Health Tech News This Week – March 18, 2023

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

Image Credit: Shutterstock.com

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.

Image Credit: Inviza Health

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.

Image Credit: Dr. Bertalan Mesko, The Medical Futurist Institute

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.

Image Credit: Sg2, a Vizient Company

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.


Competition in Surgical Robotics Heats Up. But, Can Anyone Dethrone the King?

“On their own, these robots are just an impressive piece of kit, they don’t improve things without highly skilled surgeons to operate them — and there’s not enough of those.”

Roger Kneebone, Professor, Surgical Education, Imperial College London
Image Credit: Shutterstock.com

The robotic surgery space is being transformed by declining costs, new players entering the market, and the rise of technologies like AI and 5G. Even though the tech has been around for over 20 years, in many ways, it has remained in the early stages of adoption. But now, with several MedTech powerhouses entering the market and new technologies enabling better robotic systems, the industry looks set to be on the verge of a significant transformation.

The global surgical robotics market attained a value of around USD 5 billion in 2020. The market is further expected to grow at a CAGR of about 21% in the forecast period of 2023-2028 to reach a value of nearly USD 15 billion by 2026. While general surgery will remain the most advanced market, several indicators suggest orthopedics and neurosurgery will grow substantially. Despite significant advances and rising interest, there’s still plenty of room to grow: Today, around 44% of surgeons say they aren’t using robotics in hip replacement procedures at all. And more than a third of surgeons say they aren’t relying on robots during most of a knee replacement procedure.

As one might expect, these market growth projections have attracted many competitors. Here is a quick (admittedly high-level) look at some of the current competitive landscape in surgical robotics.


Intuitive Surgical – The 800lb gorilla in the room

Founded in 1995, Intuitive remains the dominant company in the robot-assisted surgery space with its Da Vinci robots. But there is a buzz around its Ion system, with its fully articulating catheter making its way through the lungs for cancer biopsy. Watch out for even more from Ion down the road. For example, Intuitive has obtained German regulatory approval for a clinical study of Ion ablation technology.

YouTube Video Credit: Intuitive Surgical

But it is facing challenges. For example, trade-ins of da Vinci robots are significantly down because there’s a lower volume of older-generation systems out there. There are also supply chain disruptions impacting the timing of system builds. Meanwhile, hospitals are feeling pressure on their spending.


Medtronic – Hugo

Hugo represents the medtech giant’s bid to take on Intuitive in the space. Medtronic announced last October that it received three significant global market entrance and indication expansion approvals for its Hugo surgical robotics system. The Fridley, Minnesota-based company won CE mark clearance for general surgery indication, a Health Canada license for general laparoscopic surgery indication, and Ministry of Health, Labor and Welfare approval for urologic surgical and gynecological laparoscopic indications in Japan. Hugo combines wristed instruments, 3D visualization, and Medtronic’s cloud-based surgical video capture and management solution, Touch Surgery Enterprise. The idea is to offer a multi-quadrant platform for a wide range of soft tissue procedures. In the robotic spine surgery space, Medtronic competes with its StealthStation navigation, O-arm, and Mazor systems.

YouTube Video Credit: Medtronic, Inc.

Johnson and Johnson

J&J made a major push into robotic surgery in 2019, when it paid $3.4 billion upfront for Auris and took complete control of the Verb joint venture it set up with Alphabet’s Verily a few years earlier. CSATS, which J&J bought in 2018, provides a video-based surgery assessment platform. Ethicon, as part of J&J, formed Verb with Verily in 2015. Since then, the company has been beset by delays, first in 2020, when it dropped plans to bring a Verb-Auris robot to the U.S. via the 510(k) pathway, and then in 2021, when it pushed back an anticipated launch by two years.

“It’s important to remember that while we’re behind and [while] we certainly want to do better [and] we have a sense of urgency, we realize it’s very early in this game.”

Joe Wolk, CFO, Johnson & Johnson

Focus seems to be the issue here. Johnson & Johnson is laying off around 350 people at its Auris Health and Verb Surgical robotic surgery units in California. Auris accounts for most of the cuts, with J&J laying off 292 of its employees across two sites, but 47 workers at Verb and 13 people from four other businesses are also heading to the exit. It’s tough to be one small part of a large company like J&J. You are constantly fighting for resources, R&D money, and attention. And if your division is underperforming, you are in trouble. Three hundred fifty loyal employees just found that out the hard way.


Stryker:

Mako sales were up 19% year-over-year in Q2 2022. But by the third quarter, company officials reported soft installation levels amid delays stemming from variability in the hospital environment. Stryker has also made good progress with the development of spine and shoulder applications for Mako. Stryker, in March 2022, announced the launch of its Insignia hip stem for total hip and hemiarthroplasty procedures. The Insignia stem is Mako-compatible. Stryker unveiled Mako Total Knee 2.0 at the AAOS 2023 Annual Meeting in Las Vegas. It designed the system to deliver the same trusted outcomes surgeons expect from Mako. However, informed by over 500,000 procedures, the system features a new, elevated user experience.

The company said 35 countries have Mako systems installed, with more than 1 million procedures performed worldwide. Stryker began a limited release for Mako Total Knee 2.0 in August 2022. It plans to continue a phased rollout in 2023, starting with the U.S. before launching globally in select markets. In addition to its Mako Total Knee 2.0, Stryker plans for two Mako launches in the — somewhat — near future. It plans to initially launch Mako Spine in the second half of 2024, followed by Mako Shoulder by the end of 2024.


Titan Medical – Exploring a sale of assets and now delisted from the NASDAQ

Titan said its board determined to prioritize the sale of all or a portion of its assets. That includes its IP portfolio of more than 235 patents and patent applications. It added further cost-cutting measures that included a layoff of 48 employees at its Chapel Hill-based subsidiary. Those layoffs included all employees furloughed in December. The layoffs left Titan with 18 remaining employees. Due to working capital limitations, Titan halted all expenditures on developing its Enos surgical robot. That included work on its FDA investigational device exemption (IDE) filing.

At the end of December 2022, Titan received notification of potential delisting from the Nasdaq market. The Nasdaq Listing Qualifications Staff notified the company of its continued non-compliance with the $1 minimum bid price requirement. After a Feb. 16 hearing, a Nasdaq panel decided to delist the company.


Asensus Surgical

Asensus is looking to expand the use of its Intelligent Surgical Unit (ISU) called Luna, with plans for a full-scale commercial launch of 5 mm articulating instruments by the end of 2022. It’s also submitted a 510(k) application for pediatric clearance. In February, Asensus and KARL STORZ to Market the Intelligent Surgical Unit and Co-Develop New Vision and Instrument Platforms. The Companies intend to collaborate on developing next-generation instrumentation, and KARL STORZ intends to sell Asensus’ Intelligent Surgical Unit (ISU) as a standalone device.

YouTube Video Credit: Asensus Surgical, Inc.

Moon Surgical – One to watch?

Moon Surgical is a Paris– and San Carlos, California–based surgical robotics company developing the Maestro system. Call the Maestro a robotic surgical assistant — it’s designed to be small, adaptable, and integrated into existing clinical workflows. With Maestro, the surgeon is still in the operating room performing the actual surgery, but the system’s arms assist the surgeon in properly moving tools and locking them into place. It could especially be helpful in short-staffed operating rooms. The company says that the Maestro system’s data-driven capabilities in underserved laparoscopic procedures could make robotic surgery accessible across all geographies. The company has further backing from one of the biggest names in surgical robotics, with Intuitive co-founder Dr. Fred Moll serving as a board advisor. They received FDA clearance to market the device in the U.S.in December, 2022.

YouTube Video Credit: Moon Surgical

Zimmer Biomet

Zimmer Biomet’s Rosa surgical robot has produced mixed results in terms of rentals compared to upfront sales, but the company maintains a positive outlook on the system. Rosa represents a unique part of an ecosystem comprised of many parts and pieces. The integrated solution with pre-operation software through a partnership with Apple, for instance, creates a different offering in surgical robotics. Zimmer Biomet has an exclusive development and distribution agreement with NeuroOne for its thin film technology and is already selling NeuroOne’s earlier cortical strip and grid electrode devices.


Smith+Nephew

Smith+Nephew globally launched its Cori handheld surgical robot system in 2021 and, in 2022, added total hip arthroplasty to Cori’s offerings, having previously designed it for total knee arthroplasty. Cori is a compact, fully mobile offering with a 3D intraoperative imaging system and an advanced robotic sculpting tool. The surgeon uses a pointer to digitally “paint” over the bone surface that needs removal. The surgeon then uses a handheld cutting tool that has a robotic feature. The robotic feature automatically halts the spinning of the tool’s burr if it’s outside the painted area.

YouTube Video Credit: Smith and Nephew

Some thoughts

There’s a reason that Intuitive is the market leader and likely to remain so for the foreseeable future. And that is focus. For those old enough to remember it, they adapted the old KFC mantra “we do chicken, and we do chicken right.” Intuitive has a laser-like focus on robotic surgery and devotes a lot of R&D money to driving innovation forward in the discipline.

On the other hand, in companies like Johnson and Johnson, robotic surgery is just one product segment in an extensive portfolio. That means there is a constant struggle for attention, resources, and development money. The recent layoffs at J&J and others demonstrate what happens when times get tough, and money gets tight.

That doesn’t mean that there won’t be opportunities for companies who develop a solution that meets the evolving needs of surgeons around the world.

The market is changing too. More procedures are moving outside of the hospital to ASCs and private practices. See the graphic below from Sg2, who projects more robust growth opportunities in ASCs, HOPD, and physician offices over the next ten years than in inpatient surgeries.

Image Credit: Sg2, a Vizient Company

ASCs might have a difficult time justifying spending $2-3 million on a DaVinci robot and a total cost of ownership (including service contracts, consumables, etc.) estimated at ~$8 million per instrument. They also cite longer room preparation and procedure times using DaVinci as a reason to look elsewhere for solutions.

That’s why I think Moon Surgical might be an interesting company to watch. The argument they put forward is that their robotic assistance solution attached to standard laparoscopic tools has several advantages, including lower total cost of ownership, shorter room preparation times, bringing the surgeon back to the table-side, has a short learning curve since it uses instruments the surgeon is familiar with and keeps procedure times lower than DaVinci. Only time will tell whether these claims are borne out in clinical practice. But their arguments are compelling – especially for ASCs and rural providers.

Stay tuned


Source information:

Health Tech News This Week – March 11, 2023

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

Image Credit: Shutterstock.com

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.

“There is a lot of potential here. Yes, there is some nervousness attached to it as it’s a new way of using technology, but this is a gift that will keep on giving.”

Walter Jean, MD, Chief, Neurological Surgery, Lehigh Valley Health Network

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.

Image Credit: Tazeen Rizvi, MD

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.

YouTube Video Credit: MIT

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.

Image Credit: Device Talks Weekly

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.

“We are excited to see these promising results in a group which is often underrepresented in research into smartphone diagnostics. An affordable and reliable technique to screen for anemia using a smartphone could drive long-term improvements in quality of life for a large amount of people.”

Thomas Wemyss, Researcher

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.

Image Credit: NEJM Catalyst

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.

One Tech Company Steadily Expanding Their Business in Health Care That Deserves More Attention

“We are essentially nurturing a start-up within a large-scale organization and leveraging Best Buy’s core assets, including the Geek Squad, to incubate a new business.”

Corie Barry, CEO, Best Buy
Image Credit: Shutterstock.com

Best Buy isn’t the first name that comes to mind when people think of health care. For decades, Best Buy has been one of the leading consumer electronics retailers in North America. With more than 1,000 stores across the US and Canada, the company brought in over $50B in revenue in 2021, mainly driven by sales of consumer electronics such as laptops, desktop computers, and smartphones. However, in recent years the company has been heavily focused on expanding into healthcare, building out a dedicated tech-enabled offering for at-home care as the aging population increasingly looks to age in place. Nearly 90% of adults 65 and older want to live in their homes, which presents opportunities to introduce tech-enabled monitoring and engagement solutions.

Best Buy tapped into healthcare in 2018 with its $800 million acquisition of GreatCall (now Lively), which provides emergency response services to seniors. Their Lively Health & Safety Packages were recently updated to empower better those who are aging at home, and two new services were added: Nurse On-Call and Care Advocate. In addition, Lively Urgent Response was made compatible with Amazon Alexa-enabled devices. Now, users can say, “Alexa, call for help,” and will be immediately connected with someone who will assess the situation and get them the help they need in various situations.

The following year, Best Buy bought the remote monitoring company Critical Signal Technologies. Its 2021 deal with Current Health was a big bet for at-home services, building off past investments and further solidifying the retailer’s presence in healthcare. Current Health is a remote patient monitoring platform that major hospital systems nationwide rely upon to communicate with patients and track patients’ vital signs. The combination of Current Health’s technology and Best Buy’s size and ability to help customers with technology in their homes helps close the gap in enabling care at home.

And they’re delivering tangible results. Current Health customer, the Defense Health Agency’s (DHA) virtual care program was the focus of a study published in the Journal of Medical Internet Research (JMIR). In the study, researchers compared the financial impact and clinical outcomes at hospitals that participated in the care-at-home program versus those that weren’t. The researchers at Current Health and DHA found a 12% lower length of stay averaged across all COVID-19 patients, saving $2,047 per patient and a total net savings of an estimated $2.3 million in the first year of the program, with no increase in 30-day readmissions or emergency department visits. This vital research demonstrates that care-at-home programs can improve the operational efficiency of care delivery without harming clinical outcomes, which is essential to making healthcare better and more sustainable.

The company is partnering with several health systems, including Geisinger Health, and Mount Sinai Health System, to expand its at-home care technology platform. New York-based Mount Sinai Health System partnered with Current Health on remote patient monitoring starting in 2020 and already monitors cancer patients at home. Geisinger is working with Best Buy to manage at-home care for patients with high-risk hypertension, diabetes, and those recovering from sepsis.

And this week, Best Buy announced that it would offer technology support to Charlotte-based Atrium Health, part of the newly formed Advocate Health, for its hospital-at-home program launched in early 2020 in response to the COVID-19 pandemic. Best Buy’s Geek Squad will go to patients’ homes, set up technology that remotely monitors their heart rate, blood oxygen level, or other vitals, and train the patient or others in the home how to use the devices. The data would then be shared securely with doctors and nurses through the telemedicine hub from Current Health. The tech needs previously were handled within Atrium. The goal is to eventually scale these services nationwide, including across Advocate’s Southeastern and Midwestern footprints. Best Buy began setting up virtual-care systems in mid-February for ten hospitals in and around Charlotte, North Carolina. The company said it aims to have about 100 patients in the program daily — roughly equivalent to a midsized hospital but without a building.

“The reason we’re betting on this partnership is because we truly believe that we can bring so much to the table that is actually distinctly different, from not just what others are doing in the hospital-at-home space or the health-at-home space, but also really unique and what we actually need in service of the communities that we’re a part of.”

Rasu Shrestha, Chief Innovation and Commercialization Officer, Advocate Health

Best Buy is leaning into core capabilities of supply chain and logistics, data analytics and consumer wellness products. Entering the healthcare space is also a defensive move for Best Buy’s retail business, allowing the company to hedge against supply chain disruptions and increasing competition from Amazon, both of which have threatened its main consumer electronics business. The retailer expects a same-store sales decline of between 3% and 6% in the fiscal year, with most of that drop coming in the first six months. On an earnings call last week, CEO Corie Barry said Best Buy expects sales in its health division to grow faster than the rest of its business this fiscal year.

“We want to do this well. We want to create pathways that enable care at home in a more seamless manner. We want to tie technology and empathy together and really help change how health care is delivered to people in their homes.”

Deborah DiSanzo, President, Best Buy Health

Best Buy’s existing Geek Squad customer service workforce — comprised of more than 20K agents already making approximately 9M home visits a year to help customers with tech setup and use — makes the company well-positioned to take on the opportunity in at-home care. Best Buy can also leverage existing relationships with healthcare device buyers.

Best Buy is one of many retailers seizing opportunities in the healthcare space. In January, Dollar General launched three mobile healthcare clinics in Tennessee. The following month, CVS Health announced its $10.6 billion acquisition of primary care provider Oak Street Health, outlining plans to add 130 Oak Street sites by 2026. And last week, Walmart Health detailed its plans to add 28 new centers and expand into two new states.

Remote patient monitoring and efficient delivery of medical devices are important components of home health care — but hospitals are struggling in all of these areas as they scale their program. Partnering with a well-resourced tech company is a common solution.

“The vast majority of home hospital programs partner with some sort of technology solution to do the last mile monitoring of the patients,”

Constantinos Michaelidis, the director of UMass Memorial Health’s Hospital at Home program

Watch for more partnerships like the Atrium deal announced this week in the future. These leverage Best Buy’s strengths and takes the tech deployment challenges away from already overwhelmed health system tech staff. It’s a win-win for both partners and the patients they serve.

Health Tech News This Week – March 4, 2023

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

Image Credit: Shutterstock.com

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.

Image Credit: Front. Digit. Health, 23 February 2023
Sec. Health Technology Implementation
Volume 5 – 2023 | https://doi.org/10.3389/fdgth.2023.1057347

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.

Image Credit: Northwestern University
YouTube Video Credit: Northwestern University

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.

Image Credit: Yale School of Medicine

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.”

Image Credit: Pew Research Center

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.

It’s 11am. Do You Know Where Your MRI Safety Officer Is?

“Each time we have a bed, compressed gas cylinder, wheelchair, or floor polisher go flying into an MRI scanner there’s this collective wish to explain the event as some sort of freakish aberration. But how many of these freakish aberrations do we need to see before we come to terms with the fact that -to date- the radiology profession has proven unwilling to require the changes that we know would be effective in reducing these accidents?”

Tobias Gilk, MRSO, MRSE, MRI Safety Expert
Image Credit: Shutterstock.com

Well, it has happened again. Twice actually. Two recent news stories highlighted the fact that we’ve sent another object flying into an MRI scanner with disastrous and, in one case, fatal results.

The first case reported in numerous news stories was about a Brazilian man killed by his own handgun while accompanying his mother for her MRI. On Jan. 16, lawyer Leandro Mathias de Novaes was wearing a registered firearm on his waistband while assisting his mother in the MRI suite when the scanner’s powerful magnet pulled the gun away from his body. The gun subsequently discharged and shot the 40-year-old lawyer in his stomach, landing him in an intensive care unit until Feb. 6, when he passed away.

Image Credit: Tobias Gilk, MRSO, MRSE, LinkedIn post

The facts as we understand them – The site didn’t have a policy against companions going into the MRI scanner room, and they didn’t require people to change out of their street clothes. They did have a policy that people were to sign attestations that they didn’t have any metal (an attestation that the man purportedly signed but didn’t comply with). The man had a concealed pistol which, when he got close to the MRI scanner, the powerful magnetic energy of the MRI pulled from him and helped cause the gun to fire. The gunshot hit the man in the abdomen, and he died of the injuries several days later. As Professor Gilk (my go-to resource for all things MRI safety-related) outlines in his LinkedIn post:

“We’ve all heard (and probably repeated) tropes about the MRI technologist having ultimate responsibility for MRI safety. Those arise from the incredibly-long list of stories of techs whose training and observational skills have stopped off-duty police officer with a firearm, or transport with the wrong wheelchair, or anesthesia with a steel oxygen cylinder, or the patient with the lifelike prosthesis, just before the door into the MRI scanner. These ‘good catch’ happy accidents are so well known in our profession we’ve built de facto practices around the unblinking vigilance of MRI techs (often in lieu of system-level MRI safety practices).”

Tobias Gilk, MRSO, MRSE

The second example was reported just this week and happened in a hospital in the United States. In this case, the object was a hospital bed/gurney with multiple injuries.

Image Credit: Tobias Gilk, MRSO, MRSE, LinkedIn post

The facts as we understand them
• A senior MR tech was on duty but not immediately in the magnet room.
• The MRI’s undockable table was out of the magnet room to allow the transfer of the bed-bound patient.
• A nurse and tech aide brought patient-on-gurney into the magnet room.
• Patient was thrown off the gurney as it was drawn to and struck the MRI scanner (patient relatively unharmed).
• Nurse was struck by the gurney, and is reported to have suffered a broken femur and fractured pelvis.


The prevailing opinion shared extensively in most public relations campaigns is that MRI is the “safe modality. As Professor Gilk points out:

“To be clear, MRI injury accidents have been, and remain, rare, but in nearly every case of MRI injury accident there was an existing, well known and widely promulgated best practice prevention that wasn’t used. In other words, we could -if we so chose- prevent nearly every MRI injury accident that occurs… we just choose not to.

Tobias Gilk, MRSO, MRSE

To support his statement, Professor Gilk has created a chart that depicts the current state of MRI safety by looking at MRI accident rates.

Image Graphic: Tobias Gilk, MRSO, MRSE

The red line represents growth in MRI adverse events, and the blue line represents growth in MRI exam volume. If you apply ‘best fit’ slopes to each of these two datasets, you learn that reported MRI adverse events are growing at rates between 2x and 4x the rate of growth of MRI procedure volume (depending on the weighting given to the 2008 – 2012 ‘hump’ of MRI adverse events in the data). To quote Professor Gilk:

“Put simply, this data indicates that MRI adverse events are both greater in number, and represent a greater proportion of MRI exams, than twenty years ago. An MRI patient, today, appears to have a greater likelihood of an adverse event than an MRI patient in 2001. Despite more experience and more knowledge, we’re producing more MRI adverse events… Facts that shouldn’t coexist.”

Tobias Gilk, MRSO, MRSE

So what should be done to correct this problem? The industry, and each MRI provider, need to take long hard looks at their practices and identify ways in which their assumptions and ‘the way we’ve always done things’ might contribute to our national growth in MRI adverse events. Professor Gilk has studied how effective existing, established best practice standards can be at preventing MRI projectile accident injuries. In the most recent study for Metrasens, the more current data found that -for the two years studied- these same three existing best practice protections would have prevented 100% of the patient injuries from MRI projectiles.

In addition to the nine steps highlighted in the Metrasens study cited above, I always recommend the following to imaging providers:

  • Appoint an MRI Safety Officer for your organization – That person is charged with reviewing, revising, and communicating all MRI safety protocols throughout the organization. Recommended responsibilities for management of MR safety guidelines can be found here: https://www.ismrm.org/smrt/safety_page/Recommended_Responsibilities_for_Management_of_MR_Safety_JMRI2016.pdf
  • Review your MRI safety protocols annually and whenever equipment changes are made – This is an important step often glossed over by many organizations. It is critically important to do an extensive review if a new scanner is purchased.
  • Conduct regular MRI safety training for all staff involved with patient care, including transport, nursing, etc. Training is available through AppliedRadiology.com. Programs for MR personnel include: “Introduction to MRI Safety,” “Basic MRI Safety Training,” and “Advanced MRI Safety Training For Healthcare Professionals.” Please visit appliedradiology.org/MRISafety/. Videos Available on IMRSER include MRI Safety Training Programs for Levels 1 and 2 MR Personnel, What to Expect During Your MRI, Projectile/Missile Effect videos, and Superconducting magnet quenching shown from both inside and outside the MR system room. Visit: IMRSER Videos.
  • Keep a continuously updated list of MRI-safe implants and devices – A sample list can be found here: http://www.mrisafety.com/TMDL_list.php
  • Ensure you have implemented the 4-Zone MRI safety system linking screening/supervision.
Image Credit: Metrasens

Until we take the well-known steps which prevent those injury accidents, we’re going to continue to experience these head-scratching moments every time another missile-effect injury (or worse, death) is reported.

Additional resources:

Health Tech News This Week – February 25, 2023

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

Image Credit: Shutterstock.com

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 importantRoughly 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.

Image Credit: Axios – Ipsos American Health Index poll

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.

Image Credit: Rock Health

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.

Image Credit: Alberto Pappalardo and Hasan Erbil Abaci / Columbia University Vagelos College of Physicians and Surgeons

“Three-dimensional skin constructs that can be transplanted as ‘biological clothing’ would have many advantages. They would dramatically minimize the need for suturing, reduce the length of surgeries, and improve aesthetic outcomes.”

Hasan Erbil Abaci, MD , Columbia University

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.

Health Tech News This Week – February 18, 2023

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

Image Credit: Shutterstock.com

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.

“Rather than taking a careful approach to this, they’re going in a very bold fashion. Let the [AI system] make mistakes, because now the cat is out of the bag. We’re all guinea pigs at this point,”

Chirag Shah, Professor, University of Washington

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.

Image Credit: Eric Topol, M.D., Ground Truths Substack article

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.

Image Credit: Vall d’Hebron University Hospital)

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 weekMark 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.

YouTube video credit: AAM Access 2023

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.

Image Credit: Pictura Bio

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).

Health Tech News This Week – February 11, 2023

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

Image Credit: Shutterstock.com

Spotify’s founder helped develop an AI-powered body health scanner

The Verge’s Emma Roth kicks off the news coverage this week. Spotify founder Daniel Ek is getting into the healthcare industry. A post shared on LinkedIn names Ek as the co-founder of a startup called Neko Health, which specializes in providing body scans powered by artificial intelligence (AI), as reported earlier by European news outlets Sifter and Tech.eu. According to a translated version of Neko Health’s website, the Swedish company’s non-invasive full-body scanner can detect and measure the growth of birthmarks, rashes, and age spots. It also utilizes a separate scanner to pick up on abnormalities in heart function, blood pressure, and pulse throughout the body. Neko says the company’s 360-degree body scanner comes equipped with over 70 sensors that collect more than “50 million data points on skin, heart, vessels, respiration, microcirculation, and more.”

Image Credit: Neko Health

Why it’s important – We’ve seen the development of “whole body” scanners in the past, along with the emergence of companies who promote whole body scanning as an “annual checkup” to monitor for potential health issues. While interesting, physicians worry about the potential problems in reporting “incidentalomas,” which may or may not represent a serious problem for the patient.


Infographics of the week – This week’s first infographic is from Dr. Tazeen Rizvi. It shows his assessment of a methodology to address the problems of inequities in data-driven technologies. His point: “Efforts should be made to ensure the #data on which #algorithms are based is representative of the populations they will be deployed in, with sufficient breadth and depth to capture the multitude of clinically important associations between ethnicity, demographic, social, and clinical features that may exist.”

Image Credit: Dr. Tazeen Rizvi

The second infographic comes from Gartner and shows their emerging technologies and trends for 2023.

Image Credit: Gartner

Can’t find a doctor? This hi-tech telemedicine booth offers a handy, hands-on checkup

As France struggles with a shortage of doctors, its worst-hit regions are rolling out hi-tech telemedicine booths, where patients can conduct their own checkups while on a video call with a physician in another part of the country. Natalie Huet covers the story in her article on EuroNews.net. While France’s healthcare system is often hailed as one of the best in the world, it’s facing a demographic crisis in which doctors are getting older and are not being replaced where they’re most needed.

Image Credit: H4D Telemedicine

Why it’s important – According to government data, nearly 7 million people in France – one in 10 – don’t have a referring general practitioner (GP), and 30 percent live in a medical desert. Those are regions where it’s nearly impossible to see a doctor because there aren’t any nearby or because the few in the area are so busy they don’t take new patients. This design is an interesting spin on traditional kiosks and has been designed to be patient-friendly and comfortable.


Podcast of the weekNew Discoveries on Long COVID (with Dr. Eric Topol) from In the Bubble with Andy Slavitt. Three years into the pandemic, roughly 65 million people suffering from Long COVID worldwide are still looking for answers to the mix of symptoms that has baffled doctors and experts. Dr. Eric Topal and three researchers suffering from the condition themselves published a new study laying out the most recent significant findings and preventative measures. Andy asks Eric about the likelihood of getting chronic symptoms from an infection, what those symptoms typically are, and how the data influences his own precautions. You can listen to this podcast here.


Lab-Grown Retinal Eye Cells Make Successful Connections

Retinal cells grown from stem cells can reach out and connect with neighbors, according to a new study, completing a “handshake” that may show the cells are ready for trials in humans with degenerative eye disorders. This work was reported by the University of Wisconsin, Madison, and featured in an article in Technology Networks Cell Science online. During 2022, Gamm and UW–Madison collaborators published studies showing that dish-grown retinal cells called photoreceptors respond like those in a healthy retina to different wavelengths and intensities of light and that once they are separated from adjacent cells in their organoid, they can reach out toward new neighbors with characteristic biological cords called axons.

Image Credit: Shutterstock.com

Why it’s important – After they confirmed the presence of synaptic connections, the researchers analyzed the cells involved and found that the most common retinal cell types forming synapses were photoreceptors – rods and cones – which are lost in diseases like retinitis pigmentosa and age-related macular degeneration, as well as in certain eye injuries. The next most common cell type, retinal ganglion cells, are degenerate in optic nerve disorders like glaucoma.


Ten Breakthrough Technologies, 2023

Every year MIT Technology Review publishes its list of ten breakthrough technologies that matter most right now. This year, as in the past, several of their selections are health care related. I’ve listed them below:

  • CRISPR for high cholesterol – Over the past decade, CRISPR’s gene-editing tool rapidly evolved from the lab to the clinic. It started with experimental treatments for rare genetic disorders and has recently expanded into clinical trials for common conditions, including high cholesterol. New forms of CRISPR could take things further still.
  • Abortion pills via telemedicine – Abortion ceased to be a constitutional right in the US in 2022, and state bans now prevent many people from accessing them. So healthcare providers and startups have turned to telehealth to prescribe and deliver pills that allow people to induce abortions at home safely.
  • Organs on demand – Every day, an average of 17 people in the US alone die awaiting an organ transplant. These people could be saved—and many others helped—by a potentially limitless supply of healthy organs. Scientists are genetically engineering pigs whose organs could be transplanted into humans and 3D-printing lungs using a patient’s own cells.

New ‘ultrasound tornado’ device breaks down blood clots

Researchers say a new tool and technique using “vortex ultrasound” could potentially break down blood clots in the brain. Sean Whooley reports on the research in his article in Medical Design and Outsourcing online. This tool includes a single transducer for producing the swirling vortex effect. Researchers designed the transducer at a small enough size for incorporation into a catheter. That then feeds through the circulatory system to the blood clot site. The researchers tested their technology using cow blood in a 3D-printed model of the cerebral venous sinus. Testing found no damage to the walls of blood vessels, something that can happen during catheterization or surgical intervention. They also found no substantial damage to red blood cells.

Why it’s important – CVST clots increase pressure on blood vessels in the brain. This increases the risk of bleeding in the brain, which can be catastrophic for patients. Existing techniques rely in large part on interventions that dissolve the blood clot. But this is a time-consuming process. This ultrasonic tornado eliminated clots formed in an in vitro model of cerebral venous sinus thrombosis (CVST). The researchers, based at North Carolina State University, say it worked more quickly than existing techniques.


FDA has now cleared more than 500 healthcare AI algorithms

There are now more than 520 marker-cleared artificial intelligence (AI) medical algorithms available in the United States, according to the U.S. Food and Drug Administration (FDA), as of January 2023. The vast majority of these are related to medical imaging. Dave Fornell provides the breakdown in his article in Health Exec online. The FDA cleared the first AI algorithm in 1995, and fewer than 50 algorithms were approved over the next 18 years. However, the numbers have increased rapidly in the past decade, and more than half of the algorithms on the U.S. market were cleared between 2019 to 2022––more than 300 apps in just four years. Last October, the FDA approved 178 new AI and machine learning (ML) systems. That number is expected to grow rapidly into the future, the FDA has said.

Why it’s important – As I’ve explained before, AI and ML technologies have the potential to transform healthcare by deriving new and important insights from the vast amount of data generated during the delivery of healthcare every day. Medical device manufacturers are using these technologies to innovate their products to assist healthcare providers better and improve patient care, the FDA explained on its website.


Automated training system to help Singapore General Hospital nurses master IV drip treatment

Trainee nurses at Singapore General Hospital (SGH) will soon use a new automated platform that takes the guesswork out of administering intravenous (IV) drips during training, Osmond Chia reports in his article in The Straits Times. The system – comprising a sensor-equipped glove, a digital patient in the form of an avatar, and a 3D-printed hand with a human-like texture – will evaluate how well nurses can insert a needle and converse with patients. Dubbed IV Nimble (Nursing Innovation in Mobility-based Learning), the program takes training to administer IV drips closer to reality and helps trainees learn flexibly with the help of bots. The platform will be fully rolled out for training by the end of 2023.

Image Credit: ST PHOTO: KUA CHEE SIONG

Why it’s important – The new system is a step forward technologically from earlier props used in cannulation training. Previously, an instructor would guide nurse trainees to insert a needle into a dummy arm, but it was tough to tell if a trainee precisely hit or missed the vein, as they could judge only from the surface. Training is also gamified, providing trainees with different skin textures and vein sizes to vary the difficulty of administering cannulation. It can also be further adapted for other medical training scenarios, like blood collection, chest tube insertion, and other invasive procedures.

February is National Heart Month – Digital Technologies to Support Heart Health & Wellness

“The problem with heart disease is that the first symptom is often fatal.”

Michael Phelps, Olympic Athlete
Image Credit: Shutterstock.com

The simple truth is that cardiovascular diseases are one of the most common problems patients in America face. Over 92 million Americans suffer from heart disease, according to a recent American Heart Association study. And over 14% of all annual health care costs are a result of cardiovascular conditions. The numbers are sobering and are projected to grow over the next ten years. Each February, the American Heart Association tries to raise awareness of the seriousness of heart disease during National Heart Month and Wear Red Day. Research has shown that digital technologies can help raise awareness around heart health and help to reduce adverse outcomes through monitoring and other digital tools.

Here are several technologies that can benefit clinicians and patients in helping to diagnose and manage heart disease.

Big Data, Analytics, Artificial Intelligence & Machine Learning

Two recent peer-to-peer reviewed academic articles have shown how big data can be used to prevent cardiovascular diseases and assist in generating early diagnoses. The first one, “System Framework for Cardiovascular Disease Prediction Based on Big Data Technology,” was published in the November 2017 issue of the journal Symmetry. The researchers looked at various factors that could be used to predict the likelihood that specific populations will develop cardiovascular diseases over time. As it turns out, big data models can predict the probability that a patient will develop a cardiovascular disease by looking at clinical, genomic, and lifestyle data through disease correlations, drug side effects, and genome research.

A second study, published in the May 2018 issue of the journal BioMed Research International, shows big data can correctly predict the likelihood of a person developing cardiovascular disease in 80% of cases. This article offers a comprehensive list of factors most likely to lead to cardiovascular diseases. These factors include gender, chest pain type, resting blood pressure, serum cholesterol, fasting blood sugar, ECG, maximum heart rate achieved, exercise-induced angina, old peak, slope, and the number of major blood vessels colored by fluoroscopy.

As artificial intelligence and machine learning applications advance, big data will become more available outside of a purely academic environment to widely available complex databases where a specific patient’s characteristics can be entered to obtain the likelihood of that patient developing cardiovascular disease with more than 80% confidence. According to an article in the Journal of the American College of Cardiology, artificial intelligence is poised to “provide a set of tools to augment and extend the effectiveness of the cardiologist.”


Voice enabled technology

Voice-enabled technology is already making impressive strides toward improving health outcomes for heart disease patients. Voice-enabled assistants like Amazon’s Alexa and Apple’s Siri are indispensable to cardiac patients. For example, a skill developed by the American Heart Association (AHA), asking Alexa to walk you through the steps of CPR, is as easy as ordering a pizza. AHA’s skills also help users recognize a heart attack and stroke symptoms. Medical device manufacturer Omron Healthcare built a new Alexa skill that allows patients who use their blood pressure monitoring devices to manage their condition using voice commands. All users must do is pair their Omron cuff to the company’s app and ask Alexa to read their latest blood pressure results and get alerts for anything that may be considered higher than usual.

Image Credit: CB Insights, The Big Tech in Pharma Report, pg. 23

But big tech companies aren’t the only ones developing these voice-enabled solutions for cardiac patients. Mayo Clinic is on the verge of proving that voice signal analysis can become a noninvasive diagnostic tool. While the vocal features that indicate heart disease are not perceived by the human ear alone, the Rochester-based medical center discovered that a voice-analyzing app could help detect coronary artery disease based on a patient’s tone and intensity. Another pilot study by The Journal of the Acoustical Society of America vouches for this technology’s efficiency in lowering healthcare costs and reducing mortality rates among patients with heart failure.


Gamification

An article published in the April 2018 issue of the journal Clinical Cardiology documents how mHealth technologies have been helping patients with cardiovascular diseases adhere to heart‐healthy recommendations designed to modify users’ cardiovascular risk‐factor profiles. The addition of mHealth technologies can increase patients’ physical activity levels to instill a positive impact on cardiovascular conditions. As the authors contend: “smartphone applications can impact PA [physical activity] include knowledge, social support, behavioral change support, decision support, and self‐efficacy.” These stimulating and gamified mobile apps have successfully motivated patients to improve their modifiable risk factors. As a result, they’ve been proven to reduce cardiovascular risk-factor profiles.

“I think it’s quite natural to a clinician to start in the cardiovascular space. It’s just so clear how supporting people with nutrition, physical activity, mental health, all of this, can directly benefit health outcomes. Within cardiovascular, we’ve been expanding into peripheral artery disease and a few others with our clients and partners.”

Dr. Tryggvi Thorgeirsson, CEO, Sidekick

“An estimated 50% of patients with chronic diseases do not follow the prescribed treatment. Gamified health tracking creates an environment that keeps the patient from straying from the appropriate therapy path.”

Bertalan Mesko, M.D., PhD

Healthcare providers who use gamification strategies in their applications will have a competitive edge over others who don’t. By 2027, GM Insights forecasted that the global market for healthcare gamification would reach $65 Billion and grow at a CAGR of 14.6%. It is due to the growing usage and adoption of technology and global digitization.


Digital sensors and wearables

Since 2008, Geisinger Health Plan (GHP) has implemented a telemonitoring program that specifically targets patients suffering from heart failure. In 2014, an article was published in Population Health Management titled: ‘Can Telemonitoring Reduce Hospitalization and Cost of Care? A Health Plan’s Experience in Managing Patients with Heart Failure.’ Data was collected over 5 years and compared against data from patients suffering from heart failure who did not enroll in the program. The results were eye-opening:

“The odds of experiencing a hospital admission in a given month was 23% lower when the members were enrolled in the telemonitoring program. The odds of experiencing a 30-day readmission was 44% lower, and the odds of experiencing a 90-day readmission was 38% lower. […] The implementation of the heart failure telemonitoring program was associated with approximately 11% cost savings during the study period.”

Population Health Management, 2014
Image Credit: Digital Health Innovations to Improve Cardiovascular Disease Care, Santo, K., Redfern, J. Digital Health Innovations to Improve Cardiovascular Disease Care. Curr Atheroscler Rep 22, 71 (2020). https://doi.org/10.1007/s11883-020-00889-x

I’ve written about the role next-generation wearables will create new opportunities in remote monitoring in a previous post. The evidence shows that patients suffering from cardiovascular diseases are significantly more likely to improve their condition over time when they benefit from digitally-connected solutions that help them manage their chronic conditions over time.


Telecardiology

As telehealth makes inroads into a broader range of medical specialties, cardiovascular care is among the fields offering more virtual visits. This branch of telemedicine, known as telecardiology, seeks to achieve real-time, remote diagnosis and treatment of heart disease — including congestive heart failure, cardiac arrest, and arrhythmia. One of those ways is raising compliance rates for cardiac rehab, a medically supervised program designed to improve cardiovascular health after a heart attack or other event requiring care. But only 25 percent of patients follow the prescribed regimen.

In 2016, the American Heart Association published a policy statement encouraging the use of telehealth applications to improve cardiovascular and stroke care.

“Remote monitoring of patients with implantable cardiac devices resulted in timely diagnosis and management of arrhythmias and heart failure symptoms, leading to better clinical outcomes. Also, using telestroke to evaluate patients with acute ischemic stroke eligible for thrombolysis provided access to acute stroke care in underserved areas and has been shown to be as safe and effective as usual care.”

Crystal Wong, MD

Telemedicine applications are exceptionally well-equipped to connect physicians with patients who live in remote areas of the country or to quickly offer a consultation to patients living with chronic cardiovascular diseases.

There are multiple benefits to both patients and clinicians in using Telecardiology in health care. Here is a partial list:

  • Reduces Hospital Transfers
  • Increases Access to Premium Healthcare Delivery for Cardiac Patients
  • Creates Uniform Healthcare Accessibility to Larger Populations
  • Encourages Effective Collaboration of Cardiologists Worldwide
  • Makes Cardiac Healthcare More Affordable and Convenient
  • Encourages Smooth Triage and Relieves the Burden on Healthcare Providers
  • Increases Patient Satisfaction

Telecardiology is one of the fastest-growing fields in telemedicine. There is already a significant quantity of published clinical data, with some randomized multi-center trials to answer the most critical questions definitively. The contribution of telecardiology in some fields, such as emergency and chronic care, undoubtedly improves healthcare quality and helps contain rising costs.


Some closing thoughts – Digital technology does have the potential to overcome several barriers, such as geography and time. Hence, even with equivalent health outcomes to standard care, there are huge positives regarding reach from a public health perspective. Furthermore, digital health interventions should not be viewed as a stand-alone, one-size-fits-all solution but rather an addition to the current multifaceted health interventions that can be personalized to different patient populations. With the digital health revolution, we can consider these tools not only a way to achieve better patient health outcomes but also as innovative ways to reimagine the way we currently conduct clinical studies. These digital technologies can enable new models of virtual trials, potentially reducing the duration and costs of future research while increasing our ability to achieve meaningful results.