What happened in health care technology this week, and why it’s important.
Duke Health Forges 5-year Partnership with Microsoft to Reshape Health Care
Duke Health is embarking on a five-year, innovative partnership with Microsoft to responsibly and ethically harness the potential of generative artificial intelligence (AI) and cloud technology to redefine the healthcare landscape. As reported on the Duke Health News and Media site, by marrying Duke Health’s leadership in patient care and medical research with Microsoft’s technological expertise, this strategic partnership will usher in a new era of innovation, including the creation of a Duke Health AI Innovation Lab and Center of Excellence. Microsoft will equip Duke with state-of-the-art training to foster a cloud-savvy IT workforce and construct a secure cloud environment to simplify and modernize IT operations. In addition, Duke intends to use Microsoft Azure’s secure cloud to streamline clinical care, promote health equity, and further advancements in research and education.
“As advocates for the responsible and ethical use of AI in health care, we recognize AI’s immense potential to revolutionize health care, and remain steadfast in our commitment to ensuring Duke’s innovation in this area adheres to the highest ethical standards.”
Mary Klotman, M.D., Executive Vice President for Health Affairs Duke University, Dean of Duke University School of Medicine.
Why it’s important – AI has many potential applications to enhance healthcare processes, including automation of administrative tasks to reduce workloads and expanded capabilities for personalizing patient education. Duke Health and Microsoft will also pioneer new AI-based solutions designed to augment health care and fast-track innovation. Microsoft’s reputation for leading-edge advancements in generative AI technology is globally recognized, and this collaboration will use Microsoft’s Azure OpenAI Service to redefine healthcare experiences for providers and patients.
Infographic of the week – Machine learning algorithms frequently used in bioinformatics research. An example of the usage of each algorithm and the respective input data are indicated on the right. Abbreviations: SVM, support vector machines; KNN, K-nearest neighbors; CNN, convolutional neural networks; RNN, recurrent neural networks; PCA, principal component analysis; t-SNE, t-distributed stochastic neighbor embedding, NMF, non-negative matrix factorization.
Amazon Clinic now offers video doctor visits in all 50 states
Amazon has expanded its virtual care service for basic doctor visits nationwide, though its messaging care service remains limited to 34 states for regulatory reasons. The Verge’s Wes Davis reports that you can now start an Amazon Clinic video doctor visit in all 50 states as Amazon expands its virtual care service, which lets patients connect with “multiple telehealth provider groups” who each set their own rates for service. The company says those visits will cost an average of $75. Amazon will not accept insurance for the visits, however. Previously, Amazon only offered a message-based version of this in 32 states that would allow you to get in touch with clinicians on its platform using a secure portal for chatting with them about your medical issues and work out a treatment plan. Message-based care is lower in cost, averaging $35 a session, according to Amazon, but it’s only been able to add messaging in another two states; the Amazon Clinic FAQ page says this is due to regulatory issues.
Why it’s important – The company says it can be used to diagnose common conditions like cold sores or hair loss. Since the original service launched, it has added access to anti-aging skin care as well as the ability to diagnose bacterial vaginosis, renew EpiPen prescriptions, and more. Teladoc, a popular telehealth service, goes further with access to mental health practitioners and other specialists. Amazon asks patients using the service to sign an optional HIPAA authorization but says that if you choose not to do so, you can still seek care through Amazon Clinic. The company says it asks for permission to store personal health data “so customers won’t have to fill out the same forms repeatedly—even if their health care provider were to leave Amazon Clinic” and that it will not sell customer health data.
Podcast of the week – Hospitals will see a 3.1% inpatient payment increase next year, but some industry groups say it doesn’t go far enough. A bill that would overhaul the national organ donation system heads to President Biden’s desk. And the US Department of Labor sues UnitedHealth over allegations that a subsidiary of the payer denied thousands of claims. Details are in the Gist Healthcare Daily podcast. You can listen here.
Flow Neuroscience shows promising results in trial of brain-stimulation headset for depression
Stat’s Lizzy Lawrence reports that Flow Neuroscience, a small Swedish company treating depression with brain-stimulating headsets, released early data on Monday showing that its device relieved depressive symptoms in clinical trials. The company has not yet formally written up the data for a journal. But Flow leaders have included the data in an application for Food and Drug Administration approval and provided STAT with topline data before releasing them publicly. If the trial methods and results hold up under the FDA’s scrutiny, it would be the first device of its kind approved to treat depression in the United States. Flow already sells its devices over the counter in Europe, where it received regulatory approval in 2019.
“I’m very intrigued and hopeful, but at the same time I’m a little bit skeptical and want to see all these details.”
Mark George, Psychiatrist Professor, Medical University of South Carolina
Why it’s important – The headset applies a stimulation therapy called transcranial direct current stimulation, a treatment that delivers low levels of electrical currents to specific areas of the brain. Researchers are not just exploring its ability to treat depression but also other cognitive disorders like multiple sclerosis. In the U.S., at least, the therapy remains investigational. Different types of non-invasive brain stimulation have received FDA clearance, like cranial electrotherapy stimulation. tDCS headsets, meanwhile, have never been sold as medical devices, though consumers can buy them pretty easily online as long as they don’t claim medical benefits.
Flow, which received the FDA’s breakthrough device designation last July, tested its device on 173 patients at the University of Texas and the University of East London. Participants took the device home, with half receiving a sham stimulation and half receiving the treatment, over the course of 10 weeks. Flow reports that 45% of participants in the treatment group had complete relief from depressive symptoms, which they defined as receiving a score between 0 and 10 on the Hamilton Depression Rating Scale. More than half showed improvement in symptoms. Around 23% of the placebo group went into remission. Flow found no significant side effects.
Quest Diagnostics launches Alzheimer’s blood test for consumers
Quest Diagnostics (DGX.N) on Monday launched the first direct-to-consumer blood test to detect abnormal levels of beta-amyloid. This key Alzheimer’s disease protein can appear years before dementia symptoms arise. Reuters’ Julie Steenhuysen reports the $399 test, called AD-Detect, uses the same technology as a blood test the company began selling for use by doctors in early 2022. Quest’s consumer test is aimed at adults aged 18 and older who may have mild memory loss or a family history of Alzheimer’s and want to understand their own risk for the disease.
Why it’s important – Quest’s lab-developed test, created and performed in a single laboratory, has not undergone any FDA review. The agency generally does not review such tests as long as they are prescribed by a healthcare provider. If the test is positive, individuals automatically will be contacted by a doctor from an independent physician network to discuss the next steps and potentially can share the results with other physicians, the company said. Dr. Sarah Kremen, a neurologist at Cedars-Sinai in Los Angeles, was concerned that people who test positive but have no symptoms will seek further testing, possibly hoping to access new treatments. But they will not qualify for more testing if they are not symptomatic.
White House drug shortage task force held rare in-person meeting with industry
A new White House task force on drug shortages held a rare in-person meeting last Friday with representatives from hospitals, drugmakers, pharmacies, and others in the drug supply chain to brainstorm policies for stemming shortages of cancer drugs. John Wilkerson in Stat reports that the meeting at the Eisenhower Executive Office Building focused on immediate steps that could help alleviate shortages, such as allowing temporary importation of drugs from other countries, according to an attendee and three others with knowledge of the discussion. It also touched on purchasing issues. The first half of the meeting focused on what can be done immediately to relieve shortages of generic cancer drugs that hospitals and cancer centers administer. Meeting participants spent the second half of the meeting discussing how to get hospitals and the group purchasing organizations that buy products on their behalf to buy from generic drug makers that maintain high-quality manufacturing facilities.
Why it’s important – The meeting was none too soon. On July 19, a tornado hit a Pfizer facility in North Carolina that warehoused many drugs already in short supply. In Congress, there are competing drug shortage bills that take significantly different approaches, and there are measures that agencies such as the Food and Drug Administration could take without Congress providing new authorities. The Biden administration could provide some direction at a crucial point in the debate. The American Society of Health-System Pharmacists, which counts many hospital pharmacies among its members, wants Medicare to pay extra when facilities use critical generic drugs at risk of shortages. In return, those providers must buy most of those drugs from long-term contracts with generic drugmakers. Long contracts are supposed to give generics the certainty they need to invest in manufacturing facilities.
So You Want to Work in Digital Health…
This is a terrific blog post from Halle Tecco on finding a job, accepting an offer, and getting up to speed on digital health. Whether you’re contemplating a career switch or starting out, consider this a warm welcome to the industry. We need all the talent we can get to solve some pretty big problems. Your unique perspectives and skills are invaluable in this expanding and deepening arena as we collectively strive to redefine health outcomes worldwide through digital innovation.
Why it’s important – Halle is one of my go-to resources for all things digital health-related. She’s among the leading industry voices in healthcare and the digital health startup community.
Geisinger Launches Heart Failure Monitoring Program Using Bodyport’s Smart Scale
MedCity’s Katie Adams reports that Geisinger is launching a pilot program in partnership with virtual heart failure monitoring startup Bodyport. About 200 of the health system’s heart failure patients will be using Bodyport’s cardiac scale at home — the scale uses sensors to measure a person’s metrics of heart function and body fluid status after they stand on it for about 20 seconds. The health system already has case managers who monitor high-risk heart failure patients who have been discharged from the hospital, and it also uses data analytics to predict which patients are at the highest risk of an adverse event or readmission. But now Geisinger wants to try and incorporate a wearable into this program. Geisinger is preparing to enroll about 200 patients with heart failure in this 12-month pilot program. Some of these patients will come from the group of at-home heart failure patients who have already been assigned a case manager, and some will be referred after being discharged from the hospital.
Why it’s important – It’s well known that heart failure is a sweeping national problem — the condition affects more than 6 million Americans and costs the country more than $30 billion annually. Geisinger, like many other health systems, is embracing technology to manage this complex condition better. On Wednesday, the Pennsylvania-based health system announced it was launching a pilot program in partnership with virtual heart failure monitoring startup Bodyport. The overarching goal of this pilot is to see if Bodyport’s device and platform can improve case managers’ efficiency when monitoring heart failure patients.