Awareness of chronic disease technologies and remote monitoring among not only the medical community but the general population has continued to increase dramatically, as evidenced by the recent New York Times article about implantable defibrillators ability to remotely track heart failure patients. News coverage of these devices, which are poised to significantly improve quality of life for the 6 million people in the U.S. who suffer from HF, emphasizes the shift toward patient- and consumer-focused care and highlight's the public's increasing involvement in self-managing their health to a greater extent. In the Pipeline, we've covered numerous different developments in remote monitoring, which can all be found here.
For more information about remote monitoring, continue reading after the jump, or contact me at WynnP@advisory.com to discuss how Tech Insights is tracking these devices and their effect on EP and HF strategy.
New York Times Tracks Implantable CV Monitors
In his final post following the WCIO conference, my colleague Zach Binney discusses the relative roles of open, laparoscopic, and percutaneous approaches to tumor ablation:
Driven by broader trend toward minimally invasive surgery, percutaneous approaches growing in prominence across the ablation realm
Tumor ablation procedures -- including radiofrequency ablation (RFA), cryoablation, microwave ablation (MWA), and irreversible electroporation (IRE) -- may be performed via open surgical, laparoscopic, or percutaneous approaches. The specific approach used often depends on the type of physician performing the procedure: surgeons tend to prefer open and laparoscopic techniques given their expertise and training, while interventional radiologists (IRs) gravitate toward laparoscopic and percutaneous ablations.
In the past, a significant proportion of ablations were performed as inpatient surgical procedures. However, the approach's value proposition for patients and physicians alike -- namely, a less invasive manner for tumor destruction with fewer complications than surgery -- has led the field to shift heavily toward laparoscopic and especially percutaneous procedures in recent years.
WCIO 2010 Roundup: Open, Laparoscopic, and Percutaneous Ablations
To continue with the previous posts following the WCIO conference, Zach Binney has weighed in below to discuss the strategies for building an effective interventional oncology (IO) program:
Building an interventional oncology program requires broad interdisciplinary cooperation
Many conversations at the conference revolved around how to best structure an interventional oncology program. Most IO procedures are shared by interventional radiologists and surgeons. In the ablation space, in particular, most open surgical procedures are handled by surgeons, while percutaneous procedures remain primarily the domain of interventional radiologists. Laparoscopic procedures may be done by either group.
Cooperation with other specialists is also critical to driving the creation and growth of an IO program. Medical oncologists coordinate the treatment of many cancer patients, and as such they -- along with surgeons -- serve as "gatekeepers" to the interventional radiologists, who report typically seeing patients only after a surgical consultation. To drive volumes, radiologists stress, both surgeons and medical oncologists must be willing to refer patients for consults with interventional radiologists.
The increasing prominence of multi-disciplinary tumor boards will likely help drive the integration necessary to strengthen IO as, potentially, a fourth leg of the chemo-surgery-radiation cancer care stool. However, this is contingent on interventional radiologists being willing to attend and actively participate in multi-disciplinary care conferences, physicians noted.
Even absent broad-based cooperative initiatives, however, programs can flourish on personal relationships. Dr. James Urbanic, a radiation oncologist at Wake Forest University Baptist Medical Center (WFUBMC), presented on how he and a radiologist colleague have collaborated on a number of cases requiring an IO and RT perspective. They regularly discuss whether RFA or radiation makes the most sense for any given patient based on the tumor's location, patient's treatment history, and other factors. They have even split patients in the past: one female patient with two lung tumors received SBRT for one and had the other ablated.
Dr. Urbanic described ideas for several clinical trials with his colleague and other physicians across WFUBMC, which he hopes will be vehicles for further collaboration.