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The danger in hospital at home

The ideas and innovators shaping health care
Feb 01, 2024 View in browser
 
Future Pulse

By Erin Schumaker, Daniel Payne and Ruth Reader

DANGER ZONE

United HomeCare Services home health aide Wendys Cerrato cleans Robert Granville after shaving him in his home in Miami in 2009.

Using medical devices at home poses risks without proper training. | Joe Raedle/Getty Images

There’s potential danger in moving hospital care to the home.

The Pennsylvania-based nonprofit ECRI, whose mission is to improve health care safety, says at-home medical devices are the greatest hazard facing patients in its annual report on the Top 10 Health Technology Hazards.

It’s the second year in a row ECRI has put at-home medical devices at No. 1, reports POLITICO’s Gregory Svirnovskiy.

The case: With more people receiving medical care at home due to aging and an uptick in chronic diseases, devices intended for use in health facilities are now winding up in living rooms.

Caregivers and family members aren’t exactly experts in the tech.

“Severe harm can result if patients or their caregivers do not fully understand how to use a device and troubleshoot problems that arise,” ECRI’s authors wrote in the report.

Why it matters: By 2030, a fifth of the U.S. population will be 65 or older, according to AARP. And the number of Americans serving as caregivers is rising to meet their needs. In 2021, around 38 million people spent roughly 36 billion hours caring for family members.

People tend to prefer receiving care at home and there’s bipartisan interest in moving more care from hospitals to homes. Lawmakers see it as a way to reduce Medicare costs.

What’s next? ECRI says medical device manufacturers should center the at-home user in product design, make devices intuitive and provide easily digestible instructions for patients and families.

Other risks: Also in ECRI’s top 10 were inadequate device cleaning instructions, overlooked environmental impacts of patient care and ransomware targeting health care systems.

Artificial intelligence oversight came in fifth. The authors warned that faulty or incomplete data and algorithms could taint AI systems, especially without robust and transparent testing and performance monitoring in place.

 

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This is where we explore the ideas and innovators shaping health care.

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THE LAB

A microscopic image of cancer cells in the cervix.

AI could help develop better immunotherapies for cancer, researchers believe. | American Cancer Society via Getty Images

Cleveland Clinic and IBM researchers have joined forces to develop an artificial intelligence model that can learn how immune cells, which scour the body for signs of disease, identify cancer.

The AI can identify the characteristics of the protein molecules that immune cells use to recognize threats. With a clearer idea of what to target, researchers could develop better immunotherapy treatments — such as more effective vaccines and more targeted therapies — for cancer.

The researchers published a peer-reviewed study on the strategy in the journal Briefings in Bioinformatics.

Why it matters: Traditionally, the many variables affecting how the immune system identifies threats have slowed research and led to limited, and sometimes inaccurate, models.

“In the past, all our data on cancer antigen targets came from trial and error,” Dr. Timothy Chan, study co-author and chair of Cleveland Clinic’s Center for Immunotherapy and Precision Immuno-Oncology, said in a statement.

The backstory: The new research is the byproduct of the Discovery Accelerator center, a 10-year collaboration between the Cleveland Clinic and IBM meant to speed biomedical research by combining the Cleveland Clinic’s clinical expertise and research with IBM’s computing technology.

“Partnering with IBM allows us to push the boundaries of artificial intelligence and health sciences research to change the way we develop and evaluate targets for cancer therapy,” Chan said.

What’s next? The partnership, launched in 2021, aims to shrink the amount of time — 17 years on average — it takes for scientific discoveries to become approved tests and therapies for patients.

 

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WORKFORCE

A subject's waist is measured during an obesity prevention study in Chicago.

More effective weight-loss drugs could have pros and cons for plastic surgeons. | M. Spencer Green/AP

New weight-loss drugs could mean boom times for plastic surgeons — but it could spell trouble for them in the long term.

How’s that? Patients taking semaglutide drugs, such as Ozempic and Wegovy, are losing weight fast — which could lead to more people seeking excess skin removal and facial revolumization, which involves moving fat to different parts of the face, Dr. Steven Williams, president of the American Society of Plastic Surgeons, told Daniel.

“I think most plastic surgeons are seeing that as like, ‘Wow, it’s gonna be great. We’re gonna really be able to help people get the rest of the way there,’” he said.

Even so: If the drugs reduce obesity and improve health outcomes tied to the disease, that could reduce demand for internal medicine doctors, orthopedic surgeons, OB-GYNs and other physicians who treat the downstream health effects of obesity.

That could lead more doctors to choose plastic surgery as their specialty.

“The aesthetic [surgery] space is kind of that thing people look at as a way to potentially generate revenue,” Williams said.

Fallout: Plastic surgery is a relatively small specialty, Williams said, so an influx of new doctors could have a big impact on the bottom line.

“In some ways, it may mark the end of plastic surgeons, but not the end of aesthetic surgery,” he said.

 

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