What happened in health care technology this week, and why it’s important.
A micro-thin smart bandage can quickly heal and monitor wounds
First up this week is this story by Andrew Paul in Popular Science online. Researchers at Stanford University have designed a smart bandage capable of monitoring wounds’ healing in real-time, accelerating tissue growth and blood flow around them while reducing scar severity. First described through findings published in Nature Biotechnology, the team’s new material is only 100 microns thick (equivalent to a single layer of latex paint) yet contains a radio antenna, electrical stimulator, biosensors, and other components resting atop a skin-like polymer known as a hydrogel. Once adhered atop a patient’s injury, the smart bandage monitors temperature and other biometric readings and then transmits that data to a smartphone program. If the wound is healing too slowly or if an infection is detected, the device emits small electrical stimulations across the site to boost tissue growth and reduce inflammation.
Why it’s important – Millions of people dealing with diseases and suppressed immune systems are often forced to deal with chronic wounds—usually minor injuries that take much longer to heal because of compromised health. In addition to vastly varying degrees of recovery, issues like diabetic ulcers are also costly, with treatment for a single incident costing as much as $50,000. Overall, chronic injuries cost Americans $25 billion a year.
Infographic of the week – This infographic from Dr. Tazeen Rizvi’s LinkedIn timeline shows that digital transformation must begin with understanding the patient’s need and health journey in its entirety, starting with the ailments that brought them to the hospital, along with their lifestyle, habits, social, environmental, and financial factors affecting their wellbeing. Healthcare organizations and leaders must focus on building patient-centric systems to facilitate preventive care.
Podcast of the week – My favorite listen this week was “The Doctor Can’t See You Now” from In the Bubble with Andy Slavitt. Americans are having a hard time getting in to see a doctor, and burnout among healthcare workers is a leading reason why. The stressors of the Covid-19 pandemic exacerbated a burnout crisis among physicians and nurses. But even before the pandemic, burnout was already a rampant problem for physicians and other health workers. Dr. Bob Wachter sits in for Andy and talks with AMA vice president and burnout expert Christine Sinsky about the root causes of burnout and what it will mean for all of us.
Continuous glucose monitor startups still have to prove their worth
Nicole Wetsman in the Verge reports that over the past few years, companies like Levels, January, and Nutrisense started selling programs that promise to help people start managing their blood sugar levels. They sell devices called continuous glucose monitors: small sensors that embed a tiny needle in someone’s body to track how their blood sugar (glucose) levels rise and fall. These companies say that people without diabetes should also track their blood sugar levels. These applications are new, and there still isn’t clear evidence that wearing a CGM can help people lose weight or fix metabolic problems. Many experts on obesity and metabolic disorders (like diabetes) aren’t convinced we know enough yet to recommend them.
“In terms of overall health, if you’re keeping your blood sugar at 110, I’m not sure you’re going to be affecting long-term outcomes or healthcare costs or quality of health.”
Nicole Ehrhardt, Endocrinologist, University of Washington
Why it’s important – There’s still a lot researchers don’t know about what blood sugar levels, ranges, and responses look like, particularly after eating. People without diabetes can have a wide range of blood sugar responses to the same foods. Some people have large swings in glucose levels, while others stay more steady. Tech companies like Apple and Fitbit are interested in blood sugar, and groups are looking to develop noninvasive ways to measure glucose — which could allow them to be part of smartwatches or other wearable devices. It’s crucial, then, to scrutinize groups marketing glucose monitors to everyone to figure out what that type of information can do for people. If studies show benefits, making changes to keep glucose levels steady using a continuous glucose monitor is problematic. People at risk for diabetes or who have Type 2 diabetes and who use continuous glucose monitors tend only to see minor improvements in their glucose levels. It’s still early days which even people promoting the devices recognize.
Smartwatch ECG Transforms Into a Heart Failure Diagnostic Tool
A study published in Nature Medicine reports the ability of a smartwatch ECG to detect heart failure in nonclinical environments accurately. Researchers at Mayo Clinic applied artificial intelligence (AI) to Apple Watch ECG recordings to identify patients with a weak heart pump. Participants in the study recorded their smartwatch ECGs remotely whenever they wanted, from wherever they were. Periodically, they uploaded the ECGs to their electronic health records automatically and securely via a smartphone app developed by Mayo Clinic’s Center for Digital Health. Mayo researchers interpreted Apple Watch single-lead ECGs by modifying an earlier algorithm developed for 12-lead ECGs that are proven to detect a weak heart pump. The 12-lead algorithm for low ventricular ejection fraction is licensed to Anumana Inc., an AI-driven health technology company, co-created by nference and Mayo Clinic.
Why it’s important – The ability to diagnose a weak heart pump remotely, from an ECG that a person records using a consumer device, such as a smartwatch, allows timely identification of this potentially life-threatening disease at a massive scale. While the data are early, the modified AI algorithm using single-lead ECG data had an area under the curve of 0.88 to detect a weak heart pump. By comparison, this measure of accuracy is as good as or slightly better than a medical treadmill diagnostic test.
‘Virtual wards’ run via smartphone app could see more patients treated at home – and more free hospital beds
From Ashish Joshi at Sky News in the UK comes this story reporting that the NHS has created virtual wards, run via a smartphone app, as part of its plan to tackle winter pressures and hopes it will make 25,000 beds available by the end of next year. Doccla’s ‘virtual ward’ system allows patients at home to monitor and report basic issues. The virtual wards are monitored in control centers that look just like ordinary offices. Clusters of desks with staff on telephones, all are staring at their computer screens. The one in Stevenage monitors up to 90 patients at home at any time.
Why it’s important – As many as one in three UK patients in some hospitals are medically fit to be discharged, but cannot be because of a lack of adequate social care. The delayed discharge puts enormous pressure on emergency departments and ambulances. Hospitals using this technology are seeing benefits.
“We work with over 20 hospitals, and we’ve found you can reduce the chances of an emergency admission by around a third, which is really important for hospitals who are under a huge amount of pressure right now, particularly going into winter.”
Greg Edwards, MD., Chief Medical Officer, Doccla
The virtual wards pose their own workforce challenges, and on their own, they will not solve all the problems facing the health service. For the patients they serve, however, the ward might be virtual – but its impact is real.
Activity Tracker Data Can Shed Light On Heart Health
Maura Kinney posted this article on Futurity online, highlighting new research that shows that data gathered from wearable activity trackers can be used to obtain several metrics associated with the user’s general physical health and cardiovascular health status. The Cleveland Clinic provided the research team with activity tracker-obtained data for 22 individuals with PAH who wore activity trackers between two clinic visits. At both clinic visits, Cleveland Clinic medical professionals recorded 26 health measurements of each participant, including health-related quality of life, heart rate measurements, and results from the commonly used aerobic capacity and endurance test known as the six-minute walk distance (6MWD) test.
“Finding so many statistically significant differences in a relatively small cohort suggests to us that activity-tracker data may make it possible to identify surrogate markers of disease severity that can be monitored remotely. We also believe that activity tracker-measured health parameters could serve as proxies for clinically measured health parameters of patients with chronic disease.”
Peter Searson, Professor, Johns Hopkins University Whiting School of Engineering
Why it’s important – While these sensors are generally marketed as daily step counters, the researchers believe they could potentially serve a greater purpose: supporting clinical care for patients with pulmonary arterial hypertension (PAH) and other chronic diseases.
The biggest security risks of using fitness trackers and apps to monitor your health
Another fitness tracker article focuses on the security issues in using the devices. Cheryl Munk posted this article on CNBC’s site. While these devices are growing in popularity — and have legitimate uses — consumers don’t always understand how their information could be available to or intercepted by third parties. This is especially important because people can’t simply change their DNA sequencing or heart rhythms as they could a credit card or bank account number.
Why it’s important – The information that fitness trackers collect isn’t considered “health information” under the federal HIPAA standard or state laws like California’s Confidentiality of Medical Information Act. This means personally revealing data can potentially be used in ways a consumer might never expect. For instance, personal information could be shared with or sold to third parties such as data brokers or law enforcement. Here are the recommendations from the article to protect yourself:
- Stick to a name brand, even though they can be hacked too.
- A fitness tracker’s default settings may not offer the most stringent security controls. To boost protection, look at what settings can be adjusted, such as those related to social networking, location, and other shareable information.
- Be sure to secure your account by using a strong password that you don’t use with another account and enabling two-factor authentication for the associated app. And don’t share credentials.
- Be sure to keep the device and the app up-to-date with security fixes.
Mark Cuban in talks with hospitals to solve drug shortages
Molly Gamble in Becker’s Hospital Review reports that Mark Cuban is in talks with hospitals to identify generic drugs that often run in short supply, which he aims to make in a robotics-driven manufacturing plant currently in development in Dallas. Mr. Cuban appeared on the Motley Fool podcast on Nov. 23 with host Chris Hill to talk about disrupting healthcare, which Cost Plus Drugs has managed to do since its establishment in May 2020. The company’s portfolio now has nearly 1,000 generics, which are sold with a 15 percent markup for the price, a $3 pharmacy fee to pay the pharmacists it works with, and a $5 fee for shipping. Generic Crestor, a cholesterol-lowering med, costs $151 a month at the local CVS, a steep discount from the brand-name pill, which runs $329. Cuban sells it for $4.80. Ditto Glucophage, a diabetes drug. The generic sells for $20 at CVS, versus $3.90 at Cost Plus. Or there’s the generic version of antidepressant Zoloft, which is $50 at CVS but $4.20 at Cost Plus. Walmart and Costco are experimenting with similar models.
“I don’t think they’re paying attention to us yet. They know we exist. We’ve heard them say things to politicians and heard them say things to others. But it’s going to be very difficult — as these huge public companies — to adapt as quickly as we can.”
Mark Cuban
Why it’s important – Don’t underestimate what Cuban is doing here. His Cost Plus Drugs has received little to no reaction from pharmacy’s legacy players. Robotics in the plant will allow Mark Cuban Cost Plus Drugs to be agile in manufacturing simple drugs “that are supposed to be regularly available” and turn around numerous injectables in a day to boost hospitals’ supply. But, for all its benefits, Cost Plus has some major limitations. The company doesn’t accept insurance. Nor does it currently sell drugs that are still protected by patents, which include blockbusters like Humira (arthritis) and Trulicity (diabetes).