What happened in health care technology this week, and why it’s important.
Bicycle Health partners with Tele911 to offer opioid use treatment
First up this week is Emily Olsen’s article in MobiHealthNews on Bicycle Health, which offers virtual opioid use disorder treatment, and is partnering with emergency telehealth provider Tele911 to connect patients to continuing care after an overdose or health crisis. Tele911 works with paramedics to determine if patients need to be transported to a hospital emergency room or if they can be treated at home or another care site. Under the partnership, those who experienced an overdose or have symptoms of opioid use disorder will be evaluated by Tele911 emergency physicians, and a social worker can refer them to Bicycle Health.
Why it’s important – A recent study published in the International Journal of Drug Policy found that most opioid use disorder patients don’t receive medication-assisted treatment. According to the 2019 National Survey on Drug Use and Health, just over 10% of people 12 and older with a substance use disorder received any treatment in the past year. Other companies offering telehealth care for substance use disorder include Boulder Care, which recently scooped up $36 million; Ophelia, which announced two fundraising rounds in 2021; and Quit Genius, which partnered with B2B insurance company Evry Health earlier this year.
Infographics of the week – This graphic from an open access article on Nature Digital Medicine presents a comprehensive Framework for Digital Health Equity, detailing key digital determinants of health (DDoH) to support the work of digital health tool creators in the industry, health systems operations, and academia. The rapid digitization of healthcare may widen health disparities if solutions are not developed with these determinants in mind.
This week’s second infographic comes from the New England Journal of Medicine’s Catalyst publication Digital Technology’s Promise for Better Health Care Delivery: How emerging technologies will drive the transformation. It shows that health care organizations, 70%, use technology such as screening apps, mindfulness and meditation apps, and chat-based psychotherapy for mental and behavioral health, according to our survey. More than half of Council members, 62%, say their organizations use digital tools to care for dementia patients. Nearly half of the organizations, 47%, use or plan to adopt digital chronic disease management technologies within the next two years for remote patient monitoring and data analytics tools.
An ‘EpiPen’ bracelet? Assuta Ashdod develops concept to save lives
Judy Siegel-Itzkovich published this article in The Jerusalem Post about a pediatric nurse at Samson Assuta Ashdod University Hospital who has developed the concept for the first-ever compact epinephrine injection device (often referred to by the proper name “EpiPen”) that can be worn on a child’s wrist like a bracelet. The device, which would be comfortable to carry, water resistant, and have a 16-millimeters long needle, could help save the lives of children and adults with food, drug, and other allergies. Sberro-Cohen said she has already met with engineers and knows that creating her epinephrine injection device is possible. Now, she is just looking for an investor to help make it happen. She said it would take five to seven years from the time the device was made until it received full Food and Drug Administration approval as a medical device.
Why it’s important – In the US alone, there are 32 million people who have such allergies, and 200,000 are rushed to emergency medicine departments for urgent treatment to prevent or treat anaphylactic shock. As Sberro-Cohen noted, hospitalization results from the person forgetting to carry an epinephrine injection device containing epinephrine, which is an essential first treatment for such allergic reactions. While this is still in early-stage development, the benefits of such a device are considerable.
NHS trust dramatically reduces acute kidney injury, with help from AI
A condition linked to thousands of UK deaths has been significantly reduced by healthcare professionals at County Durham and Darlington NHS Foundation Trust, with the help of a new care model supported by specialist nurses and developed in partnership with NHS technology provider C2-Ai. This article appeared in Health Tech Digital online. Created to help identify and promptly treat patients in hospitals at risk from acute kidney injury, the project has led to a reduction in hospital-acquired AKI of more than 80%. It also enables a range of other patient safety improvements in and beyond the hospital. It combines risk stratification digital tools developed by C2-Ai, accessed by staff through an app, with care processes developed at the trust involving a new specialist nursing team, preventive specialist intervention, assessment, and follow-up.
“There has been a big policy emphasis on the importance of data in saving lives in the NHS in recent months. This project is a prime example of how using technology to give healthcare professionals near real-time and quantifiable risk information, combined with a culture focussed on learning and driving forward clinical best practice, can make a big difference to patient safety and ease pressure on busy NHS hospitals.”
Mark Ratnarajah, M.D., Pediatrician and UK managing director at C2-Ai
Why it’s important – The partnership has resulted in patients being detected earlier – preventing AKI from occurring or mitigating the worsening of existing AKI. Accordingly, patients have been more effectively triaged to the correct care pathways, including referral and transfer to tertiary renal units where appropriate. In addition to its impact on patient care, the project has delivered significant financial gains. The trust has saved more than £2 million in direct costs from reductions in AKI incidence. Additional savings at the commissioner level have also been achieved through avoidance of renal replacement therapy, while improved transfers of patients have released ICU capacity to support other elective surgery activities at a time when hospitals across the country are dealing with a growing national backlog.
Why aren’t digital pills taking off?
Manasi Vaidya’s article on Pharmaceutical Technology online on why digital pills have not exploded in pharma. Privacy and logistical concerns, especially while studying such applications for vulnerable populations, have lingered. When dealing with vulnerable people, it is essential to make sure patients are aware of what the sensors in digital pills intend to do, that there is no penalty if they forget a medication, and that they are meant to be helpful and not a hindrance. Despite these concerns, the development of digital pills and sensors continues to evolve. For example, the digital health company etectRx (pronounced as e-tect-are-ex) works with investigators who can use such real-time data. The company’s FDA-cleared ID-Cap system involves an ingestible capsule plus a device worn around the neck with a lanyard. An app relays messages from the device to a secure cloud-based server.
“The issue here is we haven’t created a compelling case from an economic, payer, and user space, all at the same time, in such a way that everybody can win.”
Eric Buffkin, CEO, etectRx
Why it’s important – Digital pills offer the chance to monitor and improve medication adherence. High adherence is critical in HIV to get the viral load to undetectable levels and to protect people from getting AIDS. Hepatitis C treatments cost several thousand dollars, and digital pills can help us understand if a lack of a response is because the patient hasn’t taken their pills or if it’s something else. The biggest obstacle to the widespread adoption of digital pills has been payment. Payers have to see the health and economic benefit to buy in. There have been some recent steps in that direction. In its 2022 Physician Fee Schedule, CMS included five codes that can be used to seek reimbursement for remote therapeutic monitoring and included therapy adherence, respiratory system status, and musculoskeletal system status as examples. This presents a straightforward therapy monitoring reimbursement system in those areas.
Tough Gel Adhesives for Wound Healing
From the Wyss Institute comes this article highlighting work by researchers who have developed a new super-strong hydrogel adhesive inspired by the glue secreted by a common slug that is biocompatible, flexible, and can stick to dynamically moving tissues even in the presence of blood. The hydrogel itself is a hybrid of two different types of polymers: a seaweed extract called alginate that is used to thicken food, and polyacrylamide, which is the primary material in soft contact lenses. When these relatively weak polymers become entangled with each other, they create a molecular network that demonstrates unprecedented toughness and resilience for hydrogel materials – on par with the body’s natural cartilage. When combined with an adhesive layer containing positively-charged polymer molecules (chitosan), the resulting hybrid material can bind to tissues stronger than any other available adhesive, stretch up to 20 times its initial length, and attach to wet tissue surfaces undergoing dynamic movement (e.g., a beating heart).
Why it’s important – The hydrogel adhesive has numerous potential applications in the medical field, either as a patch that can be cut to desired sizes and applied to many tissues, including bone, cartilage, tendon, or pleura, or as an injectable solution for deeper injuries. It can also be used to attach medical devices to their target structures, such as an actuator to support heart function. While the current iteration is designed to be a permanent structure, it could be made to biodegrade over time as the body heals from an injury.
The Unintended Consequences of OTC Hearing Aids
Over-the-counter hearing aids will be available by October. They’ll benefit many but could lead to stigmatization, inadequate testing, and even hearing loss. This opinion article in Wired by Jaipreet Virdii highlights some of the potential issues associated with the decision by the FDA that over-the-counter (OTC) hearing aids can be sold without a prescription to people with mild-to-moderate hearing loss. OTC hearing aids will be available as soon as October. The author contends that while this new business model means manufacturers can sell directly to consumers, it may have unintended consequences for him or other deaf people who have more than moderate hearing loss. One issue is that without individualized fitting, consumers may experience frustration with their hearing devices, if not further deterioration of hearing loss—an issue that OTC hearing aids will likely exacerbate, as they will have preset or limited settings. The most pressing concern is how OTC hearing aids are marketed. Advertisements and press releases emphasize that untreated hearing loss can be serious: In addition to physiological stresses, it is often associated with dementia, depression, and social isolation. These campaigns primarily target older adults on a fixed income, thus reinforcing stereotypical associations of hearing loss with aging.
Moreover, advertisements for these OTC hearing aids indicate that they will be “invisible” and therefore able to reduce the stigma or embarrassment of deafness. Such marketing strategies push deafened people into a binary: Either they’re “hearing passing,” or they’re part of Deaf culture and communicate predominately with sign language. Both groups, however, are expected to accept medical and technological options for “cures.”
Why it’s important – According to the National Institute on Deafness and Other Communication Disorders, approximately 13 percent of the American population—30 million—aged 12 years or older have hearing loss as determined by standard hearing tests. About 28.8 million US adults could benefit from wearing hearing aids, but for reasons of cost, accessibility, stigma, and preference, they choose not to. Once OTC hearing aids hit the market, they will offer consumers cheaper, accessible, and technologically sophisticated options for improving hearing. It’s important to understand that while OTC hearing aids will undoubtedly transform the consumer market, they are not a one-size-fits-all solution, nor will they replace the intricate services provided by professional audiologists and hearing instrument specialists.
Engineers fabricate a chip-free, wireless electronic “skin”
Jennifer Chu from the MIT Technology Office posted this article online reporting that MIT engineers have devised a new kind of wearable sensor that communicates wirelessly without requiring onboard chips or batteries. Their design, detailed today in Science, opens a path toward chip-free wireless sensors. The team’s sensor design is a form of electronic skin, or “e-skin” — a flexible, semiconducting film that conforms to the skin like electronic Scotch tape. The heart of the sensor is an ultrathin, high-quality film of gallium nitride. This material is known for its piezoelectric properties. It can produce an electrical signal in response to mechanical strain and mechanically vibrate in response to an electrical impulse.
“You could put it on your body like a bandage, and paired with a wireless reader on your cellphone, you could wirelessly monitor your pulse, sweat, and other biological signals.”
Jeehwan Kim, Associate Professor, mechanical engineering and of materials science and engineering, Research Laboratory of Electronics.
Why it’s important – Most wireless sensors today communicate via embedded Bluetooth chips powered by small batteries. But these conventional chips and power sources will likely be too bulky for next-generation sensors, which take on smaller, thinner, more flexible forms. The researchers see their results as the first step toward chip-free wireless sensors. They envision the current device being paired with other selective membranes to monitor other vital biomarkers.
DIY Blood Draw – Could Patients Collect Blood At Home?
Finally, here’s an article from Dr. Bertalan Mesko and his team at The Medical Futurist Institute discussing that blood draws are essential, but this doesn’t make them anyone’s favorite pastime: they are time-consuming and involve needles. They ask: Is there a way to make it in a do-it-yourself (DIY) fashion? Can we collect blood samples at home? This is an excellent review of the current state of research and clinical applications.
Why it’s important – DTC tests have one thing in common: the results arrive directly to the customer, who can decide if and with whom they are willing to share them. But, it’s important to understand that having a DIY blood collecting machine will not create a brave new world, but – if nothing else – they could vastly improve participation in clinical trials.