Alexandra 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 »
The only time most of us ever look at an insurance claim is after a hospital or doctor visit, when we get a claim summary from our carrier. And then as far as we know, it gets filed away, never again to see the light of day.
But there’s a lot to be learned from these claims data.
As with electronic medical records (EMRs), behind every claim an insurer receives is a detailed record about symptoms, tests, diagnosis and treatment. Properly compiled and analyzed, claims data can be an excellent resource for taking population-level snapshots of disease, helping to identify trends and reveal or probe associations.
That’s why claims data recently caught the eye of Kenneth Mandl, MD, MPH, and Mei-Sing Ong, PhD, two researchers in Boston Children’s Informatics Program (CHIP). Using claims records for roughly 2.5 million Americans, they turned their attention to two conditions—epilepsy and asthma—with interesting results. Full story »
David Altman is manager of marketing and communications in Boston Children’s Hospital’s Technology and Innovation Development Office.
Successful therapeutic development requires multiple stakeholders along the path from discovery to translation to clinical trials to FDA approval to market availability. At various points along this path, academia, industry, government, hospitals, nonprofits and philanthropists may work together. Would bringing these stakeholders together from start to finish lead to greater success?
A growing number of private-public consortia are launching in defined “pre-competitive” spaces where potential rivals collaborate to generate tools and data to accelerate biomedical research. In 1995, consortia were rare in health care: Only one was created. In 2012, 51 new consortia were launched, according to the organization Faster Cures.
Why? you may ask. Banding together in consortia can reduce costs, minimize failures and shorten the timeline to approval for new drugs. Full story »
If you’ve ever watched Shark Tank, you’ve gotten a taste of venture capitalists’ (VC) innate skepticism and hard-nosed ability to triage ideas. A recent webinar hosted by Cambridge Healthtech Associates offered a good practical “101” for scientists, inventors and clinical innovators—which we’ve distilled into the six tips below.
1. Find the pain.
VCs will want to know what “pain points” you are solving—the burning need or unpleasant thing a customer wants to avoid or fix right now. In health care, this could be the need for a more definitive diagnostic test or a cost-saving option, or, for the pharmaceutical industry, the need to reduce R&D costs by finding a better way to pick compounds to take to clinical trial. Full story »
Did arbaclofen really fail in autism and fragile X?
Walter Kaufmann, MD, is co-director of the Fragile X Syndrome Program and a member of the department of Neurology at Boston Children’s Hospital. He was site principal investigator for three arbaclofen trials sponsored by Seaside Therapeutics and currently advises the company on data analyses. This post is second in a two-part series on clinical trials in autism spectrum disorders. (Read part 1)
The outcomes of drug trials in autism spectrum disorder (ASD) have, to date, been mixed. While atypical neuroleptic drugs have been effective for treating disruptive behavior in people with autism and are FDA-approved for that purpose, no available psychotropic drug has improved the core symptoms of ASD, such as social interaction deficits or stereotypic behaviors.
The heterogeneity—diversity—of ASD in both causes and symptoms may explain treatment failures to some extent. However, we have also lacked drugs targeting the brain mechanisms that underlie ASD. For this reason, targeted trials in fragile X syndrome, informed by neurobiology, have raised hopes of finally addressing core autistic symptoms.
Fragile X syndrome is a genetic disorder in which ASD occurs in 15 to 40 percent of cases. Initial results from a Phase 2 trial using the GABA-B agonist arbaclofen demonstrated relatively selective improvements in social avoidance in a wide age-range sample of subjects. Full story »
Good 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.
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The people who deliver care are starting to think in terms of population health.
A growing number of health care professionals are looking at their patients not just as individuals with unique concerns but also as members of larger groups with common problems and needs. This broader, population-based framework could lead to better health outcomes for more people, according to Jonathan Finkelstein, MD, MPH
of Boston Children’s Hospital.
“The health care system is changing from one that’s more reactive to illness—you come see the doctor when you’re not well—to one that’s more responsible for the promotion of health for defined groups of people,” he explains. While individual patients will always be treated as, well, individuals, the concept of population health can help providers “figure out the most appropriate services within a set of limited resources for specific groups.” Full story »
With appendicitis readmissions rates at some hospitals as high as 30 percent for children with severe disease, a group of children’s hospitals has started handing out comparative performance report cards to grade the way they diagnose and treat the condition. The quarterly reports are tools for hospitals to examine their performance across the entire scope of appendicitis care, prioritize quality improvement efforts and establish best practices.
According to Shawn Rangel, MD, a surgeon at Boston Children’s Hospital, the report cards grew out an effort to “understand high rates of preventable readmissions for complicated appendicitis.” A few years ago, Rangel and his colleagues began comparing appendicitis readmission rates at hospitals in the Children’s Hospital Association. The researchers found that the rate of kids readmitted within 30 days ranged from a low of 5 percent to a high of 30 percent for children with severe (ruptured) appendicitis. Full story »
On the minds of everyone involved in the care of sick children is the pressing need for more pediatric research funding. Last November, Congress finally passed the National Pediatric Research Act. It authorizes the National Institutes of Health to support a nationwide network of up to 20 pediatric research consortia, but it falls short of actually increasing NIH spending. Indeed, the next step in implementing the Act is to secure a specific funding commitment from the NIH or Congress.
Currently, only about 5 percent of NIH’s budget goes to pediatric research. Rather than wait for the government, an editorial in Vector’s new sister publication, Innovation Insider, proposes that foundations and companies become active participants in the consortia.
The prospects for such alliances are good. Patient advocacy foundations are increasingly active in research, and academic-industry partnerships are on the rise. At Boston Children’s Hospital alone, sponsored research and collaborations with foundations and industry have tripled from nine in 2009 to 29 in 2013. Alan Crane, MBA, a partner at Polaris Partners and an advisor to Boston Children’s Technology and Innovation Development Office, points out that drug discovery is much harder and more complex today than it used to be—just as many products are coming off patent.
Read more on what makes these partnerships work.
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Ed. note: This is the second in a two-part series on making clinical trial data more transparent. Click here for part 1.
To grossly oversimplify, there are two kinds of people in the world: those who want to see data from clinical trials made widely and freely available, and those who would rather have the data restricted for privacy or business reasons. And as we noted in our last post, there are valid arguments to be made on both sides.
But is there a way to balance the benefits of openness and the safety of confidentiality? Full story »