Two hundred years from now, medical tricorders like the ones depicted in Star Trek will be as common as tongue depressors. They’ll be unremarkable, mobile tools on our SpaceX starships shuttling us back and forth to Mars. Diagnosing cancer will only take a single wave over our bodies with a palm-sized sensor.

That’s the dream.

The reality, best embodied in two XPRIZE Tricorder competition finalists, is that the devices are somewhat ungainly and they feature distinctly 21st century diagnostic equipment. They work with mobile phones, but don’t try hanging either one of them around your neck.

They are tricorders in only the most limited sense, and should not be confused with the so-called “Tricorder phone,” from SCiO. That one includes a molecular scanner for identifying everything from the medicine in pills to the freshness of tomatoes. That device is more akin to the Tricorder Star Trek’s chief science officer Mr. Spock carried.

What the XPRIZE’s tricorder-like devices can do, however, is help average consumers diagnose themselves for a variety of conditions.

Final Frontier and its co-finalist Dynamical Biomarkers emerged out of a field of approximately 40 other contenders. All were competing to develop the first commercial medical tricorders, and all are at least inspired by Star Trek medical officer Dr. McCoy’s favorite tool.

Competition sponsor Qualcomm Foundation first whittled that list down to 10 companies that would develop prototypes and test them at University of California, San Diego. That work has been going on for about a year.

“Based on initial performance, only two teams made it to final consumer testing phase,” said Grant Campany, prize lead for the Qualcomm Tricorder XPRIZE.

Competition organizers identified 13 illnesses and conditions, including amemia, HIV, cancer, COPD, urinary tract infection and leukocytosis, that the winning systems would have to accurately identify.

“We looked at a large range of diseases, chronic and acute that affect the majority of people in the world,” said Campany. In the end, they chose based on the frequency of the disease and availability of subjects based, at least in part, on proximity to UC San Diego.

For the tests, XPRIZE recruited people whom they knew had these maladies and then let them spend anywhere from 90 minutes to a full day with the two remaining competitor devices. Could these tricorder wannabes accurately diagnose maladies these subjects already knew they had?

Test time

Both the Final Frontier and Dynamical Biomarkers devices are designed for consumers, not doctors. They use mobile interfaces and customized diagnostic equipment, like blood pressure cuffs, a pulse oximeter (those things that clip onto your fingertips) and hand-held thermometers. The devices ask a series of questions, through mobile apps, collect vital signs and then choose which tests to run to identify what’s wrong.

It’s a lot like what happens to you in the first 10 minutes of your visit to urgent care, but without a nurse or doctor present.

The Dynamical Biomarkers tricorder entrant, which doesn’t have a name, was developed by Chung-Kang Peng, director of the Center for Dynamical Biomarkers at the Beth Israel Deaconess Medical Center/Harvard Medical School. Trained as a medical doctor, but with a background in science and engineering, Peng and his team built a system that has modules for each of the 13 maladies.

The device, which was built in cooperation with HTC, is a small printer-sized box with a smartphone sticking up out of the center. If someone uses the Bluetooth camera to take a picture of their inner ear, the phone will show them their diagnosis.

While neither of the tricorders is intended for medical offices, they could end up near them or with people who have some medical training.

“In our scenario, we want to deploy this kind of system in rural village with no healthcare resource,” said Peng, who noted that China’s 1 million “barefoot doctors,” who have helped spread medical care across the country through the use of trained townspeople, might be some of the best caretakers for this technology.

They could use the tricorder to diagnose, send the information to the cloud where medical professionals are waiting, confirm the diagnosis and get treatment delivered to them on the ground.

Peng says China’s barefoot doctors is a good program, but “now it needs to be upgraded to high-tech barefoot doctor.”

The Dynamical Biomarker tricorder may eventually sell for $500.

Basil Harris, who works as an ER doctor in Philadelphia, hopes to get his Final Frontier Dexter tricorder, which features wearable sensors and the hand-held forehead temperature reader, into more urban environments. He explained that such a device could break down the barriers that currently prevent 30 percent to 40 percent of his patients from getting the medical care they need.

While Dexter is designed to be used by consumers, Harris said early deployment could be in urgent care and emergency rooms.

Dexter may sell for $200 (not counting the cost of a paired smartphone), but in the long run, Harris envisions different levels of tricorder devices. There might be the $200 take-home device and larger kiosk-based ones that end up in your local Walgreens, where customers can walk in and do a quick self-diagnosis.

Winning the future

On Wednesday, XPRIZE announces how the judges are divvying up the remaining $9 million in prize money. Campany wouldn’t share which system did the best job on diagnosis. However, he’s excited about the results and potential impact 23rd-century-inspired diagnostic equipment could have on our 21st-century healthcare problems.

The XPRIZE competition is designed, at least in part, to “address current market failure” in healthcare. Grant pointed to the escalating healthcare costs around the world and asked the fundamental question, “How do you care for millions of people outside the system?”

With doctors being one of the scarcest resources in healthcare, these tricorders could have a “profound potential impact.”

It’s difficult to resolve the grand dreams of Campany, Peng, and Harris with the reality of these devices that sit on a table top and require the user to blow into tubes, cuff their arms and measure their pulse and blood oxygenation through their fingertips. It just doesn’t feel like the future.

“They’re not like a magical wand device that you can wave over somebody. The way I view it, these are the first-generation tricorders,” said Harris. “We’re just scratching the surface of what’s possible.”