Tuesday, November 3, 2009
Shareable Ink Turns Paper Forms Into Digital Entry System
At TEDMED last week we spoke with Dr. Vernon Huang from Shareable Ink, a company that provides a digital solution for physician practices that prefer to stay with paper. We were a bit skeptical at first, having seen other "digital pens", but Shareable Ink is impressively simple, ingenious, and intuitive to use.
Link: Shareable Ink ...
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Monday, November 2, 2009
Medgadget's Sci-Fi Writing Contest: Return of the Prose
We are excited to announce our annual Medgadget Sci-Fi Writing Contest! Now in its fourth year, the competition is designed to showcase fictional stories written by our readers, stories that transport us into the future of medicine. Whether it is a hitherto unknown ethical dilemma that will come up many years from now or an imaginary technology, we can't wait to see this year's entries! You might recall the amazing set of stories that dazzled and stirred the imagination last year. So lets take a look at the future of medicine together again!
Just like last time, here are the rules:
That's it! Get your thinking caps on and start typing! Feel free to browse our archives ... for inspiration.
Flashbacks: 2008 Medical Sci-Fi Contest: Please Meet the Stories! ; 2007 Medical Sci-Fi Contest: Please Meet the Winner!; Medgadget 2006 Sci Fi Contest Results
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Saturday, October 31, 2009
TEDMED 2009 - Day 4 (The Final Day)
It's over. TEDMED just ended with yesterday's morning session of talks by Ken Kamler, surgeon and mountaineer, oceanographer Dave Gallo, another short talk by VisualMD founder Alexander Tsiaras, an insightful talk by David Blaine, who told the story behind how he held his breath for 17 minutes and 4.4 seconds, and a closing performance by Jill Sobule.
Kicking off the morning theme of extreme feats, surgeon Ken Kamler told us about some of his experiences climbing Mount Everest and the sort of medicine, or lack of medicine, they're able to practice at such heights. Medications commonly used on Everest are simply steroids and pain killers. After Ken, oceanographer Dave Gallo gave a talk about his ocean exploration that had stunning imagery (take a look at videos from his previous TED talks) and spoke of the ocean's health as being indicative of human health.
But by far the highlight of the morning was David Blaine, who gave a fascinating, candid, and behind the scenes talk about what it took to hold his breath for 17 minutes and 4.4 seconds. Richard Saul Wurman, in introducing him, mentioned that David was extremely nervous for the talk, as he doesn't generally give presentations in front of people, rather he just does magic. In fact, this was the first time David had spoken in front of a large audience. Yet David was calm, humble, and reflective on stage, and he opened by talking about a little teaching session he did the night before with some members of the TEDMED audience. At the end of yesterday, he asked ten people to stay afterward so he could teach them breathing techniques to help them learn how to hold their breath too. The basic strategy David discussed was to not move a single muscle when holding one's breath and purge off as much CO2 as possible by essentially hyperventilating. The body has two molecular signals that lets it know it needs to breath, oxygen concentration, and carbon dioxide concentration. When oxygen concentration is low, your body wants to breathe, but also when carbon dioxide concentration is high, your body wants to breathe, in order rid itself of the CO2. When you hyperventilate, you breathe off much of your CO2 and it makes holding your breath much easier. With this training, David was able to get members of the audience, with no prior experience in holding their breath, to do so for 4 minutes.
David went on to talk about his own journey toward breaking the world record for holding one's breath. After his surgeon friend told David he'd have irreversible brain damage if he held his breath for over 6 minutes, he started by brainstorming all sorts of cooky ideas to create a breath holding illusion: a tube device that would filter out CO2 that they tried to shove down David's throat and breathing through a liquid that's high in O2 content. When none of those worked he decided to actually give it a go, and met up with an ocean free diver to help him train. To prep for his famous and failed Lincoln Center attempt, he lost weight and slept in a hypoxic tank at night to trigger the physiologic adaptations in the concentration and properties of his blood hemoglobin. His big mistake at Lincoln Center was to try to and perform the stunt while releasing himself from handcuffs, thus burning too much oxygen from his movements. After his failure, he went back to the drawing board, started another training regiment, and ended up holding his breath for 17 minutes and 4.4 seconds live on Oprah (a different world record this time, one where you breathe pure oxygen before you start holding your breath). His description of those 17 minutes was riveting. We apologize for the poor quality of this clip, but listen in on David's description of his heart rate during the last few minutes of his record:
TEDMED then wrapped up with some more beat poetry by Sekou Andrews, and a lovely musical performance from Jill Sobule. Well, that's it. Thank you for following Medgadget's coverage. Also keep in mind that all of the videos from the conference will be posted online at TEDMED and TED. We will let you know when that happens so you can relive the conference yourself.
We'd also like to say a big thanks to the organizers of TEDMED, Marc Hodosh and Richard Saul Wurman, both for their extraordinary efforts in putting together a great event, and for working with Medgadget to help get us there.
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Friday, October 30, 2009
TEDMED 2009 - Day 3
The third day of TEDMED came and passed in a blur, with twenty three talks, the filming of some great video content for Medgadget, lunch outside on the lawn, and a few cups of coffee to keep us going. As with yesterday's overview, we cannot cover all the talks so we'll focus on a subset that stood out.
Another Jill Sobule original song kicked off the day, this time about a girl named Lucy who goes to the gym. She's been doing TED conferences for many years now and has become in a way, a TED tradition. Her story based songs are quite fun and I'm looking forward to listening to more of her after the conference is over.
Jill's songs led into the first talk of the day, a joint conversation of sorts between the spiritual Deepak Chropra and the scientific Dean Ornish. Richard Saul Wurman and Marc Hodosh, the two leaders of the conference, thought it'd be a good idea to let these two people, with relatively different ideas of medicine, meet head to head on stage. And it largely worked and made for insightful conversation. After establishing that their end goals of health, positive relationships, empathy, and community, were similar, the two of them talked about how they believe people should get there. Dean discussed the importance of a patient having a support community and gave a short presentation with content such as the fact that depression increases one's risk of a slew of medical maladies. Deepak spoke of spirituality's role in healing and gave his outline of how one should look at and treat his or her's soul in order to treat the body. By far the best quote of the talk, however, goes to Deepak when he jokingly said that "Dean is a real doctor and I am a witch doctor" when asked about what makes the two of them different.
Keith Black, Chairman of the Department of Neurosurgery and Director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center, came on next to talk about his work on using the immune system to target cancer of the brain. He noted that cancer cells essentially cloak themselves from the immune system in order to hide their abnormal physiology and growth from the body's natural defenses. To do so, cancer cells release a flood of immunosuppressant cytokines and the healthier a person's immune system, the more likely they are to survive a brain cancer. In fact, age is the strongest predictor of surviving a glioblastoma. Why? Because younger people have healthier immune systems. He talked about his attempts to make the tumor cells more visible to the immune system by using dendritic cell vaccines based off samples excised from the patients' cancers. Essentially they make a vaccine off tumor markers that hyper sensitizes the patients immune system to their cancer. In about 60% of patients given this vaccine, they were able to both activate the immune recognition of the tumor as well as activate the killer T cells to help fight the tumor. And interestingly, in the 40% of patients where this immune modification did not occur, there still seemed to be the effect of increased sensitivity to chemotherapy. Strong data in support of this research comes in the from of a direct correlation between the intensity of the patient's immune response and their length of survival.
Right after Keith was Peter Diamandis, founder and chairman of the X-Prize Foundation. As most of you know, the idea behind the X-Prize is simple: offer a lot of money to spur private industry competition and innovation. So far this framework for innovation has worked remarkably well, with the Ansari X Prize for private space flight producing the Space Ship One, and the Archon X Prize for genomics likely months away from being awarded. In crafting their prizes, the foundation tries to find goals that will be achievable in between 3-8 years - any fewer than 3 and it's too easy, and more than 8 and people loose interest. The big item of interest in his talk was the upcoming Healthcare X-Prize, set to be launched in the spring of 2010. The Healthcare X Prize awards first the creation of a suitable metric to determine the health of a community, because you can't improve what you can't measure, and then the creation of a healthcare system for a population of 10,000 people that most improves this wellness metric for the least amount of cost. A set of five 10,000 person large groups of people have been identified for participation in the prize. We can't wait to see what might come out of this.
The next person to keep the morning excitement going was Kary Mullis, who won the Noble prize in chemistry for developing PCR. He discussed updates to his latest project (that was previously highlighted at TED; see video below) that involves taking randomly generated 30 base pair DNA oligonucleotide aptamers, or more simply, random lengths of DNA that have binding affinity to a variety of molecular substrates. The idea is that it is relatively easy to create a massive library of aptamers that bind to almost anything at a highly selective level. So, if you've got a microbe you want to kill, you figure out which unique surface proteins it's got that you'd like to target and select an aptamer that binds to it. Then, you take this aptamer and attach it to something that the body has a strong innate immune response to. This combination means that the aptamer binds to the microbe but is attached to a giant flag that tells your immune system to come over and eat up whatever the aptamer is bound to. The technology has been proven to completely eliminate anthrax in animal models and we're quite excited to see where it goes over the coming years. Here's an overview of this technology from a previous TED conference:
After quite a content strong morning session, we had a one hour coffee break during which we interviewed a few companies and wandered around between snack tables. Soon after the break, we heard from Steve Cole, one of the men behind HopeLab, the company that makes a cancer fighting video game called Re-Mission to help pediatric patients contextualize and play a more active role in the fight against their disease. The idea is to give these patients the experience of taking charge in their fight against cancer and have them understand both visually and emotionally what the chemotherapeutic agents might be doing to their body so that they remain more optimistic, more compliant with their medications, and more engaged with their treatment.
After a few more talks we went off to the lawn of the hotel for lunch, during which time we talked to David Bolinsky, founder of XVIVO, an animation company that makes beautiful videos of molecular biology events. They had been showing David's company's videos after almost every talk and each time they completely captivated the audience. You can see our brief interview with him up on Medgaget, few posts below.
After lunch Colin Angle, the co-founder and CEO of iRobot gave a talk about his company and the sorts of robots they might build to help elderly people stay out of the nursing home longer. The staggering statistic he spoke of as impetus for his work was that 23% of people self-identify as informal care givers. That's quite a lot of people whose lives are dramatically affected by the need to constantly care for a loved one. To illustrate his point, he used the example of his mother (including a life-size cardboard cutout) to talk about the sort of assistance she might someday need and how robotic technology might be able to help provide her with that and let her live in her home longer, grounded in the statistic that 3/4 of seniors would prefer to stay in their home rather than go to the nursing home. He attacked this problem from a few angles. The first was monitoring. He noted that one of the biggest reasons a son or daughter might choose to put their parent in a nursing home is simple worry, the constant concern that their parent is not OK and the pressing need to always keep in touch with them. iRobot might someday have a solution to this in the form of a household robot that provides a video feed and activity monitoring of the house and the people in it. This sort of always-on monitoring would help alleviate concerns from the parent's side. He also noted that the inability to comply with complicated medication regimens is the number one reason that an elderly person ends up in a nursing home. iRobot is looking at how they might be able to take a more active stance in this problem by programming a robot to literally hand a person the right medication when the need it, allowing elderly people to just sit back and wait for the robot to offer up what pills they should take. Lastly, Colin noted that the point of the robot is to extend independent living, not replace it. An example of the type of robot that might someday be tweaked into a household version can be seen in the video below.
Next up was Rick Satava, the Senior Science Advisor at the US Army Medical Research Command. One of his major ideas was that as science progresses, the methodology needs to keep up as well. Double blind clinical trials are certainly a gold standard for much of medical progress, but he advocates for supplemental approaches such as simulations that will be valuable in their own way. He also said that he thinks we're on the verge of the fourth wave of human technological revolution, the first being agricultural, the second being industrial, the third information technology, and the fourth, biointelligence, which he defines as a hybrid of IT and biology. Richard went on to present a flood of impressive medical technology, much of which we'll cover in subsequent posts.
After Rick, Helena Foulkes, the Executive Vice President of CVS spoke about how dismally poor patient compliance is for medications, especially those to treat chronic conditions. More than half of patients who start taking "maintenance" medications stop taking them after a year. And over 70% of hospital readmissions are due to medication noncompliance. CVS is testing out a medication counseling program called First-fill that aims to address these problems using the pharmaceutical staff as more of a resource. So far they've seen that this program can improve refill rates by over 15%.
Last on the list we're going to cover is Jamie Heywood, co-founder and chairman of the medical networking site PatientsLikeMe. He gave a riveting talk, both in content, presentation, and graphics, on how PatientsLIkeMe is not only providing a support network for patients with similar medical conditions, but is looking to be a hotbed of the aggregate mock clinical trials. The site collects structured data for multiple medical ailments and their associate symptoms, treatments, and responses for each patient. On the individual level this is valuable as a source of record and a way to seek out others who are undergoing similar treatments, but at aggregate this power really shines. Jamie used the example of ALS, which his brother died from, to show just how powerful something like PatientsLIkeMe can really be. A study in PNAS came out that demonstrated that lithium helped to slow the progression of ALS. The study, though, had multiple methodological problems, yet many ALS patients who used PatientsLIkeMe started taking lithium as a result of the study. Using PatientsLIkeMe data to compare those who didn't take lithium to those who did (along with some advance mathematical transformations), they were able to demonstrate that lithium did not have an effect in their patient population. The results for an aggregate patient "trial" like this were vastly quicker than what current medical literature can produce. We're definitely going to keep an eye on PatientsLIkeMe in the next few years.
From San Diego and the beautiful Hotel del Coronado, that's it for day three. Stay tuned for the last wrap up of day four.
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Knome Personal DNA Sequencing Services
Yesterday we spoke with Ari Kiirikki of Knome, a company that provides full DNA sequencing for people willing to dish out $68,000. This is a bargain considering the price just dropped from $99,000. Of course this isn't for everybody, but people willing to spend the money are promised some tangible benefits. Here's our interview with Mr. Kiirikki at TEDMED 2009:
Link: Knome, Inc.
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XVIVO's David Bolinsky on Benefits of Scientific Animation
We had a chance to catch up with David Bolinsky, co-founder of XVIVO, a company that does some amazing animations for the life science companies and organizations. We asked him to briefly speak about what his company does and how high quality visualization can help people understand medical concepts.
XVIVO flashbacks: Video: The Beautiful Side of a Viral Infection; The Inner Life of the Cell; The Inner Life of the Cell: A Full Version ; Can a Digital Projected Heart Replace a Much Beloved Solid One?
Link: XVIVO...
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The Woz Showing Off a Prized Gadget
One of the attendees to this year's TEDMED was the venerable Steve Wozniak, founder of Apple Computer. Steve is an engaging person so he wanted to show us his NIXIE tube wrist watch and how he uses it to intimidate fellow airline travelers. It ain't medical, but is surely amusing:
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Thursday, October 29, 2009
Interview with Philip Low About Roche and NeuroVigil Partnership
Yesterday Philip Low of NeuroVigil spoke at TEDMED and demonstrated the amazing iBrain technology his firm developed to monitor and interpret EEG signals. Today NeuroVigil announced a partnership with Roche that would provide the iBrain for use in outpatient clinical trials. We were lucky to be able to grab a few minutes of Philip's time immediately after the announcement to explain what this news means to our audience:
Press release: NeuroVigil and Roche Launch Personalized Neurodiagnostics Initiative for Enabling Preventive Treatment of CNS Disorders ...
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TEDMED 2009 - Day 2
We had a long and eventful second day at TEDMED, filled with plenty of laughs, thought provoking technology, spitting into vials for 23andMe, embarrassing ourselves in front of med tech celebrities, and even a conversation with Aubrey de Grey over a clam bake dinner on the beach. Yesterday sessions featured twenty two speakers, far too many to write up, but we'll highlight a few that we feel stood out from the rest, those that showed something new or especially interesting.
The conference opened with the second appearance of songwriter Jill Sobule. She's quite talented and today's song was a bit more upbeat than yesterday's, about the apocalypse, and was a great lead in to John Abele, co-founder of Boston Scientific. Everyone expected John to talk about catheters, stents, or something else from his world, but instead he threw a curve ball and discussed the concept of collaboration. It seems that research into how people best collaborate is a deep personal interest of John's, and he even bought a conference center called the King Bridge Center to better investigate his ideas on collaboration. He thinks medicine is lacking in the sort of productive collaboration that helps other fields quickly advance and be optimally productive. Through his talk he discussed a few ideas surrounding collaboration, but the kicker was his insight into the idea of surgical collaboration, where an audience of medical professionals sit in an auditorium with real time high definition operative data, and they all participate in a procedure by giving advice on what the surgeon should do next. This is actually already happening. He showed a video of a vascular surgery event of sorts in which at least one hundred leading vascular surgeons were all participating in the surgery. The doctor actually performing the procedure was collecting advice on what to do next and getting real time consensus data via real time polls. This, no doubt, made the procedure last longer, but most of the doctors in attendance said they thought they learned from it and that it produced a better result for the patient. A poll even indicated that they trusted their established consensus more than something they would read in a peer reviewed journal.
Soon after John, David Agus, professor of medicine at the University of Southern California and founder of Oncology.com and Navigenics spoke of his views on cancer. He would like to see a paradigm shift in the thinking of cancer as a tissue defined disease to a molecular marker defined disease. Rather than calling a disease breast cancer, for instance, we should eventually know the molecular gene mutations that caused the disease and be able to identify the cancer as HER2 cancer, etc. This hyper specific focus on the molecular basis of medicine should help refocus our thinking of the disease into a more curative direction. He also requested that researchers examine other ways to attack cancer besides targeting the diseased cells themselves. Citing a highly successful trial with zoledronic acid (a drug that improves bone growth), he noted that sometimes when you "change the soil" (make the bone more healthy), "the seed can't grow" (the cancer cannot thrive).
After a quick break in the coffee room, which, by the way had a 103" flat screen TV broadcasting the talks as they went along, we heard from Alexander Tsiaras, artist, scientist, and founder of The Visual MD. The idea behind VisualMD is to be the Google Earth for medical imagery. News organizations, for instance, might use the images from VisualMD to explain health concepts to their audiences just as how now they use Google Earth to convey geographic information. His goal is to make all of the data free and available and to serve as a resource for individuals, as well as doctors explaining health matters to their patients. Their images are beautiful 3D reconstructions of organs that the user can spin around, interact with, annotate, and even create their own slide shows for easy email to others.
Also before lunch was the science of aging pair up with Aubrey de Grey, CSO of the SENS Foundation, and David Sinclair, professor at Harvard Medical School. If you've not heard of these gentlemen before, both view aging as a disease but both are approaching aging in very different ways. Aubrey spoke first and has a more futuristic view of aging. His mantra is that aging is metabolism caused cellular damage that leads to organism pathology, and the human body, just like cars, can be made to run longer with adequate maintenance and repair. He views age related problems as belonging to seven types and in order to tackle aging, all seven cellular and molecular problems need to be cured. Aubrey also coined the idea of a Longevity Escape Velocity (LEV), which is the point of life span where progress in aging science is occurring faster than the degradation of the body itself. He believes that if someone is able to live to 150 years old, then by that point the progress in the ability to keep them alive will be faster than their rate of death, thus they will live into their 1000s. Still focused on the same target, but shooting from a different angle was David Sinclair, who focuses his research on a set of proteins called sirtuins. Multiple studies have shown that when an animal (it has been done in many specifies, including primates) undergoes caloric restriction (fed about 75% of what would be considered normal for that animal), they live about 30% longer. David has some great data to show that this is due to a cellular starvation response that is healthy for the cells and is activated by sirtuins proteins. He founded a company off this idea called Sirtris™ Pharmaceuticals which was quickly snapped up by Glaxo Smith Kline for $720 million dollars. Yes, you read that correctly, a $720 million dollar buy out for a company that so far has no proven drugs. Clearly GKS is betting big on this technology. The early uses of Sirtuins would be for diabetes, but might carry the side effects of less cancer, stronger bones and muscles, a longer life, and a few other wonderful things.
Eric Dishman, the director of Intel's Digital Health group spoke next about the power of in-home care. His central insight is that medicine needs to leave what he calls the mainframe model and move to a personal computer model, where care is delivered in the home if at all possible. He noted several ideas that might have clinical significance in gerontology. The first was simply engineering a smarter monitoring phone, that over time would track the responsiveness of the elderly person answering calls to determine how quickly they recognized the person calling in an attempt to detect any early signs of dementia. They would also be able to monitor the person's tremors to check for trends in motor deficiencies. Along these lines of elderly monitoring, Eric showed a prototype system that can be installed in a patient's home that might delay the necessity for them to move to a nursing home. Through a network of sensors and an high quality pedometer, an elderly person can be monitored to make sure they are able to take care of themselves in their house, are physically stable while walking, and are not injured or in need of help. These sorts of innovations let those who might be at risk of going to a nursing home live in their own home longer and safer.
After a lunch on the lawn of the Hotel Del Coronado, we heard from Greg Lucier, CEO of Life Technologies, the company that makes a slew of biological technologies, but of more recent relevance, DNA sequencers. He talked about how quickly DNA sequencing technology has grown and scaled, with the first genome being sequenced in 2000 for a cost of $3 billion. Now full human genome sequencing can be done for $10,000 in 10 days. This technology has advanced even quicker than Moore's Law (seen in cpu speed increases), and has far outpaced how the data is used clinically. With all of the genetic information that will soon flood the field of medicine, Greg advised the creation of a specialty of medicine akin to a genetic doctor, or someone who would help interpret genetic test results for clinical action. The technological advance of DNA sequencing, to Greg, parallels the introduction of more advanced radiological techniques which spawned the creation of a dedicated branch of medicine.
Keeping with the DNA sequencing trend, we then heard from Anne Wojcicki, founder of 23andMe. She spoke of her frustration with patients not being able to take an active stance in their medical care as the impetus for founding the company. We've covered 23andMe many times before so we'll hold off on most of the smaller details, but the two big announcements she made at TEDMED were that 23andMe now has 30,000 genomes in their library (likely one of the larger collections in the world) and that the company is introducing a relative finder that looks for people who might be your cousins (from 2nd to more distant) based on your genetic profile. But by and large our favorite thing about 23andMe being at the conference was that we got to spit in tubes and get our DNA sequenced for free. It took us imaging a quality cut of steak to work up the requisite saliva, but we did so, sealed it off, and it will be sent for processing.
In the last session of the conference, Philip Low, the founder and CEO of Neurovigil told us about his mathematical techniques for processing EEG readings. EEGs pick up electrical activity in the brain and Philip figured out a miraculous way of processing them that not only showed a brand new stage of sleep (a subset of REM) but also might, in combination with a large database of EEGs, be able to clinically diagnose neurological pathologies such as schizophrenia or depression. It's still in the early stage, but his preliminary data looks remarkably promising.
The last of talk of the day was David Pogue, from the New York Times, who gave an entertaining review of all of his favorite medical iPhone apps on the topic of "will your iPhone save your life?". We've covered many of the ones he's talked about, but for all of you medical students out there, take a look at Anatomy Lab, which lets you virtually dissect a cadaver on your iPhone. It looks like a slick application.
That's it for day two. We're looking forward to be fascinated by today's sessions. The report is coming up tomorrow...
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Patch Adams on Medical Technology
Yesterday at TEDMED we got a chance to speak with Patch Adams, the world famous physician, author, and activist. Being the eccentric that he is, we were wondering what novel medical technologies he uses in his practice to help people deal with their conditions. Here is the premiere of the uncut interview as it unfolded before our eyes:
More from Dr. Patch Adams blog...
Dr. Patch Adams on Twitter....
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Wednesday, October 28, 2009
TEDMED 2009 - Day 1
Yesterday we settled into our hotel room in San Diego, grabbed a burger, and went straight to session one of TEDMED. The first set of speakers consisted of a beat poet and performance artist Sekou Andrews, synthetic geneticist Craig Venter, regenerative medicine gurus Daniel Kraft, Anthony Atala, and Damien Bates, magician Eric Mead, ER and Law and Order SVU writer Neal Baer, geographic medicine popularizer Bill Davenhall, and songwriter Jill Sobule.
Sekou Andrews kicked off the conference with an energetic, free-flowing poem of sorts about health care, rhyming a mash-up of medical terms and concepts to get the crowd excited for the conference at hand.
After him, Craig Venter took the stage and chatted about synthetic biology and how his team synthesized the entire bacterium of Mycoplasma genitalium from four bottles of nucleotides (for a good overview of synthetic biology, take a look at this New Yorker piece). The main idea that kept emerging in his talk is that the DNA of a life form is analogous to the software and then all of the hardware is sculpted upon its code. It intuitively made sense, but the team was surprised when they actually were able to transplant the DNA of one bacterium into another, which lead the recipient organism to undergo physiologic metamorphosis.
Next we heard from a series of speakers involved with regenerative medicine. Daniel Kraft (flashback: MarrowMiner) spoke of the role of stem cells in medicine and how he discovered a better way to harvest them from the pelvis. 
Damien Bates, the chief medical officer of Organogenesis, the company behind biologic wound healing film Apligraf, passed around a sample of their wound healing tissue for people to feel as well as talked about how the skin heals and how it can be aided by regenerative biology.
Anthony Atala, from the Wake Forest Institute for Regenerative Medicine, talked about the various methods his research center is using to grow specific tissues and organs. He described much of the tissue creation process as sort of building the layers of a cake, with each tissue type placed one on top of the other. For linearly organized organs, such as arteries, this isn't so much of a problem, because you can just grow layers upon layers of tissues. However, for the more complicated, highly solid organs with lots of blood vessels, this methodology breaks down, and the scientists have to either use some sort of pre-made matrix or need to harvest tissues from other sources and de-cellularize them, leaving behind only the collagen scaffold that can be populated by cells.
To wrap up the hard science part of things, Bill Davenhall talked about the importance of adding more environmental data to patients' charts, under the hypothesis that living in some environments predisposes a person to certain diseases, and this sort of geo-medicine data might be useful to practicing clinicians.
Lastly, Neal Bear, writer and producer of ER and Law and Order SVU, discussed story telling in medicine, and Jill Sobule sang a lighthearted song about the apocalypse (surprisingly not as depressing as it sounds).
That's all for today. Note that all of these talks will be later made available online for free at TEDMED.com.
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Monday, October 26, 2009
We're off to TEDMED Tomorrow
Keep an eye on the blog this week, because tomorrow two of your editors head to TEDMED to feast on the latest and greatest in medical technological and cultural innovations. The line up of speakers and attendees is quite impressive, and for the rest of the week we'll be wandering around chatting up and interviewing as many people as possible in order to give you an inside view into the conference.
So what is it going to be like? TEDMED consists of 10 two hour sessions, each with around 5 or 6 speakers, scattered among 4 days on Coronado Island outside of San Diego. Interspersed between all of these sessions are breaks, lunches, and dinners to chat, network, and think about the future of medicine.
The speakers include the likes of Dean Kamen, Craig Venter, Peter Diamandis, Sanjay Gupta, and even David Blaine (presumably to tell us how we too can hold our breath for 17 minutes and 4.4 seconds). Let us know who you would like us to try and track down from the full list of speakers.
Link: TEDMED...
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Thursday, October 22, 2009
A Closer Look at GE's Vscan Pocket Ultrasound
As we wrote yesterday, GE released a handheld ultrasound system unlike any other. Yesterday, at a GE press conference in New York, we saw the device first hand and we brought a video back of a company rep demonstrating its use. At 3 inches wide, 5.3 inches long, and about an inch high, the device already has FDA and European approval. GE plans to first conduct a real world study of how the Vscan will be used by clinicians before releasing it to the general market.
Flashback: GE's New Ultra Small Ultrasound May Become as Ubiquitous as Stethoscope...
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Monday, October 12, 2009
Our Trip to a Philips Respironics Medical Device Factory
We write about medical devices every day, but we've never actually seen them being made. Thanks to an invitation from Philips Respironics to join the company in the opening of their new factory, 
we discovered how technologically advanced medical device production really is. Philips Respironics is a leading firm in PAP (Positive Air Pressure) technology for helping people with obstructive sleep apnea (OSA) get quality sleep throughout the night. Philips Respironics' CPAP (Continuous PAP) and BiPAP (bi-level CPAP) devices have been sold in the tens of thousands worldwide, but the field continues to be ripe for innovation.
Even the latest CPAP machines continue to have serious disadvantages that keep patient compliance at levels that need much improvement. To build the next generation of PAP machines that overcome some of these drawbacks, Philips has built a new high tech factory in New Kensington, outside of Pittsburgh, Pennsylvania.
Paperless, all computerized assembly allows the tracking of individual components that go into each PAP machine. So if a recall of one of the parts does occur, Philips Respironics will be able to know immediately which units are affected. Each device undergoes pressure, noise, and safety testing and every worker has a switch to stop the assembly line if an error is detected. Moreover, all the line workers know how to do each part of the assembly process, essentially creating a system where all work is at least double checked as it goes along the line.
During our tour of the factory, we got to see the latest generation of 
PAP machines that Philips is now building that will be formally unveiled tomorrow at Medtrade in Atlanta, Georgia.
The REMstar line of PAP machines with Philips Respironics' Flex technology promises to deliver some serious advantages over current market offerings. For one, positive pressure is continuously controlled by an algorithm that adjusts to patient's breathing. So, unlike current models, the air stream should feel much more comfortable as you breathe in and out. This is probably the biggest drawback of PAP machines that Philips is trying to overcome, and hopefully the new generation of smart PAP devices can significantly improve patient compliance.
The other major advancement Philips Respironics is touting is a solution to "rainout", a common side effect of CPAP machines where the mask will spit out a bit of water that has condensed inside the delivery tube. Company reps were mum on how this is actually accomplished, but promised calmer nights without the surprises.
One more feature we found particularly interesting is REMstar's ability to store a full night's stream of data to an SD memory card for later analysis by a physician or sleep therapist. This means that every breath throughout the night can be scrutinized at a later time.
We'd like to thank the company for inviting us out to Pittsburgh, the City of Champions, to take a look at their new facility that we feel they should be properly proud of.
And, finally, here's Edmund Kruse, Police Chief of the local Upper Burrell Police Department, one of the guests invited to the factory opening, trying out the new REMstar PAP machine.
Philips Respironics official product launch site: 10/13 @ 10:13...
Link: Philips Respironics...
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Friday, October 9, 2009
Announcing Winners of Guess-A-Nobel 2009
All of this year's Nobel Prizes in the sciences were very relevant to healthcare and biomedical research. Our readers were able to guess the Medicine and Chemistry winners, but no one named the Physicists.
And now, a drum roll....
Beth Cimini was the first person to correctly guess all three of the winners of The Nobel Prize in Physiology or Medicine 2009. Coincidentally, Beth is a student in Dr. Elizabeth H. Blackburn's lab at UCSF, one of the winners of the Nobel Prize. Congratulations Beth, and we hope you can also relay our congratulations to Dr. Blackburn.
David Staple, a Technology Specialist at the IP Law firm of Casimir Jones SC in Madison, Wisconsin was the only person to correctly guess the winners of The Nobel Prize in Chemistry 2009. Of note, David believes that Harry Noller, a major figure in ribosome research, was wrongfully omitted from the Nobel prize. Congratulations David, on your cunning and sharp guessing.
Both of today's winners will receive an individually engraved Apple iPod Touch.
We'd like to thank everyone for playing and be sure to play Guess-A-Nobel again at around the same time next year.
Link: Announcing The 2009 Guess-A-Nobel Contest...
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Monday, September 28, 2009
Announcing The 2009 Guess-A-Nobel Contest
Next Monday, the Nobel Foundation will announce the winner(s) of this year's Nobel Prize in Physiology or Medicine. In the following two days, two more Nobels will be revealed: in Physics and in Chemistry. Because of the success of last year's inaugural Guess-A-Nobel Contest, we decided we'll repeat this event annually until there is no more science worthy of the prize. This year we're giving out three 8GB Apple iPod Touch devices to those who correctly guess in each of the three science categories. Because we profile a good deal of apps for the iPhone/Touch platform, we thought this might be a useful tool beside all the fun it can provide on the off time. Furthermore, if someone does manage to guess all three correctly, he or she will be getting the souped-up 64 GB version of the iPod device with all the trimmings.
Here are the rules of the game:
1. Anyone can enter by writing a comment to this post. Please make sure you leave your email address in the form so we can get in touch with you. Your entry will be invalid without a proper email.2. Identify either the scientist(s) or discoveries in Medicine, and/or Physics and/or Chemistry, for your chance to win an iPod.
3. If we have multiple people who guessed correctly, the winner in each category will be chosen randomly. The lucky person who guesses all three will automatically win.
4. If a winner lives outside the US, Canada, or EU, instead of sending the prize, we'll transfer an equivalent amount of ca$h via a PayPal account.
5. Deadline for entries is Midnight Pacific Standard Time on Saturday Oct. 3, 2009 AD
Good luck to all!
Flashback: The First Ever Guess-A-Nobel Contest (2008)...
UPDATE: Announcing Winners of Guess-A-Nobel 2009...
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Wednesday, June 10, 2009
iMedicor's Core Competency
Last week we met with the leadership of iMedicor, the secure healthcare portal and conduit for medical documents. Today we'll take a look at the interface and platform they plan to use to elevate them to an essential part of the US healthcare infrastructure.
At it's core, iMedicor is a social networking app -- it has more in common with Linkedin than any electronic health record or information system. But it's got features that may make it indispensable to healthcare communication in the future.
Like LinkedIn (or Facebook or Sermo or iMedExchange) any physician, nurse, tech, administrator, or patient can log into iMedicor and set up an account for free.
Physicians are prompted to enter their DEA number, NPI number, license number, and other numbers that signify great power and responsibility (in a nifty twist, this info can be used, if the MD wants, to auto-populate a CV that can then be tweaked and expanded). Administrators can batch-upload an entire office or department full of physicians, or nurses and techs, too.
Once you're logged in, what's there to do? Well, lots, much of which we'll cover later this week. But the first thing may be to set up or import contacts and create a community of doctors. If you're a primary care doctor, you'd probably link up to specialists to whom you refer patients, or other docs with whom to share notes or ideas. Once they're in the system, you can securely transmit medical information to them in a HIPAA-compliant fashion.
That might not sound like a headline feature, but it is. If you're not in health care, we can't tell you how frustrating it is to try to get medical records in a timely fashion -- it often involves mail or fax or the personal delivery of folders, phone calls before and after, permissions and letterheads, wrong numbers, busy signals, paper jams, and suspicious clerks. Health communication in 2009 looks a lot like it did in 1989, except for those brave, misguided souls that use unsecured email to transmit patient data, risking exposure and legal action.
iMedicor is well-positioned to change that. In addition to doc-to-doc communication, there's the option for office-based transmission of records -- a 'shared inbox.' You can have your clerk or the nurse up front access or receive certain reports, organizing what's necessary for the day's patient visits. Doctors can also send patients their health information through a relationship with Microsoft Health Vault (covered here previously) .
But where iMedicor really stands out, in our estimation, is its interoperability between electronic health information systems. Through some clever coding and pdf manipulation, iMedicor can abstract a patient record from your office EMR, rearrange it to conform to an XML-based standard, and transmit it to another EMR where it should be able to populate a new electronic patient record. We have not seen this in action but iMedicor is confident their engineers have pulled this off.
If this does work as well as they say, you can see how powerfully this system scales as more physicians join. Instead of the current plan to spend billions to build regional, then national health information exchanges (HIE's) administered by ad hoc agencies with insurance, government, and hospital stakeholders, iMedicor is proposing their flavor of social networking can accomplish the same information exchange, much cheaper.
Are they right? We posed some familiar use cases -- the chest pain patient in one emergency department, with a recent cath report across town in another hospital, or the traveler who sees a doc while vacationing, whose doc back home wants lab results. iMedicor always has a solution or two -- either through physicians granting access to other docs or empowering patients via MS Health Vault.
It's not the on-health information exchange quite the way we were trained to expect it -- where a single login gets you access to whatever you're cleared for. iMedicor's network system, with permissions and inboxes, is different, but may provide the same functionality... and will be available much sooner.
Next: if this is free, how is iMedicor going to make money?
Link: iMedicor
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Friday, June 5, 2009
What's Next for iMedicor
It's been a year and a half since we've profiled iMedicor, the secure healthcare portal and conduit for medical documents.
They've been quietly busy in the interim, choosing to develop their technology behind the scenes over growing their user base. When we talked with them in 2007, they touted iMedicor's secure, HIPAA-compliant transmission of data as an alternative to fax and mail. But this week they announced their data conduit will work between disparate electronic medical record systems, essentially entering the field of regional health information exchange. In fact, they plan to answer the government mandate for an interoperable health infrastructure, all by themselves, for free:
"iMedicor, a Vemics Company VMCI, today announced the unveiling of its proprietary technology solution that addresses the long-standing and widespread inability of disparate Electronic Health Records (EHR) systems to communicate, collaborate and exchange medical records in a HIPAA compliant environment.“Vemics iMedicor portal delivers on the Obama Administration’s call for a secure, interoperable health information infrastructure that will enable healthcare providers to become interconnected,” said Vemics chief executive officer Fred Zolla. “iMedicor’s technology facilitates the transfer of medical records and images between disparate Electronic Health Record (EHR) systems in real time, and provides the critical first step in allowing the healthcare community to communicate electronically through secure messaging specifically designed to compliment clinical workflow.”
iMedicor’s technology provides physicians, healthcare providers and patients with the capability of transporting medical records in a manner that eliminates the risk of them being intercepted or altered. The portal, which also provides physicians with a social and professional referral network and access to continuing medical education programs, is available to health care organizations, professionals and patients free of charge at www.imedicor.com...."
Yesterday we met with their leadership and talked about their technology, their approach to medical record storage and transmission, and their solution for the challenges of interoperability. Next week we'll share what we learned, covering iMedicor's interface, their tools for physicians, and their strategy to make money on this free service.
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Friday, January 23, 2009
2008 Medical Weblog Awards Sponsored by Epocrates: Meet the Winners!
This competition was established to highlight and award the best writers in the medical blogosphere. The polls were open, and the readers have spoken, thanking their favorite blogs one vote at a time.
Medgadget would like to thank everyone involved in the competition, including our sponsors Epocrates and Placebo Journal, nominators, judges, and everyone who voted. Without your participation this would have been impossible.
And now, imagine a drum roll...
The winner of the Best Medical Blog of 2008 is the legendary KevinMD. Dr Kevin Pho has built an exemplary blog that features timely news and opinion of the latest in medicine, bringing in one of the most devoted audiences and keeping thousands of curious minds satisfied with smart and funny writing. While working on his own blog, Kevin has consistently promoted the rest of the medical blogosphere as a useful and reliable source for medical knowledge and opinion. And so, we tip our collective hats to Kevin who will be receiving, thanks to the generous sponsorship by Epocrates, a Palm® Tungsten™ E2 handheld loaded with the latest version of Epocrates Essentials Deluxe, a premium mobile suite of drugs, diseases and diagnostics that also features a medical dictionary, coding reference, clinical calculators and more. The package is valued at over $500.
This year's winner of the Best New Medical Blog of 2008 is Life in The Fast Lane by Dr Mike Cadogan, an Aussie emergency physician who profiles amusing cases, and discusses medical technology and the power of Health 2.0 to influence medicine. Having developed a loyal audience, Dr. Cadogan is an exciting new member of the medical blogosphere who we hope will continue writing for many more years.
The voters have chosen Ronni Gordon's Running for My Life as the Best Literary Medical Weblog of 2008. Ronni is a leukemia patient who tells her story through a running journal that inspires others and opens our eyes to the contrasting moments in the life of a chronic disease sufferer. We wish Ronni the very best and congratulate her for creating some of the best writing in the medical blogosphere.
The Best Clinical Sciences Weblog of 2008 is Clinical Correlations, a group effort by physicians from NYU's Department of Medicine. As one of the most professional and meticulously edited medical blogs, Clinical Correlations provides clinically useful commentary and analysis of the latest in the science of medicine. We congratulate all the individual authors and editors of this extraordinary blog.
Orac of Respectful Insolence has been chosen as the Best Health Policies/Ethics Weblog of 2008. As one of the members of Science Blogs, Orac attempts to bring sanity to the world full of medical quackery. His efforts at exposing the dangers of alternative medicine, pseudoscience, and evolution deniers have made Orac one of the most recognized online activists against medical fraud and pseudoscience.
In the Best Medical Technologies/Informatics Weblog of 2008 category the winner is Dr. John D. Halamka who writes Life as a Healthcare CIO. Dr. Halamka is Chief Information Officer of the CareGroup Health System, Chief Information Officer and Dean for Technology at Harvard Medical School, Chairman of the New England Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE (the Regional Health Information Organization), Chair of the US Healthcare Information Technology Standards Panel (HITSP), and a practicing Emergency Physician. Sporting such a resume, Dr Halamka is an invaluable source of thought and wisdom for anyone interested in contemporary developments in medical informatics and how data interoperability could practically be implemented in America's hospitals and clinics. We'd like to congratulate Dr. Halamka and look forward to more from one of the finest blogs in the business.
Finally, Kerri Morrone Sparling wins the Best Patient's Blog of 2008 award for her Six Until Me. Kerri opens her world to the rest of us as she describes the life of someone dealing with the reality of diabetes on a daily basis. Six Until Me brings together other diabetes sufferers, their families, and many curious folks to learn and reflect on the frustrations and joys of life with one of the most common, frustrating, and debilitating diseases around. Congrats Kerri, and we look forward to more of your writing!
All winners of the individual categories will receive a Palm Z22 handheld with Epocrates Essentials, a package valued at $250.
And to wrap up the prizes, all winners will receive an annual subscription to the Placebo Journal, "The Only Medical Journal That Will Make You Laugh... On Purpose!"
Finally, we'd like to again congratulate all the winners and nominees who have displayed some of the most engaging and interesting writing in medicine. Together we disseminate information about medicine, entertain, and help others cope with the physical and emotional consequences of disease. We look forward to another exciting year of medical writing and can't wait to see new blogs and new posts in the most important, challenging, and exciting industry around.
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» The 2008 Medical Weblog Awards: The Polls Are Open! (January 9, 2009)
» The 2008 Medical Weblog Awards Finalists (January 5, 2009)
» The 2008 Medical Weblog Awards Nominees (December 23, 2008)
» The 2008 Medical Weblog Awards Sponsored by Epocrates (December 11, 2008)
» 2008 Medical Sci-Fi Contest: Please Meet the Stories! (November 28, 2008)
» goLITE Fights the Coming Winter Blues (November 5, 2008)
» CARDIOHELP, World's Smallest Bypass Machine (November 5, 2008)
» Medgadget's Sci-Fi Writing Contest: Return of the Prose - Sponsored by Epocrates (October 31, 2008)
» Guess-a-Nobel Awards Announcement (October 9, 2008)
» Guess-A-Nobel Update (October 7, 2008)
» Guess-A-Nobel Contest (September 29, 2008)
» The Future of Clinical Computing: A Vision from Panasonic (September 19, 2008)
» An Interview with Navigenics (July 28, 2008)
» Introducing Medpolitics.com: A Voice for Doctors (July 21, 2008)
» Medgadget Interviews Dr. J. James Rohack, President-elect of the AMA (July 14, 2008)
» Youngest Editor Admitted to The Board (June 9, 2008)
» Max.MD: Exclusive Provider for Medical Domains (.md) (April 7, 2008)
» Grand Rounds Lands at Medgadget, Receives a Proper Scientific Perspective (April 1, 2008)
» The Great 2008 Medgadget Debate (February 22, 2008)
» 2007 Medical Weblog Awards Sponsored by ScrubsGallery.com: Meet the Tech Winner! (January 29, 2008)
» 2007 Medical Weblog Awards Sponsored by ScrubsGallery.com: Meet the Winners! (January 23, 2008)
» The Dr. Anonymous Awards Preview Spectacular (January 20, 2008)
» 2007 Medical Weblog Awards Sponsored by ScrubsGallery.com: The Polls Are Open! (January 14, 2008)
» Breaking: Calcium Rich Carrots for Better Bones in Young and Old (January 11, 2008)
» The 2007 Medical Weblog Awards Nominees (December 26, 2007)
» Grand Rounds Vol. 4, No. 14 (December 25, 2007)
» Grand Rounds at Medgadget (December 18, 2007)
» The 2007 Medical Weblog Awards Sponsored by ScrubsGallery.com (December 17, 2007)
» Medical Sci-Fi Contest: Please Meet the Winner! (October 23, 2007)
» Sermo Confidential? (October 1, 2007)
» A Note and a Follow Up On Sermo (September 27, 2007)
» Open Letter to Dr. Daniel Palestrant, CEO of Sermo.com (September 26, 2007)
» Medgadget's Sci-Fi Writing Contest: Return of the Prose (September 25, 2007)
» Confirmed: Sermo Is Not for Physicians Only; New Important Questions Raised (September 24, 2007)
» Medgadget's Guide to Hacking into Social Networks for Doctors (September 20, 2007)
» Medgadget on NYT (September 19, 2007)
» Pzizz for Sleep (September 17, 2007)
» Medgadget on Kuwait TV (July 26, 2007)
» iPhone Running Electronic Medical Records! (July 9, 2007)
» Chatting with the MEDgle.com Founders (May 15, 2007)
» Playstation 3 Cell Chip to Handle Medical Imaging (April 9, 2007)
» Generic Medical Devices as a New Frontier: An Interview with Richard Kuntz (March 30, 2007)
» Feet to the Fire: Responding to Dr. Godlee (March 2, 2007)
» Fionagate: An Illustrated, Interactive Website (February 27, 2007)
» BMJ Urges Others, Fails to "Lead by Example" on Climate Change (February 20, 2007)
» Carbon Footprint, or How to Spot Other People's Garbage (February 16, 2007)
» America's Next Great Debate: Health Care (January 24, 2007)
» 2006 Medical Weblog Awards: Meet the Winners! (January 19, 2007)
» 2006 Medical Weblog Awards: Polls Are Open! (January 3, 2007)
» The 2006 Medical Weblog Awards Nominees (December 29, 2006)
» The 2006 Medical Weblog Awards (December 11, 2006)
» Medgadget Sci Fi Contest Results (December 6, 2006)
» Reminder: Get Your Sci Fi On (November 17, 2006)
» Medgadget's Sci-Fi Writing Contest (November 16, 2006)
» The Cure@PS3 Project; A New Way to Join Our Team (September 6, 2006)
» Unbound Medicine releases Harrison's Practice (July 11, 2006)
» Medgadget Launches Medtech Wiki (June 19, 2006)
» Major Newspapers Hotlink Images from Unsuspecting Companies; Drain Bandwidth and Server Resources Without Permission (May 12, 2006)
» The Hatzolah Volunteer Ambulance (May 10, 2006)
» American Medical Association: No Doctors Day Celebrations? (March 30, 2006)
» Frost and Sullivan Executive MindXchange: Worth Your Time (March 23, 2006)
» Frost & Sullivan's 2006 Medical Device Awards: A Roundup (March 17, 2006)
» EXCLUSIVE: Interactive Breath Monitor for Lung Biopsy (March 16, 2006)
» 2006 Excellence in Medical Devices Awards (March 15, 2006)
» Symbol's View of the Road Ahead (March 10, 2006)
» Handheld Hospital Tech: State of the Art (March 6, 2006)
» 2005 Medical Weblog Awards: Meet the Winners! (January 17, 2006)
» 2005 Medical Weblog Awards: Polls Are Open! (January 3, 2006)
» The 2005 Medical Weblog Awards Nominees (December 30, 2005)
» Medgadget Widget and More (December 14, 2005)
» The 2005 Medical Weblog Awards (November 28, 2005)
» Medgadget Partners With Health I.C. (November 14, 2005)
» Folding@home Medgadget Team (October 28, 2005)
» Versaform: Free Electronic Medical Record-Keeping (October 11, 2005)
» Exclusive: AMA Goes for New Logo (June 16, 2005)
» The Chopstick Surgical Closure Technique (June 1, 2005)
» AMNews Editor Responds (May 18, 2005)
» Urgent Action Needed! (May 17, 2005)
» Medgadget.com Goes to Frost & Sullivan's Awards (March 17, 2005)
