ECRI Institute’s annual Top 10 Hospital C-suite Watch List is in, and a mobile app that addresses the U.S. opioid crisis made it to the number one spot. It's fitting, since more than 90 Americans die per day from an opioid overdose, according to the NIH.
“This year we selected a range of technologies and infrastructure issues hospital leaders and their teams are facing, will be facing, or should consider,” Diane C. Robertson, director of health technology assessment at ECRI, said in a statement.
The list provides information on the safety, efficacy and cost-effectiveness of these emerging technologies. ECRI develops this list every year so health care professionals can use it when making decisions regarding their capital planning programs and strategic initiatives.
Here is a complete list of the topics for 2018:
1. Pear Therapeutics’ reSET mobile app for addiction treatment
— The FDA cleared this app in September as a prescription-only adjunct treatment for patients with substance use disorder. Pear Therapeutics claims that it almost doubled the rate of abstinence and increased retention in treatment, compared to standard face-to-face therapy in a clinical trial.
Another emerging technology in this field is a default prescription setting for the EMR. Penn Medicine researchers found
that when the default quantity was set to 10 tablets, a smaller amount of opioid tablets were prescribed at two of their emergency departments.
2. Direct-to-consumer (DTC) genetic testing
— Zymo Research Corp.’s myDNAge Epigenetic Aging Clock test analyzes blood or urine samples to estimate a person’s biological age, which is compared to their chronological age. DNA Diagnostics Center offers several tests that analyze DNA and provide health-related instructions based on the genetic results.
If a patient receives uncertain results from these DTC genetic tests, that may increase the demand for follow-up services at hospitals and health care clinics. ECRI recommends forming a task force to educate front line staff on the downstream consequences of these tests and the questions they might expect from patients.
3. Acuity-adaptable rooms
— Some hospitals are testing out the acuity-adaptable care delivery model, in which a patient remains in the same room from admission to discharge, regardless of their acuity level. They’re hoping this will reduce length of stay and costs, and improve care continuity, patient safety, and workflows.
4. Insertable cardiac monitor (ICM)
— The FDA cleared the world’s first and only smartphone-compatible ICM in October
— Abbott Laboratories’ Confirm Rx. It’s implanted in the patient and connects via Bluetooth to their smartphone to transmit data to their physician.
In November, the Texas Cardiac Arrhythmia Institute at St. David’s Medical Center became the first in Texas
and among the first in the country to use this new device. ECRI suggests that hospitals determine how many patients would benefit from Confirm Rx, gauge cardiologists’ interest and evaluate any potential reimbursement issues.
5. Virtual reality for pediatrics
— A handful of children’s hospitals and companies are working on 3-D virtual reality software to distract children from repeated injections and infusions that are required to treat serious conditions. Potential applications include hemophilia, many forms of cancer and severe burns.
In the September 2017 issue of HCB News
, John Vartanian, industry expert and former CEO of Medical Imaging Resources wrote, "Researchers posit that the mesmerizing 3-D sights and sounds of VR provide ‘virtual distraction,’ taking over the patients’ visual and auditory senses to the point that pain, discomfort or anxiety are reduced or even eliminated.”
6. Neuronix’s NeuroAD Therapy System
— The is the first device-based treatment for Alzheimer’s to score CE mark. It combines noninvasive transcranial magnetic stimulation and computer-based cognitive training.
It doesn’t modify the disease, but a few small studies suggested that it may improve scores on the Alzheimer’s Disease Assessment Scale cognitive subscale by about three to four points after six months.
7. Seventh Sense Biosystems’ TAP microneedle blood-collection device
— It’s a single-use, 1.5-inch diameter device that uses 30 microneedles and a tiny vacuum to collect 100 microliters of capillary blood in two to three minutes. The company claims that it’s “nearly painless,” which is ideal for pediatric patients with chronic conditions that require recurrent blood draws.
8. Aspect Imaging’s Embrace neonatal MR system
— This system, which got the FDA nod in July
, can be used directly in the neonatal intensive care unit, since it’s fully enclosed. Traditionally, neonates have to be transported out of the NICU to undergo MR exams on a conventional system.
GE Healthcare and several partners have also developed
a miniature MR for neonates. It’s located in the Jessop Wing Maternity Hospital in Sheffield and was still in the prototype stage as of January 2017.
9. GT Medical Technologies Inc.’s GammaTile Radiation Therapy System
— This investigational system intraoperatively delivers brachytherapy for brain tumors. It’s intended to standardize seed placement, improve dose targeting and delivery, and lessen the risk of seed migration.
It leverages IsoRay’s Cesium-131 brachytherapy seeds. They are embedded into a bioabsorbable collagen mesh that the neurosurgeon and radiation oncologist sutures or staples in the cavity left by the tumor excised during surgery.
— It’s not a full-service hospital, but not quite an urgent care center either. Microhospitals generally provide emergency care and inpatient beds, but not intensive care services.
Health care systems are experimenting with these to expand access to acute care without investing in large infrastructure projects. Whether it can increase access to health care in fast-growing areas still remains to be seen.