“Reflective thinking turns experience into insight.”
John C Maxwell
For my first blog post of 2023, I wanted to review the posts that readers found most interesting and received the most interactions last year. In analyzing the data from 2022, thanks to you, the Talking Healthcare Technology blog had over 160,000 impressions across all social media platforms. Time is a precious commodity. So, a big thank you to everyone who took the time to read, share, and comment on the material I published last year. Your comments, suggestions, and encouragement are greatly appreciated.
These are the twenty-five posts that received the most interactions (links included):
While I’ve focused on the technology that underlies digital health in this blog, it is essential to remember that healthcare is still all about the people. While we rely on technology to ease some of the burdens felt from 2022, focusing on people is essential. Technology is only a tool. Creating further digitization to manage the overall patient engagement experience will help reduce unnecessary friction in gaining access to the doctors and medical care patients need. Enhanced telephony solutions, combined with a more seamless and personalized patient experience, will further engage patients and their families in their care more conveniently and cost-effectively.
As I look forward to 2023, I am even more excited to find topics that highlight the ability of digital health technology to streamline care delivery, improve patient access to needed services, reduce the administrative burden on healthcare providers, lower the cost of providing care, and enabling critical research into developing new care pathways and treatments for patients around the world. I invite you to join me on this journey again this year. If you have suggestions for topics or technologies you want to see covered in more depth, please let me know in the comments section on the blog or via DM. Thanks again for reading!
What happened in health care technology this week, and why it’s important.
Digital Health Tools Need a New Benchmark
Saira Ghafur’s article in Wired kicks off the news coverage this week. In it, she states that the whole-scale adoption and impact of digital health technology in national health systems worldwide has not yet fully materialized. A critical reason is that they often lack the necessary scientific evidence to back the range of benefits—from improved health outcomes for patients to better cost-benefit outcomes for payers such as insurance companies and health care providers—that its manufacturers claim they can deliver. A recent study by health tech seed fund Rock Health and Johns Hopkins University demonstrated the extent of the problem. Only 20 percent achieved the threshold considered acceptable for rigorously tested solutions.
Why it’s important – In 2023, we will see heightened scrutiny for the evidence required of digital health technologies and how that evidence is generated. This will be led by regulators and payors, who will need increasing clarity on evidence for reimbursement. This is already happening in the UK, the US, and Germany. Regulators will also move toward accepting these novel methodologies as validation and favor a more pragmatic approach to evidence generation. Recently, the National Institute for Health and Care Excellence (NICE) has set up the Early Value Assessment Program for Digital Tools. This program will help select promising technologies and rapidly assess their clinical effectiveness and impact before embarking on more robust trials. In 2023, pilots will be conducted for digital apps for anxiety and depression in children, and it is hoped this will be rolled out as well for early cancer diagnostics, adult mental health, and cardiovascular disease. Soon, programs such as these will allow clinicians to properly evaluate any bold claims made by digital health companies regarding their products.
Infographics of the week – We know Digital health opens up new opportunities for entrepreneurs and startups, and larger MedTech companies to add value. However, as the chart from McKinsey & Company below suggests, these tools and solutions (be they apps or devices or wearables, or even virtual-care solutions like telehealth) should ideally fix a real problem or jobs to be done along the entire patient pathway, from primary prevention and screening through diagnosis and staging to treatment and the subsequent management of a disease, condition. Capturing such opportunities depends on understanding where these pain/friction points lie for patients, physicians, other clinicians, providers, and payers and how a given digital health or health-tech solution will address them. The clearer this is (to target customers or investors), the more likely it is that the e-health tool will experience growth.
The second infographic this week is from Dr. Tazeen Rizvi. Ambient clinical intelligence utilizes technologies, including artificial intelligence, big data, the Internet of Things (IoT), human-computer interaction (HCI), and others, to allow voice-enabled AI to automatically document patient encounters during a consultation between clinicians, healthcare teams, patients, and their families.
Google might use rings and bracelets as input methods for its upcoming AR glasses
This year at Google I/O, one of the things Google also teased was the launch of future AR glasses. They might work a little differently from what we saw from Google previously with Glass, though. Google’s already exploring two wildly different input methods for the upcoming device, according to sources. Arol Wright reports on the rumors in Android Police online. As per 9to5Google, and its sources familiar with development at Google, the company is looking at smart rings and bracelets as input methods for these upcoming glasses. The other solution Google is looking at, bracelets, might work with a similar principle, letting you swipe and tap on it with your finger. The bracelet would also have haptic feedback.
Why it’s important – It’s perhaps early days to know how these AR glasses will work, but one thing is clear from the reporting on both Google and Apple, 2023 will be a big year for new AR wearables coming to market. I’ve written on this topic and various use cases in this earlier post. These will be exciting developments to watch in the new year.
Mass General, Mayo Clinic, & More Share AI, Analytics Plans for Next Year
Shania Kennedy, Assistant Editor at xTelligent Media, reports that leaders from Mass General Brigham, Mayo Clinic, Mount Sinai, and Cleveland Clinic discussed with HealthITAnalytics what their health systems’ plans are for next year to build on existing initiatives, deploy new projects, address challenges, and innovate in the AI and data analytics space. Some data indicate that health systems still face challenges caused or worsened by the COVID-19 pandemic. These organizations plan to use and invest in health IT tools, such as patient portals, telehealth, and artificial intelligence (AI), to overcome them.
Why it’s important – For many, top priorities from last year, such as patient access to care and efficiency improvements, will carry over into 2023. But the question of what tools organizations will leverage and how they’ll deploy them remains. This article is excellent background information for companies looking to develop AI solutions for healthcare.
Yes, The Waverly Labs Ambassador Can Translate Languages Live
While not recent news, this device is hew to me, so I wanted to feature it in this post. Waverly Labs Ambassador makes instant translation possible. Designed to be worn over an ear, the Ambassador allows you to step into any conversation around you, regardless of their spoken language, and engage with them. It is not an audio recorder, nor is it a transcription device; it’s a bonafide instant translation tool. The Ambassador design is simplistic and comes in two colors: Black and Wine Red. To equip it, slide it over one of your ears, and you can start hopping into conversations.
Why it’s important – The Ambassador can translate 20 languages and 42 dialects. Specifically, these are the available options: English, French, German, Italian, Portuguese, Spanish, Arabic, Greek, Russian, Hindi, Turkish, Polish, Chinese Mandarin, Japanese, Korean, Cantonese, Hebrew, Thai, Vietnamese and Dutch. If you consider that many countries share the same languages and more than one educational systems stress bilingual or trilingual education, you’ll be able to communicate with virtually anybody you’d like. The days of scrambling for a translation app on your phone are gone and out the window. All you need to do is choose which translation mode you’d like (Listen/Lecture/Converse), and you’re all set. Imagine not having to wait for a hospital translator to come down to converse with a patient about their condition and care plan. It could be a real time-saver.
Wearable skin patch monitors hemoglobin in deep tissues
A team of engineers at the University of California San Diego has developed an electronic patch that can monitor biomolecules in deep tissues, including hemoglobin. This gives medical professionals unprecedented access to crucial information that could help spot life-threatening conditions such as malignant tumors, organ dysfunction, cerebral or gut hemorrhages, and more. As reported in Nanotechnology World, The new, flexible, low-form-factor wearable patch comfortably attaches to the skin, allowing for long-term noninvasive monitoring. It can perform three-dimensional hemoglobin mapping with a submillimeter spatial resolution in deep tissues, down to centimeters below the skin, versus other wearable electrochemical devices that only sense the biomolecules on the skin surface. It can achieve high contrast to other tissues. Due to its optical selectivity, it can expand the range of detectable molecules, integrating different laser diodes with different wavelengths, along with its potential clinical applications.
Why it’s important – Low blood perfusion inside the body may cause severe organ dysfunctions and is associated with various ailments, including heart attacks and vascular diseases of the extremities. At the same time, abnormal blood accumulation in areas such as the brain, abdomen, or cysts can indicate cerebral or visceral hemorrhage or malignant tumors. Continuous monitoring can aid the diagnosis of these conditions and help facilitate timely and potentially life-saving interventions.
New AI Listens to Toilet Sounds to Detect Diarrhea
In what must be one of the unusual headlines of the year, this Medscape article by Denny Watkins reports that a design for a “Diarrhea Detector” that could alert health officials to disease outbreaks like cholera was recently presented by engineers from Georgia Tech Research Institute. The AI could be used with home smart devices to monitor one’s bowel health. A prototype accurately identified diarrhea 98% of the time in tests; the engineers told a conference of the Acoustical Society of America in Nashville. Even with background noise, it was correct 96% of the time.
Why it’s important – Cholera infects millions of people each year, killing up to 143,000 who become dehydrated from severe diarrhea, according to the World Health Organization. Many deaths could be avoided with an oral rehydration solution if the outbreak is spotted fast enough. Cholera can be lethal within 24 hours after symptoms start. The device could be installed in public toilets where inadequate plumbing raises the risk of a cholera outbreak.
How the Right Technology can Simplify a Healthcare Worker’s Life
In a guest post in Healthcare IT Today, Marcus Mossberger, Future of Work Strategist at Infor, contends that hospital and health system C-suite must adopt new, strategic approaches to technology—embracing a practical, objective, and sustainable workplace well-being technology platform. The right technology, which is the manifestation of contemporary thinking by hospitals and health systems, does three things on a single, cloud-based platform. It advises. It augments. And it automates.
Why it’s important – Today’s healthcare workers put up with poor user experiences on their current technologies. They’re frustrated by unconnected, disparate IT systems that force them to interrupt their workflows to log in and out of a system before they can continue their work. Technologies that simplify or eliminate repetitive tasks can empower clinical and non-clinical staff to practice at the top of their license or perform higher-level and more gratifying responsibilities. Technologies that help people do their jobs better can improve job performance and satisfaction.
It’s hard to believe that we’re at the end of another year already. My sincere thanks to all those who have read, commented upon, and shared my posts on this blog in 2022. I wish you and your loved ones a Happy, Healthy, and Prosperous 2023. It will be interesting to see how technology innovations will impact health care next year.
“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
“Old habits die hard”
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.
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.
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.
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.
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!
What happened in health care technology this week, and why it’s important.
It’s been a pretty quiet week on the tech news front as folks prepare for the holidays. So this will be an abbreviated post.
Google Takes on Doctors’ Terrible Handwriting
Lauren Leffer in Gizmodo reports that Google has proposed a remedy for the doctor’s note. The tech giant is working on an AI technology tool to decipher hard-to-read handwritten medical prescriptions, as announced at its yearly Google for India conference on Monday and described in a company blog post. The feature will be part of Google Lens’ library of applications. Lens can already assess, copy, and paste handwriting from real life into your phone or computer and automatically offer supporting context and information based on that text through its Search capabilities. And the in-development prescription decoding tool will work similarly. Users can take or upload a photo of a doctor’s note, and then the Lens app will process the image, detect listed medications, and automatically offer information about those drugs.
Why it’s important – It might seem like a small step for Google Lens, which technically should’ve been able to read doctor’s scripts like any other texts this whole time. However, a doctor’s handwriting is worse than most peoples’ after hours and hours of daily wear on their hands, and physicians often operate in a unique shorthand. Plus, the stakes are much higher for digitizing a prescription than they are for transferring a handwritten grocery list into a text note on your phone. Google framed the in-progress product as most useful for pharmacists and indicated that pharmacist expertise was also crucial in training and developing the new tech. The technology isn’t quite ready for doctor deployment yet, though.
Infographic of the week – During last week’s Drug Channels Outlook 2023 video webinar, they shared the latest version of their chart mapping the insurer/PBM/specialty pharmacy/provider organizations that now dominate U.S. drug channels.
The IPO market disappeared in 2022. Will it return in 2023?
Digital Health and Business Technology’s Gabriel Perna highlights that 20 digital health companies went public in 2021. In 2022, there were two, only one of which was listed on an American-based stock exchange. Industry watchers blamed a challenging macroeconomic environment and investor uncertainty on digital health business models and said late-stage private companies should use the pause to strengthen their business.
Why it’s important – Investors are not expecting a comeback for public market financing in digital health in the coming year. The lack of outside funding means companies will have to conserve cash. 2023 may be worse than 2022, and in that case, you want to make sure you have money for a long time, so you don’t need to raise it any time soon.
Our Homes as HealthQuarters – Finding Health and Well-Being at CES 2023
This is Jane Sarasohn-Kahn’s annual preview of what she’ll be looking for at CES 2023. As her advisory work with companies across the health/care ecosystem has increasingly shifted to omnichannel, home-based, and retail sites, CES has emerged as a critical touch point for her every year to receive updates and check in with key innovators that increasingly serve up tools underpinned with clinical evidence and enchanting design.
Why it’s important – As Jane points out in the post, we can think about the home’s “HealthQuarters” by “room,” such as the bedroom (for sleep and healthy sex lives), the bathroom (for weight and mood observed in the mirror, or the toilet as a collector of health data), the kitchen (for healthy food and cooking), and the overall home environment itself for air and water quality. For wonkier healthcare folks, you can consider these the “home determinants of health,” a subset of the big umbrella of social determinants or drivers of health. I’ve written on the topic before and am a big proponent of moving care to the home setting as much as possible. And Jane is one of the best at writing about digital health. I’m looking forward to following her CES reporting to see what she finds.
Well, that’s about it for this week—my sincere best wishes to you and your loved ones for a happy, healthy holiday season. Thanks for your support of the blog throughout the year.
“ChatGPT is incredibly limited, but good enough at some things to create a misleading impression of greatness. It’s a mistake to be relying on it for anything important right now. it’s a preview of progress; we have lots of work to do on robustness and truthfulness.”
Sam Altman, co-founder of OpenAI
If you’ve been following the tech reporting over the last several weeks, there’s been a new AI panic brewing: this time, it’s about whether ChatGPT, a chatbot created by OpenAI, is poised to render vast swaths of our society obsolete. Even though OpenAI’s founder has said, “slow down, it’s too early,” that doesn’t seem to have stopped anyone from predicting the imminent demise of college, professors, journalism, and much more.
One Guardian piece opens with the warning that “professors, programmers, and journalists could all be out of a job in just a few years” and points to examples of ChatGPT and other chatbots mimicking the prose of Guardian opinion pieces, as well as generating essays for assignments made by a journalism professor at Arizona State University. Similar concerns were echoed in a Nature essay, which raises concerns about the ability of students to submit ChatGPT-generated essays. Or, how about this Axios story, titled “AI chatbot could spell doomsday for truth.”
The only problem, however, is that none of this seems to be accurate or even possible. ChatGPT is a large language model that effectively mimics a middle ground of typical speech online, but it has no sense of meaning; it merely predicts the statistically most probable next word in a sentence based on its training data, which may be incorrect.
When considering applying ChatGPT or any other generative model to work-related activities, it’s essential to consider a fundamental limitation: Generative AI models generate responses; they do not read sources or cite their work. Thus, their output has no guarantee of reliability. If you ask it a critical business question like “what are the biggest risks associated with this investment” in an M&A transaction, you will receive a plausible-sounding answer, but not one with a source of truth. To use a generative model in the workplace, it is critical to feed these models with facts and cited information so that answers are based on research and not inference.
As expected, the press reports ranged from wildly optimistic to predictions of Armageddon. An article in the Harvard Business Review stated:
“This is a very big deal. The businesses that understand the significance of this change — and act on it first — will be at a considerable advantage. Especially as ChatGPT is just the first of many similar chatbots that will soon be available, and they are increasing in capacity exponentially every year.”
Ethan Mollick, Associate Professor of management, The Wharton School of the University of Pennsylvania.
At the other end of the spectrum was this article in The Times of London which went total “dark side” with this statement:
“An artificial intelligence programme which has startled users by writing essays, poems and computer code on demand can also be tricked into giving tips on how to build bombs and steal cars, it has been claimed.”
Tom Kington, The Times, Rome
The problem with the hype around ChatGPT is that we’re not talking about the real issues around using these chatbots. We should be asking instead questions along the lines of: “Are large language models justifiable or desirable ways to train artificial systems?” or, “What would we design these artificial systems to do?” or if unleashing a chatbot to a public whose imagination is constantly under siege by propagandistic and deceptive depictions of artificial intelligence (and using that public to train the chatbot further) is something that should be allowed to happen.
This week there was an interesting discussion of the topic in Office Hours Global online. While the discussion focused primarily on video production, the questions asked throughout were critical examples of how far we have to go in formulating a strategy for deploying these generative AI platforms. A link to that discussion follows (the debate begins at 1:01:59 in the video)
Open AI’s DALL-E platform is fun to play with too. As discussed in the Office Hours Global conversation, you get some interesting results. Here’s what the AI-generated when I input “Princess Leia in the style of Rembrandt”:
What about ChatGPT in healthcare?
Dr. Bertalan Mesko, the Medical Futurist, wrote a post with his initial thoughts on potential use cases in healthcare this week. It is important to note that he would certainly not use it in any way that could harm patients, like finding a diagnosis, where the slightest error could have dire consequences. Also, When he first started playing with it, it was prone to come up with fake stuff that looked convincing, just as it came up with three non-existing articles proving the benefits of echocardiograms for Systematic Sclerosis. It looked legit, but if you try to find the referenced articles in the scientific literature, you will find none, as many commenters pointed out. They are just things the algorithm fabricated. But he does think there are potential use cases that are simpler and less risky. Here are his examples:
Summarizing medical records based on patients’ family history, symptoms and lab results, among others
Summarizing and analyzing research papers: list keywords in an abstract or summarize a long and detailed research paper for physicians not working in that field of interest
Writing general texts, like emails, a book blurb or anything that saves time and you can further customize it for your needs and personal style
Answer broad questions
Work as a chatbot to answer FAQ-like questions for the doctors’ office, or handle appointments (see case example below)
I’m not sure I’m on board with all of his examples, but it makes for an interesting discussion.
There is also an article in The Journal of Medical Internet Research that outlined the following three major operational factors that could drive the adoption of GPT-3 in the US health care system: (1) ensuring Health Insurance Portability and Accountability Act compliance, (2) building trust with health care providers, and (3) establishing broader access to the GPT-3 tools. This viewpoint can inform health care practitioners, developers, clinicians, and decision makers toward understanding the use of the powerful artificial intelligence tools integrated into hospital systems and health care.
In the case illustrated below, the hospital is providing a chatbot triaging mechanism for incoming patients to reduce the overhead at clinics and increase the safety and quality of care during the COVID-19 pandemic. The chatbot has to be connected to the hospital network, combined with a triage text summary service that is to be reviewed, and stored in the electronic health record. In this example, triage could be initiated by a patient or a hospital to conduct a health screening.
For me, the fundamental question is what roles algorithmic and automated systems should have in our education, healthcare, and business systems. Then you have the other thorny issues around ethics, legal, and copyright protections. We’re currently unprepared to answer questions like: Who owns the rights to the generated output of the AI? The complications associated with the legal aspects of Intellectual Property rights also come to the fore in text-based generative AI. Assuming that the text being trained upon is copyrighted, would you say the generated text violates those legal rights? Our regulatory bodies are nowhere near being ready to address those questions, and until they are, caution should be the watchword of the day when experimenting with these AI platforms.
Recent weeks have offered a glimpse into the current state of AI capabilities, which are both fascinating and worrying. Regulators must adjust their thinking to address coming developments, and the industry must collaborate with policymakers as we navigate the next AI platform evolution. For now, platforms like ChatGPT are enjoyable to play around with but not ready for primetime adoption in any critical business applications.
“I haven’t read a book properly until I’ve had it read to me.”
Mark Haddon, author of The Curious Incident of the Dog in the Night-time
Since I’ve already shared my favorite books and podcasts for this year, I thought I’d finish with a list of my favorite audiobooks. But first, some context.
Even for people who love books, finding the opportunity to read can be challenging. Many, then, rely on audiobooks, a convenient alternative to old-fashioned reading. You can listen to the latest bestseller while commuting or cleaning up the house. We can debate whether listening to an audiobook constitutes “reading,” but there’s no doubt that audiobooks have continued to grow in popularity over the last few years.
What makes a great audiobook? For me, content is king. I’ve claimed I’d happily listen to certain favorite narrators read the phone book. And to an extent, I would. But, if I’m being honest, I’d much rather listen to them read something I’m interested in, especially if it’s something that lends itself well to the audio format.
Next is the narrator. A pleasant and natural-sounding voice can blend into the background, allowing the story space to shine. The characters’ voices a narrator creates for an audio production can make or break the audiobook. While I’ve heard there are readers who prefer an audiobook read matter-of-factly and without using distinctive voices for different characters, I tend to think that approach takes much of the fun out of the format. I love it when a narrator uses differences in character voices. I have a list of my favorite audiobook narrators, and I will almost always purchase a book that features them regardless of genre. For example, I’ll listen to anything narrated by Stephen Fry: Greek mythology, Sherlock Holmes, biography of Oscar Wilde, anything.
Sometimes, there’s just that special something that takes a good audiobook and makes it great. It could be a spot-on accent. It could be an excellent use of music or sound effects. Or maybe it’s when the narrator verbally acts out stage directions like laughter, tears, singing, or slurred speech. You know, actually chuckling, rather than just reading, “He laughed.”
Finally, since I purchase all of my digital and audiobooks on Amazon, I like the ability to seamlessly jump back and forth between the printed page (to take notes or highlight a section to read again) and the audio version without having to search to find where I left off. I can even use my Alexa device to continue listening to audiobooks in my home office.
So, here are some of my favorite audiobooks from 2022. Note that most are not healthcare related, and many aren’t focused on technology. They just hit my major criteria for selecting an audiobook, and they give me hours of enjoyment.
Have I told you that I’m a space geek? I had watched almost every launch since Project Mercury right through to Project Orion last week. So this was a no-brainer for me. Collaborating with NBC’s veteran space reporter Jay Barbree (the best reporter on the U.S. space program, in my opinion), Shepard and Slayton narrate in gripping detail the story of America’s space exploration from the time of Shepard’s first flight until he and eleven others had walked on the moon.
Another admission – I love Sondheim. And Sunday in the Park With George is the finest musical I’ve ever seen (multiple times). Putting It Together chronicles the two-year odyssey of creating the iconic Broadway musical Sunday in the Park with George. In 1982, James Lapine, at the beginning of his career as a playwright and director, met Stephen Sondheim, nineteen years his senior and already a legendary Broadway composer and lyricist. Shortly after, the two decided to write a musical inspired by Georges Seurat’s nineteenth-century painting, A Sunday Afternoon on the Island of La Grande Jatte. Growing up in Chicago, I can’t begin to tell you how many times I visited The Art Institute to view the painting, marveling at the visual effect those tiny dots made when you stood just the proper distance from the work. Hearing how the musical came together was a revelation. Highly recommend this one.
I’ve thoroughly enjoyed the first two seasons of the series on Apple TV+. So I decided to go back and listen to Asimov’s original novel to see if I could pick out any differences. The Foundation novels of Isaac Asimov are among the most influential in the history of science fiction, celebrated for their unique blend of breathtaking action, daring ideas, and extensive worldbuilding. In Foundation, Asimov has written a timely and timeless novel of the best – and worst – that lies in humanity and the power of even a few courageous souls to shine a light in a universe of darkness.
I’ve already mentioned that I’ll buy any audiobook read by Stephen Fry. This is the third in his series on Greek mythology and a delightful listening experience. The legendary writer, actor, and comedian breathes life into ancient tales, from Pandora’s box to Prometheus’s fire, and transforms the adventures of Zeus and the Olympians into emotionally resonant and amusing stories without losing any of their original wonder. Learned notes from the author offer rich cultural context. This volume is a doorway into a captivating world.
Joanne B. Freeman, a professor of history and American studies at Yale University, is a leading authority on early national politics and political culture. I’ve had the pleasure of attending several of her lectures at Yale and have taken her online course on American history. In The Field of Blood, Freeman recovers the long-lost story of physical violence on the floor of the U.S. Congress. Drawing on an extraordinary range of sources; she shows that the Capitol was rife with conflict in the decades before the Civil War. The Field of Blood offers a front-row view of congressional mayhem. It sheds new light on the careers of John Quincy Adams, Henry Clay, and other luminaries, as well as introduces a host of lesser-known but no less fascinating men.
“…it was reading the Sherlock Holmes stories as a boy that first turned me on to the power of writing and storytelling.” (Stephen Fry)
As an avid Holmes fan, this is by far the best audio adaption of the Conan Doyle stories. Fry’s Holmes is crisp and high-handed, his Watson enthusiastic and bemused, and the rest of the narration colorful without being mannered. Have fun with these.
Ulysses S. Grant’s life has typically been misunderstood. He is often caricatured as a chronic loser and an inept businessman or as the triumphant but brutal Union general of the Civil War. But these stereotypes don’t come close to capturing him, as Chernow shows in his masterful biography, the first to provide a complete understanding of the general and president whose fortunes rose and fell with dizzying speed and frequency. This is one of America’s greatest biographers, bringing movingly to life one of our finest but most under-appreciated presidents.
I know, “not another space-themed audiobook!” 😏 – I thought I was pretty well informed on what it took to get American astronauts to the moon and back. But I had never heard this story before. Released to coincide with the 50th anniversary of the first moon landing, this book tells the story of John C. Houbolt, an unsung hero of Apollo 11 and the man who showed NASA how to put America on the moon. His plan was ridiculed and considered unthinkable. But this junior engineer was irrepressible. He stood by his concept, fired off memos to executives, and argued that LOR was the only way to success. This is a fascinating story, and Zwillich tells it well.
This book was highly recommended by Dr. Bertalan Mesko, The Medical Futurist who is a big sci-fi fan. So I listened to the audio sample online and was immediately hooked. The author poses the following question: If you had the chance to look one year into the future, would you? Two best friends create a computer that can predict the future. But what they can’t anticipate is how it will tear their friendship – and society – apart. Told through emails, texts, transcripts, and blog posts, this bleeding-edge tech thriller chronicles the costs of innovation and asks how far you’d go to protect the ones you love – even from themselves.
From 1501 to 1505, Leonardo da Vinci and Michelangelo Buonarroti both lived and worked in Florence. Leonardo was a charming, handsome 50-year-old at the peak of his career. Michelangelo was a temperamental sculptor in his mid-20s, desperate to make a name for himself. Oil and Marble is the story of their nearly forgotten rivalry. Storey brings early 16th-century Florence alive and has entered with extraordinary empathy into the minds and souls of two Renaissance masters. The book is an art history thriller and well worth a listen.
The captivating inside story of the man who helmed National Geographic for six decades is a front-row seat to audacious feats of exploration, from the successful hunt for the Titanic to Jane Goodall’s field studies. Offering a rare portrait of one of the world’s most iconic media empires, this revealing autobiography makes a passionate argument to know—and care for—our planet. For Grosvenor, running National Geographic wasn’t just a job. It was a legacy motivated by a passion not just for leaving the world a better place but for inspiring others to do so, too
The Rosetta Stone is one of the most famous objects in the world, attracting millions of visitors to the British Museum every year, yet most people don’t know what it is. Discovered in a pile of rubble in 1799, this stone slab proved to be the key to unlocking a lost language that baffled scholars for centuries. Dominating the world for 30 centuries, ancient Egypt was the mightiest empire the world had ever known, yet everything about it – the pyramids, mummies, the Sphinx – was shrouded in mystery. Whoever was able to decipher the Rosetta Stone would solve that mystery and fling open a door that had been locked for two thousand years. Two brilliant rivals set out to win that prize. The Writing of the Gods chronicles this high-stakes intellectual race in which the winner would win glory for himself and his nation.
So, there you have it—my dozen favorite audiobooks this year. I hope you find one or more of them interesting enough to download a copy and give it a listen. What have you heard recently that you would recommend? Leave a comment below and let me know. I’m always looking for new adventures to explore. And thanks for reading this blog.
What happened in health care technology this week, and why it’s important.
Here’s How Skilled Nursing Facilities Can Use Virtual Reality Too
Avi Philipson writes in MedCity News that skilled nursing facilities are no strangers to innovative technology. Their equipment is more advanced than ever before, technology is an integral part of their services, and it’s helping to improve staff’s day-to-day lives. While some skilled nursing facilities and long-term care centers have already found a use for virtual reality in their facilities, many SNFs and LTC centers have yet to make VR a part of their offerings. He highlighted three areas where VR can use virtual reality at their organizations to benefit residents.
VR can improve rehabilitation services – It’s challenging to maintain a resident’s interest and motivation when it comes to working out, especially because routines can become monotonous so quickly. VR can make stretches and exercises more exciting, thus keeping more residents engaged.
VR can slow cognitive decline – Using VR exercise games, which is also known as ‘exergaming’ or ‘gamercising,’ can help to prevent and slow cognitive decline. Research backs this up, saying that VR exergaming has the potential to have a significant impact on dementia, Alzheimer’s, and even Parkinson’s disease.
VR promotes socialization – VR headsets can be handed out to a large group, and these individuals can play games or travel worldwide together. Engaging in a group activity like this is a great way to mix up the usual events and bring an entirely new visually entertaining aspect to your residents’ days, which will bridge connections on a whole different level.
Why it’s important – Virtual reality gives residents freedom that facilities can’t offer without technology. Early pilot projects have demonstrated benefits in all three areas described above and have been shown to improve the quality of life for residents in facilities that use the technology.
Infographics of the week – CB Insights has unveiled the fourth annual Digital Health 150 — a list of 150 of the top private companies transforming healthcare with digital technology. Winners are focusing on everything from reimagining clinical care to making healthcare more accessible for underserved populations to leveraging tech like AR/VR to improve surgical training.
The second infographic this week is from The Medical Futurist Institute. Nutrigenomics could be the biggest flop in digital health or one of the most exciting trends. It could help people better adjust their diet based on their genomic and metabolic background. They analyzed the global market to find those companies that provide such services. It contains the countries companies originate from, the year they were founded, and the price of their service now.
DEVICES THAT DELIVER INJECTABLE DRUGS RIGHT AT HOME
Abigail Klein Leichman on Israeli21c online reports that automated drug delivery is a critical star in the constellation of technologies enabling more people to get medical care outside hospitals. Devices that deliver medications can extend “hospital at home” services to many more patients.
Why it’s important – Devices that deliver infusions at home or close to home reduce stress on patients, reduce costs, and reduce the workload of chronically short-staffed hospitals.
Base editing: Revolutionary therapy clears girl’s incurable cancer
A teenage girl’s incurable cancer has been cleared from her body with the first use of a revolutionary new type of medicine. The BBC’s James Gallagher reports on Alyssa’s story in his online article. Alyssa, who is 13 and from Leicester, was diagnosed with T-cell acute lymphoblastic leukemia in May last year. Her cancer was aggressive. Chemotherapy and then a bone-marrow transplant could not rid it from her body. The team at Great Ormond Street used a technology called base editing, which was invented only six years ago. The large group of doctors and scientists used this tool to engineer a new T-cell capable of hunting down and killing Alyssa’s cancerous T-cells. After a month, Alyssa was in remission and was given a second bone-marrow transplant to regrow her immune system.
Why it’s important – The technology used in Alyssa’s case, though, only scratches the surface of what base editing could achieve. In Alyssa’s therapy, each base edit involved breaking a section of genetic code, so it no longer worked. But there are more nuanced applications where instead of switching an instruction off you can fix a defective one. Sickle-cell anemia, for example, is caused by just one base change that could be corrected. There are already trials of base editing underway in sickle-cell disease, as well as high cholesterol that runs in families and the blood disorder beta-thalassemia.
England to sequence genomes of 100,000 newborns, to try to catch illness earlier
Stat’s Andrew Joseph reports that The Newborn Genomes Programme will scan DNA for mutations that can cause some 200 conditions. Such early sequencing is meant to identify genetic diseases quickly and to help families avoid the often yearslong “diagnostic odysseys” that can begin when children start to show vague symptoms — missing developmental milestones, for example — and only end when they eventually get a firm diagnosis. Early interventions, perhaps before symptoms appear, could also stave off the damage these diseases cause. The study’s results — which will also consider the economics and ethics of such an intervention — will inform whether and how the U.K.’s National Health Service would offer wider newborn sequencing.
Why it’s important – Sequencing of newborns has proven its worth when there’s suspicion of a genetic disease; an early diagnosis can inform treatments before a condition gets particularly severe.
Amazon Alexa supports care providers with senior living product
Amazon has launched Alexa Smart Properties for Senior Living, enabling Alexa devices to be integrated into assisted living and care facilities. Cora Lydon outlines the details in her article in Digital Health online. Alexa Smart Properties will specifically support the needs of older residents and those providing care to them. It allows care providers to deploy, manage and service a fleet of Echo devices quickly, remotely, and at scale, working with solution providers to customize them. Care teams can communicate with residents using Amazon Alexa features such as making announcements and voice and video calls. Property managers will also be able to engage with residents by displaying activities, menus, and reminders on Echo Show devices.
Why it’s important – This isn’t the first time Amazon has announced this type of initiative. Two years ago, Amazon introduced The Care Hub, a set of care features for US customers to help support independent living for older people. And, while the platform can empower residents to control their environment with an Amazon Alexa device, giving them greater independence, recent reports that Amazon is cutting back on their commitment to Alexa devices raise concerns that the long-term support for platforms like this is questionable. We need to watch this closely.
ChatGPT Is a Tipping Point for AI
Ethan Mollick, in the Harvard Business Review, discusses the impact of ChatGPT on businesses across multiple industries. While versions of GPT have been around for a while, this model has crossed a threshold: It’s genuinely useful for a wide range of tasks, from creating software to generating business ideas to writing a wedding toast. While previous generations of the system could technically do these things, the quality of the outputs was much lower than that of an average human. The new model is much better, often startlingly so. His conclusion: This is a very big deal. The businesses that understand the significance of this change — and act on it first — will be at a considerable advantage. Especially as ChatGPT is just the first of many similar chatbots that will soon be available, and they are increasing in capacity exponentially every year.
Why it’s important – It has an incredible capacity to perform different kinds of writing with more significant implications than might be initially apparent. The use of AI in writing can significantly increase the productivity of businesses in a variety of industries. By utilizing AI’s ability to quickly and accurately generate written content, companies can save time and resources, allowing them to focus on other essential tasks. This is particularly beneficial for industries such as marketing and advertising, consulting, and finance, where high-quality written materials are vital for communicating with clients and stakeholders. What about healthcare, you ask? Some physicians have already started using ChatGPT to generate letters to insurance companies to challenge denials of critical procedures for patients. (See video below) And we’ve only scratched the surface of the platform’s full potential.
Facing rising costs and widespread economic uncertainty, big tech companies continue laying off their skilled workforce in droves. From Meta to Twitter, Amazon to Stripe, and AirBnB to Zillow, network effects-driven platforms across industries are trying to right-size their forces, facing the consequences of over-hiring in recent years while navigating 40-year inflation highs. I’d been following the layoffs since the start of the year. But I had no idea how many people had been affected by the cuts. The graphic below shows the cumulative numbers since the beginning of the year.
The number of layoffs is staggering. But as the two articles point out, within every crisis is a silver lining. For both big-tech workers debating their next career move and healthcare organizations needing big-tech chops and network effects experience, the landslide of layoffs means there is an abundance of tech talent available and plenty of companies – and an entire industry – that stand to benefit.
Using the three reasons healthcare is a prime landing spot for these out-of-work tech professionals in Joseph’s article, I’ll add some comments on why I think techies should seriously consider a move into the healthcare industry and healthcare nonprofits.
My Take: If you like to solve big problems, healthcare is a good fit for your skills. We still function in multiple data silos, and sharing patient records across platforms is a nightmare. Platform companies are uniquely suited to address challenges endemic to healthcare – where issues stem from a lack of consistent data and massive fragmentation, impacting everything from care coordination and quality to cost and patient/consumer experience. And healthcare data companies like Truveta are hiring
My Take: If you are skilled in user interface design, we desperately need you in healthcare. Take a look at most consumer-facing healthcare apps, and you’ll see they are challenging to navigate, confusing for the end user, and do not integrate well with the information infrastructure of most organizations.
My Take: If you want to do work that dramatically impacts people’s lives, healthcare needs you. There is personal merit in working in healthcare technology, a mission, and a purpose in the space absent in other industries. Finding this purpose can be a welcome shift for technologists looking for more meaning in their work while helping improve their mental health and well-being. The work that you can do in healthcare benefits not only patients and their families but also the workers who provide care to those patients. Your work in making the healthcare system easier to navigate for patients and their families is crucial to eliminating friction and frustration in dealing with the system. And anything you can do to eradicate frustrating, non-value-adding work for healthcare workers would go a long way in reducing the burnout they are currently experiencing. The best part of this work is it is immediately visible to you. You can see that you are making an impact.
My Take: If you are passionate about making an impact for organizations and causes that have a real social impact, consider looking at the nonprofit sector for meaningful work. As Hendler points out in his article, exploring resources such as All Tech Is Human, U.S. of Tech, U.S. Digital Response, Fast Forward, Tech Jobs for Good, and Design Gigs for Good are helpful starting points to explore full-time, part-time, and volunteering opportunities in the impact sector. These organizations have put together job boards, talent pools, guides, and virtual and in-person communities to unite technologists who aim to make their mark for the good of society.
Bottom line – Healthcare needs you. There is a huge opportunity to do good via tech and digital strategy in healthcare. And the timing is right, as the market will only be growing and is (relatively) recession-proof. While this is a challenging time, technologists have the power to create meaningful change, improving the lives of others, as well as their own, at an unprecedented scale. Join us.
“The medium of podcasting and the personal nature of it, the relationship you build with your listeners and the relationship they have with you – they could be just sitting there, chuckling and listening… there’s nothing like that.”
Marc Maron, Podcaster
Last week I shared a list of some of my favorite books this year. Since podcasting has become an important channel for information sharing and learning, I thought I’d update the list of my favorite podcasts in health care and technology (and other topics) for your consideration. But first, some current stats on the popularity of podcasts in general.
Insider Intelligence reports that there are currently over two million active podcasts worldwide. The average podcast consumer spends 7 hours weekly listening to podcasts. Projections show that by 2028, podcasting will be a $94.88 billion industry. Podcast listeners will account for 20.3% of all internet users in 2022. That’s 424.2 million people who listen to podcasts worldwide. The number of podcast listeners in the US is expected to reach 138.6 Million by 2024. Most podcasts get around 141 downloads in the first month. Podcast stats from Edison Research found that most people listen to podcasts for educational purposes, 71% do so for entertainment, 60% want to keep abreast with news, and 51% said they find them relaxing. On the flip side, it’s equally vital to know why people don’t tune in to podcasts. 75% of non-listeners said podcasts are just not for them, 51% say they provide content they can find elsewhere, while 49% said they consume a lot of phone data.
Research from The Infinite Dial shows that 90% of podcast listeners prefer listening to podcasts at home. 59% of people listen to podcasts while doing household tasks. 52% listen while driving, 50% while cooking, and around 37% of people consume podcasts when commuting. Podcasts are a medium for listeners to enjoy “passively” in the background.
So, with so many options, how do you select ones to listen to regularly? My first criteria are the credentials of the host. I want respected professionals in the field, not someone doing this as a sideline. Second, I look at the quality of the guests on the podcast. Can the host attract excellent guests in every episode? Finally, I look at the topics being discussed. Are they interesting? Do they add credible information to the conversation, or are they simply a rehashing of what’s already out there? So, with those as my guideposts, here are my favorite podcasts for 2022 (Click on the titles for links to subscribe):
Becker’s Healthcare offers a suite of niche podcasts from every area of the healthcare industry landscape. I especially like their series on digital health and IT. They cover the topic well with interviews with industry leaders, leading companies, and corporate investors to give listeners a broad perspective on new developments and growth opportunities.
Direct questions, real answers. On with Kara Swisher is where “Silicon Valley’s most feared and well-liked journalist” gets to the heart of what makes influential people tick. Kara makes sense of tech, business, and politics through tough conversations with the newsmakers who matter. So why do they show up? “Smart people,” says Kara, “like difficult questions.” I included two podcasts with Kara in last year’s list. She’s changed affiliations since then and is now a contributor to NY Magazine. With that change comes this new podcast series. Next to Walt Mossberg, Kara’s the best interviewer in the technology industry.
Passionate Pioneers with Mike Biselli, a nationally ranked healthcare and innovation podcast and a member of the Health Podcast Network, highlights the innovators, the game changers, and the pioneers who are deeply passionate and relentless in valiantly solving the problems our healthcare industry is facing.
Senator Bill Frist is no stranger to American health and healthcare. He is an accomplished heart and lung transplant surgeon, as well as a two-term United States Senator representing Tennessee. Now he is using his influence to connect with leaders and innovators to bring awareness and understanding to more than just healthcare but health in general. His mission is to substantially improve health and healthcare in communities across America through education and engagement at the nexus of policy, medicine, and innovation. The podcast addresses challenging healthcare issues of today from three distinct vantage points: policy, medicine, and innovation.
Paddy Padmanabhan is an award-winning business leader and trusted C-suite Advisor with a proven history of success guiding digital transformation and growth strategies across the healthcare and technology sectors. He has worked in various leadership roles at globally recognized firms such as Accenture, GE, and Wipro, where he built sizeable global technology businesses and spearheaded strategic growth initiatives. Featuring C-suite executives from the healthcare and technology sectors, Paddy discusses how they are driving digital health innovation and leveraging emerging healthcare technologies to create improved patient experiences.
The Next Big Idea is a weekly series of in-depth interviews with the world’s leading thinkers. Rufus Griscom — along with curators Malcolm Gladwell, Adam Grant, Susan Cain, and Daniel Pink, lead conversations that might change the way you see the world. This podcast forces you out of your comfort zone and stretches your thinking on any number of topics, from neurodiversity to humor to the art of persuasion.
The world of technology and healthcare is changing in new and novel ways. John Lynn and Colin Hung discuss the latest healthcare and Health IT News meshed together in new ways which help generate ideas and new perspectives. Part of the HIMSScast series, this is a biweekly podcast that covers the latest news in healthcare IT in a fun way.
Are you looking to understand better and apply innovation theories, methods, and tools? Do you need to think about your business or industry differently? Join the Sherpas as they conduct spirited conversations and tell compelling stories to guide you along your innovation expedition. Atrium Health’s Ben Tingey, Jay Gerhart, Ann Somers Hogg, and Will Behrmann lead the listeners through the resources, processes, and priorities these successful disruptors deploy.
OK, this isn’t a technology or healthcare-related podcast. All About Agatha is a podcast all about, well, Agatha. Agatha Christie, of course. The Queen of Crime, a real-life Dame of the British Empire and author of sixty-six mystery novels that spanned the Twentieth Century, defining a genre. Thousands of Agatha Christie enthusiasts across the globe have downloaded the podcast for what one listener described as a “joyfully geeky” take on the Queen of Crime’s expansive canon. Today, the podcast averages just under 100,000 downloads a month, with most of its listeners in the U.S., the U.K., Canada, Australia, Germany, and Scandinavia. If you are a Christie fan, as I am, you’ll find this podcast a delight. If you’d like to get the entire story behind the podcast, here’s a great article that the LA Times did on the series.
So, those are my top nine podcasts for the year. I hope you find one or more of them interesting and informative. If you have a favorite healthcare or tech podcast that I’ve missed, drop a comment below and let me know what you’re listening to these days. Thanks for reading!
What happened in health care technology this week, and why it’s important.
Short term memory problems can be improved with laser therapy, according to new study
UK and Chinese scientists demonstrated that a non-invasive laser light therapy lasting only a few minutes could improve short-term memory in people by up to 25%. The treatment, called transcranial photobiomodulation (tPBM), is applied to an area of the brain known as the right prefrontal cortex. This area is widely recognized as essential for working memory. They also tracked changes in brain activity using electroencephalogram (EEG) monitoring during treatment and testing.
Why it’s important – They don’t yet understand why the treatment positively affects working memory or how long the results will last. Further research is planned to investigate these aspects. This is the first study, however, to confirm a link between tPBM and working memory in humans.
Infographics of the week – All five of the infographics this week come from the folks at CB Insights. I’ve highlighted their platform before and have been consistently impressed by the quality of their research. This compendium of strategy maps was released this week and is available for download here. Their 67-page coffee table book of strategy maps shines a light on the strategies behind some of the world’s most influential companies — from Amazon and PayPal to Tesla and CVS Health. I’ve included the big tech in healthcare maps below. You can find the maps for CVS and Walgreens in the document.
A Proactive Way to Detect Cancer at Its Earliest Stages
Wired’s Grace Browne reports that Medtech firm Earli is working on a way to make tumors announce themselves as they appear—and even provide directions to where they are in the body. German-American entrepreneur Cyriac Roeding read a profile of Sam Gambhir, a physician, and scientist at Stanford University School of Medicine, in a magazine. Roeding, the co-founder and former CEO of the mobile shopping app Shopkick, was struck by Gambhir’s story and immediately sent him an email asking to meet. Earli’s approach essentially forces the cancer to reveal itself. Bioengineered DNA is injected into the body; when it enters cancer cells, it causes them to produce a synthetic biomarker not generally found in humans—something like limonene, a chemical found in the peel of citrus fruits. If subsequent breath or blood tests find traces of that biomarker, it could be a sign of cancer. The next step is figuring out where the cancer is in the body. An injected compound forces the cancer cells to produce an enzyme that gobbles up a radioactive tracer, rendering it visible to the naked eye in a scan. Localizing cancer makes it treatable—clinicians can use precision radiation or targeted surgery to then take it out.
Why it’s important – The plan is for Earli to be used at every stage of cancer prevention and treatment: for diagnostic monitoring in high-risk groups like smokers; for pretreatment, to find out if there is cancer anywhere else in the body; during treatment, to make tumors easier for surgeons to locate; and post-treatment, to detect earlier any recurring cancer. If the trials are successful, this could be a game changer in cancer care and a fitting legacy for Dr. Gambhir, who devoted his career to early cancer detection, only to lose his teenage son Milan to a highly aggressive brain tumor in 2015 and succumbed himself to the disease in 2020.
Digital Tech Holds Great Promise for Expanding Patient Access According To A New Report
Among all of the challenges healthcare providers will face in 2023, digital health tools could have the greatest potential to improve patient access, according to the issues most Top of Mind for Top Health Systems 2023 from UPMC. The Center for Connected Medicine, Nokia, and KLAS Research. The challenge of improving patient access is once again the primary focus of this report, given its importance in many health systems and its potential impact on so many other priorities. If you can’t get patients in the door, does it matter what you do with other technology? Patient access remains top of mind for leaders because the challenge is complex, and health systems continue to grapple with the long-term impacts of the COVID-19 pandemic. There is economic uncertainty, patients who remain wary about returning for care, and greater demand from consumers for more convenient care options.
From the patient-demand point of view, we can see a gap between what best serves the patient and what is currently the most effective tool. Patient portals appear to have the best match between serving patient needs and being effective. Telehealth appears to “over-perform” based on this small sample of perceptions among healthcare leaders, while scheduling may be under-delivering in terms of effectiveness.
Why it’s important – While a relatively small study sample, this study gives us important food for thought in terms of direction and information for planning digital health investments among health systems over the coming year. Looking ahead into 2023, it would seem that health systems are chipping away and making incremental progress. At least by prioritizing patient access and acknowledging the demands of consumers, health systems are heading in the right direction, however slowly it may seem.
UMass Memorial Health proves RPM virtual sitting is as effective as in-person care
Bill Siwicki of Healthcare IT News reports that remote patient monitoring has allowed the health system to maintain patient safety while reducing labor-pool costs. For years, UMass Memorial Health has leveraged technology to augment in-person care at the bedside. Launched in 2006, its tele-ICU program remotely monitors more than 150 adult critical care beds across Central Massachusetts. The system partnered with Caregility and its iObserver platform, which allows a remote care team to monitor up to 12 patients per screen, with two-way audio/video support, night vision, and rapid-response bedside alerts.
Why it’s important – Staff initially started with a three-to-one patient ratio and gradually increased to six-to-one, ultimately with an additional six patients monitored as a backup for another virtual sitter. In the first year of operation, the remote team logged more than 100,000 interventions through the iObserver system. This included direct patient engagement through audio or two-way audio/video interaction and alerting the bedside team to potential adverse events such as getting out of bed, tugging at lines, and agitation. This let staff maintain patient safety while at the same time reducing labor-pool costs.
ChroniSense Medical receives FDA 510(k) for RPM wearable
In another story on remote patient monitoring, MobiHealthNews’ Jessica Hagen reported that Israeli company ChroniSense Medical received FDA 510(k) clearance for its Polso wearable that collects and shares vital signs with a mobile app for patients and a cloud-based platform for clinicians. The wrist-worn wearable enables clinicians to monitor patient’s vitals, including blood oxygen saturation (SpO2), pulse rate, and respiration rate. The company touts the watch as ideal for remote patient monitoring and use in decentralized clinical trials.
Why it’s important – With six out of 10 adults in the U.S. living with a chronic condition, and over $1.1 trillion in direct healthcare costs annually, there is a serious need for an easy-to-use, medical grade, remote patient monitoring solution. Adding Polso to the list of available solutions allows researchers to compare multiple options and measure which devices provide the most value to caregivers and patients.
The Era of One-Shot, Multimillion-Dollar Genetic Cures Is Here
Gene therapies promise long-term relief from intractable diseases—if insurers agree to pay. Emily Mullen in Wired Science online reports on Hemgenix, which gained US approval from the Food and Drug Administration on November 22 to treat patients with severe hemophilia B. The big issue is paying for the drug. Shortly after its approval, CSL Behring, the pharmaceutical company commercializing the drug, announced its price: $3.5 million for a one-time dose. It’s now the most expensive drug in the world. As part of a research study, Pipe’s trial participants didn’t have to pay for the therapy. But future patients and their insurers will. And Hemgenix isn’t the only gene therapy with a sky-high price. Luxturna, the first such treatment approved to fix an inherited trait—a rare form of vision loss—debuted in 2018 at $425,000 per eye. The therapy is meant to restore eyesight in people with a specific genetic mutation that causes the retina to degrade over time.
In 2019, pharma company Novartis won FDA approval for its gene therapy Zolgensma, which is meant to treat children under age 2 with spinal muscular atrophy, or SMA, a leading genetic cause of infant mortality. Novartis subsequently priced the therapy at $2.1 million, making it the most expensive drug on the market at the time. But earlier this year, newly approved gene therapy Zynteglo grabbed the title at $2.8 million. The drug is for patients with a blood disorder called beta thalassemia who require regular blood transfusions.
Why it’s important – The companies behind these therapies have justified their high prices, saying they provide immense benefits and are more cost-effective than current treatments since they are given just once. But Michael Gusmano, professor of health policy at Lehigh University and a research scholar at the Hastings Center, an independent bioethics research institute in Garrison, New York, says the price of Hemgenix and other gene therapies shouldn’t be considered a bargain.
While most patients never pay the total cost of drugs out of pocket, uninsured people and those with high-deductive plans may have trouble accessing these therapies.
A new coalition aims to close AI’s credibility gap in medicine with testing and oversight
Most of the AI models described in journals — and lionized in press releases — never make it into clinical use. And the rare exceptions have fallen well short of their revolutionary expectations. Casey Ross from Stat reports that a group of academic hospitals, government agencies, and private companies unveiled a plan to change that. The group, billing itself as the Coalition for Health AI, called for the creation of independent testing bodies and a national registry of clinical algorithms to allow physicians and patients to assess their suitability and performance and root out bias that so often skews their results.
Why it’s important – As it stands today, there are few guideposts hospitals can use to help test algorithms or understand how well they will work on their patients. Health systems have been left on their own to sort through the complicated legal and ethical questions AI systems pose and determine how to implement and monitor them. The hardest part of the work remains to be done. The coalition must build consensus around ways to measure an AI tool’s usability, reliability, safety, and fairness. It will also need to establish the testing laboratories and registry, determine which parties will host and maintain them, and convince AI developers to cooperate with new oversight and added transparency that may conflict with their business interests.
FDA outlines benefits and risks of emerging augmented and virtual reality medical devices
In the document, the FDA outlines how AR/VR affects medical devices, explaining how the technology can deliver certain clinical services, including some typically confined to hospitals and clinics, to patients in their homes. The FDA’s non-exhaustive list of medical devices incorporating the technology features 39 products across therapeutic areas, including orthopedics, ophthalmics, radiology, neurology, and cardiovascular.
Why it’s important – The FDA has now set out its thinking on the emerging class of products. The document provides definitions of AR and VR and then digs into how the technology impacts medical devices. The FDA sees value in the ability of AR/VR to move care to patients’ homes and other non-clinical settings. This could enable patients, including the socioeconomically vulnerable and underserved communities, the elderly or disabled, to access needed health care services when accessing them in person would otherwise be difficult, and this could make it easier, and more likely, for patients to complete treatment and monitoring regimens.
Camera Measures Blood Pressure with Quick Look
Finally, MedGadget’s Conn Hastings reports that University of South Australia researchers have designed a system that allows them to measure a patient’s blood pressure with a camera. The camera visualizes the patient’s forehead and focuses on two regions in particular to optically determine photoplethysmographic signals that AI algorithms then convert to blood pressure data.
Why it’s important – Blood pressure is an essential health indicator, but our method of measuring it can be a little cumbersome. The system could provide contact-free measurements in as little as ten seconds. It could be very useful for large health screens or in situations where minimal contact is preferred for safety, such as during a pandemic. This latest technology has been tested on 25 volunteers with different skin tones and in different ambient light conditions. The researchers compared the readings with those obtained using a commercial sphygmomanometer. They found that the contact-free camera-based technology was approximately 90% accurate, suggesting that it has significant promise as a diagnostic technology.