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Innovation in the health care industry is seen by many as a way to address rising health care costs by improving technology, managing Big Data to develop best clinical practices, reducing pain and suffering or maybe even curing diseases.

Recent innovative developments in Michigan include a statewide telestroke program at the University of Michigan, a precision medicine program at Barbara Ann Karmanos Cancer Institute and a device that can identify pathogens developed by Seraph Biosciences Inc., a Detroit-based spinoff company of Wayne State University.

At Crain's 12th annual Health Care Leadership Summit, moderator David Ellis, a futurist and also head of the Detroit International Research and Education Foundation, led a three-member panel on a discussion about how innovation has changed medicine and patient care.

"I like to think that my colleagues here (on the panel) are representative of the people who are moving towards the speed of light, if not at the speed of light" to develop innovative clinical solutions, Ellis said. "Innovation is not just happening, but it is happening faster and faster."

Ellis asked the panel Mollie McDermott, M.D., a neurologist and stroke specialist with Michigan Medicine; Elisabeth Heath, M.D., a medical oncologist at Karmanos; and Greg Auner, a medical engineer at Wayne State University School of Medicine to describe the biggest innovation to happen in their field in the past five years and to project the next five years.

McDermott, who is the director of the telestroke program at Michigan Medicine, said the biggest innovation in her field is the widespread use of a special type of imaging called "perfusion imaging in acute stroke." This advancement can identify tissue that could be saved through the use of thrombolytic therapy, or "clot buster" drugs, in clogged arteries.

"When I started medical school, there were interventions available for stroke out to three hours from last known normal. And now that time has expanded to 24 hours with the idea that we're selecting patients who may benefit based on this specialized imaging. Stroke call has gotten very complicated," McDermott said. "It used to be, three hours and then you're done. Now we're getting called out to 24 hours. Decision-making is very complicated and there is a lack of vascular neurology expertise in our country."

McDermott said Michigan Medicine uses its telestroke program to pass along this vascular neurology expertise to small and rural hospitals where they don't have specialists trained in perfusion imaging.

Heath, who is Karmanos' associate center director of translational sciences, said the field of genomics and precision medicine more specifically precision oncology has grown tremendously over the past five years.

"Explosion would be a small word to characterize (the pace of change) because there's no meeting that you go to now in the world of oncology where that concept (using an individual's DNA to customize cancer treatment) is not discussed," she said.

Heath said Karmanos' partnership with McLaren Healthcare Corp., a 14-hospital system based in Grand Blanc, has been especially helpful in spreading knowledge of precision oncology throughout Michigan.

McDermott said the next five years for telemedicine will bring even more specialists closer to patients in helping to diagnose complex problems. "Patients (are) at home and trying to figure out, do I need to go to the emergency room? Do I need to go to urgent care? Do I need to set up an appointment with my primary care physician? Do I need to call 911? These kinds of decisions (influenced by telemedicine or virtual care) ... seems to be the next place we're headed."

Auner, one of the co-founders of Seraph, said individualized genetic analysis will transform cancer treatment. But the massive amount of data available will challenge researchers and clinicians going forward.

"Something that is quite interesting is deep learning (or) artificial intelligence that can gather through data from different sources, images, diagnostic signals ... and put that together and provide that as a tool," Auner said. "I see that probably is the biggest future breakthrough."

Heath said the next five years will challenge medical researchers because of all the clinical data on patients. "There's a fine line between a hoarder and a collector (of clinical data)," she said. "I would really like to be a collector, not a hoarder. And at this moment we're all hoarders of data and it's wonderful ... but really understanding what it means, especially if on a patient level, that's (another) discussion."

Ellis said one of the problems hospitals, doctors and health insurers have is trusting each other to share claims data and other medical records on patients to deliver appropriate care.

"One of the reasons for that of course, is purely technical. Not every system (electronic health record) is as good as the next and data breaches do occur," Ellis said. "That's got pretty severe implications."

But he said innovations occurring now to share "Big Data" using artificial intelligence and other systems could overcome trust and technical issues.

"I always see a solution. That's why I'm the perpetual optimist," Heath said. "As an oncologist, there's always a solution. I'm not saying it's right, but I think you have to have a plan" to share and use data.

McDermott said changing provider and hospital behavior is difficult. "We're taught basically from day one of medical school not to trust anybody. You have to verify for yourself, don't trust other people's exams," she said. "I don't trust research unless I have read the methods' section. So overcoming that is a cultural, not just a pragmatic phenomenon."

Auner said there is a "scary" aspect as clinical research becomes more individualized to patients "from the standpoint of what is known about a particular patient (and) knowing everything about you genetically."

For example, what if your genetic data and predisposition to disease or illness finds its way to your health insurance company? "(They) may then predict what's going to happen to you and how that may" affect your health and premium dollars charged to you or your employer.

"The knowledge of that can be unnerving," Auner said.

Heath said the big unanswered question out there is who owns the data. She wondered if patients own their data or does the health system, the university, the researcher?

"When you say it's in my medical record, that has a lot of implications when you're talking about genomic data," she said. "Is it just knowing that its the breast cancer gene itself? Is it knowing down to the nucleotide? Are you looking at things that exist only in the webspace because we can't house it in the computer? What is that sort of ownership from a patient level?"

Ellis said the reality is right now there are companies out there like Mark Zuckerberg's Facebook that contends if there is data out there "it's mine, I'll grab it. ... It's a free for all. It's the first come, first served."

Read more here:
Health care innovation moving at 'speed of light' - Crain's Detroit Business

This entry was posted on November 18, 2019 at 4:46 am and is filed under Genetic medicine. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |