Low Cost Blood Test

A centrifuge is a device that fractionates blood. Blood fractionation separates blood into plasma, white blood cells, and red blood cells. Fractionated blood is easier for researchers to analyze. Unfortunately, centrifuges can be pricey and bulky. They also require electricity. As a result developing countries and field-hospitals can’t utilize them. Recently, however, scientists at Stanford have developed an inexpensive alternative.

Inspired by a Children’s Toy

Manu Prakash is a bioengineering professor at Stanford University. He and his team traveled to Uganda and spoke with healthcare workers. The team discovered that the workers had a centrifuge, but they were using it as a doorstop. With no electricity, the device was useless to them. Prakash returned home and decided to explore children toys for inspiration. He eventually found a toy called a whirligig or buzzer. It spins much faster than a yo-yo, so it made sense to explore it as an option.

The Paperfuge

The paperfuge works just like a whirligig. A string runs through the middle of the paper disc. Handles are attached to either end of the string. When a person pulls on the handles, the disc in the middle rotates quickly. Prakash and his team found that their device makes 125,000 revolutions per minute. That number is one of the fastest rotational speeds ever recorded for a human powered device.

While the device’s disc is made out of paper, it is coated with polymer to make it less likely to break. Healthcare workers can attach blood samples to the disc and then pull on the strings to separate the blood. Prakash and his team traveled to Madagascar to test the device. It worked just as they planned.

Inexpensive Tool

One of the most important aspects of the paperfuge is its cost. It can be produced for as low as 20 cents per device. The disc itself can even be created with a 3D printer, so it’s easy to produce a large number of the devices. So far the device has only been used to detect malaria. Since it’s shown success Prakash and his team plan to test the device with other diseases. To learn more about Manu Prakash visit his Stanford profile.

The 5 Biggest Healthcare Cybersecurity Threats

This month Quest Diagnostics became the latest healthcare organization to be attacked by hackers. As a result of the data breach, up to 34,000 people’s health information has been compromised. Quest Diagnostics reports that a hacker gained access to the data via the company’s mobile app MyQuest. The exposed data includes lab results, names, and date of births. However, the company claims that financial information wasn’t accessed.

Quest Diagnostics’ situation is the latest reminder that healthcare organizations need to take precaution when it comes to cybersecurity. Below are the biggest cybersecurity threats that healthcare organizations face.

Employees

Sometimes the biggest threat comes from the inside of the organization itself. Healthcare organizations need to do a better job of monitoring employees that have access to patient data. For example, if a particular employee seems to access patient records more than other employees than the organization should take action and investigate. While there could be a legitimate reason for unusual activity, organizations need to do a better job at monitoring all employee activity related to data.

Outside Vendors

Healthcare organizations like hospitals work with numerous organizations. In order to protect their data, they need to do a better job of analyzing the risk associated with working with different vendors. Vendors should be willing to comply with cybersecurity training. If they aren’t willing to comply, then healthcare organizations shouldn’t work with those vendors.

Malware

As long as there are computers, there will be malware, and each year malicious software gets more sophisticated. Healthcare organizations need to protect themselves against malware by using the latest antivirus software and making sure it remains up-to-date. Antivirus software is one of the easiest ways that healthcare organizations can protect themselves.

Mobile

The Quest Diagnostics situation is a prime example of the dangers of mobile apps. Sometimes in order to make an app more functional manufacturers will compromise on security. In general, healthcare organizations should avoid putting sensitive data on mobile apps.

Medical Devices

Medical devices are vulnerable to hacking just like computers and mobile devices. As more medical devices become connected to the internet, the security risk increases. Healthcare organizations must take steps to protect the medical devices they use. They must ensure that the devices they use are reputable and don’t pose any unnecessary security risks.

New Science May Lower Cancer Treatment Costs

Currently, any cancerous tumor found in the human body must be treated with aggressive chemotherapy. Unfortunately, chemotherapy is an arduous, painful treatment that has its own limitations and risks. All of the different chemotherapy drugs were created to kill cancerous cells and, therefore, shrink the tumor. These drugs, however, tend to kill healthy cells as well. Furthermore, doctors usually must combine different chemotherapy treatments to get the most effective result possible, which results in the death of more healthy cells. Cancer treatment is also, of course, quite expensive. Thankfully, scientists at Nanyang Technological University in China are in the process of testing a treatment method that is able to transcend chemotherapy’s limitations.

The most pressing issues of chemotherapy today are that chemotherapy drugs kill cells indiscriminately and cannot sink deeply enough into a tumor to ensure that all of the cancer cells are affected by the chemicals that will kill them. This is where magnetized microbubbles come in. These scientists have found a way to inject the drugs in ‘bubble’ stages, magnetize them, and lead them directly to the tumor. The microbubbles attach to the tumor, and the drug particles sink deep into the mass in order to ensure all cancerous cells are reached. The reach of the microbubbles is 50 cell layers deep.

The scientists who began this project were moved by wanting to find a safer way of treating cancer. They therefore combined magnets and ultrasound technology to create this new treatment method. They started with the understanding that current cancer treatment methods take a significant toll on the human body, and they may not even be entirely effective long term. It is not uncommon for those who undergo chemotherapy to be in remission, only to have their cancer reappear after a certain amount of time.

If effective, cancer treatment will be more effective, less invasive, and less costly overall. Localizing the cancer treatment drug will ensure that healthy cells are affected less, and cancerous cells are wiped out at their core. Patients will not have to undergo significant duress while in treatment, and their bodies will not be as detrimentally affected by the time treatment ends.

Unfortunately, there is a long way to go before this new method of delivery is tested on human patients. Currently, the 12 person, international team is working on perfecting their methods and running tests on different types of cancer. It is estimated that it will take about 10 years until this method is tested on human subjects.

Low-Cost Test That Detects Cystic Fibrosis

Cystic fibrosis is a genetic disorder that affects the lungs; however, it can also cause damage to other organs in the body like the liver and kidneys. At the moment doctors do not have a cure for the disorder. Today a person with cystic fibrosis has a life expectancy of about 40 years. This is actually an improvement from fifty years ago when children with the disorder rarely lived past 10 years. Early detection is one of the reasons why people with cystic fibrosis now live longer. Newborns are usually tested days after they are born so that they can receive treatment as soon as possible.

New Low-Cost Test

Scientists have recently developed a new low-cost test for cystic fibrosis. The two most popular ways to test for the disorder are genetic and sweat tests. Genetic tests can be very expensive, so sweat tests are the most popular option. The current sweat test is a labor-intensive process that is not always accurate due to human error. As a result some, cases go undetected. However, the new sweat test is much cheaper and more effective than previous tests. The new test will especially be important to developing countries that often don’t have access to more advanced tests.

Fluorescent Sensors

The new test uses a new sensor that produces fluorescent light. When the sensor detects chloride, though, it emits less light. Scientists compared their test with the current sweat test and found that the new test is just as accurate. Plus, compared with the current test, the new test is better at detecting a variety of chloride levels. One of the reasons why the older test is prone to errors is because it has trouble distinguishing chloride and others ions. Sometimes medications increase the level of ions like iodide. The new test doesn’t have this issue since it can detect the difference between chloride, iodide, and bromide.

Hospital Trip Vs Home Test

Researchers are working on making their test even more effective by giving patients the ability to conduct the test at home. The prototype involves plugging a device into a cellphone, and this device will detect the light change. This version of the test will save clinics and developing countries a significant amount of money. Researchers hope that their test will also be used to detect other disorders that affect chloride levels like Addison’s disease or ALS.

Using Low-Cost Diagnostics to Fight Zika

The newest health concern circulating the globe is the Zika Virus. In the past couple of years, there has been an outbreak of this dangerous virus. It is spread through bites by infected mosquitoes and, while rarely being life-threatening to those bitten, can cause brain defects, such as Microcephaly, in fetuses. The worrisome component of this virus is the fact that its symptoms are not specific to Zika, therefore pregnant women have no way of knowing whether or not they have the virus. Fortunately, researchers at Harvard University have been working to change that.

The aforementioned researchers have been able to invent a low-cost paper diagnostic test that can detect the presence of the Zika Virus. They hope it will slow the spread of the notorious virus, as well as pave the way for low-cost diagnostics for different virus outbreaks in the future. The tests have been engineered to work in three steps. Firstly, they detect the presence of Zika. Then, they search for the specific strain. Finally, they search for genetic markers related to Zika. This results in a strip of paper that changes color depending on if a drop of blood shows signs of the Zika Virus or not, all within 30 minutes.

The project began in an attempt to create a low-cost diagnostic test for Ebola. When Zika became a worldwide concern, it only made sense to research the genetic indicators of it as well. Currently, testing for such RNA viruses requires an anti-body method, which costs thousands of dollars and takes months to generate. Since researchers took the time to find genetic indicators of said viruses, the costs can be reduced a great deal.

These paper diagnostic tools are also useful in that they can identify the region from which the infected genome originated. This basically means that the diagnostic can communicate from where it came, which would allow researchers to predict where an outbreak will next occur.

The implications of this newly developed health technology are enormous. The Zika Virus is just one RNA virus that could be detected by diagnostics similar to the Zika one. The researchers are confident that they will be able to develop, test, validate, and release new diagnostic tests in under a week’s time. Such an ability has the potential to greatly reduce diagnostic tests all over the world.

The Zika Virus is just one outbreak we have experienced in the past decade. Low-cost diagnostic tests make treatment and prevention of future outbreaks that much easier.

Targeting Mosquitoes for Low Cost Diagnostics

Mosquitoes are notorious for their ability to transmit diseases from one person to another. They have come to be a source of fear, as they carry concerning illnesses such as Malaria, the Zika Virus, and the West Nile Virus. Diagnostics for such conditions can cost a large sum of money, meaning that those living in undeveloped nations rely on symptoms to determine if they carry a disease. However, it has been difficult to eradicate the pests carrying these diseases in a short amount of time because it is hard to determine which ones will transmit illnesses, not to mention the fact that mosquitoes breed quite quickly. However, researchers are hoping to remedy the problem by shedding light, literally, on which mosquitoes carry these certain diseases.

Engineers at Sandia National Laboratories have created a way to scan insects for viruses such as the West Nile Virus, and they are hoping to soon add Zika Virus to the list of diseases their technology can detect. They managed to use an isothermal nucleic acid amplification technique to lower the cost of discovering whether or not mosquitoes carry a certain disease, and also to pinpoint which disease is present specifically. The researchers’ RT-LAMP uses fragment sequences of DNA to complete this seemingly impossible task. They have managed, with this technique, to drastically cut down on cost and false positives.

Right now, discovering if an insect carries a disease, and identifying which disease, can take a long time. Insect samples must be gathered and sent to a lab, in which PCR techniques are used. This new method being used by these researchers, however, makes a diagnosis possible within one hour. Field workers, with this quick information, can decide if they should focus on eradicating a certain area of mosquitoes to cut down on the spread of diseases.

One of the most useful things about this new technology is that, with some trial and error, it can be adapted to detect a vast number of diseases. It is now on the cusp of being able to detect the Zika Virus, for example, which only recently became a known condition. The ability to distinguish between such illnesses is also pertinent because each must be treated in different ways.

Currently, the team of researchers is moving the technology forward by attempting to have it screen more than one targeted sample at a time. Hopefully, in time, this will provide field workers in all countries and environments to determine quickly if a mosquito population is carrying diseases and if it should, therefore, be eradicated.

Healthcare and Cybersecurity

October is cybersecurity month. It’s a time for individuals and businesses to reflect on their online habits and make sure that they protecting themselves from any possible threats. As the healthcare industry begins to rely more and more on technology, it must make sure that its cybersecurity is as strong as possible. Earlier this year hackers attacked Hollywood Presbyterian Medical Center and held it data hostage until a ransom was paid. The hospital ended up paying the hackers $17,000 in order to regain access. If the healthcare industry isn’t careful, events like this one will happen more frequently. In order to protect patients, the healthcare industry must take steps to protect their cybersecurity. Below are four cybersecurity tips that every healthcare organization should follow.

Security Culture

Healthcare professionals need to understand that cybersecurity is a big deal. Everyone should take precautions to protect the private data of patients. Organizations can accomplish this by offering required training to all members of their staff. When people understand what a security culture looks like, they’ll be less likely to make mistakes that could jeopardize patient data. Protecting patient data must be a priority of healthcare organizations. If this mindset is present from the beginning, mistakes will be less likely to occur.

Mobile Devices

Mobile devices like cell phones and laptops are easy to lose. They are also easy to steal. These devices pose a threat to privacy. Staff who use laptops must be aware of their setting. They must make sure that no unauthorized person can view the information on the screen. If data is transmitted over a mobile device, it should be encrypted to ensure its protection. Healthcare organizations also need to have policies about taking mobile devices out of the workplace. The device should be password protected so that access is limited to the appropriate person only.

Computer Habits

Computers must be properly maintained in order to ensure they are safe and function properly. This means that the computer should be set up properly. It should be password protected. It shouldn’t have unnecessary applications on its system. Staff shouldn’t download any unnecessary applications. The computer should be updated regularly to protect it from new threats. Some organizations use parental controls so that employees cannot download unnecessary files.

Anti-Virus Software

Every healthcare organization should employ anti-virus software on its devices. New viruses appear every day, and hackers routinely develop new methods to steal data. Even a new computer with the best hardware is vulnerable to viruses. Anti-virus software is relatively inexpensive and worth the investment. Every computer should be set up so that at the end of each day the software scans for viruses. Anti-virus software will monitor threats and prevent them from seriously jeopardizing patient data.

Your Doctor Could Be Making A Profit From Tests You Don’t Need

Doctor_examines_patient_(1)Some doctors may be trying to get more money out of their better-insured patients than is necessary. A study conducted by Rachel Reid, lead author and policy researcher at Rand Corp, showed that almost 8% of people had received “low-value services” in 2013. The statistics were based on 2013 insurance claims from nearly 1.5 million adults with commercial insurance. The researchers defined “low-value services” as services that provided little value to patients, given the costs and the alternatives.

These services can include anything from brain scans for uncomplicated headaches to hormone tests for thyroid problems to X-rays or MRI scans for lower-back pain. The researchers found the costs for the 28 low-value medical services studied made up 0.5% of total spending. This may not seem like much, but it adds up. In 2013 alone, it added up to $32.8 million of spending. The researchers referenced a previous report which estimated that of the total $2.5 trillion spent each year on health care in the US, over $750 billion represents waste.

Needless to say, underinsured patients are largely affected by health care disparities. Many underinsured patients do not receive enough healthcare. Highly insured patients, on the other hand, may get a huge amount of poor-quality care. In an editorial accompanying the research, Dr. Anna L. Park and Dr. Patrick G. O’Malley wrote that doctors need to communicate with patients about medical decisions, especially those regarding low-value care. Some doctors do not have the skills to discuss the benefits and the risks of diagnostic tests and treatments with their patients.

According to Dr. Jane Orient, who is the executive director of the Association of American Physicians and Surgeons, patients often have difficulty knowing who to believe because there is a lot of individual variation. Add to that a huge number of doctors and a substantial amount of money that those doctors want to get their hands on and you’ve got a pretty jumbled situation.

Dr. Orient added that doctors are influenced by a number of factors when discussing treatments and tests with their patients. Sometimes a patient will ask for a certain test. At this point, it can be hard to go against the patient’s wishes, especially given that the failure to diagnose can often lead to a lawsuit. Doctors are under a lot of pressure to test for anything they think might be possible. In addition, some patients may refuse tests despite the doctor’s recommendation because they are in high-deductible plans.

Another issue is the possibility of biases within the committees that decide which treatments or procedures are low-quality. These committees are self-appointed, so their guidelines may be skewed by conflicts of interest or by a lack of direct responsibility for patients.

There is a lot to consider before implementing a way to prevent patients from spending on “low-value services.” But one thing that can be taken away from this study is that doctors need to learn to read and interpret scientific studies in a way that allows them to know the potential risks and rewards for patients. Dr. Orient believes medical schools do not provide enough of this type of training. Clearly there’s still a lot of think over, but equipping doctors with the skills to help their patients in the best way they can would be a big first step in the right direction.

The World Needs an Essential Diagnostics List: Here’s Why

Heart CareIn the medical field, vaccines and drugs receive a huge amount of attention while diagnostics hide in the shadows. This is unfair to say the least, since diagnostics are at the basis of medicine. Without diagnostics, doctors would not know how to treat people. In a number of low-income areas throughout the world, serious health issues go undiagnosed. Even when diagnostic testing is done in these areas, it is not always of good quality. But what are we to do about the extremely high number of people suffering and dying due to lack of a diagnosis?

A recent article in NEJM suggests that to improve access to critical diagnostics, we should make a list. The World Health Organization started a Model List of Essential Medicines (EML) in 1977, and the list has since improved access to medicines. So why don’t we do the same with diagnostics? We could create a Model List of Essential Diagnostics, or an EDL. Here are a few ways that such a list would make an impact:

1) More affordable diagnostics

When it comes to vaccines and drugs, volume discounts, bulk and advanced purchasing, and pooling mechanisms are widely used. While TB can be detected using the Xpert MTB/RIF test, affordability is limited. A list of essential diagnostics could encourage group purchasing by international organizations. With larger and more predictable volumes, manufacturers would be able to lower the costs of diagnostics tests. Countries can use the list to waive import duties and impose price controls in order to ensure affordability.

2) Better detection of emerging infectious threats

The epidemics of both Ebola and Zika have emphasized the need for surveillance. While there are a number of countries with reference laboratories, laboratory capacity at lower health system tiers tends to be weak. An EDL could increase laboratory capacity at every tier, thus helping countries to prepare for epidemics and implement international health regulations.

3) Better patient care and clinical outcomes

Patients will consistently receive access to quality essential diagnostics that will be always available as well as affordable. Governments, funders and manufacturers can make sure that a diagnostic is available and accessible once it is added to an EDL.

4) Better quality and regulation of diagnostics

While developed countries have regulatory agencies that determine the accuracy of diagnostic devices, resource-poor settings either do not have these agencies, or they are weak. An EDL could allow these agencies to focus on priority tests. It could also help to identify sub-standard diagnostics, as is already being done for malaria rapid tests.

5) Improved laboratory infrastructure and supply chain

In many low income settings, laboratory devices are unusable due to poor infrastructure and inconsistent supply chains. With an EDL in place, ministries of health could strengthen key infrastructures and create targeted supply chains for the important tests.

Our world does not have an equal distribution of healthcare. While we often focus on giving struggling people access to vaccines and drugs, there is not enough focus on diagnostics. Without diagnostics, we cannot know which drugs and treatments to give patients. We need to start treating diagnostics with the same importance at vaccines and drugs, and the first step to achieving this globally could be to create a Model List of Essential Diagnostics.

The ‘DxBox’ And Other Upcoming Low-Cost Diagnostics

HealthWhile some of us have access to advanced technology that can diagnose serious illnesses, not everyone in the world is so lucky. A lot of advancements have been made in the past year with regard to low-cost diagnostics, including a revolutionary new device called the DxBox.

The DxBox is a wallet-sized card made of Mylar that is able to differentiate between six pathogens that are likely causes of fever in the developing world. This Mylar card contained dehydrated reagents are able to withstand warm temperatures for months. There is no electricity or refrigeration necessary. DxBox was developed by a team led by Paul Yager. Yager is a professor of bioengineering at the University of Washington. Funding for this endeavor was provided by the Gates Foundation’s Grand Challenges in Global Health Initiative.

This is just one of the many new products used to create portable, easy-to-use, and inexpensive diagnostics that can be used in low-resource settings all around the world. This device and many others are increasing access to healthcare in the developing world because they are simple enough to be used by almost anyone and robust enough to withstand use in the field.

There are a number of promising new tests for global health problems in the works. Scientists, biotech companies, public health professionals, and nonprofits are all working together to develop these solutions. Some represent scientific breakthroughs, while others utilize established technologies, like the home pregnancy test.

The DxBox processes results using microfluidics, which is the manipulation of liquids at very small scales. In order use the DxBox, clinicians only need a drop of the patient’s blood. The blood then travels via the device’s tiny channels to an area that contains dried antibodies. When infected blood binds to the appropriate antibody, the pattern of colored spots indicates the cause of the fever to clinicians. This can be tested within minutes.

Yager and his University of Washington colleague Patrick Stayton have also developed a reagent system that can be used in other types of diagnostic tests, such as paper-based lateral flow tests. Lateral flow tests, like the home pregnancy test, can often be limited in sensitivity but are very robust.

Stayton and Yager created systems in order to purify and enrich targets. The developed these systems out of samples such as blood and then captured them so that they could be directly placed on existing lateral flow tests. This led to increased sensitivity of lateral flow tests for malaria.

According to Yager, the team’s goal is to create diagnostics that are disposable, cheap, more sensitive than existing tests, and able to be stored at room temperature for as long as a year. The researchers are currently zeroing in on influenza and other respiratory viruses, in addition to urinary and blood-borne pathogens such as Dengue virus.

Yager says that the papers for the DxBox can be manufactured in bulk, making them inexpensive. Yager felt that there is a lot of incredible technology in the United States that we take for granted. He and Stayton are motivated to transport these technologies to people who do not have access to 21st-century medical technology and to make them affordable.