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Bluetooth Smart
Connecting Medical Devices to Smart Phones

MD&M
Rob Milner
30 October 2013

SmartSys-P-007 v0.3
WHO WE ARE
& WHAT WE DO

30 October 2013

2

SmartSys-P-007 v0.3
WHO WE ARE

A world leader in
technology and product
innovation
 Established out of Cambridge
University UK in 1960
 ~ 380 scientists and designers
in Cambridge, UK and 30 in
Cambridge MA, USA

 For clients worldwide, we
– develop breakthrough
products
– create and license
intellectual property
– provide business
consulting in
technology-critical
issues
30 October 2013

3

SmartSys-P-007 v0.3
WHO WE ARE

You may not know us..

…but you are probably familiar
with some of our work

The world’s first
digital fertility
monitor

Handheld satellite
phone technology
for Iridium

30 October 2013

4

First ever singlechip Bluetooth
solution, now found
in 7 out of 10 cell
phones worldwide
Spun out Cambridge
Silicon Radio (CSR)

Continua Compliant
Bluetooth devices for
A&D Medical.

Designed & helped
manufacture the first
round tea bag,
helping client increase
market share by 30%

The first cellular
patient monitor (in
WMTS) for Philips.

SmartSys-P-007 v0.3
WHAT WE DO

We work for clients in a diverse range of sectors

Medical
technologies

|

Industrial and

| consumer products |

Wireless

Healthcare and
innovation mgmt

Our clients range from global blue chips to dynamic start-ups

30 October 2013

5

SmartSys-P-007 v0.3
DIGITAL
HEALTH

30 October 2013

6

SmartSys-P-007 v0.3
DIGITAL HEALTH

A Quantified Self
Several different terms are
being used but regardless,
digital health is about
quantifying one’s-self, and an
attempt to engage (“connect”)
an individual with his/her self &
his/her circle in a seamless
manner

Telehealth
Digital Health
Health &
Wellness
eHealth

QUANTIFIED
SELF

Connected
Health
Telemedicine

30 October 2013

7

mHealth

Health 2.0
SmartSys-P-007 v0.3
DIGITAL HEALTH

The Health Continuum

Optimizing
care delivery

Acute care
monitoring

Solutions must be targeted
depending on whether the
quantified self is applied to:
 A professional athlete
 A fitness freak or the worried
well
 A healthy individual
 An individual with chronic
disease
 Or a patient in hospital or
clinic,

Chronic disease Preventive
Management
care

Well
being

Sports &
fitness

THE QUANTIFIED SELF

However, they can & must
leverage similarities across the
Health Continuum

30 October 2013

8

SmartSys-P-007 v0.3
DIGITAL HEALTH

Solutions for the Health
Continuum

Optimizing
care delivery

Acute care
monitoring

Chronic disease Preventive
Management
care

Well
being

Sports &
fitness

THE QUANTIFIED SELF

Three primary categories in
which solutions are required.

SERVICES

They require a very similar set of
skills complemented by specific
domain expertise.

DEVICES
APPS

DOMAIN EXPERTISE

STRATEGY
EXPERIENCE DESIGN
SENSOR DESIGN
ALGORITHMS
WIRELESS TECHNOLOGIES
PRODUCT DEVELOPMENT

30 October 2013

9

SmartSys-P-007 v0.3
CONNECTING
TO PHONES

30 October 2013

10

SmartSys-P-007 v0.3
There are many ways to communicate between an app and a device
 QR codes / Computer Vision

30 October 2013

11

SmartSys-P-007 v0.3
There are many ways to communicate between an app and a device
 QR codes / Computer Vision
 NFC

30 October 2013

12

SmartSys-P-007 v0.3
There are many ways to communicate between an app and a device
 QR codes / Computer Vision
 NFC
 Audio / headphone jack

30 October 2013

13

SmartSys-P-007 v0.3
There are many ways to communicate between an app and a device





QR codes / Computer Vision
NFC
Audio / headphone jack
Wired connector

30 October 2013

14

SmartSys-P-007 v0.3
There are many ways to communicate between an app and a device






QR codes / Computer Vision
NFC
Audio / headphone jack
Wired connector
Bluetooth, WiFi

30 October 2013

15

SmartSys-P-007 v0.3
There are many ways to communicate between an app and a device







QR codes / Computer Vision
NFC
Audio / headphone jack
Wired connector
Bluetooth, WiFi
Bluetooth Smart

30 October 2013

16

SmartSys-P-007 v0.3
There are many ways to communicate between an app and a device







QR codes / Computer Vision
NFC
Audio / headphone jack
Wired connector
Bluetooth, WiFi
Bluetooth Smart

 Understanding your requirements is important when selecting the technology
– Use cases
– Simplicity
– Size
– Cost
– Attachment rate
– Lifetime
30 October 2013

17

SmartSys-P-007 v0.3
There are many phones to connect to

30 October 2013

18

SmartSys-P-007 v0.3
BLUETOOTH SMART

30 October 2013

19

SmartSys-P-007 v0.3
Bluetooth Smart is a low power variant of Bluetooth
 Other low power radios exist – so what’s special about
Bluetooth Smart?
 It’s performance is similar to other technologies:
– ANT+
– Zigbee
 Bluetooth is in phones!
– In November 2011 Apple included Bluetooth Smart
in the iPhone 4S
– By 2012 750M phones were Bluetooth Smart
ready (although Smart ready is not Smart)
– That’s pretty much all smart phones
– Both Apple and Android (*) fully support Bluetooth
Smart

30 October 2013

20

SmartSys-P-007 v0.3
Bluetooth Smart offers unprecedented flexibility in creating new devices
 Previously devices were constrained to particular use cases

30 October 2013

21

SmartSys-P-007 v0.3
Bluetooth Smart offers unprecedented flexibility in creating new devices
 Previously devices were constrained to particular use cases

30 October 2013

22

SmartSys-P-007 v0.3
Bluetooth Smart offers unprecedented flexibility in creating new devices
 Previously devices were constrained to particular use cases
 Developers can now create their own use case

30 October 2013

23

SmartSys-P-007 v0.3
Bluetooth Smart offers unprecedented flexibility in creating new devices
 Previously devices were constrained to particular use cases
 Developers can now create their own use case

30 October 2013

24

SmartSys-P-007 v0.3
Bluetooth Smart offers unprecedented flexibility in creating new devices
 Previously devices were constrained to particular use cases
 Developers can now create their own use case

30 October 2013

25

SmartSys-P-007 v0.3
Bluetooth Smart is attractive for a number of reasons
 Makes connectivity a low marginal cost increase to electronic
devices
 Benefits are valuable enough to consider adding connectivity to
products that have never contained electronics
 Removes the need for partner device development
– Handheld devices
– Hubs

30 October 2013

26

SmartSys-P-007 v0.3
Bluetooth Smart devices are truly connected
 All our enquiries are for devices that fit within this
architecture
 This enables system features that cannot be implemented
on the device alone
 This means that the device must be considered within the
context of the system

Cloud service

App

Device

30 October 2013

27

SmartSys-P-007 v0.3
NITTY GRITTY

30 October 2013

28

SmartSys-P-007 v0.3
Technology architecture
 A phone can connect to multiple peripherals
 A peripheral can connect to only one phone
 Pairing is used to associate and secure devices
 Standard is based around profiles
– Blood pressure profile
– Glucose profile
– Battery service
– Find me profile
 You can also develop custom profiles
 Data rates are modest but workable

30 October 2013

29

SmartSys-P-007 v0.3
Bluetooth Smart chips can provide a standalone solution
 You can put application code on them
 They have general purpose features
– Analog and digital IO
– I2C/SPI
– Power management
 They are designed to run from a single coin cell battery
 There is a healthy competition amongst chipset companies
– Latest parts tend to be the best
– Some trade off power for range
– Different companies have different support models

30 October 2013

30

SmartSys-P-007 v0.3
Bluetooth management
 Bluetooth Special Interest Group (SIG) manage the
technology
– License technology to members
– Define standards
– Police compliance
 To bring a Bluetooth product to market you need to:
– Join the SIG
– Design to their standards
– Show compliance against test suite
 Manufacturers can self certify
– Aim is to keep barriers low to increase adoption
 Modules can help to simplify the process

30 October 2013

31

SmartSys-P-007 v0.3
Fragmentation is a problem on Android
 Android
– Fragmentation of versions and
hardware
– Variable tech attachment rates
– Limited visibility of upcoming features,
but a slow roll out of new features
– Jelly bean - July 2012
– ICS – October 2011
 Apple
– Good roll out of new OS’s
– 58.3% of iDevices updated to iOS 7
within a week

– Good developer info
– Lower market share
30 October 2013

32

SmartSys-P-007 v0.3
The app sandbox on phones constrains solutions
 The core OS controls most of the phone
 It determines how and when your app can run
 It determines which parts of the phone you can control

Profile
Service
Characteristic

 You only get access to parts of the radio
 The OS manages how the different radios share resources
 These constraints can have a big impact on your device

GATT
ATT
L2CAP

HCI
LC/LM

30 October 2013

33

SmartSys-P-007 v0.3
Example – connection setup
 Imagine a device that generates data
every few minutes and sends it to a
phone

30 October 2013

34

SmartSys-P-007 v0.3
Example – connection setup

Bluetooth Smart radio power
budget to transfer one data
packet

 Imagine a device that generates data
every few minutes and sends it to a
phone
 This is how the device will spend it’s
power
 The connecting power can be altered
by varying a parameter

Handshake
19%

Data
transfer
1%

Connecting
80%

30 October 2013

35

SmartSys-P-007 v0.3
Average Number of Attempts to
Connect

There is a sweet spot for minimising the power to connect
40

37

35

30
24

25

22

+85%

24
20

20

10

0
20

30

40

50

60

70

80

Advertising Interval (ms)

30 October 2013

36

SmartSys-P-007 v0.3
There is a sweet spot for minimising the power to connect

This is the difference between
a user getting 20 days of
battery life and getting a
month

30 October 2013

37

SmartSys-P-007 v0.3
Average Number of Attempts to
Connect

The sweet spot changes between OS versions
50
40

OS vA
OS vB

40
37

3535
+35%

29
24

30

25
22

26
22

26
24

60

70

27

20

20
10
0
20

30

40

50

80

Advertising Interval (ms)

30 October 2013

38

SmartSys-P-007 v0.3
Average Number of Attempts to
Connect

Other OS’s behave in the same way
30
22

20
15

15
13

+175%

10

10

9

8

70

80

0
20

30

40

50

60

Advertising Interval (ms)

30 October 2013

39

SmartSys-P-007 v0.3
CONCLUSIONS

30 October 2013

40

SmartSys-P-007 v0.3
THINK SYSTEM

30 October 2013

41

SmartSys-P-007 v0.3
UNDERSTAND YOUR
REQUIREMENTS

30 October 2013

42

SmartSys-P-007 v0.3
PLAN TO ADAPT

30 October 2013

43

SmartSys-P-007 v0.3
For further information contact:
 Robert Milner, Senior Consultant - Wireless Division
robert.milner@cambridgeconsultants.com
 Vaishali Kamat, Associate Director - Medical Technology
vaishali.kamat@cambridgeconsultants.com
 Tim Ensor, Business Development Manager - Wireless Division
tim.ensor@cambridgeconsultants.com

30 October 2013

44

SmartSys-P-007 v0.3
Cambridge UK

Cambridge USA

Singapore

www.CambridgeConsultants.com
Cambridge Consultants is part of the Altran group, a global leader
in Innovation. www.Altran.com

30 October 2013

Registered No. 1036296 England

SmartSys-P-007 v0.3

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Bluetooth Smart: Connecting Medical Devices to Smart Phones

  • 1. Bluetooth Smart Connecting Medical Devices to Smart Phones MD&M Rob Milner 30 October 2013 SmartSys-P-007 v0.3
  • 2. WHO WE ARE & WHAT WE DO 30 October 2013 2 SmartSys-P-007 v0.3
  • 3. WHO WE ARE A world leader in technology and product innovation  Established out of Cambridge University UK in 1960  ~ 380 scientists and designers in Cambridge, UK and 30 in Cambridge MA, USA  For clients worldwide, we – develop breakthrough products – create and license intellectual property – provide business consulting in technology-critical issues 30 October 2013 3 SmartSys-P-007 v0.3
  • 4. WHO WE ARE You may not know us.. …but you are probably familiar with some of our work The world’s first digital fertility monitor Handheld satellite phone technology for Iridium 30 October 2013 4 First ever singlechip Bluetooth solution, now found in 7 out of 10 cell phones worldwide Spun out Cambridge Silicon Radio (CSR) Continua Compliant Bluetooth devices for A&D Medical. Designed & helped manufacture the first round tea bag, helping client increase market share by 30% The first cellular patient monitor (in WMTS) for Philips. SmartSys-P-007 v0.3
  • 5. WHAT WE DO We work for clients in a diverse range of sectors Medical technologies | Industrial and | consumer products | Wireless Healthcare and innovation mgmt Our clients range from global blue chips to dynamic start-ups 30 October 2013 5 SmartSys-P-007 v0.3
  • 7. DIGITAL HEALTH A Quantified Self Several different terms are being used but regardless, digital health is about quantifying one’s-self, and an attempt to engage (“connect”) an individual with his/her self & his/her circle in a seamless manner Telehealth Digital Health Health & Wellness eHealth QUANTIFIED SELF Connected Health Telemedicine 30 October 2013 7 mHealth Health 2.0 SmartSys-P-007 v0.3
  • 8. DIGITAL HEALTH The Health Continuum Optimizing care delivery Acute care monitoring Solutions must be targeted depending on whether the quantified self is applied to:  A professional athlete  A fitness freak or the worried well  A healthy individual  An individual with chronic disease  Or a patient in hospital or clinic, Chronic disease Preventive Management care Well being Sports & fitness THE QUANTIFIED SELF However, they can & must leverage similarities across the Health Continuum 30 October 2013 8 SmartSys-P-007 v0.3
  • 9. DIGITAL HEALTH Solutions for the Health Continuum Optimizing care delivery Acute care monitoring Chronic disease Preventive Management care Well being Sports & fitness THE QUANTIFIED SELF Three primary categories in which solutions are required. SERVICES They require a very similar set of skills complemented by specific domain expertise. DEVICES APPS DOMAIN EXPERTISE STRATEGY EXPERIENCE DESIGN SENSOR DESIGN ALGORITHMS WIRELESS TECHNOLOGIES PRODUCT DEVELOPMENT 30 October 2013 9 SmartSys-P-007 v0.3
  • 10. CONNECTING TO PHONES 30 October 2013 10 SmartSys-P-007 v0.3
  • 11. There are many ways to communicate between an app and a device  QR codes / Computer Vision 30 October 2013 11 SmartSys-P-007 v0.3
  • 12. There are many ways to communicate between an app and a device  QR codes / Computer Vision  NFC 30 October 2013 12 SmartSys-P-007 v0.3
  • 13. There are many ways to communicate between an app and a device  QR codes / Computer Vision  NFC  Audio / headphone jack 30 October 2013 13 SmartSys-P-007 v0.3
  • 14. There are many ways to communicate between an app and a device     QR codes / Computer Vision NFC Audio / headphone jack Wired connector 30 October 2013 14 SmartSys-P-007 v0.3
  • 15. There are many ways to communicate between an app and a device      QR codes / Computer Vision NFC Audio / headphone jack Wired connector Bluetooth, WiFi 30 October 2013 15 SmartSys-P-007 v0.3
  • 16. There are many ways to communicate between an app and a device       QR codes / Computer Vision NFC Audio / headphone jack Wired connector Bluetooth, WiFi Bluetooth Smart 30 October 2013 16 SmartSys-P-007 v0.3
  • 17. There are many ways to communicate between an app and a device       QR codes / Computer Vision NFC Audio / headphone jack Wired connector Bluetooth, WiFi Bluetooth Smart  Understanding your requirements is important when selecting the technology – Use cases – Simplicity – Size – Cost – Attachment rate – Lifetime 30 October 2013 17 SmartSys-P-007 v0.3
  • 18. There are many phones to connect to 30 October 2013 18 SmartSys-P-007 v0.3
  • 19. BLUETOOTH SMART 30 October 2013 19 SmartSys-P-007 v0.3
  • 20. Bluetooth Smart is a low power variant of Bluetooth  Other low power radios exist – so what’s special about Bluetooth Smart?  It’s performance is similar to other technologies: – ANT+ – Zigbee  Bluetooth is in phones! – In November 2011 Apple included Bluetooth Smart in the iPhone 4S – By 2012 750M phones were Bluetooth Smart ready (although Smart ready is not Smart) – That’s pretty much all smart phones – Both Apple and Android (*) fully support Bluetooth Smart 30 October 2013 20 SmartSys-P-007 v0.3
  • 21. Bluetooth Smart offers unprecedented flexibility in creating new devices  Previously devices were constrained to particular use cases 30 October 2013 21 SmartSys-P-007 v0.3
  • 22. Bluetooth Smart offers unprecedented flexibility in creating new devices  Previously devices were constrained to particular use cases 30 October 2013 22 SmartSys-P-007 v0.3
  • 23. Bluetooth Smart offers unprecedented flexibility in creating new devices  Previously devices were constrained to particular use cases  Developers can now create their own use case 30 October 2013 23 SmartSys-P-007 v0.3
  • 24. Bluetooth Smart offers unprecedented flexibility in creating new devices  Previously devices were constrained to particular use cases  Developers can now create their own use case 30 October 2013 24 SmartSys-P-007 v0.3
  • 25. Bluetooth Smart offers unprecedented flexibility in creating new devices  Previously devices were constrained to particular use cases  Developers can now create their own use case 30 October 2013 25 SmartSys-P-007 v0.3
  • 26. Bluetooth Smart is attractive for a number of reasons  Makes connectivity a low marginal cost increase to electronic devices  Benefits are valuable enough to consider adding connectivity to products that have never contained electronics  Removes the need for partner device development – Handheld devices – Hubs 30 October 2013 26 SmartSys-P-007 v0.3
  • 27. Bluetooth Smart devices are truly connected  All our enquiries are for devices that fit within this architecture  This enables system features that cannot be implemented on the device alone  This means that the device must be considered within the context of the system Cloud service App Device 30 October 2013 27 SmartSys-P-007 v0.3
  • 28. NITTY GRITTY 30 October 2013 28 SmartSys-P-007 v0.3
  • 29. Technology architecture  A phone can connect to multiple peripherals  A peripheral can connect to only one phone  Pairing is used to associate and secure devices  Standard is based around profiles – Blood pressure profile – Glucose profile – Battery service – Find me profile  You can also develop custom profiles  Data rates are modest but workable 30 October 2013 29 SmartSys-P-007 v0.3
  • 30. Bluetooth Smart chips can provide a standalone solution  You can put application code on them  They have general purpose features – Analog and digital IO – I2C/SPI – Power management  They are designed to run from a single coin cell battery  There is a healthy competition amongst chipset companies – Latest parts tend to be the best – Some trade off power for range – Different companies have different support models 30 October 2013 30 SmartSys-P-007 v0.3
  • 31. Bluetooth management  Bluetooth Special Interest Group (SIG) manage the technology – License technology to members – Define standards – Police compliance  To bring a Bluetooth product to market you need to: – Join the SIG – Design to their standards – Show compliance against test suite  Manufacturers can self certify – Aim is to keep barriers low to increase adoption  Modules can help to simplify the process 30 October 2013 31 SmartSys-P-007 v0.3
  • 32. Fragmentation is a problem on Android  Android – Fragmentation of versions and hardware – Variable tech attachment rates – Limited visibility of upcoming features, but a slow roll out of new features – Jelly bean - July 2012 – ICS – October 2011  Apple – Good roll out of new OS’s – 58.3% of iDevices updated to iOS 7 within a week – Good developer info – Lower market share 30 October 2013 32 SmartSys-P-007 v0.3
  • 33. The app sandbox on phones constrains solutions  The core OS controls most of the phone  It determines how and when your app can run  It determines which parts of the phone you can control Profile Service Characteristic  You only get access to parts of the radio  The OS manages how the different radios share resources  These constraints can have a big impact on your device GATT ATT L2CAP HCI LC/LM 30 October 2013 33 SmartSys-P-007 v0.3
  • 34. Example – connection setup  Imagine a device that generates data every few minutes and sends it to a phone 30 October 2013 34 SmartSys-P-007 v0.3
  • 35. Example – connection setup Bluetooth Smart radio power budget to transfer one data packet  Imagine a device that generates data every few minutes and sends it to a phone  This is how the device will spend it’s power  The connecting power can be altered by varying a parameter Handshake 19% Data transfer 1% Connecting 80% 30 October 2013 35 SmartSys-P-007 v0.3
  • 36. Average Number of Attempts to Connect There is a sweet spot for minimising the power to connect 40 37 35 30 24 25 22 +85% 24 20 20 10 0 20 30 40 50 60 70 80 Advertising Interval (ms) 30 October 2013 36 SmartSys-P-007 v0.3
  • 37. There is a sweet spot for minimising the power to connect This is the difference between a user getting 20 days of battery life and getting a month 30 October 2013 37 SmartSys-P-007 v0.3
  • 38. Average Number of Attempts to Connect The sweet spot changes between OS versions 50 40 OS vA OS vB 40 37 3535 +35% 29 24 30 25 22 26 22 26 24 60 70 27 20 20 10 0 20 30 40 50 80 Advertising Interval (ms) 30 October 2013 38 SmartSys-P-007 v0.3
  • 39. Average Number of Attempts to Connect Other OS’s behave in the same way 30 22 20 15 15 13 +175% 10 10 9 8 70 80 0 20 30 40 50 60 Advertising Interval (ms) 30 October 2013 39 SmartSys-P-007 v0.3
  • 41. THINK SYSTEM 30 October 2013 41 SmartSys-P-007 v0.3
  • 42. UNDERSTAND YOUR REQUIREMENTS 30 October 2013 42 SmartSys-P-007 v0.3
  • 43. PLAN TO ADAPT 30 October 2013 43 SmartSys-P-007 v0.3
  • 44. For further information contact:  Robert Milner, Senior Consultant - Wireless Division robert.milner@cambridgeconsultants.com  Vaishali Kamat, Associate Director - Medical Technology vaishali.kamat@cambridgeconsultants.com  Tim Ensor, Business Development Manager - Wireless Division tim.ensor@cambridgeconsultants.com 30 October 2013 44 SmartSys-P-007 v0.3
  • 45. Cambridge UK Cambridge USA Singapore www.CambridgeConsultants.com Cambridge Consultants is part of the Altran group, a global leader in Innovation. www.Altran.com 30 October 2013 Registered No. 1036296 England SmartSys-P-007 v0.3