Earbuds amplified with Mindmics technology can hear and sense sounds in the body to provide real-time heart rhythm metrics such as heart rate and heart rate variability. —RWJBARNABAS HEALTH
From remote patient monitoring to 3D printed body implants, healthcare organizations are embracing technology more than ever. We spoke to some regional institutions to find out about their latest progress.
In October, St. Joseph’s Health announced that it is the first institution in New Jersey to perform spinal surgery with a 3D printed patient-specific spinal implant. dr Geoffrey Appelboom, chief of neurological surgery at St. Joseph’s Health and instructor in spinal surgery at New York University’s Grossman School of Medicine, performed the procedure on a patient who had difficulty walking and suffered from chronic pain. Appelboom used a personalized implant to replace a diseased disc after “the patient had already undergone multiple unsuccessful surgeries to treat the chronic and debilitating pain.”
“Personalized implants are a game changer for patients with spinal deformities and other spinal cord disorders,” added Dr. Mark Connolly, Chair of the Department of Surgery at St. Joseph’s Health. “As the first hospital in the state to use an implant tailored to the specific needs of each individual patient, rather than a one-size-fits-all approach, this advanced treatment represents the advanced care provided by our highly skilled surgeons at St. Joseph’s Health.”
Sengupta
According to Dr. Partho Sengupta also describes “new and growing ways to detect, monitor and treat heart problems and related diseases,” and a clear example of this is the Center for Innovation Hospital launched in September by Robert Wood Johnson University and Rutgers Robert Wood Johnson Medical school.”
Located on the hospital’s main campus, “we are creating an environment where we can solve real-world problems with technology by bringing together multidisciplinary teams of clinicians, researchers, engineers, industry partners and other stakeholders from the healthcare system and community. added Sengupta, Henry Rutgers Professor of Cardiology and Chief of the Department of Cardiovascular Diseases and Hypertension at Rutgers RWJMS, Chief of Cardiology at RWJUH and a member of the RWJBarnabas Health Medical Group.
The Cardiovascular Services team is currently conducting a number of clinical studies, including the evaluation of a U.S. Food and Drug Administration-approved robotic ultrasound telemedicine system for effective remote acquisition of expert-quality cardiac ultrasound images, and a study of the use of wristbands and other wearables Sensors that collect health data from patients diagnosed with high blood pressure and/or early-stage heart failure. The information is then used to remotely initiate guideline-based medical treatment. Other high-tech advances include earphones that could potentially both play music and provide real-time heart rhythm metrics like heart rate and heart rate variability, and a medical vest with sensors a patient can put on to record vital information that indicates a heart attack without causing a heart attack Blood collection and analysis is required.
“It’s important to create a space and environment that is optimized for creativity, innovative thinking and collaboration,” Sengupta said. “We see a whole journey of patient care that encompasses wellness, disease development, in-hospital care, and disease management.”
De Gregorio
At Valley Health System in Ridgewood, a team uses the SmartCurve Breast Stabilization System for breast imaging; and a non-invasive, artificial intelligence imaging technology for cardiac imaging developed by Cleerly, according to Dr. Scott DeGregorio, director of breast imaging, The Valley Hospital; and dr Himanshu Gupta, director of cardiac imaging, Valley Health System.
“The SmartCurve system delivers a more comfortable mammography without compromising image quality or dose,” said DeGregorio. “The system features a proprietary curved surface that mirrors the shape of a woman’s breast to reduce pinching and allow for better distribution of force across the entire breast. SmartCurve not only allows us to enhance our patients’ experience by giving them a more comfortable mammography they’ve been waiting for, but more importantly, allows us to do so while maintaining clinical accuracy, by providing our physicians with the industry’s fastest, highest resolution 3D images to accelerate screening and analysis.”
Use of AI
In cardiovascular imaging, the team uses AI technology to prevent heart attacks by characterizing unstable plaque build-ups with high rupture potential that can lead to a heart attack. Cleerly’s approach uses coronary artery phenotyping — a technique to define the characteristics of plaque formation, according to Gupta. “This approach builds on traditional CT angiography tests to help physicians determine which high-risk asymptomatic patients are at greater risk of a heart attack.”
Using an artificial intelligence approach and machine learning algorithms, Cleerly compares each patient’s plaque characteristics to a database composed of cardiac imaging and data from large-scale clinical trials, he added, and provides clues to possible underlying heart disease, characteristics of existing coronary blockades, and risk of a future heart attack. “In my opinion, this analysis, combined with physician review and analysis, provides an increased level of confidence in the assessment of coronary artery disease, particularly in patients with significant coronary calcification.”
Kohli
Other hospitals are also implementing technologies that drive digitally integrated care in acute and outpatient functions. At Englewood Health, for example, “All patient rooms have wall-mounted Epic monitors that alert caregivers to important patient data such as fall risk, isolation precautions, dietary restrictions and more,” said Vice President and Chief Information Officer Inderpal Kohli. “Each room features a large, interactive, patient-friendly whiteboard with pertinent details about the patient’s stay, including the names of the care team, medications, upcoming treatment plans, and recovery goals. The digital whiteboard also has an interactive area where patients and family members can message each other and healthcare providers.”
The whiteboard also serves as a physician dashboard displaying active medications, vital signs, intake and output, lab results, and imaging to complement interdisciplinary rounding (IDR) activity. “These monitors and digital whiteboards are designed to streamline information, encourage collaboration and improve the patient,” he said.
Other technical initiatives include “a remote patient monitoring program operated by RPM Healthcare that helps patients manage their condition between doctor visits using at-home monitoring devices and personalized health coaching,” Kohli added. “Patients automatically transmit their physiological data to their physicians, improving outcomes and adherence to therapy, and reducing emergency room and hospital admissions.”
The mixture of traditional medicine and technology raises a question: do the doctors of tomorrow need an engineering or computer science degree in addition to a medical degree? “The next generation of clinicians will not need an IT degree, but will certainly benefit from increased technology awareness,” he said. “An understanding, knowledge and even a formal education in technology will go a long way in fostering a culture in which clinicians play a role in the development and implementation of new tools and solutions. This idea has taken root in several US universities, and we see this trend continuing in pre-med education programs and, for that matter, all industries. Everyone will be in the tech business if they aren’t already.”
opportunities and challenges
Healthcare technology “is constantly evolving to improve patient outcomes. In recent years, telemedicine and remote patient monitoring have become increasingly popular in healthcare systems across the country,” said Dr. Beth Kushner, chief medical information officer for the St. Joseph Health System. “For many healthcare providers, behind-the-scenes technologies such as remote patient monitoring offer different strategies for improved, more complete documentation and data collection about a patient’s health.”
cuddler
Remote patient monitoring includes devices that enable non-face-to-face monitoring and analysis of physiological factors that can help healthcare providers better understand a patient’s health status. “This can include common activity trackers that allow patients to monitor and collect data about their health at different times of the day and then transmit that data electronically to their doctor,” she noted. “Remote patient monitoring also allows the patient to trend their own data. This [offers] more detailed parameters for providing information to their providers to help have more informed conversations about chronic disease conditions.”
The increasing use of devices to monitor patients remotely has led to shared patient-provider decision-making while leveraging IT solutions, but “these new technologies are not without their own challenges,” Kushner warned. “Physicians must be nimble and ready to give new technologies the leap of faith. Even if they don’t need special degrees, they must be willing to try new devices to see which ones work best for them and their patients. Physicians must also anticipate that the relationship with their patients will change as these technologies become more widely used. Healthcare providers need to adjust their expectations when using these technologies. Rather than just seeing patients in person, patients and providers are increasingly communicating through telemedicine visits from remote locations. Although technology can be daunting to some, with proper training and use, it can help provide physicians with additional tools to help them better care for them
