Are you really ready for Healthcare's changes?

If you are the average healthcare provider, you probably are not as well prepared for what is coming your way as you may think. Brian Fonseca, who writes for InfoWorld, said “As a traditionally modest adopter of new technologies and ideas, the healthcare industry has stood idly by as other industries move toward a greater interconnectedness with customers through a wireless environment that can improve daily business practices.” What makes this statement somewhat damning, is the person who wrote it and where he wrote it. It seems that everyone else knows healthcare is behind except for healthcare.”

Within the last several days, $500 billion in Medicare cuts, an increase in bureaucratic hurdles, and new healthcare taxes were inculcated into the law of the land. This environment translates into reduced reimbursement, and a projected rise in consumer choice which demands an increase in the efficiency of operations combined with a demonstrated quality of care. This exigency makes the above excerpt from “Healthcare's Next Tsunami” even more problematic.

I wrote Healthcare's Next Tsunami in an effort to prepare health care providers for their inevitable future. that being said, “Healthcare's Next Tsunami, A Providers Primer” was published on June 26th and is available at Smashwords or it can be found on our website www. ohmc-systems.com.

Like our first book this is an e-book only and it is available for the iPad, Kindle, Sony Reader, or your laptop, and in a few weeks it will be available for the Kobo Reader.

By the end of the year I hope to have it's sequel “Healthcare's Next Tsunami, The Tech Savvy Patient” ready for publication. As the name implies, the advancement of personal electronics, coupled with the cloud, and tablets, have brought healthcare information to the living room. It is a given that knowledge translates into the power of choices and the informed choice will have a dramatic impact on the old system of healthcare delivery.

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Newly developed oxygen particles injected into blood could save lives

Newly developed oxygen particles injected into blood could save lives
By Loren Grush
Published June 29, 2012
FoxNews.com

Read more: http://www.foxnews.com/health/2012/06/29/newly-developed-oxygen-particles-injected-into-blood-could-save-lives/#ixzz1zESz2KQI

When a patient suffers from acute lung failure or a blocked airway, their blood needs oxygen – and fast. Without enough blood flow to the heart and brain, he or she can suffer from cardiac arrest or massive brain damage.

But often times, the complex machines needed to keep blood oxygenated are not so readily available. So what if there was a temporary fix for patients who need oxygen in a hurry?

That solution may well be on its way. A team of researchers at Boston Children’s Hosptial have developed tiny, oxygen-filled microparticles that can be injected straight into a person’s veins in order to quickly oxygenate a person’s blood, giving doctors or paramedics more time to perform more complex life-saving procedures.

According to Dr. John Kheir, of the department of cardiology at Boston Children’s Hospital and the study’s lead author, the motivation to design these microparticles came to him after a tragic incident occurred with one of his patients in 2006.

“I was taking care of a cute redhead girl in ICU who had severe pneumonia,” Kheir told FoxNews.com. “She didn’t have a breathing tube at the time, and all of a sudden she had a pulmonary hemorrhage – when lung tissue gets damaged and actually erodes into the pulmonary arteries.

“Her lungs filled up with blood and she went into cardiac arrest,” Kheir continued. “So we put her on an ECMO machine… [which] removes blood from the body, transfers it to a machine that exposes it to oxygen and then puts it back in the body. We were able to get her onto that machine, which requires a surgical procedure. So that took about 25 minutes, but during that time her brain was very deprived of oxygen and it was severely injured.”

While pulmonary hemorrhages happen very rarely, Kheir realized that many patients could benefit from a temporary method for restoring oxygen that’s less invasive. After working with various chemical engineers, six years later Kheir and his team have developed their microparticles that successfully restored oxygen in the blood of mice.

The tiny “bubbles” consist of a single layer of fatty molecules called lipids that surround an even smaller pocket of oxygen gas. Delivered in a liquid solution, the particles can be injected straight into the bloodstream without causing a deadly air embolism – in which a large bubble of gas blocks blood flow in a vein or artery.

“We packaged the gas within small particles,” Kheir said. “It creates a lot of small particles rather than one large gas bubble, which allows them to disperse and break apart and navigate capillaries and arties. The second thing it does is increase the surface area to volume ratio, so it allows for a huge surface area for the gas to transfer. It brings oxygen into very close proximity to red tissue and red blood cells – a very rapid transfer.”

After injecting their microparticles in mice, the researchers saw that the animals’ blood-oxygen levels became normal within seconds. To test how their microparticles fared in a more dangerous scenario, Kheir and his colleagues completely blocked the mice’s tracheas and immediately injected the particles. The mice stayed alive for 15 minutes without taking a single breath.

While this feat is extraordinary, Kheir noted the microparticles should only be administered for a limited period of time – between 15 and 30 minutes.

“We limited it to 15 minutes for a reason,” Kheir said. “The particles don’t really exchange carbon dioxide at all. Carbon dioxide is normally carried in the plasma. Most patients don’t die from high carbon dioxide, but they definitely die from low oxygen. It’s only intended to stabilize patients for a period of time while another procedure is being done.”

According to Kheir, numerous lives could potentially be saved if their invention is made for humans. For example, if someone has drowned and needs oxygen on their way to the hospital, a quick injection could prolong their life for another 30 minutes.

“The drug could be stored in bags or syringes and administered on a semi-continuous basis,” Kheir said. “Our vision for this is that this drug would be stored on emergency carts all over the hospital and even outside the hospital in an ambulance. Any time a patient is really, really sick for any reason, whoever is taking care of them could rescue them with a standard intravenous line. The primary reason that patients have a cardiac arrest is for breathing reasons. There’s a serious potential to improve the mortality and morbidity rate of patients in the hospital.”


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Simple liver cells grown in the lab

Rudimentary Liver Grown in the Lab: Scientific American
scientificamerican.com

From Nature magazine
---------------
Japanese scientists have used induced stem cells to create a liver-like tissue in a dish.

Although they have yet to publish their results and much work remains to be done, the achievement could have big clinical implications. If the results bear out, they would also constitute a significant advance in the ability to coax stem cells to self-organize into organs.

The work was presented by Takanori Takebe, a stem-cell biologist at Yokohama City University in Japan, at the annual meeting of the International Society for Stem Cell Research in Yokohama last week. “It blew my mind,” said George Daley, director of the stem-cell transplantation programme at the Boston Children’s Hospital in Massachusetts, who chaired the session.

“It sounds like a genuine advance,” says Stuart Forbes, who studies liver regeneration at the University of Edinburgh, UK. Forbes, who also works as a consultant for Scotland’s liver-transplantation unit, says that the advance could one day help to avoid the “bleak outcome” currently experienced by the many patients who don’t survive long enough to get a new liver.

But the liver described by Takebe has a long way to go before that. Takebe told how his team grew the organ using induced pluripotent stem cells (iPS), created by reprogramming human skin cells to an embryo-like state. The researchers placed the cells on growth plates in a specially designed medium; after nine days, analysis showed that they contained a biochemical marker of maturing liver cells, called hepatocytes.

At that key point, Takebe added two more types of cell known to help to recreate organ-like function in animals: endothelial cells, which line blood vessels, taken from an umbilical cord; and mesenchymal cells, which can differentiate into bone, cartilage or fat, taken from bone marrow. Two days later, the cells assembled into a 5-millimetre-long, three-dimensional tissue that the researchers labelled a liver bud — an early stage of liver development.

Under development
The tissue lacks bile ducts, and the hepatocytes do not form neat plates as they do in a real liver. In that sense, while it does to some degree recapitulate embryonic growth, it does not match the process as faithfully as the optic cup recently reported by another Japanese researcher. But the tissue does have blood vessels that proved functional when it was transplanted under the skin of a mouse. Genetic tests show that the tissue expresses many of the genes expressed in real liver. And, when transferred to the mouse, the tissue was able to metabolize some drugs that human livers metabolize but mouse livers normally cannot. The team claims that its work is “the first report demonstrating the creation of a human functional organ with vascular networks from pluripotent stem cells”.

Takebe says the success depended on properly timing the addition of the other two cell types. “It took over a year and hundreds of trials,” says Takebe.

The team says that the tissue’s three dimensions will give it advantages over simple cell-replacement therapies. It could be used for long-term replacement or short-term graft while the recipient waits for a suitable liver donor, or in cases in which doctors anticipate that the native liver will eventually regain its function. But such applications would require extensive development, including making sure that the tissue contains the proper arrangement of lobules.

It won’t be easy, says Forbes. To treat chronic liver disease, the cells would have to be stable for at least five years, the average survival period for those with the disease. But it is not clear whether that would be possible, especially considering that they would be exposed to many toxins and pathogens. Furthermore, the organ would need to stay the right size, without atrophying or developing cancerous growth. “Any deviation from the mature phenotype could be catastrophic for the graft,” says Forbes.


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Vaccines that don't need a fridge for storage

A Fridge-Free Vaccine, Powered By Silk
fast company


Keeping vaccines cold enough for them to survive is one of the largest challenges of global health efforts. A new breakthrough uses silk to dramatically increase the temperature at which a vaccine can live—which could save millions.

Vaccines that don’t spoil have long been a hope of the international health community. Each year, 2.4 million people die from vaccine-preventable diseases. One of the primary reasons isn’t that there aren’t enough vaccines, it’s that they’re not cold enough. Vaccines need to be stored at quite low temperatures, and in many of the more tropical regions where they’re needed most, there isn’t power to keep them cool. Spoilage can account for wasting of 50% of vaccines, and some international nonprofits estimate that more than 10 times our current vaccine storage will be needed in the developing world over the next 15 years.

A new startup has decided to solve the problem in another way: Make vaccines that don’t need cold storage at all. Vaxess has just won the Harvard University President’s Challenge for social entrepreneurship and will receive $70,000 to commercialize new technology that uses silk to stabilize routine vaccines and eliminate the need for refrigeration in transport and delivery.

We want it to be sustainably profitable, but it also has a huge potential global health benefit.
“We really see this as a double-bottom-line business,” says Michael Schrader, one of the co-founders of Vaxess. “We want it to be sustainably profitable, but it also has a huge potential global health benefit.”

The technology involves extracting fibroin, a protein found in silk, to stabilize vaccines at temperatures of up to 113 degrees for up to six months. By transporting and delivering vaccines on a thin filmstrip of silk-derived protein, the need for refrigeration is eliminated, explains Kathryn Kosuda, another co-founder of the company. “The silk forms a matrix around the vaccine, so it’s a structural stabilization. One of the advatages of our technology is that it doesn’t alter the vaccine itself, which is simpler from both a scientific and regulatory standpoint, compared with other thermostabilization techniques.” The technology was developed at Tufts University by two professors, David Kaplan and Fiorenzo Omenetto, who have pioneered the use of silk in biomedicine.

We’re trying to not disrupt the end health care worker at the other end, so administration of the shot would be the same.
Kosuda says that, normally, vaccines at room temperature spoil within a few days. Even stabilized vaccines still need to be kept cool, between 35 to 46 degrees and require refrigeration all along their lifetime of transport and storage. The plan is for Vaxess’s technology to add a last step in the process that wouldn’t change the end product. “At the present time, we’re trying to … not disrupt the end health care worker at the other end, so administration of the shot would be the same,” says Kosuda.

The team is working on the MMR (that’s measles, mumps, and rubella, all live virus vaccines) shot, but they hope to expand it to other vaccines as well. Schrader says the fledgling company is talking to pharmaceutical companies as well as assessing the safety of the technology in rotovirus, hepatitis B, and meningococcus vaccines.

All that extra shelf life could have a big impact. “More people die from vaccine-preventable diseases than HIV/AIDS, or diabetes-related problems around the world,” says Patrick Ho, another Vaxess founder.


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How about that, a Microsoft Game System and Vascular Surgery

Microsoft’s Kinect Technology Utilized for Vascular Surgery
by SCOTT JUNG on Jun 1, 2012 • 2:44 pm




Researchers and surgeons from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust are piloting ‘touchless’ technology in the operating theatre.

The pioneering enables surgeons to view, control and manipulate medical images without contact. It is the first time the technology has been used in this way.

Developed in conjunction with Microsoft Research and Lancaster University, the software for the imaging surgery system was created by researchers from King’s Imaging Sciences department to help surgeons during complex aneurysm procedures. The computer program takes the 3D image of a patient’s anatomy, and produces several 2D images (which look like x-rays) from different view directions. The Kinect technology allows the surgeon to operate the imaging system themselves, rather than instructing an assistant to do so.

Surgeons operate in a challenging environment where they are required to maintain sterility at all times. Re-scrubbing is time consuming and therefore surgeons are frequently compelled to instruct others to manipulate visual-aid equipment for them; an often impractical and imprecise method.

This new gesture-based system uses Kinect for Windows hardware and the Kinect for Windows Software Development Kit (SDK), to allow the vascular surgery team to maintain a sterile environment, whilst being able to view and manipulate medical images through a combination of gesture and voice control.

Mr Tom Carrell, Senior Lecturer at King’s College London and vascular surgeon at Guy’s and St Thomas’, said: ‘This technology is very exciting as it allows me to easily and precisely control the imaging I need during operations. Touchless interaction means there is no compromise in the sterility of the operating field or in patient safety.’

The system is currently under trial on vascular patients at St Thomas’ Hospital with a view to expanding to the manipulation of 3D volumetric models of the brain for neurosurgery at Addenbrooke’s Hospital in Cambridge.

The ultimate aim is to develop a touchless interaction in surgery toolkit that can be used in any hospital or system interested in applying touchless interaction to their imaging system.

Dr Mark Rouncefield from Lancaster University, commented: ‘This is a lovely example of a successful interdisciplinary research project, combining the technical skills of computer scientists with a social scientific and medical expertise that ensures the new technology resonates with the way in which surgeons actually do their work.’

Location:Georgetown,TX United States

Healthcare's next Tsunami the Providers Primer

Coming this month




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5 Ways Mobile Tech can improve your health

5 Ways Mobile Tech can improve your health

http://mashable.com/2012/06/01/mobile-health-tech/

Just a decade ago, if someone had said that Steve Jobs would have a huge effect on how medical professionals administer care, that prediction would have been met with an eye roll.

But the reality is people increasingly access healthcare services via mobile, or “mHealth.” The result: Mobile is having a transformative effect on the way physicians and nurses care for patients. It’s also impacting how consumers manage their own health and well-being.

Unconvinced? The following statistics might change your mind.

By the end of 2012 mHealth apps will have been downloaded 44 million times. By 2016, that number is expected to increase to 142 million downloads.
By this summer, 13,000 consumer health apps will be available for download on the iPhone. About half of those (6,000) are for medical professionals.
More than 80% of physicians own a mobile device, compared to 50% of the general U.S. population.
About 30% of physicians are using smartphones and tablets to treat patients.
So exactly how are these devices shaping healthcare? Here are five ways companies are adopting mobile technologies to improve healthcare delivery.

1. Tracking Physical Activity

We’ve all been told that losing weight involves taking that extra flight of stairs, walking instead of driving, and cutting back on calories. But who has the time to keep track of all that?
Enter health monitoring devices that can be snapped to your belt loop. Mobile apps like FitBit help log workouts, meals and weight. Naturally, weight loss is a key benefit of these apps, which is timely, given that obesity is a serious health epidemic facing the U.S. So much so, that First Lady Michelle Obama has strongly pushed her Let’s Move campaign.

2. Medical Reference Technology

Imagine walking into your local hospital with symptoms of a near-fatal, but perfectly treatable, breathing disorder. However, not one of the attending physicians is able to properly diagnose it, not to mention figure out the exact dose of medicine with which to treat you.

In many parts of the world, access to quality healthcare and skilled medical professionals is a hard-won luxury. That means the above scenario is a reality for many patients.

Health eVillages is working to fix this global health dilemma. The non-profit organization donates mobile phones and iPads pre-loaded with Skyscape medical reference technology to clinics in at-risk and underserved regions. The organization is currently working to train clinicians on the mobile devices in places such as Kenya, Uganda, Haiti, and China. The goal is to improve patient care where the latest and best medical education is not readily available.

3. Getting to the Right Clinician

We’ve all been to the doctor’s office on a tight schedule, and have waited through what feels like tedious but necessary check-ins, check-outs, and other administrative tasks. Oftentimes, we just want answers to our most common medical questions: “What might I have?” and “Where should I go for treatment?”

ITriage is a mobile health app designed to enhance the doctor-patient visit. Six million people have downloaded the app, which helps patients identify their symptoms and then directly connect to the most appropriate physician for their medical condition. Patients also have the ability to make medical appointments and check in to the emergency room via their mobile phones.

4. Connected Hospitals

More hospitals are adopting mobile as part of their care methods. Take Miami Children’s Hospital, one of the country’s top pediatric hospitals, with more than 650 physicians covering 40 pediatric specialties and sub-specialties. The hospital recently signed on PatientPoint’s HealthSync platform, a mobile care coordination system for patients and staff. The patient engagement mobile tool includes registration functions (check-in and check-out), ways to increase medication compliance, and general health and wellness promotions.

Miami Children’s Hospital also plans to leverage iPads with HealthSync to address potential treatment gaps, and deliver clinical surveys and screenings to patients.

5. VA Telehealth Services

The U.S. Department of Veteran Affairs has been at the forefront of providing mobile health services to make veterans’ (and their families’) lives easier.

Just recently, the VA announced plans to give 1,000 family caregivers iPads pre-loaded with health apps. That way, primary caregivers can take better care of their veterans without leaving home.

The initiative is also part of a pilot program called Clinic-in-Hand, which is testing distribution through a VA app store set to launch next year. This includes health apps that allow for the exchange of personal data between the VA, veterans, and caregivers, providing greater insight into what veterans need in terms of treatment and at-home care.

What mobile technologies do you think are driving the mHealth revolution?

Image courtesy of iStockphoto, Lisa-Blue


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