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DAILY UPDATE

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October 30, 2014   Download print version

Happy 10th Anniversary to SMI

Why China’s SARS legacy may give it an edge against Ebola

New Jersey hospitals in spotlight

Cleveland Clinic unveils top 10 medical innovations for 2015

New York surgical mask manufacturer responds to PPE recommendations, healthcare worker concerns

TECSYS granted U.S. Patent, positioned as a visionary in Gartner's Magic quadrant for warehouse management systems

North Shore-LIJ publishes Ebola preparedness manual to assist other healthcare providers, local governments in preparedness efforts

Google is developing cancer and heart attack detector

 
 
 

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November 2014

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Happy 10th Anniversary to SMI

The Strategic Marketplace Initiative’s (SMIs) 10th Anniversary is being celebrated this week in Orlando, with over 200 supporters from healthcare providers, suppliers and supporters allied in the industry.

The Strategic Marketplace Initiative (SMI) is a consortium of executives united to shape the future of the healthcare supply chain for the purpose of improving the overall healthcare marketplace in the United States. Through SMI, members have discovered an open, non-competitive forum for innovative idea-exchange and the development of collaborative process improvement initiatives. SMI’s mission is to establish new standards of supply chain performance for delivering healthcare to patients and their communities throughout the United States.

The group was conceived by founders; Carl Manley, vice president of materials management Sentara Healthcare, now retired; Thomas Hughes, former vice president of BD Healthcare Consulting & Services and the founding principal of Concepts in Healthcare, named Executive Director; and John Gaida, senior vice president supply chain management at Texas Health Resources. The three saw the need to reengineer and advance the future of the healthcare supply chain.  The visionaries were lauded at the 10th annual meeting as part of the celebration.

Additionally SMI was formed to act as a change agent for healthcare. SMI provides critical mass representing key industry stakeholders and decision makers within the healthcare supply chain interacting and sharing best practices. Through collaboration, tools and techniques are developed that members can take back to their organizations and customize to meet their unique needs. As SMI is dedicated to improving the entirety of the healthcare supply chain, all such tools/findings/improvements/established best practices are shared free of charge with the healthcare marketplace.

Visit HPN’s August issue for an exclusive interview with Tom Hughes, Executive Director for SMI.

For more information on SMI visit www.smisupplychain.com/.

 

 

Why China’s SARS legacy may give it an edge against Ebola

During the 2003 SARS outbreak, China lost more than 300 lives and was berated for delays in cooperating with global health agencies. Lessons from that epidemic may now give the country an edge should Ebola arrive within its borders.

China is Africa’s biggest trading partner, highlighting the risk that the virus that’s killed about 5,000 in West Africa could reach the world’s most populous nation. The country has been preparing for months, aided by public health systems that were bolstered after SARS.

As Ebola has reached the U.S. and Europe, China has ordered designated hospitals to stockpile equipment, disinfectants and protective gear and map out detailed directions for medical workers. In the southern province of Guangdong, which receives more than 100 direct flights from Africa each month, thousands of people are being monitored.

“After SARS, China doesn’t want to be in the same situation again,” said Ben Cowling, an associate professor of infectious disease epidemiology at the University of Hong Kong’s School of Public Health. “In the last 10 years, they’ve built up massive capacity to respond to this kind of situation, to avoid damage to public health and prevent the socio-economic problems that arise with it.”

In Guangdong, Chinese authorities tracked 8,672 visitors from Ebola-hit countries in the two months through Oct. 21, a government release said, without giving details on the screening process. More than 5,000 are no longer being monitored.

Chinese companies have been drawn to the commodities and mining industries in West Africa. The official Xinhua news agency, citing government statistics, in August said there were about 20,000 Chinese workers in Sierra Leone, Guinea and Liberia, the worst-hit countries.

Guangdong is screening travelers arriving from the three countries, and they are monitored for 21 days, the incubation period for the virus, according to China Central Television, the state-controlled broadcaster.

The southern province is home to a sizable population of African migrants, and more than a thousand people from Africa arrive at the Baiyun Airport in its capital city of Guangzhou every day, according to state-owned China Daily.

China’s health ministry issued its Ebola control plan in July, laying out procedures for screening, reporting cases and controlling potential infections, according to China Daily. Calls to the Chinese Center for Disease Control and the country’s health ministry weren’t answered.

China has steadily increased its capacity to respond to emerging infectious pathogens since setting up its CDC in 2002 in response to SARS. Doctors dispatch more than 16,000 patient case notes daily for vetting by the CDC, Feng Zijian, an official at the agency, told Bloomberg News last year.

While there have been no reported Ebola cases so far in Asia, Cowling says the disease could be exported from West Africa to countries such as China and India. If that happens, infectious-disease experts see risks at the hospital and local levels despite China’s improved processes.

China’s CDC will need to ensure that administrative measures, such as having a buddy to ensure proper undressing from protective gear, are followed tightly, Cowling said.

Also, the possibility of local-level authorities covering up initial cases can’t be completely eliminated, said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations in New York. “There’s a lack of integration in the system,” he said, and only if a directive comes from the very top could this be avoided.

China’s density of humans and animals, especially in the southern Pearl River Delta region, facilitates the exchange of tropical viruses. That gave rise to the so-called Asian influenza pandemic in 1956 and the H5N1 strain of avian flu, which isn’t easily transmitted between people, 40 years later.

SARS infected more than 5,000 people in China between November 2002 and July 2003, according to statistics from the World Health Organization. While Ebola is contracted through direct contact with infected bodily fluids such as blood or vomit, SARS is a lung disease that’s spread through the air.

Henk Bekedam, who ran the WHO’s Beijing office from August 2002 to 2007, recalls calling local officials every day during the SARS epidemic and not getting straight answers. After several months, China’s communication improved and it became one of the best countries to work with, he said.

On the treatment front, China’s Sihuan Pharmaceutical Holdings Group Ltd. (460) announced an agreement this month with a military institute to develop an anti-Ebola drug. The company is preparing to apply to Chinese regulators for approval to conduct clinical trials. The drug is three to five years away from hitting the market if there’s no outbreak in China, Sihuan said via e-mail. Visit Bloomberg for the article.

 

 

New Jersey hospitals in spotlight

The experience of a nurse who complained about her quarantine in a makeshift tent inside a Newark, NJ, hospital after treating Ebola patients in Sierra Leone is putting a focus on how the state’s hospitals will handle those exposed to the disease.

New Jersey officials said they are ready to quarantine and treat medical workers returning from West Africa. At the same time, a senior health official in the administration of Gov. Chris Christie said that while the tent quarantine of nurse Kaci Hickox at University Hospital in Newark wasn’t ideal, the state needed a separate environment in a busy city hospital to house her.

Two other New Jersey hospitals that have been designated to receive Ebola patients said they intend to quarantine any patients in dedicated facilities.

“People will be as comfortable as they can be under those circumstances,” said Robert C. Garrett, chief executive of Hackensack University Health Network, which along with University Hospital and Robert Wood Johnson University Hospital in New Brunswick has been designated by the state to received Ebola patients.

Hickox, who volunteered for Doctors Without Borders, wrote about her hospital confinement in the Dallas Morning News, calling it “inhumane,” and complained about it on CNN. The tent had a portable toilet but lacked a shower. One of Hickox’s lawyers, Steven Hyman, said the tent was set up in a large room with a concrete floor and that she was fed through a plastic window. “It seems to me a tent is not the best isolation chamber one could think of,” Hyman said.

Hickox was allowed to return home to Maine on Monday.

Some contrasted Hickox’s experience with that of Ebola patient Craig Spencer, a doctor who volunteered in West Africa. He is being treated at New York City’s Bellevue Medical Center in an isolation ward built to handle the AIDS crisis, with ventilation and plumbing separate from the rest of the hospital. Rooms employ special ventilation systems that allow air in but don’t let contaminated air out.

Some healthcare providers said they couldn’t remember an instance where a patient in the U.S. was quarantined in a tent, particularly when he or she wasn’t showing acute symptoms. Hickox tested negative Saturday morning for Ebola. State officials said the nurse had a fever, though she disputed that.

New Jersey said it would work to quarantine people at home when possible.

A spokeswoman for University Hospital said officials with the Centers for Disease Control and Prevention recently toured the unit and consulted on it.

Best practices for housing someone showing signs of infection at a hospital include a dedicated unit that is stripped of linen, has designated equipment and attendants wearing protection suits, said Albert Wu, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. Dr. Wu said the conditions of Hickox’s quarantine appeared to be spartan but not inhumane.

Officials at Hackensack University Medical Center said their hospital built a dedicated facility in 2012 for housing those needing to be quarantined. The unit has a separate entrance, private bathroom with a standard toilet and shower, a television and Internet access, officials said. Visit the Wall Street Journal for the story.

 

 

Cleveland Clinic unveils top 10 medical innovations for 2015

Cleveland Clinic announced its 9th annual list of Top 10 Medical Innovations that are likely to have major impact on improving patient care in 2015. The list includes a mobile stroke ambulance, fast, painless blood-testing, and a novel intra-operative radiation approach for breast cancer.

The list of up-and-coming technologies and drug therapies was selected by a panel of 110 Cleveland Clinic physicians and scientists and announced during Cleveland Clinic’s 2014 Medical Innovation Summit.

The Top 10 Medical Innovations for 2015 are:

1. Mobile Stroke Unit - Time lost is brain lost. High-tech ambulances bring the emergency department straight to the patient with stroke symptoms. Using telemedicine, in-hospital stroke neurologists interpret symptoms via broadband video link, while an onboard paramedic, critical care nurse and CT technologist perform neurological evaluation and administer t-PA after stroke detection, providing faster, effective treatment for the affected patient.

2. Dengue Fever Vaccine - One mosquito bite is all it takes. More than 50 to 100 million people in more than 100 countries contract the dengue virus each year. The world’s first vaccine has been developed and tested, and is expected to be submitted to regulatory groups in 2015, with commercialization expected later that year.

3. Cost-effective, Fast, Painless Blood-Testing - Have the days of needles and vials come to an end?  The new art of blood collection uses a drop of blood drawn from the fingertip in a virtually painless procedure. Test results are available within hours of the original draw and are estimated to cost as little as 10% of the traditional Medicare reimbursement.

4. PCSK9 Inhibitors for Cholesterol Reduction - Effective statin medications have been used to reduce cholesterol in heart disease patients for over two decades, but some people are intolerant and cannot benefit from them. Several PCSK9 inhibitors, or injectable cholesterol lowering drugs, are in development for those who don’t benefit from statins. The FDA is expected to approve the first PCSK9 in 2015 for its ability to significantly lower LDL cholesterol to levels never seen before.

5. Antibody-Drug Conjugates - Chemotherapy, the only form of treatment available for treating some cancers, destroys cancer cells and harms healthy cells at the same time. A promising new approach for advanced cancer selectively delivers cytotoxic agents to tumor cells while avoiding normal, healthy tissue.

6. Checkpoint Inhibitors - Cancer kills approximately 8 million people annually and is difficult to treat, let alone cure. Immune checkpoint inhibitors have allowed physicians to make significantly more progress against advanced cancer than they’ve achieved in decades. Combined with traditional chemotherapy and radiation treatment, the novel drugs boost the immune system and offer significant, long-term cancer remissions for patients with metastatic melanoma, and there is increasing evidence that they can work on other types of malignancies.

7. Leadless Cardiac Pacemaker - Since 1958, the technology involved in cardiac pacemakers hasn’t changed much. A silver-dollar-sized pulse generator and a thin wire, or lead, inserted through the vein kept the heart beating at a steady pace. Leads, though, can break and crack, and become infection sites in 2 percent of cases. Vitamin-sized wireless cardiac pacemakers can be implanted directly in the heart without surgery and eliminate malfunction complications and restriction on daily physical activities.

8. New Drugs for Idiopathic Pulmonary Fibrosis - Nearly 80,000 American adults with idiopathic pulmonary fibrosis may breathe easier in 2015 with the recent FDA-approval of two new experimental drugs. Pirfenidone and nintedanib slow the disease progress of the lethal lung disease, which causes scarring of the air sacs. Prior to these developments, there was no known treatment for IPF, in which life expectancy after diagnosis is just three to five years.

9. Single-Dose Intra-Operative Radiation Therapy for Breast Cancer - Finding and treating breast cancer in its earliest stages can oftentimes lead to a cure. For most women with early-stage breast cancer, a lumpectomy is performed, followed by weeks of radiation therapy to reduce the likelihood of recurrence. Intra-operative radiation therapy, or IORT, focuses the radiation on the tumor during surgery as a single-dose, and has proven effective as whole breast radiation.

10. New Drug for Heart Failure - Angiotensin-receptor neprilysin inhibitor, or ARNI, has been granted “fast-track status” by the FDA because of its impressive survival advantage over the ACE inhibitor enalapril, the current “gold standard” for treating patients with heart failure. The unique drug compound represents a paradigm shift in heart failure therapy.

Visit Cleveland Clinic for the release.

 

 

New York surgical mask manufacturer responds to PPE recommendations, healthcare worker concerns

The CDC recently revised their Personal Protective Equipment (PPE) recommendations for healthcare workers caring for Ebola Virus Disease (EVD) patients to include the use of N95 or PAPR respirators and full coverage of all exposed skin. Emory Healthcare, a targeted treatment facility for EVD patients, also released their Healthcare Ebola Preparedness Protocols draft document.

While the CDC recommendations are specific only to direct patient care of diagnosed EVD patients and exclude the use of medical face masks in this specific scenario, Emory's recommendations involve a broader set of EVD scenarios (Appendix 5; a "PPE Guidance Matrix for EVD"), and specifically recommends the use of face masks in every situation, except during the care of a diagnosed, symptomatic EVD patient.

Crosstex International, Inc., a subsidiary of Cantel Medical Corp., a U.S. manufacturer of earloop face masks and other infection prevention control products, has seen increased demand for its SECURE FIT fitted face masks as a result of heightened concern over the ability of PPE, including surgical masks,  to provide full coverage and protection.

Face masks are a form of PPE and are FDA-cleared medical devices that are classified according to their filtration and fluid barrier properties. They are designed and FDA-cleared to prevent large particle (droplet) transmission of infection, from the wearer to others, and from others to the wearer, such as from coughs and sneezes. Their ability to fit the wearer, however, is not a formal requirement.

Lisa Brosseau, Director of the Industrial Hygiene program at the University of Illinois at Chicago's School of Public Health, and committee member of the 2007 Institutes of Medicine panel on reusability of facemasks during an influenza pandemic, stated in a 2003 letter to the FDA: "Drawing from my experience with respirators, I believe surgical mask failure is due in large part, or entirely, to their lack of fit," and added, "The criteria used by FDA to evaluate surgical masks neglect entirely the issue of fit."

Cantel sponsored published in vitro (laboratory) research to better understand the factors that contribute to mask performance, and mask fit was found to be a critical factor in particle capture. SECURE FIT fitted masks enable the wearer to adjust the mask to the face and avoid the typical gapping around the sides and bottom of the mask that are seen with most loose-fitting surgical masks.

Crosstex is offering free trial supplies of SECURE FIT masks to any concerned healthcare provider or institution. Visit www.crosstex.com for further mask education and research, and to order free samples of SECURE FIT masks.

 

 

TECSYS granted U.S. Patent, positioned as a visionary in Gartner's Magic quadrant for warehouse management systems

TECSYS Inc., announced that it has been granted Patent No. 8,839,132 from the United States Patent and Trademark Office that covers the method and system for providing visual instructions to warehouse operators. This technology empowers users to become significantly more efficient and accurate at executing their task, while at the same time helping drive increased responsiveness to their customers.

"Providing users visual and graphical instructions is an integral part of our WMS, a capability that requires no programming and represents a paradigm shift in warehouse management solutions to customers. Workers are able to access critical information to make decisions more quickly, accelerating their workflows, enabling improved customer satisfaction and profitability. This technology has been on the market for nearly four years and its benefits have already been proven. In both healthcare operations and in complex high-volume distribution environments this technology is enabling workers to perform more complex tasks, faster, with more precision and less mental fatigue," stated Larry Lumsden, Vice President, Products at TECSYS.

On September 30th, 2014, Gartner, the world's leading information technology research and advisory company, published its Magic Quadrant for Warehouse Management Systems. For the fourth consecutive year, TECSYS has been positioned in the "Visionaries" quadrant of the Warehouse Management Systems Magic Quadrant Report. According to Gartner, "To be a Visionary, a vendor must have a coherent, compelling and innovative strategy that seeks to deliver a robust and vibrant offering to the market. Visionaries are often thought leaders in one or more WMS solution dimensions (for example, functionality, services, go-to-market or deployment strategies), and they tend to be on the leading edge of some emerging concepts."

Visit TECSYS for more information.

 

 

North Shore-LIJ publishes Ebola preparedness manual to assist other healthcare providers, local governments in preparedness efforts

As a public service, the North Shore-LIJ Health System announced the publication of an Ebola Virus Disease Preparedness Manual for healthcare organizations and local governments across the US to aid in preparedness efforts and shed light on key clinical and operational best practices that can prevent the virus from spreading.

This detailed resource guide - available as a free download at www.nslijalerts.com--covers a range of topics, including: Emergency management structure; Clinical guidelines; Policies and procedures; Staff education and training; Communication (internal and external); Internal evaluation tools; and External resources.

For more information, go to www.northshorelij.com.

 

 

Google is developing cancer and heart attack detector

Google is aiming to diagnose cancers, impending heart attacks or strokes and other diseases, at a much earlier stage than is currently possible. The company is working on technology that combines disease-detecting nanoparticles, which would enter a patient's bloodstream via a swallowed pill, with a wrist-worn sensor.

The idea is to identify slight changes in the person's biochemistry that could act as an early warning system. The work is still at an early stage.

Early diagnosis is the key to treating disease. Many cancers, such as pancreatic, are detected only after they have become untreatable and fatal. There are marked differences between cancerous and healthy tissues.

Google's ambition is to constantly monitor the blood for the unique traces of cancer, allowing diagnosis long before any physical symptoms appear. The project is being conducted by the search company's research unit, Google X, which is dedicated to investigating potentially revolutionary innovations.

It marks the firm's latest shift into the medical sector following its work on glucose-measuring contact lenses for patients with diabetes and the acquisition of a start-up that developed a spoon to counteract the tremors caused by Parkinson's disease.

Google has also bought stakes in Calico, an anti-aging research company, and 23andMe, which offers personal genetic-testing kits. The diagnostic project is being led by Dr. Andrew Conrad, a molecular biologist who previously developed a cheap HIV test that has become widely used.

Google is designing a suite of nanoparticles which are intended to match markers for different conditions. They could be tailored to stick to a cancerous cell or a fragment of cancerous DNA. Or they could find evidence of fatty plaques about to break free from the lining of blood vessels. These can cause a heart attack or stroke if they stop the flow of blood. Another set would constantly monitor chemicals in the blood.

High levels of potassium are linked to kidney disease. Google believes it will be possible to construct porous nanoparticles that alter color as potassium passes through. Unattached nanoparticles would move differently in a magnetic field from those clumped around a cancer cell. In theory, software could then provide a diagnosis by studying their movements.

As part of the project, the researchers have also explored ways of using magnetism to concentrate the nanoparticles temporarily in a single area. The tech company's ambition is ultimately to create a wristband that would take readings of the nanoparticles via light and radio waves one or more times a day. Visit BBC for the report.