The Smart Magazine About Medical Technology Innovations
Live From MEDICA
This month, MedicalExpo E-mag is traveling to Düsseldorf, Germany to attend the MEDICA international trade fair, from 14-17 November. For the occasion, we’re publishing a special issue in which you can read about the latest developments in integrated operating rooms, the growing scourge of healthcare hacking, and the challenges of disaster medicine. You’ll also get a taste of some of the most innovative products and medical devices showcased at MEDICA. Enjoy your read!
Operating rooms are now more and more “integrated”, with improvements in high-resolution imaging equipment and the enhanced ability to use large amounts of visual OR data.
What does “integrated” refer to? It means that all the operating room technology—patient information systems, audio, video, lighting and medical...
The healthcare industry’s digital systems and devices are under attack as never before.
This year, numerous hospitals across the United States have been the victims of so-called ransomware—malicious software that blocks access to a computer system until a sum of money is paid. For example, the Hollywood Presbyterian Medical Center in Los Angeles paid a $17,000 ransom in bitcoin to a hacker who seized control of the hospital’s computer systems and would give back access only when the money was paid.
There is also growing concern that medical devices such as insulin pumps, pacemakers, fetal monitors and scanners are vulnerable to hacking.
The role of technology in healthcare has never been greater. New and increasingly mobile technologies, coupled with the growing complexity of the Internet of Things (IoT), enable healthcare professionals to engage patients in their own care, support clinical relationships and provide bigger and better data for more effective planning and decision making. Yet putting IT at the heart of care increases the risk of data breaches, as recent high-profile public- and private-sector incidents have demonstrated.
“Cyberattacks are now a huge headache for healthcare IT management,” says Jonathan Lee, the UK Healthcare Sector Manager for UK-based security software company Sophos. “It’s a real challenge to keep control of device data and functionality without compromising care.”
While most healthcare management professionals are aware of cyberattack dangers, there is a general consensus that today’s medical facilities remain highly vulnerable.
An example of a typical ransomware warning, designed to look like it’s from the FBI (Courtesy of Symantec).
“I don’t think hospital IT people have underestimated the threat, but many do not know where or how to begin protecting themselves,” says Robert Maliff, Director of the Applied Solutions Group at the ECRI Institute, an independent nonprofit organization that researches approaches to improving patient care.
Medical devices with data ports are located in unprotected areas like patient rooms.
“There are numerous attack points in hospitals,” continues Maliff. “Medical devices with data ports are located in unprotected areas like patient rooms. They also continue to run obsolete operating systems with next to no digital security in place.”
In the face of increasingly sophisticated threats, healthcare-specific security solutions must evolve to address the clear and present danger.
“It’s not enough to keep throwing disparate products at the problem any more,” says Sophos’s Lee. “We need products that can communicate and share intelligence so they can better respond to multi-vector threats.”
Basic Steps to Bolster Defenses
A growing number of cyber-criminals are now shifting their aim away from the relatively well-protected banking and commercial sectors toward the sitting duck that is healthcare. Going forward, the number of attacks on hospitals and other healthcare providers is likely to increase. “With ransomware continuing to be big news, the threat is not only significant, but also intensifying,” says Steve Mulhearn, Director of Enhanced Technologies at the California cybersecurity software company Fortinet.
Pressure grows to boost security of infusion pumps (Courtesy of Purdue University).
While many medical facilities remain exposed, a number of basic steps often can be taken to bolster defenses. Many of these measures are inexpensive and simple common sense.
Perhaps the single most important step hospitals can take is to routinely back up data. This removes one motivation for hackers to attack. Many organizations end up paying ransoms simply because they haven’t made copies of their most important systems and files.
It’s also important to keep software up to date. “Be sure to enable automatic updating on all security software and operating systems,” says Lee. “Where possible, mobile devices and apps must be updated too.” Exposed systems often can be given an extra layer of protection with multi-factor authentication. This means that even if cyber-criminals obtain system passwords, they are still prevented from accessing the most critical data. “Two-step verification is good—think SMS codes. Two-factor authentication is best—think hardware tokens or biometrics,” says Lee.
In a digital world where malicious software abounds, and where phishing emails are more convincing than ever, healthcare employees should always connect with care. “Be suspicious of all emails containing attachments or links,” cautions Lee. “Especially ones that urge you to act right away. Take time to spot anything that looks odd and always verify those communications.”
Healthcare workers are increasingly on the move. As their mobile devices proliferate, security questions should not be underestimated. The multi-faceted challenge of cyberattacks means hospitals and their security suppliers must work hand-in-hand to minimize risk.
The single most important step hospitals can take is to routinely back up data.
While factors such as the engagement of digital security specialists and comprehensive employee training can be vital, this clearly involves a significant investment of time and money.
“Hospitals are waking up to the cyber threat, but the vast majority have budget constraints,” says Sophos’s Lee. “There is now a move toward cost-saving models such as the consolidation of IT security services and the pooling of financial resources and technical expertise. Such shared services offer many healthcare providers the best option for delivering effective protection across all service areas.”
Amid growing concern over traumatic brain injury (TBI), more and more athletes are wearing head-mounted sensors that gauge the speed and force of the impacts sustained during competition.
Anyone who has seen the 2015 biographical sports drama, Concussion, featuring Will Smith as a Pittsburgh forensic pathologist,...
Disaster medicine has grown in importance as terrorism, humanitarian aid and climate disasters have proliferated around the world. Efforts are underway to strengthen disaster response to save more lives and encourage countries to improve infrastructure for emergency response. MedicalExpo e-mag spoke with Francesco Della Corte, Professor in Anesthesia, Critical Care and Critical Emergency Medicine at the University of Piedmont, Italy. He’s the founder of the European Master in Disaster Medicine.
ME e-mag: When was the European Master in Disaster Medicine program launched and what are its objectives?
Della Corte: The Master of Science in Disaster Medicine was launched in 2000-2001. So far, we have trained about 400 people. Students come from 75 nations, spread over the five continents. Responding well to a disaster is one of the most challenging things in medicine.
There has been a marked expansion in using disaster medicine to provide humanitarian aid.
Having specific knowledge, planning and organizing a health system, adapting to unique situations and providing skilled professional care in an often austere environment pose challenges. Our overall goals are to give students a clear picture of current concepts and developments in the medical management of disasters, so that health workers become high-level disaster medicine professionals, capable of working as academics and/or staff or field workers for governmental and nongovernmental or international organizations.
We also hope that students develop skills to contribute to the global development of disaster medicine as an academic discipline through collaboration with program universities and institutions, the students and alumni.
Disaster medicine has grown in importance as terrorism, humanitarian aid and climate disasters have proliferated around the world (Courtesy of ECDM)
ME e-mag: In the past year, we have heard about terrorism, climate disasters, and humanitarian problems. What is the most striking change in the field of disaster medicine?
Della Corte: There has been a marked expansion in using disaster medicine to provide humanitarian aid. Disaster medicine programs look at the big picture. They aim to give students skills in planning, hospital incident command, information management, safety, personal protective equipment and decontamination, medical management, essential resources, psychological support and ethics.
ME e-mag: Only doctors and nurses are eligible for this program. What will graduates be qualified to do?
Della Corte: Graduates should be able to work in one or more of five capacities: 1) define the main academic, legal, and ethical principles associated with disaster medicine; 2) assess the impact of disasters on the health system, including risk assessment and development of primary prevention programs; 3) manage medical response in diverse disaster situations; 4) organize local education and training in disaster medicine; 5) develop research projects in disaster medicine.
Clarius Mobile Health hopes to launch its new wireless ultrasound scanner by late 2016, assuming it receives the FDA’s 510(k) clearance and complies with Health Canada, CE, and other regional regulations. MedicalExpo e-mag asked Dave Willis*, Clarius Co-Founder and Chief Strategy Officer, to describe the innovative aspects of the new device.
ME e-mag: What sets the Clarius ultrasound scanner apart from other scanners?
Dave Willis: Several features make it stand out in the market. For example, its stellar imaging quality. As far as we know, this is the only wireless scanner that fits in a large pocket. It weighs less than one pound. Therefore, instead of dragging a cumbersome ultrasound cart around, it’s possible to perform a scan anywhere, and without messing with wires.
It also has a rugged magnesium shell that makes the device drop-resistant and fully submersible. We see this as especially valuable in resource-poor domains, such as global public health or emergency medical services. Although the price point is not precise at this time, it will be priced so that several Clarius scanners could be purchased for the price of one traditional cart-based system.
ME e-mag: Where do you see such a portable, wireless device being most useful?
Dave Willis: Ideally, we see this as extremely valuable when you want to take a quick look at a patient. We see it as important for guiding anesthesia nerve blocks, anything musculoskeletal, line placements and emergency care. Also, anywhere that access to computed tomography or MRI is limited, it adds diagnostic information.
It gives you a good quick look and works well for telemedicine applications.
Ultrasound is very sensitive to blood in the abdomen and other parts of the body. We see it as a very useful first look in emergency care. We see it as extremely valuable in areas where access to radiology is poor or there is a long wait for CT or MRI. In remote emergency or trauma situations, a scan can be done and reviewed through a smartphone. It gives you a good quick look and works well for telemedicine applications.
One application that surprised us is obstetrics. But obstetricians told us that often ultrasound rooms are backed up, and that sometimes all that they need is a quick look to see whether the head is up or down, and to check the placenta. Another place that this might prove valuable is in home healthcare, which is replacing hospitalization for some patients.
Obstetricians can use Clarius to see whether the head is up or down, and to check the placenta (Courtesy of Clarius).
ME e-mag: Is this device unique?
Dave Willis: As far as we know, we are the first company to launch a wireless device like this. Another company has one, but our image quality is much better.
ME e-mag: How is Clarius addressing concerns about patient privacy and cybersecurity?
Dave Willis: We are using the newest encryption methods and think that our system is more secure than intra-hospital communications. We also are working to comply with HIPAA (the US Health Insurance Portability and Accountability Act). We do not think that Clarius scanners are vulnerable to hacking.
*Erroneously called Dave Wilson in a previous version.
It’s good to know your weight. But it’s even better to know your muscle, bone and fat mass, as well as your body’s water content. The French bioimpedance measurement specialist, Aminogram, is presenting its BIODY XPERT at MEDICA. The wireless device can deliver an extremely precise measurement of a person’s total body composition in just one minute. Alain Letourneur, Aminogram founder, explains how the CE- and FDA-certified product works.
ME e-mag: What is bioimpedance measurement?
Alain Letourneur:In bioimpedance measurements, a very weak current is passed through the body. At 400 microamperes, it’s not felt at all. The resistance of the tissues is calculated as the current passes through them. This enables us to quantify the different substances making up the body, which is essentially water, fat, protein and minerals. The technique has been in use for about 50 years, but has evolved a lot recently.
ME e-mag: Can you briefly describe how BIODY XPERT came about?
Alain Letourneur: Aminogram was founded in 2003. Our first product was Aminostats Bio ZM, the forerunner of BIODY XPERT. To measure the body properly, it must be measured in its entirety. The current must pass from one end to the other, from the hands to the feet. Aminostats used cables with electrodes at the end. The measurement used two electrodes on the hands and two on the feet. I wanted to simplify this to make it easier to use, with no cables to get tangled, and I wanted to increase accuracy. This requires making a direct connection between the hand and the foot. This is the principle behind the new BIODY XPERT.
ME e-mag: How is it used?
Alain Letourneur: The device is shaped like a claw. The patient holds it by the butt end, places the claw around the ankle and holds a button down for five seconds. The device’s four electrodes send the current from the hand to the foot, making the measurements. It’s very easy to use.
Once the measurements are made, the data is transferred via Bluetooth to the processing software on a computer, tablet or telephone. The information also can be stored in the device for subsequent processing.
In bioimpedance measurements, a very weak current is passed through the body (Courtesy of Nutrilog).
ME e-mag: What information will the software give us?
Alain Letourneur: We’re at the cutting edge of impedance measurement technology. This is a multi-frequency device which gives us a more complete scan of body constituents. For example, we’ll be able to distinguish between the percentage of intracellular and extracellular water. This will tell us if there is a proper balance between the two, a fundamental aspect of good health.
We’ll also be able to determine fat, muscle and bone mass. In addition, the response to the current will yield a certain number of indicators of good health.
ME e-mag: Who are the intended users?
Alain Letourneur: This type of device is basically for elite athletes, fitness centers and coaches. It also can be used in hospitals in the diagnosis of cancer, kidney failure and cardiovascular disease. We follow kidney transplant patients to see how their water content level changes. Kidney problems can provoke sudden jumps in hydration levels, which can be very dangerous. The device can reveal elevated water levels and determine whether they are intra- or extracellular. The only other way to measure that is via blood and urine analysis. BIODY XPERT measures this in five seconds and analyzes the results in one minute.
In general, a multi-frequency device costs between 7000 and 20,000 euros. Our product is available for 2000 euros.
ME e-mag: What are the most innovative aspects of this product?
Alain Letourneur: First, there’s the measurement system, which is extremely simple and rapid. Then there’s the price. In general, a multi-frequency device costs between 7000 and 20,000 euros. Our product is available for 2000 euros. This was one of our goals. I think this is a tool that is as indispensable for a doctor as a stethoscope or a sphygmomanometer.
ME e-mag: Will you be presenting other innovations at MEDICA?
Alain Letourneur: Yes. We’re also presenting BIODY LIFE. This device resembles BIODY XPERT, but is designed to be recommended by a doctor or a coach for home use. The doctor or coach will be able to keep track of the person’s measurements remotely. This is particularly useful for patients with kidney problems or for those on a diet. The doctor is alerted if things aren’t going well, and can check measurement history to see if the data are moving in the right direction. We’re working on using such evaluations in the fight against obesity. BIODY XPERT yields more information, but is only for professionals. With BIODY LIFE, we’re right in the middle of the doctor-patient relationship. It’s telemedicine.