It seems like a vicious good news—bad news cycle: biomedical engineers invent effective techniques for diagnosing and treating diseases, and the medical profession readily adopts them.

But as medicine and medical research goes increasingly high-tech, their costs go higher and higher. R&D must be amortized over the life of a product. Technicians must be trained to run new machines. Companies must make a profit. And it is the basic nature of research that no one knows what techniques will prove effective and which ones will simply turn out to be expensive dead ends.

The result? Patients, physicians, and insurance companies all see the cost of health care skyrocket. It can look as though high tech is part of the problem rather than part of the solution.

But engineering can also lower costs, if it can be focused on early detection of disease before any symptoms are apparent, as well as on wireless electronic monitoring and diagnosis at home. That’s the theme of a high-level conference being organized by the Biotechnology Council—a consortium of the IEEE and eight other biomedical and engineering nonprofit societies: the Society for Biological Engineering, a technical community of the American Institute of Chemical Engineers; the American Medical Informatics Association; the American Society of Mechanical Engineers; the Biomedical Engineering Society; the Healthcare Information and Management Systems Society; the Radiological Society of North America; the Society for Computer Applications in Radiology; and the Society for Biomaterials.

The council’s Bioeconomics Conference, scheduled for late September in Washington, D.C., is expected to address the economics of biomedical technology and health care. The invitation-only conference is intended to attract not only industry executives, health-care association managers, prominent engineers, and physicians, but also economists, members of the U.S. Congress, state and local government officials, and other policy-makers.

“We want to point out that spending money on biotechnology is not a bottomless pit, but can be cost-effective for the nation and have a positive influence on local, state, and federal economies. We must, however, evaluate which evolving technologies to concentrate on,” says Dr. Michael Rozen, a physician and an IEEE senior member serving as the IEEE’s representative to the Biotechnology Council and as the conference chair.

“It used to be that technology only raised costs,” says Dr. Jerome Grossman, physician, senior fellow, and director of the Harvard/Kennedy School Health Care Delivery Program, who is serving as honorary chair of the conference. “Now it can lower costs in two ways. First, it can make medical diagnosis and treatments more precise. Second, it can shift care downward from doctor to nurse to assistant to patient.”

REAL EARLY DETECTION “The ultimate vision is to treat illnesses before they become symptomatic,”Grossman says. Early diagnosis and targeted treatment mean more effective results, shorter treatment times, less medication, fewer side effects, faster recovery, and a better quality of life for the patient—all for less money.

The decade-long project to map the human genome—the full genetic structure of a human being—revealed that genes hold the keys to disease. “Almost all deviations from the norm have a genetic biomarker,”Grossman explains. “Already, that is allowing early diagnosis and more targeted treatment of cancers.” He points out that a number of genes have been associated with breast cancer, and a new treatment for people with two of the genes is about to be approved.

The genome-mapping project also revealed that engineering is key to lowering costs. “Mapping the human genome required extremely sophisticated computer tools for the analysis, and each generation of equipment did it faster and cheaper,”Grossman recounts. “The spectrometers that dissected and identified genes during the 10-year project did 50 percent of the work in just the last two years.” The Biotech­nology Council wants to harness that high-tech analysis multiplier as well as the huge database of information resulting from human genome mapping.

“How can potential investors and policy-makers evaluate which technologies will be most efficient for lowering medical costs instead of raising them?” Grossman asks. In his view, three sets of technologies stand out.

One involves genetic screening?identifying the biomarkers for major diseases. Today, “the cost of screening a person for biomarkers is quite high—much higher than is usually spent on the diagnosis and treatment of a breast-cancer patient,” Grossman says. “But advanced tools double in power and halve the cost every 18 to 24 months, so that cost is falling exponentially.”

Eventually, identification of biomarkers will become affordable for most major diseases, he says—even for so-called orphan diseases, which are relatively rare ailments that can cost a stratospheric US $30 000 to $100 000 per year to treat.

The second set of technologies tailors treatments using genetic molecules—which involves traditional medicines attached to genomic delivery systems to aim treatments at tumors or find the locations of disease.

The third high-tech area deals with devices for delivering health care at home. For chronic diseases such as diabetes, many patients already manage their own care, administering blood tests, reading results, and taking medication. But such care is beyond the capacity of many people. What Grossman calls “machine-mediated care” could solve that problem. The process involves wireless, implantable devices that monitor blood-sugar levels, heartbeat, blood pressure, or other parameters and transmit the results to a physician via the Web. Such home monitoring would reduce the need for visits to a doctor’s office or for in-home nurse’s visits, while allowing “one doctor to oversee many patients and be more productive,” as Grossman puts it.

BATTLING THE STATUS QUO In the United States, at least, such technical approaches are radical and challenge the nation’s infrastructure of medical insurance and reimbursements. So the conference is likely to point out that policy-makers must focus on more than just engineering and medicine. They must also rethink medical insurance. “As health care moves from the doctor to the patient,” Grossman says, “the insurance industry must change to reimbursing for a condition regardless of who gives the care.”

A second challenge is that the United States, like most of the developed world, must deal with its aging population. Within the next two decades most of the U.S. baby-boom generation, born between 1946 and 1964, will be retiring—including many physicians, right at the time when the population will need doctors most.

And thirdly, with some 45 million people—a sixth of the U.S. adult population—medically uninsured and with a relatively high rate of infant mortality, health-care delivery in this nation has to change,” Rozen declares. In his view, biotech­nology can be part of that change, through identifying the genetics of disease, targeting therapies, monitoring health care, and communicating with physicians.

According to Grossman, those three challenges “spell the need for a fundamental shift in the paradigm of diagnoses and treatment” in the United States—-a shift in which careful engineering can offer great improvements and lower costs.

FOR MORE INFORMATION about the Bioeconomics Conference, contact Bichlien Hoang, IEEE staff liaison to the Biotechnology Council, at +1 732 562 5549 or b.hoang@ieee.org.