permanent, lasting effects. Apparently the NFL decided that was not something they were ready to fight in court, after agreeing to a landmark $765 million settlement with the NFL Players Union — without admitting guilt or conspiracy.

This development is important not only in the sports we play, but the way we defend our nation. The military has had to deal with its own TBI crisis, with two major wars winding down and almost 30% of soldiers injured in combat sustaining some type of head injury. Hopefully, the U.S. military will realize that the brain doesn’t heal like a broken bone. The stigma has to be removed from these proud warriors, who need help putting the pieces back together after suffering head injuries in the line of fire. There could be no better example than Staff Sergeant Ty Carter, our newest Medal of Honor recipient. Carter was later diagnosed with a mild traumatic brain injury from an RPG blast. He has permanent hearing loss and ringing in his left ear, as well as post-traumatic stress disorder. “I promise the mothers, fathers and spouses of my fallen brothers that I will strive to live up to the responsibility that this medal brings,” he said in a statement after the ceremony. “I’m eager to represent the thousands who suffer from the invisible wounds of war.”

Enjoy the sports and medical technology features, as well as our regular departments and our newest edition, the Gaming and Entertainment section. Please share your feedback with us. After all, innovation and technology affects our daily lives and belongs to all of us, but this publication belongs to you, our readers.

See you next issue!

Charles Warner Publisher 4

Innovation & Technology Today

Summer 2013

Contents contents

Dr. Joshua Hackel

44

iDevelopers

66 04

From the Publisher

72

Gift Guide

74

Product Revolution

76

In Our Next Issue

30 I&T TODAY CONVERSATIONS

08 DEPARTMENTS 08

Metric Mania

10

Communications

12

Point of Purchase

14

Smart Homes

16

Green Technology

18

Women in Technology

22

Education

24

Social Media

26

Security

30

Brad Roy, The Summit

44

Dr. Joshua Hackel, Andrews Sports Institute

62

John Capurso, Visioneer

John Capurso

62

66 FEATURES 66

A Gathering of iDevelopers

69

Gaming: 30 is the New Teenager

28 SPECIAL FOCUS: SPORTS & MEDICAL TECHNOLOGY

6

30

The Summit of Sports & Medicine

36

Imaging Head Trauma & Traumatic Brain Injury

40

Head Trauma Gets an App — and Goes Wireless

48

Healthy Measures & Wearable Sensors

56

Keeping Football Players Safe

58

Innovative Approaches to Cancer

64

The 3D Growth of Medical Imaging

Innovation & Technology Today

Keeping Football Players Safe

56

Summer 2013

Metric MANIA

8

Innovation & Technology Today

Summer 2013

Communications

By Stephanie Clarke

The Future of Media Bundling Recently, I received a phone call from my cable company offering me a great deal as long as I bundled my cable, internet and telephone line.

Telephone line? I haven’t used a land line in nearly a decade. Didn’t matter. As long as they could install it, I would have the line and save about $50 a month on what I consider my cable bill, because let’s face it: I’m going to pay $99 for cable. The other stuff is free.

Hold on. If I decide to use their home security system, upgrade to Showtime and HBO, then I can save more … right?

This whole scenario seems like a late night infomercial where they keep throwing the discounts at you, but only if you act now! So I acted now. I have cable, internet, a phone line, two premium cable channels and a home security system for the low $199 per month. Not bad, right?

I’m only paying $100 more for all that stuff … that I won’t use. That’s why companies want you to bundle.

Bundling isn’t a new concept. Fast food has done it for decades with meal deals. Discount travel sites offer attractive flight, hotel, and car rental packages. Even ebook sales, now a billion dollar market, have begun to bundle new bestsellers with other authors you may not have read otherwise. Dish Network and DirectTV? Bundling experts.

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Why do companies bundle?

Bundling is marketing. The more products a customer uses, the more likely he or she will stick with the company. A company will offer a popular item with an unpopular product to create perceived added value. By snagging me with a threefor-one deal, as long as I hold onto that deal (and extend my cable contract), I can have a discount on premium channels. Since I am doing the full bundle, I now have a security system. Theory holds I am less likely to get rid of something I possess than to sign up in the first place. A good example is the 60% of people who have a gym membership and never use it. Guilty.

With constant phone calls, television commercials, flyers and billboards attacking the population in a bundling frenzy, I began to wonder, “What’s next”? Media companies such as Netflix and Hulu have started to

Innovation & Technology Today

jump on board. According to Wall Street Journal insiders, Hulu has been considering a makeover, offering subscription bundling packages for premium cable TV shows and channels. They also offer affiliate programs that turn bundling into an incentive for subscribers and businesses. Netflix has overcome its 2011 blunder of separating streaming and CD delivery by opening up deals for more streaming entertainment, while making themselves highly compatible with almost every game system and hand-held electronic device on the market.

What if you get creative with your bundling, and ditch the TV in favor of Netflix, HuluPlus and occasional sports broadcasts on, say, ESPN3?

Then you’ve given yourself a plethora of entertainment for $16 per month. That’s becoming a trend as people try to skirt the turf wars brewing between cable providers and networks (i.e. Time Warner Cable and CBS).

What is the future of media bundling? Let’s consider other facets of the quickly advancing media industry. As competition on the Smart phone app market grows, should we keep our eyes out for the bundling of game, finance, and news apps? Will the next big bundle package be smartphones, tablets, and a Hulu account? ■ Summer 2013

P oint of Purchase The Card That Saves Lives

The scenario is familiar: A person suffers a heart attack or a horrible car accident. No one can identify them.

The EMTs arrive, ready to provide life-saving treatment — but can’t.

They know nothing about the person, or his or her medical history. They don’t even know the person’s name.

What sometimes happens? Sadly, an otherwise avoidable death.

“One of the leading causes of death is when first responders do not have access to your emergency medical information,” says Jeff Mullen, the CEO of Dynamics Inc., a multiple award-winning provider of nextgeneration power credit cards. “The information they need is contained in your head, questions you could answer if you were conscious.

Basically, what’s on hospital entrance forms. If you could answer, then EMTs could use all the tools and medicines at their disposal. If you’re unconscious, they take a far more conservative approach. A lot of deaths happen between the time you go unconscious and when they figure out how to treat you, because you can’t give them the information they need.”

Enter the innovative Mullen, whose devices are revolutionizing credit card 12

potential. Dynamics Inc.’s ePlate Credit Card Devices, launched at the 2013 International CES show, provide customers with instant, high-value rewards for their purchases. The diverse family of reward providers regularly changes to assure fresh experiences and offerings. (We’ll look more into these cards in our next issue).

From this killer technology, which Mullen began developing in 2009, comes Life Code — a game changer in emergency situations.

“We had to determine how we could create this service, this lifesaving tool, without changing the structure of our card,” Mullen said.

“Our solution was to create a nextgeneration power card that attaches to your driver’s license. When you buy a Life Code, it comes with a sleeve, so you can put your driver’s license and card together.”

Here’s how it works: You purchase a subscription to Life Code for $44.99 per year. On the website, you fill out a hospital entrance form, which is connected to the electronic card with a passcode. You can visit the website as often as you wish to update or

Innovation & Technology Today

add information. Furthermore, dependents can be listed.

Now let’s say there is an emergency. How do EMTs access the information when they reach you, and locate your driver’s license and Life Code card?

“The majority have Internetenabled devices, such as tablets, and they all have cell phones,” Mullen said. “They go to our website and press the display button on the card.

They’re provided with a one-time passcode to retrieve the person’s hospital entrance form.”

Security is another huge concern with medical records — but not in this case. Mullen and his team figured out an ingenious way of assuring security for Life Code subscribers. “After the EMT obtains the card and accesses your information, there’s an algorithm inside the card that automatically changes the passcode,” he said. “This ensures the security of your data. If a nurse gets the original passcode and Tweets it out, no one else can use it.”

In this crazy world of credit card offerings and new technologies, what could be more vital than a life-saving electronic card? Not very much. ■ Summer 2013

Smart Homes Set Your Sights on CEDIA EXPO 2013 One of the sexiest aspects of Smart Home design concerns its electronic features. The way in which we coordinate our appliances, media and entertainment says a lot about our style and tastes, and also the quality of our homes.

Which is why CEDIA EXPO 2013 is one of those trade shows that generates a creative as well as practical buzz. Whenever you fill a room with custom electronics designers and installers, and they showcase their newest products and services, you can expect an eventful weekend of orders, stories and ideas.

It’s trendy, it’s now, and it’s innovative — which is why Innovation & Technology Today joins the show as a CEDIA partner in 2013.

When members of the Custom Electronic Design & Installation Association, media and others convene Sept. 25-28 at the Colorado Convention Center in Denver, they will be able to partake of 107 sessions, 36 new courses, 13 learning lab courses, 11 networking courses, and five certification and credential opportunities. They will also walk into some of the latest developments in the Smart Home world: • The constant advancement of high performance media rooms. This is the alternative to a home theater set-up for those of us who cannot dedicate an entire room of the house to our listening and viewing enjoyment. Media rooms can be 14

developed within living rooms, family rooms or even guest rooms, using the combination of compact audio technology, large screen wall displays for front, flat or rear projection, and universal remotes.

Expect to see the latest products in this fast-growing area.

• New homes are not the cash cow for smart home technology. As of 2012, 73% of residential product revenue for home technology professionals came from existing homes. That number continues to rise at about 5% per year as people find retrofitting a far more economical way to create smart homes. This and other trends (recurring revenue services, integrated systems and control, etc.) will be dissected, and broken into specific training steps for companies and individuals.

• The New Solutions Village. Hot

Innovation & Technology Today

new products, presentations from new CEDIA members, and minisessions on emerging trends will be showcased in this section of the expo, enabling you to get a solid read on the present and future direction of smart home electronics.

• The Electronic Lifestyles Awards. The Roaring ’20s will be the theme for the fete that honors many of the top innovators and designers in custom electronic design and installation. This is the big part of CEDIA EXPO 2013.

• Breakout discussions and sessions. The many breakout discussions, courses and sessions at CEDIA EXPO 2013 cover every category of smart home technology, service and installation: Business Growth, Emerging Trends, Forging Alliances, Operational Excellence, Technical Excellence, Manufacturer Product Training, and Certification Information. They run all the way through the expo, from 9 a.m. on September 25 to 5 p.m. on September 28.

The keynote speaker will be Nest CEO Tony Fadell, who worked with the late Steve Jobs to create the first 18 generations of iPhone and iPod products at Apple. Fadell has authored more than 100 patents.

If you want to get ahead of the game, download the CEDIA 2013 App or grab the Virtual Registration Brochure. ■

Summer 2013

Green

TECHNOLOGY

By Kelsey Elgie Domier

The Next Generation of Design: Sustainable Stadiums

Images courtesy of the San Francisco 49ers

As the world’s population grows and demands more energy, businesses and consumers are working diligently to conserve available resources while exploring new renewable technologies. This movement has gained a considerable following among those constructing mega structures — skyscrapers, stadiums, and colossal manufacturing facilities that have equally extreme energy demands.

One of these structures will soon be the new home of the San Francisco 49ers.

NRG Energy has grown into one of the largest solar power installation companies in the U.S., currently set to produce more than 900 Mw of solar power this year. “NRG is much more than a founding partner, they are providing the energy leadership, infrastructure and expertise to help us achieve the vision of making the new stadium an economically and environmentally sustainable showcase for innovation,” said Jed York, Chief Executive Officer of the San Francisco 49ers.

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The team’s new $1.2 billion venue will have a seating capacity of 68,500, with the capability to expand to 75,000 fans for other major events, such as the Super Bowl or FIFA World Cup. It will also pioneer the way for nextgeneration stadium design.

NRG’s partnership with the 49ers will result in the first professional football stadium to open its gates with LEED certification — the standard for measuring a building’s sustainability. HTNB, a globally renowned architecture firm, along with Turner-Devcon Construction, have been working tirelessly around the clock (according to recent estimates, the duo is actually ahead of schedule) to ensure the stadium will be open for the kickoff of the 2014 NFL season.

One of the most unique features contributing to the LEEDS certification is a 27,000 square-foot Green Roof installation on the west side of the stadium, atop the suite tower. The state-of-the-art Green Roof retains rainwater, filters

pollutants out of the air, and acts as an insulator to the luxury suites, which can reduce cooling costs by over 50% via evaporative cooling.

Furthermore, a 20,000 square foot array of solar panels supplied by SunPower and installed by NRG Energy will provide a total peak capacity of 400 Kw, resulting in enough power to achieve a net zero energy performance during home games. The stadium will also promote renewable energy efforts with an NFL first; three bridges shaded by solar arrays connecting the main parking area to the stadium, creating an eco-friendly fan experience unlike any other.

Since 1987, the facility has served as the home to the 49ers administrative offices and training facility. The new expansion will address all of the team’s needs in a single location. Thanks to the foresight of NRG Energy, HTNB, Turner/Devcon Construction, and the 49ers, the new stadium will set the standard of sustainability to which future stadiums will be held. ■

Innovation & Technology Today

Summer 2013

Women in Technology

By Lisa Lunney

Sirens of Success: Innovative and Inspiring Women Women are now having a bigger impact on our world than ever. Bold truths such as this are exciting, and spread feelings of hope and optimism for the future. These individuals are confident enough in themselves to be exactly who they are — not what society suggests they should be. A woman completely confident in herself and her own identity is an icon of power and ingenuity.

Especially when they combine their clout with instantaneous product and social networking technology.

In the last twelve months, diverse females across the globe have been praised for their contributions to the world at large. The now iconic name of Tory Burch had humble beginnings. Ten years ago, Tory Burch LLC launched from Tory’s kitchen and began by marketing her signature ballet flats. Her line has expanded significantly and in 2012 brought in $800 million in revenue.

In addition to being a fashionista, Tory is also a notable philanthropist, launching the Tory Burch Foundation in 2008 that provides economic Tory Burch opportunities to women and their families. In 2013, she became a billionaire, proving dreams and hard work pay off.

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Sara Blakely is the youngest selfmade billionaire in the world.

Blakely revolutionized an industry in which no others dared venture by reinventing a wardrobe essential for women — girdles. She transformed them into Spanx, giving them a fashionable facelift.

Before Spanx, she was a greeter at Disney World and sold fax machines doorto-door for a living. Blakely now makes $250 million in annual revenues and Sara Blakey owns 100 percent of her company. Blakely is the idol of entrepreneurs worldwide.

Hollywood starlet Jennifer Lawrence epitomizes the idea of a “normal” girl in Hollywood.

Despite her numerous accomplishments, including winning an Oscar, Golden Globe, Spirit Award For Best Actress and a Screen Actors Guild award, Lawrence makes the idea of Hollywood accessible, while enjoying tremendous success. She is down-to-earth and knows the value of money. In a recent interview with UK Fabulous magazine, Lawrence stated, “I was raised to have respect for money, even though you have a lot of it.” It

Innovation & Technology Today

is refreshing to see a starlet embrace normality and humility in a field where conformity often occurs.

America’s First Lady is a force set to inspire.

Michelle Obama is a Harvard-Law School educated Jennifer Lawrence fashion icon who candidly talks about having an equal marriage, and equal opportunities for society. Obama uses her platform as First Lady to fight child obesity in America with her campaign, Let’s Move. Obama wants to inspire the next generation to take big risks and reap big rewards. She is an icon of strength.

Impressive women are finally receiving the credit and honor they deserve. Businesswomen have proven to be incredibly creative, motivated forces driving the economy forward.

Success and inspiration for other females is a part of their life mission.

Success stories of women today are paving the way for the future success of other women. These successful ventures inspire females to make their dreams a reality, and to create fulfilling careers from their own original ideas. ■

LISA LUNNEY is women’s technology columnist and Senior Writer for Innovation & Technology Today.

Summer 2013

Education

By Robert Yehling

Educating tomorrow’s sports medicine & fitness leaders solid classroom curriculum.

The sharp focus on the Students gain hands-on nation’s health care situation, experience through direct and a growing emphasis on participation in programs like preventing chronic disease, personal training, Pilates, kettle obesity, and head trauma, bells, free weights, Crossfit, and among other afflictions, sheds pool therapy for seniors. the spotlight in another arena: “They do externships in the sports medicine and fitness. field where they take the theory Educational offerings and put it into action, applying continue to expand in the it in the different sports medicine/fitness realm, facilities in which perhaps none more completely they will be than that of Keiser University Keiser University Sports Medicine working,” she in Florida. The school’s Sports & Fitness Technology program explained. “We Medicine & Fitness trend around — even require 320 hours of Technology, Exercise Science and creating your own externship, so by the Sports Management undergraduate opportunities, through time they graduate, programs have become model individual personal training they have been curricula for providing numerous or fitness lifestyle coaching, exposed to a variety career paths and directly addressing or working in assisted of centers, programs, the national health and healthcare Dr. Julie Snyder living. Opportunities range and approaches.” crisis by focusing on fitness, exercise from careers in the clinical setting to Keiser introduces students to the science, sports medicine, and more in-the-field, hands-on personal new technologies entering the nutrition-based solutions. training, athletic training, and sports medicine and fitness “As I say to my students, ‘These strength and conditioning options.” technology markets. That includes are the best of times and worst of A long-time fitness trainer and yoga virtual, web-based training and times,’” department dean Dr. Julie instructor before developing Keiser’s consultation. Given the rapid Snyder, PhD., said. “If you go to any Sports Medicine & Fitness increase in technology development mall, or elementary school, you see a Technology program, Dr. Snyder and market release, due to necessity host of problems, such as obesity, recognized that rote learning would — the nation’s healthcare and diabetes and hypertension, that have not produce the next generation of sports medicine issues — this is no reached epidemic proportions. It’s sports medicine doctors, physical small feat. sad, the result of our eating and therapists and personal trainers. She “Things are changing so fast, and lifestyle choices. That’s the bad news. put out her feelers in the southern becoming more virtual,” Dr. Snyder “The good news is that if you’re Florida community, and created said. “Ten years ago, you wouldn’t looking for a job or career, there’s a student “lab” time to supplement a plethora of opportunities to turn this (Continued on Page 75) 22

Innovation & Technology Today

Summer 2013

Social Media

By Robert Yehling

Drive Content Marketing with Blogs Between Facebook, Twitter, LinkedIn, Pinterest, Google + and your industry’s social networking platforms, it’s easy to get buried in social networking updates and trends. How are we supposed to create clear, innovative content marketing strategies when we can’t emerge from the social media blizzard?

Try a retro approach. Turn your blog into a content marketing goldmine. Once darlings of online marketing, blogs now can feel like a grandparent’s endless story in a truncated world of texts and Tweets.

Plus, there are more than 275 million blogs out there. Yet, with the proper blend of killer content and smart strategy, even the dustiest blog can transform into a force that drives customers to your brand, site, and their spending budgets.

A killer blog can go viral. After you post a link to social media networks, anything can happen.

And you never know who’s reading.

David Mathison, the former VP of Technology at Reuters, announced his game-changing book Be The Media from a blog, and Tweeted the link. That Tweet was read by Ruth Ann Harnisch of The Harnisch Foundation. Bingo: within three days, Harnisch wired Mathison enough money to turn Be The Media and its message — that we are now our own media centers — into a national phenomenon in 2010.

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How do we turn our blogs into killer content marketing machines? Ten quick tips, courtesy of Innovation & Technology Today: 1. Who are my clients? Who are you writing and marketing to?

Know your audience — and keep track of how their tastes and preferences change.

2. Does my content treat clients equally? Don’t talk up or down to readers. Share the journey. We’re all in this together. Make every blog as interactive as possible.

3. Share relevant industry news.

Do more than share your new innovations, products, services or company developments. Share relevant industry news. Make your blog an authority on the industry — which, by extension, adds quality to your core business in the reader’s eye.

4. How do I separate from competitors? Determine the unique

characteristics of what you are promoting — and zoom in. Readers love to feel like they’re receiving a backstage pass to something new.

5. What worked before? What are your 5 most popular blogs from the past year? Which went viral? Can you update them? Save these blogs for light news days, update them, and re-post with new headlines and rewritten opening paragraphs.

6. Write list blogs. Everyone loves lists — the 50 Best Cloud Apps, the 20 Top Green Tech Companies, the 10 Finest Wearable Sensors. Develop lists pertaining to your company and industry, and blog them.

7. What makes them listen?

Authentic, educational and engaging content works every time. Readers want information and ideas — now.

8. How do I involve readers? Ask questions within your blogs. Create spot surveys. Ask for reader comments. Engage, engage, engage.

9. What do I give my readers? What is the next step after reading your blog? Lead them to your website, or post a link within the blog to an eGuide, eBook, or product PDF. 10. Where do I transport my blog?

How to get the word out? PR Web/ VOCUS press releases are great. So are LinkedIn, Twitter, Facebook business pages, Google + and networking sites within your industry. Send out links and create blog rolls within your newsletters, and cross-link with other bloggers. ■

Innovation & Technology Today

Summer 2013

Security

By Amanda Leach

Protecting Data: The Takeaway of NSA Flap The National Security Agency has sparked considerable debate with the revelations of whistleblower/spy Edward Snowden (pick your side), which point directly to the overextension of security measures into domestic spying. Most of us would like our Internet activities and phone call histories to be hidden from others, unless we choose to share it ourselves.

Now, by all indications, it is clear the NSA has been watching all along — at a level that far exceeds their sworn testimony that they only monitor 0.0004% of all Internet and phone traffic. On top of that, recent news stories have accused the NSA of spying on the UN, and even the lovers of a few NSA employees.

Is monitoring by the NSA necessary? When it comes strictly to watching suspected terrorists or people of interest, yes. And so is the type of data they collect; terrorists are highly sophisticated communicators. The different types of data collected by the NSA are not entirely known, but they can review emails and social networking posts, records of calls made to and from the United States, instant messages, and Internet searches and traffic.

The NSA’s monitoring bounds are determined by special FISA courts that meet in secret, per a provision in the Patriot Act. Which leads to the rub: How far outside their court-approved bounds 26

has the NSA gone? According to many, they’ve obliterated FISA’s boundaries. Snowden revealed that new programs can track online activity for every person who uses digital communications technology in any way. This program is able to catch every instant message, email, browsing history, and more. Snowden stated he could tap into anyone’s searches and information. The government denied this allegation.

President Obama stated that Americans were not being spied upon, that the NSA was gathering but not actively digging through all the data. However, Snowden’s documents reveal something else: the NSA is actively spying on Americans. It certainly was enough for the President to announce surveillance reforms in mid-August.

Which begs the question: How much material is the NSA gathering?

And how much are they actively sourcing in their security operations?

Innovation & Technology Today

On August 9, the NSA released a response that said, in part: “According to figures published by a major tech provider, the Internet carries 1,826 Petabytes of information per day (about 1.9 million Terabytes).

In its foreign intelligence mission, NSA touches about 1.6% of that.

However, of the 1.6% of the data, only 0.025% is actually selected for review.

The net effect is that NSA analysts look at 0.00004% of the world's traffic in conducting their mission — that's less than one part in a million.”

However, an August 22 CNN report stated that the NSA grossly misrepresented the scope of its data collection to the FISA court. The government admitted that, for the past three years, the NSA gathered domestic data, emails and other Internet activity, even though their authority only extended to foreign communications. Much of this came from the NSA’s “upstream” program, begun in 2008, in which it collects information that travels directly across the Internet, rather than filtering data from Internet service providers in response to agency requests. It is estimated the NSA can see 75% of daily web traffic, according to the Wall Street Journal.

The controversy will not go away this month, or next. What will become the happy medium between the NSA’s quest for information, and rights of personal privacy? The next few months will prove very interesting. ■ Summer 2013

Sports & Medical Technology

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The convergence of sports, medicine, fitness and technology has fueled dynamic innovation and rapid growth in the healthcare and fitness industries.

The big headlines belong to the issue of head trauma and traumatic brain injury, which has seized everyone’s attention — at long last.

Furthermore, nearly 20 million people wear devices that monitor their heart rate, bites per minute, urine samples, blood pressure, glucose, fat content, pace per mile, miles run … and much, much more.

Competition is fierce for your wrists, legs and biceps, where the monitors are strapped. With $6 billion in annual wearable sensor sales predicted by 2015, we’re just getting started.

Meanwhile, many fitness and personal training centers integrate medical rehabilitation and sports injury therapy to some degree. They also work more directly with medical professionals. And vice-versa.

In this special report, Innovation & Technology Today visits top practitioners, experts and innovators to discuss sports and medical technology — and its impact on our personal lives, economy, healthcare, and the future.

Inside this section: 30 36 44

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48 56 58 62 68

The Summit of Sports & Medicine Head Trauma & Brain Injury Dr. Joshua Hackel, MD, Andrews Sports Institute Healthy Measures & Wearable Sensors Keeping Football Players Safe Cancer: Robotics & Innovations John Capurso, Visioneer The Final Word

Andrews Sports Institute photo courtesy of the Andrews Institute for Orthopaedics & Sports Medicine; Robotic Surgery photo courtesy of Moffitt Cancer Center; Summit photo by Martha Halda; Army Bowl photo courtesy of Xenith Helmets.

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The

SUMMIT of SPORTS & MEDICINE

By Robert Yehling integration of medicine, Let’s say you are sports, fitness, recovering from a heart rehabilitation/therapy and attack triggered by years of technology, The Summit inattention to your health, Medical Fitness Center. a poor diet, and genetic Based in the fitness-first factors. Instead of bed rest community of Kalispell, and medication, imagine Montana, an hour’s drive entering a center with a from both Glacier Phase II cardiopulmonary National Park and the rehab program. That center Canadian border, The is staffed with the Kalispell Regional Medical Center Summit has integrated finest rehab doctors (All photos by Martha Halda) medicine, fitness and and nurses, physical sports since 1996. Wholly owned by What if the answer were and occupational Kalispell Regional Healthcare and to simply join the same therapists, and located on the campus of Kalispell center, this time as a club equipped with stateRegional Medical Center (KRMC), member? Thus continuing of-the-art The Summit is a bastion of to use the same machines cardiovascular weight innovation and vision. It is also and equipment, and and fitness technology. consistently among the early spending time with the Suddenly, your 12 adopters of cutting-edge fitness and same souls who helped to weeks are up. You feel sports medicine technology. restore your health? great. You’ve lost Dr. Brad Roy The Summit’s commitment to This brings us to the weight, your diet is integration, embedded in its culture, nexus of fitness and medicine today: improved, and you possess that fit, grows from there. “All of our centers that integrate medical and confident swagger you remember medical patients are integrated in conditioning programs. These team from 15 years ago. I can live another with our regular (health club) efforts between hospitals and fitness 30 years and relish every moment, members,” says Executive Director centers, or hospital-built fitness you think. Could anyone have Dr. Brad Roy, Ph.D., FACHE, centers, are all the rage in healthcare, transformed more in three months?

FACSM, FMFA, who oversees many with dozens sprouting up in the past However, your program is finished. facets of the KRMC operation as 10 years. In some way, all owe their How do you continue? What do you existence to a pioneer in this (Continued on Page 32) do from here?

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Innovation & Technology Today

Summer 2013

(Continued from Page 30)

well. “We might have an elite athlete working out next to a really sick person, which is great for both.

And we provide services across the age span; kids are important to us.

“People sometimes say to me, ‘Why are you so broad? You need to focus on one thing or another.’ I say, ‘No! This is real life. This is the world.’”

What a world it is inside The Summit, where teamwork and modality integration is much more than a concept. It defines the place.

The 115,000 square-foot facility brings together the best in fitness and health options, including a 220-yard indoor track, water therapy and aquatic fitness pool using salt purification technology, a 25-yard, six-lane lap pool, tennis courts, climbing wall, artificial turf exercise area for everything from kids classes to isometrics, state-ofthe-art weight facilities, a spin room, a cardiopulmonary floor loaded with bikes, cross trainers and treadmills, spacious locker facilities, and a preschool area with toys specifically chosen to develop motor skills.

Then there’s the human resource side. Wellness coaches work side-byside with rehabilitation nurses.

Physical therapists discuss health strategies not only with doctors, dieticians or personal trainers, but also with clinical exercise physiologists. Personal trainers review cardiopulmonary readings with nurses on flat screens, discussing the progress of their mutual patient-client while he or she jogs on a treadmill, wearing a monitor. Overseeing the medical side are physicians and specialists, some of who ditched practices throughout the U.S. and Canada to flock to Kalispell. Why? To become part of Kalispell Regional Healthcare and The Summit’s emphasis on human technology.

“One of the reasons we took cardiac rehab out of its small environment 18 years ago and put it on the main floor is that I saw patients coming in with a few nurses and other patients, and it was like a social club,” Roy says, illustrating the emphasis on inclusion.

“As long as they came in with their little club, they did their exercises and ate right. As soon as their 12 weeks of cardiac rehab ended, too many were

intimidated from joining any other facility, and they’d go home and quit. Pretty soon, they ended up back in the emergency room with more heart problems.

“When I came here, I thought, ‘There’s a better way to do this. Why don’t we integrate them right away?’

The nurses said, ‘You can’t do that; the patients will hate it.’ I said, ‘The next set of patients won’t know the difference, so we’re doing it.’ We went from the couple percent that would work out after their prescribed cardiac rehab, to today, where we have a 65 to 70 percent retention rate.”

Not surprisingly, The Summit is immensely popular. In a county 1½ times the square mileage of Los Angeles County, with a total population of only 90,000, the center has 7,500 club members and 410,000 annual check-ins — through-the-roof numbers.

“Typically, a facility draws from within a 5- to 10-mile radius,” Roy says. “You can go to a city of a million people, and those big centers probably have 5,000 or 6,000 members. We’re way up there.”

The Summit’s focus on well-being shows in the environment it creates, with wall murals, such as the one of Glacier National Park, inside exercise machine rooms, rock climbing walls and weight rooms.

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Innovation & Technology Today

Summer 2013

One can’t help but marvel at the center’s level of expertise. The Summit is not merely a crosspollination of services, modalities and technologies. It’s the key to the kingdom so many seek — optimal, sustained health. “Medical integration is a huge model,” Roy says. “In 1996, when we opened, we were cutting edge. We were it. We were way ahead of the curve. Now there are integrated centers developing all over the country.”

The interaction doesn’t stop within The Summit’s walls. It only starts there. KRMC and The Summit provide a complete community outreach to spacious Flathead County, of which Kalispell, population 20,000, is the county seat. It ranges from doing posthire/pre-employment screenings and cardiovascular tests for businesses county-wide, to hosting classes on numerous medical, health and nutrition subjects, to supplying the local high school with a athletic trainer who possesses impeccable qualifications. “We fund the athletic training program at the high school,” Roy says. “Our athletic trainer (Amy

Thoreson) works there, but everyone thinks it’s one of the teachers. Our orthopedic group goes to all their (football) games.

And we’re in the background, providing the service.”

Then there’s Journey to Wellness, The Summit’s signature program.

The program emphasizes physical activity, appropriate use of technology, dietary and wellness counseling, and education pertaining to their specific health or medical issue. It also includes the positivity model laid out by University of North Carolina psychologist Barbara Frederickson.

(A 3:1 or greater ratio between positive and negative views in one’s life is considered suitable to make behavioral changes.) The goal is to facilitate behavior changes that instill exercise, diet, wellbeing, and knowledge.

Journey to Wellness began with a great incubator for any innovation — necessity. “I started looking at the model of cardiac rehab, pulmonary rehab and diabetes education,” Roy recalls. “We have all these chronic health conditions,

The Summit’s Cardiopulmonary Rehabilitation Floor Summer 2013

but I didn’t want to create a program for each health condition. The last thing you need is 30 different programs. So we created a program to address those things and a multidisciplinary staff (to run it). Every chronic health condition can come through this health coaching model.”

As the Executive Director, Roy never sits still. His disposition as a driven, former champion runner reveals itself as he constantly figures out ways to upgrade, refine, polish and otherwise keep The Summit’s cutting edge reputation sharp.

The Summit’s reputation traces to two people — KRMC CEO Velinda Stevens, and Roy, who moved from Eugene, OR in November 1995 with his wife, Susan, and then-young children, Heather and Stuart. (Stuart works with The Summit’s SPARK kids’ program when on summer break from Montana State University, where he is a student.)

Roy almost didn’t last the first year.

He walked into a hospital in disarray, doctors fighting with each other, and no continuity between KRMC and The Second Wind, the health club NBA

onFitness Page <None>) The Summit’s Water Therapy(Continued & Aquatic Pool

Innovation & Technology Today

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coaching legend Phil Jackson and his financial partner had sold to the hospital. The club was old, and KRMC decided to spend millions to build a new facility, The Summit, on the site. That didn’t sit well with physicians who couldn’t get badly needed diagnostic technology. Into that environment came Roy. His first job? To integrate the medical and fitness pieces, beginning with the medical providers.

Good luck. “They told me, ‘That place (The Summit) is going to fall apart. You’re not going to be here very long.’ The first talk I gave, I had a picture of four physicians with their stethoscopes around their necks and their jockey underwear on. I put that picture up and said, ‘The Summit is NOT a jock shop!’ I got a laugh. That broke the ice.”

Roy is masterful at creating consensus, identifying the positives, turning situations around, seeing the potential in others, and motivating and challenging them to reach that potential — with his direct support. Sound like the qualities of a visionary, a great coach or an elite athlete?

He is all of the above. Roy ran 14:40 for 5,000 meters (5K) at Point Loma College, where he received his bachelor’s and master’s degrees in exercise physiology. (He later dropped his 5K time to 14:20.) He also absorbed the knowledge of coach Jim Crakes, one of the finest running coaches in the country. In 1979, Roy bared nasty conditions to run 2:23 at the Boston Marathon, eventually dropping to 2:21 in the 1980 Nike Marathon — borderline world-class status at the time.

The coaching bug also bit him. He returned to Carlsbad High School, his alma mater, as a student teacher, and created one of the finest crosscountry programs in San Diego County in 1976-78. He then guided 34

the Mira Costa Community College men’s team to the California crosscountry championship. Athletes he coached went on to become doctors, professors, CEOs, screenwriter/directors, educators, authors, mayors, coaches and marathoners. More than 30 years later, many still consider him one of their foremost life mentors.

Dr. Brad Roy After running for two years with the Athletes in Action team, Roy moved to Eugene, then the world’s running mecca. His long-time fascination with medicine, science and exercise fused together. “I walked into a job at the hospital in Eugene,” he recalls. “They had just bought a cardiopulmonary testing system. I got hired to put that lab together. From there, we created a cardio rehab program.”

He hooked up with a few athletes from Athletics West, Nike’s elite track team. He did exercise testing

Innovation & Technology Today

with the distance runners, measuring blood lactate, VO2 and other parameters while they ran on a treadmill. Among these athletes was Alberto Salazar, then the world marathon record-holder, now coach of the University of Oregon’s distance team as well as Mo Farah, the 2012 Olympic 5,000- and 10,000-meter gold medalist. “We’d evaluate Alberto’s running economy and physiological response to various running velocities, and guide his training based on the data we were looking at,” Roy said.

Keep in mind: this was more than 25 years ago.

Roy continued to coach and work at the Eugene hospital until 1995, when he saw an advertisement in a journal for a facility being built in Kalispell. “I just threw it across the table and said, ‘Who wants to move to Montana?’” he recalls with a laugh. “Someone in the office said, ‘I dare you to call.’ So I did. I decided to fly up there. Before Susan and I left town, I got offered the position.”

The other component of The Summit’s visionary team, Velinda Stevens, followed in 1998 — not a second too soon. “We’d had a hospital CEO who cut staff and wouldn’t let us do anything,” Roy recalls. “We lost something like $500,000 in the first year.

“When Velinda arrived, the first thing she asked me was, ‘How do we turn this thing around?’ “‘Just let us make some decisions.’”

“She said, ‘Tell me what you need.’

We’ve operated that way ever since.”

Stevens’ brilliance extends well beyond one discussion. She has (Continued on Page 67)

Summer 2013

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IMAGING Head TRAUMA Each year in the U.S., nearly 2 million people sustain a traumatic brain injury. That’s more than breast cancer, HIV/AIDS, multiple sclerosis, and spinal cord injuries combined. Because of this invisible epidemic, more than 5 million people live with permanent disabilities, and our society shoulders an annual cost of $76.5 billion.

Still, diagnosing a TBI remains hit-or-miss. Not surprising, given that the brain is our most complex and mysterious organ.

Many TBIs are too microscopic to be discovered on traditional imaging.

Fortunately, much of today’s research is devoted to uncovering its secrets, including how to accurately diagnose and treat TBI. “We’re only scratching the surface,” says Dr. Joshua G. Hackel, primary care physician at The Andrews Institute for Orthopaedic Sports Medicine in Gulf Breeze, FL. “We’re nowhere near the point of completely understanding it. Work has been started with TAU protein and other markers that have been identified to be associated with concussions. A lot more needs to be learned about it.”

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&

Traumatic BRAIN INJURY

TBIs result from an external force, such as rapid acceleration or deceleration, blast waves, impact, or penetration. They are categorized as mild, moderate, severe or penetrating, based on medical criteria such as loss of consciousness, verbal, motor, and eye-opening reactions to stimuli. The most difficult to diagnose is mild TBI (mTBI), because the person often does not lose consciousness or may not realize an injury has occurred.

Furthermore, a computed tomography (CT) scan, the most commonly used method of neuroimaging after a suspected TBI, can reveal only bleeding, clots, bruising, or swelling — crucial

Innovation & Technology Today

By Barbara Stahura information when neurosurgery is needed. However, invisible microscopic or more diffuse injury may still be present, and symptoms often manifest days or weeks later.

A more powerful method of peering into the brain is standard magnetic resonance imaging (MRI), which uses X-rays to pick up the same abnormalities as CT as well as gross abnormalities in the gray matter, or neurons.

However, even this level of scanning is insufficient to reveal injury in the white matter, which is composed of axons, the neural processes by which neurons communicate. Neither can standard MRI pick up many milder injuries, which can nevertheless be devastating in their effects on cognitive and physical abilities.

“The MRI is still the most important imaging modality when looking at brain tissue,” Dr. Hackel says. “Being able to identify certain proteins that are created after a traumatic brain injury is becoming more and more understood. A lot more has to be done to research and interpret the data. We’re still relying (Continued on Page 38)

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on our clinical exam and history, and the standard MRI machines.

However, in some of the more research-oriented medical centers, the MRI is being utilized in ways that aren’t available to the general medical center.”

With additional software, MRI can produce more sophisticated imaging, and new technologies are emerging.

One is Fujifilm’s Synapse 3D, which provides advanced visualization and analysis for MRI and CT workflows, offering one-click access to 3D images. Another is diffusion tensor imaging (DTI). DTI tracks the diffusion of water molecules along the axons; an abnormal diffusion pattern may indicate injury. This can be crucial in diagnosing concussion, which is mTBI, as well as diffuse axonal injury (DAI), or a global disruption of axons throughout the brain. Both of these can lead to lifelong functional and psychological deficits if not properly diagnosed and treated.

The U.S. military has been instrumental in researching DTI for diagnosing blast-induced TBI. Caused by high-pressure blast waves, these TBIs are notoriously difficult to diagnose with technology. Since there is often no direct blow to the head, symptoms

may not appear immediately, and injuries are microscopic and diffuse.

Since many military personnel endure multiple blast exposures, their risk for life-long deficits is high. The statistics bear it out: according to a Defense Medical Surveillance System report, nearly 23% of all veterans who suffer TBIs face a risk of life-long deficits. That compares to 15% of civilian TBIs. “This is a case where military medicine has benefitted civilian medicine,” says Ronald Glasser,

The 3 Tesla MRI MD, affiliated with Abbot Northwest Hospital in Minneapolis and author of Broken Bodies, Shattered Minds: A Medical Odyssey from Vietnam to Afghanistan. “We’re lucky for that.”

Abbot Northwest has DTI, and he says, “Many parents and lawyers here are now demanding diffusion

3D Viewer — Synapse 3D from Fujifilm Medical Systems 38

Innovation & Technology Today

Fujifilm’s Synapse 3D Mobility

tensors for kids with concussion,” often after sports accidents.

Proper diagnosis of concussion is crucial, since “if you have another mild TBI, the likelihood of recovery is less,” says Ramon Diaz-Arrastia, MD, PhD, director of clinical research, Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences. DTI “shows a lot of promise for axonal injuries, which are common in mild TBI. But it is still used mainly for research purposes and is not in many hospitals or trauma centers yet.”

Still experimental is high definition fiber tracking (HDFT).

Also MRI, HDFT collects data from 257 directions; DTI collects from 51.

Using high-end 3 Tesla MRI (Tesla is a measure of the field strength of the (Continued on Page 40)

The 3 Tesla Magnetom brain scan Summer 2013

HEAD TRAUMA GETS AN APP — AND GOES WIRELESS 40

New research and awareness about the dangers of head trauma is slowly changing public opinion of the seriousness of situations where people suffer head injuries.

To that end, we look at two efforts to increase awareness, protect against injury, and reduce further occurrences: An App for Brain-Related Injuries To equip more people with the skills to detect the symptoms of head trauma, the Centre for Neuro Skills released a mobile app in March 2013 for iPhone, Android and iPad devices chock-full of everything you might need or want to know about brainrelated injuries. One of the more sophisticated news-related apps on the market, it is updated daily with news and research findings, leading journal articles and data relating to brain injuries. It is available on the App Store, Google Play and Amazon.

The Centre for Neuro Skills provides perhaps the most comprehensive, in-depth public access website for news concerning head trauma and other neurological injuries and conditions. Recent materials have concerned the relationship between TBIs and strokes, behavior changes in the early stages of TBI, changes in weight for TBI patients, video feedback of functional task performance following TBI, and much more.

Wireless Diagnosis MedicalDaily.com reported on a new diagnosis method for brain trauma that could lead to easier, more affordable options for people around the world. A research team headed by Boris Rubinsky, a professor at the University of California Department of Mechanical Engineering, found a way to diagnose brain trauma and differentiate between brain swelling and bleeding by using wireless signals.

The device uses two coils, one on either side of a patient’s head, to send signals through the brain. If the signal is clear, the patient is perfectly fine. If the signal is changed or suffers some sort of interference, the patience is diagnosed with brain trauma. The diagnostic does not indicate the severity of the issue. It only tells physicians whether or not an injury is present. Equally amazing is the device’s low cost — about as much as a blood pressure monitor.

— Fletcher Martin

(Continued from Page 38)

magnet), it also maps the volume and path of water molecules in the cable-like tracts of axons, with unprecedented detail. This technology offers hope for pinpoint TBI diagnosis.

Other types of sophisticated imaging are still in the research stage, and no one yet knows how effective they will be in diagnosing TBI. A few examples: • Diffusion weighted MRI — DWI tracks the intensity of image elements (called voxels) to reflect the rate of water diffusion at a location in the brain.

• Magnetic Resonance Spectroscopy — MRS noninvasively quantifies neurochemicals in the brain, many of which are disturbed after TBI. Knowing which neurochemical levels are abnormal allows better diagnosis.

MRS may be beneficial in monitoring cellular response to therapeutic interventions.

• Susceptibility weighted imaging — SWI uses extremely high-resolution imaging to detect and is exquisitely sensitive to microhemorrhages, shearing, and DAI. Originally called BOLD venographic imaging, SWI is able to detect microscopic bleeding in the gray matter/white matter boundaries and thus see more subtle injuries.

In addition, physicians and scientists are hard at work to assess functional task performance following TBIs. In August, The Centre for Neuro Skills, one of the leading brain injury resource centers in the

Innovation & Technology Today

nation, released a report highlighting work being done to provide video feedback to people recovering from TBIs. They found that the degree of functional impairment selfawareness was noticeably higher for patients using video feedback than verbal and even experiential feedback.

Ultimately, front-line physicians are working toward a goal beyond responsive diagnosis.

The good news? More people are reporting head injuries than ever, thanks to increased awareness of military diagnoses, professional sports injuries, and head trauma education among coaches and parents.

Furthermore, football, baseball, motorcycle, hockey and other types of helmet manufacturers are scrambling to provide added protection. Xenith Helmets, which outfits high school, college and NFL (Continued on Page 42)

Summer 2013

TBI patients at Journal Workshop Photo by Barbara Stahura

(Continued from Page 40)

football players, has moved from foam padding to air-cell shock absorber technology, which adapts to different levels of impact and focuses on both rotational and linear impact forces.

“We’re getting pretty good at measuring linear force, but we’re just beginning to learn about rotational force,” adds Jesse Harper, Vice President of Sales for i1Biometrics, whose cutting-edge technology measures head trauma for sports teams. “Rotational force is the unknown factor in a concussion — how much does your head bounce around? How much damage does it cause?”

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That’s a good question. No matter how solid the technology, helmets cannot entirely prevent TBIs, because they cannot stop the brain from sloshing around inside the skull. Furthermore, subconcussive hits with a helmet or otherwise — those registering under 20g’s of impact force — don’t seem like much individually. When they add up, the ingredients for a debilitating TBI often are in place.

The fact these issues are being studied, debated and focused into new products all leads to some great news, according to Dr. Hackel: We’re talking about it in a national conversation. “We now recognize that this is a serious injury, and we’re treating it with the respect it deserves,” Dr. Hackel says. “This has been the big chance. The reason why the reported numbers of concussions have increased is because the public is much more educated on the topic and we’re looking for it more.

“Still, to this day, we’re only responding to concussions. Our goal

Innovation & Technology Today

would be to have a player be in a position where their body has been up-regulated in anticipation of a traumatic event, in order to minimize the downstream effects of a collision.” ■

Barbara Stahura and her husband, Ken Willingham, a TBI survivor BARBARA STAHURA’s work has appeared in many national publications. She is a certified journal facilitator working primarily with people with brain injury and family caregivers in Tucson and southwestern Indiana. She is the co-author of After Brain Injury: Telling Your Story, the acclaimed first journaling book for people with brain injury. (For more about the author, visit www.barbarastahura.com)

Summer 2013

interview

Innovation & Technology Today Conversation with

DR. JOSHUA G.

HACKEL, MD

Looking Forward in Sports Medicine

Whereas we used to see these injuries in professional and With awareness of head trauma, college athletes, we now see them in adolescents. We see youth sports overuse injuries, and something like a Tommy John ligament tear in the elbow endurance and full-contact sports in a 14-year-old. That was once unheard of. problems increasing, one can forgive Dr. Joshua Hackel and I&T TODAY: Because these younger kids are not fully developed his colleagues for being busy physically, do these early-onset overuse injuries cause greater these days. Not only does harm to their futures?

Dr. Hackel treat these JH: Absolutely. You have more opportunity for arthritis injuries, but he also mans to develop, limited mobility, things like that. the front lines of sports Dr. Joshua G. Hackel, MD medicine itself.

I&T TODAY: What do you see as the long-term impact if we A golfer, jogger and sailor, Dr. Hackel practices at the continue to promote kids playing single sports year round? prestigious Andrews Institute of Orthopaedic and Sports JH: Injuries earlier in their careers, and earlier ends to Medicine in Gulf Breeze, Fla. This is the clinic of Dr. James their careers. We actually Andrews, to whom many have the STOP Sports professional athletes and Injuries program that my teams turn and from whom mentor and partner, Dr. many sports medicine Andrews, and the AOSSM findings originate. Dr. (American Orthopaedic Hackel’s specialties give him Society for Sports Medicine) a full picture of the present have developed. It’s a and future: musculoskeletal prevention awareness ultrasound for diagnosis and program, so coaches are treatment, non-surgical more aware of the orthopaedics, and consequences of regenerative medicine and All photos courtesy of the Andrews Institute overtraining their kids. injection therapy. for Orthopaedics & Sports Medicine In this conversation, Dr. I&T TODAY: Have you seen an increase of injuries, or severity Hackel discusses today’s sports injury issues, technologies of injuries, arising from hard contact sports such as MMA or being utilized and developed, and his perspective on the extreme sports? future. He also throws in a few surprises — starting with JH: Yes. It comes to the same point as with the young his first answer. one-sport athletes: they don’t have a period of rest. The body doesn’t have an opportunity to heal, so the aggregate INNOVATION & TECHNOLOGY TODAY: How have sports injuries of participation will cause the tendon or muscle tissue to changed in the last 10 years? break down. They are injured more often.

DR. JOSHUA HACKEL: Not only are they becoming more common, but they’re occurring at a younger age. Young I&T TODAY: What about types of injuries? people will be training, not for multiple sports like we did JH: I wouldn’t say they’ve necessarily changed. I would when we were children, but for playing one sport yearsay we recognize the complexities of individual injuries round. Because of that, their bodies do not have the (Continued on Page 46) opportunity to heal. They develop overuse injuries.

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Summer 2013

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better, because we have such better diagnostic capabilities, as compared to previously.

I&T TODAY: Non-invasive surgeries have been a blessing for all of us. Could you discuss how diagnostic tools and improved imaging have gone hand-in-hand with the ability to perform more arthroscopic and laser surgeries?

JH: With ultrasound, you can see tendon tissue with much greater detail than with an MRI. You can also see these lesions dynamically. In other words, you can see a tendon moving in the soft tissues. Before, with an MRI, it was a static image. You can’t see tissues gliding dynamically like we can now. The desire of the public to have minimally invasive surgeries has really pushed ultrasound technology to the forefront, to develop less invasive technologies.

I&T TODAY: How have refinements in technology, imaging and diagnostics enhanced your approach to rehab and therapy?

JH: The importance of rehab with minimally invasive procedures has always been magnified. We’ve always recognized that physical therapy after the surgery is just as important as the surgery itself. You can have the greatest surgical procedure, but without proper physical therapy, the outcome of that procedure will be less than you had hoped for.

Musculoskeletal ultrasound scans

I&T TODAY: Have you seen an courtesy of mskultrasound.com increase in treatment for plantar fasciitis, Achilles tendinitis, and other heel and foot injuries in recent years?

JH: Yes. It’s ironic. My father and my wife currently have plantar fasciitis, so in that respect, I see a lot of it at home (chuckles). A lot of people are recognizing the importance of physical exercise. Adults are becoming more and more active. For that reason, and the popularity of endurance sports, we’re definitely seeing an increase in endurance sports injuries, such as plantar fasciitis.

I&T TODAY: Let’s switch gears. You’re also working with stem cell therapy. Could you elaborate on that?

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JH: We are researching how to utilize the patient’s own stem cells in order to accelerate the body’s natural healing.

We’re using mesenchymal and endothelial stem cells in order to do that. We’re doing it for multiple injuries, from tendon and muscle tears to arthritic joints.

I&T TODAY: How have the results been thus far?

JH: Very good. We don’t really promote stem cell therapy; the appropriate research still needs to be conducted. I can tell you that we’re seeing great results with the utilization of the patients’ stem cells to accelerate healing. I think the future of orthopedic sports medicine lies in regenerative medicine, including stem cell therapy. We’re just scratching the surface.

I&T TODAY: What do you see as breakthrough findings and technologies in sports medicine in the next three to five years?

JH: Musculoskeletal ultrasound has been an incredible advance in sports medicine. It’s every bit as important to a sports Dr. Joshua Hackel medicine physician as the stethoscope is to a cardiologist. We don’t rely solely on the radiologist anymore to get us the interpretation of an X-ray or MRI. We’re performing ultrasounds here to diagnose pathology and accelerate a treatment plan from the first visit, and also to diagnose pathology that was going unrecognized prior.

I&T TODAY: Will musculoskeletal ultrasound technology continue to refine hand-in-hand with your ability to make new and better diagnoses from it? Will one drive the other?

JH: Absolutely. We recognize the importance of precise injections. Ultrasound allows us to inject soft tissues precisely. We’ll see even more findings in which we start recognizing things we didn’t even know existed in our body that could be isolated, harvested, and used to treat multiple soft tissue injuries. ■ — Robert Yehling

Innovation & Technology Today

Summer 2013

Healthy Measures and

Wearable Sensors

By Lisa Lunney In recent years, we have seen a noticeable movement in people becoming more interested in their health and fitness levels. Not only do they adapt their lifestyles and routines to reflect healthier living, but they are receiving more and more help from wearable body sensors and apps.

Wearable sensor technology has become the killer growth industry in health and fitness for this decade.

According to the Consumer Electronics Association, sales of wearable sensors topped $800 million in 2012 on sales of 14 million wearable gadgets. Now consider the predicted sales for 2015: $6 billion. Every year, according to Researchmoz, sales are skyrocketing by 110 percent.

It seems like everyone is either wearing a sensor, using an app to monitor their fitness and health … or both. Furthermore, it seems sensors can measure or calibrate almost anything to do with the body. A

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quick checklist includes: how long it takes to fall asleep; number of awakenings; hours spent in deep vs. light sleep; heart rate; bites per minute; perspiration levels; urinalysis; electrocardiograms; blood pressure; glucose level; blood oxygen

Innovation & Technology Today

level; or foot strikes per mile walked (or run). That’s just the beginning.

“It’s great that so many people are becoming concerned enough with fitness and their health that they buy and monitor themselves with these devices,” says Brian Russell, CEO of Zephyr Technology, a state-of-theart provider of wearable sensor technology to the U.S. military, first responders, and four National Basketball Association teams, among others. “But we need to make sure they use devices that give them data that truly helps them — and, more importantly, that they know how to properly evaluate that data.

If I’m trying to lose weight, for example, I’m much more concerned about how many calories I burned in high-intensity training than in how many steps I took that day.”

The diagnosis of a disease often triggers a switch to a healthier lifestyle. Most of us will fight with everything we have to overcome (Continued on Page 50)

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diseases or life-threatening situations. We’re learning more and more how to identify the symptoms that create deadly diseases — and wearable sensors help in that respect. Currently, beta-level testing is underway for smartphones and apps that can measure your saliva to determine when you’re about to get sick, read glucose levels, and produce white blood cell counts.

Can you imagine hijacking diabetes, cancer, or an auto-immune disease thanks to your wearable device or smart phone?

Cancer is one of the most feared diseases; for many, it is akin to a death sentence. As technology has developed, many discoveries and new approaches to treatment have been found. This is funneling all the way down to wearable sensors and apps. A breakthrough in cancer technology is the skin cancer app. It scans a photo of a suspicious mole or skin abrasion and provides a detailed analysis.

One of its greatest benefits concerns reminder intervals that can be set up every three months (or every month, or week) to reexamine suspicious moles or lesions. Along with regular

50

doctor’s visits, this app can help with prevention and early diagnosis.

Some apps and sensors are created to save lives. Others aim to prolong them through increased health consciousness. Either way, as mentioned before, the market for remote medical monitoring devices will be in the $20 billion range within ten years. Devotion to self-tracking even has a name — “Quantified Self.”

Apps and small devices are getting more sophisticated in tracking vital signs and exercise metrics. Zeo sends a graph of sleep cycle phases to smart phones. FitBit measures caloric intake and how many steps people take throughout the day. Instant Heart Rate uses smart phone camera flashes to measure pulse rate, while Stress Check measures the interval between heartbeats. An irregular interval suggests stress, while a constant rhythm points to calmness. Other apps track how you feel. MoodScope uses an online card game to assess your mood levels, and also offers tracking and comment features to determine what might be behind your ups and downs. iMapMyRide and iMapMyRun use built-in GPS technology to track the time, distance or speed you’ve cycled. Or run.

This all-out landgrab over your wrist and arm is so intense that the

forerunner of wearable sensor technology, the Garmin Watch, seems like a senior citizen less than 10 years after revolutionizing the sports fitness market.

Then there are highly advanced systems, like Zephyr Technology’s PMS Defense System, perhaps the most sophisticated wearable sensor device, with some components available to the public. While four NBA teams, numerous college soccer, hockey, basketball and Olympic sports teams and Hendricks Motorsports utilize Zephyr’s package, Brian Russell is very quick to point out that sports and fitness use is an offshoot of Zephyr’s core mission. “We focus on medical needs first, military applications second, and sports and fitness third,” he said.

The BioHarness 3 is the wearable piece of the PMS Defense System, which also includes a transmitter for wireless, remote viewing, and a viewable apparatus, such as a laptop.

It is all tied together with Bluetooth technology. The BioHarness module attaches to a lightweight smart fabric strap or garment that incorporates electrocardiogram and breathing detection sensors. Besides heart and respiratory functions, the BioHarness measures position and posture (Continued on Page 52)

Innovation & Technology Today

Summer 2013

(Continued from Page 50)

(laying down, sitting or standing up), activity level, peak acceleration, speed and distance. It also can alert field commanders, or team doctors, if the person is overheated, fatigued, dehydrated, injured, or suffering from elevated core body temperature.

The PMS Defense System was designed for military use (current customers include NAVY SEAL units, U.S. Special Forces and NASA). However, Zephyr found a wide market for this cutting-edge sensor technology, including first responders, sports teams, endurance sports athletes, medical rehabilitation and therapy units, and the Department of Homeland Security’s PHASER program.

“The basic measures between a special forces soldier and a

2013: 60% 2016: 70%

(IMS Research)

Percentage of fitness or medical devices among wearables

Total connected wearable gadgets sold, 2011:

14 MILLION (IMS Research)

Estimated total devices sold, 2017:

70 MILLION (Juniper Research)

52

48%

with a pedometer to help them become more active in their daily lives. Some of the high-tech models can be worn at night to see if there are sleep pattern disturbances and/or possible sleep apnea. of customers These can also connect likely to use a smartwatch for to a computer to track health/fitness daily results.

“It’s about awareness (Google) and feedback for the client. Heart rate monitors are useful for the recovery phase of a workout, particularly interval training. This is most applicable for someone trying to increase their lactate threshold for high-intensity, lowendurance sports.”

Apps are also expanding to focus on finding healthier alternatives to notso healthy choices, such as drinking. Alcohol Aware your core (body) keeps daily track of the amount of temperature. Core temperature alcoholic drinks you’re imbibing, as changes are our bodies telling us to well as the effects those choices will stop. When you see a runner stop have on your waistline. during a marathon on a hot day, StayHealthy.com is set to introduce that’s because their core temperature a Body Composition Analyzer, which increased. We see the same levels of measures body fat, muscle mass and exertion in a Marine who has to hydration levels. This is a desktop move quickly on rough terrain with a tracking device that sends 140-pound pack.” bioelectrical impulses through the Taken collectively, these devices body when held by a user. The give users — and their health care Analyzer functions individually or in providers, physical therapists, conjunction with a pager-like calorie personal trainers or coaches — tracker, both of which require quality, real-time measurements with StayHealthy software to connect which to work. Noted personal users to the company website where trainer Karin Yehling, owner of they can view their data, as well as Functional First Fitness in West general health and fitness news.

Hills, CA, “For the more sedentary person, we can set daily step goals (Continued on Page 54)

performance or endurance sports athlete are very similar,” Russell said. “That’s how and why our product is so versatile. We call special forces soldiers ‘industrial athletes.’ These guys are physically performing for their jobs. What a lot of endurance sports athletes don’t realize is that, after an hour or two, you’re not just managing fitness, but also lactate buildup, your carbs and oxygenation. You’re also managing

Innovation & Technology Today

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(Continued from Page 52)

Estimated Wearable Market Total Value, 2018. (Google)

$6 billion Estimated Wearable Sensor Sales, 2015.

nual growth r an a

(Consumer Electronics Association)

of wearable w te

110

%

(Researchmoz)

: ket ar

Glob

al

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$12.6 BILLION

sensor less m ire

Next-generation technology is focusing on even healthier lifestyle choices. “The next hot area for apps will focus on mental and spiritual well-being,” said Tim Chang, managing director of Mayfield Fun and an early venture capital investor in health tracking apps. Up-and-coming programs will includes personalized training in optimizing stress, meditation, yoga and core conditioning, and more.

Meanwhile, Sundaresan Jayaraman, a Georgia Institute of Technology professor of textile engineering, has invented the “Smart Shirt,” a T-shirt that integrates optical and conductive fibers into the fabric, allowing it to monitor vital signs. Jayaraman first started working on the garment for the Navy but soon saw many civilian uses. The medical Tshirt can pinpoint bullet wounds and relay information to remote triage teams. Among others, it is being marketed for babies, monitoring their breathing and safeguarding against Sudden Infant Death Syndrome (SIDS). The sensors and communication apparatus woven into the fabric wirelessly communicate data to a computer feedback mechanism the size of a pager worn attached to the parent’s hip. The “Smart Shirt” is being manufactured by Texas-based Sensatex/Lifelink and is set for an early 2014 release.

A new system aims to take heart monitoring for athletes to the next level. Under Armour has announced Armour39, a chest-strap monitor that sits near the base of the sternum, measures heart rate, and syncs up to 16 hours of stored

Total wearable sensor sales, 2012

$800 million (Consumer Electronics Association)

Innovation & Technology Today

data via Bluetooth with a mobile device or a separate display watch.

The accompanying app allows users to display heart rate in real-time, along with estimations of calories burned and intensity of workout. On the surface, this appears to be just another heart monitor. However, the company claims that the difference is the introduction of a new metric: WILLpower, which combines the length and type of the workout, information like gender and weight, and specific heart rate measures to produce a single score from 0.0 to 10.0. The score reveals how hard an athlete is training and can be used as a workout target.

Body monitoring implants may sound like sci-fi, but they are close to becoming consumer reality.

Research is being done on implants that will keep track of how your body is doing from the inside. Once inserted under the skin, sensors will provide realtime, accurate measurements of “DoDrelevant biomarkers” including stress hormones, like cortisol, and compounds that signal inflammation, like histamines. A health insurance company could offer you discounts for keeping your stress level low, eating healthy, getting more sleep, and engaging in behaviors that make you healthier and thus less expensive to insure.

Defense. Medicine. Sports & Fitness. Health. They all come together with wearable sensor technology, which is why we will be tracking developments for a long time to come. ■ LISA LUNNEY is the Women in Technology editor for Innovation & Technology Today.

Summer 2013

Keeping

Football Players

SAFE SAF E We’ve come to another football season, but with a marked twist: Never has public awareness of the effects of concussions been higher.

In late August, the NFL settled its concussion lawsuit with 4,500 plaintiffs for $765 million, which includes medical exams, concussionrelated compensation, and medical research for retired players and their families. Everyone from parents to athletic trainers has been schooled on ways to detect concussion-like symptoms, and emergency rooms i1Biometrics report a notable mouthguard increase in the reporting of head trauma.

The momentum toward increased player safety is reaching product manufacturing as well. Two companies, i1Biometrics and Xenith Helmets, operate from the middle of the debate, since their products offer direct sources of protection — i1Biometrics’ Impact Sensing HammerHead Mouthguard, and Xenith’s X2 Football Helmet.

Formed in Summer 2012 after spinning off from BiteTech, the Rowayton, CT-based i1Biometrics measures head impact through its mouthguard. The electronic sensors 56

ankles is going to have his/her back to the field and miss single hits that could lead to concussions, unless they’re massive.”

Linear force head impact is measured in g forces, with numbers that, if applied to aircraft g’s, would be off the charts. “However,” cautioned Harper, a former player and coach, “we’re talking here about tens of millisecond g force impact.”

According to the Sports Legacy Institute, hits that levy more than 50gs of Army Bowl impact force Xenith Helmets are considered within the major. When it mouthguard measure goes over 90gs, linear and rotational force the likelihood of Xenith-Bonnet impact, then transmits the head injury is TechprofileX2 data to a laptop on the high (see story on sidelines, where trainers can page 57). The other evaluate the data and assist coaches measurement, the lesser-known in determining whether or not to rotational force impact, is measured remove a player. in decarevolutions per second2.

“The system doesn’t diagnose Using the technology, coaches, concussions,” Vice President of doctors and trainers can assess the Sales Jesse Harper said. “It’s more data from hits to every player on the like eyes and ears on the field. At field by the game, season and career. the pro level, they have one or more That way, Harper noted, such trainers on the field, and one up in problems as second-impact injuries the box. High schools and most and an individual’s particular colleges can’t afford that. A trainer exposure to head impact can be that is busy trying to ice elbows and closely monitored.

Innovation & Technology Today

Summer 2013

“Our mouthguard system will deflect energy and reduce rotational among happy customers. Xenith allow them to read data from every forces,” Reynolds said. “In most earned a 5-star rating (the highest) hit to the head, and sends them ordinary helmets, the shells and foam from Virginia Tech’s Helmet Ratings. alerts if a hit exceeds the thresholds padding is directly connected, so to The big question: What’s under they set,” Harper explained. “So if speak. Our design is much different. the hood? Xenith Helmets feature they see #28 take a 92g hit, they can We have developed an innovative three interactive concepts — tap the coach on the shoulder and shock system that performs differently adaptive air-cell (called Aware say, ‘Hey, pull him out, we during an impact.” need to look at him.’”

Along with the air-cell shock i1Biometrics first tested absorbers comes the fit. We’ve all seen the Impact Sensing plenty of high-impact hits in which HammerHead Mouthguard helmets fly off heads; unfortunately, for the 2013 spring football sports media tends to highlight them. season, with four high The key, Reynolds says, is to keep the school teams, as well as the helmet attached and secure while annual MOKAN (Missouri maintaining proper fit and comfort. vs. Kansas) High School “More and more, medical experts All-Star Football Game. are saying fit is an important part “‘We were out there for a of the entire helmet equation,” he couple weeks, then for the said. “Our helmet is designed so game. About 100 athletes that, when you cinch the chin were sensored up on the strap, it conforms to the shape of i1Biometrics receiver field,” Harper said. your head, creating a custom fit. I Testing will continue through Fall, think we’re at the forefront with Flow) shock absorbers, Jesse Harper with official public rollout our adaptive fitting helmet.” the Shock Bonnet scheduled for Spring 2014.

Reaction to the Xenith Helmet has Technology that reduces sudden According to Harper, several been strong and positive from players, head movement during impact, and Division I college teams are among coaches, trainers, sports medicine an adaptive fit system to help keep those planning to use the doctors and parents. In fact, the the helmet on the player’s head.

Hammerhead Mouthguard. company produced a video to show Using air-cell shock absorbers initial reactions alone. instead of foam padding makes all Xenith Helmets have been worn “Players can’t believe a helmet with the difference in the world, since 2008. More than 100 college all this technology is so comfortable,” according to VP of Product football teams, 100 NFL players, Reynolds said. “They don’t expect that Development, Sander Reynolds. several thousand high school part of it to be addressed. Then, when “The Xenith Shock Bonnet athletes and four bona-fide NFL stars they understand everything we’ve Technology acts as a suspension (Ray Rice, Devin McCourty, Sean done, their comfort level grows that system, allowing the helmet shell to Weatherspoon and Dallas Clark) are much more.” ■ move independently, which helps

What Constitutes a Head Injury?

The Sports Legacy Institute in Boston recently classified the significance of hits to the head by scaling G forces for linear impact force.

THEIR CLASSIFICATIONS: CLASS Low Impact Medium Impact High Impact Summer 2013

FORCE 15gs 50gs 90gs

EFFECT Head impact; worthy of notice Major hit; concussion possible Head injury likely

Innovation & Technology Today

57

THE

ROBOT’S

JOURNEY from Sci-Fi to Operating Rooms

By Charles Warner It wasn’t that long ago that the idea of having robots as doctors was something reserved for Hollywood sci-fi movies. It turns out Star Wars, Alien and countless other films weren’t that far off. Today, we stand at the threshold of a major wave of technology in robotics and miniaturization that could only be dreamed of before.

What does it mean? If you ever need surgery to remove a tumor, malignant or benign, you might be a candidate for robotic surgery. That’s a good thing, because robots have helped surgeons finally level the playing field, greatly reducing the strain to themselves and patients on intricate surgeries and speeding up patient recovery time.

We’re not quite to the point of robotics becoming a common feature in all hospitals, though. Yes, the United States is the world’s leading innovator and practitioner of robotics in the operating room, but we’re also the most expensive 58

da Vinci Surgical System healthcare provider per GDP in the world, hands down. The reason why the U.S. is the runaway leader in the exciting new robotics technology is precisely because of cost. Few other nations can afford it.

Robots are very expensive. Only one company, Intuitive Surgical of Sunnyvale, CA, provides the da Vinci Surgical System used by cutting edge surgical centers. With no competition in the marketplace, Intuitive charges nearly $2 million for a shiny new model, complete

Innovation & Technology Today

with an accompanying maintenance agreement and training. That’s a lot of money to cough up for a relatively new technology with roughly the same outcome as patients opting for traditional minimally invasive endoscopic surgery.

Cost is primarily why other hospitals with limited budgets have been slow to adopt the technology.

Not only do you need money for robots, but you also need skilled surgeons with thousands of hours of training on qualified candidates.

“Without the funding for robots, other countries have not developed surgeons at the same pace as the United States, so in that sense, the U.S. is far and away the leader in this technology,” said Dr. JacquePiere Fontaine, a robotic surgery specialist at Moffitt Cancer Center in Tampa, FL. At Moffitt Cancer Center, one of the largest free standing cancer centers in the United States, robotic surgery is performed daily for patients with prostate, bladder, gynecologic, endocrine, thoracic, (Continued on Page 60)

Summer 2013

(Continued from Page 58)

and gastrointestinal cancers.

According to Dr. Eric Toloza, the results speak for themselves. “Our results with the robot are better than the national average, both open and minimally invasive,” he said.

The funding and research that led to the development of the da Vinci Surgical System was actually conducted in the late 1980s by SRI International, with funding from the Defense Advanced Research Projects Agency (DARPA). You may have heard of DARPA. Their core mission is to maintain the technological superiority of the U.S. military by inventing technologies and gadgets well ahead of their time. In 1969, for example, they put the Internet into play. The da Vinci prototype was developed because the military wanted a way for surgeons to operate remotely on front-line soldiers. There was also a desire to be able to operate on an astronaut in space while the doctor performed the virtual procedure from Earth.

Now, the technology is moving quickly toward more practical and widespread use.

Once the problem of lag time is eliminated between the doctor’s movements and corresponding robot movements (especially over long distances), then people in rural communities will have access to the most advanced procedures without having to travel to big cities.

What are the advantages of robots?

Right now, other than the accessibility to treatment over long Summer 2013

accumulate more hours on the robots, their skill levels will continue to increase. Think of how heart transplant training skyrocketed into today’s commonplace environment after Dr. Christiaan Barnard broke the ice with his successful procedure in

1967. Robotics could well follow the same arc into everyday use.

Doctors with robots view the procedure in threedimensional high def., a large leap forward from the conventional 2D TV monitor for thoracoscopic procedures. Watching a procedure on a TV monitor is counterintuitive, which makes a big difference when it comes to depth of vision.

Also, the tools are “wristed” with the robots, which allows for greater dexterity. The “old” way utilizes instruments that are straight sticks, similar to little chopsticks, that act like a fulcrum on a see-saw. The computer in the da Vinci Surgical System actually translates the doctor’s hand movements, which makes it easier to learn and teach. The good news is that tactile feedback in the surgeons’ hands is right around the corner.

There are ergonomic benefits for the surgeon as well, since he can perform procedures while sitting instead of standing. The new technology also gets rid of the surgeon’s “tremor”. Patients who have opted for this type of procedure have experienced quicker recovery time, smaller incisions, and a reduction in the amount of post-operation meds they took.

While less than 5% of procedures are conducted with robots in the U.S., that number is expected to climb, as manufacturers from Japan and Canada introduce competitor robots into the marketplace. Someone has to lead the way in this technology, and even though the U.S. wastes a considerable amount of money on healthcare, we remain innovators in this type of technology, and how it is used. ■

Innovation & Technology Today

60

distances, not a lot. However, that should change in the near future as more surgeons become adept at the new technology, and the pool of doctors with low complication rates increases. We’re in a big learning curve for doctors. As they

interview

Innovation & Technology Today Conversation with

JOHN CAPURSO

VISIONEER CEO

Imaging of a Different Sort: Mobile Medical Records

INNOVATION & TECHNOLOGY You visit your primary care physician. He or she types TODAY: How have your scanners notes into a tablet, then imports your medical record, helped to streamline the hospital already scanned from its paper source. Meanwhile, the admissions process? front desk has mobilely scanned your medical card for JOHN CAPURSO: Streamlining the insurance and prescription purposes. admissions process focuses first on After determining you need further consultation, the scanning the ID and medical doctor sends your information via email, secure cloud or cards in a secure, legible way.

Dropbox to a referred specialist. By the time you arrive, the The alternative is hand input specialist is versed on your situation, and of account numbers, which is may also have consulted with colleagues subject to error. who have also seen your physician’s notes.

Among other things, that Science fiction? Not at all. It’s starting to will delay hospital happen now.

John Capurso reimbursement by “I think it’s still forming,” says John insurance, so there’s definitely a cost advantage Capurso, President and CEO of Visioneer, (to scanning). Handling it electronically is far a pioneer in document and mobile more accurate. It’s also more convenient. scanning for 20 years. “People are being Things like that are extremely valuable to more approachable and admissions, insurance, and accounts aggressive in using technology receivable departments. that way. I think things like seeking a second opinion I&T TODAY: What about image will drive it, since the enhancement technology? second doctor will want to Pho tos c o u rtes JC: That’s a major focus. The see records and notes from the y of www documents coming from outside are a first specialist. Also, people are much more .visi one er.c om big variable. You don’t know what mobile today.” quality they are, or what condition they’re Welcome to the marriage of digital technology and in. Sometimes, they come on canary-colored paper, or scanning. While not a sexy technology in the healthcare they’re not printed dark enough. When you scan them, you and imaging world, it is one of the most vital. And we will get fallout … not the best imaging. With image see much more. Bearing that in mind, we decided to check enhancement, we make perfect pages from imperfect in with Capurso, since Visioneer scanning devices are used originals. Every page comes out crystal clear. That throughout the healthcare spectrum — including hospitals eliminates the need to scan documents a second time with (for example, Piedmont Hospital in Atlanta), insurance adjusted settings. We put them in a format the hospital companies (Blue Cross), and equipment providers prefers, which streamlines the process tremendously.

(McKesson).

“The common theme here is that paper has just not yet I&T TODAY: It also increases the convenience for patients and diminished in this industry,” Capurso says. “The need to families by the fact personnel can take information at bedside. capture documents is an urgent, ongoing matter.”

JC: Absolutely. This plays into the health of the patient Capurso lays out the status of document scanning — and himself or herself. They’re not stressed by having to do this why mobile scanning is quickly becoming a killer backat inopportune times, but rather, when they’re comfortably office medical technology.

62

Innovation & Technology Today

Summer 2013

back in their bed, in their room, maybe with family around to help.

I&T TODAY: Are these scanners also deployed into the larger healthcare family, such as rehab centers, physical therapy centers, and doctors’ offices?

JC: They are, and I would even go beyond that. They’re used not only by hospitals and care providers, but also by insurance companies, like Blue Cross, and medical equipment providers, like McKesson. All companies that participate in the healthcare business have much different document capture needs. They’re approaching different parts of the problem from different angles — as a supplier, provider, patient.

I&T TODAY: In which other aspects of the healthcare industry do you see scanners becoming more prevalent?

JC: The mobile area will be a very high-ground area moving forward. Many doctors are no longer taking notes on paper; they’re typing them into laptops and tablets.

They access documents scanned from their tablets and laptops. They communicate and transfer patient notes and records from one medical facility to another in that manner, from one doctor to another. Once that data is

moving around openly, between devices — and when I say ‘openly,’ I also mean ‘securely’ — there will be less paper involved. It has to be captured. So the mobile environment will drive more capture of paper.

I&T TODAY: Many healthcare professionals, facilities and businesspeople have accumulated five generations of data — print documents, computer files, PDFs, CDs, thumb and external drives, mobile files, and now cloud. How do they consolidate 30 or 40 years worth of data? How you address this dilemma with your business and enterprise customers?

JC: We blur the boundaries between electronic and digital data, and paper. In the end, we’re looking for quickly accessible information. When you scan paper documents, it becomes live data.

Then it’s no different from digital documents. It’s suddenly changeable, can be edited, just as alive. We encourage general business users to capture their paper data so it is accessible, can be searched, and not locked away in a filing cabinet. Our more enterprise-related customers are being driven to digitize their documents by cost, regulation, and sheer volume of information. We seek to understand what their document is going to do, and what they’re going to do with it. We have to make that easy, reliable and high quality. ■ — Robert Yehling

THE

3D GROWTH of Medical Imaging

By Amanda Leach

Medical imaging never ceases to amaze with its breakthroughs and killer technologies. Whereas, a generation ago, we were marveling over the triumphs of arthroscopic surgery, the CT scan and MRI, now we’re looking at a futuristic world of musculoskeletal ultrasound, mobile imaging, 3-Tesla MRIs, digital radiography and mammography, handheld X-ray systems, and much more.

The impact in the examination room is all good for the patient. The technology is so profound that results can be almost instantaneous, and the machines convenient for examining physicians and specialists alike. Notes Dr. Joshua Hackel of the The Andrews Institute for Orthopaedics and Sports Medicine, “We don’t rely solely on the radiologist anymore to get us the interpretation of an X-ray or MRI. We’re performing

Fujifilm’s SonoSite 64

ultrasounds here to diagnose pathology and accelerate a treatment plan from the first visit, and also to diagnose pathology that was going unrecognized prior.”

Innovation & Technology Today took a quick tour of the medical imaging world, and found a rapidly evolving series of technologies that continue to teach more and more

Fujifilm’s Synapse 3D

Innovation & Technology Today

about the wonders of the human body while providing doctors vital information to treat specific symptoms and injuries.

One new medical imaging trend gaining popularity is the use of wireless and mobile imaging devices.

These allow immediate capture, display and transmission of images to treating physicians from the patient bedside for fast, efficient patient care and treatment. One company, Fujifilm, has a new device that epitomizes this trend: the Fujifilm FDR-flex digital X-ray system. It allows X-ray techs more flexibility without having to transport patients to an X-ray room. The three-piece system features a lightweight wireless X-ray detector cassette, a small electronic communications briefcase, and a laptop that displays captured images within seconds and sends them to radiologists over the hospital’s wireless network.

Fujifilm’s Aspire HD Plus Breast Imaging Diagnostic Workstation

Summer 2013

Two other medical imaging advances and trends to watch are mobile radiology apps and cloud imaging. Both will allow doctors to put technology to use and also help make their job easier. As Visioneer CEO John Capurso noted in the Innovation & Technology Today conversation (pages 62-63), the relationship between the cloud and all types of medical imaging is still forming. “People are being more approachable and aggressive in using technology that way,” he said.

Fujifilm provides imaging devices to hospitals, doctors, and the like by featuring highly advanced machine and imaging technology. They have launched several new medical imaging products that are potential game changers. These include the Synapse 3D advanced cardiology and radiology visualization tools, which integrate with the Synapse PACS to synchronize patient lists and records with 3D and 4D viewers, comparative 3D images and compositors. Another is hand-carried ultrasound equipment, a field Fujifilm entered in December 2011 when it purchased SonoSite. The portable device makes it possible to perform ultrasounds at bedsides, reducing the time it takes — not to mention the inconvenience of transporting a patient to an ultrasound unit. The point of care ultrasound offers crisp pictures and sounds.

In addition, Fujifilm is touting its new digital mammography. The Rose, a Houston-based, non-profit breast health organization that provides screening and diagnostic services, recently received a new mammogram unit donated by Fujifilm. The mobile unit will help diagnose breast cancer quickly in rural communities, whose residents find it hard to obtain quality medical care and up-to-date technologies. The Rose mobile fleet will travel throughout the country, providing services to residents.

Mobility is also finding its way into MRIs and CT scan systems. Medical Imaging Solutions Group offers mobile MRI, PET and CT scan systems with highly technical cameras that can take multiple pictures per second.

Its fleet of imaging equipment utilizes the other killer feature of today’s technology — instant results — so patients don’t need to wait long for their results and diagnoses. These portable, mobile systems also allow

Summer 2013

Innovation & Technology Today

doctors and specialists in the sports medicine world to communicate and receive information about a sports injury immediately after it occurs, and offer treatment options much faster.

As The Andrews Institute’s Dr. Hackel says, “With musculoskeletal ultrasound, and 3-Tesla MRI, we’re able to identify lesions that prior went undiagnosed.”

These and many other new advances will help doctors diagnose and treat patients without unnecessary or overly invasive surgeries or otherwise inconvenient processes. Best of all, patients will receive pinpoint 3D and 4D imaging that gets right to the heart of their ailments or injuries — in real-time. ■

Fujifilm’s FDR Go Portable X-ray solution (Fujifilm images courtesy of Fujifilm Medical Systems U.S.A., Inc.)

65

A Gathering of

iDEVELOPERS

By Dave Batten Once again, Mac and iOS developers from around the world gathered in San Francisco in June for Apple’s World Wide Developer Conference (WWDC). The conference, held in the three-story Moscone Center, is limited to the first 5,000 developers lucky enough to get Apple's website to charge $1,599 to their credit card. And it’s all about luck: tickets sold out in a record 71 seconds. Including one to this intrepid Innovation & Technology Today contributor.

Excitement was intense. Hundreds of developers didn't bother to go to bed at all, instead getting in line as early as 3 a.m. for the opening keynote. By the time the doors opened at 9 a.m., the line of conference ticket holders stretched around a city block, all the way back to the entrance.

At Apple CEO Tim Cook’s keynote address, we get to learn what new toys we'll have available either later that day, or a few months down the road. This year's most exciting new toy is iOS 7, the new operating 66

new file tagging system, and better support for multiple displays.

Apple also showed its new Mac Pro, with capabilities far superior to the current line of Macintosh computers. It will roll out in a sexy new case about the size of a paint can. The level of computing power is better suited to Hollywood studios and rocket scientists.

Developers spent each of the five days attending five hour-long sessions. Some developers would skip a session or two and head to digitaltrends.com the labs, where they could chat one-on-one with Apple software engineers.

Lunch sessions included presentations from Major League Baseball and Bill Nye, the Science Guy. Our evenings included free parties hosted by companies trying to introduce their products policymic.com broadwayworld.com and services to developers.

The alternative rock band Vampire upcoming Macintosh operating Weekend performed at Thursday system named after a notorious bignight’s beer bash. wave surf spot between Santa Cruz By the end of the week, we were all and San Francisco. Only Apple exhausted and ready to head home. could tag an operating system with Can’t wait to add the new technology a distinct Northern California apps to iPhones, iPads and Macs over feature. This update will offer the next few months. ■ browser-like tabs in the Finder, a

system for iPhones and iPads.

Expected later this fall, it sports a redesigned interface, including new animations that promise to make the phone even more fun to use. We also learned of OS X Mavericks, the

Innovation & Technology Today

Summer 2013

THE SUMMIT OF SPORTS & MEDICINE (Continued from Page 34)

positioned KRMC as the premier hospital in Montana by closely aligning hospital administration and the medical staff, and by recruiting exceptional physicians. The growth in services, technology and quality has been exponential and almost unheard of in a community the size of Kalispell. It also stacks up at the top of facilities nationwide.

“She’s a very visionary person,” Roy says. “She put everyone on the same page, working together, strategizing together. Physicians from all over the country have visited, interviewed, looked at this set-up and said, ‘I’m tired of the environment I’m working in. I want to move here!’”

The Summit staff makes its own decisions, receives constant support and tutelage from Roy, and embodies his radiant, positive attitude. This sense of empowerment is palpable in every employee. They can push the envelope in their areas of specialty, look for better ways to provide services, and grow their departments, because that’s how their leader runs the ship. Brad Roy is that rare businessman who executes his vision and ideas, gets things done, and fires up the team along the way.

Back to technology. The Summit uses the finest medical, fitness, sports medicine and wearable sensor technology. Often, they work with manufacturers before devices or products are on the market. For instance, Roy spent the summer commiserating with Technogym, an Italian company that builds sensor technology into its cardiovascular and weight training equipment.

“Trainers can program your workout, and you can go to all those pieces of equipment and read your workout on that station,” he explains. “You Summer 2013

can get your smartphone, scan the QR code on that piece of equipment, and it will pull up your workout for the day. It will dump the results back onto your phone, send it up to the Cloud, and log it. A trainer can then go in, view the results, and change the workout. We’re going to a four-

“We like to create technology and new ways of doing things, but the flip side is sometimes, we lose focus on what’s really important in fitness and healthcare.”

— DR. BRAD ROY Executive Director, The Summit

year plan to phase that in.” (As of September, The Summit had moved into Phase I, with new equipment arrival scheduled for October.)

At I&T Today press time, he was also negotiating to bring in a platform and camera set-up that shoots 3D body images “so you see what you really look like,” Roy explains, his eyes lighting up. The acquisition will take place in 2014.

“Computer technology merges all the individual 3D pictures into one 360degree view. It’s totally different than the 2D images you see in the mirror.

Innovation & Technology Today

Over time, you can repeat this, and people can see themselves changing in the 3D. It’s very motivating.”

This leads to one of Roy’s two biggest pet peeves in medicine: the outcomes on which clinicians (and patients) focus. “I think in healthcare, we frequently focus on the wrong outcomes,” he says.

“Take blood pressure. Is lowering your blood pressure the right primary focus? Is just lowering your cholesterol the right outcome? No! The right outcome is to get you physically moving, because if we do, physiological changes happen that take you to lower risk.”

He points to the 3D imaging technology and its assumed relationship to weight loss. “We don’t focus on (numerical) weight — that’s the wrong outcome,” he says. “When you focus on how much weight you want to lose, and you don’t get there, you quit. What if you put someone into exercise and their weight goes up a bit?

They’ll fall off a cliff — even though you will be changing their body composition for the better.

Is everybody who’s overweight unhealthy? No. They might be exercising regularly, and thus are healthier than the skinny person next to them who isn’t doing anything.”

Roy’s other concern, interestingly enough, is technology; specifically, our growing dependence on it. His tone turns quite cautionary. “I’m fascinated by technology, and where it’s going in healthcare, in athletics.

That’s why I bought my GPS watch; I like to play with these toys, too.

But as I use it and think about it, I ask myself, ‘Do I really need this?’

“America loves technology, and Americans want immediate results.

We need to know now. We don’t 67

want to take time to get better. We think, ‘I want you, doctor, to fix me today, so use all that technology to make me well.’ Unfortunately, that’s not always reality.

“We like to create technology and new ways of doing things, but the flip side is sometimes, we lose focus on what’s really important in fitness and healthcare. What do we want people to do? We want them to move throughout the day. We want them to eat correctly.

We want them to change their behavior and we often lose sight of that by getting into this real fancy stuff.

Sometimes I think, if we could just pull back to the basics, we would have just as much success.”

He brought up the example of people suffering from major musculoskeletal issues that greatly inhibit their ability to walk or even stand up straight. “If we try to use canes or fancy walkers to improve their mobility, we find a lot of them get positioned incorrectly,” Roy explains. “Their center of gravity gets out in front of them, their balance gets messed up, they have a tendency to fall or trip, and they suffer other injuries.

“So we went to something simple — ski poles. We have patients all over this community who we’ve introduced to ski poles and their mobility has increased dramatically. How much technology is in that? Sometimes, the simpler, the better.”

With that basic premise, the most innovative and well-integrated model of high technology, medicine, fitness, and well being pushes forward from its nest at the top of the country. Medical practitioners, healthcare professionals and fitness experts worldwide continue to watch, and learn. ■

To read the Innovation & Technology Today conversation with Dr. Brad Roy, visit our website at www.goipw.com.

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THE FINAL WORD To close out our special coverage of sports and medical technology, we present comments from a few experts we interviewed for this issue:

On The Biggest Change in Sports & Medicine Technology: Dr. Julie Snyder, Keiser University: “Ten years ago, you wouldn’t think of a trainer doing Internet-based personal training. Now I have a student doing that online. We’re seeing a shift in the paradigm from someone coming to you, to you going to them, through the Internet, and using the modalities you’ve learned.”

On Balancing Technology with Effective, Enjoyable Workouts: Dr. Brad Roy, The Summit Medical Fitness Center: “There’s a big shift to functional training that uses exercise balls, kettle bells, body weights and bars, and all these simple things. The first three letters in functional are key. It’s FUN-ctional.

“We have a ton of technology now, all with some good purpose to it, but you have to find the right fit for the individual. What works for them? And, if you don’t have some component of fun in it, people won’t do it.”

On Nutrition: Dr. Julie Snyder, Keiser University: “Our nutritional priorities have changed in the last 30 years. Look at what we ate as kids. Good, home-cooked meals were the rule; that’s a lost art anymore. We eat so many processed foods. Often, people don’t choose healthy, physical lifestyles like we had. (Now), We’re all about convenience, and that’s put major pressure on our health and waistline.”

On Maintaining Fitness Brian Russell, Zephyr Technology: “One of the best phrases I heard about maintaining fitness came from an investment banker. He looked at it as four or five hours of weekly investment, the amount of time he would spend on his 401(k). To me, that’s a transformational phrase; it’s a call to personal responsibility.”

On Future Collaboration in Healthcare: Karin Yehling, Function First Fitness: “I’m hoping that with the right people marketing the right material, there will be a gap closure regarding dieting, nutrition in general, and the way medicine is practiced. I can imagine a time when medical professionals will be reading the same material that personal trainers, holistic practitioners etc. are, so we all get on the same page about health issues.”

Innovation & Technology Today

Summer 2013

30 is the NEW GAMING

TEENAGER Perspective By Aaron Halda

What image would you form if I asked you to envision an avid video game player? A teenage boy with acne, sitting in his basement and playing games with a couple of close friends? A social misfit who never grew up, battling it out well into his 40s? Would it surprise you to learn that the average gamer is a 30-year-old man or woman holding down jobs and friends equally well?

This average was calculated by the Entertainment Software Association (ESA), which found that 32% of gamers are under age 18, 32% are ages 18-35, and 36% are age 36 and older. As an avid 28year-old gamer, this statistic does not surprise me. I have been playing video games since the first Nintendo launch in the late 1980s, and I continue to game on multiple platforms to this day.

I enjoy playing and following multiplayer titles such as Diablo 3, League of Legends, World of Summer 2013

Warcraft, StarCraft 2, and the Call of Duty franchise. Of course, I enjoy the single player action games as well.

The incredible graphics and in-depth stories always make it difficult to put down these new games.

What has contributed to men and an increasing number of women in my age group forming the largest gameplaying group?

In recalling my original Nintendo experience, I remember inviting friends over to control the loveable Italian plumbers in Super Mario Bros.

At that early stage, social interaction was limited to friends within reach of a controller. Today, gamers can log online with any platform and play games with people throughout the world. According to an ESA video games report, 62% of gamers play with others, either in person or online.

Forty-two percent play with friends.

The large difference between pioneer gaming systems and those of today comes down to the communities and

Innovation & Technology Today

social interaction now available.

These new capabilities have brought about Massively Multiplayer Online Role-Playing Games (MMORPG/ MMO), such as the World of Warcraft (WoW). The social and competitive aspects of gaming are key ingredients.

Looking at the social implications, it makes sense that the average age of gamers has increased. Besides the fact we love video games, it is so much easier today to use video games as a social outlet. When you are a teenager, your biggest worries are going to school and whether you have plans for the weekend. As we get older, trying to juggle work and a family can make it very difficult to see friends on a regular basis. Enter the gaming scene: You can log in from your house and spend those brief available hours with friends you have made either online or inperson. Gaming has become a form of social networking.

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Then there’s the skill factor.

Dedicated gamers hone a particular set of skills. Eye-hand coordination must be solid for many games, namely First-Person Shooter (FPS) and Real-Time Strategy (RTS) titles.

Also, problem solving factors into every game available on the market.

How quickly you can view a situation, develop a reaction, and implement that action with precision? Within a brief moment?

That often spells the difference between victory and defeat. FPS games such as the Call of Duty franchise require players to master an incredibly fast reaction time that many refer to as “twitch.”

On the other side of the coin, RTS games require the constant evolution of strategic and problem solving skills. The gamer controls a complex army, and the player must micro-manage (micro) this army while at the same time building additions to their base and gathering resources to support their economy.

These games require a level of skill mastered through hours of playtime.

Not only do you need to know your plan of attack in the beginning, but you must also be able to watch how your enemy is progressing throughout the game — and potentially identify and adapt your

70

game plan to counter his strategies.

This pulls players like me into the competitive aspect of gaming. Video

games have created an entirely new arena for competition. Being an athlete and highly competitive by nature, my desire to compete drives me well in the gaming world. It is addicting to test myself against others and see my progression.

When breaking down the financial cost of our enjoyment, I find that video games provide the most bang for their buck. Forty-three percent of fellow gamers agree. Compared to

other forms of media entertainment, nothing touches the per-hour value proposition of a video game, due to the sheer number of entertainment hours and tremendous enjoyment a single game can provide. For example, compare the value of a video game to a DVD or Blu-Ray, buying a CD or downloading songs onto iTunes, or going to the movies. A brand new game costs about $65, but you will receive hundreds of hours of enjoyment from it. Head to the movies, and you will spend about $14 for the ticket plus $10-12 for a soda and popcorn. That’s roughly $25 for two hours of fun — and you better hope the critics were right about the film!

Now take a great single-player action game like the Uncharted series. I played through each game in the series multiple times, averaging roughly 10 hours of entertainment per game. The value proposition becomes even more favorable for online multiplayer games such as the Call of Duty franchise, which provide virtually limitless replay enjoyment.

Modern video games often provide a depth of character and immersion as good, if not better, than other forms of media entertainment. Storylines have evolved just as markedly as gaming systems. Our earlier example of Super Mario Bros. can attest to that. At that

Innovation & Technology Today

Summer 2013

Photo by Amy Halda

early stage, there wasn’t much more to the story than “Thank you Mario!

But your princess is in another castle!” Today, game graphics and storylines are so good that observers

This was a case where a story-driven screenplay defined a video game, which approximately 2 million players (to date) thought good enough to buy.

Video games have become an integral part of society, and their popularity will continue to grow as the years go on. I leave now with that perspective, as there is some

Another example is the recent hit game The Last of Us, which has such an engulfing story that friends and spouses of gamers eagerly await what will happen next. A close friend of mine has conquered that game three times. His wife watched every time, for pure enjoyment of the story.

virtual slaughtering to be had. See you online. ■

Photos by Amy Halda

without a controller can enjoy watching the plot unfold. Case in point? The top-selling video game of 2006, Gun, which Activision and creator J. Randal Jahnson developed from an optioned screenplay — also written by Jahnson — that was languishing at Universal Studios.

AARON HALDA writes from many allnight sessions tucked into his 20+ years of gaming experience. The new Innovation & Technology Today gaming/entertainment editor, he lives in Southern California.

72 Innovation & Technology Today

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Innovation & Technology Today

Summer 2013

EDUCATION (Continued from Page 22)

(Continued from Page 74)

superior Armpocket is to any other running band I have owned. It kept all moisture away from my phone, it is extremely lightweight, so comfortable, it conveniently fits items like a credit card, ID, keys, etc. and allows me much easier access to my phone. Not to mention the fact that it was priced less than or equal to all three brands I previously owned. I absolutely love my Armpocket! So happy to be able to stop wasting my money on other brands and finally have one that works for me.”

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Innovation & Technology Today

think of a trainer doing Internetbased personal trainer. Now I have a student doing that online. From a teaching perspective, you have webinars online, teaching tools you can access, digital textbooks.

“In our program, some things continually change, while others remain the same. For instance, it’s still important to assess heart rate and blood pressure in the conventional way. We keep up with the changes, but we still have our foundational values and core teachings that remain sound.”

With nearly 1,000 students in the program, and more entering every year, Dr. Snyder realizes her students comprise a group of potential difference-makers and leaders in sports medicine, physical therapy, personal training, chiropractic and various fitness disciplines. To that end, she points out another of Keiser’s central goals: to obtain American Council on Exercise (ACE) certifications for some students, and to prepare the more medically inclined for their continuing educations.

“We’re a big proponent on graduating students who become well-certified,” she said. “How do you know somebody is worth $60 or $70 an hour? Through their educational background, certifications and accreditations.

That’s what we strongly emphasize.

In our bachelor’s program, we have four courses that prepare students to take certification exams.

“In our exercise science program, we also set up our students for postbaccalaureate work in physical therapy, chiropractic, sports medicine and other areas that require education beyond our bachelor’s program. It’s very important to give them everything we can so they can move forward with any profession in this field.” ■ 75

in our next issue …

In the Fall issue of Innovation & Technology Today, we embark on quite a journey. We set off into tomorrow’s energy-efficient vehicles with smart interactive features (not Smart the model), visit smart farms and the latest in green tech, and look at how Big Oil is moving more energy conscious technologies into their operations.

It’s all about Transportation, Green Technology and Energy. Among our stories: ■ SMART FARMS What happens when you combine the dynamics of the American farm with smart home technology? We pay a special visit to a farming operation that does exactly that.

■ HOW TRAVEL BECAME PORTABLE, MOBILE AND INSTANT Fraunhofer IESE/ phys.org

Remember the pre-social media and mobile networking days, when setting up a trip was a series of chores? Now, all we need to do is shimmy up to the computer, smartphone or tablet and begin searching. The newest member of our writing team, Rosemary O’Brien, tells us what’s new in travel.

■ TRANSPORTATION LOGISTICS, IN THE CLOUD Seems like the Cloud can house everything now. We look at a Transportation Management System that is entirely based in the Cloud.

■ THE TECHNOLOGY BEHIND THE SPIKE In 2013, green tech-related stocks and mutual funds have enjoyed their greatest year-to-year gains ever. The biggest gainer? Wall Street’s newest darling, Tesla Motors. What changes in innovation, technology, the business climate and public sentiment are driving this spike? Editor Robert Yehling reports.

Look for these stories, in-depth conversations with innovators, regular departments, our always-entertaining links, and much more in the ever-expanding Innovation & Technology Today.

Also, be sure to check out our website, www.goipw.com, for additional interviews, articles, blogs and news.

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