Friday, 28 April 2017

Just what the doctor ordered for endoscopy equipment market

Endoscopy equipment market is forecasted to reach $35.3B by 2021. The market is likely to boom in the next five years, reaching $35.3 billion and expanding at a 6.2 % compound annual growth rate.

India’s market for endoscopy devices is expected to reach USD 2.25 billion by the end of 2020. During this period of the forecast, the market is expected to grow at a CAGR of 5.95%.

Currently, North America dominates the global market with nearly half of the share. Asia-Pacific is considered to be an emerging market with growth potential. This is due to the greater awareness among population and greater intent towards adopting minimally invasive surgery procedures.

This escalation is developing the need to analyze, review and forecast the growth of the endoscopy device market. Owing to the rapid evolution of the market in the use of endoscopes, medical device companies that are able to launch new innovative equipment will be rewarded with huge benefits.

Some of the factors driving the market for endoscopy devices are:

Increased demand for the use of minimally invasive procedures in surgeries

Technological advancements
Increase in the aging population
Reduced healthcare costs
Improved patient quality of life


Expensive procedures, limited availability of skilled labor and stringent regulatory framework are the challenges faced by the market.

Here's what you should know.

1. Analysts expect technological advancements to continue driving market growth. Large companies are creating equipment that addresses individual buyers' needs, thereby stimulating growth.

2. Gastrointestinal endoscopy makes up the largest segment of the market.

3. Hospitals are the endoscopy equipment market's largest user.

4. North America is the global leader followed by Europe and the Asian-Pacific regions, respectively. Analysts believe the rest of the world and the Asian-Pacific regions will experience the highest growth through 2021. They attribute the projected growth to government and venture capital investments by China in endoscopy.

5. Some key market players include:

Ethicon, Inc.

Olympus Corp.
Fujifilm Holdings Corp.
Stryker Corp.
Boston Scientific Corp.
Pentax Medical Corp.

Wednesday, 19 April 2017

Infection Control & Clinical Quality

Hand hygiene is undeniably an essential element in any hospital infection control and prevention program. However, according to a recent STAT piece, sinks may actually be aiding in the spread of infection.

First off, the water coming out of the sinks can be contaminated with bacteria. One clinician from Canada shared an anecdotal story of an infection outbreak eventually tied back to sinks in the intensive care unit — the sinks' faucets sent water straight down the drain, causing tiny drops of water to splash up into the air and on porous surfaces nearby, thereby spreading bacteria and causing infections.

"Some of the stuff we've learned … is: Don't have the gooseneck [faucet] drain directly into the drain; have it drain off to the side of the bowl. Don't allow it to splash. Make sure it's deep enough that it can't splash on you and splash on your clothing. Make sure that the stuff around [the sinks] is waterproof," Michael Gardam, MD, director of infection control at Toronto-based University Health Networks, told STAT.

Beyond bacteria in the water, the other main infection control problem with sinks is that their pipes and plumbing are the perfect place for bacteria to grow into biofilms.

"Once you have the biofilms there, short of ripping the sinks and the piping out, it's impossible to get rid of," Alex Kallen, MD, who is with the CDC's division of healthcare quality promotion, told STAT. He did note it is yet unknown what role these biofilms can play in spreading infections, however.

Because of issues inherent with sinks, many healthcare providers are turning to alcohol-based hand sanitizers to clean their hands instead.

The CDC recommends healthcare providers use hand sanitizer instead of soap and water in most instances. In fact, it says to use hand sanitizer except in the following situations:

  1. When hands are visibly dirty
  2. After treating a patient with known or suspected exposure to Clostridium difficile or if the facility is experiencing an outbreak
  3. After treating patients with known or expected norovirus
  4. After known or suspected exposure to Bacillus anthracis
  5. Before eating
  6. After using a bathroom

Tuesday, 11 April 2017

Internet of Things (IoT) Day: 3 takeaways for the healthcare supply chain

Whether we realize it or not, we’re past the age of the Internet and well into the age of the Internet of Things (IoT) in which increased, virtual communication among machines is poised to completely transform healthcare as we know it—making the industry smarter and more efficient. Thankfully so because there’s simply no more room for wasted time and money, says an article in Becker's Hospital Review.

The scope of current inefficiency in the medical devices market, for example, is staggering. These devices alone contribute to an estimated $5 billion1 in waste annually. There are many other sources of waste including excess inventory, product loss, expiry products, revenue leakage at the point of charge capture, and unnecessary shipping costs caused by poor inventory tracking and planning, the article noted.

As you celebrated the Internet of Things Day (April 9, 2017), the implication for supply chain is simple: Waste must – and can – be eliminated. Consider these three supply chain opportunities, and how eliminating waste with an IoT approach and advanced technologies can help promote efficiency:

View the supply chain holistically and expansively, from sourcing to usage. 
The healthcare supply chain is no longer just about manufacturing, distributing, and transporting products. In order to properly evaluate the value chain, therefore, it must be viewed holistically, encompassing both direct and indirect costs. This caliber of system-wide valuation demands data and lots of it – data that can be collected, aggregated, visualized and acted upon.

Key takeaway: Leverage IoT technologies to enable cloud-based, system-wide inventory management with data analytics to connect products and processes with their true cost.

Invest in technology to improve the “user experience” for clinical staff. 

According to a recent survey, physicians and nurses report spending nearly 20 percent of their work in a week on supply chain management tasks – like searching the store room for a specific cardiac catheter or counting the number of products used in a case. Sixty-five percent of those surveyed would trade this time to be with their patients. But with advanced product-tracking technologies, like radio frequency identification (RFID) systems, clinical documentation can be as easy as waving a product by an RFID-reader in the operating room.

Key takeaway: Use the IoT’s connectivity and data-sharing capabilities to free the frontline staff from inventory-related burdens.

Adopt automated technologies to improve accuracy, speed, and spend. 
In a recent survey, supply chain leaders estimated $500,000 in annual savings using automated supply chain technology. Properly balancing inventory levels to match usage patterns, reducing and properly managing product expirations, freeing up capital, and reducing patient risk are just a few ways automation can improve the speed and accuracy of supply chain management. Data gleaned from IoT connectivity is also enabling proper management of consignment, accurate clinical documentation, and product and workflow standardization across entire enterprises.

Key takeaway: The healthcare supply chain is a strategic asset that can yield large financial savings, and the IoT is key to propelling change.

Tech savvy and visionary hospitals and health systems are adopting this Internet of Things approach to the way they manage products and processes to reduce costs, improve efficiencies and improve the total cost of care. 

Tuesday, 4 April 2017

Surgical robots are impossible to clean, all machines contaminated

The establishment medical industry says that the 'next big thing' in their industry is the introduction of robots to conduct some surgical procedures. But a new study from Tokyo and New York has found that these devices have some major drawbacks with sterility.

Researchers have discovered that surgical robots cannot be satisfactorily cleaned – an ominous finding, considering that machines are becoming more and more common in operating rooms, including one New York hospital that recently acquired one to perform vaginal procedures, the UK's Daily Mail reported.

The study's findings reveal that it is absolutely impossible to clean robotic devices thoroughly, meaning there is also no way to avoid the risk of a post-operative infection using a robotic surgical device.

"One of the top priorities for hospitals is to treat patients safely and with minimal risk of infection," said Yuhei Saito, RN, PHN, MS, the lead author of the study and an assistant professor at the University of Tokyo Hospital.

Saito added that the results of the study found that robotic surgical instruments may be putting patients at risk because of the way such instruments are currently being cleaned. "One way to address this issue is to establish new standards for cleaning surgical instruments, including multi-part robotic tools," the lead author noted.

Even manufacturers' cleaning instructions are not effective

The study has been published in the journal Infection Control & Hospital Epidemiology, which is published by the Society for Healthcare Epidemiology of America.

To conduct the study, researchers analyzed 132 robotic and ordinary surgical instruments over a period of 21 months. Instruments were immediately collected after they were used, in order to determine their level of contamination, the Daily Mail reported.

Scientists involved in the study used in-house cleaning methods, including manual procedures utilizing ultrasonication, as per the manufacturers' instructions. They gathered measurements of protein concentration after three subsequent cleanings to gauge the total amount of residual protein.

Because of the complex structure inherent to robotic instruments, they had a much greater protein resident and a lower cleaning efficacy when they were compared to ordinary instruments used manually by surgeon.

As such, the researchers suggested in their findings that it could become necessary to devise new cleaning standards that employ repeated measurements of residual protein rather than measuring contamination only one time after instruments have been cleaned.

As noted further by Medical Xpress, the cleanings were 97.6 percent effective for robotic instruments versus 99.1 percent effective for ordinary surgical instruments.

Just bathing patients before surgery can help cut down on the number of post-surgical infections

"These instruments are wonderful tools that allow surgeons to operate with care, but completely decontaminating them has been a challenge for hospitals," Saito said. The researcher added that the implementation of new cleaning procedures that include repeated measurements "of the level of contamination on an instrument more than once" would lead to the reduction of post-operative infection in "many patients."

Hospital-borne infections have been a rising problem in the U.S. for years. In 2012 CBS News reported that bloodstream infections caused at least 30 percent of the [then-] estimated 99,000 annual hospital-infection-related deaths in the U.S.

According to the magazine Consumer Reports, hospital infection rates varied greatly even in the same region. And The Associated Press reported that as many as 30 million surgical procedures are done each year, and that of those a half-million patients develop surgical-site infections, mostly caused by the staph bacteria.

"A lot of people think it's all from the outside world, but these are your own germs," Dr. Robert Weinstein, an infectious disease expert at Cook County's Stroger Hospital in Chicago, told the AP in 2010.

A pair of studies released around that time found that simply bathing patients before surgery helped cut down on post-surgical infections.

Wednesday, 29 March 2017

Are Clinical Trials Diverse Enough to Ensure Patient Safety?

The latest data from FDA shows that clinical trials may not include enough ethnic and gender diversity, which could put patient safety at risk.

A new FDA report indicates that clinical trials may not be accurately representing real-world demographic patterns, leading to concerns that new drugs are not being accurately tested for patient safety and effectiveness. Only 48 percent of drug testing populations consisted of women, and only 7 percent of those who participated in clinical trials were African Americans.

White patients accounted for 76 percent of the test population, while participants over the age of 65 only accounted for 21 percent and just 11 percent were Asians. The imbalance of demographic identities may not accurately portray the health needs for diverse communities across the US.

“Over the past two years, FDA’s Center for Drug Evaluation and Research (CDER) approved 67 novel drugs, said John J. Whyte, MD, MPH, Director of Professional Affairs and Stakeholder Engagement at FDA’s Center for Drug Evaluation and Research.

“So it’s no surprise that in recent years, representation in clinical trials of certain subgroups, such as people of different ages, races, ethnic groups, and genders, has become of growing interest.”

Certain drugs may have different dosages for men and women, or impact patients in different ethnic groups in distinct ways. Because of these variances, it is important to test new therapies on a variety of patients representing the full spectrum of patients likely to take them.

The FDA report indicates that researchers are working to incorporate more diverse patients in clinical trials, said Whyte.

“[The report] shows for example, that women were represented at a rate of 40 percent in 2015 and 48 percent in 2016 and African Americans were represented at a rate of 5 percent in 2015 and 7 percent in 2016,” he said.

However, many trials for new drugs are still unbalanced.

Eighty-six percent of the patients involved in one clinical trial for Lartruvo, a drug that treats soft tissue sarcoma, were white. African-Americans accounted for 8 percent and Asians accounted for 3 percent of the sample population.

Ninety-one percent of the enrollees in a clinical trial for Nuplazid, the only FDA approved drug to treat Parkinson’s-induced hallucinations, were white males. Only one percent were African American, and women represented just 36 percent of the sample patient population.

Three-quarters of patients in a trial for Adlyxin, used to treat type 2 diabetes, were white. Women only represented 31 percent of the clinical trial population, and only four percent were African-American.

Key factors for demographic disparities in clinical trials include a lack of enthusiasm for patients to participate, a need for improved patient engagement strategies, and an ongoing need for clinical innovation.

Last year, the Memorial Sloan Kettering Cancer Center found that 65 percent of patients are not likely to volunteer for research purposes. The organization suggested that communicating an immediate personal gain for those who take part in a trial may increase participation.

Patient engagement strategies such as utilizing mHealth tools can make it easier to encourage people from all walks of life to participate in clinical trials. The NIH’s All of Us Research Program, for example, relies on active community support to increase diversity-based data across age and socioeconomic differences.

Researchers and organizations like the FDA can address the needs for more diverse testing groups and build testing populations that paint a more accurate picture of US demographics.

“Until the late 1980s, clinical trials were conducted predominantly on men,” Whyte said. “Much has changed since then. Our Drug Trials Snapshots program and Summary Report underscore FDA’s commitment to enhancing transparency and better understanding of patient representation in clinical trials.”

Wednesday, 22 March 2017

Patient Safety Improvements Could Cut Avoidable Deaths by 50% In The US

In an analysis of patient safety ratings, researchers highlight how many deaths could be avoided if hospitals improve their patient safety efforts.

A focus on patient safety improvements could potentially reduce half of all hospital-caused deaths in low-rated hospitals, according to a recent report from the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine.

Following the release of the Spring Hospital Ratings from the Leapfrog Group, an analysis of the ratings showed that hospitals with the lowest scores - a D or an F - could drastically cut their mortality rates if they adopted the same patient safety practices of top rating hospitals.

B-rated hospitals could reduce deaths by nine percent and C-rated hospitals could reduce death rates by at least 35 percent, study author Matt Austin, PhD, concluded.

In total, 206,021 avoidable deaths occur in all hospitals across the US, the data showed.

Of the near 200,000 annual avoidable deaths, 78 percent occur in B, C, D, or F-rated hospitals. Had all of those hospitals performed at the same level as an A-rated hospital, 33,439 deaths may have been avoided.

That said, A-rated hospitals are not entirely perfect. Austin’s research shows that there is also room for these hospitals to improve their patient safety and hospital quality measures.

“Efforts to reduce patient safety events have been plentiful, and yet elimination of all preventable harms remains elusive,” Austin noted. “While hospitals with a Hospital Safety Score of ‘A’ have better performance than hospitals with lower grades, they still have significant opportunities for improvement.”

A-rated hospitals had moderate mortality rates in all patient safety subcategories, save for the hospital acquired conditions due to foreign objects retained after surgery and air embolism safety measures.

Austin and the research team noted that these estimates were slightly below actual avoidable death rates because they only included a limited number of potential causes of avoidable death.

“The measures included in this analysis reflect a subset of all potential harms that patients may encounter in U.S. hospitals, and as such, these results likely reflect an underestimation of the avoidable deaths in U.S. hospitals,” Austin explained.

The analysis also excluded deaths due to other causes that may be equally important to patient safety and hospital quality.

That all said, the proportions of avoidable deaths compared to A-rated hospitals are likely accurate because the low estimates are consistent across all hospital ratings.

Austin and the team at the Armstrong Institute were commissioned for this project as a part of the 2016 Hospital Safety Score update from the Leapfrog Group.

In 2016, 798 (31 percent) hospitals received an A rating, 639 (25 percent) received B ratings, 957 (37 percent) received C ratings, 162 (6 percent) received D ratings, and 15 (0.5 percent) received F ratings.

Several hospitals showed that they are consistent in providing quality healthcare with high levels of patient safety. Over 100 hospitals received their third A rating in a row, showing that they have excelled in patient safety for the past three years.

The Hospital Safety Scores also highlighted certain states where patient safety is nearly universally achieved. In Maine, the state with the second highest number of A ratings, 83 percent of its hospitals received an A rating. Vermont had the highest rate of A ratings.

Other states did not perform as well. The District of Columbia had zero hospitals receive an A rating for the third year in a row, as did Wyoming and Arkansas.

According to representatives from the Leapfrog Group, these rating systems are all about promoting healthcare transparency to the consumer.

“It is time for every hospital in America to put patient safety at the top of their priority list, because tens of thousands of lives are stake,” said Leah Binder, President and CEO of The Leapfrog Group. “The Hospital Safety Score alerts consumers to the dangers, but as this analysis shows, even A hospitals are not perfectly safe.”

Tuesday, 14 March 2017

Dr. Data: How The Health Cloud Will Help Doctors Combat Disease: A GE Healthcare Initiative

It takes a typical computer several hours to process information from a CT scanner to see exactly what’s going on inside the head of a patient who’s just arrived at a hospital with certain stroke symptoms. But the typical window for treatment is limited to four hours – and likely moving to just three hours based on recent clinical studies. “Speed is one of the most important elements of treating stroke,” says Jan De Witte, president and CEO of GE Healthcare IT. “If doctors can intervene quickly, they can often help patients escape serious damage to the brain.”

De Witte’s team is now writing software that could help doctors move faster. The cloud-based app they are developing will be able to sort terabytes of raw data from a CT scanner – the primary tool for probing the brain of suspected stroke victims – into a full picture of the brain in around 5 minutes, processing of thousands of images in a single data set.

But it gets better. Since the data sits in the cloud, it will be accessible to experienced clinicians in certified stroke centers. They will be able to read patient scans from remote hospitals, discuss treatment online, and make recommendations to their colleagues in the field.

“Using the massive computing power of the cloud, we’re able to assemble complex images in 3D, manipulate them and generate little movies that show the blood flow through the brain and show doctors where the blockage is sitting.”

GE is already connecting jet engines, wind turbines and all manner of industrial equipment to the cloud. Medical machines will be no different. The shift to data gathering, software and analytics, and the powerful insights they provide are at the core of GE’s transformation to the world’s largest digital industrial company. On Monday, GE Chairman and CEO Jeff Immelt will be speaking at the annual meeting of Radiological Society of North America (RSNA) in Chicago – the medical imaging industry’s largest trade show – about the “GE Health Cloud”.

The health cloud is designed to be an ecosystem connecting software, hardware and medical devices. It will host data and also help doctors and clinicians collaborate and compare notes and insights as easily as using a social network.

John Flannery, president and CEO of GE Healthcare, says the amount of data from healthcare devices will grow 50 times by the end of the decade. The new cloud, which will meet security and privacy standard and other software development standards, will start by connecting more than 500,000 GE imaging machines.

The health cloud is built on the same Predix software platform that GE developed for the Industrial Internet. “We are fundamentally transforming life both for the radiologist and for the chief information officer,” says Justin Steinman, chief marketing officer for GE Healthcare IT. “Since it’s built on a single platform, the cloud will enable CIOs of healthcare systems to quickly scale up or scale down their IT systems and roll out the latest tools. It will also make it easier for radiologists to collaborate with their peers within their hospital and with outside experts.”

Predix is essentially an industrial-grade version of the types of platforms that power smartphones. It allows developers to quickly write apps as soon they see a new opportunity on the market.

At RSNA, GE Healthcare has announced its first cloud-based apps, focused on advanced imaging and clinical collaboration. By opening its cloud for third party app development, GE intends to attract independent software vendors (ISVs) to develop their apps in the new cloud ecosystem. “We’re looking for innovation anywhere,” De Witte says. “For example, academic medical centers have great developers who can write algorithms looking at specific diseases and then let them loose on the data that’s inside the healthcare cloud. The insights could be groundbreaking.”

Another application for the cloud could be wellness management, helping doctors and patients collaborate to proactively monitor their wellbeing. The customers could be healthcare systems as well as insurers. “We call this digital therapeutics,” De Witte says. “The cost of keeping somebody healthy is way lower than the cost of treating something that has gone wrong. At the end of the day, the payer has the biggest financial incentive to keep people healthy.”

De Witte says GE will move all of its medical software into the cloud by the end of the decade. “The industry is moving from healthcare that’s driven by volume to a system built on value,” he says. “The health cloud will help us get there.”

Courtesy: GE Healthcare