Lydia Coutré

Cleveland Clinic has unveiled its annual list of 10 medical innovations it expects will enhance healing and change health care next year, including alternative therapies for pain, expanded window to treat stroke patients and the use of artificial intelligence in health care.

Selected by a panel of doctors, researchers and scientists, the top 10 medical innovations of 2019 were announced at the end of the Clinic’s 16th annual 2018 Medical Innovation Summit, organized by the system’s commercialization arm, Cleveland Clinic Innovations.

“Health care is ever changing and we anticipate that innovations such as cancer immunotherapy and pharmacogenomics will significantly transform the medical field and improve care for patients at Cleveland Clinic and throughout the world,” said Dr. Michael Roizen — chief wellness officer at Cleveland Clinic, who led the panel that selected the technologies — in a prepared statement.

In order of anticipated importance, below are the top 10 medical innovations of 2019, according to a news release.

1. Alternative therapy for pain: Fighting the opioid crisis

Pharmacogenomic testing uses a patient’s genetic makeup to predict an individual’s metabolism of drugs, including some opiate-based drug. This testing can be used to “avoid adverse reactions and eliminate unnecessary and ineffective prescriptions, replacing them with more effective medications.” This could help address the opioid crisis, especially considering that chronic pain is the leading cause of opioid prescription. Pharmacogenomics can also be used to predict which patients may have little or no pain relief to some opiate-based analgesics and might otherwise finish their prescription quickly and return for a new one. With increased access to genetic testing, pharmacogenomics, which can provide the opportunity to tailor medication therapy, is “poised to make significant inroads into precision medicine and potentially an end to the crisis.”

2. The advent of AI in health care

Artificial intelligence is changing the game in health care with applications in decision support, image analysis and patient triage. AI can help physicians make smarter decisions in care, improve the ease and accuracy of reviewing patient scans and reduce physician burnout. As it is continually integrated into health care, AI potentially means that caring for patients has “become a matter of working smarter, not harder.”

3. Expanded window for acute stroke intervention

A timely response is critical in stroke intervention, which until now, has only been recommended within a limited window of time. But new guidelines released this past year suggest an expanded window for treatment, which is anticipated to lower the risk of disability and provide opportunity for recovery to more future stroke patients.

4. Advances in immunotherapy for cancer treatment

Cancer immunotherapy, or biologic therapy, uses the body’s own immune system to fight cancer. While these techniques have existed for some time, worldwide work toward a cancer cure continues to highlight new and novel immunotherapeutic targets. “With the near daily discovery of new immunotherapeutic targets and biomarkers,” the hope is that effective therapies will soon exist for all tumor profiles.

5. Patient-specific products achieved with 3D printing

With 3D printing technology, medical devices can now be matched to the exact specifications of a patient, making the devices more compatible with an individual’s natural anatomy. Patient-specific devices — such as external prosthetics, cranial/orthopedic implants, and customized airway stents for diseases narrowing the airway — have shown “greater acceptance by the body, increased comfort and improved performance outcomes.” 3D printing provides versatility that enables medical practitioners to provide patients with the most advanced care and minimize the risk of complication. It’s also been found to be helpful in surgical planning.

6. Virtual and mixed reality for medical education

Virtual and mixed reality systems have caught the eye of health care professionals looking to sharpen their skills. VR/MR programs also provide simulation training that can enhance traditional medical schooling. This immersive style of learning appeals to all types of learners: audio, visual and kinesthetic.

7. Visor for prehospital stroke diagnosis

Though less common than ischemic strokes, hemorrhagic strokes — in which blood escapes from a ruptured blood vessel in the brain — are responsible for nearly 40% of stroke deaths and require rapid diagnosis for effective treatment. Uncontrolled bleeding can lead to swelling of and damage to the brain. Health care professionals are using new technologies to speed diagnosis, such as the hemorrhage scanning visor that can detect bleeding in the brain.

8. Innovation in robotic surgery

Robots in the operating room provide surgeons with guidance for extreme precision, helping to keep most surgeries as short and as minimally invasive as science will allow. Benefits seen with minimally invasive robotized surgery include shortened recovery time and limited pain after surgery. “Continued advancement in the field has led to more precise and effective surgeries with improved surgical outcomes.”

9. Mitral and tricuspid valve percutaneous replacement and repair

Performed percutaneously — via a catheter through the skin — many cardiac procedures no longer require an open heart surgery approach, helping to make cardiac surgery today less invasive, more routine and more effective than in the past. Two such procedures include replacements and repair of both the mitral and tricuspid valves. “Hot on the trail of aortic valve percutaneous intervention, recent percutaneous mitral and tricuspid valve intervention has yielded significant positive outcomes while filling a void in the field of heart surgery.” While exploration of this technology is ongoing, promising post-op results show the innovation has significant implications for the future of cardiac care.

10. RNA-based therapies

RNA-based therapies — akin to DNA-based gene therapies — have shown immense potential. “Interfering with genetic data at the ribonucleic acid (RNA) level gives scientists the ability to intercept a patient’s genetic abnormality before it is translated into functioning (or nonfunctioning) proteins.” Some of today’s most popular and successful mechanisms of RNA therapy include antisense nucleotides and RNA interference, which are being explored in a variety of rare genetic diseases such as Huntington’s disease, as well as in cancer and neurologic diseases. The hope is for treatment by way of alternate genetic data.

From Crain’s Cleveland Business