Can Digital Innovation Transform Health Care? Part I

Imagine this: a city homeless shelter serves breakfast and dinner, but not lunch. Hungry residents regularly go to the fire station next door, complain of chest pain, get taken by ambulance to the hospital ER where they are evaluated, at high cost, given lunch, and then transported back to the homeless shelter in time for dinner.

Such was a scenario laid out recently at the MIT Sloan School as an example from an inefficient US social and health care system that cannot adequately keep track of patients, manage health of the poor, or control costs.

The scenario was described by Jason Helgerson, Medicaid Director for the New York State Health Department, at a day-long conference entitled “Health Systems Innovation.” At the November 29 conference, experts from industry, government, science, medicine and academe laid out some of US health care’s daunting problems, along with new visions and hoped-for solutions —many powered by digital innovation.

In introducing the sessions, which were organized by the MIT Sloan Initiative for Health Systems Innovation (HSI), moderator Jay Levine pointed out that, today, there is more uncertainty regarding health care than at any time since the enactment of Medicare in 1965—a result of “overwhelming” political turbulence and concerns about health insurance and a tax plan that could upend the health industry and lead to huge, unsustainable losses in health delivery. Levine is retired principal of ECG Management Consultants, Inc.

Retzef Levi, an MIT/Sloan management professor whose department hosts HSI, outlined burgeoning health issues that accompany an aging US population. He emphasized the need to “sow seeds now” for a “visionary, futuristic system” to prevent disease and know who is at risk in order to reduce future illness.

Such a system would integrate local, state, and national systems, medical and behavioral disciplines, primary, specialty and community care, Retsef said. Providers would be paid for performance rather than tasks undertaken. There would be a workforce sufficient to handle the nation’s long term care needs, personalize diagnosis and treatment. The system would make full use of digital health innovations such as big data, analytics, sophisticated devices and mobile apps without losing the best aspects of human care.

After Levi’s remarks, Levine asked, “ in light of huge current losses in the system, where does the money come from to fix it?”

Panelists at the day long meeting never fully answered that question, but they did lay out a variety of promising digital approaches that could lead toward transformation, as well as roadblocks to change.

Analytics, machine learning and artificial intelligence
In a panel on “Machine Learning in surgery and cancer”, MIT PhD Candidates Jack Dunn and Daisy Zhou described analytic tools, based largely on longitudinal patient records, that they are developing to predict how long an individual surgical patient is likely to live, with what quality of life, if certain decisions are made. Such tools, which evaluate “nuanced “ signals and make use of “decision trees,” are aimed at helping doctors decide on treatment plans. Under current treatment guidelines, Zhou said, many doctors tend to “overestimate” prognoses, which can diminish patients’ quality of life and increase medical costs.

Dusty Mojumdar, PhD, IBM vice president and chief marketing officer for an IBM artificial intelligence (AI) system that reads, learns, understands and interacts with humans. Named “Watson,” after IBM’s first president, Thomas Watson, the system is now used, in health care, to: combat a major shortage of radiologists; predict whether nodules on individuals’ lungs will become malignant; develop new targets for ALS drugs, predict hypoglycemic events for diabetics; rank treatment plans and options for seven cancers, and match patients to clinical trials.

Artificial intelligence is also being used to evaluate what one speaker termed an “explosion “of health data—which is reported in some 7000 new health care publications per day, and which doubles every 73 days, according to Mojumdar. Several massive health systems are employing artificial intelligence to co-ordinate electronic medical records—using “text analysis” and “pattern matching” to “catalog” patients with similar health conditions in order to evaluate and predict outcomes of particular treatments.

In September, IBM made a 10-year, $240 million investment to create the MIT–IBM Watson AI Lab to carry out fundamental AI research aimed at propelling scientific breakthroughs that unlock the potential of AI.

In Part II, I’ll share panelists’ information about a variety of digital devices and methods already in use to help streamline and personalize long-term care and health care delivery.

LINKS TO:
Part I Overview, Watson, analytics
Part II digital devices, long term care.
Part III Apps, devices, roadblocks

Videotapes and photos of the conference, held November 29, 2017, are available at http://mitsloan.mit.edu/alumni/events/2017-cambridge-health-conference/

–Anita M. Harris
Anita Harris is a writer and communications consultant specializing in health, science and technology.

New Cambridge Observer is a publication of the Harris Communications Group, a content, PR and digital marketing firm based in Cambridge, MA.

Convergence Science Transforming Biomedicine, MIT Report says

We thought our readers would like to know about “Convergence and the Future of Health,” a report released today by the Massachusetts Institute of Technology. (Slightly self-serving full disclosure: New Cambridge Observer‘s Anita Harris was one of the writers).

MIT Graphic, Convergence Report 2016

CAMBRIDGE, MA — What if lost limbs could be regrown? Cancers detected early with blood or urine tests, instead of invasive biopsies? Drugs delivered via nanoparticles to specific tissues or even cells, minimizing unwanted side effects? While such breakthroughs may sound futuristic, scientists are already exploring these and other promising techniques.

But the realization of these transformative advances is not guaranteed. The key to bringing them to fruition, a landmark new report argues, will be strategic and sustained support for “convergence”: the merging of approaches and insights from historically distinct disciplines such as engineering, physics, computer science, chemistry, mathematics, and the life sciences.

The report, “Convergence: The Future of Health,” was co-chaired by Tyler Jacks, the David H. Koch Professor of Biology and director of MIT’s Koch Institute for Integrative Cancer Research; Susan Hockfield, noted neuroscientist and president emerita of MIT; and Phillip Sharp, Institute Professor at MIT and Nobel laureate, and will be presented at the National Academies of Sciences, Engineering, and Medicine in Washington on June 24.

The report, available at http://www.convergencerevolution.net/2016-report draws on insights from several dozen expert participants at two workshops, as well as input from scientists and researchers across academia, industry, and government. Their efforts have produced a wide range of recommendations for advancing convergence research, but the report emphasizes one critical barrier above all: the shortage of federal funding for convergence fields.

“Convergence science has advanced across many fronts, from nanotechnology to regenerative tissue,” says Sharp. “Although the promise has been recognized, the funding allocated for convergence research in biomedical science is small and needs to be expanded. In fact, there is no federal agency with the responsibility to fund convergence in biomedical research.”

National Insitutes of Health

The National Institutes of Health (NIH) are the primary source of research funding for biomedical science in the United States. In 2015, only 3 percent of all principal investigators funded by NIH were from departments of engineering, bioengineering, physics, biophysics, or mathematics. Accordingly, the report’s authors call for increasing NIH funding for convergence research to at least 20 percent of the agency’s budget.

Progress and potential

In 2011, MIT released a white paper that outlined the concept of convergence. More than just interdisciplinary research, convergence entails the active integration of these diverse modes of inquiry into a unified pursuit of advances that will transform health and other sectors, from agriculture to energy.

The new report lays out a more comprehensive vision of what convergence-based research could achieve, as well as the concrete steps required to enable these advances.

“The 2011 report argued that convergence was the next revolution in health research, following molecular biology and genomics,” says Jacks. “That report helped identify the importance and growing centrality of convergence for health research. This report is different. It starts us off on a true strategy for convergence-based research in health.”

The report released today makes clear that, despite such obstacles, this “third revolution” is already well underway. Convergence-based research has become standard practice at MIT, most notably at the Koch Institute and the Institute for Medical Engineering and Science.

“About a third of all MIT engineers are involved in some aspect of convergence,” says Sharp. “These faculty are having an enormous impact on biomedical science and this will only grow in the future. Other universities are beginning to evolve along similar paths.”

Indeed, convergence-based approaches are becoming more common at many other pioneering university programs, including the Wyss Institute for Biologically Inspired Engineering at Harvard University, and the University of Chicago’s new Institute for Molecular Engineering, among others.

The report also points to several new federal initiatives that are harnessing the convergence research model to solve some of society’s most pressing health challenges.

For example, the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, launched by the Obama administration in 2013, seeks to improve our understanding of how individual cells and neural circuits interact, in order to develop new ways to treat and prevent brain disorders. And the National Cancer Moonshot Initiative, launched earlier this year to accelerate research to develop cancer vaccines and early detection methods and genomic tumor analysis, will also operate largely using convergence tools and approaches.

But the integration of new technologies and methods from genomics, information science, nanotechnology, and molecular biology could take us even farther.

The report outlines three major disease areas — brain disorders, infectious diseases and immunology, and cancer — and promising convergence-based approaches to tackling them. It also presents case studies of four emerging technology categories: advanced imaging in the body, nanotechnology for drug and therapy delivery, regenerative engineering, and big data and health information technology.

A sampling gives a sense of their transformative potential. Convergence techniques could enable rewiring the genes of mosquitoes to eliminate Zika, dengue, and malaria. They could help solve the emerging threat of drug-resistant bacterial strains, which infect over two million people in the U.S. every year. Convergence-based immunotherapy could activate a person’s immune system to fight cancer, reprogramming a person’s T-cells or antibodies to find and attack tumor cells. Big-data techniques could be used to generate and analyze huge amounts of data on people’s exposures to industrial chemicals, environmental toxins, and infectious agents, creating a new field of “chemistry of nurture,” to complement the “chemistry of nature” developed by the documentation of the human genome.

“Convergence might come just in time,” says Hockfield, “given our rapidly aging population, increasing levels of chronic disease, and mounting healthcare costs due to demographic trends throughout the developed world. But we must overcome significant barriers to get to convergence.”

Cultivating convergence

Realizing the full potential of the convergence revolution will require much more ambitious and strategic coordination and collaboration across industry, government, and academia, the report argues.

The report accordingly calls for a concerted joint effort by federal agencies, universities, and industry to develop a new strategic roadmap to support convergence-based research. As a concrete next step, the report’s authors recommend establishing an interagency working group on convergence with participation from NIH, the National Science Foundation, and other federal agencies involved in funding scientific research, such as the Food and Drug Administration and the Department of Energy.

Other pressing challenges include grant review processes based on narrow, outdated disciplinary structures, which limit the availability of resources for cross-functional research teams. The report also proposes new practices to foster “cultures of convergence” within academic institutions: cross-department hiring and tenure review, convergence “cluster hiring” and career grants, and new PhD programs wherein students design their own degree programs across disciplinary boundaries.

If the potential of convergence is great, so are the stakes.

“Convergence has grown from a little seedling to a sprouting plant, but to become a great tree and orchard yielding fruit for decades into the future, it needs to be nourished, expanded, and cultivated now,” says Sharp. “Students need to be educated, collaborations need to be encouraged, and resources need to be committed to make sure convergence thrives.”

“This integration is important to deal with the great challenges of the future: continued growth in the accessibility and quality of healthcare, growth of the economy, and providing resources for future populations.”

Funding for the report was provided by the Raymond and Beverly Sackler Foundation, The Kavli Foundation, and the Burroughs Wellcome Fund.

The report is available at http://www.convergencerevolution.net/2016-report

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Written by Jonathan Mingle, MIT News correspondent

New Cambridge Observer is a publication of the Harris Communications Group, a Cambridge, MA, PR & marketing firm specializing in health, science and technology.

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Companies Receive $1.3 M in MA-Israeli Collaboration Grants

Four Massachusetts-Israeli business collaborations have received a total of $1.3M in grant funding under the Massachusetts-Israel Innovation Partnership (MIIP)–a formal collaboration between the State of Israel and the Commonwealth of Massachusetts to encourage and support innovation and entrepreneurship between Massachusetts’ and Israel’s life sciences, clean energy and technology sectors.

The grants were announced yesterday at the 2012 BIO International Convention in Boston by Massachusetts Governor Deval Patrick and Israeli Chief Scientist Avi Hasson, of MATIMOP, the Israel Ministry of Industry, Trade and Labor.

The four winning projects are:

SBH Sciences (Natick) and Improdia (Israel) will work together toward the development and manufacture of a chronic inflammation-dependent immunosuppression prognostic kit. SBH will receive $184,000 from the Center and Improdia will receive $202,000 from Israel’s OCS.SBH Sciences is a discovery and preclinical contract research organization with expertise in production and analysis of cytokines and biomarkers. Improdia is a life science start-up focused on implementing novel biomarkers for immune system modulating therapies– using simple blood tests for patients with chronic disease.

Automated Medical Instruments (AMI – Needham) and STI Lasers (Israel) will develop new technology involving radio frequency energy to perform circumferential ablation of the pulmonary veins. AMI will receive $116,000 from the Center and STI Lasers will receive $110,000 from OCS. AMI is a start-up medical device company developing novel technology to perform atrial fibrillation treatment. STI Lasers is a medical device company specializing in laser cutting, micromachining and finishing of miniature metal components.“AMI is developing the CircumBlator™, to offer a reliable and curative, minimally invasive treatment for millions of patients with atrial fibrillation, a disease that causes over 20 percent of strokes and untold misery,” said Martin Sklar, President and CEO of Automated Medical Instruments.

Lantheus Medical Imaging, Inc. (North Billerica) and Check-Cap (Israel) will develop a novel 3-D imaging capsule that can be used to screen for polyps and lesions associated with colorectal cancer. Lantheus will receive $300,000 from MTC and Check-Cap has been selected to receive at least an equal amount from OCS. Lantheus develops, manufactures and distributes innovative diagnostic imaging agents. Check Cap is a medical device company located in Mount Carmel, Israel with a “breakthrough” solution for Colorectal Cancer Screening. “As a global leader in diagnostic imaging, Lantheus is dedicated to providing physicians with breakthrough new tools to enhance patient care. Teaming up with Check-Cap to develop and manufacture a cutting-edge imaging capsule further advances this ongoing commitment,” said Don Kiepert, President and CEO, Lantheus Medical Imaging.

FloDesign Sonics (Wilbraham) and Transbiodiesel (Israel) will use FloDesign’s acoustic molecule separation technology to separate oil that can be used to create fuel from Transbiodiesel’s oil-generating algae. FloDesign Sonics will receive $55,000 from MassCEC and Transbiodiesel will receive $20,958 from OCS. FloDesign Sonics uses a novel ultrasonic acoustophoretic separation technology developed at Western New England University for a more efficient approach to wastewater treatment and micro-algae harvesting for biofuels. Transbiodiesel is a start- up company with a novel technology for producing biodiesel fuels from a variety of oils

The MIIP program was first announced in June 2011 at the BIO International Convention in Washington, D.C. and the first joint solicitation for proposals was launched in September 2011 by MATIMOP on the Israeli side and by the three participating Massachusetts agencies: the Massachusetts Life Sciences Center, the Massachusetts Technology Collaborative (MTC) and the Massachusetts Clean Energy Center (MassCEC). Total funding for the current projects is approximately $3m.

The partnership came as a result of a 2011 trade mission in which Governor Patrick and a coalition of Massachusetts business executives and senior government officials explored growth opportunities of common interest for Massachusetts’ and Israel’s innovation industries. During that mission Governor Patrick and Shalom Simhon, Israeli Minister of Industry, Trade and Labor, signing on behalf of their respective states, signed a Memorandum of Understanding (MOU) in Jerusalem. MIIP was established to implement the MOU’s framework.

Massachusetts is the first U.S. state to establish a significant industrial R&D program with the State of Israel, according to a press release issued yesterday by Patrick’s office.

Today there are nearly 100 companies with Israeli founders or Israeli-licensed technologies in Massachusetts, according to the release. In 2009, these companies employed nearly 6,000 people and generated $2.4 billion in direct revenue for the state. Local firms exported over $180 million worth of goods to Israel in 2009. Home to 377 hospitals and 37,000 practicing physicians, Israel is an important market for health-related technologies.

The New England-Israel Business Council, the US-Israel Science and Technology Foundation, the Government of Israel Economic Mission to North America, the Consulate General of Israel to New England and MOITI have all played an important role in promoting the program, according to the release.

–Anita M. Harris

New Cambridge Observer is a publication of the Harris Communications Group, an award-winning strategic public relations, marketing communications and thought leadership firm in Cambridge, MA.

AC Immune/Genentech to Partner on R&D for Alzheimer’s Antibody; $418M Agree’t

PRESS RELEASE

· New antibody program targets Tau protein, a major cause of Alzheimer’s disease

· License agreement potentially worth more than Swiss Francs 400 Million (approximately USD 418 million*)

Lausanne, Switzerland, 18 June, 2012 – AC Immune SA, today announced that it has entered into a second exclusive worldwide license agreement and research collaboration with Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY) for the research, development and commercialization of AC Immune’s anti-Tau antibodies for the potential treatment of Alzheimer’s disease and other neurodegenerative diseases.

Under the terms of the agreement, AC Immune will receive an undisclosed upfront payment and is eligible to receive research, development and commercialization milestone payments totaling more than Swiss Francs 400 million (approximately USD 418 million*) for Alzheimer´s disease and other indications. Additionally, AC Immune is eligible to receive royalties on net sales of products resulting from the collaboration. Under the multi-year joint research collaboration, AC Immune will work in partnership with Genentech to identify and formulate several pre-clinical candidates. Genentech will have global responsibility for pre-clinical and clinical development, manufacturing and commercialization of antibodies resulting from the collaboration.

Prof. Andrea Pfeifer, CEO of AC Immune said: “We are delighted to continue our excellent relationship with Genentech through this second landmark deal to fight Alzheimer’s disease. This underlines Genentech’s trust in AC Immune’s proprietary technology platform and we are confident in our joint abilities to develop not only
first-in-class but also best-in-class medication for one of the biggest healthcare problems of this century.”

“This second licensing deal gives us financial security to continue AC Immune’s
world-leading efforts to develop disease modifying therapies and diagnostics. We are now recognized as having one of the broadest and most advanced Alzheimer’s pipelines in the industry”, remarked Martin Velasco, Chairman of The Board of AC Immune .

Commenting on the deal, James Sabry, Genentech’s Vice President of Partnering , said: “Genentech is committed to bringing innovative treatments to patients suffering from devastating neurodegenerative diseases, and is developing a number of approaches to tackle Alzheimer’s disease. The addition of this anti-Tau program to our CNS pipeline complements other approaches we are investigating, including crenezumab which we in-licensed from AC Immune in 2006.”

About the anti-Tau Program

The Tau protein forms twisted fibers inside brain cells and build tangles that are considered by many in the scientific community as the second major cause of Alzheimer’s disease besides Abeta-plaques. The anti-Tau antibodies were discovered and humanized by AC Immune through its proprietary SupraAntigen TM technology.

“The anti-tau-antibodies have proven highly specific to misfolded Tau in relevant animal models for Alzheimer’s disease and are therefore well suited to be developed as a disease-modifying drug. This has significant potential as there are at present no known cures for Alzheimer’s disease,” said Dr. Andreas Muhs, Chief Scientific Officer
of AC Immune .

About Crenezumab

An anti-Abeta antibody, crenezumab was discovered and humanized by AC Immune. It is designed to bind to amyloid beta (Abeta), the main constituent of amyloid plaque in the brains of patients with Alzheimer’s disease. Abeta is considered to be a major cause in the development of the disease. Genentech is currently evaluating crenezumab in a Phase II clinical study in Alzheimer’s patients with mild to moderate symptoms. At the time the deal with Genentech was announced in December 2006, it was stated to have a potential total value of more than USD 300 million in clinical and regulatory milestone payments to AC Immune, excluding royalties.

In May 2012, crenezumab was selected to be tested in the world’s first-ever prevention trial in healthy individuals who are genetically destined to develop Alzheimer’s disease. This landmark study to investigate whether an anti-amyloid treatment can stave off the disease is being run by the US National Institutes of Health (NIH), the Banner Alzheimer’s Institute (BAI), the University of Antioquia in Colombia and Genentech.

About Alzheimer’s Disease

Alzheimer´s is the most common form of dementia. It is degenerative, irreversible and terminal. The memory and thinki ng of the patients is progressively destroyed. Besides the personal aspect there is a huge social and economic impact. Alzheimer´s disease is recognized as a significant health crisis of the 21st century with currently more than
36 million patients worldwide. This number is expected to double in the next 20 years and to triple to more than 116 million by 2050. In 2010 global worldwide costs were estimated to be USD 604 billion and were exceeding 1% of the global domestic product (Reference: World Alzheimer Report 2011, Alzheimer’s Disease International).

Scientists don’t yet fully understand what causes Alzheimer’s disease, but it has become increasingly clear that it develops because of a complex series of events that take place in the brain over a long period of time. Two proteins – Tau and Abeta – are perceived as the major causes of neurodegeneration: tangles and other abnormal forms of Tau protein accumulate inside the brain cells, while plaques and oligomers formed by Abeta occur outside the brain cells of people with Alzheimer’s disease.

About AC Immune SA
AC Immune SA is a Swiss-based biopharmaceutical company and a leader in Alzheimer´s disease drug development. AC Immune develops innovative therapeutics with “best in class” potential against Alzheimer´s disease and other conformational diseases along three axes: vaccines, antibodies and small molecules. The anti-Abeta antibody (crenezumab) for passive immunization is partnered with Genentech and is in Phase II development. The company continues to develop in house the small molecule ACI-91 and the vaccine ACI-24 in Phase II and Phase I/IIa clinical development respectively. These three clinical programs are focused on Alzheimer’s disease, and are backed by a rich portfolio of preclinical compounds. The therapeutic molecules are also leveraged for Alzheimer´s disease diagnostic and other central nervous system and non-CNS diseases, such as Glaucoma. Since its foundation in 2003, AC Immune has raised CHF 64 million from private investors.

-Anita M. Harris
Disclosure: I will be working with AC Immune at the Biotechnology Industry Organization today in Boston.

New Cambridge Observer is a publication of the Harris Communications Group, an award-winning strategic public relations, marketing communications and thought leadership firm in Cambridge, MA.

Journalists Tell Emerson College Students About Health Communications Careers

With the job market looking up for 2012 grads–especially in health care and communications fields, according to the National Association of Colleges and Employers and Reuters– I was very pleased to join Stephen Smith of the Boston Globe and Lara Salahi of ABC News in speaking to Emerson College students about careers in health communications.

Our panel, on April 5 was one in a series comprising Emerson’s “Communications Week.” It was moderated by Bridgette Collado, who teaches at Emerson.

Stephen Smith, now the Globe’s City Editor, traced his career as a health reporter from his early days at the Miami Herald through his many years at the Globe--describing a drive to tell the stories of individuals in order to bring their plight to public attention. He pointed out that while in Massachusetts, most people have access to health care, in other parts of the US, this is not the case. He also described his coverage of the 2010 earthquake in Haiti, focusing on the story of Reginette Cineliene , a 14-year old girl who lost her father, a sister, her home and a leg, spent a year living in a tent encampment, was often hungry, yet still managed to study with the goal of one day becoming a doctor. Smith said he found Reginette inspirational–and that he was pleased that his reporting had led readers to provide Reginette’s remaining family with money to rent a home and pay for an artificial limb.

Lara Salahi, an ABC News health producer, emphasized the importance of telling the stories of “real” people-as opposed to focusing on reports by experts. She used three brief slide/video shows to illustrate the hope and difficulties autism brings to families. One featured a young man who had wanted to be a doctor but, instead, went into radiation diagnostics; a second a husband and wife who are raising three autistic daughters; and the third parents of an autistic son who died young of a seizure disorder.

Anita Harris
I described my career as somewhat unusual–mainly driven by the vagaries of the economy. I became a journalist by starting a newspaper with college friends; worked in print, radio and television in New York City, taught college, and went into public affairs when my college downsized. I emphasized that with economic and technologic changes, versatility is key; it’s important to have skills in all media, enjoy change, and if you’re going to do work independently you have to like to market yourself.

I also outlined the broad changes I’ve noticed. When I started out in, print and broadcast journalism operated in separate silos and major news organizations had tremendous power to control and shape the information reaching the public. Today, increasingly, we are experiencing a convergence of media, in which news organizations are employing multiple media to reach their readers–and no longer monopolize the flow of information. The results are both positive and negative.

Convergence of media
For example, the Globe, previously print only, now has online version that includes video reports. Reporters for public radio are asked to blog and carry cameras; many reporters and editors are using social media–all of which have the potential to inform the public in a variety of ways. However, with staff cutbacks, many journalists are working harder now than in the past; I’m concerned that covering stories in multiple media could diminish the number and depth of stories on which they report.

Dissipation of control
I think it’s great that anyone with access to a computer can provide information to the world. But without vetting by bona fide, trained journalists, this democratization makes it difficult to know where information is coming from, how good it is, and, to play on words, where the truth lies– presenting special difficulties for health communicators.

—-Anita M. Harris
Anita Harris is a writer and content strategist in Cambridge, MA.

New Cambridge Observer is a publication of the Harris Communications Group of Cambridge, MA.

Lab tests for a dime at the convenience store?

Earlier this month, in Kendall Square, two entrepreneurs described new medical devices designed to provide low-cost “point-of-care” tests-far from laboratories or medical centers in the developing world.

Speaking at a meeting of Health Care and Life Science Special Interest Group of the MIT Enterprise Forum at the British Consulate former Mass Biotechnology Council President Una Ryan described the paper-based medical testing technology that her new nonprofit enterprise, Diagnostics for All (DFA), has licensed from the George Whitesides Laboratory at Harvard.

The technology allows bodily fluid to accumulate in patterns on postage-stamp sized pieces of paper–to be used for multiple tests simultaneously. DFA’s first project, funded in part by the Bill and Melinda Gates Foundation, is a liver function test to monitor the effects of drugs for HIV/AIDS and tuberculosis, and to help manage viral hepatitis. The test kits will first be sold in convenience stores in Africa at a cost of approximately ten cents each, Ryan said.

Bill Rodriguez, CEO of Daktari Diagnostics, showed a handheld, point of care, battery-operated diagnostics device the size of a small lunch box or portable radio that will first be used to test for AIDS in Africa–at a cost of $1.50 per test–starting next year. He pointed out that while drugs are available to treat the 33 million people worldwide who have HIV– “ten million of them don’t know it.”

Scientia Advisors Partner Arshad Ahmed, who served as moderator, (and is my client) pointed out in a recent blog that emerging markets may have the opportunity to adopt the latest point-of-care products, leapfrogging developed countries, in some instances–and that “emerging markets are where we will see the first application of low cost and inovative disruptive technologies at work.” Launching in the developing world allows companies to test out and market technologies before going through the rigorous approval process required in the developed world.

I was blown away by the prospects for devices like these. I asked when and how they will affect the costs and structure of, say, US healthcare–and whether those who make and market our costly technologies will try to keep these new testing devices from our marketplace. Ryan, whose nonprofit, DFA, will have a commercial wing, responded that she does not expect opposition from stakeholders in our current system. And a marketer for the device and pharma industries was adamant that developments like these will not impact her customers–for many years, at least. Given the vicissitudes of the US regulatory system and financeers needs for ROI, that may well be true.

But, clearly, technologies like these have tremendous potential to transform health care–and I’m excited at their prospects– for the long-neglected developing world.

—Anita M. Harris

Anita M. Harris is President of the Harris Communications Group, a marketing and public relations firm specializing in health, science and technology industries, worldwide.

Health gizmos for non-geeks: new monitoring devices for staying well

You don’t need to be a geek to get into some of the newest technology for keeping track of your health. I was blown away when I heard about pill bottle caps that will tell you (or your doctor or your caretakers) if you’ve forgotten to take your meds…a kazoo that measures the chemistry of the air from your lungs…and a telephone that can assess whether you’re depressed–from the tones of your voice.

These gizmos are the brainchildren of David Rose, an entrepreneur who is now the CEO of Vitality, Inc., in Cambridge. Rose has also invented bathroom scales that can show whether you’ve lost or gained weight, an umbrella that can sense whether it’s going to rain, and objects that assess air quality.

Rose was one of four panelists who spoke last week at a program sponsored by the Medical Development Group about some astounding new health gadgets, most of which are actually on the market. (MDG is a Boston area organization for individuals involved in the medical device and technology industries).

Rose focused on the above-mentioned pill bottle “Glo-Caps”, which “sense” when a patient takes a medication, and, via a wireless Internet connection, show health care professionals, patients or caregivers whether reminders are needed.

The caps light up, play a melody, and even ring a home phone to remind patients to take their pills. The caps can send weekly emails to remote caregivers, create accountability with doctors through an adherence report, and automatically refill prescriptions.

Glo-Caps are not currently available for purchase by individuals, but they are being used by patients enrolled in programs sponsored by certain health insurers and pharmacies.

Panelist Ben Rubin, Co-Founder and Chief Technology officer of Zeo, in Newton, MA, described Zeo’s novel headset and device that monitor an individual’s REM sleep and factors influencing sleep patterns. Knowing how well you sleep is important because sleep is closely tied to health conditions like obesity, depression, diabetes and the like, Rubin said. “If you measure it, you can manage it.”

Zeo’s sleep devices, which cost $250, connect to an Internet site. For an additional $100, Zeo provides email advice coaching to help individuals improve their “sleep hygiene.”

There’s also a Smart Phone application designed to promote better sleep: using the Ap, you put your phone under your pillow to measure your movement (and restlessness) during sleep.

Panelists also described glucose monitors that send data to doctors via patients’ Smart Phones and Nike running shoes that measure your steps. At one point, Rose pulled out a keychain that tells him whether he’s met his daily walking goals and whether he’s on track (ha ha) to meet his monthly goals.

Also mentioned were Internet tools such as a Google Ap to measure flu trends; Healthmedia, through which Johnson & Johnson provides digital coaching for managing stress and chronic disease, Philips Direct, which provides live coaching over email, and various “calorie and other body monitors through which individuals can receive online coaching through gyms.

All of these devices fall under a category moderator David Barash, MD, CEO of Concord [MA] Health Strategies calls “local health monitoring” –meaning that the devices can be used by patients or consumers almost anywhere–rather than just at home or in a hospital, doctor’s office or lab.

According to a recent review by my client, Scientia Advisors, “remote health monitoring” devices are the fastest growing category in a booming home health care market.

The devices are growing in popularity in sync with an aging population, increasing chronic disease, and new Internet technologies, Barash said.

Panelist Frank McGillin, Vice President of Global Marketing for Philips Healthcare, which markets a variety of home monitoring devices, said remote monitoring will become increasing important in light of growing health care costs.

Gillin cited government statistics showing that health care current accounts for 17.6 percent of the gross domestic product in the US, and that by 2050, half of the population in the developed world will be chronically ill—making traditional medical care fiscally overwhelming.

Devorah Klein, PhD, a principal at Continuum, in Newton, MA, who designs devices and evaluates patient adherence to therapy regimes for diabetes, asthma, arthritis, multiple sclerosis and erectile dysfunction, emphasized that simple designs are key because “many patients are not all that interested” in learning to use devices.

And Barash pointed out that while many consumers may be intrigued by these gizmos, doctors have been slow to embrace them.

For one thing, with a dearth of clinical trials to assess devices’ effectiveness, insurers are reluctant to reimburse doctors for evaluating the data thus compiled.

For another, it’s not clear how doctors can manage or assess potentially large amounts of additional data, or how data collected for individual conditions can be assessed in relation to data collected elsewhere for other, possibly related, conditions.

–Anita M. Harris

Health Reform: The Right Thing To do

The Wall Street Journal editorializes rabidly that the about-to-be adopted health reform will cost multitrillions of dollars, that health insurers will become regulated public utilities, that Big Pharma, the American Medical Association, the American Hospital Association, the Federation of American Hospitals, the Business Roundtable and even Wal-Mart “have made themselves more vulnerable to the gilded clutches of the political class…all leading to higher taxes, slower economic growth and worse medical care.”

The New York Times calls the reform a triumph for countless Americans who have been victimized or neglected by their dysfunctional health care system…providing coverage to tens of millions of uninsured Americans, prevent the worst insurance company abuses, and begin to wrestle with relentlessly rising costs — while slightly reducing future deficits.

The Boston Globe says that the reform has split Massachusetts along party lines.

According to the Globe:

Republican gubernatorial candidate Charles D. Baker Jr., a former health insurance CEO, believes the package will “increase the deficit and result in higher taxes or cuts in federal aid for teaching hospitals, medical device companies, and other health care firms that make up one-third of the Massachusetts economy.”

Independent candidate State Treasurer Tim Cahill says the legislation will “wipe out the American economy within four years.’’

Gov. Deval Patrick calls the legislation “good for America and good for Massachusetts.’’

Jim Klocke, executive vice president of the Greater Boston Chamber of Commerce, said the change will have little effect on businesses here and, like hospital leaders, called it “a step forward’’ for the country.

Union leaders and progressives are frustrated that a government-run health insurance option fell through.

I do believe that taxes will go up; that government involvement will create confusion and extra layers of bungling bureaucracy; and that, because I’ll be on Medicare by the time it’s fully enacted, it won’t benefit me personally, at all.

But every developed nation but one believes its citizens deserve to stay alive and well.

Healthier people are more energetic and productive; nipping disease before it reaches costly later stages will save money in the long run; perhaps some oversight will focus more attention on streamlining hospital practices or unnecessary care.

While the legislation needs tweaking and will be subject to change, I firmly support it. It’s the right thing to do.