When a new technology shows promise, performance-wise and commercially, innovation does not stop. To the contrary, it gathers pace. New medical devices typically emerge from competing groups of scientists, engineers, and physicians. Each group has its own design concept. One design proves safe and effective. It is patented, licensed, and commercialized. Another falls by the wayside. Competition moves to the market. Much the same is true of all technologies. The customers for medical devices are physicians, surgeons, or hospital managers. Being among the first to use a new device or offer a new procedure conveys status. For patients, the ultimate beneficiaries, the device offers new hope.

Responding to growing demand, innovation continues. What modifications will generate competitive advantage? How should the device be improved? This question isn’t as simple as it looks. Technical feasibility, investments required, and customer preferences must all be considered. Different trade-offs will be made. Automobile manufacturers might aim to make their vehicles safer, more economical to run, or more environmentally friendly. Some will go in one direction, others in a different direction. The different models might compete, or distinct submarkets might emerge. Medical devices are no different. This is the history of the cochlear implant, for example, introduced decades ago. It is the likely future history of the "brain chip," or brain/computer interface (BCI)

It’s a year since I wrote about neuroprosthetic devices. Once the stuff of science fiction,........

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