1. Healthcare Technology Patient Care Sharon Roth-DeFulvio 4/20/2006

2. Agenda Technology Watch List Technology Watch List Technology #3: Heartsbreath Breathalyzers Technology #3: Heartsbreath Breathalyzers Technology #2: Dynamic 3D Echocardiography in Virtual Reality Technology #2: Dynamic 3D Echocardiography in Virtual Reality Technology #1: Nanocarriers to Fight Cancer Technology #1: Nanocarriers to Fight Cancer

3. Technology Watch List 1.Nanocarriers to Fight Cancer 2.Dynamic 3D echocardiography in virtual reality 3.Heartsbreath Breathalyzers 4.Enzyme-based computers 5.Spray-on Nanocomputers 6.A laser that sees through solid objects 7.Iris Identification 8.PACS (Picture Archival & Communication System) used with Diagnostic Radiology 9.Artemis 10.E-Prescribing 11.3-D Face Imaging 12.FIRAT (Force Sensing Integrated Readout and Active Tip) 13.Genetically engineered mice with glowing hearts 14.3D ads in the sky 15.Nanoarmors

4. Technology #3: Heartsbreath Breathalyzers A breath sensor, a billion times more sensitive than police breathalyzers, can already check for asthma, ulcers or trouble with a heart transplant, and if the chemical fingerprint of a disease is known, it can test for it. Crucial to the test is not the shallow breath from the upper part of our lungs but the breath derived from alveoli, the tiny chambers at the tips of the bronchial air passages, deep inside. Alveoli are lined with membranes loaded with tiny blood vessels. The chemicals in the blood easily cross this membrane so that the alveolar breath "mirrors the composition of the blood." A breath sensor, a billion times more sensitive than police breathalyzers, can already check for asthma, ulcers or trouble with a heart transplant, and if the chemical fingerprint of a disease is known, it can test for it. Crucial to the test is not the shallow breath from the upper part of our lungs but the breath derived from alveoli, the tiny chambers at the tips of the bronchial air passages, deep inside. Alveoli are lined with membranes loaded with tiny blood vessels. The chemicals in the blood easily cross this membrane so that the alveolar breath "mirrors the composition of the blood." Heartsbreath scanner (Credit: Menssana Research).

5. Technology#3 Heartsbreathalyzers Opportunity In the future, hand-held devices similar to a Palm Pilot may be routinely used for the early detection of breast, colon and other cancers, tuberculosis, diabetes and pre-eclampsia. In the future, hand-held devices similar to a Palm Pilot may be routinely used for the early detection of breast, colon and other cancers, tuberculosis, diabetes and pre-eclampsia. Home monitoring: hand-held breath monitors will on day be used at home to check our health and the evolution of our diseases. Home monitoring: hand-held breath monitors will on day be used at home to check our health and the evolution of our diseases. Increase testing for disease/health conditions Increase testing for disease/health conditions

6. Technology #3 Heartsbreathalyzer Benefits Early detection of diseases and conditions. Early detection of diseases and conditions. Reduction in costs of testing Reduction in costs of testing Innovative and less invasive test for diseases and health conditions. Innovative and less invasive test for diseases and health conditions. Reduction in the cost of traditional tests for diseases and health conditions Reduction in the cost of traditional tests for diseases and health conditions At home patient monitoring of progression of disease and present condition. At home patient monitoring of progression of disease and present condition.

7. Technology #2 Dynamic 3D echocardiography in virtual reality Doctors are using a virtual reality system to visualize the heart in three dimensions and detect if it is healthy or not. In a pilot study, ten doctors were able to move around virtual three-dimensional animated images or 'holograms' of the heart and to make correct diagnosis after a ten-minute training. Doctors are using a virtual reality system to visualize the heart in three dimensions and detect if it is healthy or not. In a pilot study, ten doctors were able to move around virtual three-dimensional animated images or 'holograms' of the heart and to make correct diagnosis after a ten-minute training.

8. An impression of a 6-walled I-space virtual reality system. The I-space installed at the Erasmus is a 4-walled system, without ceiling and sliding back wall. This figure shows a researcher in the I-Space, looking at the 3D hologram wearing a lightweight pair of glasses with polarizing lenses. Within the I-space the head and hand movements of the viewer is being tracking by four infrared cameras, allowing a natural interaction with the images that are displayed. A 3D hologram of a patient with an atrioventricular septal defect is seen from a ventricular view. The arrow points out the commissure between the superior (SBL) and inferior bridging leaflets (IBL) (RV = right ventricle). Images courtesy of Barco N.V.

9. Heart Disease Facts

10. Until now, the 3D echocardiographic reconstructions could only be seen on a 2D screen, but virtual reality makes it possible to 'dive' into the actual 3D anatomy of the heart. Until now, the 3D echocardiographic reconstructions could only be seen on a 2D screen, but virtual reality makes it possible to 'dive' into the actual 3D anatomy of the heart. Professionals, familiar with intracardiac anatomy, can learn how to handle the technique and cut through these holograms within 10 minutes. Professionals, familiar with intracardiac anatomy, can learn how to handle the technique and cut through these holograms within 10 minutes. Subsequently, they were all able to correctly diagnose the intracardiac anatomy or pathology of the mitral valve. Subsequently, they were all able to correctly diagnose the intracardiac anatomy or pathology of the mitral valve. At the moment, I-Space technology is only available in a few dedicated research centres throughout the world. Therefore, the combination of the 3D echocardiography and virtual reality is very uncommon and the applicability and usefulness in clinical practice is still limited. At the moment, I-Space technology is only available in a few dedicated research centres throughout the world. Therefore, the combination of the 3D echocardiography and virtual reality is very uncommon and the applicability and usefulness in clinical practice is still limited. Technology #2 Dynamic 3D echocardiography in virtual reality - Opportunities

11. Improve patient quality of care. Improve patient quality of care. Detection of abnormalities and heart disease in the earliest stages. Detection of abnormalities and heart disease in the earliest stages. Technology #2 Dynamic 3D echocardiography in virtual reality - Benefits

12. Technology #1 Nanocarriers to Fight Cancer

16. Anticancer drugs are now being administered to patients using methods that cause the indiscriminate killing of both diseased and healthy cells. Anticancer drugs are now being administered to patients using methods that cause the indiscriminate killing of both diseased and healthy cells. Such chemotherapy leads to side-effects, such as nausea, fatigue, and hair loss, and makes the patient weak and frail. Such chemotherapy leads to side-effects, such as nausea, fatigue, and hair loss, and makes the patient weak and frail. For these reasons, there is a crucial need for the development of more effective cancer therapy, which not only minimizes side-effects but also directly targets diseased cells. For these reasons, there is a crucial need for the development of more effective cancer therapy, which not only minimizes side-effects but also directly targets diseased cells. Technology #1 Nanocarriers to Fight Cancer

17. Researchers at the Institute of Bioengineering and Nanotechnology (IBN) in Singapore have designed 'smart' nanocarriers which deliver the drugs exactly where they are needed, reducing side effects and suppressing cancer growth. Their core-shell nanoparticles are both sensitive to temperature and to acidic levels. When these nanocarriers encounter acidic environments such as tumor tissues, they break apart and release the molecules they contain. Researchers at the Institute of Bioengineering and Nanotechnology (IBN) in Singapore have designed 'smart' nanocarriers which deliver the drugs exactly where they are needed, reducing side effects and suppressing cancer growth. Their core-shell nanoparticles are both sensitive to temperature and to acidic levels. When these nanocarriers encounter acidic environments such as tumor tissues, they break apart and release the molecules they contain.

18. Technology #1 - Opportunity Nanocarriers to Fight Cancer Intelligent drug delivery. Intelligent drug delivery. Opportunity for a more effective cancer therapy - Directly targets diseased cells. Opportunity for a more effective cancer therapy - Directly targets diseased cells. Minimizes side-effects of current radiation treatments. Minimizes side-effects of current radiation treatments. This technology may also be used in in-vitro and animal studies for drug discovery. This technology may also be used in in-vitro and animal studies for drug discovery.

19. Intelligent drug delivery Intelligent drug delivery Quality of life: patient and family Quality of life: patient and family Reduction in the risk to healthcare professionals. Reduction in the risk to healthcare professionals. The powerful drugs used in chemotherapy can themselves cause cancer and pose a risk to nurses, pharmacists and others who handle them. The powerful drugs used in chemotherapy can themselves cause cancer and pose a risk to nurses, pharmacists and others who handle them. Significant reduction in healthcare costs. Significant reduction in healthcare costs. Technology #1 - Benefits Nanocarriers to Fight Cancer

20. Sources American Cancer Society; American Cancer Society; American Heart Association; American Heart Association; Institute of Bioengineering and Nanotechnology; Institute of Bioengineering and Nanotechnology; Marsa, Linda, Special to The Los Angeles Times, November 19, 2005; Marsa, Linda, Special to The Los Angeles Times, November 19, 2005; http://blogs.zdnet.com/emergingtech/ http://blogs.zdnet.com/emergingtech/