Top 10 Innovations for 2012
Which are the up-and-coming technologies and which will have the biggest impact on healthcare in 2012?
Cleveland Clinic's culture of innovation naturally fosters a good deal of discussion about new "game changing" technologies and which ones will have the greatest impact each year. The passion of our clinicians and researchers for getting the best care for patients drives a continuous dialogue on what state-of-the art medical technologies are just over the horizon.
This book was developed to share outside Cleveland Clinic what our clinical leaders are saying to each other and what innovations they feel will help shape healthcare over the next 12 months.
#1 Catheter-Based Renal Denervation to Control Resistant Hypertension:
For every drop of 20 mm Hg in systolic blood pressure, the risk of cardiovascular disease is cut in half. At the annual European Society of Cardiology meeting in May 2012, multi-center study results of 46 patients with drug-resistant hypertension experienced an average 22 mm Hg drop in blood pressure after undergoing renal denervation, and another 6 mm Hg drop at the 30-day study milestone. Three months later, lowered blood pressure remained stable for all study subjects. There are currently five companies manufacturing renal denervation devices, which are only available in Europe. A study in the United States of the device and procedure is ongoing.
#2 CT Scans for Early Detection of Lung Cancer:
New guidelines published in May 2012 in the Journal of the American Medical Association recommend lung cancer screening with low-dose CT scans. About 8 million Americans between the ages of 55 and 74 would be eligible according to criteria endorsed by the American College of Chest Physicians, The American Society of Clinical Oncology, and the National Comprehensive Cancer Network. The new guidelines recommend that screening only be offered in academic medical centers or other sites with specialized radiologists on staff. The scans, which are often offered for as low as $100, are still not covered by insurance.
#3 Concussion Management System for Athletes:
Concussion worries loom large in the sports world. In the past year, more than 3,300 players have sued the National Football League, charging that not enough was done to inform them of the dangers of concussions in the past, or to take care of them today. On the grade school and high school level, there is a now a call for school systems to have mandatory, science-based concussion management systems, developed in accordance with national guidelines. A special concussion app is currently being tested with high school teams. The app checks the athlete's memory, reaction time and balance, then stores the information on an iPad. If a student suffers a head injury, the data can be compared to see if there has been a concussion.
#4 Medical Apps for Mobile Devices:
As mobile devices and applications have become more user-friendly, affordable and powerful, the appeal to healthcare providers has grown exponentially. The mobile health technology market—with its apps, devices, and services—now includes more than 40,000 mobile health apps, contributing to the $718 million global industry. The successful apps are those that provide needed services, and make doctors and patients more efficient. The field is currently unregulated but the FDA recently released a draft of guidelines requiring app creators that make medical claims to apply for FDA approval just like any other medical device.
#5 Increasing Discovery with Next-Generation Gene Sequencing:
The field of next-gen sequencers is expanding rapidly and these devices have become go-to items in the armamentarium of researchers. Pathology laboratories that utilize these silicon-based machines now offer clinicians the ability to detect and characterize disease at earlier stages when cure is still possible. A benchtop device capable of sequencing the human genome in one day for $1,000 is now available, while a newer palm-size device that can sequence the genome in 15 minutes will be available in 2013.
#6 Implantable Device to Treat Complex Brain Aneurysms:
The newly approved FDA device is proving to be superior to older forms of coiling and stenting because it forms a fabric sleeve inside the blood vessel that allows blood to move away from the aneurysm, forming a new blood vessel inside of the aneurysm. Over time, the aneurysm will heal around the stent and vanish. Over 90 percent total obliteration rates at 12 months have been consistently confirmed in international studies. Because it helps reconstruct blood vessels within the brain, experts feel that this device may one day replace traditional open brain procedures.
#7 Active Bionic Prosthesis: Wearable Robotic Devices:
Technology in newer prosthetics is advancing rapidly. Users of a new 4.5-pound lower limb prosthetic report less pain, more energy, an increase in daily activities, fewer pressures inside of the socket and more stability on uneven terrain. Increasing scientific data now supports these many advantages. In addition, patients with more severe mobility-inhibiting injuries now have a commercially-produced prosthetic exoskeleton to use instead of wheelchairs. Delivery of the first $130,000 lower body exoskeleton was made in February. This high-tech medical device supports the body while moving the user's legs for them—it lets paraplegics walk again. At present, while medical insurers will pay for basic prostheses, they typically do not pay for any of the innovative artificial limbs.
#8 Harnessing Big Data to Improve Healthcare:
Big data is becoming big business as more American hospitals digitize patient records and then analyze them to discover particular patterns that can help improve care and outcomes. With a government push and financial incentive to adopt electronic medical records, hospitals and researchers alike are using this information to find clues to the initiation of various cancers and diseases like multiple sclerosis, and to look for possible links between particular neighborhoods and the prevalence of certain medical conditions. By taking full advantage of big data accumulation, all of the resulting number crunching is expected to lead to improved patient care, unexpected discoveries, and new medical therapies.
#9 Novel Diabetes Therapy: SGLT2 Inhibitors:
With concerns about side effects that included possible liver damage and a link with bladder and breast cancer, the FDA issued a complete response letter in January for dapagliflozin and asked for additional data. In May 2012, dapagliflozin received a positive opinion from the European Medicines Agency recommending approval of the drug. At the May meeting of the American Diabetes Association, other pharmaceutical companies presented positive data on their SGLT2 class of drugs, reporting efficacy in lowering A1C levels and overall tolerability. Information about canagliflozin, a medication used in nine studies and over 10,000 patients, was recently presented to the FDA as part of the approval process.
#10 Genetically Modified Mosquitoes to Reduce Disease Threat:
With the fear of dengue fever (nicknamed "break bone fever") and its intense joint pain, cities in southern Florida and also in Brasilia, Brazil, are considering the use of genetically modified mosquitoes to eliminate the diseasecausing pests. More than 400,000 cases of dengue have been registered in Brazil in 2012, while no cases have been recorded in the Florida Keys in 2012. However, Florida authorities want to release the mosquitoes to eliminate the threat of disease. The United States Department of Agriculture was asked to issue a federal permit for the release of millions of the modified mosquitoes, but instead, due to public fears that eradicating mosquitoes could have negative consequences to the food chain, the FDA is currently reviewing the project.
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