On Cleveland Clinic’s Top 10 Healthcare Innovations of 2013

Earlier this week, I reflected on the Cleveland Clinic predictions on the Top 10 innovations in healthcare for 2012 from the vantage point of the year coming to a close. Today, I’ll review the predictions for 2013:

Earlier this week, I reflected on the Cleveland Clinic predictions on the Top 10 innovations in healthcare for 2012 from the vantage point of the year coming to a close. Today, I’ll review the predictions for 2013:

1. Healthcare programs with monetary incentives (Medicare Better Health Rewards Program)—Due to rising costs of healthcare, this program is designed to empower the patient to reach achievable health goals. Metrics gauge improvement in six areas: body mass index, diabetes indicators, blood pressure, cholesterol, vaccinations, and tobacco use. The program gives participants an incentive of up to $400 after they follow the program for two to three years. The rewards: better outcomes for seniors and reduced utilization of healthcare services. While this is not a medical device, it will be interesting to see results over the year ahead.
2. Breast tomosynthesis (3D mammography) screening for breast cancer—The technology is FDA approved and does not replace standard two-dimensional mammograms. Instead, it is performed along with conventional mammograms for a more accurate view of the breast—tissue, ducts, vessels, and ligaments at varying depths. This could help women with dense breasts where standard mammography may not detect the tumor. Preliminary studies indicate a substantial increase in cancer detection over standard mammography.
3. Modular device for complex aneurysms—Ruptured aneurysms are often fatal. Monitoring and treatment can deter a ruptured abdominal aortic aneurysm, using meticulous measurements of the aneurysm’s size and location and fitting an appropriately sized stent-graft. A custom-fit graft can take weeks to make and deliver; however, a new fenestrated stent-graft system allows treatment of the patient without detailed measurements or prolonged wait times.
4. Ex-vivo lung perfusion to reverse lung injury in donor organs rejected for transplantation—Damaged lungs are removed from a donor and connected to a cardiopulmonary pump and ventilator. As the lungs inflate/deflate, fluids and nutrients are pumped through blood vessels to repair and nourish the tissue. Ex vivo lung perfusion is approved in Europe and Canada and a multicenter study in the U.S. is underway.
5. Femtosecond laser cataract surgery—allows greater precision without a blade. Cataracts are a common eye ailment in people over 60 years of age, and cataract surgery is one of the most common and effective surgeries performed. This laser is FDA approved.
6. Handheld optical scan to identify skin lesions—The technology was used in the military for guided missile navigation. This FDA approved device is showing promising results in the largest study ever on melanoma, with a 98% detection rate.
7. Novel advanced prostate cancer medications—These drugs block testosterone production and prevent stimulation of genes that cause prostate cancer growth. Metastatic bone pain is a common problem in advanced prostate cancer; treatment with an injectable form of radiation that targets bone metastases and avoids damaging healthy cells is showing promise. Treatment of advanced prostate cancer may be managed as a chronic disease with improved survival.
8. Mass spectrometry using matrix assisted laser desorption/ionization time of flight (MALDI-TOF)—Identify pathogens causing infection in far less time compared to inoculating an agar plate and waiting hours to days for the organism to grow. This basic science lab technique may help avoid inappropriate antibiotic use and improve outcomes.
9. Neuromodulation therapy for cluster and migraine headaches—This uses a small implantable neurostimulator, placed in the upper gum. The tip of the device is placed near the sphenopalatine ganglion nerve bundle (SPG), a target for treating severe headache. A remote control delivers stimulation to the SPG when a headache is looming. In the U.S., the device is in multicenter trials. It is approved and available in Europe.
10. Bariatric surgery for control of diabetes—Initially used for weight reduction in obesity, it appears to also diminish Type 2 diabetes soon after surgery. A study in the New England Journal of Medicine showed that patients who underwent bariatric surgery reduced their medications for diabetes or were diabetes-free. Other benefits were lower blood pressure and cholesterol levels. Due to these positive results, some Type 2 diabetes patients are now being offered the surgery.

The themes for these 2013 innovations strike me as cost reduction and re-purposing. The Medicare Program, if only because of its sheer size, could make dramatic differences in healthcare spending while handing responsibility for healthcare to the patient/consumer. Meanwhile, handheld optical scanners illustrate the transfer of military technology to healthcare, and MALDI-TOF, bariatric surgery and lung rejuvenation are cases of using science and medical technology for an innovative purpose, or using previously rejected tissue. We’ll see how effective they are in the longer term.

Do you think these are the top ten innovations? What would you replace? How can the life sciences industry impact healthcare innovation over the next year? I’d love to hear your thoughts.