About a quarter of healthcare providers said their virtual care programmes – telemedicine and telehealth – are financially sustainable and are improving efficiency, patient volumes and loyalty by filling gaps in medical specialties or helping chronically ill patients, according to a poll conducted by KPMG LLP, the U.S. audit, tax and advisory firm.
Telehealth, which uses technology to connect clinicians with patients, is gaining credence in urgent care settings from mobile devices, ‘primary care plus’ from retail clinics or for psychiatric assessments in an emergency department. Telemedicine – clinician-to-clinician consults – has a long history in radiology and for remote, underserved patient populations where specialists are needed for their clinical expertise, but it is gaining greater use. For example, telemedicine is used for neurology consults for stroke patients and also for referring nursing home patients to hospitals if they need more acute care.
‘Healthcare providers need to think of virtual care as a means to improve patient access and provider efficiency, especially as value-based contracts and other reimbursement incentives gain a greater share of revenue, while meeting patient care needs by filling gaps for key medical specialties,’ said Dr. Richard Bakalar, managing director at KPMG and a member of the firm’s Global Healthcare Center of Excellence. ‘Telehealth is rapidly evolving beyond urgent care and is increasingly used for follow up visits and helping chronically ill patients connect with their doctor online. Health plans and government payers are seeing the value from the technology and enhancing reimbursement for virtual care.’
Yet, approximately 35 percent of respondents in the poll said they have not yet started a programme incorporating virtual care, and the remaining 40 percent are in early stages.

• KPMG’s poll found that the biggest drivers for expediting adoption of virtual care were:
• Increase patient volumes and loyalty (29 percent)
• Care coordination of high risk patients (17 percent)
• Reduce costs for access to medical specialists (17 percent)
• Meaningful use and payer incentives for adoption (13 percent)
• Patient requests/consumer demand (13 percent).

Implementing a virtual care programme is not without challenges, however. Healthcare providers cited several, including:

• Too many other technological priorities (19 percent)
• Maintaining a sustainable business model (18 percent)
• Organizational readiness to implement new services/technology (18 percent)
• Regulatory compliance and risk concerns (15 percent).

KPMG LLPhttp://tinyurl.com/hlgwoyk

Patients who have had a stroke in the back of the brain are at greater risk of having another within two years if blood flow to the region is diminished, according to results of a multi-centre study led by researchers at the University of Illinois at Chicago. These stroke patients are the most likely to benefit from risky intervention to unblock arteries, and they can be identified using a new MRI-based technology developed at UIC.
The vertebrobasilar region in the back of the brain is responsible for locomotion and balance. Vertebrobasilar strokes can be devastating, causing partial or total paralysis. They account for 30 percent to 40 percent of all strokes, or about 200,000 cases per year in the U.S.
Stroke patients found to have narrowing of the blood vessels in the back of the brain caused by atherosclerosis can have angioplasty, a procedure to open blocked arteries, but the procedure carries its own risks. And because blockages don’t always correlate to locally reduced blood flow – thought to be the real culprit in raising stroke risk – researchers wanted to better understand the relationship between arterial blockages, blood flow, and recurrent strokes.
‘Having a blockage present in a blood vessel doesn’t always correlate to low blood flow,’ says Dr. Sepideh Amin-Hanjani, professor of neurological surgery at the UIC College of Medicine and principal investigator on the study. ‘There can be a blockage and flow can be normal, if other nearby blood vessels are able to compensate.’
She and her colleagues wanted to try to identify which stroke patients are at highest risk for further strokes and so might benefit from angioplasty despite the risks of the procedure.
They followed 72 adult patients who had a stroke or temporary symptoms of a stroke, known as a transient ischemic attack, in the back of the brain and who also had at least 50 percent blockage of the arteries in that part of the brain. The patients were followed for an average of 22 months at five academic medical centres as they continued receiving standard care for their condition from their neurologists.
Participants were evaluated for reduced blood flow in the back of the brain using NOVA, or Noninvasive Optimal Vessel Analysis, a software program that can quantify the volume, velocity, and direction of blood flowing through any major vessel in the brain using standard MRI equipment. The NOVA software was developed at UIC by Dr. Fady Charbel, professor and head of neurological surgery, who is a co-author of the new study.
One-fourth of the study participants were found to have diminished blood flow in the back of the brain, which turned out to be a significant predictor of subsequent stroke. These patients had 12- and 24-month stroke-free survival rates of 78 percent and 70 percent, respectively, compared to 96 percent and 87 percent for patients with normal blood flow.
‘At one year, the risk for patients with low blood flow was about five times as high as risk for patients without low flow in the back of the brain,’ Hanjani said. For these patients, the benefits of angioplasty probably outweigh the risks.
‘About three-quarters of patients didn’t have low blood flow in the vertebrobasilar region – other arteries are doing the job of ensuring that proper blood flow is reaching that area – and these patients would not benefit from treatments aimed at opening the vessels, such as angioplasty – in fact, the procedure would put these patients at unnecessary risk,’ Hanjani said.

University of Illinois at Chicago http://tinyurl.com/jxl37yo

The radiology/general imaging segment accounted for the major share of 30percent of the overall ultrasound market in 2015. This is primarily due to the wide adoption of ultrasound devices in the diagnosis of rising number of abdominal diseases. Urology has emerged as the fastest growing segment, registering a CAGR of 11.3percent during the forecast period, due to the growing incidences of urinary tract infections coupled with the rapidly aging patient population.
A new report published by Allied Market Research, titled, ‘Ultrasound Devices Market – Global Opportunity Analysis and Industry Forecast, 2014 – 2022’, projects that the global ultrasound market would reach $10,476 million ( Euro 9.32 milliion) by 2022. Diagnostic ultrasound system would continue to be the highest revenue-generating segment throughout the forecast period. Europe accounted for almost one-third of the market share in 2015, and is expected to dominate the overall market during the study period.
The major factors boosting the market growth include technological advancements (such as advent of 3D and 4D ultrasound that provides detailed information about a known abnormality from different angles), rising incidence of chronic diseases, and increasing geriatric population worldwide. The rising number of application areas of ultrasound coupled with increasing adoption of ultrasound systems in the obstetrics and gynecology field, is set to boost the growth of the ultrasound market worldwide. Cost effectiveness, safety, high accessibility, and clinical value in preliminary diagnosis are strengthening the technology’s value proposition in technological advancements in the ultrasound market. In addition, increase in number of diagnostic imaging procedures, and rising awareness for early diagnosis of clinical disorders are anticipated to further drive the demand for ultrasound devices. However, dearth of skilled and experienced sonographers and technological limitations of ultrasound systems are some of the factors restricting the market growth.
Diagnostic ultrasound devices such as 2D ultrasound, 3D & 4D ultrasound, and Doppler devices have given rise to new applications (such as biopsies and image-guiding interventions) across different clinical specialities. The growing demand for both ultra-portable and portable diagnostic ultrasound systems in diagnostic and image guidance area at points-of-care have further boosted the market growth. The advent of portability in ultrasound has built a strong path for the increased demand of these devices for point-of-care applications such as emergency medicine, anesthesiology, musculoskeletal, and critical care medicine. The trolley/cart-based ultrasound devices segment accounted for the major market share of the total ultrasound market in 2015, whereas, the compact/handheld ultrasound devices segment is expected to grow at a higher CAGR during the forecast period

Allied Market Research http://tinyurl.com/hgmpxfc

In early May Siemens Healthcare unveiled its new brand name Siemens Healthineers. The new brand underlines Siemens Healthcare’s pioneering spirit and its engineering expertise in the healthcare industry. It is meant to describe the healthcare organization and its people – the people accompanying, serving and inspiring customers – the people behind outstanding products and solutions.
‘We have an exceptional track record of engineering and scientific excellence and are consistently at the forefront of developing innovative clinical solutions that enable providers to offer efficient, high quality patient care. Going forward as Siemens Healthineers, we will leverage this expertise to provide a wider range of customized clinical solutions that support our customers business holistically. We are confident in our capability to become their inspiring partner on our customers’ journey to success’, explained Bernd Montag, CEO of the company. ‘Our new brand is a bold signal for our ambition and expresses our identity as a people company – 45,000 employees worldwide who are passionate about empowering healthcare providers to optimally serve their patients.’
As part of its Vision 2020 strategy Siemens AG announced nearly two years ago that its healthcare business would be separately managed as a company within the company with a new organizational setup. Siemens Healthineers will continue to strengthen its leading portfolio across the medical imaging and laboratory diagnostics business while adding new offerings such as managed services, consulting and digital services as well as further technologies in the growing market for therapeutic and molecular diagnostics.

www.healthcare.siemens.com

A new study from the Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, shows lesions, which can best be seen on MRI scans, could help identify individuals who are more likely to suffer from more rapidly progressing osteoarthritis.
The SEKOIA study, a major international osteoarthritis disease-modifying trial, carried out MRI scanning on the knees of 176 men and women over 50 years old. They were then followed up for an average of three years with repeated knee X-rays. Individuals with abnormalities on their MRI scans at the first appointment were compared to those without to examine the effect on disease progression.
Individuals with bone marrow lesions (BMLs) on their MRI scan were found to have osteoarthritis that progressed more rapidly than those that did not. On average, the space within the joint is lost at a rate of 0.15mm per year however the Southampton study shows that, overall, individuals with BMLs had a loss rate that was 0.10mm per year faster than those without BMLs. This may lead to earlier need for joint replacement or other intervention.
BMLs show up on MRI as regions of bone beneath the cartilage with ill-defined high signal and represent areas of bone marrow edema, fibrosis, and necrosis. The Southampton researchers believe that therapies to target these abnormalities may slow the progression of this disabling joint disease, but further work is required to examine this.

University of Southampton http://tinyurl.com/zgoujax