Emerging Technologies in Healthcare

+
NMIMS
Dr. Anti M . Pethe

Sthool of Pharmacy & Technology Management, 5VKM'S iMIMS, Hyderabad Campus

< This presentation is based on publicly available information.

• The views presented are the views of the presenter, not necessarily
to author's employer, organization.

• These slides are intended for educational purposes only and for the
personal use of the audience.

The content of this slide deck is accurate to the best of

the presenter‘s knowledge at the time of production.
 G en eratio ns & Fu ture Computers

Generations and Future Computers

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Top 10 new medical technologies of 2019
10. Smart Inhal£•rS
9. Robotic Surgery
8. Wireless Brain Sensors
7. 3-D Printing
6. Artificial Organs
5. Health Wearable's
4. Precision MRdicinR
3. Virtual Reality
2. Tele-health
1. Clustered RE'gularly InterspaCRd
Short Palindromic Repeats (CRISPRj

Refers me: www.precTinicaLcom

• Inhalers are the main treatment option for asthma and if taken
correctly, will be effective for 90% of patients. However
Tn reality, researrb shows that only about 50' of patients
have their condltlon under control and as many as 94'I6 don"t
use inhalers properly
• To help asthma sufferers to better manage theiF condisen. Bluetooth-
enabled smart inhalers have been developed.
• A small device is attached to the inhaler which records the date and
time of each dose and whether It was correctly administered.
• This data is then sent to the patiems’ smartphones so they can
I‹eep track of and control their condition. Clinical trials showed
that usTng the smart inhaler device used less believer
medicine and had more relieved- free days.
• Téva has Introduced ProAlr Olglh¥fer {olbutezo¥ sulphate) In US
market & approved by USFDA In Jan Z019.
• The companies whkh are worklng on Smart inhaler Technok›gy are
3M, AdherJum. Cohero f4eakh, Propeller Health, and Teva
 Robotic surgery
• Robotic surgery is vsed in minlmally invasive procedures
and helps to aid In precision, control and flexiblllty.
• During robotic surgery, surgeons can perform very
complex procedures that are otherwise either highly
dlfflcult or Imposslble.
• As the technology improves, It cen be comblned
with augmented reality to allow surgeons to vlew
important additional information about the patient in real
time while still operating.
• While the invention raises concerns 1at it will eventually
replace human surgeons, it is likely to be used only to assist snd
enhance surgeons' work In the future.
• The flm robotic radical prostatectomy \n lndla wes
performed
tn A)\M5 In July 2006
 Gujarat Doctor Makes History, Performs World's 1st
Robotic Heart Surgery 30 Lm Away from Pati ent

• Dr Patel, who is the chief interventional cardiologist at Ahmedabad-based Apex Heart

Institute, guided the robot to perform the surgery on the patient from the Akshard ham
Temple in Gandhinagar, around 30 kilometres away. t5\ li Dece n be r 20 16}
 Wireless brain sensors
• Thanks to plastics, medical advances have allowed scientists and
doctors to team up and create bioresorbable electronics
that can be placed in the brain and dissolve when they
are no longer needed, according to elastIr‹today cnm
• This medical device will aid doctors in measuring the
temperature and pressure within the brain.
• Since the sensors are able to dissolve, lhey reduce the need for
additional surgeries.
• A team of materials science engineers from the Universil:y
of Illinois and neurosurgeons from the Washington
University School of Medicine have developed a type of
wireless brain sensor that can monitor intracranial pressure
and temperature, then dissolve and be absorbed by the body.
• The sensors consist of poIyIactic-co-gIyco1ic acid (PLGA)
and silicone, and are capable of transm1tt!ng accurate pressure
and temperature readings, as well as other Information.
 3-D printing
• 3-D printers have quickly become one of the hottest te¢hnolegies on the
mBrkef, These printers ean be used to create implants and even Joints to be
used during surgery.
• 3-D-printed prosthetics are increasingly popular as they are
entirety bespoke, the digital functi-onalhies enabling them to match an
individual‘s measuremems éown to the mfllTmetfe.
• The use of printer can create both long lasting and soluble Items.
for example, 3-D printing can be used to 'prlnf' pllb that contain
multiple drugs, which will help patients with the organisatien, timing
and monitorir\g of muItfp)e medications. This is a true example of
technology and medicine working together.
• The first 3D-printed drug to m¢eive approval from the U.S. food
and Drug Administration (7DA) is now being shipped to pfiarmaciw
Pennsylvania-based Aprecle Phsrmacesdcab 3D-printed 5pr¥wn
( ) taJzlets are used to treac epilepsy.
 Artificial organs
• To take 3D printing up another notch, bio-printing is
also an emerging medical technotogy.
• While it was Tnftially ground-breaking to be able
to regenerate skin cells for skin draughts for
burn victims, this has slowly given way to even
more exciting possibilities.
• Scientist have been able to create blood
vessels, synthetic ovaries and even a pancreas.
• Thèse artificial organs then grow within
the patient's body to replaœ original faulty one.
Tha abîlity to supply artificial organs that are
not rejected by the body‘s \mmune system could
be revolutlonary, saving millions of patients
that depend on life-saving transplants every year.
 Health wea ra bles
• The demand for wearable devices has grown since their introduction (n
the nnrt few years, since the release of bluetootfi In 2000.
• People today use their phone to trcck everything from thefr steps,
physical Rtness and heartbeat, I:a their sleeping patterns
• The advanceruenr of these wearable technologies is In conjunctlon with
ridng chronic diseases like diabetes and cerdiovasoiler dbeese, and atm to
combat these by help}rIg patlents to monitor and Improve their fitness.

Mt h l n days of fts release, customers were raving about the life saving
technology, which Is eble th detect potentially den$erous heart condidons
much earlier than usual.
• The wecrcbk devices marI‹a¢ is forecast to reach $67 billion by 2024+
 Insulin Delivery 8ystem
Fbł the Treetmæ›tofTyge Dlebe-
›‹,+,u-›,ø tee Wu‹sbk systems a›mai/mæ
 Precision medicine
• As medical technology advances it is becoming more and more personalised to
individual patients. Precision medicine, for example, allows physicians to select
medicines and therapies to treat diseases, such as cancer, based on an in url‘s
genetic make-up.
• Virtual reallty has been around for some
time. However, recently, v¥lth medical and
technological advances, medical students have been
able to get close to real life expRrlence using
technology.
• Sophisticated tools help them Main the experlence
they need by rehearsing procedures and provlding a
visual vnderstandlng of how the hurncn
anatomy 1s connected.
• The V9 devices will alse serve as a great aid for
patients, helping with diagnosis, treatment plans and
to help prepare them for procedures they are facing.
• It has also proved very useful In patient rehabllltatlon
and recovery.
• In a technolo8lcally driven wor1d, it‘s thought that as many
as 60% of customers prefer digitally-led services.
• Tele-health describes a quickly developing technology that
allows patients to receive medical care through their
digital devices, Instead of waiting for face-to-face
appointments with their doctor.
• Highly-personalised mobile apps are being developed which
allow patients to speak virtually with physicians and
other medical professionals to receive instant
diagnosis and mi•dical advice.
• It is particularly useful for patients managing chronic
conditions as ft provides them with consistent,
convenlent and cost“effective care.
• The global te1emerlfcine market is expected to be worth
$113.1 billion by 202S.
• Telemedicine is a fast-emerging sector in India.
• As of FY 2016, it was valued at $15 million and is expected to
rise at a CAGR)of 20K during FY 2016-20, reaching up to $32
million by 2020.
• The role of telemedicine had largely been iimited to use in
under-served areas, the COV1D-19 crisis has changed this and
brought telemedicine to the mainstream.
peo medical consultation,
telemedicine has become the first line of choice at this
moment as people are asLed to stay home and hospitals
suspend non- emergency Out Patient Departments (OPDs).
 Regularly Interspdced ShorŁ Palind omic Repeats (CRISPR)

• Clustered Regularly lnterspaced Short Palindromic Repeau (CRISPIt) is the most

advanced
gene-editing technolopy yet.
• h works oy hamessing the natural mechanisms of the immune systems of
bacterium cells of inveding v‹ruses, which is they abte to ’cut out‘ infected DNA
strends. This cutting of DNA is what has the power fo potemially transform tł›e
way we treat disease. By rnodifying genes. so‹ne of the biggest th‹eats to our heahh,
like cancer and H)V, could potentially be overcome in a matter of years.
• However, as with all powerfut toots there are several controversies surrounding its
w\despread use, mostly over humąnity's right to 'play God’ and worries over gene-ed\ting
bejng used to produce hordes of designer babies.
• CRISPR is still a first-generatlon tool and its full capabilities are not yet understood.
DNA e d i ti n g

HOWTHET E C HNIQ UE WORKS

Technology
trends i”n
Healthcare that
will shape the
industry in 2020
and beyond?????
1. Tele health
2. The Internet of Medical Things (IoMT)
Health Wearable's
3. The Cloud
4. Block chain
5. Artificial Intelligence
6. Virtual Reality
7. Oata Analytics
 Cloud Computing in Healthcare
• Cloud computing is the on-demand availability of computer system
resources, especially data storage and computing power, without direct active
management by the user. The term is generally used to describe data centers
available to many users over the Internet.
• Here are the ways cloud consulting is impacting healthcare.
1. Lowering of Costs
° Hospitals and healthcare providers are freed from the need not to purchase the
hardware and servers. There are no up-front charges associated with clDud
storage of data. They have to only pay for the resources actually use which
results in massive cost savings.
2. Ease Of Interoperability
• Having the patient‘s data In the cloud also promotes interoperability among
the various segments of the healthcare industry- pharmaceuticals, insurance,
and payments. This allows for a seamless transfer of data between the
different stakeholders thus accelerating healthcare delivery and introducing
efficiency in the process.
• A block chain carries no transaction cost. The block chain is a simple
yet ingenious way of passing information from A to B in a fully
automated and safe manner.
• One party to a transaction initiates the process by creating a block.
This block is verified by thousands, perhaps millions of computers
distributed around the nRt.
• The verified block is added to a chain, which is stored across the
net, creating not just a unique record, but a unique record with a
unique history.
• falsifying a single record would mean falsifying the entire chain in
millions of instances. That is virtually impossible.
• Bitcoin uses this model for monetary transactions, but it can be deployed
in many other ways.
chain Technology
 Technology

• Blockchain is used to protect patient data and improve the overall

healthcare experience.
• The technology is already being used to do everything from
securely encrypt patient data to manage the outbreak of harmful
diseases and at least one country is big on the potential of blockchain
healthcare: Estonia.
• Estonia began using blockchain technology in 2012 to secure
healthcare data and process transactions.
• Now all of the country's healthcare billing is handled on a blockchain, 95%
of health information is ledger-based and 99K of all
prescription information is digital
• Data Is everywhere.
• The amount of digital deta that exists is growing at a rapid rate, doubling every
two years, and changing the way we live.
• An artMe by Forbes states that data is growing faster than ever before.
B›r4›e 0d0, at›o‹zt L7 e g ›ytes ef seer › xw›stton wB
be ceeaaed seaondis being as the which makes It
extremely important to know the basics of the field at least.
• After all, here is where our future lies.
• Data Sclance Is the combination of szatbticz,m aaat a, prz›btem-

• In simple terms, It 1s the umbrella of techniques used when trying to

extract
insight and Information from data.
 Data Analytics
Bi D t
° A buzzword that is used to describe immense volumes of data, both
unstructured and structured, Big Data inundates a business on a day-to-
day basis. Big Data is something that can be used to analyze insights that
can lead to better decisions and strategic business moves.
Data Analytics
• The science of examining raw data to cDnclude that information.
• Data Analytics involves applying an algorithmic or mechanical process to
derive insights and, fDr example, running through several data sets to
look for meaningful correlations between each Dther.
 Data Analytics in Healthcare
° Healthcare analytics is the collection and analysis of data in the healthcare
industry in order to gain insights and support decision-making.
° From key areas like medical costs, clinical data, patient behavior, and
pharmaceuticals, healthcare analytics can be used on both macro and
micro levels to effectively streamline operations, improve patient care, and
lower overall costs.
• Healthcare data is the most cDmplex of any industry. From electronic
health records (EHR) to monitoring real-time vital signs, data not only comes
from several sources but has to comply with government regulations.
° It's a difficult and de1icate process and requires a level of security and
connectivity only an embedded analytics solution can provide.
• Considering current situation, ' '
Analytics Insight predicts
the „ the number "„ .•
of
• cases in India to rise to 13,420 with ' . • "
412 deaths by 1*! May 2020. - - • '
• “We modeled the COVID-19 ” •
coronavirus cases in India based on ’ ” '*
current case data to predict the . •
cumulative number of reported cases '. ”,
to final size. '• ••
• The key features of our model are .
,' • • '•
¢urrRnt cases, new cases
implementation of per day, thepublic
major "'"" , ',
policies. the identification and ' _, •
iSDlation Of unreported cases. » •
preparedness of the country and the * ,
recovery rate," . •
•
• The primary aim of health related
AI applications !s to analyse
relationships b£'tween prevention or
treatment techniques and patient
outcomes.
• AI programs have been
developed and applied to
practices such as diagnosis, drug
develDpment, personalized
medicine and patient monitoring.
• IBM and Google have developed
AI algorithms for healthcare.
Nano Robots: Medicine of the Future
 Robotics?
Robotics is the branch of technology
that deals with the design, construction,
operation, structural disposition,
manufacture and application of robots.

Robotics is related to the sciences of,

engineering, electronics, mechanics and
software
 What are Nano Robots?

Nanorobots are tiny machines used to cure diseases in human or in any

organism.

Performs task at nanoscale dimensions.

The size of nanorobots is 10-9 m.

The prefix ’nano’ means billionth.

 Components of Nano Robots
The various components in nanorobot include power supply, fuel tank, sensors, motors,
manipulators, onboard computers, pumps, pressure tanks and structural support. The
structures include:

• Payload: The void section hold a small dose of drug or medicine. The nanorobots
could transverse in the blood and release the drug to the site of infection or
injury.
• Micro camera: The nanorobot may include a miniature camera. The operator can
steer the nanorobot when navigating through the body manually.
 Components of Nano Robots
• Electrodes: The electrodes mounted on the nanorobot could form the
battery using thR RlRctrolytes in the blood. These protruding electrodes
could also kill the cancer cells by generating an electric current and
heating the cell up to death.
• Lasers: ThesR lasers coUld burn the harmful material like arterial
plaque, blood clots or cancer cells.
• Ultra sonic signal generators: ThE'se gE'nerators art used when thR
nanorobots are used to target and destroy kidnE'y stones.

• Swimming tail: The Nano robot will requiFE' a means of propulsion

to get into the body as they travel against thR flow of blood in the
body.
 Size & Shapes of Nano Robots
• Nanobots
Nanoids
Nanites
Nanomachines
Nanomites
Nano spiders
 Advantages of Nano Robots
• Rapid elimination of disease.

< Nanorobot might function at the atomic and molecular level to build
devices, machines or ciFCUitS known as molecular manufacturing.

Nanorobots might also produce copies of themselves to replace worn- out

units, a process called self replication.

< The major advantage of nanorobots is thought to be their Jurabilitv, in

theoy, they can remain operational for years, decades or centuries.
 Disadvantages of Nano Robots
The nanorobot should be very accurate otherwise
harmful events may occur.
cThe initial design cost is ver high.
The design of robot is very complicated
Hard to design.
Regulatory Issues
 Nano Robots Medical Applications
• Nanorobotics in drug delivery
Nanorobotics in Surgery
Diagnosis and Testing
Nanorobotics in Gene
Therapy
• Nanorobots in Cancer
Detection & treatment
Nanorobots in diabetes
Parasite removal
Breaking up of kidney stones
• Arteriosclerosis
 Nano Robots in 0rug Delivery
• Nanorobot can be useful tool in drug delivery applications.

• tAhud, by researchers at the Interdisciplinary Centre, in Herzliya, and Bar llan

University, in Ramat Gan, Israel, solved those probJems by building a nanorobot that
could be switched on and off to release drugs within the body when needed.
• The team built the nanorobot out of DNA folded in such a way that drugs could be
tethered inside. The nanorobot also has a gate, controlled by exposure to
electromagnetic energy, that opens and closes to release the drug into the
surrounding environment — ir› this case, the body of a west indiar› eaf cockroach.
 Nano Robots in Surgery

fi Surgical nanorobots are introduced into the

human body through vascular systems and other
cavities.

? Surgical nanorobot performs various functions like

searching for pathogens, and then diagnosis.
 Nano Robots in Heart Surgery
• Blood vessels play an important role in supplying
blood to all parts of our body.

4 Due to the fatty deposition on the walls

of blood vessels blood wiI1 nat move freely to all
parts.

+ These leads to heart attacks and damage the vital

organs.
 Nano Robots in Diagnosis and Testing
• Medical nanorobots are used for the purpose of diagnosis,
testing and monitoring of microorganisms, tissues and cells in
the blood stream.
 Nano Robots in Gene Replacement
Nanorobots are also applicable in treating genetic
diseases, by relating the molecular structures of DNA and
proteins in the cell.
 Nano Robots in Cancer Treatment
• Nanorobots with embedded chemical biosensors are used for detecting the
tumor cells in early stages of cancer development inside a patient's body.
A doctor offers the patient an iniection of a nanorobot.
? Seeks out cancer cells and destroy them.
Dispells the disease at the source, leaving the healthy cells untouched.
The patients has no awareness of devices working inside them.
 Nano Robots in Diabetes Monitoring
• Nowadays patients with diabetes must take small blood samples many
times a day to control their glucose levels. Such prDcedures
are uncomfortable and extremely inconvenient.
• To solve this problem, Adriano Cavalcanti and his colleagues published for
the first time the detailed work describing a medical nano robot
hardware architecture for bloDd sugar level monitoring.
• The nanorobots may use embedded nanobiosensors to monitor blood
glucose levels, and transmit every two hours this information through
RF signals for mobile phones carried with the patient.
• If the glucose is eventually not inside the desired
levels, the nanorobots activate a pre-programmed tune in the cellular
phDne, which may alert the patient to take any necessary action
regarding the diabetes control with prescribed medicaments
 Nano Robots in Infection
• Nanorobots would function similarly to the white blood cells in our
bodies, but they are designed to be much faster at destroying
bacteria.
• This type of nanorobots should be able to eliminate bacterial
infections in a patient within minutes, as opposed to the weeks
required for antibiotics to take effect.
• Microbivore nanorobots are designed so that antibodies attach to the
particular bacteria the robot is seeking.
• After bacteria attaches to an antibody, an arm grabs the bacteria and
moves it to the inside of the nanorobot, where it’s destroyed. Bacteria is
then discharged into the bloodstream as harmless fragments.
 Nano Robots in Itidney Stones

? Nanorobots might carry small ultrasonic signal

generators to deliver frequencies directly to kidney
stones
 Nano Robots i Arteriosclerosts
4 Nanorobots may treat conditions like arteriosclerosis by
physically chipping away the plaque along artery walls
 Conclusion
° Although the nano robot production is still at a nascent stage, scientists are
working hard to develop these tiny systems and hopefully come up with
functional autonomous nano robots sometime in the next two decades.

• Nano robots, A1, Data Science, Block chain, 3D Printing, Robotic surgery,
VR are going to revolutionize the healthcare industry in future.

• Technology may rule us !

 Key References

Progress in Nanomedicine and : .

Medica I NanorobotiC9
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