March 2008

NEWS REVIEW – WORLD

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Camera Pills Detect Disease

A scanning fibre endoscope can be fitted into a casing usually used for covering medicines, and is small enough to be swallowed. This device records 15 colour images per second with a resolution of more than 500 lines per inch.

Developed by a team at the University of Washington, it has been designed to take high-quality pictures in confined spaces. Such a device may help detect warning signs of oesophageal cancer, and that too, at a cheaper cost.

The oesophagus is the section of the digestive tract that moves food from the throat down to the stomach. Oesophageal cancer often follows a condition called Barrett’s oesophagus, a noticeable change in the oesophageal lining, which is treatable.

However, due to huge costs, people get dissuaded to go for internal scanning, and they often end up developing oesophageal cancer. Unlike traditional approaches, the new endoscope has been designed in such a way that it would not require sedating patients during the scan. It consists of just a single optical fibre for illumination and six fibres for collecting light, all encased in a pill.

Cisco’s ‘HealthPresence Pod’ pilot tested in Scottish hospital

A new invention, known as ‘HealthPresence Pod’, developed by the leading American technology company Cisco, is being assessed in a series of world-first patient trials at Aberdeen Royal Infirmary in partnership with the Scottish Centre for Telehealth and NHS Scotland. Using the ‘Pod’, doctors will be able to examine and diagnose the conditions of patients living hundreds of miles away – monitoring a patient’s heartbeat, their temperature, blood pressure, and carrying out a number of detailed medical examinations without having to leave their clinics.

Eventually it is hoped that the virtual-reality surgeries could be housed in dedicated booths available for use by the public in community hospitals, community centres, and even supermarkets – improving the triage assessments currently being made by the out-of-hours NHS 24 service.

Currently the system is being tested in a small room within the accident and emergency centre at the Royal Infirmary with the “virtual-reality” doctor in a separate room only a few yards away.

The first fully fitted booth is expected to go on trial at a more remote location later this year – probably within a dedicated medical facility in Aberdeen – but eventually it is hoped that hundreds of virtual-reality GP surgery pods could be used to cover the country.

New medical imager detects ultra small breast tumors

A new medical imager with the potential to spot ultra small breast tumors has been developed by the research teams of the West Virginia University School of Medicine and the Maryland School of Medicine. The imager is adept at not only detecting tumors but also in guiding the biopsy of suspicious-looking breast cancer lesions.

This medical imager provides image resolution below two millimetres while in a regular PET, the image resolution is over five millimetres. Also, the initial tests showed that the PEM/PET system could complete an image and biopsy in about the same amount of time as a traditional biopsy.

The ability of the device to do a biopsy is probably one of its most unique characteristics. The PEM/PET system has components designed for imaging the unique contours of the breast. Known as positron emission mammography (PEM), this imaging capability enables users to attain high-resolution, three-dimensional PET images of the breast.

If a suspected lesion is discovered, the biopsy is performed with a person-controlled robot arm. The system is especially useful in imaging tumours in women who have indeterminate mammograms because of dense or fibroglandular breasts.

NHS urged to partner pharma industry

New guidelines issued by the Department of Health, call for more partnerships between the NHS and drug companies, stressing they should be “of mutual benefit with the principal beneficiary being the patient.”

In response to which, a spokesperson for the British Medical Association said that, “If there are clear, transparent guidelines so that the clinical freedom of doctors is not compromised, the BMA does not see why there cannot be closer cooperation between the NHS and the pharma industry. However, we would need to see the full details of individual planned projects before commenting fully.”

The department of health cited examples of successful joint working, including East Lincolnshire primary care trust’s partnership with three drug companies to identify sufferers of chronic obstructive pulmonary disease, train clinicians and establish clinics, which helped cut admissions by nearly a quarter.

Portable, inexpensive ‘lab-on-a-chip’ a hit

It’s common knowledge that to carry out genetic tests, one would need expensive, state-of-the-art laboratory. But that might soon change thanks to a group of Canadian scientists who’ve developed a “lab-on-a-chip” device to conduct these tests. What is interesting about the device is that it’s supposed to be portable, inexpensive and efficient.

A team from the University of Alberta, have developed a US$ 1,000 device the size of a shoebox that can conduct genetic tests and deliver results in less than half an hour. Elaborating on the innovation, the researchers said that miniaturization is the key factor that has drastically brought down the cost of this gadget.

Life science technologies they said, do exist, but aren’t being utilized optimally because they’re very expensive. Hence, the key to this mini-laboratory was to integrate, shrink and automate. The ability of the device to implement a very wide range of tests on a standard platform quickly and inexpensively would make it indispensable for the future.

The research team believes that their miniature lab-on-a-chip will provide cancer patients with quick genetic tests, in turn speeding up treatment processes and that the device may be useful in finding genetic signatures for particular viruses or bacteria or for testing the quality of water and so on.

UAE to adopt WHO disease alert system

The World Health Organisation (WHO) has finalised and deployed a regional disease alert system that will soon be adopted by the UAE.

A spokesperson for WHO (Eastern Mediterranean Region) said the system has been tested and implemented 90 per cent in Tunisia as a pilot country. The system has been presented to the AGCC utive Board of Health Ministers’ Council for approval but the system is expected to be in place in all GCC countries before the end of this year. Under the system, the UAE will report disease outbreaks to WHO, which will have access to all the data and will use the appropriate information to display on its website.

WHO has opened strategic health operations centres in the GCC region for reporting of avian influenza where notifications can be received round the clock. The countries have also developed national plans to combat diseases.

WHO is also monitoring trends such as lifestyle diseases in the UAE, where there is a noticeable shift from communicable diseases such as malaria, polio and tuberculosis, to lifestyle diseases such as obesity, diabetes and hypertension causing deaths.

�33m aid to boost telemedicine throughout Wales

The Assembly government of Wales has ear-marked �33m to be spent on new machines and communications technology that allow healthcare professionals to link-up better. The new technology will mean patients’ test results can be looked at by doctors at other hospitals and practices via so-called telemedicine.

The Health Minister Edwina Hart said: “The allocation of this �33m will help the NHS deliver better services for patients, including access to diagnostic tests, such as scans… Our aim is to provide as many services as close to the patient as possible… The increasing use of telemedicine will reduce the need for patients to travel.”

But Liberal Democrat health spokeswoman Jenny Randerson said: “I will be asking the minister detailed questions about the bidding process because of the stark contrast between the more than �18m for mid and West Wales compared with less than �5m to south-east Wales. “I will want to be reassured that the money has been distributed on the basis of clear clinical need rather than on a first come, first served basis.”

BMJ, Cerner collaborate to provide better information to doctors

BMJ Group has entered into an agreement with Cerner Corporation to integrate its evidence-based medical information with a range of solutions offered by Cerner in the UK and internationally.

The first outcome of this collaboration will be the introduction of Order Entry sets for the hospital sector which brings together BMJ Group’s evidence-based research database, BMJ Clinical Evidence, with Cerner Millennium(r) software.

BMJ Clinical Evidence is a compendium of the latest research evidence. It sums up what’s known – and not known – about more than 200 medical conditions and more than 2,000 treatments and is an invaluable tool for any health professional wanting to base their clinical decisions on the best available evidence. It is widely used by healthcare professionals as a trusted evidence-based resource.

While the Cerner Millennium is a healthcare information technology computing platform that helps health professionals connect to the centralised Cerner Millennium electronic patient record to access vital information for effective decision-making. Combining technology with knowledge, Cerner Millennium empowers health professionals to order tests and track results, make diagnoses, prescribe, dispense and document care using a single information system.

This combination automates and unifies patient information and clinical content, improving the quality of patient care by giving hospital staff access to the latest clinical evidence, empirical data and best practice.

XTend Medical launches diabetic telehealth program

XTend Medical Corporation has begun a remote diabetic monitoring program with a target of 500 patients to be part of the initial program.

The program, facilitated through local physicians in Southern California, will remotely monitor diabetic patients through the XTend Medical Disease Management Program. The patients will be able to take their glucose readings and transmit the results to the participating physicians via the Eocene transmitter.

Once the glucose meter is cradled to Eocene unit, the plug-in system utilizes a standard phone line to send the encrypted patient data to a central server for review by the physician. Once the data is reviewed by the physician, then any adjustments in medication, compliance with testing, and/or any necessary follow-up visits can be relayed immediately to the patient.

The system is designed for physicians to be able to closely monitor diabetic patients from their office while the patients maintain their regular daily lives in their own homes. XTend Medical is now poised to implement this system nationwide to any healthcare company looking to remotely monitor their diabetic patients.

Surgical Robot Improves Hip Surgery Success Rates

UK scientists have developed a surgical robot that makes hip operations extremely simple. Generally, surgeries that involve using chrome alloy to resurface the ball of the hip joint are extremely difficult and need years of experience to perfect.

However, using the new technology for ‘virtual’ operations, even untrained students were able to achieve high levels of accuracy.

Researchers said that inexperienced surgeons often face a steep learning curve to gain the experience necessary to carry out hip resurfacing operations. Until now, this has only been gained through repeatedly performing the operations.

This can cause problems because if hipbones are repaired incorrectly wear and tear occurs, requiring patients to undergo further painful and expensive corrective operations.

Developed by PhD students at Imperial College London, the Wayfinder is similar to GPS navigation systems; it senses the movement of the surgical tools and compares it to detailed images of the bones. It therefore enables surgeons to see a ‘real-time’ virtual model of the progress of the operation. The robot then plots where surgical incisions should be made and calculates the correct angles for inserting chrome alloy parts needed to repair the hipbone.
In a study, it was found that students were able to carry out the procedure three times more accurately compared to when they used traditional methods to manually navigate the joint.

Clinical trials of the device are presently being carried out at Warwick Hospital, Bath Hospital, Truro Hospital and the London Clinic.

Philips led HeartCycle project to help heart patients

Royal Philips Electronics will lead a new European Union (EU) funded research project aimed at improving care of heart patients through the development of innovative telemonitoring solutions. The ‘HeartCycle’ project will be one of the largest biomedical and healthcare research projects within the EU.

The HeartCycle consortium aims to improve the quality of care for coronary heart disease and heart failure patients by developing systems for monitoring their condition at home and involving them in the daily management of their disease. These systems will comprise unobtrusive sensors built into the patient’s clothing or bed sheets and home appliances such as weight scales and blood pressure monitors.

Dedicated software will analyze the acquired data, that can be programmed to provide feedback on the patient’s health status, plus his or her adherence to prescribed therapies and progress towards achieving health status milestones. It will also report relevant data back to clinicians automatically so that they can prescribe personalized therapies and lifestyle recommendations.

Public and private partners from 18 research, academic, industrial and medical organizations from nine different European countries and China will team up in the project. HeartCycle will run for four years and has a budget of approximately 21m, of which approximately 14m will be funded by the European Union as part of the EU 7th Framework Program.

Cardiovascular disease kills around 1.9 million people every year in the EU, with the associated annual health costs estimated at 105bn. Around half of these deaths occur in people who have previously had a heart attack, most of whom will develop heart failure before they die.

Google, Cleveland Clinic team up on medical data

Web search company Google Inc is collaborating with Cleveland Clinic (US) to pilot an exchange of data that puts patients in charge of their own medical records.

The health care industry has been trying to usher in a paperless era for more than a decade, holding out the promise that electronic medical records would bring significant cost savings. However, only a tiny minority of hospitals and primary care physicians use electronic medical records even today.

Google says it chose the Cleveland Clinic because it is one of the relatively few health institutions with an electronic system already in place. Its eCleveland Clinic MyChart stores medical records of 100,000 patients.

The Cleveland Clinic now plans to enroll 1,500 to 10,000 patients in a test of the secure exchange of medical data, including prescriptions, conditions and allergies, between its systems and a secure Google profile in a live clinical delivery setting.

The goal of the model was to allow patients to interact with multiple physicians, health care service providers and pharmacies. The pilot will eventually extend Cleveland Clinic’s online patient services to a broader audience and allow patients to take their medical data with them wherever they go.

This collaboration will help Google test features and services that will ultimately allow all Americans to direct the exchange of their medical information between their various providers without compromising their privacy.

t+ provides LifeScan patients remote access to data

Telemedicine specialist t+ Medical has partnered with LifeScan to take data from blood glucose meters and wirelessly transmit the information to a central database.

Using intelligent algorithms, information from LifeScan’s One Touch Ultra system will be analysed and translated for patients into simple graphs, which can be viewed on their mobile phone or a personal computer.

Though both companies are based in the US, the partnership will also apply in Europe where t+ Medical works with a number of PCTs. The purpose of the partnership is to provide patients with a method of tracking their condition, giving them greater insight into their disease.

This agreement brings together two highly complementary technologies and offers improved clinical outcomes and services to patients while creating the opportunities for substantial savings for healthcare providers.

LifeScan will co-ordinate information with healthcare professionals, responsible for the care of the patients who are placed on the system, to include them in the support network.

Large US medical insurers to cover online doctor visits

Aetna Inc. and Cigna Corp., two of the largest insurers in the US have agreed to reimburse doctors for online visits. Other large insurers are expected to follow, say experts.

These new online services, which typically cost the same as a regular office visit, are aimed primarily at those who already have a doctor. The virtual visits are considered best for follow-up consultations and treatment for minor ailments such as colds and sore throats.

Although visits to the doctor’s office certainly won’t disappear, the recent moves are evidence that long-delayed efforts to bring American medicine into the digital age may be gaining momentum.
The new online consultations are far more structured than a simple e-mail. If insurance companies are expected to pay the bill, physicians need documentation of the event, including diagnosis and time spent. As a result, service companies have emerged to help doctors handle this. They typically arrange the online visits, maintain records and handle insurance reimbursements, patient co-payments and other payments. Doctors are encouraged to espond to patients within a day; they receive an e-mail reminder if they haven’t, with a phone call on the second day. Prices vary from US$ 25 to US$ 125, which patients pay with a credit card at the end of the session.

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