Look­ing ahead with new med tech

List high­lights health­care in­no­va­tions for 2012

Modern Healthcare - - FRONT PAGE - Jaimy Lee

De­vices and ther­a­pies that treat chronic dis­eases and med­i­cal apps for smart­phones are among med­i­cal in­no­va­tions that will pro­foundly af­fect health­care in 2012, ac­cord­ing to a list com­piled by physi­cians and sci­en­tists at the Cleve­land Clinic.

Pan­elists eval­u­ate nom­i­nated in­no­va­tions for four cri­te­ria, in­clud­ing:

Sig­nif­i­cant po­ten­tial for short-term clin­i­cal im­pact. A high prob­a­bil­ity of suc­cess. De­vices and ther­a­pies that are al­ready on the mar­ket or close to be­ing in­tro­duced.

Those with suf­fi­cient data avail­able to sup­port the nom­i­na­tion.

Some of the choices have yet to be ap­proved for use in the U.S., in­clud­ing the top in­no­va­tion on the list: a catheter-based re­nal den­er­va­tion that con­trols re­sis­tant hy­per­ten­sion.

The pro­ce­dure takes 40 min­utes and tar­gets the re­nal sym­pa­thetic sys­tem, which has small nerves that carry sig­nals be­tween the brain and the kid­neys. When these nerves are dis­rupted, blood-pres­sure lev­els im­prove.

Ardian, the Moun­tain View, Calif.-based com­pany that de­vel­oped catheter-based re­nal den­er­va­tion, was ac­quired by Medtronic in Novem­ber 2010 for $800 mil­lion, plus com­mer­cial mile­stones. Although the Food and Drug Ad­min­is­tra­tion hasn’t ap­proved the catheter sys­tem, it has re­ceived the CE mark­ing (CE stands for Euro­pean con­form­ity, in French) to be sold in Europe and is listed by Aus­tralia’s reg­u­la­tory agency for drugs and de­vices, the Ther­a­peu­tic Goods Ad­min­is­tra­tion.

“We view re­nal den­er­va­tion for the treat­ment of un­con­trolled hy­per­ten­sion as one of the most ex­cit­ing growth mar­kets in med­i­cal de­vices,” Sean Salmon, Medtronic’s vice pres­i­dent and gen­eral man­ager of the coro­nary and pe­riph­eral busi­ness, said in a state­ment at the time the deal was an­nounced.

A di­a­betes drug that re­duces blood su­gar by ex­cre­tion through uri­na­tion is an­other in­no­va­tion aimed at treat­ing a chronic dis­ease that was rec­og­nized by the Cleve­land Clinic panel, which called the SGLT2 in­hibitors a “par­a­digm shift in di­a­betes treat­ment.”

“While other di­a­betes med­i­ca­tions typ­i­cally boost in­sulin lev­els or make the body more sen­si­tive to in­sulin, SGLT2 in­hibitors work in­de­pen­dently of the hor­mone, leav­ing the door open for pos­si­ble use as an add-on ther­apy,” the Cleve­land Clinic said in an online ex­pla­na­tion of the se­lec­tion.

Bris­tol-My­ers Squibb Co. and As­traZeneca are jointly de­vel­op­ing the drug, which they call da­pagliflozin. An FDA ad­vi­sory com­mit­tee voted in July that the drug should not yet be ap­proved.

The list cites two tech­nol­ogy sec­tors as top in­no­va­tions: mo­bile med­i­cal apps and data and an­a­lyt­ics, not­ing that the lat­ter can im­prove hos­pi­tal op­er­a­tions, track out­comes in clin­i­cal and sur­gi­cal pro­ce­dures, and bench­mark ef­fec­tive­ness-to-cost mod­els.

“What (the list) shows is the op­por­tu­nity for the power of the use of data and in­for­ma­tion as a crit­i­cal tool in health­care,” said Dr. Harry Green­spun, a se­nior ad­viser of health­care trans­for­ma­tion and tech­nol­ogy at the Deloitte Cen­ter for Health So­lu­tions.

He noted that the in­clu­sion of data and an­a­lyt­ics, mo­bile apps and gene-se­quenc­ing ma­chines re­flect health­care in­no­va­tions that can im­prove the qual­ity and safety of health­care on a broad level, rather than in the treat­ment of a sin­gle con­di­tion or dis­ease.

Med­i­cal apps for mo­bile de­vices can be used by physi­cians to an­swer pa­tient ques­tions with­out leav­ing the bed­side, as well as help physi­cians se­lect screen­ing tests and cal­cu­late a pa­tient’s risk of de­vel­op­ing some dis­eases.

Four fac­tors are in­flu­enc­ing the adop­tion of mo­bile apps in health­care, ac­cord­ing to Chris Bergstrom, chief strat­egy and com­mer­cial of­fi­cer for Wel­lDoc, a Bal­ti­more-based com­pany that de­vel­ops tech­nol­ogy, in­clud­ing mo­bile apps, for dis­ease man­age­ment: Con­sumers and providers want mo­bile apps. The FDA is­sued guid­ance re­gard­ing how n they will be reg­u­lated (July 25, p. 12). EMR in­stal­la­tions are in “full up­swing.” Pub­lished clin­i­cal ev­i­dence is doc­u­ment­ing their im­pact.

“This type of ev­i­dence will give providers the con­fi­dence to pre­scribe mo­bile med­i­cal prod­ucts and pay­ers the will­ing­ness to pay for them,” Bergstrom said in an e-mail.

Other top in­no­va­tions on the 2012 list in­clude low-ra­di­a­tion-dose CT scans for early de­tec­tion of lung can­cer; ge­net­i­cally mod­i­fied mos­qui­toes that can re­duce the threat of dis­ease; wear­able ro­botic de­vices with mi­cro­pro­ces­sors and com­puter chips for am­putees; an im­plantable de­vice to treat com­plex brain aneurysms; “next gen­er­a­tion” gene-se­quenc­ing ma­chines; and a con­cus­sion man­age­ment sys­tem for ath­letes treated for head in­juries.

The top med­i­cal in­no­va­tion on the Cleve­land Clinic’s list last year was the molec­u­lar imag­ing biomarker for early de­tec­tion of Alzheimer’s dis­ease.

Med­i­cal apps for smart­phones pro­vide up-to-date, im­me­di­ate in­for­ma­tion, while

the abil­ity to har­ness data gives or­ga­ni­za­tions the op­por­tu­nity to cre­ate, col­lect and share it while en­sur­ing pri­vacy.

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