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Artificial intelligence helps stroke patients walk again

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Photo courtesy Mignardot Et Al, Science Translational Medicine
Photo courtesy Mignardot Et Al, Science Translational Medicine
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Researchers have developed an algorithm designed with a robot-assistive rehabilitation approach, to help people learn to walk again after neurological injuries such as stroke.

The new method to assist patients who have suffered severe neurological injuries is going through the clinical trial stage. The research comes from the Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland.

The regathers behind the development are hopeful it will lead to better outcomes for patients undergoing rehabilitation following incidences like a stroke or a spinal cord injury or strokes.

With strokes, for example, many people experience weakness or stiffness in some of their muscles after a stroke. This happens because the brain sends signals to the muscles, through the nerves, to make them move. A stroke can damage the brain and affect these signals.

Recovery plans for spinal cord injuries and strokes typically require usually many hours of supported walking, using devices like treadmills, with the walking aid pre-programmed by a medic to provide a steady pace. This one-size-fit-all approach does not account for each patient moving around in different directions and having different gaits, both varying according to the individual.

With a new approach, a team led by Dr. Jean-Baptiste Mignardot have used digital technology to operate a robotic harness to help resist the downward force of gravity while also permitting patients to walk forwards, backwards, and side-to-side. This robotic harness is aided by an algorithm which can give personalized support to address patient-specific motor defects. In other words, recognizing that each patient is different.

The system is controlled by an artificial neural network that is capable of assessing by how much the upward and forward force needs to be varied, and to use this information to program the cable harness.

The machine is able to assess 120 different variables relating to body movement and to apply the optimum requirements for the individual patient. This device has been tested, so far, on 26 patients (either recovering from spinal cord injuries or strokes).

The participants were tested on four tasks—standing on two separate plates, walking on a straight path, walking on a wavy path, or walking on a ladder with irregularly positioned rungs. Each patient who took part in the first trial was able to walk with motor abilities comparable to healthy individuals.

The outcomes of the trial are shown in the following video:

It is hoped this practical framework, following further assessment, will be commercialized for use in the healthcare sector. The new development has been described in the journal Science Translational Medicine, with the research paper headed “A multidirectional gravity-assist algorithm that enhances locomotor control in patients with stroke or spinal cord injury.”

 

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How will decisions made by healthcare organizations now impact the future?

Digital healthcare care is a “new normal.” What’s needed to keep it going? According to an HBR roundtable, stronger support infrastructure and increased investment in digital health.

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With the world in the early stages of COVID-19 vaccine deployment, it’s important to look even further ahead — specifically, how we can keep the momentum going on the digital transformation of healthcare. 

A recent roundtable discussion of CIOs from leading health systems, hosted by Harvard Business Review, concluded there are three main areas of focus for this new digital health frontier: Virtual care, setting, and the patient experience.

“Care providers must understand the ramifications for their digital health function and agenda — and how information technology can address the challenges and opportunities of their ‘new normal,’” wrote a team of experts for HBR, including: John Glaser (executive in residence, Harvard Medical School), J. Marc Overhage, MD (Chief Medical Information Officer, Anthem, Inc.), Janet Guptill (CEO, Scottsdale Institute), Chuck Appleby (Director of Publications & Communications, Scottsdale Institute), and Donald Trigg (President, Cerner).

The first focus — virtual care — comes into play simply because of the numbers, and how quickly solutions had to be implemented. The panel of experts cites one McKinsey study that shows physicians and healthcare professionals are seeing 50 to 175 times more patients by telehealth. As a result, they explain, “health systems must construct a sturdy, permanent bridge that includes organizational, financial, and clinical structures and processes.”

The second focus is on setting, more specifically on patient care being delivered in the most appropriate setting. One example they give is the increasing discussion around chronic care management from the patient’s home, via telehealth or virtual doctor visits.

The final focus relates to patient experience, and how to make digital health align with the quality and efficiency they’ve come to know from other services like Amazon or Uber. According to the roundtable, it comes down to ease-of-use. 

“To meet these expectations, health systems will need to double down on their ‘digital front door’ efforts,” they explain, “enabling patients to handle routine interactions such as scheduling an appointment, paying a bill, finding a doctor, renewing a medication, finding answers to health questions, and navigating the health system itself.”

The opportunity is there to create an even better ‘new normal’ than previous healthcare systems, the roundtable concluded. 

“Covid-19 has forced health care leaders and clinicians to move faster, work smarter, and take a more focused approach to decision-making than ever before.”

Want to read the whole analysis? Head to HBR.

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“Digitization is not a panacea for everything”

Biocon founder Kiran Mazumdar-Shaw on the COVID-19 response, and why Asian companies need to understand, not just embrace digital innovation.

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As founder and chair of global biopharmaceuticals company Biocon, Kiran Mazumdar-Shaw is on a mission to make healthcare affordable to all.

Under her leadership, Biocon’s mission is to “reduce disparities in access to safe, high-quality medicines, as well as address the gaps in scientific research to find solutions to impact a billion lives.”

Recently, Mazumdar-Shaw sat down for a video conference interview with McKinsey’s Sathya Prathipati and Joydeep Sengupta, senior partners out of the company’s Mumbai and Singapore offices (respectively). 

Here are some key quotes from their interview, where they discussed digital transformation in the COVID-19 response, and digitization:

The difference between Western and Asian organizations:

“While Western companies focus on value capture, Asian companies have tended to be really focused on scale, size, and market share… We have not really focused on innovation to capture value, whereas the Western model is to capture a big piece of the value share with innovation and IP [intellectual property] and to outsource whatever you need in terms of vertical integration.”

How digital transformation accelerated because of COVID-19:

“COVID-19 is a true inflection point. In India, e-pharmacies are becoming a reality, and we see a lot of opportunities to use technology in daily life. We need to leverage and build on that. There was so much resistance to e-pharmacies, but this is a new opportunity. Biocon… started digitizing everything six or seven months before COVID and were able to finish before the pandemic. It’s given us a lot of benefits and showed the huge transformative potential of digital technologies.”

Approaches to digitization:

“Digitization is not a panacea for everything… Yes, the digital world has the potential to accelerate transformation, but you need to understand exactly what digital can do to get the benefits. In our business, data analytics can help us make decisions with lower risks. We just hired a CIO whose whole mandate is to look at our digital infrastructure and see how we can future-proof ourselves. We are thinking about this very carefully, not just a cut-and-paste. That’s why I would rather bring in people from the digital world—from the tech industry—instead of the pharmaceutical industry. We want them to transform old mindsets.”

Read the full interview transcript here.

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After this year, what will healthcare look like in 2021 (and beyond)?

Experts share their opinions on what digital health will look like after a transformation-heavy 2020.

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It’s flat-out impossible to discuss healthcare right now without addressing its digitization, telehealth, and the many ways the sector has leveraged technology to improve everything from systems and workflow to patient outcomes — all in the face of COVID-19.

“There’s no going back on telehealth,” writes Ashwini M. Zenooz, MD — Chief Medical Officer and General Manager for Healthcare and Life Sciences at Salesforce — in Harvard Business Review

Dr. Zenooz does provide a warning, however. She explains that we have to make sure “providers are not only on-board with digital transformation but also see their experience of care enhanced in the process.” She outlines three considerations and requirements:

  • Telehealth adoption “will be more likely to succeed if it is “pulled” into organizations and workflows by providers rather than “pushed” on them by leadership.”
  • Human-centered design is key. Tools like AI, machine learning, and voice technologies will be doing the heavy lifting with respect to the “documentation burden.”
  • “Care coordination, enabled by seamless data sharing, is therefore as important to the provider experience as it is to care quality and outcomes.”

What innovators are saying

And the momentum is there for continued transformation into next year, according to Becker’s Hospital Review. The publication interviewed nine healthcare innovation leaders to get their 2021 predictions.

What are they saying?

Both Jeff Semenchuk (chief innovation officer for Blue Shield of California) and Muthu Krishnan, PhD (chief digital transformation officer of IKS Health) said that digital health solutions will help doctors and patients manage disease-specific care for things like chronic conditions or pregnancy. 

Mohan Nair (senior VP and chief innovation officer of Cambia Health Solutions) raises one critical area of care that we’ve mentioned before: mental health.

“The COVID-19 pandemic and mental health crisis will collide and demand attention. This will enable and force us to face our isolation but recognize our interconnected humanity, our compassion, and our empathy for others. Digital technologies, like telehealth, digital therapeutics and artificial intelligence/machine learning, are all candidates to catalyze a new world with a common cause.”

Nicole Cable, chief experience officer of InnovaCare Health predicts that both millennials and seniors will keep embracing telehealth. Cable emphasizes, however, that tech companies will need to create tools that can help address the care of chronic and complex conditions of aging populations. 

To read more expert predictions, visit Becker’s Hospital Review

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