Recent trends in healthcare technology

Recent trends in healthcare technology

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  Emerging Technologies inHealthcare Dr. Anil M. Pethe School of Pharmacy & Technology Management, SVKM’S NMIMS, Hyderabad Campus 1
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  2 Disclaimer  This presentationis based on publicly available information.  The views presented are the views of the presenter, not necessarily to author’s employer, organization.  These slides are intended for educational purposes only and for the personal use of the audience.  The content of this slide deck is accurate to the best of the presenter’s knowledge at the time of production.
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  Generations & FutureComputers 3
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  Top Mobile Handsetsin 2009 Top Mobile Handsets in 2019 Top Mobile Handset in 1999 4
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  Top 10 pharmaceuticalproducts by sales worldwide (in million U.S. dollars) Sr. No. Products in 2009 Drugs Company 1 Lipitor Atorvastatin (Lipid lowering) Pfizer 2 Nexium Esomeprazole (antacid) AstraZeneca 3 Plavix Clopidogrel (antiplatelet) Apotex 4 Adavair Diskus Fluticasone/salmeterol (Asthma) GSK 5 Seroquel Quetiapine (antipsychotic) AstraZeneca 6 Singulair Montelukast (Asthma) MSD 7 Enbrel Etanercept (autoimmune disorder) Wyeth (Pfizer) 8 Actos Pioglitazone (antidiabetic) GSK 9 Prevacid Lansoprazole (Peptic ulcer) Takeda 10 Neulasta Pegfilgrastim (Bone marrow stimulation Amgen Sr. No. Products in 2019 Drugs Company 1 Humira Adalimumab (TNF blocker for RA) Abbot 2 Eliquis Apixaban (Oral anticoagulant) (BMS/Pfizer) 3 Revlimid Lenalidomide (anticancer) (Celgene) 4 Opdivo Nivolumab (Lung cancer) (BMS/Ono Pharm.) 5 Keytruda Pembrolizumab (anticancer) (Merck & Co.) 6 Enbrel Etanercept (for RA) (Amgen/Pfizer) 7 Herceptin Trastuzumab (Breast cancer) (Roche) 8 Avastin Bevacizumab (anticancer) (Roche) 9 Rituxan Rituximab (anticancer) (Roche/Biogen) 10 Xarelto Rivaroxaban (anticoagulant) (Bayer/J&J) 5
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  Top 10 newmedical technologies of 2019 10. Smart Inhalers 9. Robotic Surgery 8. Wireless Brain Sensors 7. 3-D Printing 6. Artificial Organs 5. Health Wearable's 4. Precision Medicine 3. Virtual Reality 2. Tele-health 1. Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) 7 Reference: www.preclinical.com
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  • Inhalers arethe main treatment option for asthma and if taken correctly, will be effective for 90% of patients. However, in reality, research shows that only about 50% of patients have their condition under control and as many as 94% don’t use inhalers properly. • To help asthma sufferers to better manage their condition, Bluetooth- enabled smart inhalers have been developed. • A small device is attached to the inhaler which records the date and time of each dose and whether it was correctly administered. • This data is then sent to the patients’ smartphones so they can keep track of and control their condition. Clinical trials showed that using the smart inhaler device used less reliever medicine and had more reliever- free days. • Teva has introduced ProAir Digihaler (albuterol sulphate) in US market & approved by USFDA in Jan 2019. • The companies which are working on Smart Inhaler Technology are 3M, Adherium, Cohero Health, Propeller Health, and Teva Smart Inhalers 8
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  • Robotic surgeryis used in minimally invasive procedures and helps to aid in precision, control and flexibility. • During robotic surgery, surgeons can perform very complex procedures that are otherwise either highly difficult or impossible. • As the technology improves, it can be combined with augmented reality to allow surgeons to view important additional information about the patient in real time while still operating. • While the invention raises concerns that it will eventually replace human surgeons, it is likely to be used only to assist and enhance surgeons’ work in the future. • The first robotic radical prostatectomy in India was performed in AIIMS in July 2006 Robotic surgery 9
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  10 Gujarat Doctor MakesHistory, Performs World's 1st Robotic Heart Surgery 30 km Away from Patient • Dr Patel, who is the chief interventional cardiologist at Ahmedabad-based Apex Heart Institute, guided the robot to perform the surgery on the patient from the Akshardham Temple in Gandhinagar, around 30 kilometres away. (5th December 2018)
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  Wireless brain sensors •Thanks to plastics, medical advances have allowed scientists and doctors to team up and create bioresorbable electronics that can be placed in the brain and dissolve when they are no longer needed, according to Plasticstoday.com. • This medical device will aid doctors in measuring the temperature and pressure within the brain. • Since the sensors are able to dissolve, they reduce the need for additional surgeries. • A team of materials science engineers from the University of Illinois and neurosurgeons from the Washington University School of Medicine have developed a type of wireless brain sensor that can monitor intracranial pressure and temperature, then dissolve and be absorbed by the body. • The sensors consist of polylactic-co-glycolic acid (PLGA) and silicone, and are capable of transmitting accurate pressure and temperature readings, as well as other information. 11
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  • 3-D printershave quickly become one of the hottest technologies on the market. These printers can be used to create implants and even joints to be used during surgery. • 3-D-printed prosthetics are increasingly popular as they are entirely bespoke, the digital functionalities enabling them to match an individual’s measurements down to the millimetre. • The use of printers can create both long lasting and soluble items. For example, 3-D printing can be used to ‘print’ pills that contain multiple drugs, which will help patients with the organisation, timing and monitoring of multiple medications. This is a true example of technology and medicine working together. • The first 3D-printed drug to receive approval from the U.S. Food and Drug Administration (FDA) is now being shipped to pharmacies. Pennsylvania-based Aprecia Pharmaceuticals 3D-printed Spritam (levetiracetam) tablets are used to treat epilepsy. 3-D printing 12
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  • To take3D printing up another notch, bio-printing is also an emerging medical technology. • While it was initially ground-breaking to be able to regenerate skin cells for skin draughts for burn victims, this has slowly given way to even more exciting possibilities. • Scientist have been able to create blood vessels, synthetic ovaries and even a pancreas. • These artificial organs then grow within the patient’s body to replace original faulty one. The ability to supply artificial organs that are not rejected by the body’s immune system could be revolutionary, saving millions of patients that depend on life-saving transplants every year. Artificial organs 13
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  • The demandfor wearable devices has grown since their introduction in the past few years, since the release of bluetooth in 2000. • People today use their phone to track everything from their steps, physical fitness and heartbeat, to their sleeping patterns. • The advancement of these wearable technologies is in conjunction with rising chronic diseases like diabetes and cardiovascular disease, and aim to combat these by helping patients to monitor and improve their fitness. • In late 2018, Apple made headlines with their ground breaking Apple Series 4 Watch that has an integrated ECG to monitor the wearer's heart rhythms. Within days of its release, customers were raving about the life saving technology, which is able to detect potentially dangerous heart conditions much earlier than usual. • The wearable devices market is forecast to reach $67 billion by 2024. Health wearables 15
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  • As medicaltechnology advances it is becoming more and more personalised to individual patients. Precision medicine, for example, allows physicians to select medicines and therapies to treat diseases, such as cancer, based on an individual’s genetic make-up. Precision medicine 17
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  • Virtual realityhas been around for some time. However, recently, with medical and technological advances, medical students have been able to get close to real life experience using technology. • Sophisticated tools help them gain the experience they need by rehearsing procedures and providing a visual understanding of how the human anatomy is connected. • The VR devices will also serve as a great aid for patients, helping with diagnosis, treatment plans and to help prepare them for procedures they are facing. • It has also proved very useful in patient rehabilitation and recovery. Virtual reality 18
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  • In atechnologically driven world, it’s thought that as many as 60% of customers prefer digitally-led services. • Tele-health describes a quickly developing technology that allows patients to receive medical care through their digital devices, instead of waiting for face-to-face appointments with their doctor. • Highly-personalised mobile apps are being developed which allow patients to speak virtually with physicians and other medical professionals to receive instant diagnosis and medical advice. • It is particularly useful for patients managing chronic conditions as it provides them with consistent, convenient and cost-effective care. • The global telemedicine market is expected to be worth $113.1 billion by 2025. Tele-health 19
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  • Telemedicine isa fast-emerging sector in India. • As of FY 2016, it was valued at $15 million and is expected to rise at a CAGR)of 20% during FY 2016-20, reaching up to $32 million by 2020. • The role of telemedicine had largely been limited to use in under-served areas, the COVID-19 crisis has changed this and brought telemedicine to the mainstream. • For a bulk of people needing medical consultation, telemedicine has become the first line of choice at this moment as people are asked to stay home and hospitals suspend non- emergency Out Patient Departments (OPDs). • Telemedicine will revolutionize the Indian healthcare system in the days to come, especially in the current health crisis due to the COVID-19 epidemic 20 Tele-health in India
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  • Clustered RegularlyInterspaced Short Palindromic Repeats (CRISPR) is the most advanced gene-editing technology yet. • It works by harnessing the natural mechanisms of the immune systems of bacterium cells of invading viruses, which is then able to ‘cut out’ infected DNA strands. This cutting of DNA is what has the power to potentially transform the way we treat disease. By modifying genes, some of the biggest threats to our health, like cancer and HIV, could potentially be overcome in a matter of years. • However, as with all powerful tools there are several controversies surrounding its widespread use, mostly over humanity’s right to ‘play God’ and worries over gene-editing being used to produce hordes of designer babies. • CRISPR is still a first-generation tool and its full capabilities are not yet understood. Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) 21
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  Technology trends in Healthcarethat will shape the industry in 2020 and beyond????? 23
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  24 1. Tele-health 2. TheInternet of Medical Things (IoMT) Health Wearable's 3. The Cloud 4. Block chain 5. Artificial Intelligence 6. Virtual Reality 7. Data Analytics
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  • Cloud computingis the on-demand availability of computer system resources, especially data storage and computing power, without direct active management by the user. The term is generally used to describe data centers available to many users over the Internet. • Here are the ways cloud consulting is impacting healthcare. 1. Lowering of Costs • Hospitals and healthcare providers are freed from the need not to purchase the hardware and servers. There are no up-front charges associated with cloud storage of data. They have to only pay for the resources actually use which results in massive cost savings. 2. Ease Of Interoperability • Having the patient’s data in the cloud also promotes interoperability among the various segments of the healthcare industry- pharmaceuticals, insurance, and payments. This allows for a seamless transfer of data between the different stakeholders thus accelerating healthcare delivery and introducing efficiency in the process. 25 Cloud Computing in Healthcare
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  26 • A blockchain carries no transaction cost. The block chain is a simple yet ingenious way of passing information from A to B in a fully automated and safe manner. • One party to a transaction initiates the process by creating a block. This block is verified by thousands, perhaps millions of computers distributed around the net. • The verified block is added to a chain, which is stored across the net, creating not just a unique record, but a unique record with a unique history. • Falsifying a single record would mean falsifying the entire chain in millions of instances. That is virtually impossible. • Bitcoin uses this model for monetary transactions, but it can be deployed in many other ways. Block chain Technology
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  27 Block chain Technology
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  • Blockchain isused to protect patient data and improve the overall healthcare experience. • The technology is already being used to do everything from securely encrypt patient data to manage the outbreak of harmful diseases and at least one country is big on the potential of blockchain healthcare: Estonia. • Estonia began using blockchain technology in 2012 to secure healthcare data and process transactions. • Now all of the country's healthcare billing is handled on a blockchain, 95% of health information is ledger-based and 99% of all prescription information is digital 28 Block chain Technology
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  • Data iseverywhere. • The amount of digital data that exists is growing at a rapid rate, doubling every two years, and changing the way we live. • An article by Forbes states that data is growing faster than ever before. • By the year 2020, about 1.7 megabytes of new information will be created every second for every human being on the planet, which makes it extremely important to know the basics of the field at least. • After all, here is where our future lies. • Data Science is the combination of statistics, mathematics, programming, problem- solving, capturing data in ingenious ways, the ability to look at things differently, and the activity of cleansing, preparing, and aligning the data. • In simple terms, it is the umbrella of techniques used when trying to extract insights and information from data. 29 Data Analytics
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  Big Data • Abuzzword that is used to describe immense volumes of data, both unstructured and structured, Big Data inundates a business on a day-to- day basis. Big Data is something that can be used to analyze insights that can lead to better decisions and strategic business moves. Data Analytics  The science of examining raw data to conclude that information.  Data Analytics involves applying an algorithmic or mechanical process to derive insights and, for example, running through several data sets to look for meaningful correlations between each other. 30 Data Analytics
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  • Healthcare analyticsis the collection and analysis of data in the healthcare industry in order to gain insights and support decision-making. • From key areas like medical costs, clinical data, patient behavior, and pharmaceuticals, healthcare analytics can be used on both macro and micro levels to effectively streamline operations, improve patient care, and lower overall costs. • Healthcare data is the most complex of any industry. From electronic health records (EHR) to monitoring real-time vital signs, data not only comes from several sources but has to comply with government regulations. • It’s a difficult and delicate process and requires a level of security and connectivity only an embedded analytics solution can provide. 31 Data Analytics in Healthcare
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  32  Considering thecurrent situation, Analytics Insight predicts the number of cases in India to rise to 13,420 with 412 deaths by 1st May 2020.  “We modeled the COVID-19 coronavirus cases in India based on current case data to predict the cumulative number of reported cases to final size.  The key features of our model are current cases, new cases per day, the implementation of major public policies, the identification and isolation of unreported cases, preparedness of the country and the recovery rate,”
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  • The primaryaim of health related AI applications is to analyse relationships between prevention or treatment techniques and patient outcomes. • AI programs have been developed and applied to practices such as diagnosis, drug development, personalized medicine and patient monitoring. • IBM and Google have developed AI algorithms for healthcare. 33 Artificial Intelligence in Healthcare
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  34 Nano Robots: Medicineof the Future
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  • Robotics isthe branch of technology that deals with the design, construction, operation, structural disposition, manufacture and application of robots. • Robotics is related to the sciences of, engineering, electronics, mechanics and software 35 Robotics?
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   Nanorobots aretiny machines used to cure diseases in human or in any organism.  Performs task at nanoscale dimensions.  The size of nanorobots is 10-9 m.  The prefix ‘nano’ means billionth. 36 What are Nano Robots?
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  The various componentsin nanorobot include power supply, fuel tank, sensors, motors, manipulators, onboard computers, pumps, pressure tanks and structural support. The structures include:  Payload: The void section hold a small dose of drug or medicine. The nanorobots could transverse in the blood and release the drug to the site of infection or injury.  Micro camera: The nanorobot may include a miniature camera. The operator can steer the nanorobot when navigating through the body manually. 38 Components of Nano Robots
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  Electrodes: The electrodesmounted on the nanorobot could form the battery using the electrolytes in the blood. These protruding electrodes could also kill the cancer cells by generating an electric current and heating the cell up to death. Lasers: These lasers could burn the harmful material like arterial plaque, blood clots or cancer cells. Ultra sonic signal generators: These generators are used when the nanorobots are used to target and destroy kidney stones. Swimming tail: The Nano robot will require a means of propulsion to get into the body as they travel against the flow of blood in the body. 39 Components of Nano Robots
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   Nanobots  Nanoids Nanites  Nanomachines  Nanomites  Nano spiders 41 Size & Shapes of Nano Robots
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   Rapid eliminationof disease.  Nanorobot might function at the atomic and molecular level to build devices, machines or circuits known as molecular manufacturing.  Nanorobots might also produce copies of themselves to replace worn- out units, a process called self-replication.  The major advantage of nanorobots is thought to be their durability, in theory, they can remain operational for years, decades or centuries. 42 Advantages of Nano Robots
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  The nanorobot shouldbe very accurate otherwise harmful events may occur. The initial design cost is very high. The design of robot is very complicated Hard to design. Regulatory Issues 43 Disadvantages of Nano Robots
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   Nanorobotics indrug delivery  Nanorobotics in Surgery  Diagnosis and Testing  Nanorobotics in Gene Therapy  Nanorobots in Cancer Detection & treatment  Nanorobots in diabetes  Parasite removal  Breaking up of kidney stones  Arteriosclerosis  Breaking up blood clots 44 Nano Robots Medical Applications
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  • Nanorobot canbe useful tool in drug delivery applications. • A study, by researchers at the Interdisciplinary Centre, in Herzliya, and Bar Ilan University, in Ramat Gan, Israel, solved those problems by building a nanorobot that could be switched on and off to release drugs within the body when needed. • The team built the nanorobot out of DNA folded in such a way that drugs could be tethered inside. The nanorobot also has a gate, controlled by exposure to electromagnetic energy, that opens and closes to release the drug into the surrounding environment – in this case, the body of a West Indian leaf cockroach. 45 Nano Robots in Drug Delivery
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   Surgical nanorobotsare introduced into the human body through vascular systems and other cavities.  Surgical nanorobot performs various functions like searching for pathogens, and then diagnosis. 46 Nano Robots in Surgery
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  Blood vessels playan important role in supplying blood to all parts of our body. Due to the fatty deposition on the walls of blood vessels blood will not move freely to all parts. These leads to heart attacks and damage the vital organs. 47 Nano Robots in Heart Surgery
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   Medical nanorobotsare used for the purpose of diagnosis, testing and monitoring of microorganisms, tissues and cells in the blood stream. 48 Nano Robots in Diagnosis and Testing
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   Nanorobots arealso applicable in treating genetic diseases, by relating the molecular structures of DNA and proteins in the cell. 49 Nano Robots in Gene Replacement
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   Nanorobots withembedded chemical biosensors are used for detecting the tumor cells in early stages of cancer development inside a patient’s body.  A doctor offers the patient an injection of a nanorobot.  Seeks out cancer cells and destroy them.  Dispells the disease at the source, leaving the healthy cells untouched.  The patients has no awareness of devices working inside them. 50 Nano Robots in Cancer Treatment
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  • Nowadays patientswith diabetes must take small blood samples many times a day to control their glucose levels. Such procedures are uncomfortable and extremely inconvenient. • To solve this problem, Adriano Cavalcanti and his colleagues published for the first time the detailed work describing a medical nano robot hardware architecture for blood sugar level monitoring. • The nanorobots may use embedded nanobiosensors to monitor blood glucose levels, and transmit every two hours this information through RF signals for mobile phones carried with the patient. • If the glucose is eventually not inside the desired levels, the nanorobots activate a pre-programmed tune in the cellular phone, which may alert the patient to take any necessary action regarding the diabetes control with prescribed medicaments 51 Nano Robots in Diabetes Monitoring
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  • Nanorobots wouldfunction similarly to the white blood cells in our bodies, but they are designed to be much faster at destroying bacteria. • This type of nanorobots should be able to eliminate bacterial infections in a patient within minutes, as opposed to the weeks required for antibiotics to take effect. • Microbivore nanorobots are designed so that antibodies attach to the particular bacteria the robot is seeking. • After bacteria attaches to an antibody, an arm grabs the bacteria and moves it to the inside of the nanorobot, where it’s destroyed. Bacteria is then discharged into the bloodstream as harmless fragments. 52 Nano Robots in Infection
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   Nanorobots mightcarry small ultrasonic signal generators to deliver frequencies directly to kidney stones 53 Nano Robots in Kidney Stones
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   Nanorobots maytreat conditions like arteriosclerosis by physically chipping away the plaque along artery walls 54 Nano Robots in Arteriosclerosis
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  • Although thenano robot production is still at a nascent stage, scientists are working hard to develop these tiny systems and hopefully come up with functional autonomous nano robots sometime in the next two decades. • Nano robots, AI, Data Science, Block chain, 3D Printing, Robotic surgery, VR are going to revolutionize the healthcare industry in future. • Technology may rule us ! 55 Conclusion
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  56 Key References
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