What happened in health care technology this week, and why it’s important.
Short term memory problems can be improved with laser therapy, according to new study
UK and Chinese scientists demonstrated that a non-invasive laser light therapy lasting only a few minutes could improve short-term memory in people by up to 25%. The treatment, called transcranial photobiomodulation (tPBM), is applied to an area of the brain known as the right prefrontal cortex. This area is widely recognized as essential for working memory. They also tracked changes in brain activity using electroencephalogram (EEG) monitoring during treatment and testing.
“People with conditions like ADHD (attention deficit hyperactivity disorder) or other attention-related conditions could benefit from this type of treatment, which is safe, simple and non-invasive, with no side-effects.”
Dongwei Li, visiting Ph.D. student in the University of Birmingham’s Center for Human Brain Health
Why it’s important – They don’t yet understand why the treatment positively affects working memory or how long the results will last. Further research is planned to investigate these aspects. This is the first study, however, to confirm a link between tPBM and working memory in humans.
Infographics of the week – All five of the infographics this week come from the folks at CB Insights. I’ve highlighted their platform before and have been consistently impressed by the quality of their research. This compendium of strategy maps was released this week and is available for download here. Their 67-page coffee table book of strategy maps shines a light on the strategies behind some of the world’s most influential companies — from Amazon and PayPal to Tesla and CVS Health. I’ve included the big tech in healthcare maps below. You can find the maps for CVS and Walgreens in the document.
A Proactive Way to Detect Cancer at Its Earliest Stages
Wired’s Grace Browne reports that Medtech firm Earli is working on a way to make tumors announce themselves as they appear—and even provide directions to where they are in the body. German-American entrepreneur Cyriac Roeding read a profile of Sam Gambhir, a physician, and scientist at Stanford University School of Medicine, in a magazine. Roeding, the co-founder and former CEO of the mobile shopping app Shopkick, was struck by Gambhir’s story and immediately sent him an email asking to meet. Earli’s approach essentially forces the cancer to reveal itself. Bioengineered DNA is injected into the body; when it enters cancer cells, it causes them to produce a synthetic biomarker not generally found in humans—something like limonene, a chemical found in the peel of citrus fruits. If subsequent breath or blood tests find traces of that biomarker, it could be a sign of cancer. The next step is figuring out where the cancer is in the body. An injected compound forces the cancer cells to produce an enzyme that gobbles up a radioactive tracer, rendering it visible to the naked eye in a scan. Localizing cancer makes it treatable—clinicians can use precision radiation or targeted surgery to then take it out.
“What if we stopped searching for cancer altogether; what if we didn’t look anymore? What if, instead, we forced the cancer to reveal itself?’”
Sam Gambhir, MD, Stanford University School of Medicine
Why it’s important – The plan is for Earli to be used at every stage of cancer prevention and treatment: for diagnostic monitoring in high-risk groups like smokers; for pretreatment, to find out if there is cancer anywhere else in the body; during treatment, to make tumors easier for surgeons to locate; and post-treatment, to detect earlier any recurring cancer. If the trials are successful, this could be a game changer in cancer care and a fitting legacy for Dr. Gambhir, who devoted his career to early cancer detection, only to lose his teenage son Milan to a highly aggressive brain tumor in 2015 and succumbed himself to the disease in 2020.
Digital Tech Holds Great Promise for Expanding Patient Access According To A New Report
Among all of the challenges healthcare providers will face in 2023, digital health tools could have the greatest potential to improve patient access, according to the issues most Top of Mind for Top Health Systems 2023 from UPMC. The Center for Connected Medicine, Nokia, and KLAS Research. The challenge of improving patient access is once again the primary focus of this report, given its importance in many health systems and its potential impact on so many other priorities. If you can’t get patients in the door, does it matter what you do with other technology? Patient access remains top of mind for leaders because the challenge is complex, and health systems continue to grapple with the long-term impacts of the COVID-19 pandemic. There is economic uncertainty, patients who remain wary about returning for care, and greater demand from consumers for more convenient care options.
From the patient-demand point of view, we can see a gap between what best serves the patient and what is currently the most effective tool. Patient portals appear to have the best match between serving patient needs and being effective. Telehealth appears to “over-perform” based on this small sample of perceptions among healthcare leaders, while scheduling may be under-delivering in terms of effectiveness.
Why it’s important – While a relatively small study sample, this study gives us important food for thought in terms of direction and information for planning digital health investments among health systems over the coming year. Looking ahead into 2023, it would seem that health systems are chipping away and making incremental progress. At least by prioritizing patient access and acknowledging the demands of consumers, health systems are heading in the right direction, however slowly it may seem.
UMass Memorial Health proves RPM virtual sitting is as effective as in-person care
Bill Siwicki of Healthcare IT News reports that remote patient monitoring has allowed the health system to maintain patient safety while reducing labor-pool costs. For years, UMass Memorial Health has leveraged technology to augment in-person care at the bedside. Launched in 2006, its tele-ICU program remotely monitors more than 150 adult critical care beds across Central Massachusetts. The system partnered with Caregility and its iObserver platform, which allows a remote care team to monitor up to 12 patients per screen, with two-way audio/video support, night vision, and rapid-response bedside alerts.
“Remote monitoring has proven to be an effective strategy for augmenting care at the bedside or in the home. Likewise, a virtual sitter program can enhance quality care while at the same time reduce staffing demands and labor costs. For years our challenge was in finding a solution that could meet the needs of the day – but scale for the future – at a price we could justify.”
David Smith, Associate Vice President, Virtual Medicine, UMass Memorial Health
Why it’s important – Staff initially started with a three-to-one patient ratio and gradually increased to six-to-one, ultimately with an additional six patients monitored as a backup for another virtual sitter. In the first year of operation, the remote team logged more than 100,000 interventions through the iObserver system. This included direct patient engagement through audio or two-way audio/video interaction and alerting the bedside team to potential adverse events such as getting out of bed, tugging at lines, and agitation. This let staff maintain patient safety while at the same time reducing labor-pool costs.
ChroniSense Medical receives FDA 510(k) for RPM wearable
In another story on remote patient monitoring, MobiHealthNews’ Jessica Hagen reported that Israeli company ChroniSense Medical received FDA 510(k) clearance for its Polso wearable that collects and shares vital signs with a mobile app for patients and a cloud-based platform for clinicians. The wrist-worn wearable enables clinicians to monitor patient’s vitals, including blood oxygen saturation (SpO2), pulse rate, and respiration rate. The company touts the watch as ideal for remote patient monitoring and use in decentralized clinical trials.
Why it’s important – With six out of 10 adults in the U.S. living with a chronic condition, and over $1.1 trillion in direct healthcare costs annually, there is a serious need for an easy-to-use, medical grade, remote patient monitoring solution. Adding Polso to the list of available solutions allows researchers to compare multiple options and measure which devices provide the most value to caregivers and patients.
The Era of One-Shot, Multimillion-Dollar Genetic Cures Is Here
Gene therapies promise long-term relief from intractable diseases—if insurers agree to pay. Emily Mullen in Wired Science online reports on Hemgenix, which gained US approval from the Food and Drug Administration on November 22 to treat patients with severe hemophilia B. The big issue is paying for the drug. Shortly after its approval, CSL Behring, the pharmaceutical company commercializing the drug, announced its price: $3.5 million for a one-time dose. It’s now the most expensive drug in the world. As part of a research study, Pipe’s trial participants didn’t have to pay for the therapy. But future patients and their insurers will. And Hemgenix isn’t the only gene therapy with a sky-high price. Luxturna, the first such treatment approved to fix an inherited trait—a rare form of vision loss—debuted in 2018 at $425,000 per eye. The therapy is meant to restore eyesight in people with a specific genetic mutation that causes the retina to degrade over time.
In 2019, pharma company Novartis won FDA approval for its gene therapy Zolgensma, which is meant to treat children under age 2 with spinal muscular atrophy, or SMA, a leading genetic cause of infant mortality. Novartis subsequently priced the therapy at $2.1 million, making it the most expensive drug on the market at the time. But earlier this year, newly approved gene therapy Zynteglo grabbed the title at $2.8 million. The drug is for patients with a blood disorder called beta thalassemia who require regular blood transfusions.
Why it’s important – The companies behind these therapies have justified their high prices, saying they provide immense benefits and are more cost-effective than current treatments since they are given just once. But Michael Gusmano, professor of health policy at Lehigh University and a research scholar at the Hastings Center, an independent bioethics research institute in Garrison, New York, says the price of Hemgenix and other gene therapies shouldn’t be considered a bargain.
“It assumes that the price of current treatments are appropriate. We have a system in which prices are completely out of line internationally.”
Michael Gusmano, Professor of Health Policy, Lehigh University
While most patients never pay the total cost of drugs out of pocket, uninsured people and those with high-deductive plans may have trouble accessing these therapies.
A new coalition aims to close AI’s credibility gap in medicine with testing and oversight
Most of the AI models described in journals — and lionized in press releases — never make it into clinical use. And the rare exceptions have fallen well short of their revolutionary expectations. Casey Ross from Stat reports that a group of academic hospitals, government agencies, and private companies unveiled a plan to change that. The group, billing itself as the Coalition for Health AI, called for the creation of independent testing bodies and a national registry of clinical algorithms to allow physicians and patients to assess their suitability and performance and root out bias that so often skews their results.
“We don’t have the tools today to understand whether machine learning algorithms and these new technologies being deployed are good or bad for patients.”
John Halamka, President, Mayo Clinic Platform
Why it’s important – As it stands today, there are few guideposts hospitals can use to help test algorithms or understand how well they will work on their patients. Health systems have been left on their own to sort through the complicated legal and ethical questions AI systems pose and determine how to implement and monitor them. The hardest part of the work remains to be done. The coalition must build consensus around ways to measure an AI tool’s usability, reliability, safety, and fairness. It will also need to establish the testing laboratories and registry, determine which parties will host and maintain them, and convince AI developers to cooperate with new oversight and added transparency that may conflict with their business interests.
FDA outlines benefits and risks of emerging augmented and virtual reality medical devices
In the document, the FDA outlines how AR/VR affects medical devices, explaining how the technology can deliver certain clinical services, including some typically confined to hospitals and clinics, to patients in their homes. The FDA’s non-exhaustive list of medical devices incorporating the technology features 39 products across therapeutic areas, including orthopedics, ophthalmics, radiology, neurology, and cardiovascular.
Why it’s important – The FDA has now set out its thinking on the emerging class of products. The document provides definitions of AR and VR and then digs into how the technology impacts medical devices. The FDA sees value in the ability of AR/VR to move care to patients’ homes and other non-clinical settings. This could enable patients, including the socioeconomically vulnerable and underserved communities, the elderly or disabled, to access needed health care services when accessing them in person would otherwise be difficult, and this could make it easier, and more likely, for patients to complete treatment and monitoring regimens.
Camera Measures Blood Pressure with Quick Look
Finally, MedGadget’s Conn Hastings reports that University of South Australia researchers have designed a system that allows them to measure a patient’s blood pressure with a camera. The camera visualizes the patient’s forehead and focuses on two regions in particular to optically determine photoplethysmographic signals that AI algorithms then convert to blood pressure data.
Why it’s important – Blood pressure is an essential health indicator, but our method of measuring it can be a little cumbersome. The system could provide contact-free measurements in as little as ten seconds. It could be very useful for large health screens or in situations where minimal contact is preferred for safety, such as during a pandemic. This latest technology has been tested on 25 volunteers with different skin tones and in different ambient light conditions. The researchers compared the readings with those obtained using a commercial sphygmomanometer. They found that the contact-free camera-based technology was approximately 90% accurate, suggesting that it has significant promise as a diagnostic technology.
Love the Strategy maps
Thanks for reading!