“I think this is reaching a level of criticality that is getting the attention of CEOs and board rooms.”
Ed Gaudet, CEO and founder, Censinet – Interview with The Verge
Most of the current conversations around cybersecurity in health care have centered around ransomware and its impact on health system operations and finances. I’ve written on the topic earlier and continue to follow developments in that area. But an area that hasn’t received much attention is the risks, threats, and security issues related to IoT and related devices within healthcare environments.
An excellent new report published by healthcare cybersecurity company Cynerio reveals that over half of internet-connected devices used in hospitals have a vulnerability that could put patient safety, confidential data, or the usability of a device at risk. The report analyzed data from over 10 million devices at over 300 hospitals and health care facilities globally, which the company collected through connectors attached to the devices as part of its security platform.
The data are sobering. The most common type of internet-connected device in hospitals was an infusion pump. Infusion pumps were also the devices most likely to have vulnerabilities that hackers could exploit, and the report found — 73 percent had a vulnerability. Experts worry that hacks into devices like these, which are directly connected to patients, could be used to hurt or threaten to hurt people directly. Someone could theoretically access those systems and change the dosage of a medication, for example.
Other common internet-connected devices are patient monitors, which can track things like heart rate and breathing rate, and ultrasounds. Those types of devices were in the top 10 list in terms of numbers of vulnerabilities.
The major challenge associated with these devices is that unlike the IT world, where Microsoft Windows dominates the desktop, healthcare IoT is all over the map. In terms of security, this makes solutions like Endpoint Detection and Response (EDR) agents almost impossible to deploy. There is no way for those solutions to address the wide variety of operating systems that power devices created by different manufacturers for different medical purposes.
As you can see in the graphic above, nearly 50% of medical devices run on Linux, an open-source platform renowned for its stability and possibilities for customization. And for those devices that run on the Windows operating system, most are running on older versions of Windows, which is a problem. Most malware and ransomware are designed to attack Windows devices and will more easily threaten devices running on that operating system.
So, what’s necessary to reduce the risk? – Cynerio’s report notes that most of the vulnerabilities in medical devices are easily fixable: they’re due to weak or default passwords or a recall notice that the organization hasn’t acted on. Devices often come with default administrative passwords (like Daemon or Admin) and settings that remain unchanged and are accessible in device manuals that attackers can easily find online. Many healthcare organizations don’t have the resources or personnel to keep systems up to date and might not know if there’s an update or alert concerning one of their devices. Those organizations would benefit from engaging a company specializing in IoT security like Cynerio to help identify their specific issues and assist with mitigation. The dollars spent in that effort are small compared to the financial and operational pain the organization will experience if those vulnerable devices are breached.
What happened in health care technology this week – and why it’s important.
Researchers Turn Smartphones Into On-Demand Personalized Drug 3D Printer
Paul Hanaphy reports on research done at University College London (UCL), Universidade de Santiago de Compostela (USC), and biopharma firm FabRx, which converted an everyday smartphone into an on-demand personalized drug 3D printer. To make their setup as easy to replicate as possible, the team also developed a dedicated mobile app for their 3D printer, complete with ‘control,’ ‘print,’ and ‘configuration’ functions. Using their application, the researchers made it possible to not only control the movement of their system’s build platform but print using differently-shaped pre-prepared tablet models to streamline pill production.
Once assembled, the UCL-led team opted to test their custom printer by creating tablets containing Warfarin, a blood-thinning medication with highly reported patient response variability. Thanks to the flexibility of 3D modeling software, the scientists found they could create medication with doses ranging from 7.54 mg to 29.25 mg, showcasing their setup’s drug personalization capabilities.
Why it’s important – If the research is successful, and the UK approves its use with appropriate guidelines in place to minimize abuse, this technology could solve the “last mile” issue and be deployed to developing nations and rural areas to allow people there to 3D print medications on demand.
Infographic of the week – Share of those 65 and older who are tech users has grown in the past decade.
Strongest evidence yet that MS is caused by Epstein-Barr virus
It has long been suspected that the common Epstein-Barr virus can trigger multiple sclerosis (MS). As Michael Le Page reported in New Scientist, A huge study of US military personnel suggests almost all cases of multiple sclerosis are triggered by the common Epstein-Barr virus, meaning a vaccine could essentially eradicate the condition. The difficulty with demonstrating that the Epstein-Barr virus is the leading cause of MS is that 9 in 10 people worldwide are infected with it. This means scientists must monitor huge numbers of people to determine whether people who haven’t been infected with the virus are less likely to develop MS.
The research team found the numbers they needed in the form of US military personnel, who have blood samples taken regularly and stored, allowing them to be tested later for Epstein-Barr infections. Out of 10 million military personnel, 955 developed MS, typically around ten years after their first sample was taken. Yet only one of those who developed MS tested negative for antibodies against the Epstein-Barr virus. Another 34 were uninfected when their first blood sample was taken but became infected before being diagnosed with MS.
Why it’s important – For the 900,000 people in the United States and 2.8 million people worldwide living with MS, this is huge news. There may be new opportunities for therapy: Would a vaccine against EBV protect against MS? Can the B cells that dwell in the CSF be killed or inactivated with therapeutics? Would antivirals that target EBV provide effective therapy, especially when given early in the course of the disease? Now that the initial trigger for MS has been identified, perhaps MS could be eradicated. ‘This is really a turning point,” says Alberto Ascherio at Harvard University. It should lead to better ways to treat MS and help prevent it. While there is no vaccine against the Epstein-Barr virus, several groups are trying to develop one. On January 5th, Moderna announced that it had begun testing a candidate mRNA vaccine in people.
Researchers develop bone growth inspired ‘microrobots’ that can create their own bone
As reported in Devdiscourse online, inspired by the growth of bones in the skeleton, researchers at the universities of Linkoping in Sweden and Okayama in Japan have developed a combination of materials that can morph into various shapes before hardening. The idea was hatched during a research visit in Japan when materials scientist Edwin Jager met Hiroshi Kamioka and Emilio Hara, who conducted research into bones. The Japanese researchers had discovered a kind of biomolecule that could stimulate bone growth over a short period of time.
Why it’s important – This material could be used in, for example, complicated bone fractures. It could also be used in microrobots – these soft microrobots could be injected into the body through a thin syringe, and then they would unfold and develop their own rigid bones.
‘Fitbit for the face’ can turn any face mask into smart monitoring device
Northwestern University reported that engineers have developed a new intelligent sensor platform for face masks that they are calling a “Fitbit for the face.” Dubbed “FaceBit,” the lightweight, quarter-sized sensor uses a tiny magnet to attach to any N95, cloth, or surgical face mask. Not only can it sense the user’s real-time respiration rate, heart rate, and mask wear time, it also may be able to replace cumbersome tests by measuring mask fit. All this information is then wirelessly transmitted to a smartphone app, which contains a dashboard for real-time health monitoring.
Why it’s important – The app can immediately alert the user when issues — such as elevated heart rate or a leak in the mask — unexpectedly arise. The physiological data also could be used to predict fatigue, physical health status, and emotional state. In the study, researchers found FaceBit’s accuracy was similar to clinical-grade devices, and the battery lasted longer than 11 days between charges.
Leaders across healthcare, academia and technology form new coalition to transform healthcare journey through responsible AI adoption
Microsoft announced the formation of the Artificial Intelligence Industry Innovation Coalition (AI3C). The coalition brings together the Brookings Institution, Cleveland Clinic, Duke Health, Intermountain Healthcare, Microsoft, Novant Health, Plug and Play, Providence, UC San Diego, and the University of Virginia to maximize technology to provide recommendations, tooling, and best practices for AI in healthcare. The AI3C board, composed of volunteer senior executives acting as advisors, will work to co-create AI solutions for positive societal and healthcare outcomes, identify and set the AI strategy and vision for various projects, and track the success of AI adoption in the industry.
Why it’s important – The goal of the newly created AI3C is to establish a pragmatic coalition with public and private organizations to advance health by identifying and addressing significant societal and industry barriers. The AI3C intends to apply AI to resolve significant challenges in business such as general economic and industrial challenges – including research transfer, industry standards and funding instruments; digital skills and employability – including organizational and cultural challenges, as well as labor policies; and data privacy – including data access and shared innovation.
Healshape Raises $6.8M To Advance It’s Breast Implant 3D Bioprinting Technology
As reported by Kubi Sertoglu in 3D Printing News online, Healshape’s mission is to provide patient-specific 3D bioprinted breast implants for women who have undergone a mastectomy procedure after breast cancer. These implants can be printed in virtually any shape and size and help reconstruct both the breast volume and the nipple-areolar complex without the risk of implant rejection. Once implanted in the patient, a fat transfer of the patient’s own body cells helps colonize the breast implant and develop it into natural breast tissue, all while the hydrogel is gradually resorbed and replaced.
Why it’s important – Many of these breast reconstruction surgeries involve using either an artificial implant or soft tissue matrices from other humans and animals. Unfortunately, implants from these sources can result in too much variability for treatments to be considered reliable, and there’s always the risk of an immune response, which can slow down the healing process. Healshape’s tissue engineering approach aims to address these issues by combining 3D bioprinting technology with living cell cultures taken from the patients themselves. Still a very early stage of development here. Healshape’s 3D bioprinting technology is currently at the preclinical stage, with clinical trials expected to commence within the next two years.
AI Spots Antibiotic Resistance 24 Hours Faster Than Old Methods
Peter Ruegg published this article in Futurity.org online on research conducted at ETH, Zurich. It often takes two or more days to determine which antibiotics are still effective against a particular pathogen because the bacteria from the patient’s sample must first be cultivated in the diagnostic lab. Due to this delay, many doctors initially treat severe infections with a class of drugs known as broad-spectrum antibiotics, which are effective against a broad range of bacterial species. These researchers have developed a method that uses mass spectrometry data to identify signs of antibiotic resistance in bacteria up to 24 hours earlier.
Why it’s important – By identifying significant antibiotic resistance early, doctors can tailor an antibiotic therapy to the relevant bacterium more quickly. This can be particularly beneficial for seriously ill patients. While previous studies in this field of research have focused on individual bacterial species or antibiotics, the new research draws on several bacterial types isolated in hospitals and a multitude of associated resistance characteristics.
What happened in health care technology this week – and why it’s important.
FDA releases guidance for remotely acquiring data in clinical investigations
Kat Jercich’s article in Healthcare IT News reported on the new FDA draft report that offers recommendations for stakeholders about using digital health hardware and software to gather information from remote trial participants. The draft guidance touched on regulatory considerations, noting that DHTs used in clinical investigations of medical products would usually be exempt from applicable requirements to obtain marketing authorization and other device requirements. It also outlined considerations for study sponsors when using digital health tools in this fashion.
Why it’s important – The FDA has released a handful of draft recommendations and “guiding principles” over the past year aimed at offering clarity on medical devices. Software has become an important part of many products and is integrated widely into medical devices. The FDA recognizes this evolving landscape and is seeking to provide their latest thinking on regulatory considerations for device software functions that is aligned with current standards and best practices.
Infographics of the week – The time it takes to transmit an infectious dose of COVID-19 when non-infected person is wearing different types of masks. And a great infographic from The Public Health Collaborative.
Smart sutures to monitor deep surgical wounds
As reported in The National University of Singapore News in Nature, a team of researchers led by Assistant Professor John Ho from the NUS Electrical and Computer Engineering as well as the NUS Institute for Health Innovation & Technology has invented a smart suture that is battery-free and can wirelessly sense and transmit information from deep surgical sites. The NUS team’s invention has three key components: a medical-grade silk suture that is coated with a conductive polymer to allow it to respond to wireless signals; a battery-free electronic sensor; and a wireless reader used to operate the suture from outside the body.
Why it’s important – These smart sutures incorporate a small electronic sensor that can monitor wound integrity, gastric leakage and tissue micromotions, while providing healing outcomes which are equivalent to medical-grade sutures. One advantage of these smart sutures is that their use involves minimal modification of the standard surgical procedure. The smart sutures can be read up to a depth of 50 mm, depending on the length of stitches involved. Similar to existing sutures, clips and staples, the smart sutures may be post-operatively removed by a minimally invasive surgical or endoscopic procedure when the risk of complications has passed.
World-first pig-to-human heart transplant performed in US
In a historic procedure surgeons in the US have, for the first time, transplanted a genetically modified pig heart into a living human. As reported by Rich Haridy in The New Atlas online, the patient is currently still alive, has not rejected the pig organ and is being carefully monitored at the University of Maryland Medical Center. After much consideration the US Food and Drug Administration (FDA) authorized the surgery as part of a compassionate use provision allowing for experimental treatments in patients with life-threatening conditions.
Why it’s important – Perhaps the most significant recent steps leading up to this landmark moment were advances in gene editing allowing for the development of pig organs that are not rejected by a human immune system. The genetically modified pig heart used in the transplant was supplied by regenerative medicine company Revivicor and came from a pig that had been engineered with around 10 particular genetic modifications, all focused on reducing the chances of rejection from a human immune system.
J&J partners with Microsoft to build out digital surgery portfolio
Modern Healthcare’s Jessica Kim Cohen reports that Johnson & Johnson and Microsoft have embarked on a partnership to support development of the drug and device company’s digital surgery products. Johnson & Johnson Medical Devices will collaborate with the software company to advance its digital surgery platform and internet-connected medical devices. The companies plan to apply Microsoft’s artificial intelligence, data analytics and “internet of things” capabilities to improve connectivity between Johnson & Johnson’s surgical robotics, visualization and other digital tools. The companies plan to develop digital tools that streamline surgical workflow or support surgical decision-making.
Why it’s important – Devicemakers such as Johnson & Johnson have been pursuing more digitally connected surgical tools in recent years, including AI, pre-, intra- and post-operative care and “smart” surgical implants that send data directly to physicians. And M&A is a key element of their growth moving forward, in every segment—pharmaceuticals and medical devices.
Headspace Health grabs startup Sayana to build out AI-based mental health tools
More M&A news this week as Heather Landi from Fierce Healthcare reports that six months after the $3 billion merger with Ginger, Headspace Health acquired Sayana, an AI-driven mental health and wellness company. Sayana will expand Headspace Health’s ability to provide personalized self-care content to its 100 million users. The recent merger deal combined Ginger’s teletherapy services with Headspace’s meditation and mindfulness app. Headspace Health now aims to provide an integrated experience to tackle the full spectrum of mental health needs —from prevention to clinical care—all from one platform backed by AI and data science.
Why it’s important – With the ongoing pandemic fueling demand for mental health services, this acquisition positions Headspace to capitalize on the hypergrowth in that side of the business. The company reports 59% year-over-year growth in employer bookings. According to the WHO, more than 264 million people of all ages suffered from depression in 2020. Depression is a leading cause of disability worldwide, and is a major contributor to the overall global burden of disease. The global mental health market was valued at $383.31 billion in 2020, and is estimated to reach $537.97 billion by 2030, growing at a CAGR of 3.5% from 2021 to 2030.
Researchers shatter the speed record for diagnosing rare genetic diseases with DNA sequencing
In his first article for STAT, Jonathan Wosen reviews research conducted by a team of Stanford researchers and collaborators published a letter in the New England Journal of Medicine reporting that they had sequenced 12 seriously ill patients and successfully diagnosed five of them. In all five cases, the information led to tangible changes in how patients were treated. Throughout the six-month study, which kicked off in December 2020, researchers tweaked nearly every step of the sequencing process, from having someone run samples from the hospital to the lab to shortening the time needed to prep DNA for sequencing.
Why it’s important – Typical turnaround time for diagnosis was around eight hours and as short as seven hours and eighteen minutes – less than half the current record. And the scientists are convinced they can cut that in half yet again. Such speed could be life-saving for critically ill patients. One challenge, however, insurers are moving too slowly to cover genetic sequencing, despite studies from Rady and other places showing that the health care savings from whole genome sequencing outweigh its costs.
“All in all, even though NFTs are still in their infancy, the technology might evolve in the future to become more compelling for patients to favor the agency it provides over their data.”
Dr. Bertalan Meskó & Dr. Pranavsingh Dhunnoo, The Medical Futurist.com, January 13, 2022
Yesterday, Dr. Bertalan Meskó & Dr. Pranavsingh Dhunnoo published a thought-provoking article on The Medical Futurist website speculating whether NFTs might play a role in health care by allowing patients to monetize their health data. Here’s a link to their article.
First, some basics for those unfamiliar with NFTs. NFTs (Non-Fungible Tokens) are defined as “unique, digital items with blockchain-managed ownership,” per NFT marketplace OpenSea. In short, NFTs represent digital assets — which can range from images to songs to videos to tweets to patient data — that are verified through blockchain technology. Owning NFTs allows individuals to claim exclusive ownership over these digital assets. Crucially, NFTs offer a way to monetize digital goods by authenticating their scarcity and provenance.
A debate has arisen over what ownership means in the context of NFTs. In many transactions, NFTs don’t represent the actual asset itself (nor IP nor reproduction nor copyright) but are solely a record of ownership. Despite the ballooning hype, the tech isn’t new. In 2017, people spent millions buying and selling “CryptoKitties,” digital collectible cats created by Dapper Labs, some of which sold for more than $100K.
As reported by CB Insights, several NFT marketplaces have emerged to capitalize on the soaring demand. OpenSea, for example, recently raised $23M led by VC firm Andreessen Horowitz. Other names in the space include Sorare, SuperRare, Nifty Gateway (which was acquired by Gemini), MakersPlace, Decentraland, Rarible, and more.
In health care, as Dr. Mesko points out, NFTs could be used to allow patients’ genetic data to be minted as NFTs, so the information will come with an inherent feature to be tracked. You would be able to see where it ends up and hold those who used it without your permission accountable since you are the sole owner of the data, as certified by the NFT authentication. Moreover, the NFT owner can enable a feature to earn money whenever a transaction occurs with the data. Think of companies like 23 and Me who are using the tremendous amount of genetic data they have amassed by selling their kits to conduct drug discovery for which they might make billions – while you get nothing, even though it’s your information.
A non-digital example in the news recently was the case of Henrietta Lacks. In 1951, Henrietta Lacks, a Black mother of five who was dying of cervical cancer, went to Johns Hopkins Hospital in Baltimore for treatment. Without her knowledge or consent, doctors removed a sample of cells from the tumor in her cervix. They gave the sample to a researcher at Johns Hopkins University who was trying to find cells that would survive indefinitely so researchers could experiment on them. They were reproduced billions of times, contributed to nearly 75,000 studies, and helped pave the way for the HPV vaccine, medications used to help patients with H.I.V. and AIDS, and, recently, the development of Covid-19 vaccines.
Last October, 70 years after Ms. Lacks died at Johns Hopkins Hospital and was buried in an unmarked grave, the World Health Organization honored the contribution she unknowingly made to science and medicine. During a ceremony in Geneva, Dr. Tedros Adhanom Ghebreyesus, the director-general of the W.H.O., presented the Director-General Award to Ms. Lacks’s son Lawrence Lacks. He was 16 when his mother died on Oct. 4, 1951. On Oct. 4, 2021, her descendants sued Thermo Fisher Scientific, a biotechnology company they accused “of making a conscious choice to sell and mass-produce the living tissue of Henrietta Lacks,” according to the federal lawsuit. The family said it demanded that Thermo Fisher pay $9.9 million and “disgorge the full amount of its net profits obtained by commercializing the HeLa cell line” to Ms. Lacks’s estate.
Proponents of NFTs argue that their use would prevent what happened to Henrietta Lacks to anyone else, especially in today’s world of genomic data and CRISPR technology.
Here’s my dilemma – I’m having trouble reconciling the potential benefits versus the immense environmental impact of proof-of-work (PoW) blockchains. The annualized carbon footprint of the Ethereum network alone is estimated to be almost 16 megatons of CO2 — comparable to the carbon footprint of Lithuania — while it consumes 34 terawatt-hours of electricity, similar to the power consumption of Denmark, per Digiconomist. As such, NFTs might not be outright commercially viable soon. But alternatives for NFT minting are in the works that could use a fraction of the computing power currently involved in their transactions. Then there is the issue of whether companies offering digital health services will want to adopt the technology. They might not be particularly excited by the idea of sharing their profits with patients. I admit that I’m not a big fan of cryptocurrency, so that’s probably coloring my opinion on this topic. I don’t think that NFTs will dramatically impact health care any time in the near future. Lots of hype. Lots of challenges. And sharing potential revenues with patients isn’t in the corporate DNA of life sciences companies – and won’t be any time soon.
“Health is at the center of our ability to live a full life, and the acceleration of health technology has the potential to improve more lives in more places than ever before. We look forward to sharing some of the latest health tech advancements and future possibilities at CES 2022.”
Robert Ford, CEO and Board Chairman, Abbott Labs
Last week the annual technology geek-fest known as the Consumer Electronics Show was held in Las Vegas. Diminished by widespread concern about the Covid-19 pandemic, attendance at the latest edition of the CES tech trade show was down more than 75% from the last live version of the show in 2020. According to data released late Friday by the Computer Technology Association, which sponsors the event, “well over 40,000” people attended the show, which is down from the 171,000-plus who were on hand for the 2020 edition. In 2021, the event was all virtual. The total includes 1,800 media attendees, down from 6,517 two years ago.
I always like to track CES and see what new gadgets and products companies are propositioning for market entry. Of course, many of these products will not be huge successes. Some may not end up being sold at all, as Andy Inhatko points out in this Tweet:
I enjoyed following the online coverage, especially the reporting on health care technology. The best tech summary I found was this post by Laura Lovett on MobiHealthNews. Here are my top takeaways from this year’s event.
For the first time at CES, a health care company executive delivered the keynote address. Abbotts CEO Robert Ford’s talk was titled “Human-Powered Health: Unlocking the Possibility of You.” You can view the entire keynote below:
So, what did Abbott have to announce? A new line of biowearables they are calling Lingo. Here’s a video describing these bio wearables:
Connected health was certainly front and center at CES again this year. Product announcements from Omron who laid out the roadmap for how it will build up an ecosystem of health services around its products, including a broad expansion of its remote patient monitoring services in the U.S. and a global launch of a hypertension-focused service in the U.K.; Withings, well-known for its consumer health wearables, announced a new souped-up connected scale “with the ability to monitor segmental body composition, heart rate, and vascular age” as well as “nerve activity and heart rhythm using a 6-lead ECG”; and Highmark Health and Bosch who will team up to test the industrial giant’s SoundSee audio AI tech to see if it can detect pediatric pulmonary conditions.
“One of the great things about connected technology, implantable or wearable, is that it puts the patient in control.”
Leslie Saxon, M.D., Executive Director, USC Center for Body Computing
The Oura Ring isn’t the only smart ring on the block anymore. For CES 2022, health tech company Movano announced the Movano Ring, a wearable that aims to help people affordably monitor chronic illnesses and better understand their data. The Movano Ring will measure all the essential metrics, including heart rate, heart rate variability (HRV), sleep, respiration, temperature, blood oxygen levels, steps, and calories burned. However, instead of a raw data dump, Movano says it’ll distill how your metrics relate to each other “take a more proactive approach to mitigating the risks of chronic disease.” For example, the Movano app might tell you how your exercise habits impact your sleeping patterns or HRV over time. While the first Movano Ring won’t have FDA clearances, the goal is to eventually get Class II designation and add medical features like non-invasive glucose monitoring and cuffless blood pressure in a “step-by-step” manner over time. To do that, the company is conducting clinical trials for its radio frequency-enabled tech and algorithms, as well as accuracy studies to gain FDA clearance for heart rate, SpO2, and respiratory rate monitoring.
TV manufacturer LG announced that all 2021 and 2022 LG smart TVs would be equipped with a health education and telehealth app from the senior-focused health platform Independa. The platform will allow users to set up and have telehealth appointments through their TV. People who enable the Independa Health Hub on their TVs will also be able to message, and video chat with friends and family members. LG integrated notifications directly into the TVs’ operating systems, so users who sign up with the Independa Health Hub will still get alerts even if they’re not actively using the app. Users will get free access to a pharmacy benefit plan called Capital Rx, which offers discounts on prescriptions, and to video content geared towards older adults. For a fee, they can sign up for a network of wellness videos and exercise videos.
Another hot topic was elder care. Elder tech startups at this year’s CES demonstrated the potential breadth of the sector. If tech can help an older person live more comfortably, it can also help other people. After all, the usefulness of mobility aids, health monitoring platforms, and long-term financial planning isn’t limited to the elderly. The list of companies demonstrating products in this space is too long to cover in this post. Tech Crunch’s Catherine Shu provided the best summary I’ve seen in her online article.
Of course, A.I. was promoted heavily across multiple applications and platforms. The gamut of use cases spanned robots, autonomous vehicles, smart gadgets, and wearables, as covered above.
An area of increased focus this year was mental health. A new report was published in December 2021 by CES’s convener, the Consumer Technology Association (CTA), titled the Mental Wellness Technology Landscape — just in time for CES 2022. The report focuses on the convergence of mental and behavioral health with technology, describing the range of mental wellness tech available in the market.
As always, many new products were announced or demonstrated at CES. It will be interesting to see how many make it into production and are successful in the market. But it’s nice to see that health care innovation is alive and well despite the challenges presented by the pandemic, supply chain constraints, and decreased funding. And what has this year’s CES taught us about the future of trade shows? While the sponsors of these events are eager to bring them back, the attendees are a lot less certain. Trade shows certainly aren’t going away, but CES 2022 taught us that there’s no reason to sprint back to what they used to be either.
What happened in health care technology this week – and why it’s important.
First sickle cell patient treated with CRISPR gene-editing still thriving
NPR’s Morning Edition featured this story by Meredith Rizzo. Victoria Gray, who has sickle cell disease, volunteered for one of the most anticipated medical experiments in decades: the first attempt to use CRISPR’s gene-editing technique to treat a genetic disorder in the United States. For more than a year, Victoria Gray’s life had been transformed. Gone were the sudden attacks of horrible pain that had tortured her all her life. But one big question was: Would getting her blood cells genetically modified keep working, freeing her from the complications of sickle cell disease that had plagued her since she was a baby? More than another year later, the answer appears to be: Yes.
“You see the change almost immediately after patients leave the hospital, where they are feeling better and able to resume their lives normally without the horrible complications that can happen.”
Haydar Frangoul, M.D., Sarah Cannon Research Institute
Why it’s important – The advantage of this approach is that it uses the patient’s cells with no need for a donor. Also, the gene manipulation does not use a viral vector as with other gene therapy studies but is done with electroporation (quick production of pores into the cells with high voltage) which is known to have a low risk of off-target gene activation. The technique can be used not only in Sickle cell disease but also in beta-thalassemia and other congenital blood disorders.
Infographic of the week – Retweeted by Helen Branswell, 1/2/22, originally posted by @BusyCactus – Time to rethink what “your bubble” really means: everyone in your “bubble” is part of other “bubbles” too. I absolutely LOVE this…..
2022 forecast: Competition in retail healthcare will heat up. Here’s what to expect from Amazon, CVS and Walgreens
As Rebecca Torrence reports in Fierce Healthcare, the biggest U.S. retailers are placing huge bets on healthcare. As patients increasingly demand lower costs and convenient care delivery, retailers like Walmart, Amazon, CVS, and Walgreens have stepped in to meet their needs where traditional providers lack the resources to do the same. All four companies have accelerated their investments in healthcare this year, stepping into new areas from primary care to telehealth. And the retail healthcare boom isn’t expected to slow down anytime soon. Next year, industry experts anticipate that retailers will ramp up their investments in critical technologies and tackle issues like social determinants of health and data sharing to provide personalized healthcare experiences to their customers.
Why it’s important – Don’t write off the retail sector push into health care just yet. The five predictions highlighted in this article are spot on and represent the next wave of investment in health care by the big retail players. The one that interests me the most is the omnichannel strategy. CVS has gone all-in on omnichannel care delivery this year, with offerings from prescription delivery to primary care. The company announced in November its plans to close 900 physical locations over the next three years and create three types of stores: one for primary care, one for its HealthHUB sites, and one for its traditional retail model. Health systems need to adopt a similar omnichannel approach to blunt the potential impact of retail players in their markets.
2022 forecast: Investors will double down on these hot digital health markets
In another article in Fierce Healthcare, Heather Landi reports on five digital health markets that will get serious investment in 2022: telemedicine 2.0, wearable health, digital mental health apps, digital Women’s health, and digital therapeutics.
Why it’s important – Investment in these sectors is driven by the exponential growth value of the convergence of multiple technologies. Each of these digital health companies leads the way in healthcare innovation using artificial intelligence, machine learning, data analytics, and telehealth. The market potential for each segment is enormous. Watch for telehealth players to build out their offerings across the chronic care landscape. Deloitte predicts strong demand for wearable wellness technology in 2022, with 320 million consumer health and wearable wellness devices expected to ship worldwide in 2022. By 2024, that figure will reach 440 million units. Deloitte Global predicts that global spending on mobile mental health applications will reach close to $500 million in 2022. Digital health startups focused on women’s health saw a sudden meteoric rise in 2021, surpassing $1 billion for the first time as the sector pulled in $1.3 billion in funding across 26 deals in the first three quarters. And the global digital therapeutics market is projected to hit $13.1 billion by 2026, up from $3.4 billion in 2021, according to a Markets and Markets report.
Predicting preeclampsia from a blood test holds promise for pregnancy complications
Elizabeth Cooney in Stat reports on new research published Wednesday in Nature that shows how RNA molecules sequenced from a single blood sample could predict preeclampsia months before symptoms appear, holding promise for detecting and treating this and other pregnancy complications before they cause harm.
“We hope to look at other clinically meaningful deviations, such as, potentially, gestational diabetes or growth restriction or other areas. Once we basically have a road map of normal cases, where there’s a deviation off of that map then becomes much easier to discern.”
Thomas McElrath, M.D., OB-GYN, Brigham and Women’s Hospital
Why it’s important – Not only have the authors developed a predictive test for pre-eclampsia, but the study’s findings also have the potential to provide insights into typical pregnancies and fetal development and to advance the design of rational, precision therapeutics that can improve pregnancy care. This paper is also fascinating from a biological standpoint, identifying the path of a physiologic process as it is happening before it manifests clinically in a person without needing to rely on additional clinical information.
Stryker to buy Vocera Communications for nearly $3B
Stryker has agreed to acquire Vocera Communications for $2.97 billion, kicking off MedTech M&A in the new year. As Ricky Zipp reported in Healthcare Dive, Stryker’s early 2022 buy continues last year’s MedTech spending spree. Stryker CEO Kevin Lobo said during an October third-quarter earnings call that the company would be looking to do more deals as the debt was paid down and cash built up over last year. Lobo said in the Thursday announcement that the Vocera acquisition will “help Stryker significantly accelerate our digital aspirations to improve the lives of caregivers and patients.”
What happened in health care technology this week – and why it’s important.
At-home wireless monitoring of acute hemodynamic disturbances to detect sleep apnea and sleep stages via a soft sternal patch
An article in Science Advances describes research from Georgia Tech on a fully integrated, wearable patch for at-home use capable of wirelessly monitoring the mechanical, electrical, and optical signals that arise from acute hemodynamic disturbances during sleep apnea and changes in the sleep stage. The soft sternal patch is the first device to demonstrate simultaneous recording of ECG, PPG, and SCG from a single location, enabling accurate derivation of the vital SCOPER metrics recommended by the AASM to diagnose OSA. In addition, this device provides crucial insights into how the cardiovascular system responds to apneas with a second-by-second resolution, which is not possible with even the most expensive and sophisticated echocardiograms or alternative cardiovascular mapping systems.
Why it’s important – The combined assessment of ECG and SCG allows for a thorough evaluation of the electrical and mechanical function of the cardiovascular system during OSA. Trial results report apnea and hypopnea detection with 95% precision and 100% sensitivity compared to data professionally scored by licensed clinicians. In addition to accurately detecting apneas, this device provides clinicians with critical insights into how each apnea affects the patient’s cardiac mechanics, blood oxygenation, and sleep quality. One limitation to the study was the small sample size. So, more extensive studies will be required to determine whether these results hold across a larger cohort of test subjects.
Infographic of the week – COVID-19 Risk Level by State as of December 27th
New Wearable Detects Respiratory Exacerbations: Interview with Dr. Maria Artunduaga, CEO of Respira Labs
Conn Hastings of Medgadget interviews the CEO of Respira Labs in this online article. Respira Labs, a MedTech company, based in California, created the Sylvee sensor, an adhesive patch that the user wears on their lower rib cage and monitors respiratory health. The device works through acoustic resonance, whereby it emits sound into the chest cavity and analyzes the echoed vibrations. The measured data provide information on lung air volume and correlate with the amount of air trapped in the lungs, which can offer a warning sign that a respiratory exacerbation is possible.
Why it’s important – COPD (or Chronic Obstructive Pulmonary Disease) is the third leading cause of U.S. deaths, affecting 30 million Americans today and killing more than 150,000 people a year in the U.S., with a cost of $49 billion annually. Asthma affects 26 million Americans at an annual cost of more than $80 billion per year. With many COVID-19 patients experiencing impaired breathing for sustained periods after their initial infection has subsided, this type of technology could be very useful in monitoring respiratory health. Up to 43% of hospitalized COVID-19 patients report persistent dyspnea (breathlessness) up to six months after discharge, and a substantial proportion of them continue to suffer from respiratory symptoms for much longer. Today, up to 30% of COVID-19 survivors report long-term respiratory symptoms — about 11.5 million people to date in the U.S. It’s clear from these statistics that left unchecked or untreated, respiratory symptoms can lead to permanent lung damage and progressive deterioration of lung function.
Three missing pieces the digital therapeutics sector needs to succeed in 2022
The digital therapeutics space saw notable advances in both regulation and funding rounds in 2021, as hundreds of millions in new funding poured into the sector. Mario Aguilar reports in STAT (subscription required) that to get widespread adoption, digital therapeutics will need to continue to prove they work and that they can save money, secure more reliable reimbursement from health plans, and streamline patient experiences.
Why it’s important – Evidence continues to be a sticking point for digital therapeutics. Unsurprisingly, clinical trials conducted by companies in controlled settings don’t sway all observers. Real-world data acquisition and analysis will help solve that problem. In 2022, we’ll be watching for more data. Digital products for managing chronic conditions — diabetes, hypertension, musculoskeletal problems, and behavioral health — have made significant progress already. I wrote about digital formularies in a previous post. But pharmacy benefits managers and health plans are not equipped to evaluate and adopt these products, though a few limited pilots are cropping up around the country. Finally, even if digital therapeutics companies can secure good data and reliable reimbursement, they face another major challenge: getting products out into the world so that patients use them — and do so correctly. The path to accessing products must be simple, and doctors need to be able to monitor their patients’ progress without creating loads of additional work.
What happened in health care technology this week – and why it’s important.
Test Detects SARS-CoV-2 in Breath, May Work as COVID Alarm in Enclosed Spaces
Medgadget’s Conn Hastings reports on work done by researchers at Brown University who have developed a breath test for COVID-19. The breathalyzer, termed the Bubbler, consists of a tube that someone blows into for fifteen seconds. The tube contains a mix of enzymes that reverse transcribe the RNA in viral particles into DNA, which allows for a subsequent benchtop PCR test. The technology is primarily another way to collect COVID-19 test samples, but it measures the virus in the expelled breath, it may be more meaningful than nasal swabs in terms of indicating whether someone is actively transmitting the virus.
Why it’s important – Measuring viral particles in the breath may also be more meaningful since airborne transmission is one of the significant ways in which COVID-19 spreads. Breath testing may also provide more information on lower respiratory tract involvement, a risk factor for some of the more dangerous COVID-19 symptoms, such as pneumonia. So far, the Brown team tested the Bubbler in 70 patients at Rhode Island Hospital and found that it could be used to detect the virus successfully. The results are more predictive of lower respiratory tract involvement than nasal swabs.
Infographic of the week – U.S. Adult Preferred Method Of Accessing Care, By Care Need 2021: Rock Health Digital Health Consumer Adoption Survey
Is artificial intelligence about to transform the mammogram?
MIT researchers have built an AI that seems able to predict with unprecedented accuracy whether a healthy person will get breast cancer in an innovation that could seriously disrupt how we think about the disease. As reported by Steven Seitchik in The Washington Post, by analyzing a mammogram’s set of byzantine pixels and then cross-referencing them with thousands of older mammograms, the AI — known as Mirai — can predict nearly half of all incidences of breast cancer up to five years before they happen.
“If the data is validated, I think this is very exciting.”
Janine T. Katzen, Radiologist, Weill Cornell Medicine
Why it’s important – Assuming that validation happens — trials are about to begin — Mirai could transform how we use mammograms, open up a whole new world of testing and prevention, avoid aggressive treatments and even save the lives of the countless number of people who get breast cancer. But here’s the problem, the designers themselves don’t understand how it works. They’re just sure that it does. That fact raises many broader social and moral implications. But there’s also a more practical matter: whether the medical establishment and insurance companies will at all embrace this.
Why 2022 will be CRISPR’s most important year, according to more than 20 gene-editing experts
Andrew Dunn reports in Business Insider (subscription required) that 2022 will be a critical year of execution for the gene-editing technology known as CRISPR. Several biotechs are advancing into human clinical trials, and the results could show the potential — or limits — of gene editing to treat genetic diseases. Found in the immune system of bacteria, CRISPR is designed to fix “typos” in our genetic code. Positive results from these human trials could change medicine and catapult a new crop of biotechs into the highest ranks of the drug industry.
“Next year is a critical moment of really demonstrating clinical data and starting to get to a point where multiple developers can show the potential for patients made real.”
Rachel Haurwitz, CEO of Caribou Biosciences
Why it’s important – Despite the excitement and the potential of the technology, some issues could derail it. The field is grappling with challenges, including safety and accessible pricing.
“We’re approaching a time when we will have the ability to use CRISPR to cure genetic diseases, but the question becomes ‘For whom?’ If the cost is so high that insurance companies won’t pay for therapies, then we’re not fully addressing the problem.”
Jennifer Doudna, Co-Inventor, CRISPR technology
SMART BANDAGE CHECKS CHRONIC WOUNDS IN REAL-TIME
A new intelligent wearable sensor can conduct a real-time, point-of-care assessment of chronic wounds wirelessly via an app, according to a new study. The sensor detects temperature, pH, bacteria type, and inflammatory factors specific to chronic wounds within 15 minutes, allowing fast and accurate wound assessment. The bandage comprises a wound contact layer, a breathable outer barrier, a microfluidic wound fluid collector, and a flexible immunosensor.
Why it’s important – Given the rapidly aging population, healthcare providers see more patients suffering from non-healing wounds such as diabetic foot and chronic venous leg ulcers. Estimates suggest that about 2% of the world’s population suffers from chronic wounds. The VeCare platform and mobile app allow doctors to monitor the condition of patients’ chronic wounds remotely, reducing the hassle for patients to travel to a clinic.
US Army Creates Single Vaccine Effective Against All COVID, SARS Variants
Tara Copp, a Senior Pentagon Reporter for Defense One, posted an article reporting that within weeks, scientists at the Walter Reed Army Institute of Research expect to announce that they have developed a vaccine that protects people from COVID-19 and all its variants, even Omicron, as well as from previous SARS-origin viruses that have killed millions of people worldwide.
Why it’s important – Unlike existing vaccines, Walter Reed’s SpFN uses a soccer ball-shaped protein with 24 faces for its vaccine, which allows scientists to attach the spikes of multiple coronavirus strains on different faces of the protein. The next step is seeing how the new pan-coronavirus vaccine interacts with people who were previously vaccinated or previously sick. Walter Reed will be hiring a yet-to-be-named industry partner for that wider rollout.
What happened in health care technology this week – and why it’s important.
“Supermeres” may carry clues to cancer, Alzheimer’s disease and COVID-19
Researchers at Vanderbilt University Medical Center reported they had discovered a nanoparticle released from cells, called a “supermere,” which contains enzymes, proteins, and RNA associated with multiple cancers, cardiovascular disease, Alzheimer’s disease, and even COVID-19. The discovery, reported in Nature Cell Biology, is a significant advance in understanding the role extracellular vesicles and nanoparticles play in shuttling important chemical “messages” between cells, both in health and disease.
Why it’s important – The identification of this rich plethora of bioactive molecules raises interesting questions about the function of supermeres and heightens interest in the potential of these particles as biomarkers for diseases. The desire to translate EVP biology from the bench (or centrifuge) to the bedside relies on properly defining, describing, and attributing content and biological action to the specific particle type. The discovery of supermeres represents a large and important step in this direction, replete with exciting opportunities for adaptation and clinical translation.
Infographic of the week: Percentage of Positive COVID-19 Patients Who Were Asymptomatic by Age Group
SMART Health Card Emerging As Model For Sharing Covid Vaccine Data
As the demand for proof of COVID vaccination status has climbed, the healthcare industry has scrambled to find effective ways of sharing vaccine data between varied locations. As readers know, sharing any health data is still at best a challenge, but given the circumstances, most parties involved don’t have a choice about making it happen. Anne Zieger reports on one option gaining traction in her article in Healthcare IT Today.
The SMART Health Card, which offers a FHIR-based trusted standard for vaccine verification, was developed by a private-public partnership of technology companies called the Vaccination Credential Institute, provides a lightweight vehicle for presenting such information to anyone who needs it. The steering group managing the project includes representatives from the Mayo Clinic, MITRE Corporation, Microsoft, The Commons Project Foundation, Evernorth, CARIN Alliance, USC San Diego Health, and Apple.
Why it’s important – People can keep their SMART card in paper form or as a digital file on their phone, computer, or anywhere else they store digital information. They can share their card by letting someone scan its associated QR code or send it as a file or via a phone app. What makes the SMART Health Card approach distinctive is that it doesn’t require the use of a central database. All vaccine data is encrypted and stored on the card, and when the QR code is pulled up, only the person’s name, date of birth, and vaccination information are visible.
INTELLIGENCEWalgreens and VillageMD opening nine full-service primary care practices in San Antonio
Jeff Lagasse in Healthcare Finance online reports that these openings represent expansion into the fifth major market in Texas, following Houston, El Paso, Austin, and Dallas. Through the Walgreens and VillageMD coordinated care model, patients receive full-service primary care alongside pharmacy services the companies called “convenient and cost-effective.”
Why it’s important – Village Medical primary care physicians and Walgreens pharmacists work together, the companies said, to provide care for chronic health conditions, preventive services, and treatment of everyday illnesses and injuries. Within the same visit, patients have access to care from physicians while also ensuring their prescriptions, medication refills, and affordable substitution options are readily available.
Washable and Flexible Batteries for Wearable Medical Devices
Medgadget’s Conn Hastings highlighted research from engineers at the University of British Columbia who have created a flexible waterproof battery durable enough to undergo multiple wash cycles. The battery is so pliant that it can still function when stretched to double its original length. It’s made of low-cost materials, making it potentially highly suited for wearable health monitoring technology, such as items of clothing, patches, or watches that monitor vital signs.
Why it’s important – Wearable electronics are a big market, and stretchable batteries are essential to their development. Having a washable battery is another important step in helping smart clothing to withstand the demands of everyday use. So far, the UBC researchers have subjected a battery to 39 wash cycles, and it still worked. Google’s Project Jacquard is the most publicized example of smart clothing. They’ve created partnerships with Samsonite (backpacks), Adidas (shoes), and Levi’s (jackets).
From Alexa to COVID-19 tests, Amazon expands healthcare aspirations in 2021
Emily Olsen posted an article that summarizes Amazon’s moves in healthcare during 2021 on MobiHealthNews this week. Alexa made moves into health systems and elder care, a new Halo wearable was released, and the Amazon Care virtual care service began its expansion this year. In a separate article on CNBC, Annie Palmer and Bertha Coombs reported that Amazon has tapped Neil Lindsay, its former Prime boss, and marketing guru, to oversee its health efforts, according to his LinkedIn profile.
Why it’s important – Amazon has made clear its ambitions to grow its presence in the healthcare industry, including launching an online pharmacy and telehealth services. Analysts expect health care to be a valuable business over time. Loop Capital analysts estimated Amazon could grow its revenue by $72 billion through further health care expansion.
Scientists unveil drug discovery tool to screen more than 11 billion compounds
The University of North Carolina at Chapel Hill reported on an effort by researchers from the University of Southern California and Northeastern University to validate V-SYNTHES, a new type of computational method developed by Vsevolod Katritch, Ph.D., at USC that allows scientists to first identify the best combinations of chemical building blocks called synthons – hypothetical units within molecules – to serve as seeds that can grow into a hierarchy of molecules with the best-predicted ability to bind to the receptor targets. As described in their Nature paper, they tested 11 billion theoretical compounds against a cannabinoid receptor (CB2) that marijuana’s active ingredient, THC targets.
Why it’s important – This report underscores the importance of AI in drug discovery and life sciences research in the future. (11 billion compounds!) If you are a drug company and you aren’t heavily involved in implementing AI in your research, you will be playing catch-up to those companies who are using the technology.
Twin Robots Lighten Load So Busy Nurses Can Focus on Humans
Roni Roberts in Medscape reports (subscription required) on a project at Cedars Sinai in Los Angeles where they deployed twin robots named Moxi, who literally take some of the heavy lifting off the shoulders of nurses and run some of their errands so they can spend more time with their human charges. The robots were part of a pilot project that started in September in the short-term unit, for patients only expected to stay in the hospital for 1 to 3 days and have progressively expanded to include about half of the hospital’s nursing units.
“The staff smiles after interacting with her…. To see the staff find little joys again is nice. Something like a little robot can have that kind of happiness come back.”
Melanie Barone, RN, associate nursing director of the short-stay observation unit
Why it’s important – This is an excellent example of implementing technology that gives time back to caregivers in the clinical setting. Their jobs include making trips to labs, the pharmacy, and general transport tasks such as bringing a patient’s possessions from admissions to their rooms or returning items on discharge. Instead of having to lug several 5-pound IV pumps, wait for available staff to fetch lab samples, or respond to multiple requests for help, Barone said nurses can focus on patient care.
“Efficient supply delivery, improved nurse productivity, increased time with patients, and a positive emotional response were key themes in the results of this review.”
American Nurses Association, White Paper on use of robots to promote productivity
“Futuristic and disruptive technology implementation should be a key goal for every business. It ensures an efficient, intelligent, data-driven yet secure environment.”
Ashwin Muthiah, Chairman, AM International
One of my favorite thought exercises during my fifteen-plus year tenure at Sg2 was to sit in a conference room at the end of every year with ten to fifteen really smart people (news flash – all my colleagues at Sg2 are really smart people, and I’m almost over my Imposter Syndrome) and have a spirited discussion on what we would include in our annual Disruptors to Watch webinar in January.
After doing that for so long, 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 online and thinking about what will rise to the top of my list. Unfortunately, you won’t get the collective benefit of my friends at Sg2 here, just one old guy’s opinion about the potential key technology disruptors in health care for 2022.
Before I begin, however, I want to acknowledge some thoughts shared by Nick Neral, Director, Panda Health, in a LinkedIn post this past week:
“If you research digital health trends of 2022, depending on the website, you’ll find “beyond” telemedicine, home health, digital therapeutics, predictive analytics and more. If you ask health systems what they’re actually working on the answer is very different…..Implementing nothing. (Yes, many don’t have the resources for anything new)….The digital health trend in 2022 and 2023 is going to be how can we do more with less.”
Nick Neral, Innovation & Strategy Director, Panda Health, LinkedIn post, December 9, 2021
I agree with Nick’s comments. He’s spot on here. In this environment, it’s challenging to try and implement new technologies when you’re running as hard as you can to handle the flood of patients jamming your ER and ICUs in the middle of a pandemic. My intention here is not to promote technology for technology’s sake, but to highlight technologies that I believe can remove some of the onerous administrative burdens we place on our front-line professionals and give them time back to do what they went into the profession for in the first place – care for patients and their families.
With that said, after working through my list of over fifty technologies that I’ve been tracking in 2021, here are my top picks for the coming year.
Voice technology takes center-stage
“We are at a very interesting time for healthcare and voice technology, because of the computing power. We’re already starting to see some radical changes in the way we experience the healthcare journey,”
Teri Fisher, physician and clinical assistant professor at the University of British Columbia
I’ve written on this topic earlier this year. Since that July post, however, there have been several announcements that lead me to believe that 2022 will be the year that voice technology sees broader adoption. There have been advances in the ability for voice technology to advance telehealth progress, notably that a mix of modalities – between chatbots, text, and voice – will provide patients with the right tool for the right time in the right place. Dr. Fisher, quoted above, is the author of an excellent book on Voice Technology in Healthcare, published by HIMSS, that I highly recommend if you want a deep dive into the topic.
But why now? I believe three significant drivers will push this into the mainstream over the next twelve months: technology evolution, the ongoing pandemic, and big tech moves in health care. Let’s take them one at a time:
Voice technology evolution – As noted in the quote above, increases in computing power have accelerated the use of voice-assisted technology in health care. The global smart speaker market is poised to see a continued annual growth rate of nearly 24 percent through 2023, according to research by Technavio. Researchers expect massive market growth in the biomarker segment alone, reaching 147.59 billion USD by 2028. (For an excellent overview of this segment, here’s a link to a post from The Medical Futurist) An IHS Markit Technology report predicts more than 900,000 such devices will be used in healthcare by next year, and diverse initiatives are already in motion. Combining voice technology with AI and machine learning and coupling those with edge computing and faster 5G networks, you have a perfect storm for increasing adoption at multiple points along the care continuum.
The ongoing pandemic – Beyond just the use of voice-enabled chatbots and voice-enabled telephone triage systems, the pandemic has forced families to manage their health care issues, including dealing with kids or parents at a distance. This has created the demand for deploying smart speakers in the home, school, assisted-living facility, or other care locations to enable an easy, zero-user-interface way for loved ones to initiate calls, monitor activity, or deal with emergencies. Physicians have increased their use of voice-enabled technology to create visit records, thus minimizing the additional work required to complete EHR notes for patients.
Big tech moves – Last year, a pilot project at Cedars-Sinai placed 100 Amazon Echo devices in patient rooms throughout the hospital. Using an Alexa-powered platform, users may speak to access entertainment options and, if needed, request staff assistance. Boston Children’s Hospital targets parents with KidsMD, an Alexa skill that offers information about common ailments and medication dosing. Another, the Mayo Clinic First Aid skill, was launched by the Mayo organization to suggest care tips for non-emergency situations. Atlanta-based Thrive Senior Living is leveraging Google and Amazon smart speakers to support a custom suite of applications that route requests and questions to care teams. A test run found that residents liked the approach, and employees came better equipped to assist patients thanks to the information they received on a connected mobile app. And finally, in my Tech News This Week post last Saturday, I reported on Amazon’s announcement of their new direct-to-consumer subscription offering, Alexa Together, aimed at families caring for elderly members who are still living independently but need extra support. Here’s a short video highlighting how BayCare implemented Alexa devices in 2,500 patient rooms across 14 hospitals:
And, just yesterday, Microsoft announced it is shelling out a hefty $19.7 billion for Nuance Communications, a pioneer in voice recognition and natural language understanding, to bolster its ambitions in the healthcare market.
All of these point to 2022 being a significant inflection point in using voice-enabled technology in health care.
At-Home Lab Tests
This is another area that has seen rapid growth and development over several years. And the pandemic requirement for ongoing testing for COVID-19 got patients used to going to their local pharmacy and buying in-home tests regularly. Patients can access a wide range of analyses determining their lab markers and blood results. No need to meet anyone, go anywhere.
And there are countless at-home lab tests already cleared by the FDA. Here’s a link to the FDA database of cleared, over-the-counter lab tests. The rise of companies like imaware, EverlyWell, LetsGetChecked, Health Testing Centers, UltaWellness, Walk-In Lab, and MyLabBox has spurred continued growth in this area. For example, the imaware platform provides over 20 different types of advanced home-based health tests. The company also offers telemed physician oversight, helping people control their health. During the pandemic, they launched a collaboration with virtual care company Wheel to deliver clinician-administered at-home COVID tests. They will indeed have more ideas under development. Patients can get easy access to dozens of at-home tests. Here’s a link to the kits available from mylabbox.
Here’s a link to a comparison of Best Blood Tests based on In-Depth Reviews from Consumers Advocate.org
With market growth calculated to value over $7.6 billion by the end of 2028 and a CAGR of over 5.4% during the forecast period of 2021-2028, it seems clear that these will have a significant impact on testing and care coordination in the coming year.
Health Systems Data Companies – Data as the new health care currency
We’ve been hearing about big data and data as a strategic resource for over a decade now. But, there have been developments over the last eighteen months that signal that the industry has awoken to the fact that the trove of data they are sitting on is valuable and an asset to be mined.
Case in point – Truveta. Twenty of the largest U.S. health systems, led by Providence, have formed a startup to pool patient information, aiming to streamline efforts to analyze anonymous data to improve care, develop better therapies and drugs, and promote more equitable treatment of underrepresented groups. The Seattle-based startup is led by former Microsoft Corp. executive Terry Myerson, who ran the software maker’s Windows business. As of this writing, Truveta partners with around 20 medical providers, aggregating regular de-identified data from 42 American states and myriad patients representing about 16% of all U.S. clinical care into its collection. It has built a software service that allows researchers and other users to ask questions about the collected data. Here’s a short video featuring the Truveta Health System founders discussing their vision for saving lives by using data:
“We want to allow people to study human health. When they do, we want to make sure they’re a studying data set that’s consistent with the whole population. The transparency, the data on the data, is something fundamental we want to bring to the table.”
Terry Myerson, CEO, Truveta, Health Evolution interview, February, 2021
Another example that generated a firestorm of protest and even led to a Federal investigation was Ascension Health’s partnership with Google. Ascension and Google say the project could lead to better outcomes for patients. Privacy experts also said it appears to be permissible under federal law. But one professor told the Journal “the optics are bad” because patients and doctors weren’t informed, and several U.S. senators expressed concern. It is unclear what the departure of Dr. David Feinberg to head Cerner means for the arrangement if anything. But the partnership is another example of the accelerating trend to aggregate, de-identify, mine, and monetize these vast data resources.
Want more proof? Beckers Healthcare did an outstanding job of reporting on the growth of these partnerships in 2021. As of their June posting, they identified 38 Big Tech partnerships in healthcare this year: Amazon, Google & more. The “horse is out of the barn” on this one. So don’t expect any slowdowns in the area in 2022.
Digital Health Insurance
Digital has begun to reshape health insurance markets. According to McKinsey, payers in the United States have been slow to digitize. They are still behind other industries in their use of artificial intelligence and automation, as well as in customer satisfaction. They’re now starting to catch up. Both incumbents and disruptors are making substantial and growing investments in digital programs.
Just last month, Bain Capital announced that Enhance Health, LLC, a new technology-enabled, digital health insurance brokerage and care navigation platform focused on serving the Medicare Advantage market, launched with $150 million of total capital. Headquartered in Ft. Lauderdale, Florida, Enhance Health will serve both the Medicare and individual and family plans segments of the health insurance market.
And, Enhance Health is not alone. Digital Insurance is another digital-first insurance company now adding healthcare to its portfolio of offerings. OneDigital went to market as the new generation in health and benefits. Focused on creating harmony between people and technology, today, OneDigital delivers benefits solutions, including a sophisticated combination of strategic advisory services, analytics, compliance support, technology, and HR capital management tools.
And, of course, there’s Oscar Health. Oscar Health Insurance began in 2012 and offers health insurance to residents of Arizona, California, Colorado, Florida, Georgia, Kansas, Michigan, Missouri, New York, New Jersey, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Iowa, Oklahoma, and Virginia. Coverage may soon be available in other states. The Oscar app is downloadable and compatible with Android and iOS. The app offers 24/7 doctor-on-call services. The company operates in partnership with Mount Sinai Health System. The company provides health insurance wellness incentives for being active, tracked using free wearables. There are low-deductible options available. There are five tier plans—secure, bronze, silver, gold, and platinum—covering between 60% and 80% of medical expenses.
“Ten years from now, I think we’ll have contributed to lowering health-care costs, and that remains our far end goal and what we do everything at Oscar.”
Mario Schlosser, CEO, Oscar Health, Interview, Yahoo Finance, March, 2021
There are real benefits that will continue to drive these developments. Those payers that invest thoughtfully in human-centric digital transformation are beginning to see the value, including material changes in member satisfaction and trust, increased revenue from digital branding and improved sales tools, and double-digit reductions in administrative costs. In addition, stronger member relationships are often leading to lower medical costs. Watch this space…..
Cognitive Automation Takes On Administrative Work
Cognitive automation is a new and fast-emerging technology in digital transformation. It is one of the key IT trends in healthcare, and its popularity is expected to increase in 2022. Cognitive automation generally combines natural language processing, machine learning, and computer vision technologies into a platform to increase decision velocity in health care.
This technology makes it possible to process zettabytes of data within seconds, thereby providing decision-makers with recommendations readily available and backed with real-time data. The end goal of this emerging healthcare technology is to establish a self-driving enterprise whereby operational processes are automated.
Cognitive computing has also enhanced patient engagement and improved access to services. Researchers are leveraging the potential of cognitive systems to make clinical trials more comprehensive and valuable, making this a critical technology development in health care. Key players operating in the cognitive computing in the healthcare market include Apixio, MedWhat, Healthcare X.0, Apple Inc., Saffron Technology, Inc., Nuance Communications, Inc., Google LLC, Microsoft Corporation, and IBM Corporation.
“Technology should work for people, not the other way around.”
Brad Becker, former Chief Design Officer for IBM Watson, Knowledge@Wharton interview, November, 2014
The global cognitive computing and analytics market has been projected to be valued at $95 billion by 2022, at a Compound Annual Growth Rate (CAGR) of 42.9% during the forecast period. North America, followed by Europe, is expected to be the most significant revenue-generating region for the cognitive analytics vendors in the next five years. So, a lot of investment in the space coupled with a pressing need to remove some of the administrative and operational burdens from the shoulders of front-line health care professionals will drive the growth in this area over the next eighteen to twenty-four months.
2022 will be another challenging year in health care. We’ll still see pressure on our systems from the ongoing pandemic. Investments in new technology will be constrained because of financial and resource availability. I’m betting that many posts you’ll see from me next year will focus on the issue of – time: giving time back to our frontline professionals to provide care, having patients spend less time navigating the complexities of our crazy health system, reducing the time to diagnosing and treating diseases, and creating time to allow everyone to achieve a healthy balance in our lives. If any of the technologies I’ve listed above can help us accomplish that, we all win.