What happened in health care technology this week – and why it’s important.
OPEN-SOURCE INSULIN: BIOHACKERS AIMING FOR DISTRIBUTED PRODUCTION
An interesting article in Hackaday.com by Dan Maloney reports on efforts by the Open Insulin Foundation to create a community-based option for insulin production to help counter the high cost of insulin. A team of biohackers with a broad geographic footprint, OIF is a non-profit focused on creating community-scale systems that can produce safe, affordable insulin. Over the past six years, their volunteers have been busy building transgenic bacteria, working on culturing processes and equipment, and dealing with the fussy purification steps. They’ve succeeded in seeing the procedure all the way through to the finished product.
Granted, the option they’ve developed is not cheap – about $1Million for a medium-scale system. But, that investment would produce enough insulin for 14,000 people with diabetes, meaning that a functioning, community-level insulin factory could conceivably be funded for about $70 per person. And that factory would produce insulin at around $6 a vial, taking into account everything from raw materials to salaries, rent, and utilities.
Why it’s important – According to the American Action Forum, diabetes cost the United States $327 billion in 2017, becoming the most expensive chronic disease in the nation. Insulin costs, before accounting for any rebates or discounts, comprise an estimated $48 billion (20 percent) of the direct costs of treating diabetes; after rebates, insulin accounts for 6.3 percent of costs.
Since 1991, growth in insulin prices has been accelerating, with a reprieve only in recent years. The list price of insulin per milliliter in the United States increased, on average, 2.9 percent annually from 1991-2001, 9.5 percent per year from 2002 and 2012, 20.7 percent annually between 2012 and 2016, and 1.5 percent per year from 2016-2018.
So, if the OIF’s work can be realized at scale, it could be a real game-changer in making insulin more affordable for patients. Granted, there are huge and potentially insurmountable legal and regulatory hurdles with this plan. It may well be that the insulin industry, with a vested interest in keeping prices high — at least in the United States — shut this group down if they ever get close to realizing their goal. And they’ll undoubtedly have to deal with the Food and Drug Administration if they ever expect actually to use their insulin on humans. On the other hand, the efforts of the Open Insulin Foundation and other biohackers working on alternative sources of insulin might win in the long run. If the last year and a half have taught us nothing else, it’s that extended supply chains need to be looked at with skepticism. OIF’s vision of distributed mini-factories for insulin production seems smarter right now. It will probably only seem like a better idea as time goes on and complex systems become less and less reliable.
These four tech breakthroughs could help people live to 200 years old
Sergey Young authored a piece in Fast Company online this week on how genetic engineering, regenerative medicine, wearables, and AI combine to form a powerful “antidote” to aging. Young is the founder of the $100 million Longevity Vision Fund, and the article is an excerpt from his recent book “The Science and Technology of Growing Young.”
Young contends that “The Longevity Revolution” lives not in the realm of science fiction but in the reality of academic research laboratories and commercial technology R&D centers. The idea of aging as a fixed and immutable quality of life that we have no influence upon is ready to be tossed into the dustbin of history.
Why it’s important – Young is one of many promoting the potential benefits that technology will bring to the process of aging and the potential to extend the human lifespan. Others include Craig Venter and Peter Diamandis. While I believe that technology certainly has a role to play in the development of precision medicine and health care at the “n of 1” (see the image below from one of my 2018 conference presentations), I think something is missing from most longevity conversations.
There are many ethical, social, and personal implications generated by the potential development and use of technologies that may extend human longevity by intervening in aging. Just because we “can” do something doesn’t necessarily mean we “should” do it. Many societal issues need to be addressed if we’re going to march down Young’s longevity revolution path. Doubling life spans won’t solve any of our current social problems. What would that mean for the environment, poverty, notions about marriage, family, and work, as well as attitudes toward the young and the old? We need to think long and hard about “the laws of unintended consequences” when considering the application of technology to the human longevity question.
Zip codes have become a better predictor of health outcomes than genetic codes. Technology may be ready to fix that.
Greg Kefer, Chief Marketing Officer at Lifelink Systems, wrote an article in MedCity News that argues if the goal is to improve access and engage underserved communities where smartphone penetration is more than 80%, the path forward is mobile. At the same time, advanced conversational AI is breaking down complexity barriers and driving better engagement.
With conversational AI, the ability to connect and guide patients through countless, often complex administrative tasks from the comfort of their bedroom removes a key engagement hurdle. The digital assistant can also check in, follow up, recommend, and educate in the language, voice, or personality of the patient’s choosing. And it can all be done from the comfort of a home, or even a bus.
Why it’s important – Greg’s point is spot on. He dispels the myth that underserved communities and patients on Medicaid don’t have access to the technology. He points out that these digital experiences don’t require an army of human teams to execute. The interactions are automated and designed to run at scale across all patient populations. Digital assistants don’t replace vital person-to-person exchanges. They augment human teams by taking care of the redundant, time-consuming, often complex tasks so the care team interactions can focus on what’s important — the patient’s health. We’ve been talking about social determinants of health for years now. But, with only a few exceptions (check out the outstanding work being done at the Parkland Center for Clinical Innovation who have written what is, in my opinion, the definitive playbook: Building Connected Communities of Care: The Playbook For Streamlining Effective Coordination Between Medical And Community-Based Organizations), we’ve not moved the needle on addressing SDoH. The COVID-19 pandemic has resurfaced the critical social disparities in health care delivery in the U.S. and worldwide. It’s time to stop talking about this and get moving.
New Brain Implant Restores Sense of Touch on Fingertips
The publication Interesting Engineering featured a story by Fabienne Lang highlighting work performed by Researchers at The Feinstein Institutes for Medical Research that evoked the sense of touch in fingers using a minimally invasive electrode brain implant. The study, a first-in-human one, offers the potential to change the lives of millions of people around the world. The details were published in the journal Brain Stimulation.
Researchers had previously managed to restore some sensation in the hand through brain-computer interface technology. This new research, however, goes a step further by stimulating harder-to-reach areas in the brain, known as sulcal areas, using electrodes that elicit precise feelings in the fingertips.
Why it’s important – Millions of people live with paralysis and peripheral neuropathy — when nerves in the body’s extremities, such as hands and feet, are damaged — and cannot feel sensations through their fingertips and toes. (Approximately 20 million Americans are suffering from Peripheral Neuropathy (PN). It is estimated that the prevalence of all-cause PN is about 2.4% in the entire adult population, whereas over 8-10% in the population segment over the age of 55 (Martyn & Hughes, 1997)). This breakthrough may lead the way to a future clinical option, the study’s co-principal investigator, Chad Bouton, professor in the Institute of Bioelectronic Medicine at the Feinstein Institutes, believes.
Headspace and Ginger plan merger to form a mental health powerhouse
Ruth Reader reports in Fast Company (registration required) that teletherapy platform Ginger is planning to merge with meditation app Headspace to create Headspace Health in a deal that values the combined company at $3 billion. The two companies see an opportunity to provide a full range of mental health services, from coaching, therapy, and psychiatric care to basic resilience-building techniques like meditation.
Many people sought help with their mental health issues in the first stage of the pandemic. In March of 2020, calls to Crisis Text Line, a text-based crisis hotline, spiked. Between January and September 2020, the number of people who took an online anxiety screening with Mental Health America, a mental-health advocacy nonprofit offering services, increased 93% over the total number of anxiety screens taken in 2019. Depression screenings during the same period grew 62% over total 2019 depression screens. Earlier this year, the American Psychological Association declared that teletherapy is here to stay.
Why it’s important – In the last year, waning mental health has garnered nearly as much attention as COVID-19. It is one of many “pandemics within the pandemic” that public health officials around the world have called out. That has meant boom times for a wave of tech-enabled mental-health companies. VC funding for mental health startups was up 55% between Q1 and Q2, 2021, according to CB Insights. It’s also a highly competitive market with companies like Calm, Lyra Health, and Hims and Hers, all growing rapidly. Demand for mental health services will remain strong long after the pandemic. If this merger is successful, it can provide an integrated platform for building resilience regardless of a person’s situation.
Quantum Sensors Power Brain Imaging System to Help Scientists Investigate Autism
The website The Quantum Daily’s Matt Swayne published an article on an interesting wearable brain imaging system installed at Toronto’s Hospital for Sick Children that uses quantum sensors to conduct research into autism, according to the UK Technology Hub. The brain scanner relies on quantum-enabled sensors to measure magnetic fields above the scalp — or magnetoencephalography (MEG). Researchers at the Toronto hospital scan children who have been identified as having a greater chance of developing autism because they have siblings with the condition.
Why it’s important – The Cerca system is unique because it is the only “wearable” MEG system where patients can move freely during the scan. It can adapt to different head sizes, which makes it particularly useful when scanning children. It also offers considerably higher sensitivity and spatial specificity compared to the current state-of-the-art MEG systems while also being less expensive than conventional systems.
Apple, Bose and Others Pump Up the Volume on Hearing Aid Options, Filling Void Left by FDA
Kaiser Health News’ Phil Galewitz posted an article on how companies like Bose and Apple are meeting the needs of consumers with hearing loss. Consumers’ options have expanded with more hearing devices entering the market, alternative ways to get them, and lower prices, particularly for the largest segment of the population with impaired hearing — those with mild to moderate hearing loss, for whom the law was intended.
Leading consumer brands Apple and Bose are offering products, and several smaller companies sell aids directly to consumers, providing hearing tests and customer service online from audiologists and other hearing specialists. Even major retailers offer hearing aids directly to consumers and offer audiology services online: Walgreens stores in five Southern and Western states sell what the chain calls “FDA-registered” Lexie hearing aids for $799 a pair — far less than half the price of typical devices.
“In a sense, you can say the OTC revolution is happening without the FDA, but the difficulty is it is happening more slowly than if the FDA issued its rules on time.”
Nancy Williams, President, Auditory Insight
Why it’s important – More than 37 million American adults have trouble hearing, including nearly half of the people over age 60. Only 1 in 4 adults who could benefit from a hearing aid have ever used one, federal health officials estimate. Having a lower cost option may prompt more people with mild to moderate hearing loss to start with that, but later, if their hearing worsens, shift to more expensive devices that require assistance from hearing aid professionals. There’s more than enough business for everyone.