What happened in health care technology this week, and why it’s important.

This Self-Powered Smart Shoe Insole Tracks Vital Signs & Health of Wearers

It’s no secret to anyone that our healthcare system has problems. Healthcare professionals are being stretched thin, and hospitals are overwhelmed because of labor shortages that make it hard to keep up with admissions. This article in The Daily Moss reports that while there may be no easy solution to the problem, something can alleviate some of the burdens. And that something is Inviza Health’s new Inviza Sole, a wearable health-monitoring device that can provide doctors with all kinds of patient medical data—all without the patient needing to schedule a visit.

The INVIZA® Sole 1.0 is among the latest innovations in INVIZA’s line of wearable medical-grade RPM and digital therapeutics (DTx) technology. Designed to be an insole that can fit comfortably into a wearer’s shoe, the INVIZA Sole 1.0’s built-in sensors can accurately measure your patient’s heart rate, body temperature, blood oxygen saturation, and other critical parameters. It can also provide data on daily physical activity, including accurate step count and type, balance, and a feature to calculate body weight trends is also in development. This data is then sent to INVIZA® Care 1.0, a digital health smartphone app that allows users to view their biometrics in real-time.

Why it’s important – Using advanced energy harvesting technology, the INVIZA® Sole 1.0 captures energy from the user’s steps, allowing it to recharge as the wearer moves. Now, that’s convenient! Say goodbye to all those pesky cables and portable chargers. No need to worry about running out of battery mid-jog either! The smart insole’s sensors are also sensitive enough to detect clinically/highly accurate vital signs through socks, ensuring that wearers don’t have to sacrifice comfort for the device. It’s way more comfortable than a Holter monitor.

Infographic of the week – From Dr. Bertalan Mesko, a graphic of skin checking apps.

Telehealth use for behavioral health increases 45X since pandemic onset and more digital health briefs

Jessica Hagen in MobiHealthNews reports that Telehealth use for behavioral health services has increased 45 times since the start of the COVID-19 pandemic across all care settings and provider types, according to a report by Trilliant Health. Less than 1% of all behavioral health visits were delivered via telehealth pre-pandemic. By the second quarter of last year, 32.8% of behavioral health appointments were conducted through telehealth. As of Q2 2022, behavioral health volumes were 18.1% above pre-pandemic levels.

Why it’s important – More Americans are taking medication to manage behavioral health conditions. Prescriptions increased by 58.2% among patients who took Adderall and its generic to treat ADHD in individuals 22 to 44 years of age from Q1 2018 to Q2 2022. However, prescriptions of Adderall and its generic remained relatively unchanged in patients under 21 and over 45 years old. The report also found a 107.4% increase in eating disorders diagnoses among U.S. residents under 18 and a 44% increase in depression disorders. Alcohol use was also on the rise during the pandemic, but 84% of patients seeking treatment for alcohol or substance use disorder who went to the emergency department did not receive follow-up care within 60 days.

Podcast of the week – This week’s recommendation comes from Sg2’s Perspectives podcast series and covers disruptors. In today’s healthcare landscape, disrupters are everywhere, so this week on Sg2 Perspectives, we invited Sg2 Associate Principal Trevor DaRin and Senior Consulting Director Casi Roethler to talk to us about how these healthcare disrupters are changing the game. Trevor and Casi discuss the disrupters to watch in the payer and retail spaces, the implications for primary care, and how health systems should respond—as well as what they can learn. You can listen here.

FDA Clears TytoCare’s New Algorithm for Wheeze Detection

Virtual care company TytoCare on Wednesday received clearance from the Food and Drug Administration for its wheeze detection algorithm, allowing the company to begin commercializing the product in the U.S. Katie Adams reports that the new wheeze detection algorithm is an expansion of Tyto Insights. The newly cleared algorithm will fuel further support for at-home acute care and chronic condition management by enabling clinicians to diagnose respiratory conditions remotely accurately.

Why it’s important – The offering called Tyto Insights for Wheeze Detection combines AI with spectral analysis and signal processing techniques to analyze recorded lung breathing sounds. The algorithm automatically evaluates lung recordings after a patient conducts an at-home lung exam using TytoCare’s remote exam device. If a wheeze is detected, the patient’s doctor will receive an indication. The doctor will then decide on the diagnosis in conjunction with all other relevant exams and patient data.

This tiny chip is being used to develop a tooth-mounted sensor that can read your spit

The Verge’s Victoria Song reports that Silicon Labs is hoping its latest xG27 chipset is small and energy-efficient enough to spark some big ideas in the medical tech space — like a saliva reader that’s so tiny it can be mounted onto a tooth. As for how small these chips are, the xG27 SoCs range from 2mm-squared to 5mm-squared — roughly the width of a No. 2 pencil’s lead tip to the width of the pencil itself. It’s not the world’s smallest Bluetooth chip, but Silicon Labs spokesperson Sam Ponedal tells The Verge that’s only by “fractions of a millimeter.”

Why it’s important – The BG27 is currently being used to develop an actual product — the aforementioned tooth-mounted wearable sensor. Lura Health, a medical device maker, says it’s using the chip for its “salivary diagnostic sensor.” The sensor is small enough to be glued to a molar (or placed inside a “smart retainer”) to monitor a patient’s saliva continually. That, in turn, would allow dentists and clinicians to test for more than 1,000 health conditions potentially. Lura Health claims it has just finished clinical trials for the sensor with UConn Orthodontics and is preparing to undergo the FDA regulatory process. If all goes well, the product could hit the market in 12-18 months.

Why Billionaires Ken Griffin And Eric Schmidt Are Spending $50 Million On A New Kind Of Scientific Research

On Wednesday, Schmidt and Citadel founder and CEO Ken Griffin announced they were committing $50 million to Convergent Research, which Schmidt spun out from his non-profit Schmidt Futures in the fall of 2021. Forbes’ Alex Knapp reports that these small, non-profit research groups, which Convergent calls “focused research organizations” (FROs), aim to “support an ecosystem of small-to-mid scale projects that fall between the cracks of what startups, academia, and other organizations do,” Convergent’s current CEO Adam Marblestone and several of his colleagues wrote in a commentary in Nature in January 2022.

Right now, Convergent has two FROs up and running: E11 Bio, aimed at brain-circuit mapping for neuroscience, and Cultivarium, which seeks to build ways to work with a wide variety of microorganisms for synthetic biology applications that it plans to open source to the scientific community.

Why it’s important – FROs take on problems that might require a greater level of team science or systems engineering than is possible in an academic setting. Or they might aim at producing public goods that venture capital could not profit from.

What happened in health care technology this week, and why it’s important.

AR, VR Technology Gives Clinicians a New View of Complex Surgeries

Augmented reality and virtual reality platforms, which enhance traditional 2D images to create 3D versions, are used by health systems to train clinicians and give patients a better view of complex health concerns. Eric Wicklund’s article in Health Leaders online describes how Lehigh Valley Health Network’s chief of neurological surgery uses innovative technology to educate patients and improve surgical procedures. At LVHN, Jean uses the platform first to help his patients understand their medical conditions and how he treats them. The process is much better, he says than giving them images and trying to get them to imagine what’s going on inside them.

Why it’s important – Both technologies, the FDA says, “have the potential to transform healthcare, delivering altogether new types of treatments and diagnostics, and changing how and where care is delivered. Central to their potential in diagnosis and treatment is their ability to deliver both standard and entirely new types of content in highly immersive and realistic ways, remotely, and tailored to various clinical contexts. Physicians, patients, and caregivers can enlist AR/VR to help them prepare for, or perform, certain treatments or procedures.”

Infographic of the week – From Dr. Tazeen Rizvi – With the increasing prevalence of chronic diseases, finding new ways to improve patient outcomes and reduce healthcare costs has become more critical than ever. Understanding the patient experience is crucial in chronic condition care, as disease and long-lasting treatment significantly affect a patient’s physical, emotional, and social well-being. As we continue to innovate in digital technologies for managing chronic care, we must involve users – both patients and doctors – in the design process. By doing so, we can ensure that these tools are not only effective but also easily implemented and adopted.

MIT Researchers 3D Print Patient-Specific Robotic Heart

Ada Shaikhnag reports that Researchers at the Massachusetts Institute of Technology (MIT) have developed a method for 3D printing a flexible and soft replica of a patient’s heart in her article in 3D Printing Industry. The team can then direct the activity of the replica to imitate the patient’s blood-pumping capabilities. With this custom robotic heart, the team hopes to assist doctors in tailoring treatments to patients’ heart-related forms and functions. The soft robotic models are patient-specific and may aid clinicians in choosing the ideal implant for a particular patient.

Why it’s important – The advantage of our system is that we can recreate not just the form of a patient’s heart but also its function in physiology and disease. While MIT’s replica heart is not intended to be implanted into a patient, other 3D printing firms are actively exploring such applications – commonly referred to as regenerative medicine.

Podcast of the week – Sorry for this bit of shameless self-promotion. I joined Tom Salemi and Joe Mullings for this week’s podcast recommendation, the Device Talks Weekly episode. Here’s the episode description: “Medtech layoffs continue to mount. We’ll use this episode to begin to explore external and internal challenges. Looking externally, longtime industry watcher Henry Soch, now an executive-in-residence at Matter, shares his concerns about the current and future ability of medical device companies – both big and small – getting new technologies into hospitals. You can read Soch’s blog post here. Then, Joe Mullings, CEO of the Mullings Group, brings us inside his conversations with senior medical device industry leaders. In this interview, a sober Mullings reviews some of the mistakes large strategics have made. The result may be a few months of layoffs and cost-cutting. Mullings says companies could help themselves and the industry by not requiring their terminated employees to sign non-compete agreements. Mullings ends with hopeful signs for MedTech and useful tips for people looking to protect their careers.” You can listen to the episode here.

Forget designer babies. Here’s how CRISPR is really changing lives

Antonio Regalado’s article in MIT Technology Review recommends forgetting about He Jiankui, the Chinese scientist who created gene-edited babies. Instead, when you think about gene editing, you should think of Victoria Gray, the African-American woman who says she’s been cured of her sickle-cell disease symptoms. This week in London, scientists are gathering for the Third International Summit on Human Genome Editing. It’s gene editing’s big event, where researchers get to awe the audience with their new ability to modify DNA—and ethicists get to worry about what it all means. There are now more than 50 experimental studies underway that use gene editing in human volunteers to treat everything from cancer to HIV and blood diseases, according to a tally shared with MIT Technology Review by David Liu, a gene-editing specialist at Harvard University. Most of these studies—about 40 of them—involve CRISPR, the most versatile of the gene-editing methods, which was developed only ten years ago.

That is where Gray comes in. She was one of the first patients treated using a CRISPR procedure in 2019, and when she addressed the group in London, her story left the room in tears. “I stand here before you today as proof miracles still happen,” Gray said of her battle with the disease, in which misshapen blood cells that don’t carry enough oxygen can cause severe pain and anemia.

Why it’s important – Researchers say the technique’s march forward to use in medicine has been remarkably fast. According to Liu’s analysis, two-thirds of current studies aim at “disrupting” genes. Liu’s lab is working on next-generation gene-editing approaches. These tools also employ the CRISPR protein, but it’s engineered not to cut the DNA helix but instead to deftly swap individual genetic letters or make more extensive edits. These are known as “base editors.” The big problem is the cost and whether payers will reimburse for the technology. Patients won’t get the treatments if insurers and governments balk at paying. It’s a real risk. For instance, a different gene therapy for beta-thalassemia, developed by Bluebird Bio, was pulled out of the European market after governments there refused to pay the $1.8 million price. Now that gene editing has had its first successes; there’s an “urgent need” to open a “path to the clinic for all.”

Smartphone Photos to Detect Anemia

Researchers at University College London and the University of Ghana have developed a smartphone-based system that can detect anemia through simple photos taken using the phone’s camera. Conn Hastings reports in Medgadget that the process involves obtaining images of areas of the body that are least pigmented, including the white of the eye, the lower eyelid, and the lip. The app then analyzes the color of the imaged tissue. As hemoglobin absorbs light in a specific fashion, the app can use this information to calculate the blood hemoglobin concentration.

Why it’s important – Anemia is very common, affecting about two billion people globally. Some patients have more at stake than others. In children, for example, anemia can significantly affect cognitive development and disease susceptibility, so diagnosing and treating the condition is essential, especially since anemia is often readily treated using dietary iron supplements. The technology is intended for use in low- and middle-income countries where access to routine medical diagnostics may be unreliable. The technology could be instrumental in identifying anemia in children in remote areas, as the condition can significantly affect their development.

Building a Clinical Team in a Large Technology Company

I found this article in NEJM Catalyst by healthcare leaders from Google (Karen B. DeSalvo, MD, MPH, MSc, Chief Health Officer, and Michael D. Howell, MD, MPH Chief Clinical Officer) a fascinating read. While many believe that technology will improve health outcomes, there is a genuine and persistent concern that technology companies do not understand the complexity of health and health care. This challenge is usually discussed as an either/or problem. Either technology companies must disrupt the way health care works, or they won’t succeed because they will never understand the real world of health and health care.

The authors believe that there is a third way — one that establishes a robust, thriving clinical team within a major technology company that brings a deep understanding of the current healthcare system to bear and a passion for making real improvements. However, clinical teams represent new functions for technology companies, and so they also represent a cultural shift.

Why it’s important – This article summarizes several years of experience building Google’s clinical team and later adapting it during Covid-19 to offer six lessons for organizations embarking on similar journeys. Embedding robust, thriving clinical teams in major technology companies is an opportunity to realize the promise of improving human health at scale.

What happened in health care technology this week, and why it’s important.

Eko Launches Heart Disease Detection Platform CEO Calls ‘Shazam for Heartbeats’

MedCity News’ Katie Adams reports that Eko recently launched an AI-powered software that its CEO describes as “Shazam for heartbeats.” The platform connects with Eko’s digital stethoscopes and identifies whether or not a patient’s heart sounds indicate disease. The platform uses a machine learning algorithm to search through its database of heart sounds and determine whether the sounds that a primary care provider hears through their stethoscope are normal or abnormal.

Why it’s important – The Sensora platform was cleared by the FDA last summer, and it is in its “early access deployment” stage. Eko isn’t the only company developing AI technology for the earlier detection of heart disease. There are plenty of companies in that space, such as Cardiologs and Caption Health (which GE HealthCare acquired this month). Eko is trying to differentiate itself by focusing specifically on heart sounds.

Infographic of the week – Telemedicine Community Readiness Model – To ensure that technology solutions and initiatives are successfully implemented, communities should be empowered to facilitate adoption and increase end users’ acceptance by giving the necessary support tools, including specific measures to implement and scale up #telemedicine. The TCRM is designed to help decision-makers in #communities create a favorable environment that facilitates the implementation and scale-up of TIs. The model enables practitioners and provides a meaningful tool to support the implementation and scale-up of TIs.

Wearable Device Senses When Vocal Fatigue Sets in

Researchers at Northwestern University have developed a wearable that can detect when someone is talking or singing and tallies this information to warn when the wearer might be at risk of vocal fatigue. Conn Hastings reports on this development in his article in Medgadget. The device communicates with a smartphone app to keep track of voice use. The researchers are also developing a system whereby users can indicate in the app if they feel they are approaching vocal fatigue. The system will remember this as a personal ‘vocal budget’ and then warn the user ahead of time if they are getting close to such levels of voice use in the future.

Why it’s important – Overusing your voice in a short space of time can lead to vocal fatigue and even injury. This technology is helpful for patients with vocal disorders but also for people who rely on their voices a lot, such as singers, politicians, and teachers. By setting personal thresholds, the technology allows wearers to receive a haptic signal when they are getting near to fatiguing their voice, creating an opportunity to rest the voice for a while.

Podcast of the week – From Becker’s Healthcare Podcast – In this episode, Lee Schwamm, MD, neurologist and director of the Massachusetts General Hospital Center for Telehealth and American Heart Association volunteer, describes the new era in telehealth, focusing on the boom in virtual care as well as the past, present, and future role of telehealth in cardiovascular care. You can listen to the episode here: https://podcast.app/what-does-the-future-hold-for-virtual-care-and-heart-health-e329579437/?utm_source=ios&utm_medium=share

Common Wearables Promising for Detection of Prodromal Parkinson’s

A new screening method that combines a patient symptom questionnaire and data from technology found in most wearable sleep and fitness trackers offers new hope for very early detection of Parkinson’s disease (PD), new research suggests. Kelli Whitlock Burton describes the research in her article in Medscape. The small, proof-of-concept study combined the results of a modified patient survey with actigraphy data collected during sleep to predict patients with RBD accurately. The findings are published in the January issue of Movement Disorders.

Why it’s important – About 1%-2% of the general population has RBD, but the incidence is much higher among patients with PD, dementia with Lewy bodies, and other neurological conditions. About half of the patients with PD develop isolated rapid-eye-movement sleep behavior disorder (RBD), often years before other symptoms present. RBD causes frequent twitches, jerks, and unpredictable, often violent, episodes of dream enactment. In a clinical setting, a screening model such as this could be used in two steps. Patients who screen positive for RBD on the questionnaire would receive a wearable device to collect data on sleep behavior. Those who screen positive during that second phase would then undergo further testing to determine whether they meet the criteria for prodromal PD.

MRI FOR ALL – Portable low-field scanners could revolutionize medical imaging in nations rich and poor—if doctors embrace them

For years, some researchers have been striving to build scanners that use much smaller permanent magnets made of the alloy often found in desk toys. They produce fields roughly 1/25th as strong as a standard MRI magnet, which once would have been far too weak to glean a usable image. But, thanks to better electronics, more efficient data collection, and new signal processing techniques, multiple groups have imaged the brain in such low fields—albeit with lower resolution than standard MRI. The result is scanners small enough to roll to a patient’s bed and possibly cheap enough to make MRI accessible globally. Adrian Cho provides a detailed analysis of the technology in his article in Science.

Why it’s important – The portable scanner brings MRI closer to the patient, both in time and distance. Hyperfine envisions using it in the neuro ICU to quickly assess patients too ill or unstable to wheel to a conventional MRI or a CT machine, which produces a type of 3D x-ray. The cheaper, smaller devices might also allow patients to get more frequent follow-up scans. And, in much of the world, MRI is simply unavailable. What will win over doctors will be a “use case”—a killer app for the scanners. For example, they might be put into special ambulances for stroke care. It is unclear whether Hyperfine and others have found that use case, but most predict it will come.

Ankle Exoskeleton Algorithm Adapts To Speed And Gait

Current exoskeletons are limited because they must be tailored to a single user performing a single task, like walking in a straight line. Any changes require a lengthy set of manual readjustments. Kate McAlpine, Michigan reports that the new control algorithm demonstrates the ability to handle different speeds, as well as changes in gait between running and walking. The control algorithm directly measures how quickly muscle fibers are expanding and contracting to determine the amount of chemical energy the muscle is using while doing its work. Then, it compares that measurement with a biological model to determine the best way to assist.

Why it’s important – This approach could pave the way for exoskeletons that can better handle the uncertainties of the real world. Measuring muscle physiology directly is a key departure from current methods, which use broader motion measures. Going straight to the source of motion could result in more accurate measurements over a more extensive range of movements with far less computing power required.

Walmart Health plans clinic expansion in 2024, pushing into 2 new states

Walmart plans to expand its network of medical centers in 2024, including a launch into two new states, as retail health giants race to build out their primary care footprints. Rebecca Pifer highlights their expansion plans in her article in Health Dive. The company announced Thursday it plans to open 28 new Walmart Health centers in 2024, bringing its total locations to more than 75. Specifically, Walmart plans to open ten new locations in Dallas; eight in Houston; six in Phoenix; and four in Kansas City, Missouri.

Why it’s important – Walmart is one of a handful of retail health giants racing to build up a primary care presence as demand hikes for affordable care near the home. Along with rivals like CVS and Walgreens, Walmart is banking on its extensive brick-and-mortar footprint, brand recognition, and a series of partnerships and acquisitions to drive consumers to its medical centers. Some 30% of the primary market could belong to nontraditional players by 2030, according to estimates from Bain.

RadNet’s Path to AI Profit

Jake Fishman’s article in The Imaging Wire has my blood pressure soaring. RadNet expects its new direct-to-patient Enhanced Breast Cancer Detection (EBCD) service to generate between $11M and $13M in 2023 revenue, representing up to 72% of RadNet’s overall AI revenue and driving much of its AI profitability improvements. And EBCD’s nationwide rollout won’t be complete until Q3.

Why it’s important – Let me see if I understand this: ‘We purchased several AI companies. Uptake by our physicians has been slow. So, we will increase utilization by creating this Enhanced Breast Cancer Detection service. We’re going to expect the patient to pay extra for it’ ($59/year) even though another article further down in the newsletter shows that sixty percent of U.S. adults in a massive new Pew Research survey (n=11k) would feel uncomfortable if their healthcare providers relied on AI for their treatment, while 33% expect AI to lead to worse outcomes and 57% believe it will hurt patient-provider relationships. I’m appalled by this behavior. Shouldn’t every examination be comprehensive and “enhanced”? How does creating a “class system” for these exams benefit anyone? It will only widen the divide between the “haves,” with the financial resources to pay for the ‘enhanced’ exam, and the “have-nots,” who can’t afford the ‘service.’ I guess Gordon Gekko, in the movie Wall Street was right when he said: “The point is, ladies and gentlemen, that greed, for lack of a better word, is good.”

Closing comment – If you haven’t already subscribed to The Imaging Wire and companion newsletters, The Digital Health Wire, and The Cardiac Wire, do yourself a favor and sign up now. Some of the best reporting available today.

What happened in health care technology this week, and why it’s important.

Apple Makes Major Progress on No-Prick Blood Glucose Tracking for Its Watch

Bloomberg’s Mark Gurman reports that Apple Inc. has a moonshot-style project underway that dates back to the Steve Jobs era: noninvasive and continuous blood glucose monitoring. The goal of this secret endeavor — dubbed E5 — is to measure how much glucose is in someone’s body without pricking the skin for blood. After hitting significant milestones recently, the company now believes it could eventually bring glucose monitoring to market, according to people familiar with the effort. Years of work are still ahead, but the move could upend a multibillion-dollar industry.

Why it’s important – Roughly 1 in 10 Americans have diabetes, and they typically rely on a device that pokes the skin for a blood sample. There are also patches from Dexcom Inc. and Abbott Laboratories that are inserted into the skin but must be replaced every two weeks. If perfected, such a breakthrough would be a boon to diabetics and help cement Apple as a powerhouse in health care. Adding the monitoring system to the Apple Watch, the ultimate goal would also make that device an essential item for millions of diabetics worldwide.

Infographics of the week – Americans say they’re worried about opioids and gun violence, but what they really want the government to tackle is rising drug costs and health bills, according to the new Axios-Ipsos American Health Index. The national survey of 1,213 U.S. adults found almost 8 in 10 want insurers to cover weight-loss drugs, and nearly 9 in 10 back a monthly cap on out-of-pocket costs for insulin.

From Rock Health’s 2022 Digital Health Consumer Adoption Survey – In 2022, 46% of Survey respondents reported owning a wearable device, a steady albeit slight increase from 2021 (45%) and 2020 (43%). However, as overall wearable ownership grows toward the 50% threshold, ownership disparities remain among consumer communities. Wearable ownership remains more prevalent among respondents with “early adopter” characteristics: 74% of younger respondents with higher income and higher educational attainment reported owning a wearable. However, wearable ownership among this cohort declined from its peak in 2020 (80%)—this aligns with 2022 buying trends, with global consumer wearable sales slacking amid inflation and recessionary concerns.

Apple Watch saves owner’s life from fatal internal bleeding after nap, here’s what happened

The Apple Watch saved the wearer’s life by alerting him to a racing pulse after a nap, which led to a diagnosis of severe internal bleeding. The owner, an account called “digitalmofo,” posted the incident titled, “Well, my Apple Watch 7 just saved my life.” The Economic Times published the article online. The owner went on to say that “severe internal bleeding” was to blame.”Emergency medical services (EMS) originally reported a heart attack, but it turned out to be GI bleeding,” the report reads. “They said I wouldn’t have made it if I hadn’t gotten there for a transfusion when I did,” the user stated.

Why it’s important – Another example of how having a wearable device that is non-obtrusive and available 24×7 can identify potential health problems before they become critical. If you couple this article with the first one in this post and the infographic above, you can see Apple’s continuing focus on remote monitoring with various applications has a readymade market to capitalize upon.

Podcast of the week – From the Fixing Healthcare podcast series, hosts Dr. Robert Pearl and Jeremy Corr explore how healthcare has become monopolized, from hospitals and health systems to the drug industry and beyond. Whether you provide medical care or receive it, you’ll learn much from this conversation.

https://fixinghealthcarepodcast.blubrry.net/2023/02/21/fhc-83-diving-deep/

60% of patients uncomfortable with AI in healthcare settings, survey finds

About six in 10 U.S. adults said they would feel uncomfortable if their provider used artificial intelligence tools to diagnose them and recommend treatments in a care setting, according to a survey from the Pew Research Center. Hailey Mensik covered the story in her article on Healthcare Dive. While a majority said they would want AI technology for skin cancer detection, large shares said they would not feel comfortable being the subject of the other use cases.

Why it’s important – The potential for AI tools to diminish personal connections between patients and providers is a key concern, according to the survey, which included responses from over 11,000 U.S. adults collected in December. Patients also fear their health records could become less secure. Respondents, however, acknowledged potential benefits, including that AI could reduce the number of mistakes providers make. They also expressed optimism about AI’s potential impact on racial and ethnic biases in healthcare settings, even as the technology has been criticized for exacerbating those issues.

Zoom is helping MaineGeneral Health boost its telehealth success

Bill Siwicki reports that The health system used another telemedicine vendor’s tools when the pandemic first hit. But it quickly saw what Zoom could do for virtual care innovation across several departments and specialties. Healthcare IT News interviewed Laura Mrazik, telehealth manager at MaineGeneral Health, to discuss best uses and best practices with Zoom so others can learn from MaineGeneral’s lessons.

Why it’s important – Maine General Health appreciates Zoom’s ability for the client organization to control settings at the account level, internally, and the application’s flexibility to meet the needs of different use cases. Zoom’s support portal has both a forum to ask other clients questions and a library of instructions for how their team can troubleshoot or make configuration changes appropriately. Patients are not required to create and remember a username and password to join their virtual visit. Many have already become familiar with Zoom in their distance communication with friends or family.

Engineering skin grafts for complex body parts

A research team led by Dr. Hasan Erbil Abaci of Columbia University has been working on methods to make 3D-engineered skin in the shape of complex body parts. Such custom grafts could then be transplanted intact, with minimal suturing required. In a new study, the team tested their skin-culture system using models of human hands and the hindlimbs of mice. Results were published on January 27, 2023, in Science Advances.

Why it’s important – Skin grafts are a vital treatment for burns and other extensive skin injuries. Since the 1980s, advances in bioengineering have allowed researchers to grow new patches of skin in the lab. Such engineered grafts are less traumatic for patients than transplanting skin from elsewhere on the body. Compared with standard, flat-cultured grafts, the 3D-cultured skin was more resistant to stresses produced by movement. Further analysis showed that the 3D cultures had higher levels of extracellular matrix proteins, supportive proteins found in mature skin.

What happened in health care technology this week, and why it’s important.

Why you shouldn’t trust AI search engines

Last week was the week chatbot-powered search engines were supposed to arrive. The big idea is that these AI bots would upend our experience searching the web by generating chatty answers to our questions instead of just returning lists of links as searches do now. Only … things did not go according to plan, Melissa Heikkilä, senior reporter at MIT Technology Review, reports. Approximately two seconds after Microsoft let people poke around with its new ChatGPT-powered Bing search engine, people started finding that it responded to some questions with incorrect or nonsensical answers, such as conspiracy theories. Google had an embarrassing moment when scientists spotted a factual error in the company’s own advertisement for its chatbot Bard, which subsequently wiped $100 billion off its share price. What makes all of this all the more shocking is that it came as a surprise to precisely no one paying attention to AI language models.

Why it’s important – Here’s the problem: the technology is not ready to be used like this at this scale. The recent blunders from Big Tech don’t mean that AI-powered search is a lost cause. Search is just one of the areas where the two tech giants are battling each other. They also compete in cloud computing services, productivity software, and enterprise software. Conversational AI becomes a way to demonstrate cutting-edge tech that translates to these other areas of the business. Essentially, we—the users—are now doing the work of testing this technology for free.

Infographic of the week – The Figure below, from Dr. Eric Topol’s Ground Truths article, shows the opportunity for Hospital@Home, and other use cases, going forward. Integrating such data has been a limiting issue. Still, large language models (LLMs) that can deal with over a trillion parameters, including the interface between text, speech, and images, are well suited to actualize this capability. I recently reviewed these LLMs or foundation models, the exemplar ChatGPT is certainly the craze right now. While there’s been much interest in sensors that collect physiologic data, the progress in wearable patches for self-ultrasound imaging is also notable. He emphasizes that for HaH and any other use cases in the Figure below, this—multimodal AI—has not been done yet. It’s an aspiration that may be accelerated with LLMs, but the case hasn’t been cracked yet.

First 3D Printed Pediatric Medicine Trials to begin in Europe

A hospital in Spain is launching a study to test the efficacy, tolerability, and acceptance of a drug produced for children using a 3D printer, according to an article in 3D Printing.com. The study will be the first clinical trial with a 3D-printed drug in Europe in the pediatric field and is a result of collaboration between the Pharmacy Service at Vall d’Hebron University Hospital, the University of Santiago de Compostela, and the company FabRx. The 3D printer used for the study produces medicines in semi-solid and chewable forms, which are personalized to each child based on their weight and clinical characteristics.

Why it’s important – This new method of administering medication is much more convenient and avoids dosing errors compared to traditional syrups. The clinical trial will not only test the efficacy of the new formulation but will determine whether it increases acceptability and improves the experience of minors and their families. The 3D-printed medications have a taste that masks the active ingredient and can be customized based on each child’s preference. Additionally, they do not need to be refrigerated, increasing safety and ease of transport.

Video of the week – Mark Cuban Assails PBMs at AAM meeting – Mark Cuban made scathing, profanity-laced remarks about pharmacy benefit managers (PBMs) and heaped praise on drug manufacturers during a 26-minute fireside chat interview at the annual meeting of the Association of Accessible Medicines, the trade association of generic drug manufacturers. Currently, the company only sells generics, but Cuban said that it was getting ready to sell brand-name drugs. He was coy about sharing any specifics about the company’s plans for selling insulin and biosimilars but suggested that it would.

Neuroscientists listened in on people’s brains for a week. They found order and chaos.

Another article from MIT Technology Review, this one authored by Jessica Hamzelou, on a study that shows that our brains exist between chaos and stability—a finding that could be used to help tweak them either way. Avniel Ghuman and Maxwell Wang at the University of Pittsburgh wanted to know what happens in the longer term. After all, the symptoms of many neurological disorders can develop over hours or days, says Wang. To get a better idea of what might be going on, the pair devised an experiment to let them watch brain activity for around a week. The researchers recruited 20 individuals to volunteer in their study. Each person had 10 to 15 electrodes implanted for between three and 12 days. The pair collected recordings from the electrodes over the entire period. The volunteers were all in the hospital while they were monitored, but they still did everyday things like eating meals, talking to friends, watching TV, or reading books.

The team found some surprising patterns in brain activity over the course of the week. Specific brain networks seemed to communicate with each other in what looked like a “dance,” with one region appearing to “listen” while the other “spoke,” say the researchers, who presented their findings at the Society for Neuroscience annual meeting in San Diego last year.

Why it’s important – Understanding how our brains restore some degree of stability after chaos could help us work out how to treat disorders at either end of this spectrum. Too much chaos is probably what happens when a person has a seizure, whereas too much stability might leave a person comatose, say the neuroscientists behind the work. A better understanding of what’s going on could one day allow us to use brain stimulation to tip the brain into a sweet spot between the extremes.

Rising Costs Are Keeping Healthcare CFOs Up a Night — Can Data Help?

Katie Adams brings us this story in her article in MedCity News. The increasing costs of labor and supplies are the top issues keeping healthcare CFOs up at night, according to a new report released by Syntellis, a performance management software provider. To effectively address these concerns, healthcare providers must ensure they have access to data-driven analytics software that can help them make important decisions — such as managing their existing workforce effectively and where to shift care delivery models — the report said. Survey respondents ranked workforce optimization and productivity monitoring as their chief priority in 2023. Leaders’ top departmental goals for this year are reducing costs, managing improvement initiatives, and managing productivity.

Why it’s important – Even though providers’ margins are currently quite tight, the report recommended that healthcare organizations adopt data analytics software to remedy these concerns and help with important decisions like how to effectively manage their existing workforce and where to shift care delivery models. The report authors cited workforce optimization, effective cost management, continuous performance monitoring, decision support, and understanding market placement as key reasons why the investment is warranted.

Long COVID Now Looks like a Neurological Disease, Helping Doctors to Focus Treatments

The causes of long COVID, which disables millions, may come together in the brain and nervous system, according to an article by Stephani Sutherland, a neuroscientist and science journalist based in southern California, published in the February issue of Scientific American. The most common, persistent, and disabling symptoms of long COVID are neurological. Some are easily recognized as brain- or nerve-related: many people experience cognitive dysfunction due to difficulty with memory, attention, sleep, and mood. Others may seem rooted more in the body than the brain, such as pain and postexertional malaise (PEM), a kind of “energy crash” that people experience after even mild exercise. But those, too, result from nerve dysfunction, often in the autonomic nervous system, which directs our bodies to breathe and digest food and generally runs our organs on autopilot. This so-called dysautonomia can lead to dizziness, a racing heart, high or low blood pressure, and gut disturbances, sometimes leaving people unable to work or even function independently.

One study found that in people with neurological COVID symptoms, the immune system seems to be activated specifically in the central nervous system, creating inflammation. But brain inflammation is probably not caused by the virus infecting that organ directly. Isolated pockets of SARS-CoV-2 or even pieces of viral proteins may remain in the body well after the initial infection and continue to elicit an immune attack. The first solid evidence for “viral persistence” outside the lungs came in 2021 from researchers in Singapore who found viral proteins throughout the gut in five patients who had recovered from COVID as much as six months earlier.

Why it’s important – Although 16 million U.S. sufferers is a reasonable estimate of the condition’s toll, there are other, more dire assessments. A meta-analysis of 41 studies conducted in 2021 concluded that worldwide, 43 percent of people infected with SARS-CoV-2 might develop long COVID, with about 30 percent—translating to approximately 30 million people—affected in the U.S. Some studies have offered more conservative numbers. Determining which patients have ongoing inflammation could help inform treatments. The syndrome is still mired in a lot of medical uncertainty. Patients might have one or a combination of the problems investigated so far: Long COVID might be caused by viral particles that persist in the brain or other parts of the nervous system. Or it might be an autoimmune disorder that lasts long after the virus has disappeared. Maybe overactive immune cells continue to perturb the nervous system and nearby blood vessels. Fortunately, the increasing ability to recognize specific problems is helping clinicians hone treatments that give patients the best chance of recovery.

UnitedHealthcare Launches Rewards Program With Wearable Devices

By simply completing a health survey or meeting step goals, some UnitedHealthcare members can now receive rewards of up to $1,000 per year. Marissa Plescia reports that UnitedHealthcare Rewards members can earn up to $1,000 per year by meeting daily activity goals, tracking sleep, and fulfilling other one-time health activities in her article in MedCity News. The program is available to select employers with fully insured plans, with more employers to be added later in 2023. Those who are enrolled can use an activity tracker, smartphone, or smartwatch. To earn the full $1,000, members must complete all movement goals each day, as well as the one-time activities. The rewards can be added to a prepaid debit card or put into a health savings account. UnitedHealthcare hopes to make the rewards program available to 3 million members by the end of the year and also plans to expand it to self-funded plans in 2024

Why it’s important – While 90% of employees have access to well-being programs from their employer, only 23% are taking advantage of them, a recent study found. This program is designed to change that by spurring engagement through a combination of daily incentives and gamification and by using a broad definition of what it means to pursue health. For employers offering UnitedHealthcare Rewards, they expect the program to help cultivate a culture of wellness, bolster productivity, and help achieve overall better health for their members.

Scientists develop five minute AI respiratory disease test

Oxford University scientists and co-founders of health-tech company Pictura Bio have developed what they say is a world-first diagnostic test, powered by artificial intelligence, that can identify known respiratory viruses such as influenza and COVID-19 within five minutes from just one nasal or throat swab. Their findings, published in the peer-reviewed scientific journal ACS Nano, demonstrate how machine learning can improve the efficiency, accuracy, and time taken to identify different types of viruses and differentiate between strains. This could help better control the spread of respiratory infections and alleviate pressure on the NHS and healthcare staff while reducing medical waste. The technology is now licensed by Pictura Bio, which aims to turn the method into a diagnostic test by creating a dedicated imager and single-use cartridge for use in point-of-care testing, with limited input from the user. The team will also expand the number of viruses the models are trained on and will eventually start looking at other pathogens, such as bacteria and fungi, in respiratory samples, blood, and urine.

Why it’s important – Current tests are either lab-based and time-consuming or fast and less accurate. They are also limited. For instance, a lateral flow test only tests for one infection. This means illnesses are spread as infected people wait for results or because they are unaware they are infected.

5 Best Practices To Build A Future-Ready Digital Health Company

This week’s final article is from Dr. Bertalan Mesko and his team at The Medical Futurist Institute. Transparent communication, clinically-validated technologies, and addressing real-life clinical needs might sound like no-brainer components to a digital health company since they are working in the healthcare sector. It is also a rapidly expanding one where investments were heavily channeled during the pandemic. However, some estimate that 90% of digital health startups will go bust or be ‘acquired’ within a few years of being founded. If digital health represents the future of medicine and healthcare, it is crucial to understand why this is the case. He presents the five features of an excellent digital health company.

Why it’s important – Dr. Mesko and his team have covered this ground before. But this update features examples of companies he believes are doing it right (e.g., AliveCor) and companies that haven’t (e.g., Theranos and Proteus Digital Health).