Saturday, November 21, 2009

Looking for a lucrative, socially responsible healthcare opportunity? How about healthcare-associated-infections?

Last week I was invited to review a site by Kimberly-Clark on healthcare associated infections. As I started going through it, I was reminded of some news on the availability of federal funds for Healthcare Associated Infection remedies. I thought I would talk a little bit about both and let you know of the opportunity space ahead.


A few years ago, MRSA entered our vocabulary and Hospital Acquired Infections or, as I guess the kids now call them "Healthcare-Associated Infections" became famous. Why did they become famous?

It was found out that the developed nations were not much better off than developing nations when it came to HAI. The condition is defined as infections that you pick up as a consequence of being treated in a healthcare setting, that is, infections that you did not have when you first went in for treatment.

It is also a big deal because the current strains of HAI that infect people are much more resistant than they used to be. Some scary statistics portend that more people die from HAI in the US than from AIDS itself, on an annual basis.

Just what the heck is MRSA?

MRSA, at least in the medical field stands for Methicillin-resistant Staphylococcus aureus. Over the last few decades hospitals have been treating every possible disease condition with antibiotics. Methicillin is just one such antibiotic in the same family as penicillin and is very commonly used in the treatment of staphylococcal bacteria. Over years of treatment, the bacteria, which have the freedom to evolve much quicker than we can, have developed an amazing amount of resistance to antibiotics.

Antibiotic resistant bacteria represent a deadly threat to anyone who comes under attack by them. As I mentioned before, people do not really stand much of a chance in this battle, and even if they recover, it is a long and hard battle. MRSA is just one example out of what really exists out there. It is also just one example of the possibilities that exist for drug-resistant microorganisms to evolve in the future with much more vigor than they have already done.

The Broader Outlook

Healthcare Associated Infection or abbreviated HAI, by definition, goes broader than MRSA and other resistant strains. Any disease condition acquired in a healthcare setting is termed HAI. This is key. Why?

It is quite possible that any strain of any microorganism that you pick up in a healthcare setting can be quite harmful to you. It is also not a function of healthcare to cure you of one condition and leave you with another, possibly worse.

How do we fight HAI?

Alright, now that you are reasonably scared, you might wonder as to the methods you can adopt to fight HAI, not just on a temporary basis, but on a more permanent basis. Let us take a look.

1. Awareness - The first step, as with everything is learning about and acknowledging the problem exists. Doctors, Hospital Managers and people in the general healthcare know the problem exists. However, there is more to awareness than simply acknowledging that it exists.

This is where I believe the website I mentioned, and similar efforts come into frey.

It appears to be a website developed by Kimberly Clark, and while they themselves benefit from more awareness about HAI, I think it is a good move, and looks very much like well-fulfilled corporate social responsibility.

The impact information is all on the website - a predicted 100,000 deaths in the US, much worse across the world, and an annual impact of $6.7bn to the economy.

How exactly can awareness be spread? HAIwatchnews is part of a larger website:

Haiwatch contains a lot of information, resources for clinical information and so on, that will not only be useful for people that work in healthcare, but also to you, the medical device designer.

2. Prevention

I am tempted to call this section "Opportunities" because you can take a look at the causes and think of them as opportunities. The three major HAI sources seem to be:

2.1.1 Ventilator Associated Pneumonia
2.1.2 Surgical Site Infections
2.1.3 Cross Contamination

Surgical Site Infections and Cross Contamination are rather easy to understand and obvious. Ventilator Associated Pneumonia happens in patients who have been intubated and have a tube flushing oxygen through to their lungs. Unfortunately, this opens up a can of microorganisms, so to speak, since this simply provides them direct access to the lungs, and consequently causes pneumonia.

So, the prevention part comes in two different ways:

2.2.1 Good medical/clinical practices, and
2.2.2 Medical Device and Bioengineered solutions

3. The Opportunity Landscape

Obviously, there are a few opportunities available in the landscape here:

How about, say better ventilation systems? A very good microfiber that rests in the tube as a one-way filter, filtering out particulate matter, bacteria and anything else that they can capture.

How about specific types of coating and sealing that make it impossible for bacteria to reside on hospital surfaces? This appears to be a tried and tired idea. Obviously, it's not working, so there are some big gaps somewhere, right?

There are several other brainstorms that I can think of (and you can pay me for.. :) ), but the general landscape is wide and is something more interesting to get into, rather than yet another half-baked, ineffective piece of drug-coated plumbing, balloon or cement that has you faking and contorting clinical trial results, lying to the FDA and other wonders that "major players" are constantly getting into....

4. Federal Funding

You didn't think I was going to wind you up and send you off empty handed, did you? Not at all!

The funding, about $40 million, is of course not directly available for the design of the next solution, but it is available for states to create awareness, improve processes etc. So, if you did develop a quick and "definitely not" dirty solution to the HAI problem, you could find it easy to convince healthcare service providers to apply for the funds that may in turn see your device or solution getting used...

And then again, there's the NIH, and of course the venture capitalists...

Thursday, November 12, 2009

Reblogging: Generic Pharma, European Union and a stunted India..

A few months ago, in June 2009 to be precise, I blogged lamenting how India was being really slow in responding to overt illegal acts such as the one where the Dutch seized an Indian shipment of blood pressure meds under false pretenses:

In that post, one of the things I had suggested India do is flex her muscles rather strongly in responding to such nonsense coming in from "Developed" nations.

Amicable Solutions

Consequentially, we have now heard, a whimper from the Indian Trade Minister (I would say ostensibly, it should have been India's Home Minister or Defense Minister and not some Trade Minister).

He says that India and Europe will solve this problem "amicably". Amicably, my bleeding right foot. There is now a lawsuit, which both India and Brazil have launched. This lawsuit has brought Europe's sudden amiability, not our trade minister.

I am glad, at a minimum to see this issue move forward, as slow as it is moving forward. However, the action or the current attitude of the Indian Government does not behoove well for permanent change.

Permanent Change

The European Union is more like a bad version of the labor union. They have realized that innovation, production, productivity and such are now nearly impossible. Hence they harass US companies on one end and developing nations on the other.

Tolerating this behavior and looking for bizzarely unrealistic amicable solutions is not the right idea.

The seizure of Indian drugs at the Dutch shore wasn't a mistake.

It's almost been a year and there hasn't been a resolution, an apology or even an indication of remorse from the Dutch side.

Moral of the Story

The moral of the story is two-fold:

1. If you are a country looking to bully India, you don't have to try hard.

2. If you are looking at Europe's business plan, this is it.