ECRI Institutes 2018 Top 10 Hospital C-suite Watch List (Part 1)


Dr KK Aggarwal    28 January 2018

Mobile medical app to help treat substance use disorders


The first mobile medical application to help treat substance use disorders, which was approved by the US Food and Drug Administration (FDA) in September 2017 tops the list. The reSET App can be used as adjunct outpatient treatment of alcohol, cocaine, marijuana, and stimulant substance use disorders in patients who are not currently on opioid replacement therapy, who do not abuse alcohol solely, or whose primary substance of abuse is not opioids. It delivers cognitive behavioral therapy to patients to teach the user skills that help them to increase abstinence from substance abuse as well as compliance to treatment program.

This device is an example of upcoming field of ‘digital therapeutics’ i.e. use of digital technology to improve the health of a person, without the side effects of medications and without the added costs. It also helps the doctor to deliver more effective care to these patients.

Direct-to-consumer genetic testing


Direct-to-consumer genetic testing has made its way into the market and it is a growing trend. The test facilitates information about ‘genetic’ health risks i.e. helps people to know what disease-associated genes they might be carrying, without the involvement of a doctor. The test results are delivered directly to the patient (or the customer). Direct-to-consumer genetic testing is not yet available in India.

Direct-to-consumer tests mean more people have access to diagnostic tests and at a reduced cost.

The home pregnancy kit, blood glucose sticks are examples of direct-to-consumer test. Another example is the OraQuick In-Home HIV test, which is a rapid home-use HIV screening test kit that does not require sending a sample to a lab for analysis. The result is obtained in 20-40 minutes, and the test can be done in the privacy of home, while maintaining confidentiality of the result. The Govt. of India is also contemplating the option of introducing direct-to-consumer test HIV test in the country to improve identification of those infected with HIV.

Acuity-adaptable care delivery models

The acuity-adaptable care delivery model has recently become the focus of attention. In this, the patient remains in the same room during their hospitalization, right from admission to discharge, regardless of level of acuity (intensity of care required) and the required appropriate level of care is brought to them. This concept has been applied in pregnancy, where the woman stays in the same room for labor, delivery, recovery and postpartum care.

In the current standard of care, the patient is shifted/transferred for instance to the ICU/OT, depending on the acuity needs of that patient. There may be wait time or the bed may/may not be available. This concept is however not without its challenges in the form of staffing (cross-trained nurses), team work, infrastructure, work flow.

(To be contd)

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