From the category archives:

Devices

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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Google Glass worn by Alex Pelletier croppedAlexandra Pelletier is a manager in the Innovation Acceleration Programat Boston Children’s Hospital. She directs the FastTrack Innovation in Technology Program, a hospital initiative to accelerate, rapidly develop and deliver innovative clinical software solutions.

Do you know the feeling of opening a new box with technology in it? I’m not a tech geek, but when my Google Glass arrived, with its crisp and simple packaging, my visceral reaction was “this is really cool.” Nonetheless, I’m approaching Glass carefully, because even the best technologies still require humans to use them. That means that they must be easy to use, must connect with other systems seamlessly and must offer value that makes its adoption worthwhile.

Google Glass is gaining some real excitement in health care. Each day my Twitter feed lights up with a new report of a hospital or practice trying it out. Here at Boston Children’s, we too are investigating the use of this technology through the Google Glass Explorer Program (watch Vector for more to come). We see promising potential for Google’s head-mounted display technology to transform communication and access to real-time information. Full story »

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CatScan-00663

Robert MacDougall is clinical medical physicist for Boston Children’s Hospital Department of Radiology. Michael Callahan, MD, is a radiologist in Boston Children’s Department of Radiology and a member of the steering committee for the Alliance for Radiation Safety in Pediatric Imaging.

A recent opinion piece published in the New York Times, titled “We Are Giving Ourselves Cancer” (Op-Ed, Jan. 31), has provoked fear and anxiety in patients and parents over the use of computed tomography (CT) scans. This op-ed is the latest in a series of lay press articles to focus on the potential harm of radiation in medical imaging.

While the authors raise several important points, they fail to provide context and acknowledge the benefits of CT imaging, including the elimination of many unnecessary surgeries and improved diagnosis of cancer and other serious health conditions. This unbalanced view potentially presents a real and immediate risk to patients, who may forego CT exams that could improve their care because of concerns related to radiation exposure.

The relationship between cancer risk and radiation exposure is not well understood. Estimation of future cancers in a large population is not based on sound science: The principal data source—studies of survivors of the atomic bomb explosions in Japan—does not translate well to medical radiation and can be misused to create sensationalistic estimates of future cancer incidence and deaths.

In a policy statement, the American Association of Physicists in Medicine explains: “Discussion of risks related to radiation dose from medical imaging procedures should always be accompanied by acknowledgement of the potential benefits the procedure provides. Risks of medical imaging at effective doses below 50 mSv for single procedures … are too low to be detectable and may be nonexistent.” The vast majority of routine CT scans fall well below this level.

Nonetheless, once an exam is ordered, it must be performed in the safest way possible. Full story »

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A project that set out to build better shunts ended with potential ways to help kids avoid them altogether.

A project that set out to build better shunts ended with potential ways to help kids avoid shunts altogether.

Shunts often are surgically placed in the brains of infants with hydrocephalus to drain excess cerebrospinal fluid. Unfortunately, these devices eventually fail, and the problem is hard to detect until the child shows neurologic symptoms. CT and MRI scans may then be performed to check for a blockage of flow—followed by urgent neurosurgery if the shunt has failed.

Early detection of shunt failure was the problem pitched last fall at Hacking Pediatrics in Boston. Two bioengineers, Christopher Lee, a PhD student at Harvard-MIT Health Sciences and Technology program, and Babak Movassaghi, PhD, an MBA candidate at MIT Sloan, took the bait.

“We heard that parents would not take vacations in areas without an experienced neurosurgeon around,” says Movassaghi, a former Philips Healthcare engineer with 32 patents in cardiology and electrophysiology. “We were intrigued to solve that.” Full story »

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nanomedicineGood things, including therapeutics, can come in small packages—and increasingly this means nano-sized packages. For a sense of the scale of these diminutive tools, a strand of human DNA is 2.5 nanometers in diameter.

Nanomedicine offers the promise of drugs that are activated by physiologic stimuli in the body (like the shear stress of blood flow that’s partially blocked by a clot), that can home to very specific targets in the body (like pancreatic islets that are being attacked by the immune system in diabetes) and that carry their own imaging agents—a built-in “metric” to show that they’re working. Biomaterials are being crafted to enhance their properties—like adding gold “nanowires” to heart patches to increase their electrical conductivity.

Vector’s new sister publication, Innovation Insider, looks at the promise and challenges of nanomedicine—both technical and regulatory. Read more about nanoscissors, theranostics, quantum dots and how the future is nano.

If you’d like to receive Innovation Insider in your inbox, sign up here.

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Health care data tsunamiIsrael Green-Hopkins, MD, is a second-year fellow in Pediatric Emergency Medicine at Boston Children’s Hospital and a fierce advocate for innovation in health information technology, with a passion for design, mobile health, remote monitoring and more. Follow him on Twitter @israel_md.

A few months ago, I spent 15 minutes filling out a detailed health data form at the doctor’s office. The paper form contained multiple questions about my health, family history, medications and basic demographic information. I assumed that an administrative specialist would code it into the practice’s electronic medical record (EMR) to be put to use. So it came as a surprise when I spent another 5 minutes reviewing the form with my physician, who then proceeded to type this information into the EMR herself. I’m confident neither my physician nor I felt enabled by the experience.

Countless people have had a similar experience—or worse, filled out a form with no sign that any clinician ever saw the information. Though the industry has made outstanding progress in adopting EMRs, the practice of data acquisition from patients remains cloudy. Patient-generated health data (PGHD), a term encompassing all forms of data that patients provide on their own, is a relatively new concept in health care. It falls into two broad groups: historical data and biometric data. Full story »

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Google logo with applesAlexandra Pelletier is the Digital Health Program Manager in the Innovation Acceleration Program at Boston Children’s Hospital. She manages the FastTrack Innovation in Technology Award, an initiative to accelerate, rapidly develop and deliver innovative clinical software solutions to improve patient experience and operational efficiency.

When the largest and most innovative technology companies in the world invest, radical disruption follows. Google and Apple, multibillion-dollar companies operating across the globe, are already deeply embedded into most of our lives. They now want to bring their network and reach to health care.

Their new investments could completely transform how patient data are captured and how information is shared. Through their big data capabilities, they’re well placed to rapidly evolve health care delivery processes. In the very near future, I expect we will see connected sensors or “smart” devices of all kinds begin to integrate into our lives, weaving a web of quantified data into actionable health information and changing how patient and care providers engage together.

Consider some recent events. First, there was Google’s buzz-generating meeting with the FDA. Full story »

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An early prediction of telemedicine

The TeleDactyl, as depicted on the cover of Science and Invention magazine in 1925.

Shawn Farrell, MBA, is Telemedicine and Telehealth Program Manager at Boston Children’s Hospital.

Back in the 1920s, when medicine was more an art than a science and doctors made home visits, a publishing and radio pioneer named Hugo Gernsback predicted the future of telehealth. As described on Smithsonian.com, he wrote of a device called the TeleDactyl: “a future instrument by which it will be possible for us to ‘feel at a distance’”—dactyl, from the Greek, meaning finger.

Since that time, the practice of medicine has changed dramatically. Our understanding of the human body has advanced beyond our wildest dreams, producing drugs, devices and procedures that have made hospitals a place for healing and curing. At the same time, home visits were abandoned in favor of the office visit, making doctors more efficient. Almost 100 years later, several converging forces are making the home visit popular again, increasing the likelihood of seeing Gernsback’s vision become a reality.

The rollout of the Affordable Care Act, which will add millions of new patients to the health care system, comes at the same time that we have a shortage of primary care doctors, specialists and other care providers. Full story »

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Delivering a baby MEG

by Kipaya Kapiga on January 15, 2014

This array of sensors surrounding a baby's head will give researchers and eventually clinicians an clear and sharp image of neural activity.

This array of sensors surrounding a baby's head will give researchers and eventually clinicians a high-resolution image of neural activity.

Imagine you’re a clinician or researcher and you want to find the source of a newborn’s seizures. Imagine being able to record, in real time, the neural activity in his brain and to overlay that information directly onto an MRI scan of his brain. When an abnormal electrical discharge triggered a seizure, you’d be able to see exactly where in the brain it originated.

For years, that kind of thinking has been the domain of dreams. Little is known about infant brains, largely because sophisticated neuroimaging technology simply hasn’t been designed with infants in mind. Boston Children’s Hospital’s Ellen Grant, MD, and Yoshio Okada, PhD, are preparing to launch a new magnetoencephalography (MEG) system that will soon turn those dreams into reality. Full story »

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Roulette_wheel2013 saw an accelerated crumbling of borders and boundaries in health care, fueled by technological and scientific advances. Boundaries between high-tech Western medicine and global health practices have begun blurring in interesting ways, as are those between home and hospital, patient and doctor and even a patient’s own body and the treatment used for her disease.

Last year also saw a fierce political fight over the Affordable Care Act (ACA)—aka Obamacare—ending in some six million people crossing the boundary from uninsured to insured, according to HMS, if you count Medicaid and Children’s Health Insurance Program eligibles.

What does all this portend for 2014? This year, Vector asked leaders from all walks of life at Boston Children’s Hospital to weigh in with their predictions. Full story »

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