Philippines - The future of healthcare

If you could skip the long hours of waiting in your doctor’s office and instead consult with her through Skype or FaceTime in the comfort of your own bed, would you?

If the market could produce a wearable device that monitors your vital signs, including the quality of your sleep or the air around you, and automatically send this data to your physician on a regular basis, would you buy it? If a robot could perform precision surgery on you, would you let it?

In a report entitled “Healthcare and Life Sciences Predictions 2020: A bold future,” the Deloitte Centre for Health Solutions posits that we are not very far from this new world of healthcare. Looking at trends, developments and small but bold steps in the healthcare marketplace, Deloitte researchers have made a number of exciting predictions that patients, healthcare professionals and life science organizations would find interesting.

1. Patients will become partners in their own healthcare

Even now, individuals are already better informed about their health and wellbeing, with some going as far as subjecting themselves to genetic profiling in order to learn about their possible future health issues.

This abundance of data will give rise to patients who expect a wealth of options from their healthcare providers – from the treatments available to them, to the timing of the treatment, to the place where they can receive these treatments, and the cost. In short, patients will become more like consumers. Related to that, Deloitte researchers expect a shift in the way healthcare providers relate to patients: from a paternalistic approach, there will be a more patient-centered approach to consultation and treatment.

2. Even medical care is going the digital route

Thanks to advances in digital communication, by 2020 much of medical care will take place at home. Web-based portals will allow doctor-patient contacts to happen in the virtual world and digital diagnostic tools will facilitate physical examinations at a distance. Locally, we are already seeing evidence of this future state in the likes of Globe’s KonsultaMD, which allows users to consult with trained medical specialists just by dialing a hotline.

The digitization of medical care will revolutionize healthcare productivity, reducing traveling and waiting times for patients, and will be particularly advantageous for the Philippines, where many people living in remote areas are medically underserved. In fact, the Department of Science and Technology has already made headway in this direction with the RxBox, a device that can store and transmit patient data electronically to allow health workers in remote communities to consult with physicians in urban areas. Several units of the RxBox are already in use around the country.

3. Wearables and mHealth, or mobile health, applications will help shape quality of life

Deloitte researchers predict that by 2020, the tipping point for broad adoption of wearables will have been reached. By this time, the devices will be interoperable, integrated and engaging, and the technology will be more sophisticated and yet much cheaper, allowing more people to opt in.

With the capability to monitor a broad range of physiology – from posture to brain activity – wearables will allow clinicians and patients to focus on self-management and prevention strategies.

One wearable that is expected to hit the market soon, for example, is designed specifically to detect falls as a result of an ailment and immediately alert family members and attending doctors to send help. Its inventor, Filipino-American Angelo Umali, got the idea for the device after his own grandmother fell and hit her head while at home. She eventually passed away due to an undetected blood clot.

4. Big data in healthcare will be pervasive

Now that there are more ways to generate, store and share healthcare data, clinicians and healthcare professionals will be in a better position to transform diagnosis and treatment to improve outcomes and healthcare productivity. Deloitte also sees pharmaceutical companies collaborating with patients and healthcare systems and using data to develop better treatments and launch them faster.

With the healthcare system recognizing the value of healthcare data, the regulatory environment for patient generated data will also improve, and consumers will have more control over how their data is used.

5. New regulations will encourage innovation through the convergence of science and technology

In 2014, most regulatory processes laid down by concerned agencies centered on the science behind drugs. With the pervasiveness of big data in healthcare, Deloitte predicts that by 2020, regulators will have adopted a more data-driven approach – based on patient outcomes – in assessing the quality, safety, and efficacy of prescribed medicine.

Deloitte also sees regulators investing in new capabilities to manage data and technology regulations. For companies in the healthcare sector, Deloitte predicts rising costs of regulatory compliance as more engaged participants – particularly patients – lead to a more rigorous approach to regulation and patient safety.

These are just some of Deloitte’s predictions for the healthcare and life sciences sector, but already we can see a world of developments and improvements that could literally spell the difference between life and death. It will be interesting to see which of these predictions fully take shape in the country and how that will make healthcare for Filipinos so much better,

The author is an Audit & Assurance Partner and the Technical Research Head at Navarro Amper & Co., the local member firm of Deloitte Southeast Asia Ltd. – a member firm of Deloitte Touche Tohmatsu Limited – comprising Deloitte practices operating in Brunei, Cambodia, Guam, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam.

Wilfredo a. Baltazar

manilatimes

Singapore - More programmes leverage tech for treatment beyond the hospital

This is part of ongoing efforts by institutions to spare patients the hassle of travelling unnecessarily, and move care back into the community.

Integrating technology into patient treatment is not new, but in the push to bring care closer to the community, healthcare institutions here have been coming up with new programmes and fine-tuning existing ones to get more patients to use technology at home.

Their goal is also to spare patients the hassle of travelling unnecessarily.

Mr Bob Sayers has been suffering from facial nerve attacks for more than a decade. The 71-year-old said the pain is "agonising" and he has turned to a programme called iACT-CEL, which enables patients to do therapy exercises at home instead of the clinic.

The programme was invented by Ms Yang Su-Yin, chronic pain psychologist from Tan Tock Seng Hospital (TTSH).

"I was able to do the first sections of this programme while I was overseas," said Mr Sayers. "It didn't detract from any information or conversations I needed to have with the psychologist, which is a wonderful thing."

The programme is both audiovisual and interactive, and has a whole range of pain management exercises. It also has a portal where patients can communicate with the psychologist if they have any questions.

The trial programme is open to patients in TTSH's pain management clinic, who are assessed to be suitable for it. The next step is to make it more user-friendly so it can better serve the community.

"It's also part of the general healthcare initiatives to move healthcare back into the community," said Ms Yang. "(This is so that) people who feel they may not need tertiary care can still have that support ... they are able to function well, but can come in when it's necessary and appropriate."

Moving care back into the community has also been the crux of the Telecare Programme, which has been implemented under the National Healthcare Group Polyclinics (NHGP) for the past three years.

Nurses and care managers conduct tele-consultations with patients who have well-controlled chronic diseases like diabetes or hyper tension. As part of the programme, patients submit their readings regularly from home.

There are now 259 patients in the programme, compared to 180 patients in December 2014. However, NHGP said that recruiting patients for this programme has been a challenge, so it is refining its selection criteria to recruit moderately-controlled patients with chronic conditions.

"Well-controlled patients usually have been well-controlled for a certain period of time," said Dr Simon Lee, Chief Medical Informatics Officer at the NHGP Office of Clinical Informatics. "As such, they may not see value in doing an additional step of keying the readings into the portal.

"But with the the moderately-controlled patients, by doing so, they would save themselves a physical visit through a tele-consultation. Secondly, the moderately-controlled patients would benefit more from frequent monitoring of their conditions."

NHGP has saved S$10,000 in manpower and productivity costs in the past three years, because its doctors do not need to spend as much time seeing patients who are on the Telecare programme, it said.

By Nadia Jansen Hassan

channelnewsasia

Thailand - Science Min pushing Thailand to be bioplastic hub of ASEAN

BANGKOK, 18 February 2013 The Science and Technology Ministry is pushing Thailand to become a bio-plastic hub of ASEAN within 3 years as well as to improve and preserve the environment.

Science and Technology Minister Worawat Uea-apinyakul said the ministry is cooperating with the National Innovation Agency and the Thai Bioplastics Industry Association in helping Thai bio-plastic entrepreneurs enhance their business capacity by transforming cassava into bio-plastics to replace polyethylene plastics which are very harmful to the nature. He is targeting to make Thailand the bio-plastic hub of the ASEAN region within 3 years’ time.

The minister said that the bio-plastic industry first started in Thailand in 2004, and has since been very profitable given it has created up to six-fold increase in added-value for cassava.

http://www.pattayamail.com

Vietnam - Made-in-Vietnam kidney dialysis equipment helps save billions of dong

VietNamNet Bridge – The self-regulating kidney dialysis machine created by Dr. Vu Duy Hai from the Hanoi University of Technology and his research team, is believed to help Vietnam save VND700 billion a year.

According to the Ministry of Health, about 10,000 Vietnamese patients need to have renal failure treated with hemodialysis with the frequency of three times a week, or 30,000 hemodialysis cases in total a week. It is estimated that for each case of treatment, every patient needs 10 liters of filtration fluid.

This means that healthcare centers need to use 300,000 liters of filtration fluid every week which must be imported under the mode of ready-made fluid. The average import price is VND15,000 per liter.

As such, it is estimated that Vietnam has to spend VND4.5 billion a week on the import filtration fluid alone. If it imports the product in powder and then prepares the fluid in Vietnam, the cost price would be VND10,000 per liter.

In order to reduce the treatment costs, some domestic healthcare centers have been preparing the fluid with their methods manually, because there has been no equipment which can automatically prepares the fluid.

Therefore, the information that Vietnam has successfully created a machine that automatically blends filtration fluid for kidney hemodialysis, which allows to save VND5,000 dong per liter, has been applauded by healthcare centers. As such, Vietnam would be able to reduce the treatment cost by VND700 billion dong because it doesn’t need to import filtration fluid any more.

According to Dr. Hai, there is no establishment in Vietnam that manufacturers the equipment to blend filtration fluid automatically. Meanwhile, the imports are expensive and sometimes are not suitable. The equipment created by Hai and associates is believed to settle the problem; therefore it is suitable in the Vietnamese conditions.

Hai said that if successfully generating high capacity automatic filtration fluid blending equipments, the products would be able to provide fluid at the same time to different kidney dialysis systems. The equipment allows mixing fluid in accordance with different formulas which fit different kidney dialysis systems now most popularly used at healthcare centers.

The successful creation and testing of equipment is one of the most important things in the process to improve the kidney disease treatment, which has always been a headache to Vietnam because of the overly high expenses.

The finding by Hai and his colleagues would play a very important role in the government initiated national program on making healthcare equipments domestically in 2011-2015.

If the product invented by the scientists can be utilized in a large scale at healthcare centers, Vietnam would not have to import expensive equipments, thus enabling to reduce the treatment costs and bringing more hopes to the poor patients.

Also according to Dr. Hai, the equipment which has been completely assembled is now running on a trial basis at laboratory. The research teams looks forward to receiving the state’s investment and support to continue the research work and put the equipment into commercial development.

Science reports showed that in 1990-2010, the number of patients suffering from chronic kidney diseases increased by seven percent per annum on average. In 1990, some 426,000 patients had to experience hemodialysis treatment, while the figure soared to 2 million in 2010. In Europe, one in every 10 people suffers from chronic kidney diseases.

Tia Sang

Singapore - Nanotechnology: Spotting a molecular mix-up

High-resolution microscopy reveals that a benzene-like molecule known as HBC has a quantized electron density around its ring framework (left). Theoretical calculations show that the observed quantum states change with different tip positions (right, upper/lower images, respectively).

Information within the bonds of molecules known as super benzene oligomers pave the way for new types of quantum computers

Scanning tunneling microscopy (STM) is routinely employed by physicists and chemists to capture atomic-scale images of molecules on surfaces. Now, an international team led by Christian Joachim and co-workers from the A*STAR Institute of Materials Research and Engineering has taken STM a step further: using it to identify the quantum states within ‘super benzene’ compounds using STM conductance measurements1. Their results provide a roadmap for developing new types of quantum computers based on information localized inside molecular bonds.

To gain access to the quantum states of hexabenzocoronene (HBC) — a flat aromatic molecule made of interlocked benzene rings — the researchers deposited it onto a gold substrate. According to team member We-Hyo Soe, the weak electronic interaction between HBC and gold is crucial to measuring the system’s ‘differential conductance’ — an instantaneous rate of current charge with voltage that can be directly linked to electron densities within certain quantum states.

After cooling to near-absolute zero temperatures, the team maneuvered its STM tip to a fixed location above the HBC target. Then, they scanned for differential conductance resonance signals at particular voltages. After detecting these voltages, they mapped out the electron density around the entire HBC framework using STM. This technique provided real-space pictures of the compound’s molecular orbitals — quantized states that control chemical bonding.

When Joachim and co-workers tried mapping a molecule containing two HBC units, a dimer, they noticed something puzzling. They detected two quantum states from STM measurements taken near the dimer’s middle, but only one state when they moved the STM tip to the dimer’s edge (see image). To understand why, the researchers collaborated with theoreticians who used high-level quantum mechanics calculations to identify which molecular orbitals best reproduced the experimental maps.

Traditional theory suggests that STM differential conductance signals can be assigned to single, unique molecular orbitals. The researchers’ calculations, however, show that this view is flawed. Instead, they found that observed quantum states contained mixtures of several molecular orbitals, with the exact ratio dependent upon the position of the ultra-sharp STM tip.

Soe notes that these findings could have a big impact in the field of quantum computing. “Each measured resonance corresponds to a quantum state of the system, and can be used to transfer information through a simple energy shift. This operation could also fulfill some logic functions.” However, he adds that advanced, many-body theories will be necessary to identify the exact composition and nature of molecular orbitals due to the location-dependent tip effect.

The A*STAR-affiliated researchers contributing to this research are from the Institute of Materials Research and Engineering
 

References

1. Soe, W.-H., Wong, H. S., Manzano, C., Grisolia, M., Hliwa, M., Feng, X., Müllen, K. & Joachim, C. Mapping the excited states of single hexa-peri-benzocoronene oligomers. ACS Nano 6, 3230–3235 (2012). | article

Vietnam - ASEAN-EU review science, technology ties

The Hanoitimes - The closing meeting for the ASEAN-EU Year of Sciences, Technology and Innovation 2012 (YoSTI 2012) was jointly organised by the SEA-EU NET project and the EU Committee in Brussels, Belgium.

YoSTI 2012, initiated in November, 2011, witnessed approximately 40 events in ten Southeast Asian countries and the EU. It aimed to boost scientific and technological cooperation between the two regions.

The event created favourable conditions for researchers and policy-makers to meet and discuss the results and benefits of research activities and the bi-regional cooperation potential.

The meeting’s reports revealed the key outcomes and impacts o­n the future of ASEAN-EU collaboration.

During the engagement, high-level policy-makers from the EU and ASEAN, as well as researchers, research managers and members of key research institutions assessed how synergy in science and technology between the EU and the ASEAN region can be created.

It was mutually agreed that the emerging scientific ties create opportunities for scientists to jointly explore new technology potentials, such as gene and nano-technology, increase agricultural productivity, figure out smarter approaches to produce and conserve energy, and seek secure provision of food and clean water in the two regions.

Singapore - Proposed law to address parentage of IVF babies

SINGAPORE - With a rising number of children born in Singapore through assisted reproductive technology (ART) such as in-vitro fertilisation (IVF), a new law is being proposed to clarify who their legal parents are.

Besides conferring legal motherhood on the woman who carries the child, the law will, more importantly, address issues of who the legal father is.

Currently, no specific legislation addresses the legal parentage of children conceived through such methods.

According to a Ministry of Health spokesman, in 2010, there were 1,308 babies conceived through ART. In 2006, only 720 were conceived through this method.

A month-long public consultation starts today on the Status of Children (Assisted Reproduction Technology) Bill, put forth by the Ministry of Law.

The Bill covers three broad scenarios: Firstly, if a child was conceived with the sperm of the mother's husband. In such cases, the husband will be treated as the legal father.

The second scenario is if the sperm used does not belong to the husband of the woman. In this instance, the husband will be treated as the legal father, if he had consented to the treatment.

Legal fatherhood is also applied if the husband accepts the child as a child of the marriage, even though he did not consent to the fertilisation procedure.

The third scenario is if the mother is unmarried, but the child is conceived with sperm from her de facto partner, or if the partner accepts the child as a child of the relationship.

In such a case, the mother, child, or partner can apply for the partner to be declared the legal father. However, the child will not be considered legitimate.

The proposed Bill will also address cases of mix-ups, when the wrong sperm or embryo is used, either through negligence or mistake.

In such scenarios, the woman and her husband who consented to the fertilisation procedure will be the legal parents.

However, for the other party whose sperm or egg was used mistakenly, he or she can apply to the court to be declared as the legal parent, voiding the legality of the previous parents. This must be done within two years of discovery of the mistake.

The public can view the consultation paper and draft Bill at www.minlaw.gov.sg and www.reach.gov.sg/YourSay/E consultationpaper.aspx.

The Bill is likely to be introduced in Parliament in the first half of next year, and may come into force by the end of next year.

Adrian Lim

My Paper 

Singapore - Microfluidic Chip Maker Wins Big At The Asian Innovation Awards

Singapore-based Clearbridge BioMedics has won three awards at The Asian Innovation Awards 2012.

Singapore-based Clearbridge BioMedics has won three awards at The Asian Innovation Awards 2012. The results were announced on Tuesday in Hong Kong.

The Awards are presented annually by The Wall Street Journal in partnership with Credit Suisse.

Clearbridge BioMedics took home the grand prize for The Asian Innovation Awards 2012, which recognizes innovations that improve quality of life or productivity. It also received the Credit Suisse Technopreneur of the Year Award, which honors technologies with the greatest potential for commercial success.

It beat out 11 other finalists who had been shortlisted from more than 240 applications.

As a bonus, it also won the Audience Choice Award, which was based on the votes of the audience at the event.

“Innovation and entrepreneurship play essential roles in driving economic growth across the Asia-Pacific region. My congratulations to Clearbridge BioMedics on their ingenuity and success in this year’s Asian Innovation Awards,” said Mr. Dan Molloy, global executive director for multimedia sales, Asia, for The Wall Street Journal.

Clearbridge BioMedics began as a spin-off company from the Faculty of Engineering at the National University of Singapore.

It is commercializing its proprietary ClearCell™ System to detect, isolate, and retrieve wholly-intact circulating tumor cells (CTCs) from small quantities of patient blood samples. The ClearCell™ System has achieved ISO13485 certification, and is available for the cancer research market.

“Clearbridge BioMedics is absolutely delighted and honored to win, not one but three awards, at the Asian Innovation Awards. We aim to further develop our ClearCell™ System into a health-care solution that will empower cancer clinicians and researchers to manage cancer in a more effective manner,” said Mr. Johnson Chen, Founder of Clearbridge BioMedics.

Source: Clearbridge BioMedicsc.

Asian Scientist Newsroom | Tech & Pharma

USA - Technology Fries Food with Minimal Oil

Technology developed by a food scientist at Purdue Univ. could cook food that retains its "fried" flavor and consistency and has up to 50 percent less fat and fewer calories than food cooked using conventional methods.

The radiant fryer was developed by Kevin Keener, professor of food science in the College of Agriculture. It uses energy similar to sunlight to cook pre-formed food items like chicken patties, hamburgers and hash browns. Food is placed in wire trays that travel down a conveyor belt with radiant energy elements on either side.

Keener says many foods sold at fast-food restaurants are partially cooked at a factory and quickly frozen. Restaurant workers typically use an oil immersion fryer to finish the process.

"The radiant fryer does not require additional oil to finish the process, which means the food that it cooks could have 30 to 50 percent less oil than food cooked with the traditional frying," he says. "The food could be more appealing because a person tastes more of the food's ingredients and less oil."

The radiant fryer improves upon oil immersion fryers in other ways, Keener says.

"Because the amount of energy used to fry foods can be adjusted, the cook time could be 30 percent faster than the cook time with an oil immersion fryer," he says. "There is little to no oil to handle, which means the radiant fryer could eliminate risks associated with oil fryers, including the thousands of injuries each year from workers being burned."

Keener says the technology could benefit officials who oversee school lunch programs.

"Kids are familiar with fast food, and they consume a lot of it each year," he says. "The radiant fryer cooks food in a way that simulates fried fast foods, but with fewer calories and fat. Using the radiant fryer could satisfy kids who crave fast food."

Although the radiant fryer currently works best with pre-formed, partially fried foods that are consistently shaped, Keener says fat content and calories could be further reduced by developing foods specifically for radiant frying.

"Obesity in the U.S. is a serious health issue," he says. "Radiant frying is a technology that can achieve desirable finished food qualities while reducing calories and fat content."

http://www.laboratoryequipment.com/

Singapore - Technology can be used to meet health-care needs – Minister

The Government will innovate and use technology in health-care facilities to meet increased demand and to lower costs.

Health Minister Gan Kim Yong said it is planning for future expansion and building this flexibility into the design of new health-care facilities.

He added that services should be "sensibly co-located" so patients do not have to walk too far when they go for laboratory tests, collection of medication and consultations, reported Channel NewsAsia.

"We want designs which support healing and allow for the introduction of new models of care," said Mr Gan.

He said that technology can also be used to help to lower health-care costs.

Facilities can be designed to make use of natural lighting and ventilation and to leverage on environmentally-friendly features to maximise energy savings.

Mr Gan made these points at the Healthcare Infrastructure Technology and Engineering Conference (HI-TEC) on wednesday.

The two-day conference was organised by MOH Holdings to share best practices.

Meanwhile, at the opening on wednesday of Medical Fair Asia and Medical Manufacturing Asia, Minister of State for Health Amy Khor said that a vibrant medical technology industry is important in helping to meet the needs of Singapore's ageing population and the rising expectations in health care.

The Suntec City fair showcases technology and new products in health care.

Ms Khor said Singapore's medical technology sector has grown significantly in the past decade.

Manufacturing output in 2011 stood at S$4.3 billion - about three times higher than in 2000.

The New Paper

AsiaOne

World - Multiple Prevention Technologies to Stop AIDS

Preventing the onslaught of the disease is as important as controlling it

There is growing emphasis on preventing the transmission of HIV as being easily as important as seeking a cure once the disease is contracted.

The recently concluded XIX International AIDS Conference in Washington, DC concentrated on a range of AIDS-related interventions, with prevention one of the most important.

"We have to address the needs, challenges and opportunities for development of multiple prevention technologies that would provide simultaneous protection against HIV, other sexually transmitted infections and unintended pregnancies" said Dr Helen Rees, Executive Director, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, South Africa, co-chaired a satellite session at on combination prfevention methods for women.

Dr Rees echoed what Badri Saxena, president of Microbicides Society of India, said to before the Wasington conference opened.

"There is not one preventive product for HIV,” Saxena said. “There have to be several tools available - microbicides, vaccines and, in some cases, male circumcision, among others. And there has to be better use of existing methods like the male and female condoms. When there was a big epidemic of HIV/AIDS in the 1980s America turned the tide by effective use of barrier preventive products like condoms and safer sex practices.”

For countries like India, Africa and China the healthcare delivery systems must improve the implementation and effectiveness of existing technologies, and then work for newer technologies, Saxena continued.

“This requires training of manpower, more public participation and safe sexual practices and behavior. In India non-HIV sexually transmitted infections like Human Papilloma Virus and cervical cancer are a big problem with an estimated 3 million people suffering from them every year. These people are at risk for HIV, so better control of such infections is more essential to prevent HIV in the country. New technologies are welcome because no one method suits all, and it is for men and women who are most at risk to choose."

Multiple prevention technologies for sexual and reproductive health, also called combination or dual technologies, include vaccines, microbicides and devices like intravaginal rings and diaphragms and are designed to address multiple sexual and reproductive health needs, including prevention of unintended pregnancies, sexually transmitted diseases including HIV, and other reproductive tract infections.

Multiple prevention technologies are some of the most innovative health products under development to simultaneously prevent unintended pregnancies and sexually transmitted infections including HIV. Technologies that are safe, acceptable, affordable and easily available can improve health across the world.

Promising innovations include multipurpose vaccines and gels, easier-to-use vaginal rings and single-sized diaphragms that may provide simultaneous protection against unintended pregnancy and infection and have a major impact on the health of women and their families. New microbicide gels can lead to declines in HIV and STIs while contraceptive technologies appropriate for dual use can increase the positive global health impacts of family planning.

The pipeline of multiple technology products currently relies on combining anti-retroviral drugs and hormonal contraceptives. At present one antiu-retroviral, tenovofir, has proof of concept as a topical agent and another, dapivirine, will enter clinical efficacy testing in rings in 2012.

Women worldwide bear the social, health and economic burden of unintended pregnancies and STIs which are great public health challenges. Unprotected sex puts women at simultaneous risk of HIV, other sexually transmitted infections and unintended pregnancy—all of which can impose heavy burdens on mortality and morbidity. Multipurpose technologies integrating contraception and prevention of HIV and other sexually transmitted infections would address these combined risks and, with improved uptake, enhance public health impact. Effective, safe and affordable such technologies would save lives and money and improve the health of women and their families worldwide.

According to the World Health Organization, every day more than 1,000 women die from preventable causes related to pregnancy and childbirth (358,000 annually) with 99 percent of these deaths occurring in developing countries. Also, 215 million women experience the unmet need of family planning as they lack access to information and services and/or support of their partners and communities.

This not only leads to population growth, but also compromises women's health and economic prospects. There are 86 million unintended pregnancies and 4 million newborn deaths worldwide annually, and 16.8 million women are living with HIV. For women in their reproductive years (15-49) HIV/AIDS was the leading cause of death and disease worldwide in 2009.

Women are five times more likely to get sexually transmitted infections than men. Each day about 500,000 young people, mostly women, contract a sexually transmitted infection. Africa and South Asia are the two regions hit hardest by high rates of fertility, HIV and HPV, all of which contribute to an unacceptable high percentage of women’s deaths in this region.

Different global regions have different reproductive health needs and public health priorities, so priorities for multiple prevention therapy research and development will also differ. So we need to identify products with highest potential for public health impact. Emerging therapies include drug combinations, drug and device combinations, bacterial therapeutics, multivalent vaccines and nano-particles. Key attributes of these devices should be: storage at high temperatures; long shelf life; concealable presentation; no life style effects; easy access in low resource settings. There is variability in needs/priorities across different regions. In sub Saharan Africa it is HIV and pregnancy with STI emphasis on HSV2, BV, TV and HPV. In India it is pregnancy and HIV. IN China it is HIV/STI.

Thus the path to an ideal MPT is not linear as there are many challenges to overcome - regional differences, unique product specific regulatory considerations, hormonal contraception and HIV relationship, trial designs to test efficacy without placebo control, and above all resources (money, trial capacity, participants, development partnerships).

Today’s technologies are not meeting the health needs of women. Current prevention methods for any major risk are limited, nonexistent or partner dependent and also there are many constraints on access to and use of available methods. Most available methods address single indications. there is an urgent need to bring together researchers, healthcare providers, policy makers, health care providers, policy makers, advocates, product developers and donors to develop MPTs to protect women against unintended pregnancies, STIs and RTIs.

Technologies that can simultaneously address multiple sexual and reproductive health and rights needs will go a long way in helping women. Such products can help policymakers meet multiple health and development goals.

The consequences of unsafe sex are among the greatest public health challenges of our times. Women and their families risk unintended pregnancies, as well as HIV and other infections, leading to maternal mortality, low rates of child survival and a poor quality of life. While their needs may vary according to where they live and their stage of life, all women could benefit by improved prevention methods for reproductive health. MPTs, though still in the development stages, can empower women and decrease maternal mortality, improve child survival and health, enable women to get better education and improve the economic opportunities for women.

Shobha Shukla

http://www.asiasentinel.com/

USA - The Usage of Tablets in the Healthcare Industry

Since they were brought to market, the healthcare industry has dreamed of embracing tablets and leveraging the innovative technologies and features innate to these types of mobile devices.

The ability to gather and access information with the touch of a fingertip, and carry it around wherever you go is invaluable for those working in this sector and a trend that is transforming the industry as we speak.

The launch of the first truly portable, user friendly and user experience (UX) rich tablet the Apple iPad, a revolutionary device in terms of mobile computing is changing the way in which the healthcare sector operates.

Regarding the iPad and other portable tablets, the healthcare industry was enthusiastic about their features and abilities, yet slow to jump on the bandwagon and truly adopt/embrace the technology. The reason for this slow adoption is primarily due to issues including security, privacy of patient information and data (regulations such as HIPAA), and integration with backend systems. Additionally, no one truly figured out how to create a compelling user experience for mobile applications in this space. There was a lack of understanding about which apps would be best suited for tablets in the healthcare segment.

This however, is all starting to change. The rapid adoption of tablets, including the iPad both in the consumer and enterprise world has put pressure on the healthcare industry to evolve and truly embrace this new technology. This pressure stems from increasingly prevalent industry trends and factors such as the Bring Your Own Device (BYOD) phenomena, the use of healthcare apps in the consumer sector, and the overall adoption of smartphones and other mobile devices by doctors, patients and vendors alike.  All of these trends have brought a whirlwind of change to the healthcare sector.

The pressure to evolve was felt by healthcare industry segment, as other segments of the industry were adapting mobile technologies at a rapid pace, and the healthcare industry was increasingly being viewed as laggards. Perceiving this weakness, many entrepreneurs started writing apps for this segment as they realized that doctors, nurses, pharmacists and other healthcare personnel had acquired tablets and smartphones but they were lacking the apps to do their day to day work using these devices. There was a vacuum in this space, and this reinforced the pressure on the healthcare industry to move fast and close the gap.

Let’s take a closer look at the evolution of tablet adoption across the healthcare spectrum:

Doctors and nurses were the early adopters of tablets, which is no surprise given they were also the early adopters of smartphones, and today, are the demographic that uses them the most in the healthcare industry. Drugstores followed doctors and nurses as they searched for better, more efficient and more convenient ways to serve consumers. Drug stores began leveraging tablets to offer prescription and non-prescription drug order applications and provide store and pharmacy locations as well as drug-related information to patients.

The pharmaceutical industry followed suit by developing apps and tablet-friendly mobile web sites that offered important information about the drugs to doctors, nurses and patients alike. The ability to access drug-related information on the go as well as a patient’s allergic information at the same time helps doctors and pharmacists to avoid prescribing and issuing medicine to patients that may cause them harm, thus saving lives and costly healthcare expenditure in treating unwanted drug interactions. Instant availability on patient and drug, disease and treatment information results in fewer cases of misdiagnosis, quicker and safer drug prescriptions, quicker approvals for Rx and a reduction in medical malpractice lawsuits.

The bio-tech industry soon hopped on board as they started adopting tablets for collecting observation data, field level monitoring and quick image capture using the highly advanced tablet cameras. Genentech is an example of a company that has embraced tablet use, having standardized and issued more than 7,000 iPads to its employees worldwide.  The tablets run customized native and mobile web apps that provide accurate reports including current state of research on the many drugs and treatments that Genentech is working on. It provides the dashboard customized for each user and a communications hub built on top of Apple Facetime and iChat that allows employees in its San Francisco headquarters to be connected over voice and video with field offices in 30 other locations worldwide. Genetech also uses tablets to collect the field information and patient data on clinical trials. Unlike the traditional data collection methods, iPads enable them to record audio, video and high resolution images of the patients and send them for processing and reference in a centralized repository.

Finally, hospitals, healthcare management facilities and institutions have now warmed up to the notion of tablet use. These organizations are starting to use tablets for patient monitoring, financials, inventory updates, notifications, communication as well as to manage task lists.  Stanford medical Center Hospital in Palo Alto, California and its affiliates across the nation, The University of California San Francisco (UCSF) medical center, Kaiser Permanente, the largest healthcare provider in US, The Washington hospital group among others now provides tablets to its doctors, paramedics, pharmacists and administrative staff. They use the tablets to schedule patient checkups in both outpatient and inpatient wards, issue and authorize prescriptions, record and transmit patient data in multimedia format and use instant live audio and video conferencing and chat features to enhance collaboration. This model is being rapidly adopted across the spectrum by healthcare providers in the United States.

There are several factors driving the change in how the business and processes run inside healthcare organizations. Healthcare organizations are moving from traditional methods of information collection and retrieval to a mobile and on site and on demand collection, retrieval, collaboration and communication in the healthcare sector.  Some of these changes are being driven by the doctors, some by patients and others by pharmacies. Additionally, bio-tech and pharmaceutical companies are in fierce competition which forces them to evolve and embrace new technology if they wish to be successful. On the provider side, no hospital or healthcare provider wants to be tagged as laggard and outdated in terms of technology adoption, which is causing these institutions to embrace tablets. It’s interesting to note that according to data collected by Manhattan Research, 81% of physicians used a Smartphone in 2011, up from 72% in 2010. Doctors, nurses and patients are demanding access to information on their tablets and smartphones, which is driving organizations to embrace tablets.

In a separate study conducted by American Electronics Association, doctors and patients were asked about how they would like to use wireless devices (smartphones and tablets). Most of the respondents wanted to use their device to communicate with their doctors, pharmacists and nurses and vice versa. Many of them also want to be able to store and access their healthcare records including diagnostic records online through the mobile device.

The figure below explains the questions asked and the response in detail:

What specific applications in the consumer and enterprise space are driving tablet adoption?( Conversely, what apps are driven by the adoption of tablets in the enterprise?).

The biggest use of tablets is driven by the fact that patients feel the need to stay in touch with their healthcare providers including doctors, nurses, pharmacists and health plan administrators at all times. Patients are connected to their mobile devices 24/7, creating a natural platform from which they can interact with their healthcare providers through applications.

A Healthcare IT Insights and Opportunities’ study conducted by CompTIA found that 38% of physicians with smartphones use medical apps on a daily basis. This figure is expected to rise to 50% by the third quarter of 2012.  It was also found that two-thirds of respondents consider implementing or improving mobile technologies to be a high or mid-level priority. Within clinics, doctor’s offices, hospitals and laboratories, the biggest usage of tablets stems from four main areas:

•    Patient monitoring and data collection – this includes using the Bluetooth enabled sensor devices and Wi-Fi+ Bluetooth enabled interfaces to patient monitoring devices, to medical instruments that can transmit information to the tablet when in the vicinity.

•    Dashboard and Reports – covering patients, prescriptions, diagnostics, legal, financial and operational information summaries and details

•    Appointment scheduling – this includes doctor and nurse visits, laboratory tests, reminders, re-scheduling, cancellations and delegation, doctor to assistant/junior doctor, nurse etc.

•    Prescriptions, authorizations, refills, patient-drug interaction and dosage management. Fast and timely approval of Rx refills and Rx authorizations means the difference between life and death in many cases and this is an area that smartphones and tablets help in reducing the turnaround time required by doctors to approve the requests from pharmacies and patents by up-to 90%.

What are the key advantages of using the tablets in healthcare space?

•    Tablets avoid cumbersome and error prone human data entry. They eliminate human introduced errors such as in data entry by feeding in data form patient care systems.

•    Tablets eliminate the need to record information on paper and enter into systems.  This saves time, energy, money and improves efficiency.

•    Easy information access: Tablets provide rapid access to information wherever healthcare personnel need it

•    Paperwork minimization: Tablets help minimize the messy paperwork and the manual workflow process – again, increasing efficiencies

•    Voice, Video, Image and Text: The visual, multimedia (audio, video) and graphics capabilities can be leveraged to record and provide on demand information such as the visual images of a patient, disease progression and sounds, such as an irregular heartbeat.

•    Communication capability: Allows doctors, nurses and other healthcare personnel to communicate virtually and more effectively

•    Privacy and Security of data: The iPad and similar tablets provide 128 and even 256 bit encryption of data on storage and transmission. This minimizes data leak and security violations from manual handling of un-encrypted paper forms and other hard copy documents

Where is the industry headed?

Tablets are gaining an increasing foothold in the healthcare sector across all segments. Tablets are improving patient care wellness programs, hospitals, laboratories, clinic management systems, pharmaceutical services and bio-technological advancements.

With doctors increasingly using their own tablets to manage and maintain their schedules and reminders, the healthcare organizations are now forced on building applications that are optimized for tablets.   These applications provide the integration of existing information systems, and introduce tablets as a form for both data gathering and dissemination of critical information.

New and emerging advancements in technology have enabled patient monitoring devices and instrumentation to communicate directly with tablets within a vicinity using tools such as Bluetooth. These devices can also upload patient data using a Wi-Fi network over the web, which can then be monitored in real time by nurses and doctors.

Increasingly sophisticated apps are being created, which cater to all aspects of healthcare management for usage by both healthcare personnel and patients. These apps range from providing dashboards for patient information, disease and condition monitoring to patient data collection and consolidation. Apps also help with business intelligence and analytics, scheduling and calendar management, prescription dispensing, pharmaceutical refills and authorizations, drugs and new treatment information, collaboration, and communication. In terms of tablet adoption in the healthcare industry, we have only begun to scratch the surface. With technological advancements increasing by the day, the possibilities are endless as healthcare professionals continue to search for better ways to provide care.

Rauf Adil

Rauf Adil is director of technology at Virtusa.

http://www.healthcareitnews.com/

USA - Why cutting-edge medical technology may not lead to exploding health care costs

Sophisticated medical imaging is often cited as a leading driver of health care costs. The increasing availability of techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET), while aiding large number of patients, has also made the treatment of disease and injury more expensive.

But as a new study co-authored by an MIT economist observes, the growth of such cutting-edge medical imaging procedures has slowed, suggesting that the diffusion of technology does not necessarily lead to steadily increasing health care costs.

Instead, in the paper — “The Sharp Slowdown In Growth Of Medical Imaging,” published this week in the August issue of the journal Health Affairs — MIT economist Frank Levy and David W. Lee of GE Healthcare suggest that a more selective use of high-end imaging is evolving within the medical profession. This transformation is likely due to the changing structure of insurance plans — especially the exercise of “prior authorization,” the preapproval of certain treatments — as well as increased concerns about the side effects of some imaging methods.

In turn, the findings suggest the need for a nuanced understanding of the ways new technologies are incorporated into medical practices over time — and of the relationship medical practices may have to America’s fiscal situation.  

 “There’s no chance of ever getting the federal deficit under control unless you can get health care costs under control,” says Levy, a professor of urban economics in MIT’s Department of Urban Studies and Planning. “But just to say technology is the driver, I think, is an easy way out in terms of looking at the system.”

‘More consideration’ of avoiding advanced imaging

The study by Levy and Lee builds on a 2010 Health Affairs paper by researchers at Thomas Jefferson University in Philadelphia, who showed that after a rapid expansion in advanced medical imaging, use of the technologies for Medicare recipients slowed in 2006 and 2007. Combining statistics for the government-backed Medicare system with data from commercial insurers, Levy and Lee found that the trend extended at least through 2009, and included patients enrolled in employer-sponsored health plans, too.

Specifically, from 2000 through 2005, use of CT scans among Medicare recipients (who are age 55 and older) grew by an annual average of 14.3 percent, but that growth then declined every year after 2005, falling to 7.1 percent in 2006 and 1.4 percent in 2009. Among Medicare enrollees, the number of MRI exams increased by 14 percent from 2000 through 2005, but only grew by 2.6 percent during the 2006 to 2009 period. And among a sample of 1.1 million non-elderly, commercially insured people in the study, the number of CT scans performed on patients increased by 20.4 percent from 2002 to 2006, but by just 3.1 percent from 2006 to 2009.  

Using data from commercial insurers, Levy and Lee, who is the general manager and head of health economics and reimbursement at GE Healthcare, found that about half of the slowdown in MRI imaging involved diagnoses of back, elbow and knee problems; essentially, doctors in those cases appear to have opted for more conservative treatments to deal with ailments that may only have been temporary injuries.

“Eight or nine years ago, the atmosphere [in clinics and hospitals] was that if you’re not doing a scan, you’re not doing modern medicine,” Levy says. “Now … there’s more consideration about whether patients really need a scan or not. And in a lot of situations, that’s totally appropriate.” The study also included interviews with doctors and benefits managers to shed light on their decision-making practices.

One external factor affecting these treatment decisions, Levy and Lee believe, may have been increased concerns about the exposure to radiation involved in CT and PET tests. (MRIs do not involve the same exposure to radiation.)

But the main reason growth slowed, the paper suggests, is because of new insurance arrangements. These include larger deductibles: The percentage of employees with a deductible of at least $1,000 grew from 10 percent in 2006 to 27 percent in 2010. Levy and Lee also cite the increased use of “prior authorization” in insurance, which requires general practitioners to conform to guidelines about the appropriateness of medical treatments, such as exams and medication. Congress’ 2005 Deficit Reduction Act, which reduced reimbursements for imaging performed in physicians’ offices, also played a role. This may have reduced the incentives for doctors to acquire, say, MRI machines for their own offices and then use them frequently to pay for that initial investment.

The new “fiscal pressure on the system,” Levy says, likely drove doctors to take a more moderate approach to imaging that would not have occurred “if money were not a problem.”

Changing the norms

As Levy notes, the study implies “no general conclusion that we’re always overutilizing technology in every area.”

Yet other researchers who have seen the study think the apparent connection Levy and Lee have found between insurance changes and the altered use of imaging may have parallels in other fields of medicine.  

“I find [the paper] very plausible,” says Richard Frank, a professor of health economics at Harvard Medical School. “It’s instructive for thinking more broadly about the kinds of things we need to do to bring down health care costs.”

To be sure, Frank notes, different medical disciplines “vary a tremendous amount.” However, he adds, “There are a lot of norms in medical practice, which adapt to the financial and management systems we have in place. And when we start to change those systems … it starts to change the [medical] norms in important ways.”

Jonathan Skinner, a health care economist at Dartmouth College, calls the paper “a landmark study,” and suggests a pair of further research questions deriving from the study: one, whether the slowdown in imaging led to a slowdown in the follow-up procedures typically related to imaging, and two, whether some kinds of health care providers were quicker to than others to scale back on unnecessary imaging.

For his part, Levy’s ongoing research on health care will continue to focus on imaging: He is working with a group of physicians at a major Boston hospital as they develop treatment guidelines to avoid excessive use of imaging technology.

Levy’s work has been supported by an investigator award from the Robert Wood Johnson Foundation.

Journal reference: Health Affairs   

Provided by Massachusetts Institute of Technology 

This story is republished courtesy of MIT News (web.mit.edu/newsoffice/), a popular site that covers news about MIT research, innovation and teaching.

http://medicalxpress.com/