The Smart Magazine About Medical Technology Innovations
According to many doctors and scientists, personalized medicine—or precision medicine—is the future. Patients will take highly customized drugs targeting the specific genetic drivers of their disease or condition. This subject, which raises a lot of ethical and regulatory questions, is a key topic at many healthcare events this year such as Analytica 2018.
In this issue, you’ll read that artificial intelligence could help revolutionize precision medicine. The implementation of blockchain technology could also drive the development of personalized medicine.
Artificial intelligence could revolutionize gene therapy and precision medicine, making individualized treatment protocols the norm.
When research began on the human genome in the early 1990s, many doctors anticipated an age of precision medicine (PM), with patients taking highly customized drugs targeting the...
By transforming the usability, security and accuracy of patient-related data, blockchain technology could benefit a range of stakeholders.
Blockchain technology has the potential to revolutionize healthcare and related services. By safely and efficiently maintaining growing lists of digital information, the blockchain’s decentralized public ledgers can boost health data security and interoperability, revenue cycle management and supply chain validation. This will bring secondary benefits to patients, healthcare providers, insurers and pharmaceuticals.
At its core, blockchain is a self-auditing, trustless, immutable database of peer-to-peer transactions built from linked transaction “blocks”. With no central controlling organization, this database is located in a network of personal computers called nodes. Gaining access to the system using cryptographic techniques, users are allowed to store, exchange and view information.
“Zero-knowledge encryption makes the patient the owner and controller of their own data.”
The blockchain is certainly not a cure-all for data management problems, but it is hard to think of many other industries that need improvements in efficiency and security like healthcare. Despite the widespread digitalization of healthcare records, the uncoordinated implementation of different systems and formats, even within the same organization, has made data sharing often a hugely complicated, unsecure and error-strewn process. In the U.S., for example, updating and verifying healthcare data is estimated to cost over $2 billion a year, while AI platform Protenus estimates that the security of 5.6 million U.S. patient records was breached last year alone.
“The main benefit of applying the blockchain to healthcare is the ability to create a single, traceable patient record available to every healthcare entity,” said Andy Park, CEO of Canadian blockchain solution provider Coral Health. “Real-time shared access to secure and validated health information will enable better patient care, allow widespread automation and drive down costs for companies and individuals.”
Development of Personalized Medicine
While the development and implementation of blockchain technology in the healthcare sphere is still in its early stages, the number of related startups and offerings is now rapidly proliferating.
With pilot programs set to launch in 2018, Coral Health is working to create a blockchain-based platform where patients can safely and easily view their fully updated healthcare records and send them to other stakeholders. For example, the company’s lab record app will allow patients to access and share their results with partner laboratories, reducing data transmission costs and driving the development of personalized medicine.
California-based startup doc.ai, which has already released its first private beta, is working to create a blockchain-based platform that facilitates the sharing of biological data between patients, scientists and research sponsors. “By enabling deep learning computation on potentially millions of biomarkers in people’s bodies, this can lead to personal health insights and the development of predictive models,” explained doc.ai co-founder and COO Sam de Brouwer. “People’s medical data then becomes a financial asset.”
Slovenian blockchain startup Iryo also hopes to disrupt medical data ownership by allowing patients to securely control their data. The company is building an open-source platform with zero-knowledge data repository (zero-knowledge encryption means that nobody but the user can access data). The system will be rolled out in Middle Eastern refugee camps in May. “Zero-knowledge encryption makes the patient the owner and de facto controller of their own data,” said Iryo CEO Vasja Bočko. “This means our system is highly resistant to cyber attack.”
Consumerization of Certain Elements
Blockchain technology providers still have to overcome many challenges, such as scalability and the consumerization of certain elements. Yet with interest from medical insurance companies also ramping up, offerings will continue to multiply. In the United States, five leading healthcare organizations, including insurers UnitedHealthcare and Humana, have just announced a pilot program that will apply blockchain technology to improve data quality and reduce administrative costs.
“If only one person has a telephone it’s essentially useless,” said Glen Ogden, general manager of Estonian blockchain pioneer Guardtime. “But as blockchain offerings for healthcare continue to roll out, so the financial benefits for their implementation will become increasingly compelling.”
Faster recovery time, reduced pain and minimal scarring—the benefits of robotic surgery have been recognized by the medical world for more than three decades. We talked to Dr. Roger Smith, chief technology officer at the Florida Hospital Nicholson Center, a pioneering hub for robotic surgery.
Nowadays, technology has...
>> Anass El Hilal, director and founder of MedTrucks.
MedTrucks is using patient mapping to fight against medical deserts by planning medical mobile unit services.
MedicalExpo e-mag: Why did you decide to develop this service?
Anass El Hilal
Anass El Hilal: While I was visiting remote places in Morocco, I met patients who had to cover very long distances in the heat with public transport to receive a dialysis treatment. So I decided to change this situation by bringing the hospital to the patient instead of the opposite. That’s why we decided with my team in Montpellier to create a “Mobile hospital” or medtruck in Morocco but also in France proving dialysis care in what we call “patient deserts.”
ME e-mag: How did you improve this concept already used in continent-countries like Australia?
Anass El Hilal: The medical trucks exist elsewhere. It’s only a tool bringing services and skills to the patient. Our main innovation is the use of data analysis to optimize the service in order to know which patient to visit, when, where and with which needs. So we use patient data from authorities, hospitals and care providers to map the needs and plan the service.
ME e-mag: Is this the answer to medical deserts?
Anass El Hilal: More mobility in general is needed to fight against medical deserts, yes, because they are increasing. We know for instance that general practitioners or dentists don’t want to be based in remote areas where they wouldn’t have enough customers. Our answer is to bring them to patients when they need them, by groups or zones, and to also guaranty them a large enough volume of work. So it’s good for everybody, patients, doctors and care providers.
ME e-mag: What are the limits of the system?
Anass El Hilal: Of course we are dependent on the road infrastructures, that’s the only main difficulty. But even in Morocco more than 2/3 of the territory can be covered by this mobile service. We can go almost everywhere with our medtrucks, in Africa but also in Paris where care is becoming more and more centralized in big hospitals. The mobility of care is vital and we can put almost everything in a truck: ophthalmology, radiology, cardiology. We are already preparing a dental care mobile service at the moment. It’s the future.
>> Dr. Devendra Raj Mehta, CEO and founder of BMVSS.
BMVSS (Bhagwan Mahaveer Viklang Sahayata Samiti) is the world’s largest organization rehabilitating over 1.55 million disabled. Based in Jaipur, India, the NGO is offering full assistance for disabled people, providing them with foot, knee and leg prostheses free of charge.
Jaipur Foot (Courtesy of Jaipur Beat)
ME e-mag: Could you explain how and who you are helping?
Dr. Devendra Raj Mehta
Dr. Mehta: Since 1975 when I created the organization, we have rehabilitated more than 1.7 million amputees and polio patients by fitting and providing artificial limbs, calipers and other aids and appliances. Last year, we had in total 81,166 patients from India and other 26 countries we are present in. Most of them, probably 99%, were poor people. So we are helping the disabled regain mobility and dignity and it’s completely free, thanks to the numerous donors supporting us.
ME e-mag: Most of your prostheses cost less than US $45 to be manufactured, how is this possible?
Dr. Mehta: I’ll reverse the question. Why does a prosthesis have to cost often more than US $10,000 as is the case in the U.S. or in France? Why do we need to use carbon which is 15 times harder than bone? Our technology, known as Jaipur Foot Technology, is different from the Western one. For instance, the structure of our Jaipur Foot uses very strong high-density polyethylene (HDPE) pipes. And for above the knee, our technology developed by the world-famous Stanford University uses a four-bar polycentric knee joint. So, by using this technology we manage to provide durable and high-quality prostheses. Our Jaipur Foot costs about US $12 a piece. The Jaipur Limb, including the foot piece, costs about US $65 compared to at least US $12,000 or more in Western countries.
Additionally, we provide patients with their prostheses within a very short period of time, usually in one day—all the process of registration and fitting of the prosthesis are handled very fast so our patients can walk, run, climb or drive at the end of the same day!
ME e-mag: Would you say that your prostheses are as good as the more expensive ones?
Dr. Mehta: Absolutely. Their quality is similar to the most expensive models. The best example is our Jaipur Knee. It costs us US $20 against US $10,000 for a comparable knee joint in the USA. This product was hailed by Time magazine USA as one of the world’s 50 best innovations in 2009.
>> Dr. Eric Schulze, CEO and founder of Lifetrack Medical Systems.
Lifetrack Medical Systems radiology equipment (Courtesy of Lifetrack Medical Systems)
ME e-mag: Can you explain to us how this platform works?
Dr. Schulze and his kids
Dr. Schulze: I started to create this software from scratch in 2003. It is a platform to help and train radiologists everywhere in the world. When you use it, the platform guides you through a work list of what you need to check and do. It works for the moment in 5 languages and it uses Google voice recognition technology to write down your comments directly in the file.
Plus, it helps you chose the exact classification for each case which is very useful for an efficient diagnostic of course. And since it’s multilingual and connected, radiologists can work side by side, one in Spanish and the other one in Vietnamese for instance, with the possibility for colleagues elsewhere in the world to read their comments in English. So it’s really a fantastic tool for radiologists, easy to use and super efficient even in the most challenging areas of the world.
ME e-mag: What makes this software a perfect tool for radiologists in developing countries?
Dr. Schulze: It’s specially developed for emerging markets, that’s why we made it super efficient, very simple to use, running on any existing infrastructures, and inexpensive. It works almost everywhere, even on basic equipment—all you need is electricity and a way to connect to the Internet. So thanks to 3-4-5G you can use it even in isolated areas and work directly with colleagues in Singapore or in the USA for instance. A lot of hospitals are already working with our platform in countries like the Philippines, Nigeria, Pakistan and Bangladesh.
ME e-mag: What is the most innovative part of this platform?
Dr. Schulze: Firstly, it’s definitely the fact that it’s helping radiologists everywhere in the world, even in the most challenging environments, and whatever the education of the radiologists. Secondly, it’s the fact that it’s teaching and constantly training the radiologists throughout the work lists and by working directly with other professionals. It makes their work much more efficient.
ME e-mag: It took you more than 10 years to develop it. What were the biggest challenges you had to face?
Dr. Schulze: The first challenge was to make a software able to read any kind of digital pictures on any device. Then, we managed to reach the Holy Grail of radiologists: the reporting structure with the full list of what they need to do in different comprehensive languages. Also, we had to work on the permission matrix which is usually a big problem. To make it easy, every professional on the platform can access all the medical data. Of course, private patients’ data is anonymous and encrypted.
As Japan gears up to host the 2020 Summer Olympics, a surge in visitors is expected, up from 28 million in 2017 to 40+ million the year of the games. Some of them will inevitably fall ill or become injured and will seek medical treatment. Wherever they come from, they most likely will be unable to converse in Japanese. This was a consideration for Fujitsu as it developed a hands-free, wearable speech translation device designed for use in hospital settings.
The Japanese Information Technology giant designed the product in partnership with Japan’s National Institute of Information and Communications Technology (NICT) and the University of Tokyo Hospital. The device is currently on trial in a medical institution in Japan, deployed for conversations between patients and doctors as Masanao Suzuki, director of the Digital Transformation Group at Fujitsu Laboratories, explained. The company aims to move to full commercialization in the coming months.
When asked what the biggest nuts to crack during the R&D phase were, Suzuki said: “It was challenging to develop the technology to detect speech as well as the technology able to identify the speaker’s direction, based on the voice of the user. It was especially challenging to achieve high detection accuracy in noisy environments such as hospital reception areas and laboratories.”
Filtering out Background Noise
While the human brain is remarkably deft at filtering out background noise, anyone who has ever used a voice recorder knows how electronic devices often struggle to do so. And in a hospital setting, background noise is ever-present: chatter in reception areas, the whirring of fans, the beep of heart monitors, the click-clack of shoes down a corridor, the ping of an elevator, the list is endless.
Speech translation device (Courtesy of Fujitsu)
To overcome this challenge, the hands-free wearable device uses a technology that involves creating an L-shaped sound channel that dampens sounds from directions other than the target direction. Fujitsu says the device has attained a 95 percent speech accuracy rate for conversations between healthcare providers and patients at a distance of about 80 cm.
Asked what makes their product different from others on the market, Suzuki said: “Although previous devices required users to push buttons to begin and end translations and switch languages, our device features a hands-free function that does not require button operations.” For now, the product works with three languages—English, Japanese, and Chinese.
As for the addition of other languages, Suzuki said: “This depends on the NICT as they developed the speech translation engine but I have heard that they plan to expand it to other Asian languages, as many Asians are expected to visit Japan” for the Olympics.
An artificial vision device for people who are blind or visually impaired, OrCam MyEye 2.0 improves the user’s vision using their ears.
“Our whole mission is to communicate visual information through audio,” Rafi Fischer, director of media communications at Israeli company OrCam, explained. “What OrCam MyEye can do is instantly and discreetly read any printed text from any surface—a newspaper article, a restaurant menu, or a computer screen text.”
The user points at the text he wishes to read, OrCam will instantly read the selected text.
The wearable device is the size of a finger. It can be fixed to almost any pair of glasses. “All you have to do is put it on and wear your glasses, and you are ready to use the device,” Fischer said. It consists of a small head unit with a miniature camera in front, and a speaker by the ear, so that only the user can hear the audio. The camera is equipped with LED lights.
Fischer showed three ways to trigger OrCam MyEye 2.0. First, he made a pointing gesture that showed the machine the text to be read. Converting the text into audio, the device started reading until Fischer interrupted it with another gesture. In the second scenario, the operator just tapped the side of the appliance to activate it. Whenever no text is detected, the device emits a little chime, and it also indicates if the text is upside down. In the last scenario, OrCam MyEye automatically detected the edges of a document held in front of it.
The product demonstration included a facial recognition test. OrCam MyEye automatically detected that “a man” had been introduced in the room. It took 15 to 20 seconds for Fischer to enter this new face into the device: “now when he (the colleague) approaches me I hear his name”, Fischer explained. OrCam MyEye learns and remembers people, and recognizes the stored faces.
Shopping is also made easier for OrCam MyEye users. It identifies bar codes and logos that are manually pre-registered. OrCam MyEye also reads local currencies and detects colors. “We built our algorithms to develop this text-to-speech reading to work offline,” Fischer said. “It all happens locally: no privacy issues, no reception issues.” In addition, the text that is read is not recorded.
OrCam MyEye is currently available in twelve languages in over twenty countries, and more are in the pipeline. Each version reads at least two different languages. A small drawback is the limited autonomy of its battery: “Using it constantly, it only lasts about an hour.” The device comes with a USB charger.
Seven to 100-Year-Old Users
“We have many thousands of users at this time,” the OrCam representative said. “The youngest is seven years old and the oldest 100 years old.” All users underwent a two-hour training session to learn to use the product.
The user points at the text he wishes to read, OrCam MyEye will instantly read the selected text. (Courtesy of OrCam)
Because OrCam MyEye communicates with audio, it adapts to a wide range of needs. “Our users typically have different sorts of eye conditions, such as macular degeneration, retinitis pigmentosa, cataracts, also people with severe dyslexia,” Fischer noted. Many of them shared stories with OrCam about how the device had empowered them and increased their independence.
“We are trying to add as many functionalities as possible to the device,” Fischer said. “One of the future things to look for is speech recognition.” This would allow users to ask OrCam questions directly without resorting to any motion.