Medical Breakthroughs That Will Change Healthcare

One wireless device in the pipeline could improve medication compliance. It fits onto a prescription bottle and alerts patients when it's time to take their pills—and reminds them if they forget. In trials now at the Center for Connected Health, the device senses when a patient unscrews the cap on the prescription bottle and sends the information through a secure network to an online site. "I'm using it myself and I find it very helpful," says Joseph C. Kvedar, MD, director of the center, a division of Partners HealthCare in Boston.

"Adherence to medication alone can lower costs," Kvedar says. "It's a powerful tool, and just about every person should have some kind of medication device when we get them to the point where they're affordable and reliable."

As accountable care, bundled payments, and pay-for-performance become more common, improving health outcomes with wireless technology and other tools and devices makes business sense, Kvedar says. Partners is also using such cutting-edge technology to differentiate itself in the marketplace, he adds.

What's Next: The technologies of tomorrow can impact your purchasing decisions today. Hospitals should hold off on investing in hardwired connectivity and save the money—and the disruption, expense, and contamination risk—if you can.

Medical imaging
Imaging is one of the fastest-changing technologies, and experts say there are still more advances ahead. "It's all going to be going down to the molecular level," Ronstrom says. "It's incredibly futuristic what's going to happen with imaging . . . in five years we're going to see major, major changes," says David T. Feinberg, MD, CEO of the four-hospital University of California Los Angeles Hospital System. "Imaging has gone from being diagnostic to therapeutic. Interventional radiology is remarkably helpful in that you don't have to cut people open in the same way you did before."

UCLA was the first organization to offer clinical PET scan services to patients. Today, researchers there are studying the use of PET scans to detect Parkinson's disease, to visualize the success of different cancer treatments, and to determine the effectiveness of chemotherapy.

Minimally or noninvasive approaches such as the ones discussed can reduce complications, including postoperative infection, reduce length of stay, and lower the overall cost of care, studies have shown. They can also save money—an October 2009 study published in the journal Surgical Endoscopy found a difference of more than $15,000 on average for minimally invasive colectomies when compared to open surgery, for example.

What's Next: As minimally-invasive techniques are shown to be safer and more cost-effective, prepare for a wider variety of procedures to move to outpatient settings. And the more procedures a surgeon does outside of the hospital setting, the better the outcomes, including lower infection rates, Wenzel says.

Virtual medicine
Mayo Clinic researchers have been testing a supersensitive fiber-optic probe 2 millimeters in diameter that can be passed through a normal endoscope and can see structures as small as 1 micron, such as single cells or the nucleus within a cell. Probe-based confocal laser endomicroscopy, or pCLE, could eventually reduce colon polyp removal, and data suggest that the virtual biopsy can replace real biopsy in several other conditions, including Barrett's esophagus.

The technology is "highly promising," says Michael B. Wallace MD, MPH, professor and vice chairman of medicine at the 214-licensed-bed Mayo Clinic in Jacksonville, FL. "We also have very promising data using confocal to assess the completeness of removal of very large polyps."

"We remain very optimistic that this technology will have an important role in guiding biopsy to areas that are much more likely to be disease, and in some cases, providing 'virtual biopsy' during procedures in real time so as to guide immediate therapy [instead of waiting several days for actual biopsies then repeating a procedure]," Wallace says.

Dermatologist Babar K. Rao, MD, is particularly enthusiastic about a new device that uses laser imaging to help determine whether a lesion needs biopsy. The VivaScope, made by Rochester, NY-based Lucid, Inc., views skin abnormalities at the cellular level. "In many cases, it can save patients unwanted, unnecessary biopsies, and in some cases it may detect a lesion which otherwise might not have been biopsied."