Category: Devices

EarlySense makes touch-less vital sign monitoring a reality: Podcast

published date
October 11th, 2013 by

EarlySense make a sensor that goes under a patient’s mattress and monitors heart rate, respiration and movement without needing to affix any leads to a patient. It makes it feasible to conduct monitoring outside of an intensive care unit or inpatient hospital bed, helps reduces “alarm fatigue” by cutting down on false signals, and can improve patient care by reducing falls and pressure ulcers.

EarlySense was founded in Israel and is now based in Massachusetts, the product of Governor Deval Patrick’s trade mission to Israel in 2011. The company’s CEO, Avner Halperin is a high school classmate of mine.

In this podcast interview, EarlySense president Tim O’Malley brings us up to speed on the latest developments and describes how the Affordable Care Act is creating opportunities.

By David E. Williams of the Health Business Group.

From war to bionic legs to immortality

published date
September 30th, 2013 by

For better or worse, war has provided the impetus for new medical technology. The latest wars in Iraq and Afghanistan have sent home many men and some women who suffered the loss of legs and arms. Although prosthetic limbs have been improving over the years, they are really no substitute for the real thing.

That’s starting to change now, as we learn from an LA Times article about a study published in the New England Journal of Medicine.

A report published Wednesday in the New England Journal of Medicine describes how the team fit [a patient] with a prosthetic leg that has learned — with the help of a computer and some electrodes — to read his intentions from a bundle of nerves that end above his missing knee.

For the roughly 1 million Americans who have lost a leg or part of one due to injury or disease, [the patient] and his robotic leg offer the hope that future prosthetics might return the feel of a natural gait, kicking a soccer ball or climbing into a car without hoisting an inert artificial limb into the vehicle.

[The patient’s] prosthetic is a marvel of 21st century engineering. But it is [the patient’s] ability to control the prosthetic with his thoughts that makes the latest case remarkable. If he wants his artificial toes to curl toward him, or his artificial ankle to shift so he can walk down a ramp, all he has to do is imagine such movements.

This is pretty remarkable stuff, and great news for the many people who have lost limbs and may benefit. But it also hints at ethical issues that society will have to deal with in the future as the technology gets better and better.

We’ve already witnessed the first signs of what’s to come with Oscar Pistorius, the so-called Blade Runner (and probably murderer) whose artificial legs propelled him in the Olympics at a rate that’s likely higher than what he would have been able to do with “real” legs.

Call me crazy (go ahead) but how long will it be until we have athletes who decide to get bionic replacements for legs, knees, arms, eyes –you name it? I think it will be just 20 years or so. After that, we may find a whole cadre of people taking on replacement parts –including internal organs– in order to improve their health and have a shot at something approaching immortality. If you think there’s a wide divide between rich and poor today just wait until the rich find a way to use replacement parts to increase their strength and extend their lifespans.

I hope I won’t be around to see that happen.

 

How a tough manufacturing process for Advair might help GSK

published date
September 16th, 2013 by

When GSK introduced its Advair Diskus to the market about 15 years ago, it wasn’t expected to be such a big hit, never mind reaching close to $8 billion in sales as it did last year. It’s actually not so abnormal for demand for new drugs to be way off their initial projections and it’s typically no big deal. If a drug is unexpectedly popular it may take a while for production to ramp up but then the problem is usually over.

But Advair is a different beast. Unlike the typical round, white pill, its complex inhaler mechanism was never designed to be produced in huge quantities in multiple locations around the world, where different environmental conditions and variations in raw materials could make it hard to duplicate. So manufacturing has been a challenge for GSK and consumed plenty of resources.

The pharmaceutical world of 2013 looks a lot different than it did in the 1990s. Advair is now GSK’s biggest product and the pipeline of potential blockbusters does not look all that promising. A normal product would have had plenty of generic competition by now, but GSK has managed to hold onto the whole market. The reason: prospective generic competitors struggle at least as mightily as GSK –and with fewer resources– to produce the darn thing. The FDA is moving, but slowly, to clear a path for generics. It’s still not clear when and if such copies will be available.

So ironically, due to GSK’s inability to anticipate the high demand for Advair and develop an easier-to-make device, the company is now benefiting from a much stronger barrier to entry on its lead product than it could ever have imagined or hoped for.

The strategy looks brilliant in retrospect. If pharma developers are smart they’ll try to pull off something similar with their next launch.

Passivity: the really exciting thing about cell phones and health

published date
July 8th, 2013 by

There’s a lot of excitement about what smartphones can do for health. There are tons of apps for people who want to diagnose or monitor their condition, look up information, or connect with health care resources. The Boston Globe (My cellphone, myself) highlights Ginger.jo, a company that turns the phone into a medical monitor.

It’s true that there a lot of nifty things a smartphone can do. But the biggest gains will come from technologies that don’t require us to do anything special (like enter data, prick our fingers, or attach electrodes). And there the smartphone is already making a big difference. First, many people keep their phones with them and on just about all the time. That’s a huge hurdle for other remote monitoring equipment that the smartphone has overcome by its overall usefulness. Second, the phone already has passive data gathering capabilities, e.g., with the GPS chips that track location. And third, there is tremendous data generated by the usage of the phone in terms of mapping out who is contact with whom, when, and for how long, and how apps and the web are used.

Until only recently cameras on the phone were just a curiosity or a toy. Now they are used for all kinds of serious purposes like scanning documents and depositing checks. In the next few years I expect more clever sorts of sensors for pulse, ECG, oxygen levels and more to be built into phones, either as dedicated technologies or as extensions of existing general purpose functionality –the way accelerometers form the basis for phone pedometers.

It will be fun to be a part of it.

Uneasy about robots caring for the elderly? Read this

published date
May 22nd, 2013 by

The New York Times Bits blog has one of the better articles I’ve read about caregiver robots for the elderly. The aging population plus fewer family caregivers, fewer available human aides and relentless advances in technology are making the routine use of robotic assistants for the elderly all but inevitable.

One way or another we should expect to see robots enter the home to take care of the elderly. Certain tasks are less controversial. For example, a robot that clears dishes from the table, loads them in the dishwasher and then unloads them when they’re done isn’t that big a deal. That’s only a step or two beyond what a dishwasher does today. But even there you encounter issues of learned helplessness. If the robot can do it, why make the effort, even if effort is what provides purpose in life and staves off physical and cognitive decline?

Then there will be robots that keep track of medications and encourage people to take them on time. Those are probably good, even for non-elderly patients, because they could help boost adherence, reduce medication administration errors, and order refills in a timely manner.

It gets a little spooky when we start thinking about robots that do personal tasks, such as giving baths. And what about robots that act human to engage elders in conversation? It’s pretty clear that a lot of patients develop a relationship with such creatures, especially if they are dressed up like humans or have a human voice. On the one hand that’s a great relief to a remotely located adult son or daughter. The parent will have someone to talk to all day who keeps his/her patience and has plenty of time. But there can be feelings of guilt, too, as the son or daughter realizes they’ve delegated something critical to a machine and may even be unwittingly tricking their parent into thinking it’s human.

Things get even dicier when robots are used to monitor activities and behavior, which may lead to resentment by the parent and loss of autonomy.

I think we’ll just need to get used to these issues and work through them and that if we do so we can get to a generally happier place. The typical model I’ve seen of elders spending their last years accompanied by hired caregivers can sometimes be wonderful, but often has serious downsides.

If and when I get old and am on my own, I’ll be ready for my robot or robots.