Category: Digital Health

One Tech Company Steadily Expanding Their Business in Health Care That Deserves More Attention

hjsochLeave a comment

“We are essentially nurturing a start-up within a large-scale organization and leveraging Best Buy’s core assets, including the Geek Squad, to incubate a new business.”

Corie Barry, CEO, Best Buy
Image Credit: Shutterstock.com

Best Buy isn’t the first name that comes to mind when people think of health care. For decades, Best Buy has been one of the leading consumer electronics retailers in North America. With more than 1,000 stores across the US and Canada, the company brought in over $50B in revenue in 2021, mainly driven by sales of consumer electronics such as laptops, desktop computers, and smartphones. However, in recent years the company has been heavily focused on expanding into healthcare, building out a dedicated tech-enabled offering for at-home care as the aging population increasingly looks to age in place. Nearly 90% of adults 65 and older want to live in their homes, which presents opportunities to introduce tech-enabled monitoring and engagement solutions.

Best Buy tapped into healthcare in 2018 with its $800 million acquisition of GreatCall (now Lively), which provides emergency response services to seniors. Their Lively Health & Safety Packages were recently updated to empower better those who are aging at home, and two new services were added: Nurse On-Call and Care Advocate. In addition, Lively Urgent Response was made compatible with Amazon Alexa-enabled devices. Now, users can say, “Alexa, call for help,” and will be immediately connected with someone who will assess the situation and get them the help they need in various situations.

The following year, Best Buy bought the remote monitoring company Critical Signal Technologies. Its 2021 deal with Current Health was a big bet for at-home services, building off past investments and further solidifying the retailer’s presence in healthcare. Current Health is a remote patient monitoring platform that major hospital systems nationwide rely upon to communicate with patients and track patients’ vital signs. The combination of Current Health’s technology and Best Buy’s size and ability to help customers with technology in their homes helps close the gap in enabling care at home.

And they’re delivering tangible results. Current Health customer, the Defense Health Agency’s (DHA) virtual care program was the focus of a study published in the Journal of Medical Internet Research (JMIR). In the study, researchers compared the financial impact and clinical outcomes at hospitals that participated in the care-at-home program versus those that weren’t. The researchers at Current Health and DHA found a 12% lower length of stay averaged across all COVID-19 patients, saving $2,047 per patient and a total net savings of an estimated $2.3 million in the first year of the program, with no increase in 30-day readmissions or emergency department visits. This vital research demonstrates that care-at-home programs can improve the operational efficiency of care delivery without harming clinical outcomes, which is essential to making healthcare better and more sustainable.

The company is partnering with several health systems, including Geisinger Health, and Mount Sinai Health System, to expand its at-home care technology platform. New York-based Mount Sinai Health System partnered with Current Health on remote patient monitoring starting in 2020 and already monitors cancer patients at home. Geisinger is working with Best Buy to manage at-home care for patients with high-risk hypertension, diabetes, and those recovering from sepsis.

And this week, Best Buy announced that it would offer technology support to Charlotte-based Atrium Health, part of the newly formed Advocate Health, for its hospital-at-home program launched in early 2020 in response to the COVID-19 pandemic. Best Buy’s Geek Squad will go to patients’ homes, set up technology that remotely monitors their heart rate, blood oxygen level, or other vitals, and train the patient or others in the home how to use the devices. The data would then be shared securely with doctors and nurses through the telemedicine hub from Current Health. The tech needs previously were handled within Atrium. The goal is to eventually scale these services nationwide, including across Advocate’s Southeastern and Midwestern footprints. Best Buy began setting up virtual-care systems in mid-February for ten hospitals in and around Charlotte, North Carolina. The company said it aims to have about 100 patients in the program daily — roughly equivalent to a midsized hospital but without a building.

“The reason we’re betting on this partnership is because we truly believe that we can bring so much to the table that is actually distinctly different, from not just what others are doing in the hospital-at-home space or the health-at-home space, but also really unique and what we actually need in service of the communities that we’re a part of.”

Rasu Shrestha, Chief Innovation and Commercialization Officer, Advocate Health

Best Buy is leaning into core capabilities of supply chain and logistics, data analytics and consumer wellness products. Entering the healthcare space is also a defensive move for Best Buy’s retail business, allowing the company to hedge against supply chain disruptions and increasing competition from Amazon, both of which have threatened its main consumer electronics business. The retailer expects a same-store sales decline of between 3% and 6% in the fiscal year, with most of that drop coming in the first six months. On an earnings call last week, CEO Corie Barry said Best Buy expects sales in its health division to grow faster than the rest of its business this fiscal year.

“We want to do this well. We want to create pathways that enable care at home in a more seamless manner. We want to tie technology and empathy together and really help change how health care is delivered to people in their homes.”

Deborah DiSanzo, President, Best Buy Health

Best Buy’s existing Geek Squad customer service workforce — comprised of more than 20K agents already making approximately 9M home visits a year to help customers with tech setup and use — makes the company well-positioned to take on the opportunity in at-home care. Best Buy can also leverage existing relationships with healthcare device buyers.

Best Buy is one of many retailers seizing opportunities in the healthcare space. In January, Dollar General launched three mobile healthcare clinics in Tennessee. The following month, CVS Health announced its $10.6 billion acquisition of primary care provider Oak Street Health, outlining plans to add 130 Oak Street sites by 2026. And last week, Walmart Health detailed its plans to add 28 new centers and expand into two new states.

Remote patient monitoring and efficient delivery of medical devices are important components of home health care — but hospitals are struggling in all of these areas as they scale their program. Partnering with a well-resourced tech company is a common solution.

“The vast majority of home hospital programs partner with some sort of technology solution to do the last mile monitoring of the patients,”

Constantinos Michaelidis, the director of UMass Memorial Health’s Hospital at Home program

Watch for more partnerships like the Atrium deal announced this week in the future. These leverage Best Buy’s strengths and takes the tech deployment challenges away from already overwhelmed health system tech staff. It’s a win-win for both partners and the patients they serve.

Health Tech News This Week – February 11, 2023

hjsochLeave a comment

What happened in health care technology this week, and why it’s important.

Image Credit: Shutterstock.com

Spotify’s founder helped develop an AI-powered body health scanner

The Verge’s Emma Roth kicks off the news coverage this week. Spotify founder Daniel Ek is getting into the healthcare industry. A post shared on LinkedIn names Ek as the co-founder of a startup called Neko Health, which specializes in providing body scans powered by artificial intelligence (AI), as reported earlier by European news outlets Sifter and Tech.eu. According to a translated version of Neko Health’s website, the Swedish company’s non-invasive full-body scanner can detect and measure the growth of birthmarks, rashes, and age spots. It also utilizes a separate scanner to pick up on abnormalities in heart function, blood pressure, and pulse throughout the body. Neko says the company’s 360-degree body scanner comes equipped with over 70 sensors that collect more than “50 million data points on skin, heart, vessels, respiration, microcirculation, and more.”

Image Credit: Neko Health

Why it’s important – We’ve seen the development of “whole body” scanners in the past, along with the emergence of companies who promote whole body scanning as an “annual checkup” to monitor for potential health issues. While interesting, physicians worry about the potential problems in reporting “incidentalomas,” which may or may not represent a serious problem for the patient.

Infographics of the week – This week’s first infographic is from Dr. Tazeen Rizvi. It shows his assessment of a methodology to address the problems of inequities in data-driven technologies. His point: “Efforts should be made to ensure the #data on which #algorithms are based is representative of the populations they will be deployed in, with sufficient breadth and depth to capture the multitude of clinically important associations between ethnicity, demographic, social, and clinical features that may exist.”

Image Credit: Dr. Tazeen Rizvi

The second infographic comes from Gartner and shows their emerging technologies and trends for 2023.

Image Credit: Gartner

Can’t find a doctor? This hi-tech telemedicine booth offers a handy, hands-on checkup

As France struggles with a shortage of doctors, its worst-hit regions are rolling out hi-tech telemedicine booths, where patients can conduct their own checkups while on a video call with a physician in another part of the country. Natalie Huet covers the story in her article on EuroNews.net. While France’s healthcare system is often hailed as one of the best in the world, it’s facing a demographic crisis in which doctors are getting older and are not being replaced where they’re most needed.

Image Credit: H4D Telemedicine

Why it’s important – According to government data, nearly 7 million people in France – one in 10 – don’t have a referring general practitioner (GP), and 30 percent live in a medical desert. Those are regions where it’s nearly impossible to see a doctor because there aren’t any nearby or because the few in the area are so busy they don’t take new patients. This design is an interesting spin on traditional kiosks and has been designed to be patient-friendly and comfortable.

Podcast of the week – New Discoveries on Long COVID (with Dr. Eric Topol) from In the Bubble with Andy Slavitt. Three years into the pandemic, roughly 65 million people suffering from Long COVID worldwide are still looking for answers to the mix of symptoms that has baffled doctors and experts. Dr. Eric Topal and three researchers suffering from the condition themselves published a new study laying out the most recent significant findings and preventative measures. Andy asks Eric about the likelihood of getting chronic symptoms from an infection, what those symptoms typically are, and how the data influences his own precautions. You can listen to this podcast here.

Lab-Grown Retinal Eye Cells Make Successful Connections

Retinal cells grown from stem cells can reach out and connect with neighbors, according to a new study, completing a “handshake” that may show the cells are ready for trials in humans with degenerative eye disorders. This work was reported by the University of Wisconsin, Madison, and featured in an article in Technology Networks Cell Science online. During 2022, Gamm and UW–Madison collaborators published studies showing that dish-grown retinal cells called photoreceptors respond like those in a healthy retina to different wavelengths and intensities of light and that once they are separated from adjacent cells in their organoid, they can reach out toward new neighbors with characteristic biological cords called axons.

Image Credit: Shutterstock.com

Why it’s important – After they confirmed the presence of synaptic connections, the researchers analyzed the cells involved and found that the most common retinal cell types forming synapses were photoreceptors – rods and cones – which are lost in diseases like retinitis pigmentosa and age-related macular degeneration, as well as in certain eye injuries. The next most common cell type, retinal ganglion cells, are degenerate in optic nerve disorders like glaucoma.

Ten Breakthrough Technologies, 2023

Every year MIT Technology Review publishes its list of ten breakthrough technologies that matter most right now. This year, as in the past, several of their selections are health care related. I’ve listed them below:

  • CRISPR for high cholesterol – Over the past decade, CRISPR’s gene-editing tool rapidly evolved from the lab to the clinic. It started with experimental treatments for rare genetic disorders and has recently expanded into clinical trials for common conditions, including high cholesterol. New forms of CRISPR could take things further still.
  • Abortion pills via telemedicine – Abortion ceased to be a constitutional right in the US in 2022, and state bans now prevent many people from accessing them. So healthcare providers and startups have turned to telehealth to prescribe and deliver pills that allow people to induce abortions at home safely.
  • Organs on demand – Every day, an average of 17 people in the US alone die awaiting an organ transplant. These people could be saved—and many others helped—by a potentially limitless supply of healthy organs. Scientists are genetically engineering pigs whose organs could be transplanted into humans and 3D-printing lungs using a patient’s own cells.

New ‘ultrasound tornado’ device breaks down blood clots

Researchers say a new tool and technique using “vortex ultrasound” could potentially break down blood clots in the brain. Sean Whooley reports on the research in his article in Medical Design and Outsourcing online. This tool includes a single transducer for producing the swirling vortex effect. Researchers designed the transducer at a small enough size for incorporation into a catheter. That then feeds through the circulatory system to the blood clot site. The researchers tested their technology using cow blood in a 3D-printed model of the cerebral venous sinus. Testing found no damage to the walls of blood vessels, something that can happen during catheterization or surgical intervention. They also found no substantial damage to red blood cells.

Why it’s important – CVST clots increase pressure on blood vessels in the brain. This increases the risk of bleeding in the brain, which can be catastrophic for patients. Existing techniques rely in large part on interventions that dissolve the blood clot. But this is a time-consuming process. This ultrasonic tornado eliminated clots formed in an in vitro model of cerebral venous sinus thrombosis (CVST). The researchers, based at North Carolina State University, say it worked more quickly than existing techniques.

FDA has now cleared more than 500 healthcare AI algorithms

There are now more than 520 marker-cleared artificial intelligence (AI) medical algorithms available in the United States, according to the U.S. Food and Drug Administration (FDA), as of January 2023. The vast majority of these are related to medical imaging. Dave Fornell provides the breakdown in his article in Health Exec online. The FDA cleared the first AI algorithm in 1995, and fewer than 50 algorithms were approved over the next 18 years. However, the numbers have increased rapidly in the past decade, and more than half of the algorithms on the U.S. market were cleared between 2019 to 2022––more than 300 apps in just four years. Last October, the FDA approved 178 new AI and machine learning (ML) systems. That number is expected to grow rapidly into the future, the FDA has said.

Why it’s important – As I’ve explained before, AI and ML technologies have the potential to transform healthcare by deriving new and important insights from the vast amount of data generated during the delivery of healthcare every day. Medical device manufacturers are using these technologies to innovate their products to assist healthcare providers better and improve patient care, the FDA explained on its website.

Automated training system to help Singapore General Hospital nurses master IV drip treatment

Trainee nurses at Singapore General Hospital (SGH) will soon use a new automated platform that takes the guesswork out of administering intravenous (IV) drips during training, Osmond Chia reports in his article in The Straits Times. The system – comprising a sensor-equipped glove, a digital patient in the form of an avatar, and a 3D-printed hand with a human-like texture – will evaluate how well nurses can insert a needle and converse with patients. Dubbed IV Nimble (Nursing Innovation in Mobility-based Learning), the program takes training to administer IV drips closer to reality and helps trainees learn flexibly with the help of bots. The platform will be fully rolled out for training by the end of 2023.

Image Credit: ST PHOTO: KUA CHEE SIONG

Why it’s important – The new system is a step forward technologically from earlier props used in cannulation training. Previously, an instructor would guide nurse trainees to insert a needle into a dummy arm, but it was tough to tell if a trainee precisely hit or missed the vein, as they could judge only from the surface. Training is also gamified, providing trainees with different skin textures and vein sizes to vary the difficulty of administering cannulation. It can also be further adapted for other medical training scenarios, like blood collection, chest tube insertion, and other invasive procedures.

February is National Heart Month – Digital Technologies to Support Heart Health & Wellness

hjsochLeave a comment

“The problem with heart disease is that the first symptom is often fatal.”

Michael Phelps, Olympic Athlete
Image Credit: Shutterstock.com

The simple truth is that cardiovascular diseases are one of the most common problems patients in America face. Over 92 million Americans suffer from heart disease, according to a recent American Heart Association study. And over 14% of all annual health care costs are a result of cardiovascular conditions. The numbers are sobering and are projected to grow over the next ten years. Each February, the American Heart Association tries to raise awareness of the seriousness of heart disease during National Heart Month and Wear Red Day. Research has shown that digital technologies can help raise awareness around heart health and help to reduce adverse outcomes through monitoring and other digital tools.

Here are several technologies that can benefit clinicians and patients in helping to diagnose and manage heart disease.

Big Data, Analytics, Artificial Intelligence & Machine Learning

Two recent peer-to-peer reviewed academic articles have shown how big data can be used to prevent cardiovascular diseases and assist in generating early diagnoses. The first one, “System Framework for Cardiovascular Disease Prediction Based on Big Data Technology,” was published in the November 2017 issue of the journal Symmetry. The researchers looked at various factors that could be used to predict the likelihood that specific populations will develop cardiovascular diseases over time. As it turns out, big data models can predict the probability that a patient will develop a cardiovascular disease by looking at clinical, genomic, and lifestyle data through disease correlations, drug side effects, and genome research.

A second study, published in the May 2018 issue of the journal BioMed Research International, shows big data can correctly predict the likelihood of a person developing cardiovascular disease in 80% of cases. This article offers a comprehensive list of factors most likely to lead to cardiovascular diseases. These factors include gender, chest pain type, resting blood pressure, serum cholesterol, fasting blood sugar, ECG, maximum heart rate achieved, exercise-induced angina, old peak, slope, and the number of major blood vessels colored by fluoroscopy.

As artificial intelligence and machine learning applications advance, big data will become more available outside of a purely academic environment to widely available complex databases where a specific patient’s characteristics can be entered to obtain the likelihood of that patient developing cardiovascular disease with more than 80% confidence. According to an article in the Journal of the American College of Cardiology, artificial intelligence is poised to “provide a set of tools to augment and extend the effectiveness of the cardiologist.”

Voice enabled technology

Voice-enabled technology is already making impressive strides toward improving health outcomes for heart disease patients. Voice-enabled assistants like Amazon’s Alexa and Apple’s Siri are indispensable to cardiac patients. For example, a skill developed by the American Heart Association (AHA), asking Alexa to walk you through the steps of CPR, is as easy as ordering a pizza. AHA’s skills also help users recognize a heart attack and stroke symptoms. Medical device manufacturer Omron Healthcare built a new Alexa skill that allows patients who use their blood pressure monitoring devices to manage their condition using voice commands. All users must do is pair their Omron cuff to the company’s app and ask Alexa to read their latest blood pressure results and get alerts for anything that may be considered higher than usual.

Image Credit: CB Insights, The Big Tech in Pharma Report, pg. 23

But big tech companies aren’t the only ones developing these voice-enabled solutions for cardiac patients. Mayo Clinic is on the verge of proving that voice signal analysis can become a noninvasive diagnostic tool. While the vocal features that indicate heart disease are not perceived by the human ear alone, the Rochester-based medical center discovered that a voice-analyzing app could help detect coronary artery disease based on a patient’s tone and intensity. Another pilot study by The Journal of the Acoustical Society of America vouches for this technology’s efficiency in lowering healthcare costs and reducing mortality rates among patients with heart failure.

Gamification

An article published in the April 2018 issue of the journal Clinical Cardiology documents how mHealth technologies have been helping patients with cardiovascular diseases adhere to heart‐healthy recommendations designed to modify users’ cardiovascular risk‐factor profiles. The addition of mHealth technologies can increase patients’ physical activity levels to instill a positive impact on cardiovascular conditions. As the authors contend: “smartphone applications can impact PA [physical activity] include knowledge, social support, behavioral change support, decision support, and self‐efficacy.” These stimulating and gamified mobile apps have successfully motivated patients to improve their modifiable risk factors. As a result, they’ve been proven to reduce cardiovascular risk-factor profiles.

“I think it’s quite natural to a clinician to start in the cardiovascular space. It’s just so clear how supporting people with nutrition, physical activity, mental health, all of this, can directly benefit health outcomes. Within cardiovascular, we’ve been expanding into peripheral artery disease and a few others with our clients and partners.”

Dr. Tryggvi Thorgeirsson, CEO, Sidekick

“An estimated 50% of patients with chronic diseases do not follow the prescribed treatment. Gamified health tracking creates an environment that keeps the patient from straying from the appropriate therapy path.”

Bertalan Mesko, M.D., PhD

Healthcare providers who use gamification strategies in their applications will have a competitive edge over others who don’t. By 2027, GM Insights forecasted that the global market for healthcare gamification would reach $65 Billion and grow at a CAGR of 14.6%. It is due to the growing usage and adoption of technology and global digitization.

Digital sensors and wearables

Since 2008, Geisinger Health Plan (GHP) has implemented a telemonitoring program that specifically targets patients suffering from heart failure. In 2014, an article was published in Population Health Management titled: ‘Can Telemonitoring Reduce Hospitalization and Cost of Care? A Health Plan’s Experience in Managing Patients with Heart Failure.’ Data was collected over 5 years and compared against data from patients suffering from heart failure who did not enroll in the program. The results were eye-opening:

“The odds of experiencing a hospital admission in a given month was 23% lower when the members were enrolled in the telemonitoring program. The odds of experiencing a 30-day readmission was 44% lower, and the odds of experiencing a 90-day readmission was 38% lower. […] The implementation of the heart failure telemonitoring program was associated with approximately 11% cost savings during the study period.”

Population Health Management, 2014
Image Credit: Digital Health Innovations to Improve Cardiovascular Disease Care, Santo, K., Redfern, J. Digital Health Innovations to Improve Cardiovascular Disease Care. Curr Atheroscler Rep 22, 71 (2020). https://doi.org/10.1007/s11883-020-00889-x

I’ve written about the role next-generation wearables will create new opportunities in remote monitoring in a previous post. The evidence shows that patients suffering from cardiovascular diseases are significantly more likely to improve their condition over time when they benefit from digitally-connected solutions that help them manage their chronic conditions over time.

Telecardiology

As telehealth makes inroads into a broader range of medical specialties, cardiovascular care is among the fields offering more virtual visits. This branch of telemedicine, known as telecardiology, seeks to achieve real-time, remote diagnosis and treatment of heart disease — including congestive heart failure, cardiac arrest, and arrhythmia. One of those ways is raising compliance rates for cardiac rehab, a medically supervised program designed to improve cardiovascular health after a heart attack or other event requiring care. But only 25 percent of patients follow the prescribed regimen.

In 2016, the American Heart Association published a policy statement encouraging the use of telehealth applications to improve cardiovascular and stroke care.

“Remote monitoring of patients with implantable cardiac devices resulted in timely diagnosis and management of arrhythmias and heart failure symptoms, leading to better clinical outcomes. Also, using telestroke to evaluate patients with acute ischemic stroke eligible for thrombolysis provided access to acute stroke care in underserved areas and has been shown to be as safe and effective as usual care.”

Crystal Wong, MD

Telemedicine applications are exceptionally well-equipped to connect physicians with patients who live in remote areas of the country or to quickly offer a consultation to patients living with chronic cardiovascular diseases.

There are multiple benefits to both patients and clinicians in using Telecardiology in health care. Here is a partial list:

  • Reduces Hospital Transfers
  • Increases Access to Premium Healthcare Delivery for Cardiac Patients
  • Creates Uniform Healthcare Accessibility to Larger Populations
  • Encourages Effective Collaboration of Cardiologists Worldwide
  • Makes Cardiac Healthcare More Affordable and Convenient
  • Encourages Smooth Triage and Relieves the Burden on Healthcare Providers
  • Increases Patient Satisfaction

Telecardiology is one of the fastest-growing fields in telemedicine. There is already a significant quantity of published clinical data, with some randomized multi-center trials to answer the most critical questions definitively. The contribution of telecardiology in some fields, such as emergency and chronic care, undoubtedly improves healthcare quality and helps contain rising costs.

Some closing thoughts – Digital technology does have the potential to overcome several barriers, such as geography and time. Hence, even with equivalent health outcomes to standard care, there are huge positives regarding reach from a public health perspective. Furthermore, digital health interventions should not be viewed as a stand-alone, one-size-fits-all solution but rather an addition to the current multifaceted health interventions that can be personalized to different patient populations. With the digital health revolution, we can consider these tools not only a way to achieve better patient health outcomes but also as innovative ways to reimagine the way we currently conduct clinical studies. These digital technologies can enable new models of virtual trials, potentially reducing the duration and costs of future research while increasing our ability to achieve meaningful results.

Microsoft’s Investment In Open AI – What It Could Mean in Healthcare

hjsochLeave a comment

“We formed our partnership with OpenAI around a shared ambition to responsibly advance cutting-edge AI research and democratize AI as a new technology platform.z’

Satya Nadella, CEO, Microsoft
Image Credit: Shutterstock.com

Microsoft last week said that it’s extending its partnership with OpenAI, the startup behind art- and text-generating AI systems like ChatGPT, DALL-E 2, and GPT-3, with a “multi-year, multi-billion-dollar” investment. OpenAI says that the infusion of new capital — the exact amount of which wasn’t disclosed — will be used to continue its independent research and develop AI that’s “safe, useful, and powerful.”

Image Credit: CB Insights

The tech giant’s Azure cloud platform will continue to be OpenAI’s exclusive cloud provider, powering the startup’s workloads across research, products, and API services. Sources previously reported that Microsoft was looking to net a 49% stake in OpenAI, valuing the company at around $29 billion. Under the terms of one proposal detailed by Semafor, Microsoft would receive three-quarters of OpenAI’s profits until it recovers an investment as high as $10 billion, with additional investors, including Khosla Ventures taking 49% and OpenAI retaining the remaining 2% in equity.

Microsoft itself is currently using the developer’s language AI to add automation to its Copilot programming tool and wants to add such technology to its Bing search engine, Office productivity applications; Teams chat program, and security software. The Redmond, Washington-based company is putting DALL-E into design software and offering it to Azure cloud customers.

Image Credit: CB Insights, Big Tech in Healthcare report, 2022, page 62

So what might this significant investment in Open AI mean for healthcare applications? Here are ten potential use case scenarios that might come about from tighter integration with Microsoft products and services.

Patient Triage: By analyzing a patient’s symptoms and presenting a list of potential diagnoses and suggested next steps, ChatGPT can be used to triage patients. This can ease the pressure on medical staff and guarantee that patients get the proper care when they need it.

Virtual Health Assistant: It can create virtual health assistance for patients and can give information and direction about their diseases, available treatments, and self-care.

Medical Research: A lot of medical data can be analyzed using ChatGPT to find patterns and trends that can guide the creation of novel treatments and diagnostic equipment. Consider a model like ChatGPT trained on clinicaltrials.gov. A researcher could quickly get insights by asking a simple question, such as “What’s the most popular endpoint for all clinical trials on Crohn’s disease?” instead of scraping and evaluating all the data by hand.

Medical Transcription: ChatGPT can be used to transcribe medical reports and notes, eliminating the need for human transcriptionists and lowering the possibility of mistakes.

Clinical Decision Support: ChatGPT can help healthcare professionals make better informed and precise diagnoses and treatment decisions by offering clinical decision support.

Healthcare navigation: The goal here is to help patients navigate the complex healthcare landscape; for example, find a doctor in their network, compare prices, or learn about their benefits.

Health coaching and wellness: These chatbots try to engage patients to achieve a more healthy lifestyle. For example, they may remind patients to exercise and eat healthily daily. Examples of such chatbots include Doppel and 1-million-strong-to-prevent-diabetes. They may also assess the progress of a patient using existing clinical scales, such as PHQ9, which is a popular 9-question scale to assess depression.

Clinical trial recruitment: ChatGPT could be used to create chatbots that can help identify eligible patients for clinical trials and provide them with information on the trial process.

Medical Education: ChatGPT could be used to create virtual tutors to help students learn and retain medical information and to assist in creating interactive and engaging content for medical education.

Medical translation: ChatGPT could be used to translate medical documents and patient information from one language to another, making it easier for healthcare providers to communicate with patients who speak different languages.

While there are potential use cases in healthcare, it’s essential to understand the limitations and risks of using this technology. By far, experts named “hallucination,” the AI term for confidently making something up, as ChatGPT’s biggest problem. It’s susceptible to inventing facts and inventing things, and so the text itself might look plausible. Still, it may have factual errors, and in the medical domain, that can be extremely dangerous.

Another problem for the fast-moving world of medicine: Because ChatGPT was trained on a dataset from late 2021, its knowledge is currently stuck in 2021. Even if the company can regularly update the vast swaths of information the tool considers across the internet, it would be crucial for the system to be updated in near real-time to remain highly accurate for healthcare uses. Experts said having a ChatGPT-like AI that is updated in real-time is a long way off.

“I don’t believe in artificial intelligence. I believe in augmented intelligence — that is to say, as a human, giving me a statistical analysis of data of the past to help me make decisions in the future is wonderful. But turning my decision making over to a statistical model is not a very reasonable thing to do.”

John Halamka, president of Mayo Clinic Platform and co-founder of the Coalition for Health AI

Another weakness of the AI, for now, is that it is limited to text only. Even though ChatGPT put forth a decent performance on the USMLE, it couldn’t answer any questions that relied on images. Though there are already other AI platforms that process images — or, for that matter, audio, and video — there’s not yet an integrated platform for all of these functions. Since several medical disciplines rely on images for interpretation, diagnosis, and follow-up care (e.g., radiology, pathology, dermatology, and ophthalmology), this is a significant hurdle to overcome.

Just as new drugs demand evidence of benefits and risks, AI also needs rigorous scrutiny. But experts are worried that because AI doesn’t seem to be the same as a new therapy, it won’t undergo the same strict review that a new drug would. They’re also worried that constant changes in clinical practice or medical knowledge will impact the accuracy of such models. There are also many ways bias could unintentionally get built into machine learning models — not just at the dataset level but at the many levels of human involvement. That includes what patient populations the model gets used on, as well as the work of individuals who write model responses for training or rate AI-generated responses.

Experts said that, ideally, regulation would play a part in the ethics of AI, but they acknowledged the difficulty in regulating such a fast-changing technology. The Coalition for Health AI counts Google, Microsoft, the FDA, and the National Academies of Medicine among its over 140 members interested in figuring out the guidelines and guardrails that Halamka of Mayo Clinic Platform hopes will become a code of conduct for the industry.

Closing thoughts – Microsoft is planning to deploy OpenAI’s models across a variety of consumer and enterprise products. Microsoft is rumored to be preparing to challenge Google with ChatGPT integration into Bing search results. The company is reportedly considering integrating some language AI technology into its Word, PowerPoint, and Outlook apps. Since many healthcare systems use Microsoft Office and collaboration apps like Teams and also the Azure cloud platform, a properly implemented integration of ChatGPT applications could be easily adapted and implemented into daily care delivery.

It will be interesting to watch the developments in large language models at Google too. Google Research and DeepMind have launched an AI-based healthcare platform called MedPaLM. MedPaLM aims to generate safe and helpful answers related to the medical field. It combines HealthSearchQA and six existing open-question answering datasets that cover professional medical exams, research, and consumer queries. Medical professionals, and even non-professionals, can use MedPaLM. The platform can address multiple-choice questions via the delivery of various datasets. These datasets come from NedQA, MedMCQA, PubMedQA, LiveQA, MedicationQA, and MMLU. However, a new dataset was the HealthSearchQA, which aims to improve MultiMedQA. Answering more complex medical questions may be beyond MedPaLM’s capability. The platform is still a work in progress, and researchers are constantly looking for improvements that can make it better.

Image Credit: Google MedPALM research paper

As long as the appropriate safeguards are in place, there are opportunities to adapt the technology to good use.

Battle of the Titans – Amazon vs. Mark Cuban in Discount Pharmacy Services

hjsochLeave a comment

“Prime members already get fast, free delivery on prescription medications, and RxPass is one more way to save with Amazon Pharmacy. Any customer who pays more than $10 a month for their eligible medications will see their prescription costs drop by 50% or more, plus they save time by skipping a trip to the pharmacy. We are excited to offer our customers surprisingly simple, low pricing on the eligible medications they need each month.”

John Love, Vice President, Amazon Pharmacy
Image Credit: Shutterstock.com

More than two years after announcing Amazon Pharmacy to take some of the prescription drugs business away from big (and smaller) drug stores, Amazon is launching a new product to expand its reach in the space. Recently Amazon announced RxPass, a service where Prime users in the U.S. can pay a monthly flat fee of $5 to get as many generic versions of medications as they need. Amazon said that initially, the service would cover generic drugs for 80 common ailments — they include, for example, Losartan (the generic for the hypertension drug Cozaar) and Sertraline (the generic for antidepressant Zoloft) and hair-growth pills — and it would not comment on its plans to expand the list.

The 80 conditions were selected, so to speak, to make it an offer attractive to a broad base of potential customers. RxPass is not open to people on government medical plans like Medicare or Medicaid (Amazon Pharmacy is a provider for these and thus cannot offer it directly). One pays the $5 out of pocket, not on insurance. You sign up for it in your app as a Prime user under Pharmacy. Amazon works with Inside Rx, a prescription drug pricing comparison service owned by Express Scripts, to administer RxPass and PrimeRx.

“We think this is going to be super valuable for Americans who have a chronic condition or those who might be taking two to three medications. With this specific offering, any eligible medications would all be for the single low flat fee of $5, and it’ll be delivered to their door.”

John Love, Vice President, Amazon Pharmacy

The service is available to customers in 42 states, though those in California, Louisiana, Maryland, Minnesota, New Hampshire, Pennsylvania, Texas, and Washington are not currently eligible.

YouTube Video Credit: CNBC Squawk Box

This is a big and pretty bold move for Amazon; $5/month is the fee regardless of the amount a customer orders, meaning the service is aimed at those who are currently already paying more than this per month for their meds for these 80 conditions, or think that they might over time need to pay more, or are looking for one-stop services with a predictable cost each month. It also competes with a few other things also brewing in the market: namely, Mark Cuban’s Cost Plus Drugs effort.

“This approach really leverages the core capabilities in which they excel—merchandising, order processing, logistics infrastructure, the back end order management and they have an estimated 150 million Amazon Prime members who have already bought into the company’s value as a merchandiser.”

Michael Abrams, Managing Partner, Numerof and Associates

Amazon would not disclose how it arrived at $5 and whether that’s a subsidized figure to attract more users. Still, data published last year by health policy researchers Kaiser Family Foundation, citing figures from the OECD, noted that in the U.S. in 2019, annual per-capita out-of-pocket payments for prescribed medicines averaged $164. This is not a direct comparison, as this is not a figure that covers 80 conditions, but it is the average, giving an idea of what is spent around the most common conditions that Amazon is also targeting.

It’s unclear whether RxPass is intended to drive profits for Amazon or if its goal is more strategic. In a blog post, The Advisory Board’s Gina Lohr, a managing director on the company’s research team, ran the numbers on one generic medication to see how much revenue Amazon would receive from a typical Amazon Pharmacy purchase versus the RxPass program. For Bupropion XL, a common antidepressant and smoking cessation support drug, the copay is typically around $15 or less. For Prime members, Amazon sells the drug for a cash price of $14.90 for a 30-day supply, with free shipping. RxPass members would get their 30-day supply for a $5 subscription fee. The Mark Cuban Cost Plus Drug Company price for Bupropion XL is $5.70 before adding the $5 shipping cost.

“This means that Amazon just cut the prescription cost by two-thirds, cutting their profits on the fill by $10—likely bringing it close to $0. They would have to add a whole lot of scale to make up for these discounts.”

Gina Lohr, Managing Director, The Advisory Board

Mark Cuban, owner of the Dallas Mavericks basketball team and host of the TV show Shark Tank, formed the Mark Cuban Cost Plus Drug Company roughly a year ago. The online pharmacy cuts out the drug middleman and sells the medication at cost, plus a 15% markup and pharmacist fee. Cuban’s pharmacy says it will negotiate drug prices directly with manufacturers to lower consumer costs. The pharmacy doesn’t accept health insurance but says prices will still be lower than what people would typically pay at a pharmacy. The website currently offers 100 generic drugs to treat various illnesses, including diabetes, asthma, and heart conditions.

YouTube Video Credit: Recode, 2022

For someone without health insurance (which the company does not accept in the first place) or whose plan has high deductibles or copays, the savings can be dramatic. For example, the average wholesale price for a month’s worth of the cancer treatment imatinib (generic Gleevec) is $9,657, which you could cut to $120 with a coupon from the drug-tracking company GoodRx. Meanwhile, Cuban’s company offers a one-month supply for just $47.

It partnered with EmansaRx, the pharmacy benefit manager spun out of the Purchaser Business Group on Health, in December to provide discounted prescription drugs to self-insured employers

These two behemoths aren’t the only ones looking to lower patient prescription costs. A number of health systems banded together in 2018 to form the nonprofit drug company CivicaRx, which began supplying member hospitals with generics one year after its launch. A subsidiary called CivicaScript has partnered with payers like Elevance to develop and manufacture common but pricey generics that don’t have enough market competition to drive down cost and launched its first product in August 2022. Like the Mark Cuban Cost Plus Drug Company, Civica Rx creates a direct route from the manufacturing facility to the customer. The company keeps the supply chain short, sourcing drugs from the U.S. where possible, and negotiates directly with suppliers. (Both companies are also building their drug manufacturing plants in the U.S.) Kaiser hospitals have benefited from a cheaper, more consistent supply of generic insulin, blood pressure drugs, and other vital medications after contracting with Civica Rx.

YouTube Video Credit: A Second Opinion Podcast, Senator Bill Frist, MD

ScriptCo pharmacy, a membership-based pharmacy company, offers a similar service to RxPass for an annual fee of $140.

YouTube Video Credit: ScriptCo, Inc.

GoodRx helps more than 20 million Americans save money on prescription drugs and healthcare each month, and has saved its users more than $30 billion since its inception.

YouTube Video Credit: Click on Detroit, Local 4, WDIV

There’s a growing list of startups targeting the $500 billion retail pharmacy sector as a massive opportunity to disrupt the status quo. Companies in the space include Alto Pharmacy, Capsule, Truepill, and NowRx.

So, which of the two titans comes out on top in the battle to disrupt the discount prescription drug market? Both companies take a long view of their journey to profitability. Amazon would appear to have a leg up in the competition. According to a recent JD Power survey, nearly two-thirds (66%) of brick-and-mortar pharmacy customers currently have an Amazon Prime account, and roughly half (48%) of pharmacy customers are aware of pharmacy services offered by Amazon. Fourteen percent of customers know about Amazon’s PillPack online pharmacy service. “Of that group, 38% say they ‘definitely will’ switch pharmacies in the next 12 months,” the J.D. Power study stated.

Image Credit: CB Insights, Big Tech in Pharma Report, 2022, page 25

Cuban has deep pockets. But in the interview with Kara Swisher at Recode, he was unwilling to say exactly how much he has poured into Cost Plus Drugs at this point (other than “a lot”). Amazon’s introduction of RxPass changes the pricing dynamic and will likely force Cuban to reevaluate his “cost plus fifteen percent” strategy to remain competitive. Whether or not Cuban can attract the same visibility and customer loyalty as cited in the Amazon numbers above remains unclear.

“What Mark is showing people is that so much of the costs have nothing to do with the manufacturer. They happen after the drug leaves the manufacturer before it ultimately gets to patients.”

Brent Vaughan, CEO, Cognito

The biggest challenge for Cost Plus Drugs moving forward is continuing to get manufacturers to realize that simplifying patients’ medication access is ultimately a good thing. And that’s a tall order.

At this point, I think it’s “advantage Amazon.” They’ve got the deep pockets, name recognition, infrastructure, and staying power to experiment with and refine the RxPass program into another “added value” Prime service for their vast customer base. Time will tell how much Amazon disrupts the pharmacy market, but the tech giant’s moves are worth tracking as it pushes deeper into healthcare.

January is Glaucoma Awareness Month – How Technology Can Help in Detection & Treatment

hjsochLeave a comment

“Normally for glaucoma, we’re monitoring pressure two to four times a year with patients coming in every three to six months for a pressure check in the clinic, and it’s just a single spot reading. At home with this device, you get multiple readings over continuous days, so it’s a more accurate representation of their pressure in real life. You can catch spikes in pressure that you might miss from that one in-office check.”

Leo Seibold, MD, Associate Professor of Ophthalmology, University of Colorado School of Medicine
Image Credit: Shutterstock.com

Glaucoma is an age-related chronic optic neuropathy and the leading cause of irreversible blindness worldwide. Predictions report that in 2040 the number of people with glaucoma worldwide will reach almost 112 million, disproportionally affecting Asian and African countries. A significant challenge in trying to tackle glaucoma-related blindness is to identify those with this eye disease before they become symptomatic.

Glaucoma is diagnosed clinically by detecting the characteristic changes of the optic disc and can be confirmed with a corresponding visual field (VF) defect. However, the clinical diagnosis of glaucoma is subjective and relies on the examiner’s experience. A particular challenge for detecting glaucoma is the wide variation of optic disc structure and size in the population. Therefore, there is an urgent need for novel and accurate techniques to detect glaucoma that can be used in different settings.

Fortunately, we are witnessing new practical applications of artificial intelligence (AI), including advances in complex artificial neural networks (ANNs) and constant innovations in daily-used devices such as smartphones, laptops, electronic tablets, wireless communications, etc. Here is a quick review of some new technologies that improve glaucoma diagnosis and treatment.

Tonometry

There are several well-recognized risk factors for glaucoma, including elevated IOP, older age, ethnicity, and family history of glaucoma. Of all risk factors, the level of IOP is the most important one and is the only one that can be modified with treatment. The risk of developing glaucoma rises with increasing IOP. This is supported by the fact that those patients presenting with advanced disease at diagnosis are more likely to have higher IOP. Higher IOP is also a risk factor for disease progression.

Self-monitoring of chronic diseases, such as monitoring blood glucose levels for diabetes mellitus and measuring blood pressure in hypertensive patients, can be effective for informing patients when their current treatment is not sufficiently effective, thereby giving them a sense of control over their condition along with improved disease control. The ability to measure IOP at home throughout different periods of the day will enable physicians to identify potential failures in treatment and possibly improve the prognosis for the patient. The self-monitoring approach could bring significant patient benefits, such as symptom management and improved quality of life.

Peak IOP and IOP fluctuations have been identified as risk factors for the development and progression of glaucoma. Diurnal fluctuations of IOP are highly unlikely to be observed during clinical visits. The Icare home tonometer is based on the principle of rebound tonometry. No topical anesthetic is required, and there is minimal risk of corneal injury. It may be an option for some glaucoma patients to monitor their IOP better at home and aid in managing their condition.

New technologies, such as sensors and wireless devices, present promising tools that enable continuous monitoring of IOP. One of the first platforms used was the SENSIMED Triggerfish contact lens sensor (Sensimed AG, Lausanne, Switzerland). This soft silicone contact lens is provided with a circumferential sensor that consists of 2 platinum-titanium strain gauges designed to measure changes in the radius of curvature of the cornea. A microprocessor transmits an output signal to a wireless antenna on the periocular surface. A cable wire transfers the data to an external portable recorder. The SENSIMED Triggerfish is noninvasive, but the data’s clinical value is uncertain.

Fundal Imaging

Assessment of the damaged optic nerve and retinal nerve fiber layer is a crucial method to detect glaucoma. Stereoscopic fundus examination by an expert clinician is considered standard practice. Automated imaging systems, particularly optical coherence tomography (OCT), are now widely used for glaucoma diagnosis. However, OCT examinations involve high costs, which may not be affordable by some healthcare providers. The advent of digital photography has made it easier and cheaper to acquire and process optic disc images. Nonmydriatic stereoscopic cameras are particularly useful for evaluating the optic disc and helping detect disease progression. Using image processing, relevant features, such as the optic disc and blood vessels, can be analyzed and provide helpful information. Advanced mobile phone technologies enable remote health care delivery and have been proposed as useful tools in glaucoma detection. Newer smartphone devices have high-powered computational functions, cameras, image processing, and communication capabilities, and they have been developed as an inexpensive retinal photography tools.

One example of a successful combination of fundal imaging and smartphone technology is the Portable Eye Examination Kit (PEEK) Retina (Peek Vision, London, United Kingdom), a smartphone camera adapter developed by Bastawrous et al. This portable mobile phone retinal imaging system is low-cost and easy to use for minimally trained users. The PEEK Retina can capture excellent-quality optic disc and retinal images and has recently been validated for optic nerve imaging in population-based studies in the developing world. Multiple other adapters have been developed to convert modern smartphone cameras into fundus and anterior segment cameras, thus reducing their costs and increasing potential adoption. These include the D-Eye system from Italy (D-Eye S.r.l, Padova, Italy) and the Ocular CellScope (Cellscope Inc, San Francisco, CA) from the United States.

Perimetry

Full-threshold automated perimetry (e.g., Humphrey, Octopus) is routinely used to confirm the diagnosis of glaucoma and monitor disease progression. Alternatives to clinic-based standard automated perimetry have been developed, often to facilitate home monitoring. Smartphones and tablets have been shown to be suited for vision testing, and they can communicate with other wireless platforms sending data automatically for analysis.

Although there are substantial challenges associated with home tonometry, including the calibration of monitors (e.g., securing a constant illumination intensity and size of the stimuli), determining the reliability of the test, and maintaining participant concentration, at the moment it is possible to perform VF tests using a tablet-based procedure. In addition to the role of detecting glaucoma, new perimetry technologies using tablets or portable computers have been designed to facilitate patients performing unsupervised perimetric tests as part of a home-monitoring program. Similar strategies have been tried successfully in patients with age-related macular degeneration and with promising results.

The glaucoma screening application called Visual Fields Easy (VFE) is available for the iPad and can be downloaded for free. The VFE showed promising capacity compared with diagnosis based on a Humphrey 24-2 SITA-Standard outcome. The VFE test evaluates 96 test locations (24 per VF quadrant) across the central 30-degree radius in 3 minutes on average, and the testing distance is 33 cm. The test results can be directly printed or emailed using Wi-Fi from the iPad. VFE worked well for identifying moderate-to-severe disease.

Cambridge Consultants has developed a smartphone glaucoma screening technology called Viewi that could be used in a clinic setting or from patients’ homes. The Viewi system includes a smartphone app, a Bluetooth finger button, and a headset that holds smartphones. The smartphone is slid into the viewer, the app is started, and the patient can hold the button in 1 hand, pushing when a light flash is seen. The app runs a suprathreshold static perimetry test. The test results are displayed in an intuitive format on the smartphone and can be shared instantly with healthcare professionals.

Artificial Intelligence

Using ANN and other AI strategies as glaucoma diagnostic tools are becoming a reality. Several techniques have been used to automate the glaucoma detection process. Moorfields Eye Hospital’s collaboration with Google (Alphabet Inc, Mountain View, CA) DeepMind aims to create a general-purpose AI algorithm that can look at OCT scans and diagnose age-related macular degeneration and diabetic retinopathy. VISULYTIX recently introduced PEGASUS (Visulytix Ltd), a new deep learning-based AI technology. It consists of an inexpensive smartphone clip-on optic nerve scanner that looks at several features within fundus images and provides information about the health of the optic disc. PEGASUS can be used not only for glaucoma detection but also for diabetic retinopathy and macular diseases.

Although the number of AI successes in glaucoma will likely grow in the near future, some promising applications are far from their clinical validation. Deep learning AI algorithms might allow the assimilation of multiple composite test results obtained at one screening visit to optimize diagnostic performance at a low cost.

Genetic Testing

There have been an increasing number of genetic studies on glaucoma recently, mainly due to a substantial reduction in the cost of high-throughput genome-wide genotyping platforms. In glaucoma, it seems that genetic testing may be helpful in some circumstances, such as screening of family members in OAG affecting young people with an apparent autosomal dominant inheritance. It has been proposed that genetic testing may help predict conversion from ocular hypertension to glaucoma or help predict disease progression, but the validation of these observations is required. Several international collaborations are currently ongoing, trying to understand the genetic components of glaucoma better. However, at the moment, genetic testing of broader populations is not justified.

New technologies for glaucoma detection have emerged, but their potential value and adoption greatly depend on the setting and the potential use of the test. Possible adoption of teleglaucoma and portable tablet or smartphone-based technologies is expected to facilitate glaucoma detection and management in remote and underserved populations.

Some Observations on Digital Health @CES 2023

hjsochLeave a comment

“The digital health summit is a very prominent part of the overall experience. We’re starting to see the lines between regulated medical devices and health, wellness, lifestyle devices converge.”

Joel Goldsmith, Director, Digital Platform, Abbott Diabetes Care
Image Credit: Consumer Technology Association

Every January, thousands of “techies” descend on Las Vegas to attend the annual Consumer Electronics Show to see what new things are on display and geek out on the futuristic technologies (some of which will probably never reach the market) that are demonstrated.

Digital health was at the forefront of this year’s Consumer Electronics Show, with notable speakers, announcements, events, exhibitors, and even a startup pitch competition. It isn’t easy to cover all of the products and features shown, but after reviewing all the reporting and checking out some of the companies websites, here are a few that I found interesting.

There was an odd obsession with smart toilets this year – At this year’s show, a quartet of companies is showing off urine analysis tools designed to be used at home by the general public. Most of them are built for your toilet, testing your urine for many easy-to-identify maladies.

The most talked-about gadget at CES was indeed Withings’ U-Scan. The company showed off a device that sits on the dry part of your toilet bowl and samples some of your trickle as you urinate. Once that fluid is captured inside the device, it runs a sample through a microfluidic cartridge (with reaction paper) and uses a reader to look at the result. Once completed, the results are sent to your phone, with suggestions on what you might do to improve your health. When it’s eventually released, U-Scan will offer a cartridge for menstrual cycle tracking, as well as one to monitor your hydration and nutrition levels.

Image Credit: Withings

Korean company Yellosis graduated from Samsung’s startup incubator some years ago and has already produced the Cym Boat personal urine testing kit. At the show, it also showed off its next-generation product, Cym Seat, which uses a metal arm to hold a paper stick under a person as they urinate. Once completed, it slides the strip in front of an optical scanner, and after a minute, the results are pushed to your phone. But this device, expected to launch by the end of 2023 and cost around $1,000, automates the existing process rather than adding anything new.

Vivoo, which also offers a reaction-paper stick that a smartphone app can analyze, is building its own toilet-mounted hardware, which pushes a urine stick into the toilet bowl and then pulls it back in once it’s collected a urine sample. An optical scanner then reads the reaction squares before depositing the stick in a collection bin for disposal later.

Finally, there’s Olive, which is taking a dramatically different tack. The device harnesses spectroscopy rather than reaction paper, with hardware that sits under your toilet seat and a bank of LEDs flashing toward rear-mounted photodiodes. The potential for such a technology is far greater than reaction paper, and some studies have pointed to being able to identify infection with it.

My take – I’m not sure how large the addressable market would be for these smart toilets. There are issues, including around data security, especially for menstrual cycle tracking in countries like the US. Companies that could expose fertility data will need to be mindful of the legal context that is presently in place post-Roe. Will these devices be accurate enough for the jobs they’ve been bought to do? And will the conclusions they provide be worthwhile? There’s a lot to work through before these products become ubiquitous in bathrooms worldwide.

Next is a medical-grade smart ring from Movano. After announcing the Movano ring at last year’s CES, healthcare solutions company Movano Ring upped the ante this year with its new smart ring, Evie. If cleared by the FDA, the ring will be the first consumer wearable that is also a medical device. Evie is designed to give women a full picture of their health, including resting heart rate, period and ovulation tracking, sleep stages, SpO2 levels, skin temperature variability, and more.

Image Credit: Movano Health

“We are bringing together medical grade biometric data and insights in a comfortable and contemporary wearable that allows women to take ownership of their unique health journey.”

Dr. John Mastrototaro, CEO of Movano Health

My take – Movano Health is going after Oura, the market leader in this wearable segment. While it is nothing revolutionary, it is a good step forward in the market of subtle wearable tech. It will be interesting to see how long the FDA process takes – especially since the company is touting Evie as a medical-grade wearable device.

Can taking a selfie potentially save your life? – NuraLogix’s Anura app demonstrates the usefulness of a selfie with its technology that can check vital signs using a cell phone camera. The app uses artificial intelligence to offer about 1,000 diagnostics with a 30-second selfie. The diagnostics include heart rate, blood pressure, stress levels, blood sugar levels, and more. The app is available on both the Apple and Google app stores.

Image Credit: NeuraLogix

My take – Despite the claims, there’s a big disclaimer on their website that reads:

Disclaimer image

For Investigational Use Only. Anura™ is not a substitute for the clinical judgment of a health care professional. Anura™ is intended to improve your awareness of general wellness. Anura™ does not diagnose, treat, mitigate or prevent any disease, symptom, disorder or abnormal physical state. Consult with a health care professional or emergency services if you believe you may have a medical issue.

Real-time wearable hydration monitor – Epicore Biosystems unveiled its new Connected Hydration sweat patch and mobile app at the 2023 CES. Connected Hydration is the first electronic wearable that continuously measures sweat fluid and electrolyte losses while monitoring skin temperature and movement. To prevent hydration, an alarm goes off on the device when wearers’ fluid loss exceeds two percent of body weight. According to Epicore, the device is intended for people who work in harsh conditions, athletes grappling with extreme heat, and people living through severe heat waves.

Image Credit: Epicore Biosystems

My take – At first glance, this device might appear to have limited market appeal. But the statistics around this problem are staggering. The harmful effects of high temperatures diminish physical and cognitive performance, leading to a staggering 170,000 work-related injuries and 2,000 fatalities annually in the United States. The increasing temperatures also reduce productivity, with total global labor productivity expected to decrease by more than 18% if temperatures rise by 1-3 degrees Celsius. Excessive environmental heat also takes a financial toll, costing employers upwards of $79,000 in worker compensation per affected worker.

Technology to help people with speech issues – Whispp demonstrated its AI-powered smart speech amplifier app and technology. The company’s mobile app converts whispered speech, vocal cord-impaired speech, and severe stutters into a person’s natural voice in real time. This allows users to make themselves heard anywhere while maintaining their freedom of movement.

YouTube Video Credit: Whispp

My take – The technology developed by this Netherlands-based company can aid the more than 500,000 people in the U.S. who have severe issues with voice disorders or stuttering or cancer patients who have difficulty speaking.

Portable virus detector – Opteev Technologies debuted its affordable and convenient breath analyzer, Virawarn. According to the company, the compact and reusable device can detect COVID-19, Influenza, and RSV in less than 60 seconds. Virawarn uses a silk-based biosensor that attracts the electrical discharge of respiratory viruses and an artificial intelligence processor that filters out any potential inaccuracies. Users turn it on, blow twice into the mouthpiece, and an LED notification light will indicate a positive or negative result in under 60 seconds. ViraWarn is reusable and comes with multiple biosensor replacement cartridges that only require being replaced after a positive result or after a period of 2 – 3 weeks of daily usage.

Image Credit: Opteev Technologies

My take – The company just submitted ViraWarn to the US Food and Drug Administration (FDA) for Pre-Emergency Use Authorization (Pre-EUA). Breath is one of the most appealing non-invasive sample types for diagnosing infectious and non-infectious diseases. Exhaled breath is very easy to provide and is less prone to user errors. Breath contains several biomarkers associated with different ailments that include volatile organic compounds (VOCs), viruses, bacteria, antigens, and nucleic acid. Results with COVID-19 detection were highly successful, with 95% Sensitivity and 90% Specificity.

Also, assistive technologies were prominently featured at CES this year. The need for assistive technologies is increasing and is likely to grow due to at least four interrelated reasons: an aging population, increases in the prevalence of disability, increases in the burden of chronic disease, and the corresponding increased load placed on caregivers.

L’Oréal announced plans to release late this year Hapta, a computerized makeup device with motion controls, to help people with limited arm mobility apply lipstick.

YouTube Video Credit: L’Oreal

The Scewo Bro is an adjustable-height wheelchair designed by roboticists and inspired by luxury vehicles. The device is about the same size as a traditional powered wheelchair, but it has two wheels and a pair of tank-like treads for rocky terrain and stair climbing. When approaching stairs, users tap a button. Laser sensors detect how steep the stairs are, and the chair automatically adjusts for the climb. The company tested it with several hundred wheelchair users and tweaked the design based on their feedback.

Image Credit: Scewo AG

Samsung Electronics is adding a mode to new TVs which can outline shapes and content for visually impaired viewers. Relumino Mode is a new picture mode from Samsung that is specially adapted for the visually impaired. When activated, this picture mode highlights contours, lines and colours, making the picture easier to interpret. For a person with normal vision, it may resemble a cartoon-like filter, but for a person with impaired vision, this may be exactly what is needed to decipher and understand the action.

Image Credit: Samsung Electronics

Toronto-based eSight showed its coming wearable for people with vision impairment caused by macular degeneration, glaucoma and other eye conditions.

Image Credit: eSight Eyewear

My take – Older Americans represent a growing audience for assistive technology and fuel a growing demand for increased accessibility in other products. The spotlight on accessible technology also comes as Americans face a financial strain, which might drive people to put “need” purchases over “want” purchases. And while the price tag for innovative assistive devices is often initially too high for many people who need them, startups are trying out subscription payment models for gadgets that insurance won’t cover.

Finally, for a terrific review of the key technologies featured in the age-tech space, I highly recommend this post from Keren Etkin, gerontologist, entrepreneur and author of The AgeTech Revolution – a book about the intersection of tech and aging. Keren’s blog is my go-to resource for all things age-tech related.

2023 looks to be a pivotal year for digital health companies as macroeconomic conditions continue to push investors’ demand for profitability over growth. At the same time, customers (in the form of patients, providers, employers, and insurers) are looking for technologies that prove their clinical worth and deliver seamless care journeys. Point solutions are out of favor as patents, providers, and employers are looking for integrated solutions that combine critical data with analysis tools into a comprehensive data set that reduces costs, improves care provider productivity, and improves clinical outcomes. Companies that cannot provide clear evidence that they can meet these requirements will struggle in this environment.

Time to Expand Remote Sensing Technology Use in Sports?

hjsochLeave a comment

“It was basically an eye opener for so many parents who have children who love football. Parents might be a little bit more hesitant wanting their child to play if that’s going to happen. It’s unreal.”

Harry Carson, Former Linebacker, New York Giants, on Damar Hamlin injury
Image Credit: Shutterstock.com

On the New Year holiday, while the country was enjoying a half-century-old mass ritual known as Monday Night Football, millions of people – myself included – were left watching Buffalo Bills safety Damar Hamlin fighting for his life near the 50-yard line. As we pray for his recovery, it’s appropriate to ask ourselves: can we, in good conscience, keep embracing this game? And, is there a better way to use real-time technology to monitor the health of athletes in all areas of sport?

Image Credit: Getty Images

People have been wrestling with this question for over a decade, as science has shed light on football’s health consequences. Chronic traumatic encephalopathy (CTE) was once an obscure entry in medical textbooks. Now, it’s the neurological disease associated with repeated blows to the head, known for afflicting more than 300 former NFL players and perhaps hundreds more (the condition can only be definitively diagnosed post-mortem).

“The sport of football is inherently dangerous.”

Kevin Farmer, University of Florida

And Hamlin’s injury is just the most recent example. Hamlin’s injury occurred mere months after Miami Dolphins quarterback Tua Tagovailoa suffered a gruesome concussion-related event when he began seizing on the field following a play—which occurred just weeks after he collapsed due to a separate concussion following a brutal hit in an early season game. In the preseason, the NFL finally tested new helmets designed to prevent concussions. Reports from the league suggest they were effective, but no move has been made to require them in the regular or postseason.

While Hamlin didn’t suffer a head injury (many medical experts suspect his heart stopped due to commotio cordis, an extremely rare but sometimes fatal disruption to heart rhythm resulting from a blow to the chest), it raises the issue of whether real-time monitoring technology can be used more effectively to prevent severe injuries from occurring during games.

A recent peer-reviewed study demonstrates the feasibility of utilizing medical-grade sensors for collecting and monitoring real-time digital biomarkers on elite athletes in live competitions. The peer-reviewed study, Real-time Digital Biometric Monitoring During Elite Athletic Competition: System Feasibility with a Wearable Medical-Grade Sensor, was conducted in professional squash matches in 2019-2020 in cooperation with the Professional Squash Association. The findings demonstrated the capability to reliably capture clinically valid data from medical-grade wearable sensors on athletes exhibiting extreme motion and supraphysiologic characteristics in live competition.

“There is a clear extrapolation to other sports, athletes and venues, but more importantly, the opportunity for real-time observations, reactions, adjustments, refinements of performance, and ultimately predictions derived from sensor data,”

Giulio Bognolo, M.D., Chief Medical Officer and Head of Human Data Labs, SD Labs

In professional team sports, collecting and analyzing athlete-monitoring data are standard practices to assess fatigue and subsequent adaptation responses, examine performance potential, and minimize the risk of injury or illness. GPS trackers sewn into athletic uniforms feed back real-time information on NFL players’ balance, speed, acceleration, and motion. Early signs of injury to soft tissues are readily detected, letting coaches relieve players before serious problems arise. Impact monitor stickers attached to players’ bodies alert coaches and trainers to invisible signs of potential concussion, brain trauma, over-exertion, or injured muscles, tendons, and ligaments.

But that assessment happens during practice sessions and during the recovery period following the actual game itself. The groundwork has been done with the NFL linking up with Zebra Technologies to add monitoring tags to the shoulder pads of all players. The real game-changer will be when this data is made available to coaches during live matches. Is there a case to be made that real-time monitoring should be incorporated into the game? I think we’re at a point where the usual arguments put forward against it are disappearing.

Image Credit: Zebra Technologies
  • Cost – The cost of real-time medical-grade sensors has dropped exponentially over the last five years. And for professional sports teams, where billions of dollars are spent each year, the costs are a pittance.
  • Size & Weight – Sensors and devices for athletes must be almost invisible and weightless, as well as flexible, durable, and impact resistant. Medical grade sensors today are smaller than ever, and their weight is negligible – especially if they are incorporated into clothing.
  • Interference with performance – Today’s medical grade sensors can be easily incorporated into the player’s uniforms and have minimal impact on performance.
  • What they are measuring must be accurate and actionable – Devices already in use are measuring over one hundred human metrics, including heart rate, metabolism, stress load, core temperature, and physical impact from trauma. Researchers are forging ahead, designing devices that will be available soon to more accurately measure hydration levels and deeper aspects of physical stress and metabolic function
  • Player privacy concerns – Many argue that understanding an individual player’s performance stats, physical challenges, and recovery times could be used in contract negotiations, trade talks, and performance incentives. Just as in healthcare, some privacy regulation (like HIPAA) needs to be in place and enforced.

Sports teams are quickly learning how wearable sports technology can improve their team’s performance and save players from injury and illness. But we must take advantage of today’s technology to better protect these elite athletes during the game. In professional sports, where billions of dollars are spent annually, the cost of implementing real-time, in-game monitoring for all athletes is a pittance. And as we experienced on Monday night, it only takes a few seconds for it to stop being a game—and start being about life and death.

Health Care Disruptors to Watch in 2023 – It’s Not About The Technology This Year

hjsoch3 Comments

“Trust me, you can’t change anything without causing some degree of disruption. It’s impossible, that is exactly what change is. Some people are uncomfortable with the disruption that change causes, but the disruption is necessary if anything is going to change.”

Afeni Shakur, American Activist
Image Credit: Shutterstock.com

“Old habits die hard”

Anonymous

After nearly twenty years of debating which technologies will significantly impact the coming year, the exercise almost becomes a part of your professional DNA. So, in Q4 every year, I start looking at all of the Tech Trends for the next year and thinking about which will rise to the top of my list. But this year is different in so many ways. 2022 was a very strange year. The stock market plummeted, interest rates rose, and inflation skyrocketed, creating problems for companies across all stages of growth. Healthcare companies weren’t immune as VC funding plummeted, and purchases by health systems were deferred to preserve scarce capital.

Image Credit: CB Insights report State of Digital Health, Q3, 2022

To be clear, there was no shortage of technological innovation in healthcare in 2022. Just read any of my weekly Tech News posts, and you’ll find dozens of companies creating innovative digital health solutions to many pressing problems providers face in caring for patients and their families. What has changed is the market we’re operating in. There are several reasons for the change.

We’re coming out of year three of the pandemic, and health systems are still under pressure to care for patients. For over three years, daily, under exhausting and often dangerous conditions, healthcare workers across the country have continued to care for the nation’s sickest Americans who have fallen victim to coronavirus. The burden on the health care system is made worse by nationwide staffing shortages and hospital capacity at elevated levels as many other patients seek care for non-virus-related reasons. As we close out the year, the “triple-demic” of COVID, seasonal flu, and RSV infections (especially in children) is straining the health system to its limits again.

More than half of U.S. health systems will be operating in the red in 2022. According to reporting from Kaufman Hall, More than half of U.S. hospitals (53%) are projected to have negative margins for the rest of the year. Under more pessimistic scenarios, more than two-thirds of hospitals (68%) could have negative margins this year, their report stated. Hospitals have been confronting much higher expenses this year. Hospitals’ expenses are projected to rise $135 billion in 2022, compared to the previous year, according to the report. Labor accounts for the bulk of the increase, a projected $86 billion, with non-labor expenses rising $49 billion.

The top three issues for health system executives and boards are staffing, staffing, and staffing. Hospital leaders in multiple interviews all said they are struggling to find talent. The labor shortages are forcing hospitals to close beds and scale back some services. Hospitals are seeing longer waits in emergency departments, and surgeries and other procedures are being delayed.

“The crisis is real. The shortage of healthcare workers is nothing like we’ve seen before.”

Mike Slubowski, President and CEO of Trinity Health

So, the disruption in healthcare in 2023 comes from these three drivers and will challenge innovators to come up with solutions for several major issues:

Cybersecurity and Ransomware attacks remain top of mind for health systems in 2023. Hospitals, pharmacies, care centers, and other healthcare organizations are prime targets for malicious cyber-criminals. There are a few reasons for this: healthcare organizations deal with vast amounts of personal and private data, which can be hugely valuable for criminal groups. Healthcare organizations often cannot afford to invest in the latest and greatest security technologies, making them an easy target for every type of cybercrime, from gift-card scams to sophisticated ransomware. Exacerbating these issues, the healthcare industry has been under immense pressure over the past three years, dealing with unprecedented challenges during a worldwide pandemic.

“We have to realize that cybersecurity isn’t just about data security; it’s also a matter of life and death.”

Michael Archuleta, CIO, Mt. San Rafael Hospital and Clinics, Trinidad, Colo.

Cybercriminals have cynically exploited the COVID-19 pandemic. The healthcare sector is on track to meet or exceed the more than 50.4 million patient records breached in 2021. Since cyber threats only seem to be getting worse, healthcare executives are planning on increasing their cybersecurity budgets for increased training and infrastructure in 2023 to fend off these kinds of attacks, according to a recent survey from software firm Ivanti. It has been estimated that over the next three years, healthcare-related data breaches will cost healthcare companies a total of $6 trillion. Healthcare organizations will spend $125 billion on cybersecurity from 2020 to 2025.

Addressing staffing and capacity constraints drives broader adoption of command centers in health systems. In the past half-decade, command centers have been gaining ground as permanent fixtures in healthcare organizations — a sort of air traffic control for patient care. When the COVID-19 pandemic hit, health systems with command centers up and running were well-positioned to deal with the overwhelming demand for care, providing hospitals with real-time insight into bed availability, staffing levels, and patient journeys. Health systems with command centers have real-time visibility into staffing levels, which can improve coordination between care teams and break down silos. Staff will appreciate the efficiencies command centers can bring. For example, patients who can be discharged aren’t left lingering in beds, and rooms can be cleaned more quickly. This level of coordination requires well-designed communication channels across departments, ultimately improving processes systemwide.

With the incorporation of remote solutions, these command centers can offer an opportunity to combat clinician burnout. If integrated with a virtual nursing program, for example, overextended nurses might rotate off the floor and remotely support newer nurses at the bedside. In this way, newer nurses benefit from the older nurses’ years of experience, and older nurses get a better work-life balance. Imagine how that translates into improvements in employee satisfaction and clinical outcomes.

“Nice-to-have” solutions go on the back burner. “Mission-critical” solutions get attention. 2023 will not be a year where buyers take chances on unproven technology. Startups need to sell solutions that solve problems in the short term and figure out a way to prove they can do that as quickly as possible. Getting an executive team to act on sourcing a digital solution means making a solid case around how the solution either reduces costs, increases revenue, increases staff productivity, or improves clinical outcomes. I’ve found this equation developed by Alex Lindsay of Office Hours Global to be an effective way to discuss that concept with startups (who are often frustrated by the length of time it takes for a healthcare executive team to make a decision) looking to sell their solutions into healthcare.

Image Credit: Henry Soch, of an equation developed by Alex Lindsay

The gist of the equation is that action occurs when the vendor can demonstrate that the possibilities when implementing the solution exceed the current circumstances. What does that mean in today’s healthcare market?

Health systems that are bleeding cash are primarily looking for anything that supports payment, ideally upfront, or any tools that reduce burnout or help them solve the ongoing staffing crisis. On the other hand, employers are increasingly looking to whittle down their digital health vendors, particularly when utilization is low and outcomes are still to be determined.

So what technologies will get an audience with C-Suite Executives in 2023? Christina Farr from Omers Ventures expects the essential products that will sell well next year to include: Revenue cycle management tools, anything in labor/staffing, and solutions for burnout.

So, this year I’ve taken a different approach to characterize disruptors to health care in 2023. Such exercises are always interesting but also inherently risky – particularly in uncertain times like those we have recently experienced and continue to live through. So perhaps the most significant benefit of the annual round of tech soothsaying is not so much the fine-grained detail – often derailed by contact with unexpected events – as the chance to take stock of the industry’s general direction. These are my educated and informed predictions based on the current situation. I’ll revisit them at the end of 2023 to see if they came to pass. Happy New Year!

How Digital Technologies Can Support Breast Cancer Awareness – Breast Cancer Awareness Month – October, 2022

hjsoch1 Comment

“Please get your annual mammogram. I was six months late this time. I shudder to think what might have happened if I had put it off longer. But just as importantly, please find out if you need additional screening.”

Katie Couric, Journalist
Image Credit: Shutterstock.com

Katie Couric was diagnosed with breast cancer over the summer and subsequently underwent surgery and radiation treatments that finished this week. In the personal essay and on her essay and on Instagram, Couric, who is 65, shared information about the prevalence of breast cancer. “Every two minutes, a woman is diagnosed with breast cancer in the United States. On June 21st, I became one of them,” she wrote in a social media post shared Wednesday morning. “As we approach #BreastCancerAwarenessMonth, I wanted to share my personal story with you all and encourage you to get screened and understand that you may fall into a category of women who needs more than a mammogram.”

Today, there are more than 3.5 million breast cancer survivors in the United States, with 268,600 new cases expected to be diagnosed this year alone. With an estimated 89% of United States online and 72% owning smartphones, digital health technologies are uniquely situated to bridge the gap in breast cancer care through detection, intervention, and management. As we begin Breast Cancer Awareness Month, I wanted to dig deeper into the current developments and highlight some of the most promising digital health solutions to promote early detection and improve patient care for breast cancer patients and survivors.

Breast Cancer Apps – One of the most stabilizing things you can do with a breast cancer diagnosis is to get the correct information. In addition to your doctor, the right app can be a great place to find answers to all your questions. It can also offer access to a supportive community that understands what you’re navigating. Here are some of the most highly recommended apps based on their quality content, reliability, and user recommendations:

Breast Cancer Healthline – Those who are newly diagnosed, receiving treatment, or in remission will find support and camaraderie in the app’s one-on-one chats and group discussions. This is a place to find and receive advice, access current news and research, and connect with people who genuinely get it.

Cancer Therapy Advisor – An app designed for oncology professionals, Cancer Therapy Advisor compiles the latest in oncology news and trends, cancer treatment regimens, full-length features, slideshows, case studies, and drug information for various cancer types.

BELONG Beating Cancer Together – This free app helps get you access to the best care without a high cost of entry. You can directly communicate with researchers, experts, and other medical professionals who can give you quick, accurate responses to your pressing questions about breast cancer. You can also keep all your records within the app and share them with your doctor and your loved ones, too. You can browse and sign up for clinical trials and access leading oncologists, radiologists, researchers & nurses to answer your questions.

OWise Breast Cancer – OWise is an accredited mobile app and website that helps you regain control of your life from the first day of a breast cancer diagnosis. OWise provides safe, reliable, and credible information and practical support and guidance. You can monitor and share changes in your day-to-day well-being with your care team or other trusted individuals. This way, you can help your doctors to make timely and informed decisions on how to give you more personalized care.

Mammosphere – Life Image is the creator of Mammosphere. This breast imaging and cancer prevention application lets patients digitally transfer records to and from health care providers at the click of a button. 1 in 4 patients fails to gather their records promptly, skyrocketing the risk of being called back for additional testing or receiving a false positive. Life Image, based in Newton, MA, reduces the number of false positives for breast cancer by up to 60% and drives up patients’ chances of receiving an efficient and accurate diagnosis.

Untire – Untire, founded by Door Vonk, is an app that provides cancer patients and survivors with the tools to cope with extreme fatigue. As a result of cancer, its medical treatments, and the emotional and social impact of such a severe illness causes patients to suffer from severe fatigue. Developed by psychologists with the contributions of patients and researchers, Untire uses scientifically proven theories and mindfulness-based techniques to increase cancer patients’ energy and improve their lives. With less fatigue, cancer patients can fight cancer without sacrificing their enjoyment of life.

Savor Health – By leveraging a team of oncology nutrition experts and the latest technology, Savor Health—founded by Susan Bratton—designs individually personalized nutrition solutions to meet the unique needs of cancer patients at every step along their journey. This innovative technology utilizes deep learning models to promote algorithm-driven meal, content recommendations and nutritional counseling through a team of oncology credentialed registered dietitians and nurses.

A.I. and Clinical Decision Support –

PathAI – Path AI, founded in Boston, MA, utilizes artificial intelligence and machine learning technologies to improve the accuracy and speed of pathologist diagnoses and ensure patients get the correct diagnosis and the most effective treatment.

MIT Computer Science and AI Lab – Massachusetts Institute of Technology’s Computer Science and Artificial Intelligence Lab developed a new deep learning-based AI prediction model that can anticipate the development of breast cancer up to five years in advance. This innovative technology, trained on over 90,000 mammograms and 600,000 patient outcomes, can accurately predict over 30% of all cancer patients in the highest-risk category compared to the 18% detected by current models. In developing its technique, MIT sought to address disparities in detection inequality among minorities; Black women are more than 42% more likely than white women to die from breast cancer, a statistic primarily driven by the lack of minority representation in current early detection techniques.

Kheiron – London-based Kheiron has developed a machine learning platform dubbed Mia. Mia analyzes standard mammography images to help radiologists decide whether or not a woman requires further evaluation. The company says the software has already shown success in a multi-center clinical study

Google/Hologic – Global medical device company Hologic is another early adopter of the imaging suite. The company is using Google Cloud’s offering to strengthen its diagnostic platform that screens women for cervical cancer. Hologic will store its images using the suite, and it will develop an AI model with Google Cloud to improve diagnostic accuracy for those cancer images.

Digital technologies in breast health – Some critical ideas for scaling up from pilot programs to full-scale implementation:

  • Technology is an enabler, but feedback from the people at the forefront of providing care, particularly nurses, is essential to scaling up pilot projects.
  • Equally important is making sure that the people using the technology are properly trained.
  • Implement quality monitoring protocols
  • Set up public-private collaborations
  • Identify and scale-up high-potential solutions: who’s out there working on new ideas?
  • Find people who know how to analyse data.
  • Build into projects the questions that will help provide the answers to scaling up a project: who do we need to talk to; what data will be needed to convince governments, investors, organisations to participate?
  • Scale isn’t just about reach: it’s showing that the technology can be adapted to the local environment.
  • Scaling up successfully means being able to convince investors that the environment you’re working in is viable.
  • Understand the local digital regulatory environment.
  • And finally: never lose sight of the patient’s needs throughout the process of scaling up a pilot project.

Innovations in mobile health and social media applications are occurring across the cancer spectrum, from primary prevention to screening, early diagnosis, treatment, survivorship, and end-of-life care. Thousands of health-oriented mobile sites and apps have already been developed with the advantages of low- or no-cost, high scalability, self-tracking, tailored feedback functionalities, use of images and video for enhanced health literacy, broad reach, and data sharing for large-scale analytics. More and more research demonstrates that digital health interventions can support and improve patient experiences and outcomes. For breast cancer patients and survivors, digital health technology can ultimately increase their chances of a good quality of life and positive health outcomes.