The Obama administration introduced the ACA in 2010 to move health care away from a fee-for-service model to one that promotes preventative care and overall wellness. Beginning this October the ACA will reinforce this approach by penalizing hospitals with chronic readmission problems by cutting Medicare reimbursement payments to those facilities. This policy initially targets patients suffering from three health conditions—heart failure, pneumonia and heart attack—but penalties will apply to additional conditions beginning in 2015.
Remote health monitoring systems have patients wear sensors that wirelessly collect, store, analyze and transmit health-related data. One of several approaches is the Wearable Wellness System from Italy’s Smartex, essentially an undershirt with embedded sensors and a processor that can monitor heart and respiration rates. Although not as fashionable, the Metria wearable sensor, from Vancive Medical Technologies, a medical division of Avery Dennison, can be adhesively bound to the body to measure heart rate, respiration, sleep duration and activity levels.
Two new sensor-based early detection tools for diabetic foot ulcers are being developed.
Orpyx Medical Technologies has developed a wristwatch and shoe insert. An insole is designed to support the foot, with three separate foam layers. Eight tiny electronic sensors are packed in the top of the insole so that they rest against thesurface of the foot once the shoe has been put on. These sensors are programmed to detect when pressure exceeds predetermined levels at certain points of the foot that are most susceptible to ulcers. Once they do, they wirelessly transmit a warning to the watch, which immediately sounds an alert.
Cambridge based Podimetrics is developing a home-monitoring bath mat with sensors that record changes in blood flow patterns when a diabetic patient steps on the mat. The sensors scan the foot to collect data about blood flow and send the data to the cloud to be stored and analyzed. The company’s algorithms look at that data in two ways: longitudinally over time and comparatively between the left and right foot to detect patterns that may indicate the presence of a developing ulcer. When the algorithms detect a pre-ulcer, an alert is sent to the patient and his doctor prompting an intervention early on.
A research team jointly led by scientists from Cedars-Sinai Medical Center and the University of California, Los Angeles, have enhanced a device they developed to identify and “grab” circulating tumor cells, or CTCs, that break away from cancers and enter the blood, often leading to the spread of cancer to other parts of the body.
If more studies confirm the technology’s effectiveness, the NanoVelcro Chip device could enable doctors to access and identify cancerous cells in the bloodstream, which would provide the diagnostic information needed to create individually tailored treatments for patients with prostate cancer.
With the new system, a patient’s blood is pumped through the NanoVelcro Chip — the microvilli protruding from the cancer cells will stick to the nanofiber structures on the device’s surface, much like Velcro. This phenomenon facilitates the capture of rare CTCs in the blood stream. Next, laser capture microdissection technology allows the scientists to selectively cut out and pick up the CTCs from the NanoVelcro Chip, virtually eliminating any trace of any contamination from white blood cells, which can complicate analysis. Finally, the isolated and purified CTCs are subjected to single cell “next-generation” sequencing, which reveals mutations in the genetic material of the cells and may help doctors personalize therapies to a patient’s unique cancer.
“To date, CTC capture technologies have been able to do little more than count the number of CTCs, which is informative but not very useful from a treatment planning perspective. It is a scientific breakthrough to have the ability to isolate pure CTCs and maintain their integrity for sophisticated genomic and behavioral analyses,” said Hsian-Rong Tseng, PhD, associate professor of molecular and medical pharmacology at UCLA and the inventor of the NanoVelcro Chip concept and device.
Thank you, President Obama.
Today at the White House, President Obama unveiled the “BRAIN” Initiative—a bold new research effort to revolutionize our understanding of the human mind and uncover new ways to treat, prevent, and cure brain disorders like Alzheimer’s, schizophrenia, autism, epilepsy, and traumatic brain injury.
The Initiative promises to accelerate the invention of new technologies that will help researchers produce real-time pictures of complex neural circuits and visualize the rapid-fire interactions of cells that occur at the speed of thought.
The BRAIN Initiative is launching with approximately $100 million in funding for research supported by the National Institutes of Health (NIH), the Defense Advanced Research Projects Agency (DARPA), and the National Science Foundation (NSF) in the President’s Fiscal Year 2014 budget.
Diabetes patients have been self monitoring for years. Advances in mHealth have made the process more efficient, though still complicated.
The iPhone can improve the functionality of glucometers; last month the FDA approved LifeScan’s VerioSync glucometer; the device automatically sends blood sugar levels to an iPhone via Bluetooth (fewer steps mean fewer mistakes and less anxiety). The iBGStar is a similar patient-centric tool.
The ultimate goal is a non-invasive glucose monitor, which will allow patients to check their blood levels without drawing blood. We aren’t there yet. When such devices can connect to automatic insulin pumps, which adminster insulin into a patient’s bloodstream subcutaneously through an open line rather than an injection, some of the hassle and stigma of diabetes may be lessened.