Podcast: On Call, S1E1 – The Rise of Wearables

Earlier this year, Gartner estimated that revenue from wearables would hit over 30 billion dollars this year. Roughly 50 percent of that is generated by smartwatches. The industry has some familiar faces in longtime consumer tech developers like Apple.

Wearables are all about data. How far you walk. How many calories you burned. Your heart rate. What does this trove of data mean for public health? It’s got to be valuable right? Well sure, but some things should be considered.

People who own wearables aren’t exactly representative of the nation’s population. Wearable owners skew male and have a higher average income than the general population. There are also no standards for reporting, and no central database for the information. Models have been prevented, and most include a lot of data mapping to standard semantics, which would enable analysis and segmentation of the information.

The data associated with wearables could be both useful and detrimental for an individual. A handful of studies like one being conducted by Apple and Stanford could crack the code to widespread preventative medicine.

We discuss these issues and more in the first episode of On Call with AngelMD with special guest Dr. Wendy Whittington.

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AngelMD Saturday Roundup – January 6th, 2018

The Friday Saturday Roundup is a collection of five stories that you need to know about each week. From policy, to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

OK, Google: How Do We Stop Physician Burnout?

Physician burnout is a well-recognized problem which has been compounded by the adoption of electronic health records. EHRs have added an average of 1.5 hours to a physician’s workday according to research done by the AMA and the University of Wisconsin.

Some physicians have taken to hiring medical scribes, but there aren’t people with the required skill set to meet the demand. Google has been working on speech to text software for awhile now, the same kind that is used in Google Assistant and Google Translate.

A research team at google found it is possible to build a model using multiple speakers and reached a 20 percent word error rate with their initial study

Will CRISPR Even Work in Humans?

The gene editing tool of the future has only really been tested in animal subjects, leaving the human response to the technology a bit unknown.

New research sheds some light on how CRISPR would behave, but it isn’t exactly good news. Most CRISPR uses the Cas9 protein to operate. Two of most common bacteria Cas9 is derived from are Staphylococcus aureus and Streptococcus pyogenes, which most humans have developed adaptive community to. This means Cas9 could be ineffective in a human.

The Cancer Care Disparity

Fewer Americans are dying from cancer, according to the American Cancer Society. From 1990 to 2015, the mortality rate has slowly decreased for a total 26 percent drop. However, racial and economic inequalities have persisted across the decades.

Among black Americans, the cancer rate is 15 percent higher. The report reaches the conclusion that the disparity is “largely because of inequalities in wealth that lead to differences in risk factor exposures and barriers to high-quality cancer prevention, early detection, and treatment.”

The Subtlety of the Microbiome Unlocks New Treatment

The link between the presence of microbes and poor health is more complicated than one might think. We naturally have bacteria residing in us at all times, most are neutral and some even beneficial to our health. However, the bacteria can shift into a negative state and once it happens it’s difficult to treat.

There’s good news: a research has found a way to stop the transition to negative bacteria by replacing the metal they depend on with tungsten. So far, the method has been successful in mice.

How U.S. Drug Policy is Changing

2017 saw some bipartisan cooperation in the passage of policy like the U.S. Food and Drug Administration (FDA) Reauthorization Act of 2017 (FDARA) and the latest reauthorization of the FDA user fee program.

The FDA has also changed its tune by speeding up the approval process for things like digital health applications though still emphasizing the “gold standard” of FDA review. Health Affairs thinks this new FDA style will continue in 2018.

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AngelMD Friday Roundup – December 29, 2017

The Friday Roundup is a collection of five stories that you need to know about each week. From policy, to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

Hacking Natural Development

Researchers from UCSF have found a new method of producing human tissues without compromising the complexity of the structure. The technique is called DNA-programmed assembly of cells (DPAC) and it involves patterning ells with fibers that causes them to coil and fold into their intended shape.

This is similar to how cells would naturally form into tissues during development. Previous methods to creating tissues involved 3D printing, which though promising, often lacks the complexity of real human tissue.

Opioid Deaths Will Fall in New England, But Why?

Two weeks ago, I wrote about America’s Health Rankings which revealed the mortality rate in the U.S. had risen once again. Many are pointing to the surge in deaths due to opioids as the reason for the jump, which has become the leading cause of death for Americans under 50.

However, New England is projected to have 10 percent less deaths in 2017. Several factors likely contributed but the availability of naloxone (an overdose reversal drug) and tight prescription laws are being cited as possible reasons for the drop.

The Private Sector and Interoperability

Typically, the discussion about interoperability is centered around policy but for the first time, the sector’s biggest stories this year mostly came from the private sector. Unsurprisingly, Cerner was a big player and made headlines due to its deal with the VA. The company’s Zane Burke shared his perspective on the topic at HIMSS17.

“It’s one thing to say it, it’s another thing to do it. It takes significant focus to be both open and interoperable,” Burke shared.

Catch up on the rest of the interoperability developments from 2017 here.

A Better Flu Vaccine

Currently, the influenza vaccine changes year to year, but a researcher at the University of Washington is working to develop a more long term vaccine.

The vaccine is built from influenza DNA and instead of acting as a repellent, this version seeks out infected cells and kills them. This part of the virus does not change from year to year meaning the vaccine would not need to change either.

Precision Should Extend to Quality

The field of precision medicine has expanded significantly over the past year. Unfortunately as it grows, problems are arising. I spoke previously about the supply chain issue with deactivated viruses, and now NPR has reported that there are quality control issues with the treatment as well.

The quality of patient samples can get impacted in its travel to and from the lab, and there are also discrepancies between the machines used to analyze the samples and patients’ EHRs.

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AngelMD Friday Roundup – December 22, 2017

The Friday Roundup is a collection of five stories that you need to know about each week. From policy to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

Do You Hear What I Hear?

A new study, featuring everyone’s favorite gene editing technology CRISPR, shows it can be effectively used to treat hearing loss. Researchers used the Cas-9 variation to remove a mutated gene in mice that caused hearing loss.

About 40 million Americans experience hearing loss, and currently, there are no drug treatments, only cochlear implants and hearing aids. Though it’s only a mouse study, it is the first to illustrate hearing loss reversal in animals and researchers in China will soon attempt the same process with pigs to see if it is viable across species.

New Treatment Give Glioblastoma Patients Hope

Another study revealed a nontraditional treatment for patients with glioblastoma, an aggressive form of brain cancer. The treatment uses a bathing cap-like device to stimulate electric fields in the brain. In the study, 695 patients were treated, some with just chemotherapy and some with the additional electric field simulations.

The sole chemotherapy group lived 16 months from the start of the study compared to 20.9 months for those who received the electric field treatment. Though this may seem like a short amount of time, glioblastoma patients are eager for any hope. The cancer is known for its devastating effect, about seventy-five percent of patients die within two years of being diagnosed.

My True Love Gave to Me …Three 2018 Healthcare Trend Predictions

2017 was a breakout year for digital health thanks to an astounding $4.7 billion flowing into the industry and it seemed people were finally getting serious about IT adoption in the healthcare industry.

As is the norm this time of year, publications are publishing their trend predictions for the coming new year. Here’s what Fortune shared:

  • Telehealth – No, but for real this time. Shorter timeframes, EHR integration – the whole shebang.
  • Data – Original, I know. Fortune specifically pointed out data from wearables which give enhanced insight into a patient’s everyday life.
  • Artificial Intelligence – Be sure to be nice to your robot overlords, they might be the one reading your brain scan! Radiology is the field identified by Fortune as most likely to be overtaken by software.

Life Expectancy Drops in U.S. for Second Year in A Row

The reports released Thursday indicate that deaths due to opioid overdoses contributed to the decline in life expectancy. Before the last two years, life expectancy had been steadily increasing in the U.S.

Heart disease and cancer remained the two leading causes of death while unintentional injuries rose to number three (note: many overdoses are classified as unintentional injuries). Drug deaths are, unfortunately, still on the rise: From 2014 to 2016, death rates tied to drug overdoses jumped 18 percent each year.

No Creature Was Stirring Not Even … Bacteria?

Researchers in England have discovered a possible explanation for the development of some forms of antibiotic resistance: the bacteria was asleep. So-called “sleeper cells” are bacteria in a dormant state.

Though they sound harmless, the cells could come active again and potentially be dangerous like their “persister cell” counterparts, which are bacteria that fit the more traditional description of antibiotic resistance: they’re mutated. The scientists also developed a way to identify such cells before administering antibiotics by administering fluorescent dye, this could be useful in determining if a certain antibiotic will actually be effective in a patient,

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AngelMD Friday Roundup – December 15th, 2017

The Friday Roundup is a collection of five stories that you need to know about each week. From policy, to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

Health of the Nation

The 2017 America’s Health Rankings report was released earlier this week. The report is conducted with four defined determinants of health: behaviors, community & environment, policy, and clinical care.

Massachusetts took to the number one spot and many Southern states landed in the bottom ten. The report also illustrated the disparity in health providers per state. Massachusetts had over 200 providers for 100,000 people whereas states like Utah and Idaho has less than 100 per 100,000.

Gene Therapy’s Trouble with Hemophilia

Hemophilia, a genetic disorder that prevents the blood from clotting correctly, has had some preliminary success with gene therapy, with an earlier genetic treatment inducing enough clotting to prevent serious bleeds.

However, the study had a small sample size, and there has been no study of possible long term effects. This leaves some hemophilia patients wondering if taking part in such treatments is worth it and weighing higher costs against dose uncertainty.

How Will the Loss of Net Neutrality Effect Research?

In a historic decision, the FCC overturned net neutrality this week, a vote that will likely be appealed in courts in the coming months. Removal of net neutrality means that Internet Service Providers can block or slow content for their customers.

An article in Nature points out that this means access to scholarly articles could also me impacted. Useful data could get stuck in the “slow lane,” and access to articles could be blocked meaning the scientific community bloomed in the internet age could be cut-down.

The Tax Bill’s Effect on Healthcare Providers

The House and Senate have voted in favor of a major overhaul of current tax policies which includes the reversal of the Affordable Care Act individual mandate penalty. Proponents of the bill argue this will be beneficial for the working class, and make the bill more “workable” for the public.

However, insurance companies largely supported this mandate because it stabilized the market as a whole. The Congressional Budget Office estimates that the number of uninsured would grow to 13 million over the next 10 years and increase premiums by 10 percent, meaning the bill would have a significant impact on the future of healthcare in the U.S.

A New Treatment for Irregular Heartbeats

About 325,000 Americans die each year from heartbeat abnormalities, but a new treatment is emerging: radiation. The results of a small trial were published Thursday and detailed researchers from Washington University in St. Louis attempt to “kill” the cells causing electrical malfunctions in the heart.

Based on the results, the treatment appears to have worked, but unfortunately cannot be used on cardiac patients in need of immediate intervention as the treatment takes about a week to show full effect. All the patients included in the study had previously tried and failed to control their condition with drugs, making this treatment a welcome alternative.

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