The Cleveland Clinic lists its choices on a yearly basis for the top ten medical innovations. It recently posted its 2017 list (see: Cleveland Clinic names top 10 medical innovations 2017):
- The microbiome. The microbiome is made up of trillions of helpful bacteria that make a home inside the human gut – to prevent, treat and diagnose disease.
- Diabetes drugs that reduce heart disease and death....Novo Nordisk’s liraglutide, sold as Victoza, and Eli Lilly’s empagliflozin, sold as Jardiance, have shown promise in reducing these heart-related complications (see: Novo Slumps as Study on Victoza’s Heart Impact Disappoints).
- CAR-T therapy for leukemia and lymphoma. Using a new method called chimeric antigen receptor – T-cell therapy, doctors are now enlisting the patients own immune cells in the fight against leukemia and lymphoma....
- Liquid biopsies to find cancer. Finding a way to test for a cancer that doesn’t involve the pain and cost of a doctor a chunk of tissue from your body has long been on the wish list of oncologists.. It’s now possible to find tumor DNA circulating the blood, spinal fluid and perhaps even urine....
- Automated car safety features and driverless capabilities....Starting in 2018, the NHTSA will require back-up cameras in new cars. Collision warning systems, adaptive cruise control, lane assist, and cross-traffic alerts are some other innovations on the horizon to further reduce the more than 38,000 fatal car crashes each year.
- Fast Healthcare Interoperability Resources, or FHIR. FHIR is an interoperability specification that can act as a translator for EHRs that don’t normally play well together. It’s been tested in a number of trials. Health Level 7 is expected to release it next year....
- Ketamine for treatment-resistant depression. For one-third of people with depression, nothing helps – not therapy or medication, not even electro-convulsive or shock treatments. Ketamine, once known as a club drug, improves symptoms rapidly for the majority of these patients in initial studies, prompting the FDA to grant the treatment fast-track status for development.
- 3D visualization and augmented reality for surgery. Many eye and brain surgeons do their work in very small spaces, peering through high-powered microscopes with their heads bent and necks strained....3-D cameras are helping surgeons and their teams get a better view....
- Self administered HPV test.....The HPV test, designed for routine use in women over age 30, detects te presence of high-risk types of HPV in the cells of the cervix with a vaginal swab. It’s a simple test, but women who don’t ger to the doctor will never get it.
- Bioabsorbable stents....About 2 percent of people develop life-threatening blood dots at the stent site, according to the National Health-Lung and Blood Institute....Absorbable stents are already in use in Europe and recently approved by the FDA, do exactly that. The absorbable stents also appear to reduce chest pain after surgery compared with the wire option.
Here's some more information about FHIR, the sixth item in the list above (see: FHIR’s Impact on Population Health):
FHIR is a specification from HL7.org that outlines how to support an API for the purpose of exchanging data among HIT systems. The specification itself is still in DSTU 2 phase and, therefore, still evolving. The premise of FHIR is that HIT vendors will expose the API endpoints detailed in the specification, which can then be accessed by anyone who is properly authenticated and authorized. There are numerous API functions that FHIR supports, including both putting data into and getting data out of vendors who support the API. For example, FHIR provides endpoints for lab results, procedures, medications, and documents, among others.
So, as is often the case with IT standards, success will lie in whether the various healthcare software vendors will adopt and market the feature. Regarding this likelihood, I continue to believe that the majority of vendors and healthcare executives don't support EHR interoperability in their hearts because medical record portability can enable patient shopping across competing health systems. This same point was made in a recent article about FHIS (see: FHIR: The Last, Best Chance to Achieve Interoperability?).
[A] worrisome....barrier to adoption [of FHIR] is the persistent doubt that most EHR systems, and most medical centers, are truly committed to reducing barriers to data sharing – carefully crafted public comments to the contrary. The question is whether in their heart of hearts (or more accurately, in the office of the CFO), hospitals and EMR systems really want to share data.