Archive for the ‘Hospital-based Medical Innovations’ Category

Fighting Chaos with Care, community trust, engagement must be cornerstones of pandemic response

Posted in Artificial Intelligence Applications in Health Care, Artificial Intelligence in Health Care - Tools & Innovations, Clinical & Translational, coronavirus, COVID-19, COVID-19, COVID-19 effects on Human Heart, COVID-19: Pandemic Surgery Guidance, Health Care System by Country, Hospital-based Medical Innovations, Mechanisms of infection by SARS-CoV-2, SARS-CoV-2, SARS-CoV-2 circulating variants , SARS-CoV-2 Viral Variants, Support Staff, Supportive therapies, Treatment Protocols for COVID-19, United States, tagged Community based Health care, Contact tracing, coronavirus, COVID-19, Global Health Security Index, Infectious disease, Johns Hopkins University, Partners In Health, Public Health system, SARS-CoV-2, Social Support, World Health Organization on April 13, 2021| Leave a Comment »

Fighting Chaos with care, community trust, engagement must be cornerstones of pandemic response

Reporter: Amandeep Kaur, BSc, MSc (Exp. 6/2021)

According to the Global Health Security Index released by Johns Hopkins University in October 2019 in collaboration with Nuclear Threat Initiative (NTI) and The Economist Intelligence Unit (EIU), the United States was announced to be the best developed country in the world to tackle any pandemic or health emergency in future.

The table turned within in one year of outbreak of the novel coronavirus COVID-19. By the end of March 2021, the country with highest COVID-19 cases and deaths in the world was United States. According to the latest numbers provided by World Health Organization (WHO), there were more than 540,000 deaths and more than 30 million confirmed cases in the United States.

Joia Mukherjee, associate professor of global health and social medicine in the Blavatnik Institute at Harvard Medical School said,

“When we think about how to balance control of an epidemic over chaos, we have to double down on care and concern for the people and communities who are hardest hit”.

She also added that U.S. possess all the necessary building blocks required for a health system to work, but it lacks trust, leadership, engagement and care to assemble it into a working system.

Mukherjee mentioned about the issues with the Index that it undervalued the organized and integrated system which is necessary to help public meet their needs for clinical care. Another necessary element for real health safety which was underestimated was conveying clear message and social support to make effective and sustainable efforts for preventive public health measures.

Mukherjee is a chief medical officer at Partners In Health, an organization focused on strengthening community-based health care delivery. She is also a core member of HMS community members who play important role in constructing a more comprehensive response to the pandemic in all over the U.S. With years of experience, they are training global health care workers, analyzing the results and constructing an integrated health system to fight against the widespread health emergency caused by coronavirus all around the world.

Mukherjee encouraged to strengthen the consensus among the community to constrain this infectious disease epidemic. She suggested that validation of the following steps are crucial such as testing of the people with symptoms of infection with coronavirus, isolation of infected individuals by providing them with necessary resources and providing clinical treatment and care to those people who are in need. Mukherjee said, that community engagement and material support are not just idealistic goal rather these are essential components for functioning of health care system during an outburst of coronavirus.

Continued alertness such as social distancing and personal contact with infected individual is important because it is not possible to rapidly replace the old-school public health approaches with new advanced technologies like smart phone applications or biomedical improvements.

Public health specialists emphasized that the infection limitation is the only and most vital strategy for controlling the outbreak in near future, even if the population is getting vaccinated. It is crucial to slowdown the spread of disease for restricting the natural modification of more dangerous variants as that could potentially escape the immune protection mechanism developed by recently generated vaccines as well as natural immune defense systems.

Making Crucial connections

The treatment is more expensive and complicated in areas with less health facilities, said Paul Farmer, the Kolokotrones University Professor at Harvard and chair of the HMS Department of Global Health and Social Medicine. He called this situation as treatment nihilism. Due to shortage of resources, the maximum energy is focused in public health care and prevention efforts. U.S. has resources to cope up with the increasing demand of hospital space and is developing vaccines, but there is a form of containment nihilism- which means prevention and infection containment are unattainable- said by many experts.

Farmer said, integration of necessary elements such as clinical care, therapies, vaccines, preventive measures and social support into a single comprehensive plan is the best approach for a better response to COVID-19 disease. He understands the importance of community trust and integrated health care system for fighting against this pandemic, as being one of the founders of Partners In Health and have years of experience along with his colleagues from HMS and PIH in fighting epidemics of HIV, Ebola, cholera, tuberculosis, other infectious and non-infectious diseases.

PIH launched the Massachusetts Community Tracing Collaborative (CTC), which is an initiative of contact tracing statewide in partnership with several other state bodies, local boards of Health system and PIH. The CTC was setup in April 2020 in U.S. by Governor Charlie Baker, with leadership from HMS faculty, to build a unified response to COVID-19 and create a foundation for a long-term movement towards a more integrated community-based health care system.

The contact tracing involves reaching out to individuals who are COVID-19 positive, then further detect people who came in close contact with infected individuals and screen out people with coronavirus symptoms and encourage them to seek testing and take necessary precautions to break the chain of infection into the community.

In the initial phase of outbreak, the CTC group comprises of contact tracers and health care coordinators who spoke 23 different languages, including social workers, public health practitioners, nurses and staff members from local board health agencies with deep links to the communities they are helping. The CTC worked with 339 out of 351 state municipalities with local public health agencies relied completely on CTC whereas some cities and towns depend occasionally on CTC backup. According to a report, CTC members reached up to 80 percent of contact tracking in hard-hit and resource deprived communities such as New Bedford.

Putting COVID-19 in context

Based on generations of experience helping people surviving some of the deadliest epidemic and endemic outbreaks in places like Haiti, Mexico, Rwanda and Peru, the staff was alert that people with bad social and economic condition have less space to get quarantined and follow other public health safety measures and are most vulnerable people at high risk in the pandemic situation.

Infected individuals or individuals at risk of getting infected by SARS-CoV-2 had many questions regarding when to seek doctor’s help and where to get tested, reported by contact tracers. People were worried about being evicted from work for two weeks and some immigrants worried about basic supplies as they were away from their family and friends.

The CTC team received more than 7,000 requests for social support assistance in the initial three months. The staff members and contact tracers were actively connecting the resourceful individuals with the needy people and filling up the gap when there was shortage in their own resources.

Farmer said, “COVID is a misery-seeking missile that has targeted the most vulnerable.”

The reality that infected individuals concerned about lacking primary household items, food items and access to childcare, emphasizes the urgency of rudimentary social care and community support in fighting against the pandemic. Farmer said, to break the chain of infection and resume society it is mandatory to meet all the elementary needs of people.

“What kinds of help are people asking for?” Farmer said and added “it’s important to listen to what your patients are telling you.”

An outbreak of care

The launch of Massachusetts CTC with the support from PIH, started receiving requests from all around the country to assist initiating contact tracing procedures. In May, 2020 the organization announced the launch of a U.S. public health accompaniment to cope up with the asked need.

The unit has included team members in nearly 24 states and municipal health departments in the country and work in collaboration with local organizations. The technical support on things like choosing and implementing the tools and software for contact tracing was provided by PIH. To create awareness and provide new understanding more rapidly, a learning collaboration was established with more than 200 team members from more than 100 different organizations. The team worked to meet the needs of population at higher risk of infection by advocating them for a stronger and more reliable public health response.

The PIH public health team helped to train contact trackers in the Navajo nation and operate to strengthen the coordination between SARS-CoV-2 testing, efforts for precaution, clinical health care delivery and social support in vulnerable communities around the U.S.

“For us to reopen our schools, our churches, our workplaces,” Mukherjee said, “we have to know where the virus is spreading so that we don’t just continue on this path.”

SOURCE:

https://hms.harvard.edu/news/fighting-chaos-care?utm_source=Silverpop&utm_medium=email&utm_term=field_news_item_1&utm_content=HMNews04052021

Other related articles were published in this Open Access Online Scientific Journal, including the following:

T cells recognize recent SARS-CoV-2 variants

Reporter: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2021/03/30/t-cells-recognize-recent-sars-cov-2-variants/

The WHO team is expected to soon publish a 300-page final report on its investigation, after scrapping plans for an interim report on the origins of SARS-CoV-2 — the new coronavirus responsible for killing 2.7 million people globally

Reporter: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2021/03/27/the-who-team-is-expected-to-soon-publish-a-300-page-final-report-on-its-investigation-after-scrapping-plans-for-an-interim-report-on-the-origins-of-sars-cov-2-the-new-coronavirus-responsibl/

Need for Global Response to SARS-CoV-2 Viral Variants

Reporter: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2021/02/12/need-for-global-response-to-sars-cov-2-viral-variants/

Mechanistic link between SARS-CoV-2 infection and increased risk of stroke using 3D printed models and human endothelial cells

Reporter: Adina Hazan, PhD

https://pharmaceuticalintelligence.com/2020/12/28/mechanistic-link-between-sars-cov-2-infection-and-increased-risk-of-stroke-using-3d-printed-models-and-human-endothelial-cells/

Artificial intelligence predicts the immunogenic landscape of SARS-CoV-2

Reporter: Irina Robu, PhD

https://pharmaceuticalintelligence.com/2021/02/04/artificial-intelligence-predicts-the-immunogenic-landscape-of-sars-cov-2/

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COVID-related financial losses at Mass General Brigham

Posted in Accountable Care Organizations, COVID-19, Economic Impact of Coronavirus Pandemic, Health Care System by Country, Health Economics and Outcomes Research, Health Law & Patient Safety, Healthcare costs and reimbursement, HealthCare IT, Healthcare Reform, Hospital-based Medical Innovations, Population Health Management, Population Health Management, Genetics & Pharmaceutical, SARS-CoV-2, Seasonality & Environmental Factors in Resurgence, Serology tests for coronavirus antibodies, Technology Capital Expenses, Treatment Protocols for COVID-19, Uninsured and Underinsured, United States, Virus Infective Acute Respiratory Syndrome: SARS-CoV on March 28, 2021| Leave a Comment »

COVID-related financial losses at Mass General Brigham

Reporter: Aviva Lev-Ari, PhD, RN

Based on

Mass General Brigham reports COVID-related financial losses not as bad as expected

By Priyanka Dayal McCluskey Globe Staff,Updated December 11, 2020, 3:02 p.m.

START QUOTE

The state’s largest hospital system on Friday reported the worst financial loss in its history while fighting the COVID-19 pandemic — but still ended the fiscal year in better shape than expected.

Mass General Brigham, formerly known as Partners HealthCare, lost $351 million on operations in the fiscal year that ended Sept. 30. In 2019, the system recorded a gain of $382 million.

The loss, however, is not as great as projected, thanks in part to an infusion of federal aid and patients returning to hospitals in large numbers after the first COVID surge receded.

“2020 is like no other year,” said Peter Markell, chief financial officer at Mass General Brigham, which includes Massachusetts General Hospital, Brigham and Women’s Hospital, and several community hospitals. “At the end of the day, we came out of this better than we thought we might.”

Total revenue for the year remained relatively stable at about $14 billion.

When the pandemic first hit Massachusetts in March, hospitals across the state suddenly experienced sharp drops in revenue because they canceled so much non-COVID care to respond to the crisis at hand. They also faced new costs related to COVID, including the personal protective equipment needed to keep health care workers safe from infection.

Federal aid helped to make up much of the losses, including $546 million in grant money that went to Mass General Brigham. The nonprofit health system also slashed capital expenses in half, by about $550 million, and temporarily froze employee wages and cut their retirement benefits.

Among the unusual new costs for Mass General Brigham this year was the expense of building a field hospital, Boston Hope, at the Boston Convention and Exhibition Center. The project cost $15 million to $20 million, Markell said, and Mass General Brigham is working to recoup those costs from government agencies.

The second surge of COVID, now underway, could hit hospitals’ bottom lines again, though Markell expects a smaller impact this time. One reason is because hospitals are trying to treat most of the patients who need care for conditions other than COVID even while treating growing numbers of COVID patients. In the spring, hospitals canceled vastly more appointments and procedures in anticipation of the first wave of COVID.

Mass General Brigham hospitals were treating more than 300 COVID patients on Friday, among the more than 1,600 hospitalized across the state.

Steve Walsh, president of the Massachusetts Health & Hospital Association, said hospitals across the state will need more federal aid as they continue battling COVID into the new year.

“The financial toll of COVID-19 has been felt by every hospital and health care organization in the Commonwealth,” he said. “Those challenges will continue during 2021.”

Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.

END QUOTE

SOURCE

https://www.bostonglobe.com/2020/12/11/business/mass-general-brigham-reports-covid-related-financial-losses-better-than-expected/?p1=Article_Inline_Related_Box

Integration of Mass General Hospital and Brigham Women’s Hospital was accelerated by the COVID-19 pandemic

Reporter: Aviva Lev-Ari, PhD, RN

BASED on

At Mass General Brigham, a sweeping effort to unify hospitals and shed old rivalries

Executives say greater cooperation is necessary to stay relevant in a dynamic and competitive health care industry. But the aggressive push to integrate is stirring tensions and sowing discontent among doctors and hospital leaders.

By Priyanka Dayal McCluskey and Larry Edelman Globe Staff and Globe Columnist,Updated March 27, 2021, 6:15 p.m.125

https://www.bostonglobe.com/2021/03/27/business/mass-general-brigham-sweeping-effort-unify-hospitals-shed-old-rivalries/?s_campaign=breakingnews:newsletter

START QUOTE

The work of integration was accelerated by the COVID-19 pandemic. As patients flooded hospitals last spring, Mass General Brigham — not each of its individual hospitals — set pandemic policies, from what kind of personal protective equipment health care providers should wear, to which visitors were allowed inside hospitals, to how employees would be paid if they were out sick with the virus.

During the winter surge of COVID, Mass General Brigham officials closely tracked beds across their system and transferred patients daily from one hospital to another to ensure that no one facility became overwhelmed.

And, in the early months of the pandemic, the company dropped the name Partners, which meant little to patients, and unveiled a new brand to reflect the strength of its greatest assets, MGH and the Brigham.

Officials at the nonprofit health system have instructeddepartment heads across their hospitals to coordinate better, so, for example, if a patient needs surgery at the Brigham but is facing a long wait, they can refer that patient to another site within Mass General Brigham.

Some executives want patients, eventually, to be able to go online and book appointments at any Mass General Brigham facility, as easily as they make reservations for dinner or a hotel.

Walls described it like this: “How do we put things together that make things better and easier for patients, and leave alone things that are better where they are?

“We’re not going to push things together that don’t fit together,” he said.

And yet the aggressive pursuit of “systemness,” as executives call it, is taking a toll. Physicians and hospital leaders are struggling with the loss of control over their institutions and worried that the new era of top-down management threatens to homogenize a group of hospitals with different cultures and identities.

Veteran physicians and leaders have been surprised and upset by the power shift that is stripping them of the ability to make key decisions and unhappy with abrupt changes they feel are occurring with little discussion. Most are uncomfortable sharing their concerns publicly.

“If you’re not on the train, you’re getting run over by the train,” said one former Mass General Brigham executive who requested anonymity in orderto speak openly. “It’s not an environment to invite debate.”

Amid the restructuring, senior executives are departing in droves. They include the CEO of the MGH physicians group, Dr. Timothy Ferris; Brigham and Women’s president Dr. Elizabeth Nabel; chief financial officer of the system, Peter Markell; Cooley Dickinson Hospital president Joanne Marqusee; and president of Spaulding Rehabilitation Network, David Storto.

Some also fear the internal discord could hinder Mass General Brigham’s ability to attract talented leaders.

Top executives acknowledge there is angst — “Change is hard,” Klibanski said — but are pushing ahead.

https://www.bostonglobe.com/2021/03/27/business/mass-general-brigham-sweeping-effort-unify-hospitals-shed-old-rivalries/?s_campaign=breakingnews:newsletter

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mHealth market growth in America, Europe, & APAC

Posted in Health Care System by Country, Health Economics and Outcomes Research, Hospital-based Medical Innovations, Investment in Technological Breakthrough, Medical Devices R&D Investment on October 19, 2020| Leave a Comment »

mHealth market growth in America, Europe, & APAC

Reporter on this Industry News: Aviva Lev-Ari, PhD, RN

An industry news titled ‘Pivotal trends propelling mHealth market growth in America, Europe, & APAC’ by Graphical Research released on 10/19/2020

Pivotal trends propelling mHealth market growth in America, Europe, & APAC

Rapid expansion of digital healthcare for the provision of delivery, medical support, and intervention through mobile technologies is likely to augment mHealth market expansion through the coming years. Active involvement of patients toward bettering their own health will further contribute to mHealth market growth over the forecast period.

The recent years have witnessed an upsurge in government initiatives in the mHealth technology sector in turn prompting major market players to get involved in product development and promotion programs at both regional and global level.

Prominent trends likely to propel the regional expansion of mHealth market:

Rising internet penetration to push North America mHealth revenue share

Surging internet and mobile phone penetration coupled with a rise in the usage of healthcare mobile applications has been instrumental in creating a high demand for mobile health devices in the region. North America mHealth market will surpass USD 113 bn by 2026, with an estimated CAGR of 39.5%, having registered a valuation of 11,364.1 million in 2019.

Surging demand for fitness apps for the maintenance of healthy body in Canada and the U.S. has been instrumental in impelling the growth of mHealth apps segment in the region. Mobile apps contributed a revenue of USD 7,877.2 million holding the largest revenue share in 2019.

In terms of the end-use spectrum, physicians’ segment was worth USD 3,431.1 million in 2019. The segment in fact, accounted for the largest revenue share in the year. The growth can be aptly credited to the rising adoption of digitization in medical care facilities, in tandem with the increasing healthcare spending in the region.

Around 2,000 healthcare providers in San Francisco presently utilize mHealth wearables for temperature monitoring for the identification of people who have been infected with COVID-19, cites study. Increasing use of healthcare wearables will thus propel North America mHealth industry outlook over the coming years.

Rising technological advancements in Europe mHealth market

Increasing adoption of leading-edge technology for the minimization of extra bulk devices usage for blood glucose level monitoring will add to industry expansion in the region.

Europe mhealth market size will exceed USD 137.5 billion valuation by 2026 with a targeted CAGR of 39%, having registered a revenue of USD 14,162.0 million in 2019.

The International Diabetes Foundation (IDF) has stated that about 9.1 per cent of the people in Europe suffered from diabetes in 2017. Scientists are on the path of developing skin-based glucose monitor for the purpose of detecting glucose levels in sweat, opening up avenues for Europe mHealth market expansion in the near future.

Reports state that Germany accounted for 20 per cent of the overall market share in 2019 and is poised to witness commendable growth in the coming years, driven by the rising advancements in the ehealth technology sector in the region. The hardware segment pertaining to the use of medical devices and mobile sensors will augment Europe mHealth market size over the estimated period. What’s more, the region has been manifesting proliferating trends pertaining to health and fitness consciousness as well as healthcare digitalization that’ll further boost the regional growth.

Prominent players in the Europe mHealth industry comprise Masimo Corporation, Allscripts Healthcare Solutions, Cardionet, AT&T, Qualcomm, Apple, Philips Healthcare, Boston Scientific, and others.

Latin America mHealth market to gain massive proceeds from remote data collection

Remote data collection in Latin America accounted for a valuation of USD 523.6 million in 2019 and is estimated to account for a remarkable revenue share over the forecast period. Latin America mHealth industry is slated to depict a commendable CAGR of 40.7 per cent over 2020 to 2026.

The largest segmental share can be attributed to the transmission and collection of data through mobile phones. The system has been designed for sending messages or e-mails given the data is aggregated in a centralized database and the symptoms are recorded.

Based on application, Latin America mHealth market has been segmented into disease and epidemic outbreak tracking, communication and training, remote data collection, education and awareness, diagnostics and treatment, remote monitoring, and others.

According to a 2017 study, over 40 million patients in Mexico and Brazil were treated through mobile health services. Patients segment in the Latin America mHealth market will witness lucrative growth at a CAGR of 41.6 per cent over the estimated timeframe. This will also create remarkable mHealth deployments and lucrative job opportunities, in turn adding to mHealth product adoption over the estimated period.

Rising government intervention to bolster Asia Pacific mHealth market over the forecast period

Surging consumer awareness is likely to bolster regional mHealth product demand over the forecast period. The Asia Pacific mHealth industry will register an appreciable CAGR of 41.1 per cent from 2020 to 2026.

The rise is primarily attributed to the surging government interventions coupled with the substantial growth in developing economies. As per the National Center for Biotechnology Information, highest number of mHealth program initiatives have been undertaken owing to considerable government investments in healthcare sector across the region.

Various limitations pertaining to availability and the access to healthcare services in addition to inaccurate results emerging from discrepancies in mHealth devices will, however, hinder mHealth industry growth in the Asia Pacific region.

Improving global access pertaining to point-of-care tools for supporting enhanced patient outcomes and better clinical decision making will, thus, improve and bolster mHealth business landscape over the coming years. Rising focus of industry players on application strategies for the purpose of fighting chronic diseases will further spur industry expansion.

SOURCE

From: <pradip.s@graphicalresearch.com>

Date: Monday, October 19, 2020 at 12:39 PM

To: “Aviva Lev-Ari, PhD, RN” <AvivaLev-Ari@alum.berkeley.edu>

Subject: Exclusive Article On “mHealth market”

Dear Editor,

An industry news titled ‘Pivotal trends propelling mHealth market growth in America, Europe, & APAC’ by Graphical Research is relevant to your esteemed website https://pharmaceuticalintelligence.com/ . This email is a suggestion to publish this news (content attached in word format) on your website with an objective to share the information with your audiences.

Looking forward to hear from you.

Regards,

Pradip Shitole | Sr. SEO Executive

Graphical Research

Web: https://www.graphicalresearch.com/

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US Responses to Coronavirus Outbreak Expose Many Flaws in Our Medical System

Posted in and Bioethics, Bio-Ethics, Biomarkers: Inflammation, coronavirus, Coronavirus Gene Expression, COVID-19, COVID-19 effects on Human Heart, COVID-19: Pandemic Surgery Guidance, Economic Impact of Coronavirus Pandemic, Ethics and Leadership, Federal Budget Appropriations, Health Economics and Outcomes Research, Health Law & Patient Safety, Health Law Policy, Healthcare costs and reimbursement, Healthcare Reform, Hospital-based Medical Innovations, Immune-Mediation (independent immunopathology: lung and reticuloendothelial system), Key Opinion Leaders in eScientific Publishing - Interviews with, Law and Medicine Conflicts, Leadership, Power, Social Interlocking Connections, number of asymptomatic infections, Patents, Patient Experience, Patient Experience: Personal Memories of Invasive Medical Intervantion, Patient Outlook, Patient’s Voice: Personal Experience with Invasive Medical Procedures, Population genetics, Population Health Management, Population Health Management, Genetics & Pharmaceutical, SARS-CoV-2, Seasonality & Environmental Factors in Resurgence, Serology tests for coronavirus antibodies, Support Staff, Treatment Protocols for COVID-19, United States, Vaccinology, Virus Infective Acute Respiratory Syndrome: SARS-CoV, tagged #COVID-19, cancer patient advocacy, COVID-19, defining patient experience, drivers of patient experience, healthcare communication, healthcare quality, Medical research, physician-patient relationship, public health response, public interest, US healthcare on March 25, 2020| Leave a Comment »

US Responses to Coronavirus Outbreak Expose Many Flaws in Our Medical System

Curator: Stephen J. Williams, Ph.D.

The coronavirus pandemic has affected almost every country in every continent however, after months of the novel advent of novel COVID-19 cases, it has become apparent that the varied clinical responses in this epidemic (and outcomes) have laid bare some of the strong and weak aspects in, both our worldwide capabilities to respond to infectious outbreaks in a global coordinated response and in individual countries’ response to their localized epidemics.

Some nations, like Israel, have initiated a coordinated government-private-health system wide action plan and have shown success in limiting both new cases and COVID-19 related deaths. After the initial Wuhan China outbreak, China closed borders and the government initiated health related procedures including the building of new hospitals. As of writing today, Wuhan has experienced no new cases of COVID-19 for two straight days.

However, the response in the US has been perplexing and has highlighted some glaring problems that have been augmented in this crisis, in the view of this writer. In my view, which has been formulated after social discussion with members in the field ,these issues can be centered on three major areas of deficiencies in the United States that have hindered a rapid and successful response to this current crisis and potential future crises of this nature.

The mistrust or misunderstanding of science in the United States
Lack of communication and connection between patients and those involved in the healthcare industry
Socio-geographical inequalities within the US healthcare system

1. The mistrust or misunderstanding of science in the United States

For the past decade, anyone involved in science, whether directly as active bench scientists, regulatory scientists, scientists involved in science and health policy, or environmental scientists can attest to the constant pressure to not only defend their profession but also to defend the entire scientific process and community from an onslaught of misinformation, mistrust and anxiety toward the field of science. This can be seen in many of the editorials in scientific publications including the journal Science and Scientific American (as shown below)

Stepping Away from Microscopes, Thousands Protest War on Science

Boston rally coincides with annual American Association for the Advancement of Science (AAAS) conference and is a precursor to the March for Science in Washington, D.C.

byLauren McCauley, staff writer

Responding to the troubling suppression of science under the Trump administration, thousands of scientists, allies, and frontline communities are holding a rally in Boston’s Copley Square on Sunday.

#standupforscience Tweets

Three years ago, I was honored to stand with dozens of earth scientists to #StandUpForScience at #AGU16. I was terrified, but resolute. In many ways, we've come so far. But wow, #AGU19, we still have so far to go. My remarks: https://t.co/Txul1T9qYP via @CollinMaessen pic.twitter.com/G1C2YI28Re

— Dr. Kim Cobb (@coralsncaves) December 11, 2019

Tomorrow, people around the world march to #StandUpForScience. https://t.co/IxyPOlLagc via @NexusMediaNews #MarchforScience pic.twitter.com/uCaH1a7FiR

— Climate Nexus (@ClimateNexus) April 21, 2017

“Science serves the common good,” reads the call to action. “It protects the health of our communities, the safety of our families, the education of our children, the foundation of our economy and jobs, and the future we all want to live in and preserve for coming generations.”

It continues:

But it’s under attack—both science itself, and the unalienable rights that scientists help uphold and protect.

From the muzzling of scientists and government agencies, to the immigration ban, the deletion of scientific data, and the de-funding of public science, the erosion of our institutions of science is a dangerous direction for our country. Real people and communities bear the brunt of these actions.

The rally was planned to coincide with the annual American Association for the Advancement of Science (AAAS) conference, which draws thousands of science professionals, and is a precursor to the March for Science in Washington, D.C. and in cities around the world on April 22.

Source: https://www.commondreams.org/news/2017/02/19/stepping-away-microscopes-thousands-protest-war-science

https://images.app.goo.gl/UXizCsX4g5wZjVtz9

https://www.washingtonpost.com/video/c/embed/85438fbe-278d-11e7-928e-3624539060e8

The American Association for Cancer Research (AACR) also had marches for public awareness of science and meaningful science policy at their annual conference in Washington, D.C. in 2017 (see here for free recordings of some talks including Joe Biden’s announcement of the Cancer Moonshot program) and also sponsored events such as the Rally for Medical Research. This patient advocacy effort is led by the cancer clinicians and scientific researchers to rally public support for cancer research for the benefit of those affected by the disease.

Source: https://leadingdiscoveries.aacr.org/cancer-patients-front-and-center/

However, some feel that scientists are being too sensitive and that science policy and science-based decision making may not be under that much of a threat in this country. Yet even as some people think that there is no actual war on science and on scientists they realize that the public is not engaged in science and may not be sympathetic to the scientific process or trust scientists’ opinions.

From Scientific American: Is There Really a War on Science? People who oppose vaccines, GMOs and climate change evidence may be more anxious than antagonistic

Certainly, opponents of genetically modified crops, vaccinations that are required for children and climate science have become louder and more organized in recent times. But opponents typically live in separate camps and protest single issues, not science as a whole, said science historian and philosopher Roberta Millstein of the University of California, Davis. She spoke at a standing-room only panel session at the American Association for the Advancement of Science’s annual meeting, held in Washington, D.C. All the speakers advocated for a scientifically informed citizenry and public policy, and most discouraged broadly applied battle-themed rhetoric.

Source: https://www.scientificamerican.com/article/is-there-really-a-war-on-science/

In general, it appears to be a major misunderstanding by the public of the scientific process, and principles of scientific discovery, which may be the fault of miscommunication by scientists or agendas which have the goals of subverting or misdirecting public policy decisions from scientific discourse and investigation.

This can lead to an information vacuum, which, in this age of rapid social media communication,

can quickly perpetuate misinformation.

This perpetuation of misinformation was very evident in a Twitter feed discussion with Dr. Eric Topol, M.D. (cardiologist and Founder and Director of the Scripps Research Translational Institute) on the US President’s tweet on the use of the antimalarial drug hydroxychloroquine based on President Trump referencing a single study in the International Journal of Antimicrobial Agents. The Twitter thread became a sort of “scientific journal club” with input from international scientists discussing and critiquing the results in the paper.

Please note that when we scientists CRITIQUE a paper it does not mean CRITICIZE it. A critique is merely an in depth analysis of the results and conclusions with an open discussion on the paper. This is part of the normal peer review process.

Below is the original Tweet by Dr. Eric Topol as well as the ensuing tweet thread

I reviewed the cited paperhttps://t.co/E4Iw7GpVh6 an open-label, non=randomized study
The endpoint was viral PCR (mostly + or -, many ND) by nasopharyngeal swab.
6 of the 36 people were asymptomatic.
6 with pneumonia (LRTI)
6 people received "H + A" pic.twitter.com/KBjR1QcZRV

— Eric Topol (@EricTopol) March 21, 2020

Eric – a huge issue here is they only report data on 20 of the 26 patients, and of the 6 – all deteriorated! Six hydroxychloroquine-treated patients were lost in follow-up: they worsened and weee sent to the ICU! They need to do last observation carried forward for those.

— Christopher Cannon, M.D. (@cpcannon) March 21, 2020

OMG, do you realize none of the patients in the treatment arm were definitive positives to start with? They were all in the "gray zone". JFC, this study was worse than I thought when I skimmed it the first time!

— Rob Hutton (@DMINologist) March 21, 2020

https://twitter.com/EricTopol/status/1241442247133900801?s=20

Within the tweet thread it was discussed some of the limitations or study design flaws of the referenced paper leading the scientists in this impromptu discussion that the study could not reasonably conclude that hydroxychloroquine was not a reliable therapeutic for this coronavirus strain.

The lesson: The public has to realize CRITIQUE does not mean CRITICISM.

Scientific discourse has to occur to allow for the proper critique of results. When this is allowed science becomes better, more robust, and we protect ourselves from maybe heading down an incorrect path, which may have major impacts on a clinical outcome, in this case.

2. Lack of communication and connection between patients and those involved in the healthcare industry

In normal times, it is imperative for the patient-physician relationship to be intact in order for the physician to be able to communicate proper information to their patient during and after therapy/care. In these critical times, this relationship and good communication skills becomes even more important.

Recently, I have had multiple communications, either through Twitter, Facebook, and other social media outlets with cancer patients, cancer advocacy groups, and cancer survivorship forums concerning their risks of getting infected with the coronavirus and how they should handle various aspects of their therapy, whether they were currently undergoing therapy or just about to start chemotherapy. This made me realize that there were a huge subset of patients who were not receiving all the information and support they needed; namely patients who are immunocompromised.

These are patients represent

cancer patient undergoing/or about to start chemotherapy
Patients taking immunosuppressive drugs: organ transplant recipients, patients with autoimmune diseases, multiple sclerosis patients
Patients with immunodeficiency disorders

These concerns prompted me to write a posting curating the guidance from National Cancer Institute (NCI) designated cancer centers to cancer patients concerning their risk to COVID19 (which can be found here).

Surprisingly, there were only 14 of the 51 US NCI Cancer Centers which had posted guidance (either there own or from organizations like NCI or the National Cancer Coalition Network (NCCN). Most of the guidance to patients had stemmed from a paper written by Dr. Markham of the Fred Hutchinson Cancer Center in Seattle Washington, the first major US city which was impacted by COVID19.

Also I was surprised at the reactions to this posting, with patients and oncologists enthusiastic to discuss concerns around the coronavirus problem. This led to having additional contact with patients and oncologists who, as I was surprised, are not having these conversations with each other or are totally confused on courses of action during this pandemic. There was a true need for each party, both patients/caregivers and physicians/oncologists to be able to communicate with each other and disseminate good information.

Last night there was a Tweet conversation on Twitter #OTChat sponsored by @OncologyTimes. A few tweets are included below

There’s still time to JOIN our #OTchat! Here's Q3: What communication strategies have you implemented to reach out to patients? #OTchat #COVID19nCancer #coronavirus #healthcomm #FlattenTheCurve pic.twitter.com/7PsSnVhLsn

— Oncology Times (@OncologyTimes) March 25, 2020

https://twitter.com/OncologyTimes/status/1242611841613864960?s=20

A4: #COVID19 is adding stress to #cancer patients & survivors. SHARE this patient handout to help them manage #anxiety and take appropriate precautions. https://t.co/BrBIXX2VX7 #OTchat #COVID19nCancer pic.twitter.com/HeHrJ8GzEB

— Oncology Times (@OncologyTimes) March 25, 2020

https://twitter.com/OncologyTimes/status/1242616756658753538?s=20

Share #cancer care resources to help protect patients during #COVID19. #OTchat https://t.co/O0yT51Db3c

— Oncology Times (@OncologyTimes) March 25, 2020

https://twitter.com/OncologyTimes/status/1242615906846547978?s=20

The Lesson: Rapid Communication of Vital Information in times of stress is crucial in maintaining a good patient/physician relationship and preventing Misinformation.

3. Socio-geographical Inequalities in the US Healthcare System

It has become very clear that the US healthcare system is fractioned and multiple inequalities (based on race, sex, geography, socio-economic status, age) exist across the whole healthcare system. These inequalities are exacerbated in times of stress, especially when access to care is limited.

An example:

On May 12, 2015, an Amtrak Northeast Regional train from Washington, D.C. bound for New York City derailed and wrecked on the Northeast Corridor in the Port Richmond neighborhood of Philadelphia, Pennsylvania. Of 238 passengers and 5 crew on board, 8 were killed and over 200 injured, 11 critically. The train was traveling at 102 mph (164 km/h) in a 50 mph (80 km/h) zone of curved tracks when it derailed.[3]

Some of the passengers had to be extricated from the wrecked cars. Many of the passengers and local residents helped first responders during the rescue operation. Five local hospitals treated the injured. The derailment disrupted train service for several days.

(Source Wikipedia https://en.wikipedia.org/wiki/2015_Philadelphia_train_derailment)

What was not reported was the difficulties that first responders, namely paramedics had in finding an emergency room capable of taking on the massive load of patients. In the years prior to this accident, several hospitals, due to monetary reasons, had to close their emergency rooms or reduce them in size. In addition only two in Philadelphia were capable of accepting gun shot victims (Temple University Hospital was the closest to the derailment but one of the emergency rooms which would accept gun shot victims. This was important as Temple University ER, being in North Philadelphia, is usually very busy on any given night. The stress to the local health system revealed how one disaster could easily overburden many hospitals.

Over the past decade many hospitals, especially rural hospitals, have been shuttered or consolidated into bigger health systems. The graphic below shows this

From Bloomberg: US Hospital Closings Leave Patients with Nowhere to go

https://images.app.goo.gl/JdZ6UtaG3Ra3EA3J8

Note the huge swath of hospital closures in the midwest, especially in rural areas. This has become an ongoing problem as the health care system deals with rising costs.

Lesson: Epidemic Stresses an already stressed out US healthcare system

Please see our Coronavirus Portal at

https://pharmaceuticalintelligence.com/coronavirus-portal/

for more up-to-date scientific, clinical information as well as persona stories, videos, interviews and economic impact analyses

and @pharma_BI

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HUBweek 2018, October 8-14, 2018, Greater Boston – “We The Future” – coming together, of breaking down barriers, of convening across disciplinary lines to shape our future

Posted in Artificial Intelligence Applications in Health Care, Health Care System by Country, Hospital-based Medical Innovations, Innovations, Intellectual Property, Innovations, Commercialization, Investment in technological breakthrough, Interviews with Scientific Leaders, United States on October 8, 2018| Leave a Comment »

HUBweek 2018, October 8-14, 2018, Greater Boston – “We The Future” – coming together, of breaking down barriers, of convening across disciplinary lines to shape our future

Reporter: Aviva Lev-Ari, PhD, RN

3.4.6 HUBweek 2018, October 8-14, 2018, Greater Boston – “We The Future” – coming together, of breaking down barriers, of convening across disciplinary lines to shape our future, Volume 2 (Volume Two: Latest in Genomics Methodologies for Therapeutics: Gene Editing, NGS and BioInformatics, Simulations and the Genome Ontology), Part 2: CRISPR for Gene Editing and DNA Repair

HUBweek 2018

Hi Aviva,

At HUBweek and in this community, we believe a brighter future is built together. In these times of division, particularly when many are feeling excluded from the benefits brought forth by rapid technological development, there is critical importance in the act of coming together, of breaking down barriers, of convening across disciplinary lines to shape our future.

That’s why this year’s theme for HUBweek is We the Future. It is a call to action and an invitation. Throughout the week, we’ll bring together innovators, artists, and curious minds to explore the ways in which we can shape a more inclusive and equitable future for all.

Today, HUBweek kicks off with dozens of events taking place across the city–from public art tours, a drone zoo, and discussions on nuclear weapons and the impact of emerging technologies on people with disabilities, to a policy hackathon hosted by MIT and the first ever Change Maker Conference.

There are 225+ more experiences to take part in throughout HUBweek–a three-day Forum and a documentary film festival; open dialogues with leading thinkers; a robot block party; and collaborative and participatory art. And we’ve got a little fun in store for you, too–make sure you sign up and stop by The HUB later this week to check it all out.

At its core, HUBweek is a collaboration. If not for our partners and the unwavering support of this community, this would not be a reality. A big thank you to our presenting partners Blue Cross Blue Shield of Massachusetts, Liberty Mutual Insurance, and Merck KGaA, to our sponsors, and to the hundreds of collaborating organizations, speakers, artists, and creative minds that are behind this year’s festival.

On behalf of the HUBweek team and our founders The Boston Globe, Harvard University, Mass. General Hospital, and MIT, we’re thrilled to invite you to join us at HUBweek 2018.

Linda Pizzuti Henry

SOURCE

From: Linda Pizzuti Henry <hello@hubweek.org>

Reply-To: <hello@hubweek.org>

Date: Monday, October 8, 2018 at 9:38 AM

To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>

Subject: Welcome to HUBweek

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PCI, CABG, CHF, AMI – Two Payment Methods: Bundled payments (hospitalization costs, up to 90 days of post-acute care, nursing home care, complications, and rehospitalizations) vs Diagnosis-related groupings cover only what happens in the hospital.

Posted in Centers for Medicare & Medicaid Services, Health Care System by Country, Health Economics and Outcomes Research, HealthCare IT, Hospital-based Medical Innovations, United States on July 10, 2018| Leave a Comment »

PCI, CABG, CHF, AMI – Two Payment Methods: Bundled payments (hospitalization costs, up to 90 days of post-acute care, nursing home care, complications, and rehospitalizations) vs Diagnosis-related groupings cover only what happens in the hospital.

Reporter: Aviva Lev-Ari, PhD, RN

UPDATED on 8/17/2018

Certain risk factors make survivors of an acute MI more likely to suffer major cardiovascular events within a year, researchers said.

A model with 19 factors (comprising 15 unique variables) was created for the identification of high-risk patients; the strongest factors in the training sample (n=2,113) were found to be:

Age 85 years and older: HR 6.73 (95% CI 2.83-15.96)
Prior angina: HR 2.05 (95% CI 1.17-3.58)
Prior ventricular tachycardia or fibrillation: HR 2.15 (95% CI 0.99-4.70)
Ejection fraction under 40%: HR 2.86 (95% CI 1.89-4.34)
White blood cell count greater than 12,000 per μL: HR 2.65 (95% CI 1.53-4.61)
Heart rate faster than 90 beats per minute: HR 2.02 (95% CI 1.43-2.84)

With the tool, 11.3%, 81.0%, and 7.7% of patients were stratified to high-, average-, and low-risk groups, with respective probabilities of 0.32, 0.06, and 0.01 for 1-year events. Moreover, the model showed predictive ranges of 1.2%-33.9%, 1.2%-37.9%, and 1.3%-34.3% in these groups.

“This may aid clinicians in identifying high-risk patients who would benefit most from intensive follow-up and aggressive risk factor reduction,” the researchers wrote, noting that past efforts to identify risk factors have focused on the period immediately after initial hospitalization for acute MI.

SOURCE

Primary Source

JAMA Network Open

Source Reference: Wang Y, et al “Risk factors associated with major cardiovascular events 1 year after acute myocardial infarction” JAMA Network Open 2018; DOI: 10.1001/jamanetworkopen.2018.1079.

https://www.medpagetoday.com/cardiology/myocardialinfarction/74528?xid=nl_mpt_cardiodaily_2018-08-17&eun=g99985d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=AHAWeekly_081718&utm_term=AHA%20Cardiovascular%20Daily%20-%20Active%20Users%20180%20days

PCI, CABG, CHF, AMI – Two Payment Methods: Bundled payments (hospitalization costs, up to 90 days of post-acute care, nursing home care, complications, and rehospitalizations) vs Diagnosis-related groupings cover only what happens in the hospital.

Bundled payments (hospitalization costs, up to 90 days of post-acute care, nursing home care, complications, and rehospitalizations) vs Diagnosis-related groupings cover only what happens in the hospital.

A retrospective, cross-sectional comparison of the BPCI model 2 bundles for percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), congestive heart failure (CHF), and acute myocardial infarction (AMI).

The bundled payments covered hospitalization costs and, in most cases, up to 90 days of post-acute care, including nursing home care, complications, and rehospitalizations. Diagnosis-related groupings cover only what happens in the hospital, while bundled payments cover the entire 90-day episode in most cases.

A Good, Not Simple Idea

Blumenthal and Joynt Maddox agree that the idea of using financial incentives to drive quality improvement is a good one, but one that requires careful consideration and input from clinicians.

“I think policymakers think that it’s easier than it really is and, to be fair, why would a lawyer in DC understand how to make good health policy? I think we really need more clinicians and people with clinical knowledge involved in policymaking,” Joynt Maddox said.

“The idea is to build the bridge between inpatient and outpatient care, by coordinating care better, coordinating transitions better, reducing unnecessary care, and avoiding complications and readmissions,” she added.

An example might be to switch from automatically sending certain patients from the hospital to a nursing home for 30 days. “Maybe they only need 10 days or 1 week, or maybe they can just go home,” she said, but to allow better transitions and lower costs, there needs to be “someone to strategically approach the issue, and a lot of hospitals don’t have that ability.”

“You could argue that all hospitals should have the ability, and I totally agree that we should be doing a better job of organizing across settings, but the problem is that realistically these voluntary programs aren’t going to attract under-resourced hospitals, so this pilot will tell us what is possible in a well-resourced hospital but not much more,” said Joynt Maddox.

To date, the only outcomes reported on the new payment models have been a few evaluations from the federal government. Joynt Maddox recently reported some preliminary outcomes showing a lack of “clinically meaningful changes in access, utilization, or clinical outcomes” with episode-based payment for AMI, CHF, and pneumonia. Her final findings will be published soon.

SOURCE

https://www.medscape.com/viewarticle/899026?nlid=123768_3866&src=WNL_mdplsfeat_180710_mscpedit_card&uac=93761AJ&spon=2&impID=1680511&faf=1#vp_2

Key Points

Question  Are hospitals participating in Medicare’s Bundled Payments for Care Improvement initiative for cardiac bundles different from nonparticipating hospitals in ways that could limit the generalizability of program outcomes to all US acute care hospitals?

Findings  In this cross-sectional study, participation in Bundled Payments for Care Improvement model 2 bundled payments for acute myocardial infarction, congestive heart failure, coronary artery bypass graft surgery, and percutaneous coronary intervention was associated with larger hospital size, non–safety net hospital status, and access to cardiac catheterization laboratories.

Meaning  Outcomes of cardiac bundled payments included in Bundled Payments for Care Improvement may have limited external validity, particularly among small and safety net hospitals with more limited cardiac capabilities.

Abstract

Importance  Medicare’s Bundled Payments for Care Improvement (BPCI) is a voluntary pilot program evaluating bundled payments for several common cardiovascular conditions. Evaluating the external validity of this program is important for understanding the effects of bundled payments on cardiovascular care.

Objective  To determine whether participants in BPCI cardiovascular bundles are representative of US acute care hospitals and identify factors associated with participation.

Design, Setting, and Participants  Retrospective cross-sectional study of hospitals participating in BPCI model 2 bundles for acute myocardial infarction (AMI), congestive heart failure (CHF), coronary artery bypass graft, and percutaneous coronary intervention and nonparticipating control hospitals (October 2013 to January 2017). The BPCI participants were identified using data from the Centers for Medicare and Medicaid Services, and controls were identified using the 2013 American Hospital Association’s Survey of US Hospitals. Hospital structural characteristics and clinical performance data were obtained from the American Heart Association survey and Centers for Medicare and Medicaid Services. One hundred fifty-nine hospitals participating in BPCI model 2 cardiac bundles and 1240 nonparticipating control hospitals were compared, and a multivariable logistic regression was estimated to identify predictors of BPCI participation.

Exposures  Bundled payments.

Main Outcomes and Measures  Hospital-level structural characteristics and 30-day risk-adjusted readmission and mortality rates for AMI and CHF.

Results  Compared with nonparticipants, BPCI participants were larger, more likely to be privately owned or teaching hospitals, had lower Medicaid bed day ratios (ratio of Medicaid inpatient days to total inpatient days: 17.0 vs 19.3; P < .001), and were less likely to be safety net hospitals (2.5% vs 12.3%; P < .001). The BPCI participants had higher AMI and CHF discharge volumes, were more likely to have cardiac intensive care units and catheterization laboratories, and had lower risk-standardized 30-day mortality rates for AMI (13.7% vs 16.6%; P = .001) and CHF (11.3 vs 12.4; P = .005). In multivariable analysis, larger hospital size and access to a cardiac catheterization laboratory were positively associated with participation. Being a safety net hospital was negatively associated with participation (odds ratio, 0.3; 95% CI, 0.1-0.7; P = .001).

Conclusions and Relevance  Hospitals participating in BPCI model 2 cardiac bundles differed in significant ways from nonparticipating hospitals. The BPCI outcomes may therefore have limited external validity, particularly among small and safety net hospitals with limited clinical cardiac services.

SOURCE

https://jamanetwork.com/journals/jamacardiology/article-abstract/2686124

Invited Commentary

June 27, 2018

What Can We Learn From Voluntary Bundled Payment Programs?

Karen E. Joynt Maddox, MD, MPH¹

Author Affiliations

JAMA Cardiol. Published online June 27, 2018. doi:10.1001/jamacardio.2018.1734

SOURCE

https://jamanetwork.com/journals/jamacardiology/article-abstract/2686128

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Top 10 Medical Innovations for 2018, 2020 and 2021 by Cleveland Clinic

Posted in Hospital-based Medical Innovations, tagged Distance Health, Enhanced Recovery After Surgery, Gene Therapy for Inherited Retinal Diseases, Next Generation Vaccine Platforms, Scalp Cooling on July 10, 2018| Leave a Comment »

Top 10 Medical Innovations for 2018, 2020 and 2021 by Cleveland Clinic

Reporter: Aviva Lev-Ari, PhD, RN

UPDATED on 12/26/2020 from

OCTOBER 6, 2020 / NEWS RELEASES

Cleveland Clinic Unveils Top 10 Medical Innovations For 2021

Top clinicians and researchers present transforming medical advancements and new award to recognize healthcare innovation

https://newsroom.clevelandclinic.org/2020/10/06/cleveland-clinic-unveils-top-10-medical-innovations-for-2021/

Here, in order of anticipated importance, are the Top 10 Medical Innovations for 2021:

1. Gene Therapy for Hemoglobinopathies

Hemoglobinopathies are genetic disorders affecting the structure or production of the hemoglobin molecule – the red protein responsible for transporting oxygen in the blood. The most common hemoglobinopathies include sickle cell disease and thalassemia – which combined affect more than 330,000 children born worldwide every year and more than 100,000 patients with sickle cell disease in the United States alone. The latest research in hemoglobinopathies has brought an experimental gene therapy, giving those who have the condition the potential ability to make functional hemoglobin molecules – reducing the presence of sickled blood cells or ineffective red blood cells in thalassemia to prevent associated complications.

2. Novel Drug for Primary-Progressive Multiple Sclerosis

In individuals with multiple sclerosis (MS), the immune system attacks the fatty protective myelin sheath that covers the nerve fibers – causing communication problems between the brain and the rest of the body that can result in permanent damage or deterioration and eventual death. Approximately 15 percent of people with MS experience a disease subset known as primary-progressive, characterized by gradual onset and steady progression of signs and symptoms. A new, FDA-approved therapeutic monoclonal antibody with a novel target is the first and only MS treatment for the primary-progressive population.

3. Smartphone-Connected Pacemaker Devices

Implantable devices like pacemakers and defibrillators deliver electrical impulses to the heart muscle chambers to contract and pump blood to the body. They are used to prevent or correct arrhythmias – heartbeats that are uneven, too slow or too fast. Remote monitoring of these devices is an essential part of care. Traditionally, remote monitoring of this device takes place through a bed-side console that transmits the pacemaker or defibrillator data to the physician. Though millions of patients have pacemakers and defibrillators, many lack a basic understanding of the device or how it functions and adherence to remote monitoring has been suboptimal. Bluetooth-enabled pacemaker devices can remedy these issues of disconnection between patients and their cardiac treatment. Used in conjunction with a mobile app, these connected devices allow patients greater insight into the health data from the pacemakers and transmit the health information to their physicians.

4. New Medication for Cystic Fibrosis

Today, more than 30,000 people in the United States are living with cystic fibrosis (CF) – a hereditary condition characterized by thick, sticky mucus that clogs airways and traps germs, leading to infections, inflammation and other complications. CF is caused by a defective cystic fibrosis transmembrane conductance regulator (CFTR) protein. A class of drugs called CFTR modulators correct the protein’s action, but medications developed prior to last year had only been effective in a subset of people with certain mutations. A new combination drug, FDA approved in October 2019, provides relief for patients with the most common CF gene mutation (F508 del) – estimated to represent 90 percent of individuals living with the disease.

5. Universal Hepatitis C Treatment

Classified as a “silent epidemic” by the CDC, hepatitis C has emerged as a major public health issue in the U.S. Infection with the hepatitis C virus can lead to serious, life-threatening health problems like liver failure, cirrhosis and liver cancer. With no vaccine for the virus, patients have been limited to medication, but many treatments were accompanied by adverse side effects or only effective for certain genotypes of the disease. A new, approved fixed-dose combination medication has vastly improved hepatitis C treatment. More than 90 percent effective for hepatitis C genotypes one through six, the therapy represents an effective option for a wider scope of patients.

6. Bubble CPAP for Increased Lung Function in Premature Babies

Underweight and frail, babies born prematurely often require specialized care – including ventilation for those with infant respiratory distress syndrome (IRDS). For IRDS, infants are commonly administered surfactant during mechanical ventilation, a practice that can cause lasting lung injury in preterm infants and contribute to the development of chronic lung disease. Unlike mechanical ventilation, b-CPAP is a non-invasive ventilation strategy – delivering continuous positive airway pressure to newborns to maintain lung volumes during exhalation. The oscillating, rather than constant pressure, plays a role in its safety and efficacy, minimizing physical trauma and stimulating lung growth when administered over a prolonged period.

7. Increased Access to Telemedicine through Novel Practice and Policy Changes

COVID-19 saw increased adoption of telemedical practices as clinicians needed to conduct patient visits online. An increasingly virtual care model and increased consumer adoption came by way of fundamental shifts in policy at both the government and provider level. Since March, state and federal regulators have moved quickly to reduce barriers to telehealth, understanding that these new tools can speed access to care while protecting healthcare workers and community members. These measures opened the floodgates for telehealth, allowing for new programs and the expansion of existing networks.

8. Vacuum-Induced Uterine Tamponade Device for Postpartum Hemorrhage

Characterized as excessive bleeding after having a baby, postpartum hemorrhage is a devastating complication of childbirth, affecting from one to five percent of women who give birth. Mothers experiencing postpartum hemorrhage may require blood transfusions, drugs which may cause dangerous side effects, long uncomfortable procedures, and even emergency hysterectomy with loss of fertility. Non-surgical interventions directed at the site of bleeding has been limited to balloon devices that expand the uterus while compressing the site of bleeding. But the newest advancement is that of vacuum-induced uterine tamponade – a method that uses negative pressure created inside the uterus to collapse the bleeding cavity causing the muscle to close off the vessels. The vacuum-induced device represents another minimally invasive tool for clinicians as they treat the complication and provides a low-tech solution that is potentially translatable to developing countries with low resource availability.

9. PARP Inhibitors for Prostate Cancer

About one man in nine will be diagnosed with prostate cancer in his lifetime. While there has been progress in the last decade, the disease remains the second-leading cause of cancer death among men in the U.S. PARP inhibitors – pharmacological inhibitors for cancer treatment – block proteins called PARP that help repair damaged tumor DNA in people with BRCA1 and BRCA2 gene mutations. Though known for their success in women’s cancers, two PARP inhibitors have been demonstrated to delay the progression of prostate cancer in men with refractory cancer and DNA repair pathway mutations. Both were approved for prostate cancer in May 2020.

10. Immunologics for Migraine Prophylaxis

Migraines affect more than 38 million people in the U.S. – an estimated 12 percent of the adult population. For some time, multi-purpose drugs like blood pressure medications, antidepressants, anti-seizure drugs and Botox injections have been used to prevent attacks. However, not developed specifically for migraines, these methods have been met with mixed results. In 2018, new medications were developed to help head off migraine pain. The class of drugs works by blocking the activity of a molecule called calcitonin gene-related peptide (CGRP), which spikes during a migraine. Actively prescribed in 2020, this new FDA-approved class of medication is the first to be specifically designed for the preventive treatment of migraine, marking a new era of migraine therapeutics.

At next year’s Medical Innovation Summit, in addition to the annual Top 10 list, Cleveland Clinic will present a new award in honor of its rich history of innovation and advancements in healthcare delivery. The inaugural prize will be awarded to a team, organization or individual who has made a significant contribution to healthcare delivery with a focus on one or more defined areas. Details will be released in early 2021.

For more information on the annual Top 10 Medical Innovations list including descriptions, videos, and year-by-year comparisons, visit Cleveland Clinic’s Top 10 Medical Innovations page.

OCTOBER 23, 2019 / NEWS RELEASES

Cleveland Clinic Unveils Top 10 Medical Innovations for 2020

A panel of top doctors and researchers presents the medical advancements with the power to transform healthcare in the next year

https://newsroom.clevelandclinic.org/2019/10/23/cleveland-clinic-unveils-top-10-medical-innovations-for-2020/

1. Dual-Acting Osteoporosis Drug

Osteoporosis is a condition in which bones become weak and brittle, effectively increasing their risk of breaking. With osteoporosis, the loss of bone occurs silently and progressively – often without symptoms until the first fracture. Providing more bone-strengthening power, the recent FDA approval of a new dual-acting drug (romosozumab) is giving patients with osteoporosis more control in preventing additional fractures.

2. Expanded Use of Minimally Invasive Mitral Valve Surgery

The mitral valve allows blood flow from the heart’s left atrium to the left ventricle. But in about 1 in 10 individuals over the age of 75, the mitral valve is defective causing the action of regurgitation. Expanding the approval of a minimally invasive valve repair device to a population of patients who have failed to get symptom relief from other therapies provides an important new treatment option.

3. Inaugural Treatment for Transthyretin Amyloid Cardiomyopathy

A disheartening cardiovascular disorder, ATTR-CM is a progressive, underdiagnosed, potentially fatal disease in which amyloid protein fibrils deposit in, and stiffen, the walls of the heart’s left ventricle. But a new agent to prevent misfolding of the deposited protein is showing a significantly reduced risk of death. Following Fast-Track and Breakthrough designations in 2017 and 2018, 2019 marked the FDA approval of tafamidis, the first-ever medication for treatment of this increasingly recognized condition.

4. Therapy for Peanut Allergies

It’s a terrifying reality for 2.5 percent of parents – the possibility that at any moment, their child might be unable to breathe due to an allergic reaction. Though emergency epinephrine has reduced the severity and risk of accidental exposure, these innovations are not enough to quell the ever-present anxiety. But development of a new oral immunotherapy medication to gradually build tolerance to peanut exposure holds the opportunity to lend protection against attack.

5. Closed-Loop Spinal Cord Stimulation

Chronic pain is a terribly frustrating condition, and a large reason for prescription of opioid medication. Spinal cord stimulation is a popular treatment for chronic pain through which an implantable device provides electrical stimulus to the spinal cord. But unsatisfactory outcomes due to subtherapeutic or overstimulation events are common. Closed-loop stimulation is allowing for better communication between the device and the spinal cord providing more optimal stimulation and relief of pain.

6. Biologics in Orthopaedic Repair

After orthopaedic surgery, the body can take anywhere from months to years to recover. But biologics – cells, blood components, growth factors, and other natural substances – have the power to replace or harness the body’s own power and promote healing. These elements are finding their way into orthopaedic care, allowing for the possibility of expedited improved outcomes.

7. Antibiotic Envelope for Cardiac Implantable Device Infection Prevention

Worldwide, roughly 1.5 million patients receive an implantable cardiac electronic device every year. In these patients, infection remains a major, potentially life-threatening complication. Antibiotic-embedded envelopes are now made to encase these cardiac devices, effectively preventing infection.

8. Bempedoic Acid for Cholesterol Lowering in Statin Intolerant Patients

High cholesterol is a major concern for nearly 40 percent of adults in the U.S. Left untreated, the condition could lead to serious health problems like heart attack and stroke. Though typically managed with statins, some individuals experience unacceptable muscle pain with statins. Bempedoic acid provides an alternative approach to lowering of LDL-cholesterol while avoiding these side effects.

9. PARP Inhibitors for Maintenance Therapy in Ovarian Cancer

PARP, or poly-ADP ribose polymerase, inhibitors block repair of damaged DNA in tumor cells which increases cell death, especially in tumors with deficient repair mechanisms. One of the most recent important advances ovarian cancer treatment, PARP inhibitors have improved progression-free survival and are now being approved for first-line maintenance therapy in advanced stage disease. Several additional large-scale trials are underway with PARP inhibitors set to make great strides in improving outcomes in cancer therapy.

10. Drugs for Heart Failure with Preserved Ejection Fraction

Heart failure with preserved ejection fraction (HFpEF) – also known as diastolic heart failure – is the condition in which the ventricular heart muscles contract normally, but do not relax as they should. With preserved ejection fraction, the heart is unable to properly fill with blood – leaving less available to be pumped out to the body. Currently, recommendations for this treatment are directed at accompanying conditions and mere symptom relief. But SGLT2 inhibitors, a class of medications used in the treatment of type 2 diabetes, is now being explored in HFpEF – alluding to a potential new treatment option.

For more information on the annual Top 10 Medical Innovations including descriptions, videos, and year-by-year comparisons visit: https://innovations.clevelandclinic.org/Summit/Top-10-Medical-Innovations

SOURCE

https://newsroom.clevelandclinic.org/2019/10/23/cleveland-clinic-unveils-top-10-medical-innovations-for-2020/

Top 10 for 2018

#1 Hybrid Closed-Loop Insulin Delivery System

This approach has not just made T1D management easier than ever, it is also getting praise for stabilizing blood glucose at an unprecedented level.

#2 Neuromodulation to Treat Obstructive Sleep Apnea

While C.P.A.P. is the gold standard treatment for OSA, the risk of misuse or discontinued use has created an opportunity for innovators to search for a less intrusive way to treat it. The result is ne

#3 Gene Therapy for Inherited Retinal Diseases

In 2018 gene therapy is expected to make its comeback with expected FDA approvals for a variety of inherited retinal diseases (“IRDs”).

#4 The Unprecedented Reduction of LDL Cholesterol

These new drugs are taking cholesterol to low levels never seen before.

#5 The Emergence of Distance Health

In 2018, the prevalence of connectivity enables distance health.

#6 Next Generation Vaccine Platforms

In 2018, innovators will be upgrading the entire vaccine infrastructure to support the rapid development of new vaccines (a concept that was #1 on the Top 10 Medical Innovations for 2015).

#7 Arsenal of Targeted Breast Cancer Therapies

For breast cancer patients that are BRCA1 or BRCA2 positive, there is new hope for a targeted therapy that is already seeing success in the ovarian cancer market.

#8 Enhanced Recovery After Surgery

After seeing substantial growth in hospital readmissions and an opioid epidemic spiraling out of control, it is clear that physicians need to overhaul the post-surgery strategies currently in use.

#9 Centralized Monitoring of Hospital Patients

Centralized monitoring has emerged as the answer, as part of a “mission control” operation in which off-site personnel use advanced equipment monitor patients.

#10 Scalp Cooling for Reducing Chemotherapy Induced Hair Loss

The practice of “Scalp Cooling” has been shown to be highly effective for preserving hair in women receiving neoadjuvant or adjuvant chemotherapy for early-stage breast cancer.

SOURCE

http://innovations.clevelandclinic.org/Summit/Top-10-Medical-Innovations/Top-10-for-2018.aspx