e-HealthExpert.org - Primum non nocere

By Matthew Holt One of the most fun times at HIMSS last week was the MEDecision party at the Georgia aquarium. I took a few videos of the Fish and the humans—so something a little different for you all The...

The Third Eye Retroscope from Avantis Medical Systems (Sunnyvale, CA) is getting some good reviews in two studies just published in Gastrointestinal Endoscopy. The device works in conjunction with a standard colonoscope to look behind, kind of like a rear view mirror in a car. And as designed, this device is proving valuable in spotting polyps that would otherwise have gone unnoticed. From an Avantis Medical press release: The first study was led by Dr. Jerome D. Waye, Clinical Professor of Medicine at Mount Sinai School of Medicine, New York, NY. Titled “A Retrograde-Viewing Device Improves Detection of Adenomas in the Colon: A Prospective Efficacy Evaluation,” the study involved 14 investigators and 249 patients at 8 medical centers in the U.S.1 The investigators found that the Third Eye improved detection and removal of polyps by 13.2% compared to the colonoscope alone. For adenomas, the polyps that are most likely to become cancers over time, the additional detection rate with the Third Eye was 11.0% for lesions of all sizes. For medium-size adenomas (at least 6 mm in diameter), the additional detection rate with the Third Eye was 25.0%, and for large adenomas (at least 10 mm), they found 33.3% more with the Third Eye. Thus, the Third Eye not only allowed for identification of more polyps, but its greatest yield was in the detection of larger adenomas, which are further along in the progression to cancer. The second study was led by Dr. Daniel C. DeMarco, Director of Endoscopy at Baylor University Medical Center, Dallas, TX. Titled “Impact of Experience with a Retrograde-Viewing Device on Adenoma Detection Rates and Withdrawal Times during Colonoscopy: the Third Eye Retroscope Study Group,” the study involved 298 patients at 9 U.S. sites, and was conducted by 17 investigators who had not previously used the device.2 Overall, beginning with the very first time they used the device, the Third Eye allowed the investigators to find 16.0% more adenomas in addition to those they were able to find with the colonoscope alone. However, after each investigator had gained some experience with the device by performing 15 procedures, their average additional adenoma detection rate with the Third Eye compared to the colonoscope alone was 25.0%. Again considering their overall results from start to finish, the endoscopists found a higher proportion of larger pre-cancerous adenomas that were hidden from the colonoscope by folds, including 24.3% more adenomas at... Michael

Next week at the Intercompany Long Term Care Insurance Conference (ILTCI) in New Orleans, Robosoft a company out of Bidart, France, will unveil a new robot that can assist the elderly and dependent in their own home. Although the video below spotlights some impressive capabilities, the robot has no hands to bring you a cup of water and is essentially a Dell laptop on wheels. From Robosoft's press release: Kompaï is intended to help dependent persons in their daily lives. It is a mobile and communicative product. Somewhat like a dog, it has its "basket", which is the recharging dock that it heads back to when its batteries are low. Equipped with speech, it is able to understand simple orders and give a certain level of response. It knows its position within the house, how to get from one point to another on demand or on its own initiative, and it remains permanently connected to the internet and all its associated services. Its primary means of communication with people is speech, with an additional touch screen that features simple icons. Future generations of Kompaï will be equipped with visual abilities, and also the possibility to understand and express emotions. And later, the addition of arms will allow it to handle objects, leading to meal preparation and tidying; more practical functions, yet still fundamental in everyday life. Press release: Robosoft introduces Kompaï...... Michael

St. Jude Medical is touting results of a recently published study that analyzed the clinical benefits of frequent and regular left atrial pressure (LAP) monitoring in patients with heart failure. In the study, patients wore a special device, called HeartPOD, that monitored their LAP and routed the data wirelessly to their cardiologist. The physician, in turn, was able to adjust the prescription drug dosage taken by the patient on a daily basis. The results show that this leads to better overall outcomes for patients and a greater understanding of the condition for the physicians involved. The above picture was given to us by St. Jude Medical. And we think it has a clue as to the future of this technology. Imagine this kind of monitoring shows more and more positive outcomes in the future clinical studies, and it wins all needed regulatory approvals. One day we might be seeing these pressure monitoring sensors embedded into the electrodes of AICDs and pacemakers. Wouldn't that be neat? Results from this study demonstrated that regular monitoring of LAP in combination with a dynamically adjusted prescription plan can be used to drive appropriate adjustment of HF treatments, and as a result, improved LAP control and reduction of HF events that may result in hospitalization or death. Following implantation of an LAP sensor, all subjects in the study were free of major adverse cardiac and neurological events at six weeks, meeting the trial's primary endpoint. Over a median follow-up of 25 months, LAP control was achieved for at least six consecutive months in 76 percent of patients, with a 67 percent reduction in the frequency of elevated LAP readings (over 25 mmHg). Throughout this same period, there was a significant 84 percent average decrease in HF events including HF hospitalization and all-cause mortality once LAP-guided therapy was initiated. Over the course of treatment, patients also had significant improvements in HF symptoms and quality of life. The report outlined results of the first 40 patients enrolled in the trial; 20 patients enrolled in three Australian or New Zealand sites and 20 patients enrolled in four U.S. sites. The early results of the HOMEOSTASIS trial led to the establishment of the LAPTOP-HF (Left Atrial Pressure Monitoring to Optimize Heart Failure Therapy) Study, a larger pivotal, randomized, controlled, prospective, multi-center clinical investigation. The LAPTOP-HF study will be conducted under a U.S. Food and Drug Administration (FDA) Investigational... Michael

Nuance Communications (Burlington, MA), makers of the popular Dragon Naturally Speaking voice recognition software, have unveiled new smart phone apps specifically developed for clinical professionals. The Dragon Medical Mobile package provides transcription, medical voice search, and voice recording capabilities. There's also a software development kit (SDK) available to allow other firms to integrate Dragon Medical voice recognition ability into their own applications. By utilizing Nuance's advanced, cloud-based Dragon Medical speech recognition technology, clinicians can dictate and capture information via a smartphone in real-time without having to return to the desktop or rely on the keyboard or touch screen. With Dragon Medical Mobile Dictation, all of the speech recognition is performed in the cloud using advanced real-time streaming capabilities. Utilizing the same cloud-based speech recognition technology as the Dragon Medical Mobile Dictation app, the Search app will allow clinicians to simply speak a request to conduct fast and easy searches on various medical websites. A unique display carousel will show search results simultaneously from popular websites, including MedScape, MedLine, Epocrates and Google. Once recorded, the clinicians' voice file is forwarded through Nuance's background speech recognition technology and onto transcription where a high quality draft document is created and then is sent back to the clinician for review and sign-off. The Dragon Medical Recorder app is designed for healthcare organizations that leverage either of Nuance's enterprise-wide speech-enabled dictation and transcription solutions, eScription or the Dictaphone Enterprise Speech System. Press release: Nuance Extends Power and Experience of Mobile, Voice-Enabled Documentation and Search to the Healthcare Industry; Unveils Dragon Medical Mobile Apps for Smartphones ... Product page: Dragon Medical Mobile Technologies for Smartphones ...... Michael

Rcadia Medical Imaging out of Haifa, Israel won European approval for the COR Analyzer software for identifying coronary artery stenosis from coronary CT angiography (cCTA) data. The app runs on standard PCs and will automatically process CT angiogram studies sent to it over the hospital network. The application then replies whether it identified a stenotic legion, pointing out to radiologists or cardiologists the area of concern. Here's the application workflow and features of the COR Analyzer: Isolate the heart region within a study Find major anatomical structures Locate the coronary artery tree and track the arteries Label coronary artery segments Segment the blood vessel internals and draw an accurate center line Detect severe stenotic lesions Findings can be easily verified and validated using simple visualization tools including standard 2-D projections, schematic 3-D and curved MPR views. The system automatically generates a report which includes a summary of findings and curved MPR snapshots. It can be easily edited by the physician to produce the final report. The automatically generated curved MPR images with marked detected lesions can be exported to any PACS/Workstation either manually or automatically upon completion of processing. These images will appear as secondary capture series for the corresponding study. Main features Detects of significant coronary lesions Displays 3D coronary tree & curved MPRs Generates patient findings' reports Exports to PACS and workstation Runs on any 64-slice or higher CTA scanner Product page: COR Analyzer System ... Press release: Rcadia Medical Imaging's COR Analyzer(R) System Receives CE Mark ... (hat tip: MassDevice)... Michael

By MICHAEL MILLENSON The Joint Commission, which accredits four-fifths of the nation’s hospitals, is being accused of misleading consumers about the quality of care at those hospitals and then ignoring suggestions on how to correct the problem. “The organization that...

By PAUL LEVY What happens next in Massachusetts with insurance reimbursement rates now that many of the facts and figures have been made public? Here's what I see. The dominant parties in the state on whose watch the disparities in...

At New York-Presbyterian Hospital, we’re building technology and influencing policy that will shape the future of health care delivery. Visionary executive leaders are driving momentum in the movement toward a connected health information technology environment—the next frontier in modern medicine....

By BILL KRAMER As the health reform effort moves into the final stages, everyone seems to be taking a whack at health insurers. Some of the insurers’ wounds are self-inflicted, such as WellPoint’s announcement of 39% premium increase for individual...

By Matthew Holt Just when we thought things were calming down in the world of Health 2.0, it’s kicking off. WebMD has been watching Everyday Health take over its spot as top Health site ranking in the ComScore rankings (cue...

By Amy Tenderich We have just opened the 2010 DiabetesMine Design Challenge. This year, we’ll be selecting THREE Grand Prize winners to EACH receive $7,000 in cash and a support package to help winners realize and commercialize their design ideas....

Researchers at the City of Paris Industrial Physics and Chemistry Higher Educational Institution (ESPCI) have shown that opaque substances can actually be viewed through, and can be made to perform like optical lenses, using laser light and a bit of mathematics. The technology may allow viewing of cells and other biological components through tissue that would otherwise shield them. In order to demonstrate their approach to characterize opaque substances, the researchers first passed light through a layer of zinc oxide, which is a common component of white paints. By studying the way the light beam changed as it encountered the material, they were able to produce a numerical model called a transmission matrix, which included over 65,000 numbers describing the way that the zinc oxide layer affected light. They could then use the matrix to tailor a beam of light specifically to pass through the layer and focus on the other side. Alternatively, they could measure light emerging from the opaque material, and use the matrix to assemble of an image of an object behind it. In effect, the experiment shows that an opaque material could serve as a high quality optical element comparable to a conventional lens, once a sufficiently detailed transmission matrix is constructed. Abstract in Physical Review Letters: Measuring the Transmission Matrix in Optics: An Approach to the Study and Control of Light Propagation in Disordered Media Viewpoint in APS Physics: The information age in optics: Measuring the transmission matrix More: Physicsists find a way to see through paint, paper, and other opaque materials ...... Michael

ThermalTherapeuticSystems of Pittsburgh, Pennsylvania received FDA regulatory approval to market the VERATHERM Portable Hyperthermic Perfusion System in the US. The portable device provides cardiac perfusionists with the ability to regulate and monitor the temperature, pressure and flow of sterile fluids, such as cardioplegia. Features from the product page: Overall Console Dimensions: 12" x 19" x 14.7" [HxWxD] Weight: 26.4 pounds Computer: Touch screen controls, stores and manages procedure data Propulsion: 250-4000mL/min flow range Temperature Source: Direct thermoelectric Temperature Set-point: Warms fluid to maximum settable 43°C regardless of liquid or base temperature Temperature Monitoring: Built-in direct temperature monitoring In-line Pressure Monitoring: Built-in direct pressure monitoring Disposable: Proprietary design with integrated temperature and pressure sensors efficiently delivers sterile fluids Features: Disposable pressure and temperature sensors are built into the device; telescoping IV pole (37.5" extended height) Use and Location: Portable and fully functional wherever 115 VAC, 50/60Hz, 15 Amp power is available Storage: Shelf, storage closet or table-top Disinfection: Fluid is contained within the disposable set, so that there is no direct console contact with any fluid. This allows for quick and easy disinfection of the console. Press release: ThermalTherapeutic Systems Announces FDA Clearance of the VERATHERM(TM) Portable Hyperthermic Perfusion System ... Product page: VERATHERM Portable Hyperthermic Perfusion System ... (hat tip: MassDevice)... Michael

This Wednesday, March 10th at 4:30 CET / 7:30AM PST our FREE hour long webinar series will be highlighting the upcoming Health 2.0 Europe conference with our Parisian partner, Denise Silber of Basil Strategies. Joining in the discussion and presenting...

Biospace Med, maker of X-ray imaging systems out of Paris, France, just received FDA approval to use the firm's sterEOS 2D|3D workstation on pediatric patients to image the spine. The company claims that the system provides imagery competitive to that of CT scanners, but with only .1% of the radiation dose. Patients remain standing while the system simultaneously takes an X-ray from the front and laterally, after which a computer reconstructs the two frames into a three dimensional representation of the spine. This allows for quick imaging of patients in a weight bearing position while significantly reducing their radiation exposure compared with CT. From the press announcement: “FDA clearance for sterEOS pediatric use in spine will have a significant impact on demand for EOS as it will allow for the first time to visualize in 3D the spine deformations in the standing, weigh bearing position and retrieve fundamental clinical parameters for surgical planning. This is all done at a drastically reduced radiation exposure, and enables to repeat exams for a better follow up from childhood to adulthood,” said Peter Newton, M.D., Rady Children’s Hospital, San Diego, Ca. “Reduction of radiation exposure is especially important for children and adolescents who have scoliosis or other types of musculoskeletal disorders that are being followed on a frequent basis and therefore need to have regular x-rays over a long period of time to watch the progression of their condition and treatment. A technology that can reduce radiation exposure up to 10 times compared to a conventional x-ray and up to 100 or more times compared to a CT scan is a major breakthrough for orthopedic imaging, especially for the pediatric population.” Press release: FDA clears Biospace med's sterEOS 2D|3D workstation for pediatric use in spine... Biospace Med homepage... (hat tip: MassDevice)... Michael

At the Henry Ford Hospital in Detroit, Michigan researchers have been testing the effectiveness of a pulsed electromagnetic field device to help with pain and inflammation management in patients with osteoarthritis of the knee. According to Ivivi Health Sciences of San Francisco, California, the maker of SofPulse System, its device produces pulsed electromagnetic fields (PEMF) to induce micro-currents in injured tissues, which in turn are thought to act on the binding kinetics of calcium and calmodulin to increase production of nitric oxide which then reduces inflammation. Paint us skeptical, but hopefully the company is right on the physiology of its device. The findings of the latest study will be presented at this week's Orthopaedic Research Society's annual meeting in New Orleans. From a statement by the Henry Ford Health System: In the double-blind, randomized placebo-controlled study, 34 patients used a portable battery-operated device that emits a low-intensity pulsating electromagnetic frequency and experienced more than 40 percent pain relief on their first day. Patients strapped the small, ring-shaped plastic device around their knees for 15 minutes, twice daily for six weeks. The device was lightweight and patients could position the device directly over clothing. All participants were given a device with a coil that appeared to work but some were assigned active coils and others were given non-active coils. Press release: Electromagnetic Pulses Provide Pain Relief ... Product page: Ivivi's SofPulse ...... Michael

Dr. Steven Palter of Docinthemachine was given a chance to check out a new disposable HD endoscopic video camera. The device, made by Olive Medical of Sandy, Utah, has a 1080p resolution and will cost around $300 once regulatory clearance has been obtained. Here's from Dr Palter's post: I had a chance to speak with them about the system and they claim they are using a native HD imaging sensor chip. if so, they would be the first surgical camera system to do so. All other HD systems available today do not natively sense in 1080 but rather employ post imaging processing to upscale and modify the image. Their camera unit also includes integrated still image capture software eliminating the need for yet another $10,000-$30,000 box - although with obviously less features (no video, printer, etc). Here are two videos, one made with a "market-leading endoscopic camera" and the other with the new disposable HD cam. Olive isn't saying which one is which, so judge for yourself: Docinthemachine: First Disposable Single Use HD Endocopic System-DITM Exclusive... Product page: Olive Single-Use HD Camera ...... Michael

By David C. Kibbe and Brian Klepper A surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they've fallen off Democrats' broader health reforms. David Blumenthal and his staff have...

THCB would not exist without the support of our generous sponsors. So we'd like to give a shout to our friends at Eliza, our latest corporate sponsors. "Who says nerds can't talk to people? We use technology to engage people...