Vector has been deliberating about its predictions for 2013, consulting its many informants. Here’s where we’re putting our money this year; if you have other ideas, scroll to the bottom and let us know.
Genome sequencing scaling up at health care institutions
Last year we predicted genome sequencing’s entry into the clinic; this could be the year it goes viral. Technology companies with ever-faster sequencers and academic medical centers are teaming up at a brisk pace to offer genomic tests to patients. Just in the past two weeks, a deal was announced between The Children’s Hospital of Philadelphia and BGI-Shenzhen to sequence pediatric brain tumors; Partners HealthCare and Illumina Inc. announced a network of genomic testing laboratories; Full story »
A new spinoff business will make large-scale genomic diagnostics a reality in medical practice (Image: Rosendahl)
Genomic sequencing and molecular diagnostics are becoming a global business. At the recent American Society of Human Genetics meeting, dazzling technologies for reading genetic code were on display—promising faster, cheaper, sleeker.
Nevertheless, it’s become clear that the ability to determine someone’s DNA or RNA sequence doesn’t automatically translate into useful diagnostics or even actionable information. In fact, the findings are often confusing and hard to interpret, even by physicians.
That’s where academic-industry partnerships can flourish—tapping the deep expertise of medical research centers to bring clinical meaning to sequencing findings. Yesterday, Boston Children’s Hospital and Life Technologies Corp. announced a new venture with a great list of ingredients: fast, accurate, scalable sequencing technology—Life’s Ion Proton® Sequencer—but also research and clinical experience in rare and genetic diseases, bioinformatics expertise to handle the big data, and the medical and counseling expertise to create meaning from the results. Full story »
Inventions need a little extra incubating to make them attractive to health care.
Jenna Rose is director of Healthbox, a platform that brings together entrepreneurs, strategic partners, industry experts and investors to accelerate innovative healthcare solutions. She spoke recently at Boston Children’s Hospital at a forum sponsored by the Innovation Acceleration Program. She welcomes inquiries from entrepreneurs and others at [email protected].
When we think about the future of health, it’s generally medical science that captures our imagination—the source of groundbreaking pharmaceuticals, medical devices and diagnostics. But what about the business of health care? With the passage of the Affordable Care Act and the widespread adoption of mobile technologies, there has never been a better time to be a health tech entrepreneur. One recent report suggests that the healthcare IT sector could receive more than $1B in venture capital in 2012.
But change won’t be easy. As they seek to disrupt this $2.7 trillion industry, health tech entrepreneurs face a unique set of challenges. Full story »
What will happen to medically complex children if insurance coverage is reduced and fewer pediatricians are trained to care for them? (Image: Wikimedia Commons)
My first encounter with a children’s hospital was as a first grader in 1980, when my 5-year-old cousin was diagnosed with cancer. Although her family was challenged to afford her cancer treatments, St. Jude Children’s Hospital in Memphis welcomed her and treated her cancer into remission. I remember my parents saying, “Everybody in that hospital loves children. No child is turned away.”
In 1997, walking into the Children’s Hospital of Alabama as a medical student, I felt the same sense of hope and courage. Everyone on the staff believed that they could make a difference in the lives of the children and families, despite the horrific illnesses that many of the children endured. I knew, immediately, that I wanted to become a pediatrician and to learn how to care for sick children. Full story »
It’s been more than a decade since the Human Genome Project cracked our genetic code. DNA sequencing is getting cheaper and cheaper. So why isn’t it being used every day in medicine?
The truth is that while we have the technology to blow apart a patient’s DNA and piece it back together, letter by letter, and compare it with normal “reference” DNA, doctors don’t really know what to do with this information. How much of it is really relevant or useful? Should they be giving it back to patients and their families, and how?
Handled badly, the information could do more harm than good. “We don’t want to scare patients for no reason, or for the wrong reason,” says Isaac Kohane, MD, PhD, who chairs the Children’s Hospital Informatics Program.
Seeking a set of best practices for safe, clinically useful genomic sequencing, Boston Children’s Hospital took a crowd-sourcing approach. Full story »
Telemedicine has the potential to transform healthcare and lower costs. A new Massachusetts law requires insurers to pay for it—but with a potential loophole.
The mandate for broader access to health care in Massachusetts has brought millions of newly insured patients into the system. At the same time, the cost of health care in Massachusetts has continued to rise, and care access issues have emerged.
This past August, Massachusetts Governor Deval Patrick signed a new law that attempts to lower costs by shifting providers away from fee-for-service payment to alternative payment models (APMs) in which they incur more financial risk, and encouraging the development of accountable care organizations (ACOs).
One provision of this law requires insurers to pay providers for services delivered remotely via “telemedicine.” Full story »
The Gutenberg press disseminated ideas to a wider society. But in the clinical world, much information is still on "lockdown." (Wikimedia Commons)
The best things in life are free: friends, sunny days, beautiful vistas. Wouldn’t it be nice if knowledge were also free? Historically, libraries promulgated knowledge sharing because it was for the public good. We see this spirit increasingly embraced on the Internet – take the recent announcement of a collaboration between Harvard and MIT to make their courses freely available to users around the world via the edX platform.
But have we made all useful knowledge available in a way that allows for the greatest societal advancement? Not really. According to Ken Mandl, MD, MPH, director of the Intelligent Health Laboratory at the Children’s Hospital Informatics Program (CHIP), one important source of information still on lockdown is clinical trial data. In an article called, “Learning from Hackers: Open-Source Clinical Trials” published this month in Science Translational Medicine (not currently available in full text), Mandl and his coauthors call for making raw, de-identified clinical trial data free to the public. Full story »
National data suggest that up to 70 percent of sentinel events—the most serious errors in hospitals—stem at least in part from miscommunications. Communication problems are especially apt to occur during hospital shift changes, when a patient’s care is transferred to incoming doctors and nurses—known in health care as the “handoff.”
More than a year ago, a team led by Amy Starmer, MD, MPH, of the Division of General Pediatrics at Boston Children’s Hospital, developed and began testing a bundle of interventions to ensure that the hospital’s residents were thoroughly and accurately briefed on each patient’s medical history, status and treatment plan in a standardized way.
Through measures such as communications training, a mnemonic to help residents remember key information to pass on and a computerized handoff tool that integrated with the patient’s electronic medical record, they managed to move the needle: Medical errors fell by 40 percent—from 32 percent of admissions at baseline to 19 percent of admissions three months after the program started.
IDEO's Rodrigo Martinez believes we all have the power to improve people's lives by gleaning small insights from everyday interactions
“What is the purpose of healthcare?”To a room full of doctors, nurses and other healthcare experts at Boston Children’s Hospital, it was a startling question—justifying why they save lives was not part of their everyday experience.
“It may seem like a crazy question but it’s important to ask why we do what we do,” said Rodrigo Martinez, life sciences chief strategist from the international design firm IDEO, during a monthly Innovator’s Forum at the hospital. “Is it to care? Is it for us to feel better? Is it for us to have less emotional trauma in our lives?”
One audience member admitted that a lot of his time in the Emergency Department is spent reporting what he does. “During an eight hour shift, I may spend a significant amount of time recording all the things I’ve done to help a patient, but that’s time I’m not with the patient.” Martinez nodded. Full story »
Margaret Coughlin is a Senior Vice President and the Chief Marketing and Communications Officer at Boston Children’s Hospital.
Here at the TEDMED conference, it’s all about horizontal or lateral thinking – coming at problems from new directions, without regard to conventional boundaries. I like the thoughts of Edward DeBono (not a TEDMED speaker), who coined the term “lateral thinking” in 1967:
Some people are unhappy about lateral thinking because they feel it threatens the validity of vertical thinking. This is not so at all. The two processes are complementary, not antagonistic. Lateral thinking enhances the effectiveness of vertical thinking by offering it more to select from. Vertical thinking multiplies the effectiveness of lateral thinking by making good use of the ideas generated.
Lateral thinking is, in a way, an antidote to the way we’re all taught—vertically and specifically. Our education systems seem to be getting more vertical – more concerned with meeting prescribed benchmarks, and, in so doing, discarding the creativity and imagination of learning that is critical to real innovation and real forward movement. As for medical education, radiation oncologist and TEDMED speaker Jacob Scott said it has replaced creativity in the brain with a warehouse. Full story »
