From the category archives:

Devices

Wearable health gadgets fitness trackers Apple HealthKit Google fit

Fitbit, Jawbone, Nike, Withings…a lot of companies are already in the wearable/mobile health technology and data tracking game. But a couple of really big players are stepping on to the court.

At their most recent Worldwide Developers Conference, Apple announced both an app and a framework—Health and HealthKit—that will tie in with various wearable technologies and health apps. HealthKit will also feed data into electronic medical record (EMR) systems like Epic, which runs at some of the largest hospitals in the country. And rumors abound that an upcoming Apple smartwatch (iWatch? iTime? Only Tim Cook knows right now) will carry a host of sensors for tracking activity and health data.

Google also wants to get into the game with a health data framework called Fit that they announced at their I/O conference in June. Unlike Apple, its strategy seems more focused on providing a standard way for trackers, devices and apps from different manufacturers to talk to Android Wear devices.

What will entry of these big players mean? We asked Michael Docktor, MD, clinical director of Boston Children’s Hospital’s Innovation Acceleration Program. Full story »

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(Pyh2/Wikimedia Commons)

(Pyh2/Wikimedia Commons)

Geoffrey Horwitz, PhD, is a business development associate in the Technology and Innovation Development Office (TIDO) at Boston Children’s Hospital. Follow him on Twitter @GeoffHorwitz

At the recent 2014 Biotechnology Industry Organization (BIO) International Convention, the message was clear: Digital health is the new blockbuster. For the first time ever, BIO spotlighted digital health, with a specific focus on how digital health is influencing the pharmaceutical and biotech industries. Also featured was a digital health zone where companies and other exhibitors from all over the world could demo their products and services to thousands of attendees.

In pharmaceutical lingo, a blockbuster is a drug that generates revenues of at least $1 billion. Digital health certainly fits this definition. By 2018, reports suggest that revenues will exceed $6 billion for wearable wireless devices alone. A recent McKinsey study found that 75 percent of consumers surveyed, of various ages and located throughout the world, would like to use digital health devices. Full story »

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a wave of wearable devicesProjections that the global mobile health market will boom to nearly $50 billion have ignited interest among innovators. A pair of physician innovators from Boston Children’s Hospital peg wearables as the technology to watch and offer a sneak peek at what adoption might mean, while others ask about the pediatric market for wearables and point to a few potential stumbling blocks. Read on for their views. Full story »

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Judy Wang, MS, is a program manager in the Telehealth Program at Boston Children’s Hospital. She is currently serving on the Mayor’s ONEin3 Council, which works on projects dedicated to maximizing the positive impact that young people have on the City of Boston.

young health tech entrepreneurs

(ITU/Rowan Farrell creativecommons.org/licenses/by/2.0/legalcode)

If you Google the term “millennials,” you’ll see that Google automatically fills in such search terms as “millennials lazy,” “millennials spoiled,” “millennials trophy kids” and “millennials entitled.” Ouch.

As part of the Mayor’s ONEin3 Council and a Founding Hacker for MIT’s H@cking Medicine, I could not disagree more with this assessment of my generation. I’ve observed young people increasingly drawn to civically minded work with public impact—including work in health tech. Full story »

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Drug-eluting contact lens

(Credit: John Earle Photography)

Growing up, my grandmother’s eyes were always a problem. For years, she was losing her central vision to glaucoma, and numerous surgeries and treatments did not seem to help. Later in life, she could not see my face but could always tell who I was when I was close.

Glaucoma is the leading cause of irreversible blindness worldwide. While FDA-approved medications such as latanoprost can prevent vision loss by reducing pressure in the eye, their beneficial effects are limited by poor patient compliance: At six months of treatment, compliance is estimated to be little more than 50 percent.

Why? First, the medications are typically delivered as eye drops, and the drops themselves can cause stinging and burning. The drops also contain preservatives that can cause ocular surface disease.

Perhaps most importantly, latanoprost and other glaucoma drugs halt the disease’s progression but do not reverse it. Taking the drugs does not provide positive feedback that will motivate patients, such as relieving pain. Full story »

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Rotenberg_AlexanderAlexander Rotenberg, MD, PhD, is a pediatric neurologist and epileptologist at Boston Children’s Hospital and director of the hospital’s Neuromodulation Program.

In recent years, electrical devices stimulating the brain or peripheral nerves have emerged as clinical and scientific tools in neurology and psychiatry. In 2014, the Food and Drug Administration has approved three tools at this writing: a device for treatment of epileptic seizures via electrodes implanted beneath the skull; a device for shortening migraine headache via transcranial magnetic stimulation (TMS) of the brain; and a transcutaneous electrical nerve stimulation (TENS) device for migraine prevention. (Click image below for details.)

Stimulating the nervous system to treat neuropsychiatric symptoms is not new. In the first century AD, the Roman physician Scribonius Largus documented treating headaches by applying electric torpedo fish to the head. Full story »

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heart chip BarthIt was the variability that intrigued pediatric cardiologist William Pu, MD, about his patient with heart failure. The boy suffered from a rare genetic mitochondrial disorder called Barth syndrome. While he ultimately needed a heart transplant, his heart function seemed to vary day-to-day, consistent with reports in the medical literature.

“Often patients present in infancy with severe heart failure, then in childhood it gets much better, and in the teen years, much worse,” says Pu, of the Cardiology Research Center at Boston Children’s Hospital. “This reversibility suggests that this is a disease we should really be able to fix.”

Though it needs much more testing, a potential fix may now be in sight for Barth syndrome, which has no specific treatment and also causes skeletal muscle weakness and low white-blood-cell counts. It’s taken the work of multiple labs collaborating across institutional lines. Full story »

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direct-to-consumer genetic testingLast November, the U.S. Food and Drug Administration issued a “cease and desist” order to 23andMe, a major purveyor of direct-to-consumer (DTC) genetic testing. In its letter to the company—issued after three prior warnings—the FDA reiterated its view that 23andMe’s Personal Genome Service (PGS) constitutes a medical device requiring further premarket evaluation:

FDA is concerned about the public health consequences of inaccurate results from the PGS device…we still do not have any assurance that the firm has analytically or clinically validated the PGS for its intended uses.

The FDA’s order, based on potential rather than actual medical harm, has generated a great deal of controversy. In a recent critique published in Nature, Robert Green, MD, MPH, of the Partners HealthCare Center for Personalized Genetic Medicine, and Nita Farahany, PhD, JD, of the Duke Institute for Genome Sciences and Policy, argued against regulating DTC genomic interpretation services as medical devices:

… doing so could put FDA regulations in greater tension with the First Amendment of the US Constitution, which protects the rights of individuals to receive information, and of ‘commercial speech’ ….the agency should avoid restricting consumer genomic testing unless faced with empirical evidence of harm. Full story »

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(Photo: Crossroads Foundation https://creativecommons.org/licenses/by/2.0/legalcode)

(Photo: Crossroads Foundation https://creativecommons.org/licenses/by/2.0/legalcode)

The United Nations global Millennium Development Goals (MDGs) for 2015 aim to cut mortality among children younger than 5 by two-thirds. As 2015 approaches, there’s a sense of hope: By 2012, the 1990 base annual figure of 12 million was nearly halved, in part through curbing infectious diseases.

However, two under-recognized, highly preventable chronic conditions—spina bifida and hydrocephalus—have not declined in low- and middle-income countries. Each year, there are an estimated 200,000 new cases of infant hydrocephalus in sub-Saharan Africa alone, and 100,000 neural tube defects in India alone. As other causes of death and disability recede, data suggest that spina bifida and hydrocephalus are gaining a larger share of mortality in young children.

A multi-institution conference at Boston Children’s Hospital on April 11 sounded a global call to action, convening a mix of surgeons, pediatric neurologists, international patient advocacy groups, food fortification proponents, health economists, obstetricians, neuroscientists and others. Many innovative approaches are being explored, including two that caught Vector’s eye. Full story »

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Last week, Boston Children’s Hospital’s Innovation Acceleration Program hosted a jam-packed Innovators’ Showcase where teams from around the hospital networked, traded ideas and showed off their projects. Here are a few Vector thinks are worth watching.

isotropic diffusion reveals information on axons on DTI1. An imaging ‘biomarker’ after concussion

Thirty percent of people who suffer a mild traumatic brain injury—a.k.a. concussion—have ongoing symptoms that can last months or years. If patients at risk could be identified, they could receive early interventions such as brain cooling and anti-seizure medications. New MRI protocols that can measure free, non-directional diffusion of water, coupled with sophisticated analytics, are achieving unprecedented pictures of what happens inside the brain after injury. Full story »

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