DIGITAL HEALTH BRIEFING: FDA greenlights first 'digital pill' -- Wearables, AI can detect major medical conditions -- UK paramedics trial image, video scanning

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FDA GREENLIGHTS FIRST ‘DIGITAL PILL’: The US Food and Drug Administration (FDA) announced Monday the approval of the first pill embedded with a sensor that can tell patients, doctors, and caregivers if and when a patient is taking their medication. The approval could lead a wave of dose-tracking drugs that could give doctors and researchers better insights into medication adherence rates. Nonadherence is projected to cost between $US100 billion and $US300 billion each year in the US, in large part because patients who do not follow protocol often worsen and need additional treatment.

The new pill, Abilify MyCite, was developed by drug-maker Otsuka and sensor-creator Proteus Digital Health. It works by having the pill transmit information to a wearable patch worn by the patient. The patch then sends information to the patient’s mobile app. Patients can then allow caregivers and physicians to access this information via a web portal.

Abilify MyCite could face a number of hurdles as it enters the market.

  • There’s not yet any evidence yet that Abilify MyCite’s sensors can improve medication adherence, according to the FDA. More so, the drug’s label warns that the tech should not be used in emergencies because real-time detection may be delayed, or simply not occur.
  • Patients can opt-out of sharing their data at any point. If a patient decides they no longer want to share information, the tech loses its usefulness.
  • There could be backlash from privacy pundits concerned of insurance companies using coercive measures to get patients to use pills with sensors in them. Insurers could offer incentives so appealing that they’re almost coercion, Scripps Translational Science Institute director Dr. Eric Topol said.

Nevertheless, this first FDA-approval could pave the way for other sensor-embedded products in the pipeline. These include generic versions of blood pressure pill Lisinopril and the standard diabetes drug Metformin, according to FierceHealthcare. Eventually, the tech could expand to things like ensuring post-op patients are taking the correct amount opioid medication, or to confirm that clinical trial patients correctly took the drugs being tested.

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PAIRING WEARABLES WITH AI TECHNOLOGY CAN HELP DOCTORS DETECT MAJOR HEALTH CONDITIONS: Wearables, such as Apple Watches and Fitbits, can accurately detect hypertension and sleep apnea when paired with Cardiogram’s deep neural network, DeepHeart, according to a collaborative study between digital health startup Cardiogram and UC San Francisco’s eHealth Study. DeepHeart is an artificial neural network — a form of AI — that uses heart rate and step count data obtained from wearables to detect medical conditions. The study found that DeepHeart was able to recognise hypertension with 82% accuracy and sleep apnea with 90% accuracy. These conditions are commonly undiagnosed — around 80% of people with sleep apnea don’t know they have it and 20% of hypertension cases go undiagnosed. The results show how advances in emerging technology, such as wearables and AI, can be used to improve the rate of diagnosis. It could also help to pick up on warning signs associated with chronic and preventable illnesses, which could help cut down on healthcare costs. Combined, sleep apnea and hypertension account for almost $US200 million in medical costs, lost productivity, and car accidents annually.

CONNECTED AMBULANCE COULD HELP STREAMLINE EMERGENCY CARE: ViaSat, the broadband service and technology company, is piloting a new SatCare program in the UK that enables paramedics to send high-resolution videos and images from a connected ambulance to doctors and specialists prior to a patient’s arrival at a hospital. The company partnered with The University of Aberdeen’s Centre for Rural Health, NHS Highland, and the Scottish Ambulance Service for the pilot, which is expected to last for one year.
It will include five ambulances in the Scottish Highlands, all of which will be equipped with scanning equipment and ViaSat’s satellite broadband communications system. The ability to send scanned images, rather than just having a phone conversation, is expected to help both medical providers and patients by giving doctors and specialists more information about the patient’s condition before they arrive at the hospital. This could allow doctors to give paramedics critical information en route to the hospital as well as allow paramedics to discuss the best hospital to take patients to based on their condition and the hospital’s specialty. Although the current goal of this service is to provide better care for patients on long journeys to hospitals in rural areas, if successful, it’s reasonable to think that this technology could eventually be used in any emergency situation.
PATIENT RELATIONSHIP MANAGEMENT PORTAL RECEIVES $US8M: Welkin Health, a US patient relationship management portal, raised $US8 million in its latest funding round, increasing the company’s total funding to $US12 million, according to MobiHealthNews. The San Francisco-based platform sells its customer relationship management tool to digital therapeutics companies to allow them to manage and coordinate with large groups of people at the same time. Digital therapeutics refer to the use of digital and online health tech, such as websites and mobile apps, to change a patient’s behaviour for the treatment or prevention of medical conditions. For instance, a type II diabetes patient could be guided by a digital therapeutics service to maintain or improve their condition through monitoring blood-sugar levels, exercise, and diet. Welkin Health will use the funding to make its platform more functional to businesses and to support its growing staff — the company almost doubled in size, from 17 to 31, in 2017 alone. Looking ahead, services like Welkin Health will likely become increasingly important given that prevention and maintenance of disease can help alleviate the growing cost of healthcare. In the US, chronic diseases and the health risk behaviours that cause them account for most health care costs, according to the CDC. By 2025, US healthcare spending is projected to account for nearly 25% of GDP.

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