28 January 2015

Unlocking innovation in healthcare logistics


Healthcare innovation is not all about new miracle drugs that will be able to cure every cancer or eliminate the risk of heart disease. Although pharmaceutical advancements are certainly crucial, they are the solution to just one small part of the challenges facing the global healthcare industry today: aging populations in developed nations, high population growth in emerging countries, and increased healthcare demands across the world.

While pharmaceutical firms and biochemists are investigating new drugs, teams of engineers, technicians and entrepreneurs are solving some of the logistical issues of providing cutting-edge healthcare to millions of people.

Last month on CapX we covered Theranos, founded by Elizabeth Holmes, a start-up that provides blood tests with a single needle-prick costing less than a tenth of a standard syringe test. We have also looked into graphene, a revolutionary miracle material which could, among other uses, be used in bioelectric sensory devices and DNA sequencing. Here are three more start-ups which are reducing the financial and time costs of healthcare with technological innovations and finding more efficient solutions to some of the most common health problems.

As healthcare needs grow, increasing efficiency is becoming even more important, especially when it comes to diagnosis. Around 3% of the NHS budget is spent on pathology alone  – that’s over £2 billion annually in the UK. Diagnostic technologies and techniques are improving, but it is expensive and often unrealistic for every hospital to implement the most accurate procedures. Rather than investing in their own pathology labs, hospitals are already starting to outsource biopsy diagnosis to pathology groups which have the equipment and expertise to find accurate results at lower costs.

CellNetix, a Seattle-based company founded in the merger of three existing pathology groups, is going one step further. The firm focuses on specialisation, ensuring that the pathologist analysing a specimen has experience in that specific discipline – a dermatopathologist for skin samples, haematopathologist for blood samples.

But in addition to providing a more specialised service in their own labs, CellNetix uses digital pathology to extend the group expertise of their pathologists to small hospitals in remote regions. This includes both telepathology, where a camera on a microscope transmits a live stream which pathologists can view online in real time, and Whole Slide Imaging, where high-resolution images of complete slides can be saved and sent for pathologists to review in their own time, making it easier to get second and third opinions from specialists across the world.

Both these methods increase accuracy and provide any hospital with access to a team of highly specialised pathologists. With high-quality microscope photographs, algorithms trained for pattern recognition, and integrated computer systems, specimens from all over the world could be analysed by specialised teams of experts.

With America’s aging population putting a strain on the healthcare industry, pathologists will, as CellNetix CIO Pat Cooke says, “have to do more with less”, and that is where innovation becomes crucial.  “As technology advances, image analysis will allow accurate diagnosis in situations where a human would find it difficult.” Whether that’s an over-capacity hospital providing next-day results or doctors in developing countries confirming their diagnoses with experts abroad, the benefits of this technology could be huge.

For diagnostic technology already FDA-approved and on the market, the company to watch is Mobisante. Founded by former Microsoft mobile executive Sailesh Chutani, Mobisante turns smart-phones and tablets into ultrasound devices, making it possible to obtain ultrasound images quickly and inexpensively outside of a hospital setting.

Mobisante’s devices cost less than $10,000, while standard ultrasound machines can cost ten times that. There are also rental deals for between $400 and $800, making ultrasounds suddenly an affordable option in unexpected places.

“If you’re working at the Everest Base Camp, the smartphone is going to make a lot more sense,” explains Chutani. “But if you are at a private practice and can stay in one place, the tablet makes more sense with the larger screen.”  Chutani has also said that the affordability of Mobisante’s products means even hospitals in poor regions across Africa and Asia will have access to ultrasound technology.

The low cost, combined with the small size and portability of these devices, offers potential benefits across the healthcare industry. From paramedics assessing internal bleeding at the scene of an accident or in an ambulance, to midwives monitoring foetal development through home visits, Mobisante is making ultrasounds cheaper, quicker, and more convenient.

Also improving the convenience of existing technologies is a new monitoring and treatment system for diabetes, currently in its development phase. Diabetes is one of the most common diseases facing the developed world, affecting 9.3% of the US population – that’s nearly 30 million people. In England and Wales, diabetes costs the NHS 10% of its budget, amounting to £13.75 billion a year, and £1.5 million an hour. The potential savings from new diabetes technology are therefore huge.

Diabetes requires constant glucose monitoring (CGM), which is currently done intravenously, with invasive or semi-invasive techniques that require piercing the skin to measure blood glucose.

Philadelphia-based company Echo Therapeutics is investigating another way. The Symphony CGM system is a “non-invasive (needle-free), wireless, continuous glucose monitoring system designed to provide accurate, real-time blood glucose data conveniently and continuously”. The technology is still being developed and has not yet been approved by the FDA, but it if approved it could improve lives for millions of diabetes patients.

Symphony involves permeating the skin (removing the top 0.0015mm, which can be done painlessly), then placing a patch with a biosensor over the permeated area. The sensor is close enough to the blood vessels to read glucose levels, which it then transmits wirelessly, so the patient’s blood glucose can be tracked. The patch currently in development would need replacing every three days, but the procedure would still be less painful than current CGM systems.

In addition to its monitoring system, Echo Therapeutics is developing a drug delivery method using the same technology. Transdermal drug delivery is not only more comfortable for the patient, but safer – in hospitals, where the risk of infection is high, the ability to administer drugs non-intravenously could dramatically reduce contamination, as well as decreasing costs. Echo Therapeutics is currently working with the Ferndale Pharma Group to adapt their technology for administering anaesthesia. In other words, it is not just diabetes patients who could benefit – everyone involved in healthcare, from doctors to patients to insurance providers, has something to gain.

New drugs and medical breakthroughs can save lives, but it is technological innovations like these which will keep healthcare affordable as our needs grow. All three of these companies are helping to take the strain off hospitals by outsourcing to specialists, enabling mobile treatment, and giving patients the means to manage their conditions themselves. This specialised, individual approach is the future of healthcare.

Rachel Cunliffe is Deputy Editor for CapX.