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Digital technologies provide an opportunity to move musculoskeletal care to the heart of value-based healthcare. MedTech Views spoke to Satschin Bansal of Zimmer Biomet about some of the innovations that will change the field. Will digital health deliver the Holy Grail of better results for patients and better value for health systems? The technologies we have today, and those I see emerging from start-ups, are more than capable of changing musculoskeletal care. These digital tools contribute to the promise of value-based healthcare – improving patient outcomes while allowing greater cost-effectiveness. Digital health has to deliver both of these elements if it is to be adopted widely. What kinds of technologies are you thinking of? Think of rehabilitation after a knee or hip replacement. The six weeks after surgery are crucial to the patients’ quality of life after they recover. A major challenge, particularly in older patient populations, is patient compliance with physiotherapy. One of the solutions is to use wearable devices with sensors that give biofeedback to patients on whether they are bending their knee correctly or whether their mobility has improved. It can become like a “game”, making them more likely to stick to exercising. How else could technology improve rehabilitation without adding costs? The major costs of rehab are performing physiotherapy at a clinic and then later at home. The strong increase in using mobile technology also among elderly patients means physiotherapy can be delivered remotely. The physio could, for example, programme exercises for the patient to do in their own time – and then review the data afterwards. This helps each physiotherapist work more effectively with a larger number of patients – which is crucial as our population ages. In addition, further reducing length of stay in hospitals after joint replacement allows patients to return to their...
How do we prepare Europe for future technologies? Technologies such as AI, robotics and precision medicine are a mix of challenge and opportunity. But how can we prepare for this new era of tech in the healthcare sector? Modern technologies have immense potential to improve health through promotion, prevention and protection; this represents not only innovation within a specific area, but a general change of the entire healthcare service workflow. To succeed, we need to lay a broad foundation – from investments and infrastructure to patients’ benefits and acceptance. For Europe to truly embrace digital health, technologies need to be made: available, affordable and acceptable. Europe has the opportunity to provide end-to-end conditions to shape the future of health technologies, improving the life of citizens. Success will not come from a sole player. To build trustworthy health databases we need to cross borders and open markets. We need to learn from each other. Front-runner countries must show the way for others. And most importantly, citizens need to trust the system with their data. The EU cannot reach these results, unless all member states are on board. The specifics of national and regional systems require stakeholders on all levels to work together towards the common goal of advancing infrastructure and engaging citizens. Therefore, the European Health Parliament will propose in 2018 that a Connected European Health Area is established to remove structural barriers and act as a vision for infrastructure, and that digital health is included in all relevant policy initiatives to accelerate a meaningful adoption of AI & robotics in healthcare.. Our full report “Breaking down barriers to digital health” will be available in April. Elin Mignérus The European Health Parliament brings a new angle to the work on health policy. By gathering young professionals from across Europe with experiences...
In its 40-year history, Fenin, the Spanish medtech federation, has seen enormous changes in Spain’s healthcare landscape. In the second part of a two-part interview, Margarita Alfonsel, General Secretary of Fenin, shares her thoughts on the future. Read part one, reflecting on Fenin’s 40-year history Q. How is Fenin working to shape the future of Spanish healthcare? Fenin has been researching and working for technological development for forty years with the aim of incorporating innovation into the Spanish healthcare system in an agile and equitable manner. We are working to value health technology, representing the interests of the sector in the appropriate forums, promoting free competition and preserving market unity. Q. What are the current priorities of the organization? One of the most important priorities for our Federation is to work towards correcting the obsolescence of hospital equipment. For this reason, we have collaborated with the Spanish Ministry of Health on a Renewal Plan to solve this problem. In addition, the new Code of Ethics of the Health Technology Sector in Spain is another of our most immediate challenges. Since its approval at Medtech Europe in 2015, Fenin immediately began to work on its implementation, becoming the first national association in its transposition. We are also working to facilitate the adaptation of the members companies to the new regulation on Medical Devices and In Vitro Diagnostics with the great support of Medtech Europe. Finally, one of Fenin aim’s is to work with the public administration on health technology investment to establish new management models to introduce value-based innovations for health professionals and patients. Q. What major future trends do you foresee in the coming years? Currently, the Spanish medical technology industry is going through a period of change. The ageing of the Spanish population and the increasingly high prevalence of...
People with a rare eye disease known as retinitis pigmentosa (RP) suffer a gradual loss of vision; some become completely blind. Now, an innovative new approach to treatment has given dozens of people the chance to see again. With the help of a retinal implant, special glasses and intensive training, people who were blind have a new way of viewing the world which could one day benefit people with other degenerative eye diseases. We spoke to Professor Marie-Noelle Delyfer, University Hospital of Bordeaux, who has already performed eight such operations. What is retinitis pigmentosa (RP) and what is the prognosis for patients? RP is actually around 300 distinct genetic disorders that lead to the loss of photoreceptors on the retina. Some affected individuals have a reduction in their visual field while others become blind. With such a rare disease, it is difficult to describe a typical patient. Some lose their sight early in life or in early adulthood but there are others who become blind only in their 70s or 80s. Until 20 years ago, there were no treatments at all and the disease was not well understood. The first genetic cause of the disease was identified in 1984 – before that it was thought of as an inflammatory disease. What treatments are available? Some pharmaceutical therapies help to maintain photoreceptors but this only slows the progression of the disease – it’s not a cure. In the longer-term, there is some research on gene therapy targeting the mutations responsible for RP. How can technology help? I have used a new technology, from SecondSight, with eight carefully selected patients living with end-stage RP. These patients have an electrode array implanted in their retina. They wear glasses that are fitted with a camera that ‘sees’ their surrounding environment. This signal is sent...
eHealth technologies are pulling together personal information from diverse sources to ensure a more personalised, informed healthcare service – it’s what patients expect Precision medicine is the use of all available information about a patient to produce the most informed care plan possible. This is often associated with using genetic or other “-omics” information to help doctors select which medicine to prescribe for their patient. For example, testing a cancer patient for specific biomarkers can tell doctors which chemotherapy will work best. But it’s much bigger than that. If you look at what contributes to premature death, around 30% is thought to be genetic. The rest is a combination of our environment, diet, exercise, work, mental health, social interactions and other exogenous factors. So why limit ourselves to genetic data alone? As healthcare is now in the information era, the challenge is to pull together the vast quantity of data that exists and aggregate it in a way that allows health services to be tailored to each patient. There is already a wealth of data and this is expected to increase 50-fold in the next eight years. There is no way any physician can cope with this volume of information. That’s why software companies are playing an increasing role in healthcare. Information overload is essentially an IT challenge: how do we access and surface these data in a way that makes them accessible and actionable? How do we acquire and aggregate data, then reason against it to help manage populations and drive insights? Healthcare is unique but software experts have already overcome huge challenges in areas such as e-commerce and financial services to deliver a more tailored and user-friendly experience while safeguarding data privacy. In fact, the public is so used to this kind of customised intelligence that some patients...
Professor Kevin Warwick is pushing the boundaries of artificial intelligence and cyborg technologies How can artificial intelligence (AI ) improve healthcare? AI can be used to learn what is going on in different parts of the body and to predict problems. This gives us the power to prevent problems before they arise or to counteract malfunctions which are detected by sensors. Could you give us an example that will be part of the near future? One immediate application is in the use of deep brain stimulation or DBS. This technology is already used in people with Parkinson’s disease, epilepsy or depression to stimulate the nervous system with electrical pulses in order to alleviate symptoms. AI allows us to take it a step further by predicting when stimulation is needed. This means we could apply DBS before the patient experiences symptoms. What areas of future research are most exciting? An interesting area is the use of cultured neural networks. Typically, we use neurons (brain cells) taken from rat embryos and connect them to a robot. Sensors from the robot stimulate the culture and we have observed different pathways in the cell culture changing the direction of the robot. How do you do this? Firstly, we separate the brain cells using enzymes and them lay them out on a multi-electrode array (essentially a small dish). Very quickly the neurons start connecting with each other. We have to feed the brain cells using minerals and nutrients. The growing brain, consisting of approx. 150,000 cells has to be kept in an incubator at a controlled temperature of 37 degrees C. After about 10 days the brain has lots of connections so we give it a body. The brain is connected to its body, bi-directionally, via a Bluetooth link. Sensory signals from the robot body...