Cleveland Clinic pegs 10 top care innovations for 2019

10 top medical innovations for 2019 identified by the Cleveland Clinic

In its annual assessment of emerging advancements, the Cleveland Clinic ranked the game-changing potential for new technologies—including information technology—that will hit the market in 2019. “The passion of our clinicians and researchers to get the best care for patients drives a continuous dialogue about what state-of-the art medical inventions are just over the horizon,” its announcement indicates.

The organization says it uses a rigorous process to gather the opinions of Cleveland Clinic physicians and researchers, interviewing “nearly 100 Cleveland Clinic experts to elicit more than 150 nominations, which are presented, debated, and ranked in a series by two separate committees.” The innovations must have a major clinical impact and offer significant patient benefit; have high user-related functionality that improves healthcare delivery; have a high probability of commercial success; be in or exiting clinical trials and be available on the market sometime in the coming year; and have significant human interest in its application or benefits.

Alternative therapy for pain—fighting the opioid crisis

The opioid crisis has increased attention on finding alternatives to using powerful, addictive drugs responsible for more than 75,000 deaths in 2018. Experts believe that true innovation in pain management lies in a new approach to opioid prescription. “Pharmacogenomics—the study of how genes affect a person’s response to drugs—is an excellent tool to individualize the prescription of medications for pain.” The field of pharmacogenomics seeks to apply an individual’s genetics to lead to the most rational and tailored administration of medication. “In 2019, with increased access to genetic testing, pharmacogenomics is poised to make significant inroads into precision medicine,” the Cleveland Clinic’s report suggests.

The advent of AI in healthcare

AI is being used in healthcare for applications such as decision support, image analysis and patient triage. “Today, artificial intelligence is helping physicians make smarter decisions at the point of care, improving the ease and accuracy of viewing patient scans and reducing physician burnout,” according to the Cleveland Clinic. “For instance, machine learning algorithms have the ability to highlight problem areas on images, aiding in the screening process and quickly making sense of the mountains of data within a physician’s EMR system.” Ed Marx, the Cleveland Clinic’s chief information officer, says, “We’ve seen sound results early on with pathology, radiology and dermatology. We call it augmented intelligence, not artificial intelligence, because we will never replace the clinician.”

Expanded window for acute stroke intervention

Timely intervention for stroke can mean the difference between life and death. A drug or mechanical intervention can be effective, but intervention is only recommended within the six hours after stroke onset. Intervention rarely occurred outside the window, and patients who arrived late to the hospital were often left with clots, tissue death and impairment. However, new research suggests that the window for intervention may be larger than previously advised. In 2019, providers and researchers will seek to find ways to lengthen the window for stroke treatment.

Advances in immunotherapy for cancer treatment

Cancer immunotherapy, or biologic therapy, is a technique that uses the body’s own immune system to fight cancer. Immunotherapies boost the body’s natural defenses and work to either stop or slow the growth of cancer cells, prevent cancer cells from spreading or destroy cancer cells all together. Immunotherapies are highly selective and efficient at identifying and destroying tumor tissue. In the past two years, the market for immunotherapeutic cancer therapies has seen an unprecedented number of FDA approvals. In 2019, the number of agents available to patients will only continue to grow.

Patient-specific products achieved with 3D printing

3D printing now is enabling medical devices to be matched to the exact specifications of a patient. “Everybody tends to be different, (especially) when we’re facing problems related to anatomic structures—where the diseases manifest differently in each human being,” said Tom Gildea, MD, with the Cleveland Clinic’s Respiratory Institute. Devices modeled from patient-specific dimensions are more compatible with an individual’s natural anatomy and have shown greater acceptance by the body, increased comfort and improved performance outcomes, according to the Cleveland Clinic.

Virtual and mixed reality for medical education

Virtual and mixed reality technologies are helping to advance medical education by providing simulation training that serves to enhance traditional medical schooling. The Cleveland Clinic and Zygote Medical Education have joined forces to develop a virtual reality-based clinical anatomy curriculum to train future doctors. The medically accurate and precise 3D anatomical models are designed to be easily accessible via mobile and desktop apps to complement the VR curriculum. Virtual and mixed reality training programs provide future physicians, surgeons and emergency medical personnel the “hands-on” experience –the simulations made possible by the technology are an excellent alternative to traditional videos and textbooks.

Visor for pre-hospital stroke diagnosis

A new visor-like device worn by patients can help providers and emergency medical personnel detect a stroke that requires comprehensive care within seconds. The visor received FDA clearance in January and is expected to be commercially available in 2019. The volumetric impedance phase shift spectroscopy (VIPS) device identifies patients having a stroke by sending low-energy radio waves through the brain that assess fluid volume differences (asymmetry) between the cerebral hemispheres, which are indicative of stroke. “With a 92 percent accuracy rate, it can tell if you’re having a large stroke or a large bleed in the brain,” said Mark Bain, MD, director of cerebrovascular surgery in the Cleveland Clinic’s Neurological Institute. “Over the next year or two, you’re going to be seeing this visor on ambulance units.”

Innovation in robotic surgery

Continued advancement in robotic surgery has led to more precise and effective surgeries with improved surgical outcomes. “It moved from being in the operating room mostly for urology and cardiology into fields that were not there before,” said Jihad Kaouk, MD, director of the Cleveland Clinic’s Center for Robotic and Image Guided Surgery. Surgical platforms are highly advanced and are being used anywhere from spine to endovascular procedures. For example, urologic surgeons at the Cleveland Clinic were the first in the country to successfully perform prostate surgery using a new generation of robot that inserts surgical instruments through a small incision.

Mitral and tricuspid valve percutaneous replacement and repair

A minimally invasive approach, percutaneous cardiac intervention is an effective alternative to cumbersome open heart surgery, especially for high-risk patients. Efficient for both valve repair and replacement, innovation in the percutaneous transcatheter surgery space has expanded to include replacements of the mitral and tricuspid valves. When either of these valves are faulty, blood flow is compromised and the patient’s health is negatively affected. The exploration of percutaneous procedures technology in a greater patient population is ongoing, but with promising post-op results, the innovation has major implications for the future of cardiac care.

Emergence of RNA-based therapies

As the central intermediary in the expression of genetic information, RNA has become a popular target for therapeutics. Interfering with genetic data at the RNA level gives scientists the ability to intercept a patient’s genetic abnormality before it is translated into functioning (or nonfunctioning) proteins. Today, the most popular and successful mechanisms of RNA therapy include antisense nucleotides and RNA interference. To date, there are a few FDA approved antisense nucleotide therapies for the treatment of conditions such as AIDS-related retinitis and familial hypercholesterolemia. But innovative work in the space is focused on the treatment of the rare neurological disorder, Huntington’s disease.