CIMIT blog

Medical Innovations in Global Health

Global Health, Intellectual Property and Access to Medical Innovations

Moderator: Utkan Demirci, PhD, Assistant Professor of Medicine and Health Sciences and Technology, Harvard Medical School, Brigham & Women's Hospital

Panelists:

Sarah Sorscher, JD/MPH Candidate, Harvard Law School and Harvard School of Public Health

Maryann Fenerjian, PhD, JD, Director of Technology Transfer Policy, Harvard Office of Technology Development

Kevin Outterson, JD, Associate Professor of Law, Boston University School of Law

F.M. Scherer, PhD, Aetna Professor Emeritus, John F. Kennedy School of Government, Harvard University

Jonathan Spector, MD, MPH, Pediatrician and Neonatologist, Massachusetts General Hospital/Harvard Medical School; Research Associate, Harvard School of Public Health

While innovation in the developed world brings the promise of new drugs, diagnostics, vaccines, and medical informatics, bringing these technologies to patients in developing countries, that carry the bulk of the global disease burden, poses complex challenges. Universities serve as a source for one in every five of the highest-priority medical treatments approved by the FDA each year. How can university research be targeted to develop products that serve the needs of people in low-resource settings? What is the role of universities, as major sources of innovation, in expanding access to the end products of research? 

The Harvard chapter of Universities Allied for Essential Medicines, in collaboration with the Global Health Initiative of CIMIT, has invited noted experts in the field to a panel and discussion that will address these questions, with a special focus on university licensing policies. Forum moderator, Utkan Demirci, PhD, of HST/BWH, runs a lab working on micro- and nano-scale technologies in medical engineering; these have led to end-products with global health applications. Prof. Demirci also co-directs the HST course, "Designing and Sustaining Technology Innovation for Global Health Practice."

Forum panelists bring a wealth and diversity of viewpoints to this important issue. Maryanne Fenerjian, PhD, JD, Director of Technology Transfer Policy of the Harvard Office of Technology Transfer, will share experience from working at the heart of technology transfer, and address how Harvard currently tackles access issues in licensing. Kevin Outterson, J.D., L.L.M, at Boston University Law School, researches global pharmaceutical markets and health disparities. F. M. Scherer, PhD, MBA, Harvard Kennedy School Emeritus, has published on global welfare and pharmaceutical patenting. Jonathan Spector, MD, MPH, at MGH and HSPH, works with geographically disadvantaged patients as a volunteer with Medecins Sans Frontieres.

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology (CIMIT)

Predictive Models for Healthcare

Sleepless, Overheated, Sugar-charged and Broken-hearted: Predictive Models for Improving Performance and Assessing Risk

Predictive Models for Individualized Medicine

Jaques Reifman, PhD, Senior Research Scientist, DoD Biotechnology High-Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Materiel Command, Ft. Detrick, Maryland

 

The U.S. Army Medical Research and Materiel Command, Ft. Detrick, Maryland has developed a suite of bio-mathematical predictive models for on-line estimation of an individual’s physiological state. Dr. Reifman will outline the requirements for developing individual-specific, field-deployable models based on both first-principles and data-driven approaches. He will demonstrate models for:

(1) improving the management of cognitive performance impairment due to sleep loss,
(2) avoiding undesirable hypo- and hyperglycemic episodes for patients with type 1 and type 2 diabetes
(3) reducing the risk of heat illnesses by predicting body core temperature.

 

A Novel Non-invasive ECG-based Method for Predicting Adverse Cardiovascular Outcomes

Collin M. Stultz, MD, PhD, Principal Investigator, Research Laboratory of Electronics and W. M. Keck Associate Professor of Biomedical Engineering, MIT

An important goal of clinical cardiology is to accurately identify patients who are at high risk of adverse cardiovascular events. Such high risk individuals may benefit from aggressive interventions. Risk assessment methods utilizing non-invasive physiologic signals are of particular interest. We have developed a novel risk assessment metric, called morphologic variability (MV), which measures subtle beat-to-beat changes in the shape of ECG signals. Unlike other ECG-based metrics, morphologic variability uses information from the entire ECG signal and does not focus on any specific segment of the ECG. Our results suggest that MV adequately predicts mortality in patients who are at high risk of casualty 90 days after admission for an unstable coronary syndrome (e.g., heart attack). MV may be clinically effective in identifying high risk patients that would benefit from more intense monitoring and therapy.

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology (CIMIT)

Acute Kidney Injury (AKI)

Acute Kidney Injury

Moderator: Joseph V. Bonventre MD, PhD, Samuel A. Levine Professor of Medicine, Harvard Medical School; Chief, Renal Division, Department of Medicine, Brigham and Women's Hospital; Director, BWH/HST Division of Biomedical Engineering

Mario F. Rubin, MD, Physician, Massachusetts General Hospital; Director, Transplant Nephrology Fellowship, Massachusetts General Hospital; Coordinator, Renal Unit Outpatient Medical Residency Training Program, Massachusetts General Hospital; Harvard Medical School

Acute Kidney Injury (AKI) is a clinical entity encountered in different settings (pediatrics, adults, ICU, Non-ICU) with different causes and protean clinical manifestations. It is associated with a very high mortality (especially if dialysis is required) and is emerging as an important cause for chronic kidney disease (CKD) and is a causative factor for progression to end-stage renal disease (ESRD). Despite major advances in the understanding of its pathophysiology, its early detection and proper therapy remain elusive.

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology (CIMIT)

How to Improve Patient Safety through Medical Device Interoperability

Improving Patient Safety and Clinical Workflow: System Integration through Medical Device Interoperability

Moderator: Peter Szolovits, PhD, Professor of Computer Science and Engineering, Massachusetts Institute of Technology Department of Electrical Engineering and Computer Science; Professor of Health Sciences and Technology, Harvard/MIT Duivision of Health Sciences and Technology; Head, Clinical Decision-Making Group, MIT Computer Science and Artificial Intelligence Laboratory

Speaker: Julian Goldman, MD, Medical Director of Biomedical Engineering, Partners HealthCare; Principal Anesthesiologist, Massachusetts General Hospital "Operating Room of the Future"; CIMIT Director of Interoperability; Founder, Medical Device "Plug-and-Play" Interoperability Program

The absence of open standards and related technologies for cross-vendor point-of-care medical device integration is impeding national efforts to revolutionize the delivery of safe, efficient, high-acuity patient care. In contrast to the Internet – which was designed for ease of connectivity, and not specifically for safety, reliability and security – high-acuity health care requires connectivity to and from medical devices in a manner that permits the functional integration of device capabilities into a network and the EHR. A foundational step toward realizing this goal will be the implementation of standards-based medical device interoperability as broadly implemented as the Internet. Dr. Goldman will describe the leadership necessary to keep an endeavor of this magnitude on track to deliver clinically meaningful solutions.

Panel Discussion

Forum participants above, and: Andrew Reisner, MD, Emergency Physician, Massachusetts General Hospital; holds appointments at Harvard Medical School, MIT, and US Army Telemedicine and Advanced Technology Research Center

Fully integrated clinical environments will support real-time decision support, complete clinical documentation, and closed-loop therapy. Despite these important clinical benefits there have been longstanding challenges to successful implementation. Our panelists will add their perspective on current and historical efforts to leveraging clinical and information technologies to enable healthcare innovation.

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology (CIMIT)

A First for Non-Invasive & Collaborative Surgery Around the Globe

 
“NOTES has the potential to revolutionize the way some operations are conducted” David Rattner, MD, Chief of Gastrointestinal and General Surgery, MGH

Guest Author: Patricia Sylla, M.D., Instructor of Surgery at Mass General & Harvard Medical School

7 December 2009, Boston - In the early days of November a groundbreaking surgical procedure, that we put through years of careful testing, was finally ready to be performed by our international team bridging Barcelona and Boston. Our patient was a 76 year-old woman diagnosed with a malignant tumor of the rectum that would traditionally require painful abdominal surgery and a long recovery period. However, she underwent our new procedure that left only tiny scars resulting in significantly reduced pain and shorter recovery time. The procedure I preformed, alongside my colleague Dr. Antonio Mª de Lacy of the Hospital Clinic, was transanal NOTES rectal cancer resection using Transanal Endoscopic Microsurgery (TEM).

You won't yet find TEM on Wikipedia, but it has been increasingly used in the field of NOTES (Natural Orifice Translumenal Endoscopy Surgery), born from the similar field of Endoscopic Surgery. The idea is to use the natural openings and orifices of the body to enter the abdomen, colon, or other areas to preform lifesaving surgeries. Our TEM technique uses rectal endoscopy to introduce a specially-designed proctoscope and CO₂ system that creates a working space within the rectum and allows us to introduce the needed instruments.

We've known for a long time that less invasive surgery can be associated with better outcomes. For this reason we have been working across institutions to develop this surgical application for a crucial area of the body while having the smallest surgical profile possible. Transanal NOTES expands upon recent advances in other similar surgical areas of the body (mainly the abdomen), but now aims to address an important need in diseases of the colon and rectum, including colorectal cancer.

This first procedure represents a great example of successful Collaborative Medicine. However, it also brings us a renewed awareness that as treatment for diseases of the body improve through technology and collaboration, we need to be proactive as patients. As a physician, I carry with me the determination to care for the lives of those around me from many perspectives. This means that as new devices and procedures are developed for saving lives, we must work to pair those advances with a proactive patient focused approach to health.

I would like to give special thanks to Dr. David Rattner, my colleague and mentor and an integral part of our research over the past years. As well as the entire NOTES collaboration, the surgeons and endoscopists at Mass General Hospital, Brigham and Women's Hospital, Beth Israel Deaconess Hospital, and Dartmouth Medical Center. 

You can read more about this procedure here

Patricia Sylla, M.D.

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology (CIMIT)

Innovation & Investment: The Future of Life Sciences

Last week we had some old friends and some new friends come together here at MGH to discuss the future of Life Sciences and innovative opportunities for business development and venture capital investment.  You'll know Juan Enriquez from his ground breaking book As The Future Catches You. Luis Barros comes to us from the Massachusetts Life Sciences Center, where they focus on creating jobs in the Commonwealth by developing Boston as the center for biotechnology around the world. David Constantine is a new CIMIT face coming from the initiative, MassChallenge, a Collaboration and Competition model just getting started. Finally, John Abele, served as the continual driving force behind a need for better collaboration in medicine.

Moderator: Richard Anders, Managing Director, Rubin/Anders Scientific, Inc.

Innovation has charged the world’s biotech and medical device industries, academic medical centers, universities and global health organizations. In the context of the current United States debate over HealthCare Reform, Enriquez and Barros will discuss the impact and outlook for life science innovation.

 

Why Life Sciences will be the Dominant Language and Economic Driver of this Century  

Juan Enriquez, Managing Director, Excel Medical Ventures and Chairman and CEO, Biotechonomy LLC
 
As we live through an almost unprecedented economic crisis, we are also living through an extraordinary scientific age. On the one hand, we are witnessing unprecedented wealth destruction. On the other hand there are, especially in Boston, extraordinary opportunities to create the next great industries and power the global economy.

The life science revolution is already having extraordinary political, ethical, economic, and financial impacts. You can begin to see this in both the pattern of mergers and acquisitions as well as new investments.

Life science applications are transforming how pharma, biotech, food, feed, fiber, insurance, chemical, insurance, and energy companies do business.

 

Investing in Innovation 

Luis Barros, Senior Vice President, Investments & Industry Development, Massachusetts Life Sciences Center
 
Luis Barros is the Vice President for Investments and Industry Development for the Massachusetts Life Sciences Center, the quasi-public agency charged with implementing the state's ten-year, $1 billion Life Sciences Initiative. His presentation will discuss the Center's investment strategy, the investments made thus far, and the return on investment to date.

 

Panel: Where to Invest in Innovation 

John Abele, Founding Chairman (retired) and Director, Boston Scientific Corporation
 

David Constantine, Founder and Chief Operating Officer, MassChallenge

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology (CIMIT)

#FDASM - The FDA's Public Hearings on Social Media

19 NOVEMBER 2009, BOSTON - Zen Chu (Accelerated Medical Ventures and CIMIT's Innovation Grand Rounds) recently testified at the FDA's public hearings on Social Media and Internet (#FDASM). The FDA is grappling with a number of questions centered around regulation and accountability for Healthcare and the use of Social Media, with implications for direct-to-consumer advertising, patient safety, adverse event reporting, disease management, and new technology innovation.

The FDA thought it wise to bring together qualified experts from a wide range of areas to give testimony. Streaming video available for the next 20 days: http://www.fdasm.com/

I thought Zen had an interesting testimony, perspective and has shared it with us.

Zen Chu: My purpose was to lend an innovation and new ventures perspective to the FDA panel:

• FDA should lend clarity to regulations and exercise restraint to enable new technologies and services to engage patients
• FDA needs to distinguish between ads and messages delivered to benefit wellness, compliance, adherence
• FDA must hire more expertise in new media and technology to understand and provide more timely guidelines
• A New Media & Technology Advisory Board, comprise of both industry, academia and patient advocates should be created to advise FDA

Zen Chu Healthcare Innovation FDA Testimony DDMAC Public Hearings on Internet & Social Media #FDASM

View more documents from MedicalVentures.

Socialnomics & Healthcare

18 NOVEMBER 2009, BOSTON - Nice old piece on Socialnomics, which has been seen a lot by now, but with the FDA Public Hearings on Social Media (#FDASM) I think it is appropriate to bring it back and refresh us. The Social Media Revolution...

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology

Farewell, Don Baim

10 NOVEMBER 2009 - BOSTON  It is with a heavy heart that CIMIT says goodbye to our friend and colleague Dr. Don Baim. Don passed away last Friday, 6 November 2009, following complications of surgery to treat adrenal cancer.

We will remember Don as a former CIMIT Site Miner (one of many roles here) and as someone who continually pushed medicine forward -- be it from Harvard Medical to Boston Scientific. He was a Forum speaker, a panelist multiple times and from time to time we found him in the audience of Forums focused on Venture Capitalism in Medicine. 

This morning John Parrish called a moment of silence for Don here at CIMIT and we remembered how much he gave to medicine and the better outcomes he helped produce.

Don was a friend to all of us here and his loss is a tremendous one.

CIMIT

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology

Innovation Congress 2009 Keynotes!

Last week headed off to the CIMIT Innovation Congress 2009 in Boston. There we found ourselves at the intersection of academic medicine, government and industry with clinicians and researchers doing groundbreaking work. The conference was a tremendous success with the Focus Session breakouts, the Exploratorium, and the Keynotes. Embedded below you'll find a few great keynotes and links to all the rest.

For full versions of the CIC09 Keynotes, including additional speakers please click here

Clay Christensen Harvard Business School - Talks about Disruptive Innovation and healthcare reform

Maj. General James K. Gilman Commander of Medical Research and Materials Command at Fort Detrick - Tells us how we take care of today's Wounded Warriors

Susan Axelrod President and Founder, CURE - Tells the story of her daughters struggle with Epilepsy

CIMIT blog is a publication of the Center for Integration of Medicine and Innovative Technology (CIMIT)