What happened in health care technology this week, and why it’s important.
New Technology Visualizes Radiation Therapy Dose in Real Time
First up this week is this article in Aunt Minnie that was recommended by my friend and colleague Christopher Farr. U.S. researchers say they have developed a new 3D imaging prototype for visualizing real-time radiation dose in patients undergoing radiation therapy. They published the results of their study on January 2 in Nature Biotechnology. The prototype is based on ionizing radiation acoustic imaging (iRAI), a noninvasive imaging technology that reconstructs radiation doses using acoustic waves. These waves stem from the absorption of pulsed x-ray beams in soft tissue. In testing, the system provided real-time 3D visualization of the radiation dose delivered to a patient with liver metastases.
“In future applications, this technology can be used to personalize and adapt each radiation treatment to assure normal tissues are kept to a safe dose and that the tumor receives the dose intended.”
Kyle Cuneo, ME, Radiation Oncologist, University of Michigan, ‘Ann Arbor
Why it’s important – Successful radiation therapy in cancer patients is contingent on delivering sufficient radiation doses to tumors while sparing surrounding normal tissues. Maximizing tumor control while minimizing toxicity requires that the planned radiation dose is delivered accurately. This development could be game–changing. To quote Chris:
“If they can turn this idea into a product, they have opened up the holy grail of rad therapy. Individual treatment that can be customized and verified on the fly. Other folks have tried to do it for proton therapy using PET, but this method works for x-ray and uses ultrasound so should be much cheaper and applies to far more treatments (linacs generate high energy x-ray). This is potentially Nobel prize important.”
Christopher J Farr, Personal Correspondence
Array Behavioral Care announces $25M funding round led by CVS Health
CVS Health joins Array’s earlier investors in supporting the company, including Wells Fargo Strategic Capital, Harbour Point Capital, Health Velocity Capital, OSF Healthcare, HLM Venture Partners, and OCA Ventures. Jessica Hagen reports on this development in her article in MobiHealthNews. The funding will help Array scale its virtual behavioral therapy platform, which the company says CVS Health will allow it to do faster.
Why it’s important – Mental healthcare continues to make up a significant portion of telehealth visits. A 2022 analysis by the Kaiser Family Foundation of 126 million patients revealed 39% of telehealth outpatient visits were for a mental health or substance use diagnosis. The article lists other providers in the mental telehealth space, which has grown as demand for services has increased during the pandemic.
Infographics of the week – This graphic, initially created by the World Health Organization, and reprinted with permission in an excellent report Enhancing Equitable Access to Assistive Technologies in Canada, from McMaster University, outlines key issues in the development of assistive technologies. Assistive technologies are becoming increasingly important as the older adult population increases and the prevalence of disability rises. However, more focus must be given to lowering the barriers to adoption to make it more affordable, accessible, and inclusive.
The second infographic this week comes from Dr. Tazeen Rizvi. I am very impressed with the quality of his work and the topics he chooses to cover. This graphic on AI Challenges reviews the common issues related to AI and machine learning which include values and biases reflected in data, potential bias across the development and deployment process, transferability, legal, moral and professional responsibility, and, critically, patient/end-user experience and outcomes.
Researchers crawled search engines and searched the dark web to find out the true extent of healthcare ransomware attacks
Fierce Healthcare’s Annie Burky reports that researchers from the University of Minnesota and the University of Florida measured attacks on healthcare delivery organizations from 2016 to 2021, publishing their findings in the December issue of the JAMA Health Forum. During the study period, 374 attacks were identified as exposing the personal health information (PHI) of 41,987,751 individuals—more than 10% of the U.S. population. According to the study, annual attacks doubled from 43 to 91, while PHI exposure increased more than 11-fold, from approximately 1.3 million in 2016 to more than 16.5 million in 2021. In these attacks, about half of healthcare organizations could restore backups. While findings show that only 15.8% of these attacks seemed to result in PHI being sold on the dark web, Neprash thinks that number is only a fraction of the truth.
“It took a long time to get healthcare providers to adopt electronic health records and now here is this threat to them. The more comprehensively networked you are, the more vulnerable that network can be to a cyberattack. So it does feel kind of like an unintended consequence of finally convincing everybody to switch to digital records.”
Hannah Neprash, Ph.D., Study Co-Author
Why it’s important – Despite hospitals being the most well-known victims of healthcare-directed cyberattacks, the JAMA study found that clinics were the most common healthcare delivery organization to experience a ransomware attack, followed by hospitals, ambulatory surgical centers, mental/behavioral health organizations, dental practices, and post-acute care organizations. More than half of all attacks affected multiple facilities. In an earlier post, I pointed out that ransomware and cybersecurity are top-of-mind issues for healthcare systems in 2023. Mitigating risk is a major focus of boards and executives around the country.
Podcast of the week – The Fixing Healthcare podcast series began its eighth season with an interview with Dr. David Feinberg, currently chairman of Oracle Healthcare, former CEO of Cerner (acquired by Oracle in 2022), and previous head of both Google Health and Geisinger. They discuss the difference that strong leadership can make, both for patients and clinicians. You can listen to the episode here.
New Oral Drug Lowers Cholesterol by 70%
A team from University Hospitals and Case Western Reserve University has identified a small-molecule drug that effectively reduces cholesterol by 70% in animal models. These findings, published in the journal Cell Reports, represent a new approach to managing cholesterol and may have implications for cancer treatments.
Why it’s important – Cholesterol lowering is one of the most important therapies to prolong life and protect people from heart disease, which is still the number one cause of morbidity and mortality in the Western world. In addition to impacting the field of cholesterol metabolism, the findings may impact patients with cancer, as emerging evidence suggests targeting PCSK9 can improve the efficacy of cancer immunotherapies.
Videos of the week – This video from Cable Labs titled The Near Future, Step Inside shows how internet experiences that we’re accustomed to today will soon give way to tomorrow’s fully immersive virtual world. The latest film in CableLabs’ Near Future series illustrates a day in the life of one family of four—at home, at work, in learning, and at play—as they encounter the integrated technologies that will power the future. These innovations are already in the works, setting all of us up for richer opportunities and seamless interactions in our personal and professional lives in the years to come. The second video shows the technologies behind the Step Inside video.
Hinge Health launches physical therapy house calls
Hinge Health announced the expansion of its clinical capabilities with the launch of a physical therapy house call service. Starting in Chicago, followed by a nationwide rollout, it will be the nation’s first fully integrated model for musculoskeletal (MSK) health that combines digital with in-person care.
“Integrating digital and in-person care is a leap forward in bridging care gaps and reimagining a healthcare model that works for everyone.”
Daniel Perez, co-founder and CEO, Hinge Health
Why it’s important – Digital care has eliminated wait times and increased healthcare access for millions globally. Yet many Americans – from Gen Z to retirees – prefer complementing a digital experience with in-person visits. This is especially true for back, joint, or muscle pain, where in-person evaluations can substantially enhance downstream digital care.
Top Verily executives depart amid leadership shakeup and layoffs
Matthew Herper in Stat reports (subscription required) that Verily, a health technology company spun out of tech giant Alphabet, announced Wednesday that it is restructuring its management team and business and cutting 15% of its workforce. According to a memo exclusively obtained by STAT, Amy Abernethy, the former Food and Drug Administration official that Verily brought on to advance the use of technology in speeding up clinical trials, will be elevated to president of product development and chief medical officer. Verily also confirmed to STAT that co-founder and onetime chief medical officer Jessica Mega, a longtime public face of the company, has left Verily. Vivian S. Lee, a radiologist and former health system executive who joined Verily in 2018 as president of health platforms, has also left the company.
Why it’s important – The changes represent a new focus for the organization. The company has recently shifted its focus to the technology and infrastructure needed to support clinical trials. Verily has bolstered those efforts by bringing on experts like Abernethy, who joined the company in 2021 after serving as FDA’s principal deputy commissioner and acting chief information officer. The company has hired other regulatory experts, including former policy director Joe Franklin and senior technical adviser Laura Roe. Last fall, Abernethy told STAT the company is building tools to support “the 2022 model of clinical trials,” such as online consent forms to streamline health research and systems to help recruit clinical trial participants and manage study sites. Abernethy said those tools, along with Verily’s work to enable health data collection with its Study Watch and other tools, could help researchers work toward better real-world evidence generation.
The US Just Greenlit High-Tech Alternatives to Animal Testing
Animal testing has long been necessary for a drug to gain approval by the US Food and Drug Administration—but it may be on its way out. A new law seeks to replace some lab animal use with high-tech alternatives. Emily Mullen reports the development in her article in Wired online. The FDA Modernization Act 2.0, signed by President Biden at the end of December with widespread bipartisan support, ends a 1938 federal mandate that experimental drugs must be tested on animals before being used in human clinical trials. While the law doesn’t ban animal testing, it allows drugmakers to use other methods, such as microfluidic chips and miniature tissue models, which use human cells to mimic certain organ functions and structures.
“I don’t think the organ-on-chip will do it all. I think we’ll need a battery of different, complementary tests.”
Jeffrey Morgan, Professor of Engineering, Director, Center for Alternatives to Animals in Testing, Brown University
Why it’s important – An estimated 90 percent of drug candidates in clinical trials never reach the market, and drugs that target the brain typically have an even higher failure rate. These inconsistencies, combined with the time, expense, and ethical issues associated with using animals, have led scientists to develop alternative testing methods that aim to recapitulate human physiology better. These include microfluidic organs-on-chips—clear, flexible polymer gadgets about the size of a computer memory stick that contain different kinds of human cells and push fluid through tiny channels to mimic blood flow.