Fast, low-cost device uses the cloud to speed up diagnostic testing for HIV and more

Samuel K. Sia, associate professor of biomedical engineering at Columbia Engineering, has taken his innovative lab-on-a-chip and developed a way to not only check a patient's HIV status anywhere in the world with just a finger prick, but also synchronize the results automatically and instantaneously with central health-care records - 10 times faster, the researchers say, than the benchtop ELISA, a broadly used diagnostic technique. The device was field-tested in Rwanda by a collaborative team from the Sia lab and ICAP at Columbia's Mailman School of Public Health.

In the study published online January 18, 2013, in Clinical Chemistry, and in the print April 2013 issue, Sia describes a major advance towards providing people in remote areas of the world with laboratory-quality diagnostic services traditionally available only in centralized health care settings.

"We've built a handheld mobile device that can perform laboratory-quality HIV testing, and do it in just 15 minutes and on finger-pricked whole blood," Sia says. "And, unlike current HIV rapid tests, our device can pick up positive samples normally missed by lateral flow tests, and automatically synchronize the test results with patient health records across the globe using both the cell phone and satellite networks."

Sia collaborated with Claros Diagnostics (a company he co-founded, now called OPKO Diagnostics) to develop a pioneering strategy for an integrated microfluidic-based diagnostic device -the mChip - that can perform complex laboratory assays, and do so with such simplicity that these tests can easily be carried out anywhere, including in resource-limited settings, at a very low cost. This new study builds upon his earlier scientific concepts and incorporates a number of new engineering elements that make the test automated to run with data communication over both cell phone and satellite networks.

"There are a set of core functions that such a mobile device has to deliver," he says. "These include fluid pumping, optical detection, and real-time synchronization of diagnostic results with patient records in the cloud. We've been able to engineer all these functions on a handheld mobile device and all powered by a battery."

This new technology, which combines cell phone and satellite communication technologies with fluid miniaturization techniques for performing all essential ELISA functions, could lead to diagnosis and treatment for HIV-infected people who, because they cannot get to centralized health care centers, do not get tested or treated.

"This is an important step forward for us towards making a real impact on patients," says Jessica Justman, MD, senior technical director at ICAP and associate clinical professor of medicine in epidemiology at the Mailman School of Public Health. "And with the real-time data upload, policymakers and epidemiologists can also monitor disease prevalence across geographical regions more quickly and effectively."