Many innovative and exciting new technologies are emerging in healthcare, 2017. Some are new discoveries and devices; others are maturing technologies that will impact care delivery, clinical research, medicine, patient treatment options, chronic care management, and the effective control of disease throughout the world.
The key changes that I feel will have the most impact in 2017 are:
• mHealth including Telemedicine,
• Remote Patient Monitoring
• Health Wearables
• Behavioral Health
• Precision Medicine
More than 8.2 billion Internet-connected video devices are now installed worldwide, an average of 1.1 devices for every citizen, and nearly double the number in use just four years ago. In healthcare, these devices enable expansion of e-health; provide new mobile solutions for dealing with non-communicable diseases; foster advancements that help patients monitor and manage multiple chronic conditions and accelerate the expansion of health services to areas of the world where there have been few resources in the past, therefore impacting population health in new ways.
Last Fall, at the Connected Health Symposium, these innovations were visibly in place. They illustrated new ways to engage patients to use their mobile phones or tablets to foster consistent monitoring and measuring of vital health metrics such as blood pressure, blood sugar, weight, heart rate, temperature and to help patients adhere to and remember to take medications at the right time and in the right amount.
For example, there is Decadoo, a Swiss company that has combined mobile technologies, social networking, gamification and big data analytics with the mhealth monitoring and enables an individual to track, manage that benchmark their health by calculating a scientifically determined score in real time based on who you are (body), how you feel (feelings) and how you live (lifestyle). When tracked over time, Decadoo offers a directional indicator of how your health is evolving.
Another example is Twine Health, a digital health company that has developed a health activation platform that helps patients reach their goals and achieve sustained behavior change through close, continuous, light-touch collaboration with the people that care for them, including coaches, providers, family and friends, The Twine Health platform supports patients on their own personalized healthcare journey Studies published from Twine clinical trials with MGH and Joslin Diabetes Center, show that the program has enormous impact on hypertension, blood pressure and diabetes with an average 26 point drop in BP and 3.2 drop in HbA1c in 90 days, respectively.
There are also innovative mhealth wearables, including watches such as Healthstats, that monitors the patient’s blood pressure continuously via a sensor that rests against an artery in the wrist and detects the shape of the pressure wave as blood flows through it. Healthstats comes with software designed to keep patients and doctors informed of the wearer’s vital signs. A wired version of the Health stats monitor is currently used in hospitals in Singapore and other parts of the world.
Such watches are precursors of miniature laboratories, small sensors, inserted by needle and placed just beneath the skin. These sensors can remain in the body for months before needing to be replaced or removed. Although still experimental, they offer the advantage of direct, continuous monitoring in real time for individuals with chronic conditions such as diabetes and high cholesterol, hypertension, as well as the ability to track the impact of drug treatments such as chemotherapy. There is even a sensor that has been developed to warn of an impending heart attack. This sensor is able to identify a molecule called troponin which is released by heart muscle around three to four hours before a heart attack. An advance warning such as this enables individuals to have the time to seek treatment and hopefully avert a fatal event.
Remote Patient Monitoring/Telehealth
Remote patient monitoring (RPM) is a technology that delivers healthcare using digital technology to monitor patients outside of conventional clinical settings (e.g. in the home), in order to increase access to care and decrease healthcare delivery costs. It is referred to as telehealth, is based on a patients’ medical and health data being collected and transferred to a clinician located a distance away from the patient.
According to information released by research firm InMedica, the American telehealth market grew by 600 percent between 2012 and 2017 with more than 1.3 million telehealth patients by the end of 2017. This means that our ability to address issues such as congestive heart failure which currently accounts for the majority of telehealth patients, and is one of the costliest for hospitalization, COPD which is second in terms of telehealth patients .
Reinforcing the use of telehealth and home monitoring are measures by payers, including CMS, who has raised the bar for hospital readmission penalties which incentivizes hospitals to implement telehealth models to monitor patients who are being released from the hospital but still have extensive oversight needs. One example is the use of telepsychiatry, secure Web-based video conferencing technology, that enables individuals who cannot get to a therapist or mental health clinic for care and monitoring, to use telepsychiatry/therapy to provide consistent care.
An example of telehealth for addressing behavioral health issues is AbilTo Inc. a new company that provides behavioral health programs for medical populations at high risk for depression and anxiety following a cardiac event or a diagnosis of heart disease, diabetes, or chronic pain. AbilTo uses a secure video link or telephone to deliver consultative services to the patient, helping them achieve their goals, reduce stress, and improve their mood and overall quality of life. Participants receive personalized support and tools from a professional therapist, a licensed clinical social worker and behavior coach. They have been treating many patients for over five years and have a proven record of improving patient outcomes by integrating behavioral and medical healthcare.
Robotics in Healthcare
Robots will play an increasingly important role in healthcare going forward. Technological development in artificial intelligence, computer vision, navigation, MEMS sensor, and semiconductor technologies will drive innovation in the capability, performance, autonomy, ease of use, and cost-effectiveness of robots. For example, robotic nurses will help carry out mundane tasks leaving the nurses with the time and energy to deal with issues that require human decision making skills and empathy. Robots will do blood draws and interact with patients, checking on their living conditions and setting up medical appointments. There are also robots equipped with strong human-like arms and a unique tactile guidance system with very accurate tactile sensors who are trained to lift up or set down a patient into a bed or wheelchair.
There is a robot that can help hospitals address tough to tackle issues as MRSA by using a high intensity ultraviolet light to disinfect any space in a healthcare facility quickly and efficiently. Hospital acquired infections are among the leading causes of death in the US. According to CDC statistics, 1 in every 25 patients contracts a hospital acquired infection. Of those, 1 in 9 die. These infections cost more than $30 billion dollars a year.
Pharmacists are also using robots to process information much faster and much more accurately than humans. These robots have the ability to make precise recommendations after sifting through a patient’s available medical data. As Pharma dispensers they can work as an ATM does, so no matter the time of day, patients can get access to their prescriptions. This gives the pharmacist the time to participate in the social aspect of healing: educating people in preventive measures, and giving practical advice to improve health outcomes.
There are also robots that work inside the body, including the “origami” robot, which, when swallowed, dissolves in the patient’s stomach and unfolds itself. Controlled by a technician with the help of magnetic fields it can patch up wounds in the stomach lining or safely remove foreign items such as swallowed toys.
Precision medicine (PM)
Precision medicine is a medical model that customizes healthcare delivery tailored to a single individual. Diagnostic testing is required to determine the appropriate and optimal therapies for the patient based on the context of a patient’s genetic content or other molecular or cellular analysis. Precision medicine revolves around the idea that a condition like cancer or heart disease, even the same type of cancer, is not the same in different individuals. The disease will differ based on the genetic make-up of the individual, inherited from one’s parents, and determined from environmental surroundings.
Precision medicine contends that a treatment that helps shrink one person’s tumor or eases their arthritis symptoms doesn’t necessarily work for somebody else. At its core, precision medicine, is focused on matching the right drugs to the right people. For example, doctors know that Gleevec (imatinib), a cancer drug, works to treat leukemia only when the cancer cells have one particular genetic makeup. So, rather than treat every leukemia patient using Gleevec, doctors test people for that specific genetic mix and give the drug only to those patients who will benefit.
The Precision Medicine Initiative, launched by President Obama, will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for the individual, taking into account individual differences in genes, surroundings and lifestyle. Patients with breast, lung, and colorectal cancers, as well as melanomas and leukemia’s, for instance, routinely undergo molecular testing as part of patient care, enabling physicians to select treatments that improve chances of survival and reduce exposure to adverse effects. The potential for precision medicine to improve care and speed the development of new treatments has only just begun to happen and 2017 will be a pivotal year to advance this approach.