Usually, detecting cancer is done through a combination of physical exams, imaging tests, blood tests, and biopsies. A biopsy, where a tissue sample is taken and examined under a microscope. This process is time-consuming and often relies on parts of the health system working together quickly, which does not always happen. Some cancers, like brain, pancreatic, and ovarian cancers, are difficult to detect, which can slow diagnosis even further.

By contrast, liquid biopsies can detect cancer more quickly. This type of testing looks at bodily fluids (typically blood) for evidence of cancer cells by finding biomarkers that are shed by cancer cells into the bloodstream. Liquid biopsy technology is advancing fast and with new technologies emerging, such as using light to detect these signals. This is a similar approach to that used when small swabs are passed over luggage and analysed at airport security.

By combining this spectral analysis with artificial intelligence (AI), it is possible to speed up cancer detection at a significantly lower cost. At the forefront of this revolution in cancer detection is Dr. Holly J. Butler. Dr Butler is the co-founder and CTO of Dxcover, the company behind the award-winning multiomic spectral analysis platform. Grounded in biophotonics and driven by an unwavering dedication to improving patient outcomes, Dr Butler is striving to bring about a new era of non-invasive diagnostics; one where a couple of drops of blood and a beam of light might one day save millions of lives.

Dr Butler, alongside an award-winning leadership and research team, has been developing methods to analyse blood samples using infrared spectroscopy. What they discovered was a way of ‘reading’ the biochemical fingerprint of disease in a standard blood test. This research became the foundation of an award-winning proprietary platform that leverages a unique combination of AI and spectral analysis to detect patterns in small blood amounts, allowing clinicians to find cancer earlier, more accurately, and far more affordably than many existing techniques.

The potential is enormous. Unlike conventional liquid biopsies, which rely on picking up fragments of tumour DNA, this platform is more wide-ranging in its approach. It uses a multiomic strategy – looking at proteins, lipids, metabolites, and more – through a process known multiomic spectral analysis. It translates to even tiny tumours, sized at just 0.2 cm, being capable of leaving a detectable trace. And it’s all done with just nine microlitres of blood.

Dr Butler’s drive to transform scientific ideas into reality started early. After her Ph.D., she took on a Scottish Enterprise-funded project to translate laboratory-based research into clinical diagnostics. Her entrepreneurial endeavours were making waves as early as 2017 – she was ‘Young Entrepreneur of the Year’ at the Scottish Women’s Awards and received the Women in Innovation award at the Global Game Changers Awards. She has continued to be a vocal advocate for women in STEM and an active mentor to early-career scientists and entrepreneurs via the Strathclyde Inspire network in the intervening period.

“I’ve always been drawn to problems where science can make a real, tangible difference in people’s lives,” she says. “To me, early detection for the most difficult to detect cancers is one of the biggest, most urgent problems we face – and one we hope to solve.”

Dr. Butler’s role in bringing this innovation along is as much practical as it is strategic. She is part of a team that spans lab operations, data, software, quality and regulatory affairs, pushing the science to clear the bars for real-world medical use. “You can’t just invent a technology,” she says. “You need to prove that it works, scale it with safety, meet stringent quality specifications, and prove how it fits into clinical pathways. That is the challenge.”

For Dr Butler, it is about the impact on lives. “Cancer still kills nearly 10 million people a year,” she says. “The difference between early or late detection can be life and death. We want to make early detection routine – not something that’s just for some individuals or comes too late.”

Now pursuing an Executive MBA, Dr. Butler is expanding her leadership credentials. “Science gave me the means to innovate,” she says. “But the MBA is teaching me to lead, to strategise, to build something that can last.”

That ecosystem, she hopes, will be one where innovation and inclusion go hand-in-hand. She’s particularly passionate about ensuring that diagnostic breakthroughs become accessible across communities. “We’re aiming for a future where your GP can run a test like this early—long before you’re even referred to a specialist,” she explains.

Dr. Butler’s work remains patient-centred and personal. “Every time we detect a cancer that would have been missed – that’s the goal,” she says. “And every time we improve the technology is a step closer to a world where fewer people have to hear the words, ‘if only we’d caught it sooner.'”

The post Shining a Light on Early Cancer Detection appeared first on Medika Life.

In this context, I am pleased to report that we have one more colorectal cancer screening tool.

The U.S. Food and Drug Administration has approved Guardant Health’s blood test for detecting colorectal cancer.

Current Colorectal Screening Change

Colorectal cancer screening typically involves stool-based tests or optical/visualization tests, each aiming to detect the disease before symptoms arise.

Recognizing an increasing risk in younger adults, the U.S. Preventive Services Task Force updated its guidelines in 2021, lowering the recommended screening start age from 50 to 45.

This decision stemmed from mounting evidence revealing a concerning rise in colorectal cancer cases among adults under 50.

Statistical modeling further supported this change, indicating that initiating screening at 45 could potentially extend lifespans compared to the previous starting age of 50.

Colorectal Screening Summary

Here are the recommendations in graphic form:

Colorectal cancer screening encompasses various methods, broadly categorized into stool-based tests (like fecal occult blood test (FOBT), fecal immunochemical test (FIT), and FIT-DNA) and optical/visualization tests (such as sigmoidoscopy, colonoscopy, and virtual colonoscopy).

These diverse screening tools play a crucial role in detecting colorectal cancer before the onset of symptoms, significantly improving survival rates through early diagnosis and timely treatment.

Here’s a link to the many ways you can screen:

Colorectal Cancer: Screening

www.uspreventiveservicestaskforce.org

Colorectal Cancer Screening Blood Test: FDA Approval

Previously limited as a test with a self-pay price of $895, Shield’s U.S. Food and Drug Administration approval marks a significant milestone.

This pivotal decision paves the way for potential Medicare coverage, making this groundbreaking blood test for colorectal cancer screening accessible to a wider population, particularly older adults.

Blood Test Accuracy

While Guardant Health’s Shield blood test, which detects tumor DNA in the bloodstream, has shown promise with an 83 percent effectiveness in identifying colorectal cancers, it primarily excels in detecting later-stage cancers.

The test’s lower sensitivity for early-stage polyps (13 percent) necessitates regular screenings at least every three years, starting at age 45.

It’s important to note that a positive result does not equate to a diagnosis requiring further confirmation through a colonoscopy.

This test marks the second approved blood one for colon cancer screening, following Epigenomics’ Epi proColon, which faces challenges regarding its accuracy and insurance coverage.

My Take

This landmark decision opens the door for potential Medicare coverage in the United States, making colorectal cancer screening more accessible and affordable for older adults.

Do I think this blood test will replace colonoscopies?

No, but hopefully, it will boost the suboptimal screening rates in the United States.

Colonoscopy Is The Gold Standard

Beyond detecting tumors, colonoscopies play a preventive role by removing precancerous polyps.

However, the inconvenience of scheduling and preparation deters some individuals.

Guardant Health’s Shield blood test offers a simpler alternative with a straightforward blood draw.

The New Blood Test Available Soon

The company aims to make this screening option available soon. Hopefully, we will see increasing adherence to recommended colorectal cancer screening guidelines for healthy adults aged 45 to 75.

Shield is not the first blood for colorectal cancer screening. Epigenomics’ Epi proColon was approved in 2016.

However, the proColon test is not often used. Its accuracy is suboptimal, and there is a lack of insurance coverage in the U.S.

Summary

In conclusion, Guardant Health’s recent approval of its blood test for detecting colorectal cancer marks a significant milestone in improving accessibility to screening options for older adults.

While this blood test offers a simpler alternative to colonoscopies, I should note that colonoscopies remain the gold standard for detecting tumors and preventing the development of precancerous polyps.

It’s important for you to consider discussing colorectal cancer screening options with your healthcare providers to make informed decisions regarding your health.

The evolving landscape of colorectal cancer screening provides hope for increased adherence to recommended guidelines, ultimately contributing to improved early detection and patient outcomes.

As an oncologist, I would love to see fewer patients.

Please don’t get me wrong: I am not directly advocating for this particular new blood test; rather, I am pleased with any reasonable maneuver that nudges folks who don’t get recommended colorectal cancer screening.

What has been your colorectal cancer screening experience?

The post The Future of Cancer Screening Is Here: A Simple Blood Test You Can Take at Your Doctor’s Office appeared first on Medika Life.

Amid her surprising news, she discovered the Vancouver, Washington-based Pink Lemonade Project, a source of peer support and empowerment for breast cancer patients. Through their guidance, she rediscovered the strength within and built a new community of friendships.

This is the story of how Lisa Heathman turned medical lemons into “pink lemonade” and how she continues to navigate the maze of breast cancer decisions, drawing on the support of the patient advocacy community created by the Pink Lemonade Project. Her guiding mantra: “Get busy living or get busy dying.”

Gil Bashe:

I‘m going to jump in, and we’re going to explore your story because it is unique to you, and unfortunately, it’s not unique to women. It’s become a medical self-health tradition for women to have an annual mammogram, and I imagine that’s something you’ve been practicing for some time.

Lisa Heathman:

I always made a point of getting my mammogram. I got them regularly, and the diagnostic center always used to send me that letter afterward saying I have dense breast tissue, so the scan techniques were not nearly as accurate. A routine mammogram looks dark, and then if there’s anything alarming, it looks white. On a woman with dense tissue, everything looks white. It’s hard to find an anomaly in it because of the white-on-white. That is core to the problem. Because even though I was getting those mammograms regularly, they didn’t see the problem.

Bashe: 

You know, for women who have dense breast tissue, and it’s not a small number. It affects cardiovascular scans and mammograms – leading to the danger of false negatives.  I hear about this too often. 

Heathman: 

It’s pretty darn common.

Bashe: 

It’s the equivalent of going through the motions but not having a mammogram; It’s a public health risk worthy of greater awareness and physician-patient conversation.

Heathman:

Exactly. According to my doctor, I’m doing what I needed to happen from a self-care standpoint; there wasn’t a family history. My grandmother did have breast cancer, but my grandmother is just one-quarter of my genes. My physician didn’t regard me as particularly high risk. So when I kept getting those notifications that the screening tool wasn’t wholly accurate (and we talked about this for two years in a row), he told me not to worry.  Accessing advanced screening is challenging; the insurance companies wouldn’t cover it. That meant I had to get the screening and pay out of pocket. On top of that, I would have had to do that every year. We’re talking about thousands of dollars out of pocket.  

Bashe:

Insurance is a little bit like the law of averages. They think, “We’re not going to cover this because the chances of her having breast cancer are pretty slim, and if we cover it for her, we’ll set a precedent, and we’ll have to cover it for everyone. Let’s pretend we’re going through the motion of doing breast cancer screening.” 

Then boom, something happens.  There is something suspicious when you call up. I imagine your doctor said, “Well, come on in, and we’ll talk about it.”

Heathman:

Something you said reminded me of something I think is essential to share. And then, I’ll get to how I found my cancer. The other thing that’s recommended is that women do self-exams.

First of all, I breastfed both my kids, and I always had trouble in my left breast with clogged milk ducts and all kinds of lumpiness, nothing hard, nothing like they always used to say. If you’re feeling anything that feels like a pea or a pebble, that’s alarming. You need to be checked out. But if everything feels like it always has, you’re probably fine.

It always felt normal. My left breast was lumpy because it had been lumpy ever since I breastfed my kids. Nothing felt odd, and I never did have that hard stone or pea-shaped shot that they always say it feels like.

Bashe: How did this surprising discovery unfold?  How was this discovered?

Heathman:

How I found my breast cancer was a stroke of luck, which doesn’t sound like a stroke of luck when I tell you this story. My partner Tom and I went mountain biking. We were on a camping trip up near McCall, Idaho, mountain biking almost every day. One day, we decided to take the mountain bikes up to this lake – there was supposed to be great fishing up there. It’s five miles on the single track. There was one place near the lake where you had to cross a creek on a little bridge, and I fell off the bridge into the water! Fortunately, it was September, so the water level was relatively low, but the bike fell on top of me and pushed me into a tree trunk. I dislocated my shoulder.

When I got back to Portland, I told my doctor what had happened, and we decided that I should do a course of physical therapy because it was still painful. The physical therapist and I worked on this for about a month. Instead of getting better, the symptoms got worse. My physical therapist said I should get an MRI.

I had to see the doctor for an MRI, and he said: “It’s been a year since I’ve seen you, so you might as well just come in.”

That was the luckiest thing ever because when I went in 10 days later, he did the usual check of the lymph nodes. He was doing the examination and said, “How long have you had this lump under your left arm?” I said I didn’t know I had a lump under my left arm. I can hardly reach it right now because my right shoulder was so screwed up from the accident. He said, “I feel a lump under your left arm, and we need to get you in for an ultrasound.” That was the beginning of the odyssey of finding out I had breast cancer; it was just a stroke of luck.

Bashe:  I don’t know if it’s a stroke of luck, but it’s like, “How I dislocated my shoulder and saved my life.”  From the moment your doctor said, “What’s this lump underneath there?” What went through your mind?

Heathman: 

Honestly, I was not terribly concerned, and I’ll tell you why. I’ve always been very active and very healthy, and nothing traumatic or awful health-wise has ever happened to me. I first talked to my physician sister, and she said, “Well, it could be many different things. Let’s not get too worried.”

So I wasn’t upset. I was like, I’m sure it’s nothing, I’m sure it’s nothing, but it wasn’t nothing. I went in for the ultrasound. I was lying on the table, and it was quiet. I remember thinking I was tired. I could almost take a nap. She went away after she was done and was gone for a long time. I thought, well, that’s odd. Then the doctor came in, sat down, and asked me all these questions. “Have you been feeling okay? Are you losing any weight?” All of a sudden, I began to perspire profusely. Suddenly, I thought nervously, “Oh goodness, oh gosh. What is happening here?” My stomach was immediately nervous. “Uh oh. This is not nothing.”

All of a sudden, I was very, very afraid. I had never had cause from a health standpoint to be so scared. I was terrified, like we were not talking about a nothing thing here at all. He sent me then for a biopsy, I believe.

Bashe:

Did he say at any point you might be looking at cancer?

Heathman:

He did. That was the root of all those questions: are you feeling okay? Have you been losing any weight? I feel fine. And no, I have not lost weight. But I was just terrified. Suddenly, it was like it was real. I went in for the biopsy next, and it came back positive for cancer. I then had an MRI, where they could first visualize it. That was the first time anyone had seen that there was a tumor in my breast. It appeared pretty good-sized and had probably been growing there long.

Bashe:

The challenge with the diagnostic system, particularly the mammogram, is that we get into a “check the box” mindset, as opposed to the need for your doctor, other doctors, to say that if someone has dense breasts, we have to reject the mammogram approach, have a diagnostic procedure, and ensure coverage. At least reimburse women for the scan every other year.

Heathman:

You could alternate. Over the years, I’ve often thought, you know, it would have been great if every other year I had a mammogram one year and an ultrasound another year, and they could have alternated. Ultrasounds are not expensive; they’re standard.

Bashe:

A part of it is that the payor contracts with the radiology center to have mammograms done at a base price. Let’s say the insurance company will tell you to go to one of three radiology labs in your area. They’ve created a volume discount price. That discount takes precedence over your specific physiological or biological needs. That’s the challenge we face in the payor system: health for everyone, but not necessarily health for you.

Heathman:

Health for the average baseline. I learned from the Pink Lemonade Project that in the Northwest, one in seven women will be diagnosed with breast cancer at some time in their lives. Nationally, it’s one in eight. That’s many women.

Bashe:

How did you get involved with the Pink Lemonade Project?

Heathman:

That’s an interesting story. When I was first diagnosed, one thing that seemed right was to join a support group, so I did.

It was through my hospital, and I hadn’t even lost my hair yet. I was super early in the process. I think I lost my hair after my second or third chemotherapy round, but I was in the support group even before that –  just diagnosed. I remember my first support group meeting, which was not a Pink Lemonade support group meeting. It was just through the hospital.  It wasn’t completely satisfying, but of the eight women, one woman, Susan (Susan Stearns), well, we hit it off and became friends.

Susan got the job of CEO of the Pink Lemonade Project. I was introduced to Pink Lemonade through her and her fortune in working with this amazing organization, which drove the conversation and possibility.

Bashe:

The personal connection was very important here.

Heathman:

There’s a silver lining in this cloud, and that silver lining was Susan and the Pink Lemonade Project. They’re based in Vancouver, Washington. I live across the river in Portland, Oregon, and Susan Komen is a well-known breast cancer charity in Portland. What a lot of people don’t realize is that Susan Komen is no longer providing local support. They are only a national nonprofit now. The local programming in almost every community had to be pulled.

It is up to local organizations like the Pink Lemonade Project to pick up the slack and provide those programs locally that Susan Komen could no longer fulfill. Organizations like the Pink Lemonade Project must create opportunities and support for women seeking local support.

Bashe:

You had some difficult decisions to make then. You’re diagnosed with breast cancer. It sounds like chemo and radiation were part of the decision-making process, maybe more. Tell me a little bit – not about the medical stuff; I understand that, but the sense of how you felt at that moment and what role the Pink Lemonade Project played in getting your perspective. It sounds like you’re very self-aware and in touch with other people, but you’re now in what I’ll call an “extreme situation.”

You enjoy bicycle riding, fishing, hiking, skiing, and the great outdoors. Your sister is also an official hand-holder. You have a medical guide at your beck and call. Tell me what role the Pink Lemonade Project played in your life and what role you played in their life.

Heathman:

From the standpoint of an organization like the Pink Lemonade Project, I was very fortunate that I didn’t need to take advantage of some of the programs that Pink Lemonade delivers to women or people with breast cancer — because men get breast cancer, too, as you know.

Pink Lemonade provides practical support, transportation to appointments, treatment options, care for lymphedema and swelling after the lymph nodes have been removed, support groups, and valuable information, such as whether a woman needs a wig because she’s lost all her hair. I took advantage of some of the things that the Pink Lemonade Project provides.

I do have a good employer, a car, and good insurance. I had all those things covered. I have a really good support system. You could argue there wasn’t much I needed. What I found that I took advantage of was the support groups. They have a metastatic breast cancer support group. It’s geared mainly toward women who have a stage 4 cancer diagnosis, such as me. They are women who are in many ways in the same boat that I am in, and their questions are the same questions that I have, and the kinds of experiences they have are the same kinds of experiences I have.

Many women are older, have retired, and are no longer working. But not all of them – many of them are young women who are raising families. Many of them are younger women who are still working, trying to have a career while they’re going through treatment. That was important to me because I am still working, and I continue to work through treatment, but it hasn’t always been easy.

Having other women to bounce ideas off and get good advice was unbelievably important. The other important thing about being involved with an organization like the Pink Lemonade Project is that you are surrounded by women and people who hear what’s on the cutting edge of treatment. When you have a stage four diagnosis, your doctors, you, as the patient, and your family must understand that the breast cancer community, the medical community, is constantly coming to the table with new treatment ideas and new treatment options.

In time, treatments may stop working for a person, and they may need to go to whatever the next treatment is. And that’s incredibly important for someone with a stage four diagnosis because the treatment that I’m on may not always work. So that’s important, too.

Bashe:

As we spoke, I remember the first time you had a very reflective way of looking at this. You know you have a philosophical strength about life and being present. I also sensed you were quizzical about the future. There’s an authentic presentation when you speak. I’m curious if that mindset is present in your conversations with other members of the Pink Lemonade community and if the conversation is equally sharp.

Heathman:

That’s why there’s such a striking difference between the people I’m now talking to within support groups and that first experience, which was very negative and unsupportive.

The women in the support groups are very practical. It’s odd, but you rarely encounter a person in these support groups saying “Woe is me” or wringing their hands. By and large, they have been the most positive, gracious, giving, extraordinary women, people, but mainly women, and that’s what I needed in a support group. I needed to be surrounded by other people going through the same situation but meeting it with this: “We’re going to get through this.”

One of my favorite movies is The Shawshank Redemption, and Tim Robbins, one of the main characters, says a line that goes something like, “Get busy living or get busy dying.” I think about that all the time – here I am, and this is what I’ve got to get through today or this week, or this surgery or that treatment; I’m going to get busy living because it’s the only choice I have.

I’ve been surrounded by people making that same choice, which I needed in a support group. There’s no Pollyanna; not many women say this is not a big deal. It’s a huge deal. But they’re practical about it; maybe we’re all good at compartmentalizing it. This is a bucket that’s over here. This is another bucket that’s today. This is another bucket that’s tomorrow. I am still determining what the future will bring, but worrying about it doesn’t change it.

Bashe:

The sharpened sense of mortality creates a vibrancy about life. You might not have taken special vacations beforehand, saying, “Oh, I don’t know if I want to spend the money right now.” Now you say, “I think we will take that vacation. I want to go there and see that. I want to do that with you.” Does that play out from time to time? I don’t know about 20 years from now, but I do know right now.

Heathman:

It’s an excellent question. My version of vacation is being able to get outdoors and do the things I love, whether skiing, biking, hiking, or fishing. You’re right—I find it easier to say yes to those things because I don’t tend to talk myself out of them like, “Oh, you shouldn’t” or “It’s too expensive.” Life is short.

Those kinds of things are things that I need to experience, things that I need to do. This sharpened sense of mortality goes beyond just thinking about time away or vacations. It just factors into my overall decision-making. Are we going to build that addition on the house? My car was eight years old. Am I thinking maybe it’s time to get a new car? And it’d be easy to say I might not need that new car. Does that make sense? But if I decide that I don’t need that new car, I’ll not be getting busy living.

Bashe:

That line you shared about the Shawshank Redemption is true – “Start living.” You can think about the clock stopping, running out of line, the click, click, click. The clock is still working, and I don’t want to break down on the side of the highway. Why not enjoy the new car now?

Heathman:

Exactly. Why not do it now? Because you may not have forever. And to your point, Gil, we all imagine ourselves immortal until we have a significant health crisis. It’s too terrifying to think of the alternative, and most of us don’t until we have to. But in no way has it consumed me. I’m not going to say I never think about it. I think about it. I’ve even explored some things that are specific to that. But it isn’t as though I’m consumed by it. I don’t live my life like that.

Bashe:

“I’m here, and I need just to enjoy the fact that I know I could be elsewhere, so to speak, but I have a certain sense of strength and understanding that lean into the here and now.”

Heathman:

Some days are hard. There are things about being in treatment that are hard, and sometimes challenging things happen that are work-related or what have you. Then, I’ll join a support group, and I’ll be able to talk about what is happening. Someone will have had a similar experience, and someone else will have a funny thing to say about it.

Before long, I found that I was happy I was here and that they were here. There have been times when someone was not there. In particular, one woman is no longer a part of our support group because her cancer came back, and it came back with a fury, and she died. I still miss her. She was such an incredibly kind, caring, altruistic person. In support groups, you meet people who may show you something you didn’t see, something that feels like someone making your day better.

Bashe:

Well, they say you’re exceptional, and those that do are beyond spot on. The reality is that you’re in the midst of an adventure in which the ending has not been written, and you are very present about where you are and what you’re feeling, but you’re very much in harmony with other people. The support group, I think, the Pink Lemonade Project community, has brought out something that was always within you: the understanding that we need each other.

Heathman:

Absolutely. If there is a silver lining in all of this—and some days, it’s hard to find one—I have a much different understanding of others and what others want and need. It’s changed me. There’s no getting around the fact that cancer has changed me, and I think that cancer has changed me for the good as well.

I cannot say enough about my experience. Again, it is not always pleasant, and it’s not fun, but I feel so supported. I think back to that woman that night who I met who had nothing good to say about her employer, and I think, Oh, honey, I wish you’d had a very different experience, like I’ve had, of what real support feels like because I think she was bitter.

Bashe:

You know, it’s a two-way street. You’re an incredibly inspiring, uplifting person who understands and speaks about the importance of patient support groups like the Pink Lemonade Project.

Your experience is distinctly unique. You are an incredibly inspiring person, and the fact that you welcomed this special community into your life speaks volumes about your ability to recognize this level of life challenge is difficult enough – but going it alone adds another complexity to the health struggle. I think many people need people like you, Lisa; they need to read about people like you because it gives them a sense of hope for this day and tomorrow. Thank you for this time.

We often read about people confronting cancer diagnoses and their worries about therapy and survival. We read about varied patient advocacy and support communities. Lisa Heathman and the Pink Lemonade Project offer another perspective—how friendship forged through this difficult journey leads to better medical and emotional care. A key lesson is that people with dense breast tissue should take advantage—advocate for advanced screening!

You can connect with the Pink Lemonade Project, which offers support to men and women, through its website and follow its updates on social media.

The post A Cycling Accident Saved My Life appeared first on Medika Life.

In her first book, Fragmented: A Doctor’s Quest to Piece Together American Health Care, published by W. W. Norton, Dr. Yurkiewicz explores one of medicine’s daunting challenges – how patients, payers, policymakers, and providers must navigate the sea of medical record information that can be used to accelerate or become an obstacle in medicine’s primary mission – to heal.

Suppose we continue to avoid addressing the pitfalls of health-sector fragmentation. In that case, it will continue to increase costs, result in unnecessary hospital visits, negatively impact patient adherence and care disparities, and, even worse, lead to death.

Other bestselling books champion the concept of patient centricity – with information used to address medical needs swiftly.  But what information is available and how it is accessed remains a human function – a system-wide hurdle.  The desire to be healed and the readiness of healers to answer that call still faces a significant challenge – fragmentation.

“There’s an unspoken assumption when we go to see a doctor: the doctor knows our medical story and is making decisions based on that story. But reality frequently falls short. Medical records vanish when we switch doctors. Critical details of life-saving treatment plans get lost in muddled electronic charts. The doctors we see change according to specialty, hospital shifts, or an insurer’s whims. Physician Ilana Yurkiewicz calls this phenomenon fragmentation, and, she argues, it’s the central failure of health care today.” [W. W. Norton]

Medika Life offers readers this exclusive interview with Dr. Ilana Yurkiewicz, an award-winning author and dedicated physician with expertise in internal medicine, oncology and hematology, who unites the story of patients and physicians working to overcome one of the more significant challenges modern medicine faces. In her book, which outlines how information goes unshared, she highlights how “Critical details of life-saving treatment plans get lost in muddled electronic charts. The doctors we see change according to specialty, hospital shifts, or an insurer’s whims,” providing a much-needed perspective.

The Journey of a Physician-Author – To Illuminate and Heal

Gil Bashe: Congratulations on your work. Fragmented is a word I’ve used to describe the health ecosystem. You eloquently bring it all together in your book. You have been a journalist since your undergraduate years and now combine your love of medicine with writing. Could you give me some insight as a clinician, as a physician why you also wanted to be an author?

Ilana Yurkiewicz: I’ve always had those two careers going on in parallel. I knew from an early phase when I was in college that I wanted to become a doctor. I was always interested in both the sciences and the humanities. My interests were in combining them to make science and medicine accessible to everyday people.

I was a writer and an editor for the Yale Scientific Magazine, and since then, I’ve written in long and short form. I see the skill set I use in medicine and journalism as overlapping. When I counsel patients, I try to take complex ideas and break them down into information nuggets that people can understand. I do that when I’m in the exam room and when I write.

Bashe: In your book, you demonstrate a unique superpower to hone in on the patient you’re with. Is the real challenge about lack of access to information uniformly, not giving the clinical staff sufficient time to absorb patient information or a combination?

EMRs are Not a Book – They Remain a Puzzle

Yurkiewicz: It’s a very insightful question with a very long answer, but the short answer is that it is a combination. The electronic medical record (EMR) is not currently written in a format that is readable and meaningful to most providers. We first have the issue of interoperability, which addresses sharing records between different facilities. Sometimes I work in my clinic or the hospital, and I don’t have access to records from a doctor’s office down the street. So one issue is that records go unshared.

The second issue, though, is that even when all of the data is technically there – even if it’s all in the EMR – the EMR, as it stands, could be more organized. It’s little bits of discrete data put in different tabs that providers have to click, click, click, click through, trying to find a meaningful narrative themselves. I often tell my patients that the EMR is not written like a book. There’s no beginning, middle, and end. There are a ton of redundancies. A recent study showed that about 60% of doctors’ notes are identical to their previous notes.

To understand a patient’s full story, you are doing a lot of digging and clicking. You are trying to put pieces together manually to create a useful narrative about a patient that can help you make decisions. That process is labor-intensive and error prone.

Thirty percent of primary care doctors report missing findings even if all the information is in the EMR, because they’re clicking through so many tabs and need to know where something will be stored. So that’s problems one and two: how the EMRs are shared and organized. Issue number three, then, is time. You can imagine clicking through, say, 30 tabs to find one piece of data you’re looking for and then clicking into outside records and trying to collate them takes time.

When I meet a new patient in the clinic, if I’m doing it right, it takes about 30 minutes to do the preparation part of collating all the data into a narrative where I can think about next steps. And I’m only given 30 minutes per appointment.

So all this work starts accumulating for doctors, and we’ve gotten to a place where it’s unsustainable. We don’t have the time even if all the data is in one place. We need more time to sort through it in a meaningful way. I’ll add that one more study recently said that if primary care doctors did everything they’re supposed to do in a day, they would be working 26 to 27-hour days.

The Challenge of Navigating the Fragmented Health Ecosystem

Bashe: In the book, you discuss your interactions with patients across institutions like Cleveland. I wanted to get your read on the bigger fragmentation of the health system. When you think of information fragmentation, you say, ‘How does a patient navigate all this?’ How do you navigate the fragmentation as a clinician? You’re an expert in knowing the system and a visitor to the system. What do you think about that? I’m not asking you for the prescription to resolve fragmentation, but I think the readers would value your perspective on how patients must navigate the system.

Yurkiewicz: How do people do it? With incredible difficulty. Doctors do it with great difficulty, and patients do it with even more difficulty.

All sides need to communicate in a way that can help patients make the best decisions for themselves. At the same time, the cruel twist of irony is that patients are the ones who are currently expected to do all of the work of navigating the healthcare system, and inequalities fester. Some patients have become experts at navigating insurance and their different clinics and teams of doctors. They have learned to advocate for themselves by sending just the right message with phrasing that will push their doctors to communicate well. But not everybody can do that. And nor should they have to.

Recently one of my patients in her late 60s was diagnosed with mild cognitive impairment, which is a precursor to dementia. She lives by herself. She has no family to help her with day-to-day tasks, including navigating the medical system. She came to see me for a first appointment. I started running through a list of medical issues we had to address, and by the end, I gave her a to-do list. I wrote instructions down and said, ‘You call this number; you go to the lab in this location. Then you have to print out this data and bring it to the next place.’

I went through all these steps, and then she asked me them again. By the third ask, my heart was breaking as I knew she could not follow these steps; I could see the gulf of fragmentation enveloping her. I knew she would fall through the cracks if we didn’t change the approach. I simplified the list and put the highest-priority items on it. I said, ‘This time, do one and two, then come back to see me in a month, and we can try to address three and four.’

Tragically, our system is set up to let people like her fall through the cracks. The people who don’t have family members – patient advocates – are often unable to navigate this complicated system.

The Vulnerable Patient – Struggling to Understand and Be Understood

Bashe: Perhaps the most vulnerable and costly patients suffer because of the fragmentation. Now we have systems being created on systems that are being created on systems. What are your thoughts on how that addresses the spiraling fragmentation? Or are we just really adding to or splintering the fractured system? Is it getting further and further away from being pieced together, and are we seeing the rise of information anxiety or any hope of a cure for this fragmentation?

Yurkiewicz: We are seeing an explosion of fragmentation. We now have diagnoses and treatments for things that, 50 years ago, we never thought we could diagnose and treat. But the devil is in the details, and a patient’s ability to do well through a disease depends so much on what is often ignored – logistical hurdles.

The focus in the mainstream is often on treatment innovation rather than the details of whether the medication regimen is appropriately transferred from one doctor to another. Suppose the details of that life-saving treatment plan are written in a way in the EMR that everybody can see and access. Of course, it’s wonderful that we can treat illness better. But without an equal investment in connecting these logistical pieces, we are getting an explosion of information fragmentation, and patients can’t get the most out of these treatments.

I think in our public and political discourse, we need to emphasize equal investment in making sense of the information we already have and connecting it between doctors’ offices, between hospitals, and between one doctor to another within the same hospital.

The Power of Generalists and Specialists in Collaboration

Bashe: You’re focused on the human experience in medicine and oncology. You see medicine as the journey of a person – a patient – from their diagnosis, treatment, and then ideally post-treatment and dealing with the survivor experience. You’re also seeing your clinical journey through the eyes of the patient experience. How does that help you pinpoint fragmentation and help patients?

Yurkiewicz: Internal medicine is designed to look at the big picture.  I trained first in internal medicine and afterward in oncology and hematology. When I was done with all that training, which was 14 years, including undergrad, med school, residency, and fellowship, I decided to open a primary care practice focusing on cancer patients and survivors.

My job is to take care of the whole patient. I’m privileged to take care of their cancer and everything resulting from their illness and treatment even years later.

In my training, I learned to look at a fragment of a patient’s narrative from the specialist lens. So when I was in internal medicine, my vantage point was very different from when I was in oncology. When I became an oncology fellow, I felt like I had crossed this invisible line where my training told me to look for clues suggesting cancer or a blood problem.

And so I learned how to look for those clues and hone in on a patient’s needs using my specialist lens. I’ve had to retrain myself to take a step back and look at the big picture. I try to see the whole patient and embrace how their concerns fit together.

Neither Hope nor Hype – Cautious Optimism

Bashe: You were already a great writer of magazine articles and op-eds. You were published in Scientific American a few times. The book is coming out, and certainly, people in the health system will read the book very carefully realizing how significantly fragmentation impacts care and cost. Try to project that people will read your book a year from now.  What do you hope will be achieved through their experience of reading your words?

Yurkiewicz: There is a one-year goal and a longer-term goal. In one year, I want the book to help empower patients and family members to navigate the system better. I am an optimist, but unfortunately, I don’t think fragmentation in health care will be solved in one year. There are many factors and many incentives that make it very complex.

I’m hoping that in 20 years, my book will be closer to obsolete. Over the years, we can start to tackle each one of the factors of fragmentation toward a more sustainable healthcare system.

Bashe: Medicine is becoming increasingly specialized. Once upon a time, of course, gastroenterologists were gastroenterologists. Now you have clinicians at Stanford who only deal with the upper GI; others deal with the lower GI. You have cardiologists who are interventionalists. Others deal with lipids and so forth. Specialties pushed them to be experts. Are we getting to that level in medicine where doctors are becoming skilled in a tiny piece of the human body and patient experience?

Yurkiewicz: I once heard from a colleague in the sciences that we’re learning more and more about less and less until we know everything about nothing. And I wish that did not apply to medicine, but we’re heading in that direction because we promote specialization and sub-specialization.

For many reasons, it often leads to greater financial reward and respect within the medical hierarchy to become an expert in something narrow. And while specialization itself is not necessarily a problem, problems can arise when we have to reconcile different narratives that doctors tell themselves about a body part or an organ system.

Sometimes, no one person is looking at the whole patient, seeing if we can put the different narratives together into a unifying diagnosis or a unifying treatment plan.

I share in my book one story about a woman that I took care of in the hospital. She had leukemia and was very immunosuppressed due to chemotherapy, and she had an issue brewing in her lungs. She was gasping for air while I had to increase her oxygen support every day to the point that I had a frank conversation with her about whether she would want to go on a ventilator if her oxygen levels continued to worsen.

We had three teams of doctors on the case. There were infectious disease doctors, pulmonary (lung) doctors, and hematologists who specialized in her cancer. Each team came up with a perfectly reasonable assessment from their vantage point.

The infectious diseases team said, ’We’ve already treated her for most infections, so just throwing on an additional treatment is not going to help her. We’ve treated her with antibiotics and antifungals for a long time. We’ve treated the most highly likely things.’ And then the pulmonary doctors said, ‘Well, she already went to bronchoscopy. That didn’t reveal the diagnosis, so we shouldn’t do another one that’s going to be low yield, and it’s going to be risky because her platelets are low, and taking a biopsy could cause her to bleed.’

Meanwhile, the hematology team said, ‘She’s immunocompromised from chemotherapy. There’s no way to speed that up.’ Every single one of those analyses was perfectly sound. However, you put them all together, and we had a patient deteriorating before our eyes. Three narratives added up to say we should stay the course, which didn’t feel like a narrative that was the right one yet.

I share in the book what ended up happening to this patient, where I decided to treat empirically for the unlikely possibilities after each team ruled out the likeliest ones.

I don’t share this story to toot my own horn. But sometimes it takes somebody to take that step and say these reasonable assessments from each specialist’s point of view do not add up to a reasonable conclusion when taken together. An internist is trained to look for that big picture, but the empowering fact is that it can be a specialist who takes those proactive steps to look at what other specialists say about their patients and consider whether it adds up to a reasonable conclusion. It can even be patients and their family members at the bedside who advocate for their teams to come together and reconcile their assessments.

Again, it was not specialization itself that caused this problem. But we have to take that extra step to ensure that specialists reconcile their clinical narratives in a way that makes sense for the patient.

How to Obtain Fragmented

The public health urgency in the shadow of the pandemic continues to reveal serious vulnerabilities. We see inequitable access to care and lopsided disease and mortality burden among diverse communities as another tragic manifestation of racial injustice. We read about an increasingly fragmented care-delivery system splintering even further as new technologies such as AI and ChatGPT create expectations that physicians should see more patients daily – not dedicate more time to each patient.

Dr. Yurkiewicz’s book is a welcome, first-hand objective look at this struggling health system dedicated to helping patients while awash in information.  Her candid expression of the patient and provider journey is vital in helping unite the disparate pieces.

Dr. Ilana Yurkiewicz’s book Fragmented: A Doctor’s Quest to Piece Together American Health Care, published by W. W. Norton, is available via the publisher, Amazon, and where all major books are sold.  Follow Dr. Yurkiewicz on Twitter and LinkedIn.

[Special thanks to Carolyn Neugarten, editorial assistant, Medika Life, for her keen eyes and comments. Coming from a healthcare household, her interest in journalism and social action accelerated the publication of this interview.]

The post The Book Fragmented is a Key Step Toward Navigating America’s Ailing Health System appeared first on Medika Life.

A Duke University professor of bioscience, Dr. Nita Farahany, has published a book on the subject, and what it reveals may be intellectually exciting, but also seriously concerning. The broad scope of the book’s topic I’ve summarized below, along with some additional information.

Two distinct businesses, Meta and Neuralink, are investigating the potential for using innovative technology to reveal people’s thoughts. The ultimate aim of both businesses—which are addressing it in different ways—is to create tools that can record and decipher the neural activity of the brain.

Meta, formerly known as Facebook, is looking into the development of brain-computer interfaces (BCIs) that allow for the direct recording of neural activity from the brain. Scientists want to create a wearable gadget that can record electrical signals produced by brain activity and convert them into digital signals that a computer can understand.

Users will talk to digital systems with their minds thanks to the device, which works like a keyboard or mouse. Even though we don’t know all of the details about their technology yet, it is thought that their device would accurately read brain activity by using electrodes and machine learning algorithms.

On the other hand, Neuralink is investigating the creation of a brain implant that can communicate with the brain directly. The implant consists of a tiny chip that is placed into the skull and coupled to electrodes that are inserted into the brain. It is currently being tested on animals. The ability of the electrodes to pick up neural activity lets the brain and digital systems talk to each other in both directions and makes certain parts of the brain work.

Neuralink’s goal is to create a tool that can treat neurological conditions like Parkinson’s and Alzheimer’s, but the technology can also divulge private thoughts. The idea of the “thought police” is becoming a reality. It has shades of the book “1984” only this one is a definite reality.

Though they are both still in the early phases of research, Meta and Neuralink’s technologies have the power to completely change the way we interact with digital systems and disclose private thoughts. But this technology also brings up important ethical and legal questions about how these devices can be used and abused.

One of the biggest worries about brain-computer interfaces is that they could spy on people. Devices might be able to reveal private information like opinions, thoughts, and emotions if they can accurately read cerebral activity. They might employ this information in criminal investigations or even to influence people. As a result, there might be a need for legal action to control the use of such devices and safeguard people’s privacy.

The potential for such technology to be abused is another worry. For instance, there would be a risk of cyber-attacks or hacking if a brain-computer interface were used to control a digital system like a car or an airplane, which may have disastrous effects. Also, this technology could make mind-controlled soldiers or other mind-controlled laborers, which would take away people’s freedom and be against human rights. Are we headed for the world of Total Recall?

The development of brain-computer interfaces has the potential to completely change how we use digital systems and reveal our deepest thoughts. However, it also raises important ethical and legal questions. It is crucial to carefully weigh the possible advantages and risks of such technology and to make sure that moral and legal frameworks are in place to safeguard people’s liberty and privacy.

Obviously, one of the problems with this technology is the lack of understanding in legal circles about it. If people in Congress can’t follow explanations of current technology, how will they respond to highly complex systems?

The post “Cognitive Liberty” May Be Imperiled in a World of AI Intrusion appeared first on Medika Life.

Blood sugar levels are already routinely monitored in patients with diabetes or those at risk of developing diabetes, but the importance of maintaining stable blood sugar levels for overall health is becoming more widely recognized. Elevated blood sugar levels, even if not high enough to indicate diabetes, may be associated with an increased risk of cardiovascular disease, kidney disease, and other health problems.

As a result, tracking blood sugar levels without diabetes or pre-diabetes may become a tool for managing both disease and wellness. Or perhaps, availability of broader data sets can foster research examine blood glucose levels and trajectory to offer new insights into the pathophysiology of related diseases at earlier points in time.

Digital health has often offered monitoring solutions that reside in the consumers hands (or wrists). And this has certainly been a mixed blessing.  Some tools have provided valuable insights into health.  Yet some have become merely a source of arbitrary information that cannot be translated into clinical value.  Further, this added burden to healthcare providers may further preclude adoption.  But as innovation has taught us, the next big thing can often be close at hand.  The emergence of continuous blood glucose monitoring (CGM) has been transformative for patients.  And the new data sets have given scientists powerful insights into glucose kinetics and insulin administration.   And these insights maybe game-changing with the global concerns of obesity and metabolic syndrome.

Your watch is becoming a value tool in wellness and disease management.  And that value is only beginning to be realized and implemented.

The post Will Blood Glucose Become The New Blood Pressure? appeared first on Medika Life.

Trepidation. That one word describes the uncertain economic climate that grips corporate and investment decision-makers. If we are to believe headlines, wallets have tightened, and investment in digital health and health tech, as a result, has taken a nose dive. That go-to conclusion overly simplifies complex investment strategies in a sector that has shown great resilience year-after-after.

Two-Year Pandemic Funding Spree Fizzles Out

After an extraordinary two-year pandemic funding spree, there are apparent shifts in how investors make economic decisions. In this year of geopolitical turmoil and uncertain financial performance, digital health remains integral to the future of the health economy and in addressing public health pressure points. However, the development stages in which funds are directed, therapeutic categories selected, provider systems that demand transformation, and the regions where innovators establish headquarters are now key investment decision factors.

COVID served as an urgent sector testing ground. But the obsession with COVID must not overshadow the possibilities for continued growth in new areas of medicine and sustainability. As life-saving efforts around patient care and drug development ground to an almost complete halt, technologies that enhanced telemedicine and remote patient monitoring became the “no going back” path to pursue medical practice and innovation. This is just the beginning of the surge in how these technologies will transform human and planetary health.

Also, the human body – our well-being and survival- is biological and ecological.  We are beginning to see first-hand the harsh realities of climate change and these stormy reminders that the planet doesn’t need people; people need the planet. Follow shared urgencies, and you find value investors at the earlier stages seeking equity and influence.  Corporate environment, social and governance (ESG) priorities are becoming new due diligence points for investors as they access technologies and services of significant importance to governments and industries that have pledged commitment to net zero policies.

Tel Aviv Joins the Medika EcoHealth and Health Travelogue

While the digital health sector has grown significantly during the past decade, it must be mobilized to address unmet needs. From $2 billion invested in 2011, that figure morphed 28-fold to $56 billion in 2021. In the shadow of the COVID pandemic, unprecedented investment poured into digital health during this two-year window, accelerating the adoption of AI, AR, remote patient monitoring, telehealth, digital therapeutics, wearables, VR and more. These are all technologies Israeli entrepreneurs have called upon to improve care, track patient needs and reduce costs.

Tel Aviv, Israel – the first spot on our ecohealth and health tech travelogue – is taking the lead globally by combining the talents of biologists and engineers. Among the key people to watch in this market is Levi Shapiro, founder of mHealth Israel – a not-for-profit community of almost 20,000 innovators – from start-ups to established players.  Shapiro is more than the curator for this community. He is Israel’s unofficial ambassador for innovative ideas.

Collaboration is the SynBio Power Ingredient

Among the hottest new areas for investment – just coming onto our radar screen – is synthetic biology or SynBio.  Experts such as Avital Adler, Ph.D., Yuval Dorfan, Lior Nissim, Gita Reinitz, and Tamir Tuller are among the leaders in this growing collaborative movement to unlock solutions to the mega planetary challenges. Pearl Cohen, a leading Tel Aviv-based global law firm representing emerging innovation companies, is hosting SynBio 2023.

While too many headlines cite a significant drop in digital health private equity and venture capital investment, the magnetic pull to “follow the money” is misleading.  More “value” is being infused into the digital health category – monies are entering at earlier stages and targeting specific spots on the global innovation map.  Early in translates into more equity and influence. Follow the money and where the money is headed are linked.

If dollars and Euros are the only indicators of enthusiasm and commitment, it is easy to see why hand-wringing news stories prevail. Look at all the metrics that determine a vibrant sector. Look at the regions where funds are being directed and at what stages to resolve what broad–global – challenges. The cities in the Medika Life “Hot Spot Series” will explore what’s happening and some of the companies that are working to sustain human and planetary health.

Israel is an excellent example of that positive narrative.  From 2021 – the acknowledged boom year of capital infusion into the category – to the supposed global drop in investment – Israeli did not see a noticeable decline in private equity investment.  It continues to be a value-driven market and a testing ground for innovation.  We’re watching several Israeli-headquartered private equity funds, including aMoon, Our Crowd, Start-Up Nation, Welltech Ventures, and others, to see where they will place their bets – our future – in the coming months. They are active and strong.

“Israel is a paradigm-challenging innovation culture. Disrupting a conservative industry such as healthcare requires this kind of mentality of not accepting the way things have been done forever,” reflects Eran Eshed, co-founder and CEO of Fairtility, a cutting-edge company using AI, clinical, high-tech, software development, and business leadership experience to rapidly introduce new technologies and applications to the IVF process.

Among the hot Israeli companies on our Medika Life EcoHealth and Health Tech Hot Spot, radar screen are these six covering decentralized clinical trials, environment and sustainability and patient adherence.  During the week of February 6^th, we will be onsite and meeting with these and other company leaders – hearing about their ideas and plans to improve people’s and the planet’s health and sustainability. 

Six Israeli Health Tech Companies Worth Watching

Next week, we head to Tel Aviv, Israel, and look forward to meeting companies on the leading edge of health innovation.  Here are six companies on our radar screen – we’re planning on meeting more and updating this list.

Belong.Life is a leading global tech provider of high-engagement social and professional care management platforms and patient communities, with more than one million users providing and receiving emotional support, advice, and information from peers and health professionals. Plus, as more patients with serious health concerns seek access to clinical trial options, Belong offers a clinical trial matching service that analyzes all available clinical trials around the globe in real-time, matching patients to trials relevant to their diagnosis and location. The Belong Beating Cancer Together app is used by almost 1 in 10 U.S. cancer patients, and 1 in 5 US-based multiple sclerosis patients are using BelongMS.

BloomX is addressing the challenge of crop pollination and sustainability. Farmers and crop growers rely on insects and honeybees for pollination, which plays an integral role in crop and fruit development and higher crop yields. Due to parasites and habitat loss, the honeybee population is decreasing, leading to a crisis that impacts crop production and food supply. BloomX is an early-stage ag-tech startup that has developed bio-mimicking pollination technology. This AI-based tech solves significant challenges by improving crop productivity and quality over the pollination process and supporting sustainability goals.

Enzymit may have cracked the price and time code for enzyme development and functionality.  Inventing new enzymes for bioproduction, the company is poised to replace outdated, pollution-producing chemical manufacturing with validated green production methods efficiently and cost-effectively. The Enzymit proprietary technology platform uses deep-learning algorithms and high-throughput testing methods to rapidly screen billions of sequence changes for every single experiment. The company can uncover and develop novel proteins for varied applications, such as fine chemical manufacturing, food and beverages, health and nutrition, biodefense and energy.

Sweetch is tackling chronic conditions that consume the health system and providers using the transformational power of AI, behavioral science, and its “Just-in-Time-Adaptive-Intervention” (JITAI) technology. Medication non-compliance results in more than 100,000 preventable deaths and $100 billion in preventable medical costs annually. The company has developed a precision engagement solution for chronic conditions through hyper-personalized communication with individual patients powered by. The Sweetch solution is cost-effective, sustainable and scalable, offering a ready-made solution for healthcare providers, pharmaceutical companies and device manufacturers globally.

UBQ Materials is transforming unrecyclable and organic waste into bio-based thermoplastic using advanced conversion technology. The company diverts unsorted household waste from landfills and incineration, protecting the natural environment and people’s health. Water, soil, and air quality suffer when waste is sent to landfills or incineration. It is well known that there is increased respiratory risk for people residing near incineration plants. Also, there is significant research on microplastics in humans resulting from plastic pollutants in the water supply. UBQ Materials is among the pioneers engaging the health and planet sustainability challenge by focusing on renewable material solutions.

X-trodes has developed the world’s first multimodality dry wearable technology for advanced electrophysiological monitoring and analytics so that people with health concerns can be diagnosed in their home setting. X-trodes technology is a smart skin conforming to inaccessible areas of the body and provides a user-friendly solution to generate data. This new approach monitors EEG (brain activity), EOG (eye movement), EMG (muscle stimulation), and ECG/EKG (cardiac monitoring).  Applications include sleep, fitness, sports, rehab and general health, and specialized monitoring targeted to specific markets.

We hope to feature other companies in this special Health Innovation Hot Spots Tel Aviv Report. We will continue to use the Galen Growth/FINN Partners “Global State of Digital Health” as our guide in highlighting innovation that can improve people’s and the planet’s well-being.

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Significant change is needed. But what change? Lowering drug costs will not lower total spending on health so long as pharmacy benefit managers (PBMs) continue to profit from the “spread.” Access to care will not improve so long as we ponder the future of essential telehealth services. Patient adherence will not be supported if formularies can call upon “non-medical switching” as a go-to negotiating tool. The US percentage of GDP will not align with other developed nations’ investments in health if we don’t redirect effort to emotional and physical preventive and value-based care. Fixing one piece of the healthcare puzzle is helpful – but is it transformational?

There are changes afoot that we need to make happen sooner rather than later by moving minds, systems and behaviors so that life-sustaining and life-saving approaches to patient care may eventually tip the scale of human survival toward health and wellness. However, we see data through the lens of a human perspective – sometimes self-interests or emotional needs for control.

Here are 10 possibilities that are not dreams – they can happen – if the health ecosystem leaders think beyond cost, reimbursement or authoritative voice and focus on people’s healthy longevity:

1. Artificial Intelligence (AI) — A future of engagement and collaboration:

AI has been around since the Gutenberg Bible! In 1899, medicine made a giant leap into AI by publishing the Merck Manual — a handbook that collected all known medical advice and gave physicians a compendium of diagnoses and treatments. No expert can remember the vast canon of medical information within their specialty, and books became a source of “augmented knowledge.”

Too many health systems and physicians view AI as “novel.” Addressing the obstacles to implementation within their health systems is critical to enhanced decision-making benefits offered by AI. Concerns about cybersecurity and training are valid! However, the value of implementing artificial intelligence is not about embracing technology — it’s about amplifying human wisdom to address patient urgencies effectively.

Human intelligence can be augmented by uniting data, patient files and other health professionals’ patient-care experiences, channeled through this technology platform. We must now rally to address questions about data quality, emotional resistance to change and cybersecurity. As innovation theorist, John Nosta writes about the emerging importance of aligning IQ and EQ with TQ (technology quotient).

“The battle of man versus machine might be ending where cooperative engagement provides transformative solutions to a wide variety of problems and opportunities.”

2. Behavioral Health — America does not lack a supply chain to manufacture chronically ill citizens:

We are killing ourselves slowly…with poor nutrition. We continue to add belt notches to our waistlines. The added weight also increases risks for heart disease, diabetes, cancer, mental health stressors, and more. Who pays those sickness bills? Employers foot a large percentage of the nation’s workforce health insurance. It’s time to look beyond providing an expected workplace benefit. Physicians, employers, payers and the people they seek to help must reduce the waistlines of people tipping toward the obesity border! Helping consumers shed unnecessary pounds and meeting their corresponding medical priorities offers immediate life-saving and personalized health benefits.

The best option for corporations footing a large part of the health bill is to intervene with payers and recognize benign neglect in tackling the obesity epidemic only adds to suffering and expense. Louis J. Aronne, M.D., who founded the breakthrough patient-centered health-tech Intellihealth along with Weill Cornell Medicine physician colleague Katherine Saunders, MD, notes:

“Obesity is a very complex chronic disease with a number of causes from diet to underlying medical conditions, medications and genetics. “Through our extensive research and applied medical model, we have incorporated all of our practice methodologies into a single software platform, which delivers a blueprint for treating obesity with supervision and continued oversight. Evaluation of our approach demonstrates 3x the number of patients reaching the key outcome measure of 5% or greater weight loss compared to programs that incorporate behavioral interventions alone.”

3. Decentralized Clinical Trials — Democratize drug development:

Even before COVID-19 appeared, traditional clinical trial recruitment models were being reconsidered. Drug development was almost sidelined during the pandemic, and clinical research organizations (CROs) recognized that they needed to reinvent patient recruitment. Operation Warp Speed showed how to put the pedal to the metal for COVID-19 vaccines; systems developed now can be applied to other high-priority, clinical urgencies such as treatments for rare diseases and often-fatal cancers.

Collaboration to advance the process is working. Science and research pioneers such as Amir Kalali, MD, and Craig Lipset, who co-lead the industry-wide DTRA.org group, show the sector’s readiness to change direction collectively. Innovators like Michelle Longmire, MD, CEO of Medable, and Irfan Khan, MD, CEO of Circuit Clinical, demonstrate that an industry known to advance new medications from bench to bedside can innovate how and where patients are invited to participate in urgently needed therapeutic discoveries. Innovation is based on finding new paths to address unmet needs.

To accelerate drug discovery and development possibilities, biopharma and medical device companies need to find a new set of allies – patient advocacy organizations and their communities; primary care centers with access to people in rural and inner-city communities. They must recognize that in working with government, sector companies, and those that seek to serve – people with health needs – they can go farther, faster.

4. Digital Health — Physicians and patients need coverage clarity:

Food and Drug Administration approval for life-sustaining innovations does not necessarily sway payer access decisions. “Claim denied” is the all-to-often refrain when physicians and their patients seek access to a 510 K-approved medical device or digital therapeutic.

Payers may have sufficient justification to deny coverage. But what are the criteria for those “dead-on-arrival” reimbursement decisions? What are the guidelines to secure formulary approval? If more data are needed to ensure access for patients — insurance customers — payers must become partners in the sector’s and patient-care success. Adding bricks to the walls patients must circumvent to secure care for themselves and their families does little to improve care or customer relationships.

Digital health analyst and author Artur Olesch outlines a challenge for the coming year in a question many more should be asking:

The COVID-19 pandemic has accelerated the implementation of telecare and telemedicine. Individuals are increasingly using mobile health apps. What can be done not to waste this potential?

5. Ecohealth — We need a healthy planet or else:

Where you live impacts how long and how well you live. Thousands of U.S. communities are ticking time bombs. The harsh reality is that 26% of Black Americans and 29% of Hispanic Americans live within three miles of a toxic landfill site, exposing these communities of color to dangerous levels of lead and other heavy metals and chemicals. We must face the harsh reality that while planet earth can do just fine without humanity; humanity needs a healthy planet. This was the striking call-to-action by Meharry Medical College President and CEO Dr. James E.K. Hildreth.

The longer we wait, the harder it will be to course-correct. The shift to a healthier world requires other innovative superpowers — courage and collaboration. According to Bob Martineau, senior partner FINN Partners, a former Federal and State government official focusing on environment issues: 

Though we breathe, eat and live in the environment, we often forget just how interconnected all aspects of our health are with the world around us. Exposure to dangerous levels of air, soil and groundwater pollution is proven to cause a cascade of life-threatening woes that include cancers, nervous system disorders, respiratory diseases, and premature births.

6. Tackle older patients’ care and adherence challenges:

When people are diagnosed with a chronic or severe medical condition, we must ensure that the patient-physician relationship guides care and that the medical ecosystem prioritizes medication adherence. The National Health Institute reports that 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring healthcare advice. We don’t need to invent or create new care challenges. Let physicians already seeking to do good oversee clinical-care decisions.

Age discrimination and comfort with using technology to access the health system are barriers to access and understanding medication use and adherence. Age bias is often attached to health conditions often experienced in older persons. While older Americans often are the health system’s most significant customers, they face continued discrimination. We must see continued innovation in earlier detection of illnesses that impact seniors, such as loneliness, Alzheimer’s and even sexually transmitted diseases.

7. Health disparities — The most vulnerable need access to care now:

Decades of racism place people of color in harm’s way from COVID-19 more than any other community. Blacks are dying at a rate of 50.3 per 100,000 people, compared with 20.7 for whites. In New York City, the most densely populated place in America, 19% of residents, many people of color, live in poverty, while 17% live in overcrowded conditions. We seem unable to come to grips with the reality that health disparities cause multiple public health disasters and cost lives and dollars.

We must reach the communities that seek information in ways that speak to their interests and needs. What groups such as Hip Hop Public Health creatively use the power of music with health-specific messages to mobilize and change mindsets.

America is among the few developed nations that deny good healthcare services to those most in need. Neglect and racism are morally counter to the health mission of medical leaders. The changes of senior citizens to access health networks easily must be addressed. Policymakers, corporate leaders and citizens must raise their voices to enact change. A cultural shift is needed to rally communities for awareness and education. According to Yele Aluko, MD, MBA, chief medical officer at EY:

The current conversation going on nationally about societal justice, about health equity, drives a moral imperative. This conversation is going on across health systems, big business, government, and philanthropic organizations. Everybody’s talking about how we need to fix this wrong, so the time is now. We have a convergence of goodwill that drives my optimism. But we must seize the moment and translate it into actionable solutions.

8. Metaverse — Smart technologies channel our imagination toward curative possibilities:

Do you have an imagination? Put it to work to heal. After all, medical engineering is a pioneering effort that connects people’s ideas with human biology to overcome sickness. We entered the “Matrix” the first time we imaged a therapeutic stent, LVAD and 3D-printed artificial limb; complex operations became possible when expert hands drew upon technology to realize new concepts.

Rafael Grossman, MD, FACS, has been tapping technology to improve patient-centered medical care. Always ready to explore the disruptive power of technology in medicine, Dr. Grossman has been at the forefront of using smart glasses, augmented, virtual and mixed reality to change the way we practice and teach medicine.

Grossman and medical compatriots such as Daniel Kraft, MD, don’t see the metaverse as sci-fi. Artificial reality, virtual reality and wearables are used by leading-edge practitioners to advance patient outcomes.

9. Remote Patient Monitoring and Telehealth — Remote care after COVID-19:

Digital systems are built into beds, furniture and watches. Medical wearables make hospital stays more customer-friendly by delivering patient information straight to providers’ smartphones and central monitoring stations. At the height of the pandemic, there was a dramatic uptick in telehealth and remote care. As reimbursement rates shift, patients worry they will lose the benefits of remote care.

Ever so often, Congress, the Centers for Medicare and Medicaid Services and private payers pump the brakes on continued remote access with life-saving services such as telemedicine. We need to change the culture of conservatism when it comes to remote advancements and access. Groups like the American Telemedicine Association are essential voices for access and a sensible hybrid approach to care.

Medicine is a culture where patients are not yet seen as customers. Cancer survivor, caregiver and health professional Stacy Hurt, a HIMSS Digital Health Influencer and recent participant in a VyTrac-sponsored webinar on remote patient monitoring, writes on the importance of a hybrid approach:

Patients ultimately want two things: hope and options. We’re finally to a point where telemedicine is an option. It for sure shouldn’t replace the in-person encounter and relationship between the healthcare provider and patient, but it is an option we need to preserve.

10. Self-Care — Our health system keeps us alive — it doesn’t keep us well:

Our health system is not built around sustaining “health.” We have invested mightily in national illness management, a sick-care structure that offers no return on investment regarding a better path to healthy longevity. Value-based and preventive care to keep the illness at bay is a big win-win-win for households, companies and governments that now foot the nation’s health insurance bill. Employers and payers will find that incentivizing self-care and illness prevention is a more innovative business model.

WebMD Chief Medical Officer John Whyte, MD, an author on bestsellers with life-saving tips to reduce cancer and diabetes risks, writes:

The biggest myth has been that (cancer) is primarily caused by genetics or just bad luck and there is nothing that you can do about it. The reality is only about 30% of cancer is caused by what we would say are inherited mutations or family history. The rest is primarily influenced by lifestyle. I know, although nothing is 100% preventable, we have learned through science that you can reduce your risk by deciding what you eat, how much you exercise, your level of stress, the quality of your sleep. These are all things you have control over.

If this roster of innovations in hand tells us anything, it’s time we put health-system mindset change front and center. There are plenty of great reasons to say, “this won’t work” or “let’s not do it; it adds to costs.” It is understandable that new products, services and approaches take time to implement and cost money. But when we look at people’s well-being, adding complexity to people’s lives that separates them from access to the best quality of care has never been medicine’s intended mission.

We look to changes such as Amazon purchasing One Medical as a pathway to fix that which is broken. We have an abundance of innovative, readily and inexpensive (often generic) medicines. We often can speak with a skilled health professional through our smartphones and tablets. Perhaps the change so sorely needed isn’t another billion-dollar acquisition and “roll-up,” it’s addressing the challenges of collaboration and transparency?

Health providers are at the forefront of confronting our significant societal challenges. They have risen to the task heroically. Health disparities between the haves and have-nots and developed and developing nations have opened our eyes and hearts. Innovation combined with our determination must open the door to fundamental system change.

The post Health Possibilities We Can’t Afford to Block appeared first on Medika Life.

If the consumer-doctor connection is the window to early prevention, diagnostic testing is the early biological warning system for some easily treatable illnesses. But discovering fixable problems often happens after the doctor’s visit.  That’s “closing the barn door after the horse has escaped.”

The process assumes that everyone is committed – or worried enough – about their health to follow through quickly and follow their physician’s request to obtain needed diagnostic information.  It doesn’t always happen that way!  Almost 70% of medical decisions use lab test results. The problem is that 40% of physician diagnostic prescriptions are never filled.

Could a change in how consumers access diagnostic data impact the tragic trend that more than 70% of US deaths (41 million annually) are related to often treatable non-communicable diseases? In this Medika Life exclusive, we talk with health-tech innovator Pouria Sanae of ixlayer about why he is working to shake up the current “sick care” system by empowering consumers and the health system through affordable, reliable, reliable and accessible home-based testing.

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Gil Bashe: Tell me about the genesis of ixlayer and your vision to make it easier for physicians and patients to work together around the convenience of diagnostic testing. What problem did you set out to solve?

Pouria Sanae: Two stories explain how ixlayer got started. Several years before I launched ixlayer, my mother was selected to participate in a clinical trial. The clinical site’s onboarding process included diagnostics that revealed abnormal blood levels.  The follow-up testing found a malignant tumor in her neck. She was operated on a month later and is alive and healthy today. This was a time-sensitive discovery; had she missed the tumor – until even six months later – it would have been too late. After that experience, I knew I needed to do something in the health sector that could help other people and families. Survival cannot be left to serendipity. 

Our co-founder, Dr. Poorya Sabounchi, lost his father to a medical condition that could have been prevented if detected earlier. His professional passion became genomics and genetic testing, and he first joined Illumina to pursue that mission. When we met, we immediately connected on this idea that so many people are ‘hosts’ to a disease without knowing it – many people need screening but don’t get it.  How many lives are lost because the information isn’t available? That is core to why we advocate for consumer engagement in diagnostic medicine.  Ixlayer is more than a company. It is a catalyst for long-awaited change that will benefit providers, payers, and, most importantly, patients and their families.

Bashe: Unfortunately, you’re right – the stories you shared happen too often. Your and Dr. Sabounchi’s experiences – harnessing diagnostic information within us as a preventive strategy – should be the standard of care. How did you transform life-changing family experiences into ixlayer? What were the operational steps?

Sanae:  I made the change very quickly – I left my job in the tech sector and moved to the health sector. First, I joined Helix, a promising sequencing lab providing the same concept for genomics.  There, I realized that the hurdle to better, frequent diagnostic testing is the difficulty in operationalizing or shifting the process itself. This is a very fragmented market.

I was involved in launching the lab testing platform for Geisinger, Mt. Sinai, Invitae, and National Geographic. On top of Helix – they were all spending millions of dollars and 18 months on development. They were inventing the same wheel over and over! We saw what was missing: infrastructure and patient experience layer on top of the lab work.  The observation and need were the basis for ‘ixlayer.’  I for infrastructure and X for the experience.  Suppose we could equip the industry with this missing piece. In that case, we could increase lab testing volume and offer preventative options, affordability, patient experience, and in-home convenience.

Bashe: When we look across the lab testing sector, even as some assays or technologies evolved, the patient experience for diagnostic testing has remained unchanged. Would you say that’s true? 

Sanae:  Yes. There are three issues when it comes to the consumer experience of diagnostic testing. One is convenience, the second is affordability, and the third is the ease of use.

For example, if I want to go and get my thyroid checked, I first need to go to a doctor and discuss the need for the test. I need to get a requisition or “req” form. Then go to drive to a lab like LabCorp or Quest. Then, return to the doctor to discuss the results. Once the test is ordered, this clinical journey requires at least two physician visits and a lab visit. Let’s also add in the scheduling and drive time. 

Another issue is affordability. Based on my current insurance, I pay $60 for this, out of pocket – two $20 copays for the doctor visits and another $20 for the lab. It adds up.

On top of it all, consider time constraints. I don’t have the time to see a doctor. Most people don’t have the time. This system assumes you have complete power over your schedule – put the employer aside. Get someone else to handle childcare. 

So those are the three things that need to change within the system. It’s not the doctors’ or labs’ fault.  No one is to blame. The system is the system, and it is failing us.

Bashe: You mentioned a thyroid test as an example. How does a consumer access a consumer-oriented diagnostic test like this?  

Sanae: The beauty of partnering with a national retail pharmacy is that we provide something the end consumer can pick up off the shelf. CVS calls this “symptom to treatment in a box.” Once you pick up a test, scan a QR code and begin a digital experience. A telehealth physician oversees the process on the back end. You get instructions on how to collect your sample. You ship it back to the lab, which processes the test, and you get a result. If your results are abnormal, a physician calls you and explains the result and next steps. And in this case, CVS owns the process; if your results are abnormal, you’re sent back to Cvs Minute Clinic for continuity of care.

Bashe: Tell me a little bit more about the tests themselves. What types of samples are used in your tests?

Sanae: We cover everything when it comes to at-home testing. Depending on the type of test, our services support all samples for at-home tests, including saliva, blood – whether finger-prick and dried blood spot or tube – and we also do stool and urine. The first one we started with for the four Cvs tests is blood.

Bashe: There seems to be a major movement to make pharmacies more accessible in personal health management. I’m curious to get your take – with the rise of at-home testing and telehealth during the COVID-19 pandemic, do you see a behavioral shift in consumers wanting more accessible care?

Sanae: Yes. We entered the market before the pandemic, back in 2018. Initially, the feedback from the industry was that the end user – the consumer – wasn’t ready. The Covid era has changed the concept of in-home care, and people realize how easy it is to engage with their health on their terms. CVS, Walgreens, Walmart, and Amazon are entering the market and have financial models where they feel they can add value. On top of that, consumers – especially Gen Z, Millennials, and Gen X – seek improved home care.

Bashe: It sounds like you’re talking about sparking a movement of health-conscious consumers – those who say maybe I should check my thyroid function or my cholesterol proactively. Is that your hope?

Sanae: A future of at-home health testing is key to preventive care. It provides a snapshot of personal health information over time. The doctor already knows that 133 million Americans have chronic conditions that often require ongoing lab testing. But 60 million Americans have a chronic condition and don’t know it. What if we could help more of those people get diagnosed sooner – maybe even before their condition becomes a serious problem? Suppose we manage to test that individual more often. In that case, we can identify high-risk patients and hopefully, get them the treatment and support they need before their condition becomes a problem.

Through the CVS partnership and others, we can help more pharmacy and health system partners realize the significant value of empowering consumer health.

Bashe: Could you share with me a little bit about ixlayer technology itself? How does your technology differ from other systems?

Sanae: Oneof the challenges for the diagnostic space and in-home testing is that it is a very fragmented market, with different regulations for each state. We developed a technology layer, a cloud layer, that integrates into forty different services, and we keep adding services daily. This includes 27 different labs, a physician network in all 50 states, fulfillment services, picking and packaging, in-home mobile phlebotomy, insurance, Emr, and so forth. On top of that, we combined this into a very easy-to-use patient experience layer, transforming a complex, segmented ecosystem into a patient-friendly flow.

We can launch our customers within six to eight weeks. It might take years if a retail company or provider network wanted to do this themselves. We are making it possible to operationalize the shift from sick care to self-care and support the medical practice of preventive care.

Bashe: When you look at the future, share with me what you think might happen realistically a year from now.

Sanae: Consumer adoption of these tests will increase. The goal is to have lab testing be like a toothbrush. If toothbrushes were invented for the first time today, your dentist would tell you that you don’t need that thing. Come in when you have a cavity. That is what health care is today.  We wait for people to have pain instead of giving them preventive tools to monitor and maintain their health. Our vision is that lab testing can and should be like that toothbrush – the preventive care in-between visits. You should test yourself every quarter, should monitor yourself, and then, when you come in for your checkup, you can show the results and discuss them with your doctor. That’s preventive engagement.

Bashe: What are your thoughts about how physicians understand this change as a fulfillment of their vision to be healers and address the needs of people who need healing? Will the fragmented health ecosystem realize that a smarter, educated, engaged consumer is the Holy Grail of wellness?

Sanae: I’m glad you brought that up because many disagree with this industry topic. Many primary care physicians are against patient-initiated testing, where an individual patient goes to a lab on their own.  They are concerned that the patient won’t get the correct information or support without guidance from a physician. In reality, there is demand for that kind of access, and we all need to find the balance between what we do and what physicians do.

This type of service benefits providers, too. If we can work together to prevent healthy people from coming into the hospital, it may reduce physician fatigue.  That means doctors will have more time and energy for patients with pressing needs. If physicians adopt in-home testing, which they are, it reduces the cost of a hospital bed and the cost of care. ixlayer adds value to preventive care, disease management, and the chronic condition diagnosis journey.

Bashe: You have a diagnostic business model, but it feels like you also have a public health model. When people are actively engaged in conditions that could be well-managed and engaged at the earliest stages, we can improve people’s survival outcomes.

Sanae: We are an ally to public health. The public health system needs to know that this is available to make lab testing more straightforward and accessible. For example, the Netherlands provided an in-home lab test for colon cancer for every household because they realized the significant benefit of pre-screening and early detection. This is a catalyst to have consumers recognize that they have the most at stake – healthy longevity.

We are a platform that powers consumer and public health. The provider network, retailer, payer, or government agency can tap into the ixlayer platform to set up their offering. They can utilize their health system lab because we’re lab agnostic. They own the data. They own the patient relationships. ixlayer is just the pathway.

Attempting to manage a person’s health without regular diagnostic data is like putting your ear on the car’s hood to understand if the engine is functioning correctly. Suppose we get more people to check more often. In that case, our system supports the medical community that seeks longer, healthier lives for everybody.

With chronic non-communicable illnesses on the rise, detecting health issues early enables health professionals to guide the course of treatment – to adjust diet, offer medication options and engage other medical specialties.  Creating this “pre-patient” model of care empowers consumers to be better informed and engage in their health. Suppose we encourage frequent lab testing by reducing cost, access and convenience barriers. Can we also reduce obstacles to lowering system costs and shift emphasis from sick care to preventive care?  Pouria Sanae and his ixlayer team are long-awaited catalysts for these changes.

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