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

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Digital Twins Will Transform Healthcare

George Lawton published an article in Venture Beat this week titled “21 Ways Medical Digital Twins Will Transform Healthcare”. The healthcare industry is starting to adopt digital twins to improve personalized medicine, healthcare organization performance, and new medicines and devices. Although simulations have been around for some time, today’s medical digital twins represent an important new take. These digital twins can create valuable models based on information from wearable devices, omics, and patient records to connect the dots across processes that span patients, doctors, and healthcare organizations, as well as drug and device manufacturers.

He segments these developments into three areas: personalized medicine, improving healthcare organizations, and drug and medical devices and development.

Why it’s important – Digital Twins can provide a secure environment for testing the impact of changes on the performance of a system. By creating a Digital Twin of a hospital, operational strategies, capacities, staffing, and care models can be observed to determine what actions to take. Virtual models can assist in bed shortages, minimizing the spread of germs, optimizing staff schedules, and scheduling operating rooms. These will help to optimize patient care, cost, and performance. Digital Twins can virtualize the hospital to create a safe environment, which tests the influences of changes on system performance without risks.

Digital Twin technology can also be used for modeling an individual’s genomic makeup, physiological characteristics, and lifestyle to create personalized medicine. It has a more individual focus than precision medicine which typically focuses on sample groups within the population. Developing a Digital Twin of a human body consists of a more advanced process than any engineering product. Sensors can efficiently provide data to a Digital Twin of any engineered object, but data derived from individuals typically come from expensive, time-consuming tasks, such as blood tests and scans.

I presented a hypothetical example of how a digital twin might be used in healthcare during one of my presentations at an Sg2 Executive Summit in 2018. “Kaitlyn” was my hypothetical patient, and the graphic of how her physician and health system used her digital twin to plan her care is shown below.

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Blood-Brain Barrier on a Chip for Neuro Drug Testing

As first reported in Medgadget.com, researchers at the KTH Royal Institute of Technology in Stockholm, Sweden, engineered a blood-brain barrier on a chip using human-derived stem cells. The device closely mimics the blood-brain barrier and allows the researchers to study its function and the effect of drugs without having to use experimental animals. By incorporating sensors, the chip can monitor barrier function in near real-time.

Why it’s important – The organ-on-a-chip (OOAC) is on the list of top 10 emerging technologies and refers to a physiological organ biomimetic system built on a microfluidic chip. Through a combination of cell biology, engineering, and biomaterial technology, the microenvironment of the chip simulates that of the organ in terms of tissue interfaces and mechanical stimulation. This reflects the structural and functional characteristics of human tissue and can predict response to an array of stimuli, including drug responses and environmental effects. OOAC has broad applications in precision medicine and biological defense strategies.

Significant progress has been made in developing organ-on-a-chip technologies in the past few years. Researchers have successfully modeled the following organs: liver, brain, lung, heart, kidney, intestines, and multi-system chips.

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How to Measure the Value of Virtual Health Care

In an excellent article in the Harvard Business Review, the American Medical Association (AMA) and Manatt Health, a legal and consulting firm, have developed a framework for assessing the value of digitally enabled care. It accounts for the various ways in which virtual care programs may increase the overall “return on health” by generating benefits for patients, clinicians, payers, and society going forward. Care providers can use the framework to develop and evaluate new digitally-enabled-care models, by payers to inform coverage and payment decisions, and by policymakers to establish regulations that guide the future of virtual care.

Why it’s important – Many organizations struggle to demonstrate the value of their investments in virtual care. While there has been much progress, the existing body of evidence for telehealth is narrowly focused on short-term measures of the financial value of virtual health. There is much opportunity to gather details on broader benefits such as improvements in access to care, clinical outcomes, the impact on the patient and clinician experience, the potential for operational efficiencies, and the impact on health equity. By adopting this framework, healthcare organizations can create a mechanism to have meaningful conversations about their virtual health programs and minimize the chances of reverting to their old, pre-pandemic posture on investing in this critical system.

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Life in 2050: A Glimpse at Medicine in the Future

In a fascinating article in Interesting Engineering, Matthew S. Williams describes what medicine will look like in the year 2050. He contends that developments in the five following categories will impact the field of medicine:

1. Big data, biometrics, and the internet of things
2. Machine learning, AI, and advanced analytics
3. Climate change and environmental health hazards
4. “Internals,” robotics, nanorobotics, and bionics
5. Genetic engineering and bio printing

Why it’s important – What I especially like about this futuristic view of medicine is the fact that the author spends some considerable time discussing the topics of climate change and environmental issues. The technologies he highlights in the article have been discussed extensively, but there has been little attention paid to the impact of climate change and environmental factors. Worth a read, in my opinion.

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Philips seeks to reduce MRI evaluation of the heart down to a few minutes

In an article in Medical Design & Outsourcing, author Sean Whooley reports that Amsterdam-based Philips is collaborating with the Spanish National Center for Cardiovascular Research (CNIC) to research a new technique to bring ultra-fast, easy cardiac magnetic resonance (MR) imaging to clinical settings in a way that benefits more patients.

A clinical trial of more than 100 patients used both the conventional and new MRI protocol, finding what expert radiologists described as “excellent agreement” between heart function measurements made using each technique, along with excellent agreement in the images to characterize tissue damage to the patient’s heart muscle. The director of CNIC’s clinical research department, Dr. Borja Ibáñez, said in the release that while the new technology obtains the same parameters as the standard technique, it reduces the time that a patient has to be inside the MRI machine by more than 90%.

Why it’s important – Currently, patients undergoing cardiac MRI scans are asked to hold their breath while images are being acquired. The process is particularly troublesome and unreliable for patients with irregular heartbeats or breathing problems. It is challenging to obtain good cardiac magnetic resonance images because the heart is beating incessantly, and the patient is breathing, so the motion makes the test vulnerable to errors. This novel approach to a longstanding problem may provide a unique solution to improve cardiac care for patients worldwide for years to come.

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A Tsunami of Disability Is Coming as a Result of ‘Long COVID’

Claire Pomeroy published a sobering article in Scientific American this past week that argues that we need to plan for a future where millions of survivors are chronically ill. The related health care and disability costs are also still unknowable. How many “long haulers” will never be able to return to work? How many will need short-term disability payments? How many will be permanently disabled and become dependent on disability programs? As increasing numbers of younger people become infected, will we see an entire generation of chronically ill?

In addition to the personal suffering, long-term disability comes with a staggering price tag—including increased health care costs, reduction or loss of employment, and economic strain on worker’s compensation and disability support programs. It’s been estimated that as much as 30 percent of the COVID health burden could arise from COVID-induced disability. This quote from Steven Martin, a University of Massachusetts physician and medical professor, sums it up nicely:

“If we end up with a million people with ongoing symptoms that are debilitating, that is a tremendous burden for each of these individuals, but also for our health care system and our society.”

Steven Martin, MD, University of Massachusetts

Why it’s important – Technology will play an important role in managing patients with “long COVID.” We know that these patients may have neurological, respiratory, cardiac, renal, gastrointestinal, and other symptoms. They will require long-term follow-up with medical imaging, lab, and other tests. Remote patient monitoring using on-body and in-body sensors will provide an “early warning system” to help identify which patients have worsening symptoms. And ongoing virtual visits will be required to check-in with them regularly.

It’s important to begin building your databases of COVID-19 patients now so that you can assess the potential impact on your organization & prepare to meet their ongoing needs. And, most importantly, begin reaching out to those patients now to let them know you are ready to care for them when the need arises.

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Moderna is developing 6-foot cubes with the US military that could pump out vaccines almost instantly. It’s the biotech upstart’s next step in the mRNA revolution. (subscription required)

As reported in Business Insider, a team of about 15 scientists at Moderna’s research hub in Norwood, Massachusetts, has been working with the US military over the past several months to develop a miniaturized way to produce vaccines.

These small-scale manufacturing pods are still several years away from prime time. If successful, they could have an even more significant effect on the world than Moderna has made with its COVID-19 vaccine — by halting pandemics before they start. Internally, the project is known as DART, for Deployable Accelerated RNA Technology.

The experimental units are designed to fit the manufacturing process into a 6-foot cube and pump out 500 doses of a vaccine against virtually any virus. All you’d need to do is enter the genetic code of what you want to target.

Why it’s important – The idea builds on the promise of mRNA vaccines, a new genetics-based approach to vaccinology. Traditional vaccines require massive, customized manufacturing facilities that can often take several years to build out. If fully realized, production pods could be dispersed worldwide, helping low- and middle-income nations access them. And, with local and nearly instant manufacturing, the logistical challenges of keeping the shots cold in storage may be overcome, too,

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A ‘MASSPEC PEN’ FLAGS PANCREATIC CANCER DURING SURGERY

Marc Airhart’s article in Futurity reports on work being done at the University of Texas, Austin. Researchers have tested a diagnostic tool called the MasSpec Pen tool for the first time in pancreatic cancer patients during surgery. They’ve shown the device can accurately identify tissues and surgical margins directly in patients and differentiate healthy and cancerous tissue from banked pancreas samples.

At about 15 seconds per analysis, the method is more than 100 times as fast as the current gold standard diagnostic, Frozen Section Analysis. The ability to accurately identify margins between healthy and cancerous tissue in pancreatic cancer surgeries can give patients the greatest chance of survival.

Why it’s important – Although it is very early in development, the technology opens the door for real-time, precision medicine to be performed in the operating room at a level that has never been seen before. It also can potentially shorten the time for completing pancreatic tumor surgery from the current 6 to 12 hours. The researchers plan eventually to submit the design to the US Food and Drug Administration for approval as a medical device.