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| Vol. 13 No. 13, June 29, 2016 |

National Health Expenditure Trends, 1975 to 2015 — the Canadian Institute for Health Information’s 19th annual health expenditure trends publication
Total health expenditure expected to reach $219.1 billion or $6,105 per Canadian in 2015
  • It is anticipated that, overall, health expenditure will represent 10.9% of Canada’s gross domestic product (GDP) in 2015, a share that has fallen gradually in the past few years, following the recession in 2009. The current trend of a declining health-to-GDP ratio, viewed in the context of the last 40 years, appears similar to that experienced in the mid-1990s. 
In 2015, rate of growth in health spending per capita expected to be less than rates of inflation and population growth combined
  • A new period is emerging, with health spending growth not keeping pace with inflation and population growth (combined). Since 2011, health spending has decreased by an average of 0.6% per year — comparable with decreases during the mid-1990s. It reflects, in large part, Canada’s modest economic growth and fiscal restraint as governments focus on balancing budgetary deficits. 
Slower growth in hospital, drug and physician spending
  • Hospitals (29.5%), drugs (15.7%) and physician services (15.5%) continue to account for the largest shares of health dollars (more than 60% of total health spending). Although spending continues to grow in all 3 categories, the pace has slowed in recent years.
  • Since 2007, physician spending as a share of total health care spending has increased. The estimated share for 2015 (15.5%) has recovered to levels comparable to those in the late 1980s.


The Next Logical Step in Healthcare Technology
Digital devices and apps are radically transforming healthcare by enabling providers to monitor patients remotely while also empowering consumers to take better care of themselves through health-related mobile apps and wearables.
The respective technologies for healthcare consumers and clinicians have advanced along parallel tracks, however, with little crossover. Physicians rely on home-based telehealth devices for monitoring patient conditions and managing chronic diseases, while consumer wearables and mobile apps provide users with more basic information about vital signs and activity levels.
But what if a consumer app could function as an intelligent, interactive and proactive digital health advisor — one that not only collects data and provides information, but also communicates with medical, pharmaceutical and insurance databases and networks to empower users?
Redox announces that its API integrates health apps with Cerner, eClinicalWorks, Epic EHRs
Redox, a health IT startup founded by former Epic engineers that creates application programming interfaces for EHRs, announced that it has integrated five cloud-based applications.
The new apps that can integrate with EHRs include Breg for in-office bracing and orthopedic supply data, Carevive’s oncology platform, Code Technology’s software for surgical case information, Gauss Surgical’s blood loss measuring tool, Relaymed’s software for accurately population patient charts with test result data, and SwervePay’s patient-centric payment software.
“The applications created by our customers highlight the power technology can have in improving patient care," Redox president and co-founder Niko Skievaski said in a statement.

A New Bio-ink for 3-D Printing with Stem Cells
The new stem cell-containing bio ink allows 3D printing of living tissue, known as bio-printing. The new bio-ink contains two different polymer components: a natural polymer extracted from seaweed, and a sacrificial synthetic polymer used in the medical industry, and both had a role to play.
The synthetic polymer causes the bio-ink to change from liquid to solid when the temperature is raised, and the seaweed polymer provides structural support when the cell nutrients are introduced.
The team's findings, featured on the cover of Advanced Healthcare Materials, could eventually lead to the ability to print complex tissues using the patient's own stem cells for surgical bone or cartilage implants, which in turn could used in knee and hip surgeries.

Tiny Device Hosts Brain Cell Networks for Neuroscience Studies
At the University of Twente in The Netherlands, a researcher named Bart Schurink has created a tiny device for fostering brain cell growth in a three-dimensional environment. It measures only two millimeters on a side and has hundreds of cavities for hosting individual neurons. The cavities are shaped like upside-down pyramids and are big enough for cells to have room to thrive and grow in every direction.
A bioreactor placed on top of the device promotes growth of the cells and the creation of an intercellular network between them. Thereafter, the growth of the cells and the electrical activity between them can closely monitored to study how the cells behave.
The so-called µSEA (micro sieve electrode array) already went through testing using rat brain cells, demonstrating the successful utilization of hundreds of cells.

Oticon’s Internet-Connected Smart Hearing Aids
Oticon, one of the most innovative companies in the hearing aid business, has unveiled what it describes as “the world’s first internet connected hearing aid.” What that means is that smart devices around the house, such as thermometers, electronic locks, and smoke detectors, can be made to talk with the new Oticon OPN hearing aids. A lock opening can trigger a notification just in case you don’t hear a family member coming in, for example. What actually happens is really up to the user to program using the IFTTT (If This Then That) online service. You can even have your hearing aids do something as a result of online activity, such as a favorite friend posting a tweet.


Electronic Medical Practice Environment can Lead to Physician Burnout
The growth and evolution of the electronic environment in health care is taking a toll on U.S. physicians. That's according to a national study of physicians led by Mayo Clinic which shows the use of electronic health records and computerized physician order entry leads to lower physician satisfaction and higher rates of professional burnout. The findings appear in Mayo Clinic Proceedings.
"Electronic health records hold great promise for enhancing coordination of care and improving quality of care," says Tait Shanafelt, M.D., Mayo Clinic physician and lead author of the study. "In their current form and implementation, however, they have had a number of unintended negative consequences including reducing efficiency, increasing clerical burden and increasing the risk of burnout for physicians."
Stanford physicians use innovation to protect children’s health in Guatemala
Stanford pediatrician Paul Wise, MD, MPH, stooped below the black tarp roof of a cinderblock house in Guatemala to offer his condolences to a mother who had just lost her child.
“Doctor Pablo,” as he is known in the communities around San Lucas Tolimán, talked softly as he relayed his sympathies to the mother, whose 9-year-old son had been a patient of his.
The boy’s genetic disorder would have been terminal anywhere, but thanks to Wise and local health promoters, the boy’s family had years with him instead of months. They found the doctor through the Guatemala Rural Child Health and Nutrition Program, a collaboration between Wise and the health promoters to eliminate death by malnutrition for children under 5.

Democratizing Data in Canada
Much like the U.S. based Precision Medicine Initiative, the University of British Columbia’s Personalized Medicine Initiative (UBC’s PMI) is engaging a coalition of stakeholders to harness the power of personalized medicine to improve health outcomes. While the U.S. effort is larger in scope, both are recruiting large numbers of citizens to contribute personal ‘omics and other health data, as well as developing curated databases of public data, to enhance individual outcomes and to advance research and development. With this wealth of patient information entrusted to them, both initiatives are deeply dedicated to privacy. UBC’s PMI has a goal of securing a political commitment from the Canadian government for leadership of the initiative, to set priorities and provide financial resources across healthcare, innovation and education sectors.
Ten companies have already spun out of UBC’s PMI, including Molecular You (MYCo). This digital health company has a vision to decipher a wide variety of individual patient data to promote health, detect disease in its earliest stages, and provide insights on therapeutic efficacy and timing.


A Painless, Quick and Reliable Method for Diagnosing Helicobacter from Exhaled Air
In the future, several illnesses can be quickly and painlessly diagnosed by the optical analysis of isotopes contained in exhaled air. VTT developed its first prototype for this purpose. With the device, it is possible to determine painlessly and with absolute certainty during the appointment whether the patient's stomach troubles are caused by Helicobacter. The certainty of the device is based on its ability to measure not only carbon13(13C) but also oxygen18(18O) in exhaled air.
The invention is based on a technology developed by VTT's MIKES Metrology, optical absorption spectroscopy in a multipass chamber with the sample volume reduced to just 40 microlitres, which is less than ten millionths of an adult's lung capacity. Due to the extremely small sample volume, the gas inside the chamber can rapidly be exchanged. This, in turn, enables the entire breathing cycle of the patient to be analysed rapidly by the same device.
Diagnosis methods based on respiratory air are a growing trend.

Healthcare Innovation: How 2016 trends are already evolving

  1. Patients’ expectations for care and care delivery are changing, and will force the industry to change. 
  2. We are going to see the evolution and increased sophistication of remote clinical technology.
  3. Providers are going to begin seriously tackling long-standing interoperability and data access challenges.
  4. There is going to be a shift in payment models to drive an outcome-based healthcare economy.

Cedars Sinai launches virtual reality pilots to curb patient pain without drugs
Cedars Sinai Medical Center will begin to use virtual reality technology from Applied VR, in hopes of easing patients' pain with without use of drugs. Hospital executives say it will introduce VR content first in its Spine Center.
Cedars-Sinai is among the first hospitals to employ scalable VR technology. It invested in AppliedVR via its TechStars healthcare accelerator. AppliedVR’s developed its main products in partnership with Cedars-Sinai.
The first product suite, Pain RelieVR, offers immersive VR games that divert the patient's focus away from the procedure or recovery process.
As an example, Guided Relaxation, which was developed with psychologists and leading academics, is used to help transport a patient from the medical environment to a peaceful scenic place, to relax and learn mindfulness and acceptance-based techniques. It is designed to help the patient manage stress and anxiety.
Doctors face barriers to harnessing potential of mobile health apps
Mobile health apps on our cellphones can hold a wealth of helpful information to take better care of ourselves, but family doctors still face barriers harnessing the potential.
Of the explosion of 165,000 health apps now available, 36 account for half of downloads, said Emily Seto, an engineer and health technology specialist at the Centre for Global eHealth Innovation at the University of Toronto. 
Seto's Bluetooth-enabled app interface which allows doctors to remotely monitor data entered by their patients is ready to use but she said implementing mobile technology in health-care is a slow process


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