(upbeat music) - Coming up in the next hour of local news on Arizona PBS on Arizona Horizon, a special medical edition, as we look at a wide range of new medical technology and research.

That's next on Arizona Horizon.

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(soft music) - Good evening, and welcome to this special medical edition of Arizona Horizon.

I'm Ted Simons.

We start with a medical advancement.

It sounds straight out of science fiction.

University of Arizona researchers are working on a new type of wearable data gathering device that can track various body conditions 24/7.

The devices will be custom-made using 3D printers.

We learn more from Philipp Gutruf who helped develop these new monitors at the U of A's College of Engineering.

Philipp, welcome to Arizona Horizon.

Good to have you here.

I'm very interested in this 'cause it sounds absolutely fascinating here.

Wearable devices that what?

Monitor medical data?

Talk to us more about this.

- Yeah, I'm very glad to be here.

Thank you for having me.

So the devices that we made in my lab, they look like this, I actually have one on.

So the cool thing about these devices is that we can tailor them to you.

We can take a 3D scan and make the device unique to the person that's wearing them.

And the other really outstanding aspect is that we can power the devices remotely.

So we have devices called Powercast, they look like this.

You set them up somewhere in the vicinity of where you work or where you sleep, and they keep the devices topped up 24/7, and that allows us to extract a really high fidelity biosignals from the wearer in a quality that you would usually only see at the clinic.

And so, this allows us to diagnose diseases.

We're currently working on, for example, at-home frailty detection while you go about your business.

You don't have to worry about it at all.

- Interesting.

So what kind of data is recorded?

Let's say you're looking at frailty, what kind of data?

And, show us that patch again because it looks like it's, I mean, it just wraps around your body, right?

- It does, yeah.

It's almost imperceptible.

So if I roll my sleeve up, you wouldn't know that I'm wearing one and that's really the unique aspect of it.

And we can do that because it's tailored to my arm.

In this particular case, we took a 3D scan of my arm and 3D printed the device itself.

So in terms of modality also the sensors that are embedded in the system, we can do a variety of things.

For this particular device, for example, we have accelerometer 6-axis IMU is just the technical term that allow us to look at how my arm moves and how my legs move, and that allows us to then detect frailty.

We have very high accuracy temperature sensors, for example, embedded.

And because the device itself has very little mass to it, it's very thin, it's basically like a piece of fabric, we can track, for example, your skin temperature with very high accuracy.

So if you, breaking a sweat walking up the stairs, we can tell by just looking at the particular data.

So this platform allows us to integrate sensors that you would not otherwise be able to embed in your average smart watch.

- And so, I was going to say, it sounds like it's a smartwatch on steroids here.

- Pretty much, yeah.

So we have this very close integration with the skin, and there's very minimal form factor because we use so little material, and that allows us to really amp up the sensitivity of the sensors that we include and put new ones in.

So for example, in a recent paper, we demonstrated that we can, for example, sense if your muscle is extracting or contracting.

And that allows us to look really into how, for example, you are exercising, what's the intensity?

How effective are you in doing this?

We have capabilities to extract sweat from the skin and look at the composition of the sweat or how much you're sweating all the time.

So these are all things that we have that we could integrate in this wearable systems that were previously not possible.

- So Philip, what kind of patients would benefit the most from this?

And are we talking about treatment?

Are we talking about preventative care or a little bit of both?

- Yeah, so the applications for this are actually quite interesting.

So what we're really aiming for is at-home diagnosis.

So let me take frailty as an example, right?

It's a disease that's very hard to diagnose.

Typically, you need to come into the clinic, there's tests that need to be administered of many hours, you have to come into multiple sessions over the course of many years in order to make a reliable diagnosis.

So the aim here is that in that particular project, to take a device like this, you put it on a person, they walk around with this a month or two, we get continuous data, and then, we look at the data and make an accurate diagnosis without you having to break a sweat.

So that's the diagnosis part, right?

But for frailty, for example, there's a distinct component of disease management.

If we see certain kinds of patterns, you would be able to alert the user, say, be careful today, your gate is not great.

Make sure that you take enough rest, for example.

- Yeah, I would imagine, correct me if I'm wrong, that drug treatments, how drugs interact with the body, is this the right medication for you or the wrong medication for you?

That could be an application here as well?

- Yes, definitely.

Any time that you want to collect data over longer periods of time, especially from people that don't keep their smartphone or smartwatch topped up, that's the usual problem that we're having with conventional devices in clinical trials.

Because these devices get powered remotely, you don't have to worry about that.

So anytime you want continuous data over longer periods of time for adjusting somebody to a new drug treatment or following them while they're doing exercises, if they're performance athletes and they really want to know, how do I recover faster?

How do I train better?

This is the application for devices like this.

- Really tracking athletic performances, that'd be a real biggie there.

All right, are these available?

How far along are you in your research?

Where does this now stand?

- Yeah, so I mean, we make enough devices to do clinical trials.

And in 2030, at this point in time, we're looking to translate them into real life so that a consumer can have them or hospital chains can have them.

And that's what we're working on currently.

So the materials and the processes that we use to make these devices, they're actually broadly available.

So we use 3D printing to make the material that soften and embed through the skin.

And for the electronics, we actually use flexible circuits that you can make on a roll.

So you can print them like a piece of newspaper.

So, the scalability of technology is there.

It's more about the translational aspects, creating a business that translates these, that's difficult at the moment.

- So 3D printed wearable devices that can monitor your body and your system, it's just amazing.

Philipp Gutruf, U of A College of Engineering.

Congratulations on this, best of luck.

And it sounds like something I'd like to try.

I mean, when can the public get into all this?

- I really hope that in a couple of years, you get to go to the store and buy one of those.

But we'll see how things go.

- All right, Phillip, thank you so much for joining us.

- Excellent, thank you.

Nice talking to you.

- And up next on this special edition of Arizona Horizon, what's known in the medical world as the Hispanic health paradox.

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- It's called the Hispanic health paradox, and it refers to the longer life expectancy and better health outcomes that some Hispanic and Latino patients can have despite facing greater social and economic risks.

Two psychology professors at the U of A received a grant to study this paradox.

One of those professors, Dr. John Ruiz discussed his research with Horizonte's, Jose Cardenas.

- Dr. John Ruiz, I thank you so much for joining us.

I find this whole topic fascinating.

The issue is not whether what you call the Hispanic health paradox exists, which is that Hispanics tend to live longer, have better health outcomes than non-Hispanics.

But why?

Have I got that right?

- That's correct.

So for many years, this data had been coming forth that the Hispanic population in the U.S. appeared to be living longer than other populations, including the U.S. non-Hispanic White population.

For a variety of reasons, this was thought to be an anomaly, perhaps due to some data problem or a multitude of different hypotheses, but it kept coming up over and over.

And finally in about 2012, 2013, a pretty convincing evidence came forth that in fact, this was a real phenomenon.

And when we talk about differences, we're not talking about small differences, we're actually talking about quite significant large differences.

The Hispanic community in the United States is often living two to three, three and a half years longer than other populations.

That's a significant amount of life expectancy difference.

- And as you've indicated, it's quite counterintuitive because living conditions for the Hispanic-Latino population at large would not be as good as they are for non-Latino.

- That's correct.

Typically, what we see is that populations vary in what we might call socioeconomic status and risk factors, the amount of education they generally have, the amount of money they have, and those things equate to access to healthcare and things that might keep one at a healthy level.

Despite significant disadvantages in those areas, the Hispanic population is living longer.

And this is what gives it that paradoxical name.

- And as you and one of your colleagues have now received significant funding to do a study to determine whether it's as you hypothesize, Latino culture, that accounts for this difference.

What aspects of culture are you going to be looking at?

- First of all that's correct.

We've seen this paradox now across the board, the Center for Disease Control now openly recognizes it.

And this has really turned the page on not whether this is a real phenomenon, but rather why does this phenomenon exist?

What is providing the source of resilience?

The first hypothesis many people have is that there is something about Latino culture itself that is driving this.

Many folks are familiar with movies like "Coco", for example, that came out a few years ago and really emphasize the importance of family.

The importance of family at the individual level, the importance of family across the lifespan and importantly, the importance of family members as they grow older, they become more central to the family network.

At a time when age is associated with more health problems, those individuals in Latino culture become more central.

They have more caregivers, they have more engagement with family.

And for all those reasons then, we believe that those social factors, that social integration is providing a real set of resilience opportunities for those folks to live healthier, longer lives.

- We should point out that the movie "Coco" is about the day of the dead.

So it seems a little counterintuitive that you would cite that as evidence but all kidding aside.

The focus of this study will be on lung cancer patients.

Is that right?

- That's correct.

I said "Coco" in part because it's all about a family dynamic, and it shows that the family integration continues even after the person has passed.

They continue to play central roles in the narrative of a family.

This particular study is focused on lung cancer.

Unfortunately, lung cancer is a condition, it's the leading cause of cancer death.

And many people with lung cancer, the average survival times are rather low.

For a study to be able to focus on whether there is a mortality benefit, there has to be enough cases of mortality to occur within the study timeframe.

Lung cancer gives us that opportunity of both the breadth of it, the number of people affected by it year in and year out, and the survivability numbers to allow us to see if culture is playing a role in those different outcomes.

- Now, the study, as I understand, will be conducted at six different sites geographically.

- [Dr. John] That is correct.

- The Latino population, though, in let's say Miami, which is one of the sites, is likely to be quite different than that in New Mexico, which would be different than that in New York and so forth.

Do you expect that that's going to complicate things so to speak?

- You know, that's a great question.

The Latino community is quite heterogeneous, meaning that there are these very different groups bound oftentimes by a common language yet those differences seem to play out equally well in terms of a mortality advantage.

All the groups do have advantages relative to the majority population in the U.S.

Within those groups, though, there are differences in culture, in behavior, in social factors that may contribute in different ways to that resilience effect.

And so, it's important for us to take a look at all those different groups and see, in fact, what are the drivers of those effects.

By doing so, I think we have an opportunity then to capture what is so important to that population and so beneficial, and begin to think about how we might use that information to help the broader public health.

- Dr. Ruiz, we talked about the differences between Hispanic populations from different countries, for example.

What about differences between new arrivals and folks who've been here for one, two, three generations?

Do you expect to see differences?

The popular conception anyway is that over time, those cultural values that reverence for family and so forth that may have existed when you had the first arrivals goes away?

- Yeah, that's a wonderful observation.

In fact, substantial evidence shows us something rather kind of intuitive.

And that is that those new arrivals, new immigrants oftentimes have the very best health.

Another paradox there, the healthy immigrant hypothesis.

And in fact, quite a bit of data actually bears that out.

In many ways, those new immigrants might be expected to be really sort of the ideal of a culture by embodying that culture.

And over time, as they become more acculturated to the U.S. they may begin to lose some of the resilience associated with those cultures, with those cultural values, such that as they spend more time in the U.S. we may begin to see a waning of those health benefits.

Now, an open question for us is whether it is the accruing of more Western culture or whether it's the loss of the native culture that is contributing to that change in resilience status.

And this study will help us bear that out.

- Dr. Ruiz, just one last question.

When will we see the results of the study?

- This is slated to be a five-year study.

We expect that it typically takes about six months to get these things going.

It'll take about two to two and a half years to run the study itself and then to another year or so to see the analysis.

But we're hoping then within four to five years to begin to see some very clear results one way or the other about whether these are in fact the drivers of this well-known effect.

- All right, I look forward to reading the results.

Thank you so much for joining us.

Dr. John Ruiz, University of Arizona, Department of Psychology.

It's been good, thanks.

- Thank you for your time.

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(upbeat music) - We wrap up our medical edition of Arizona Horizon with a look at a three-year pilot program created by the Mayo Clinic that brings acute hospital care to patients in their homes.

Proponents say that the program should help patients recover faster while reducing costs to hospitals, which in turn, could lower healthcare costs overall.

Dr. Chad Nelson is the division chair at Mayo's Hospital of Internal Medicine.

Dr. Chad Nelson, welcome to Arizona Horizon.

Good to have you here.

Let's define terms here.

When we talk about tele-health, what are we talking about?

- Well, telehealth would be any time you have an interaction with a patient, either over phone or through a virtual connection with video remotely with the patient.

- And Mayo now has this three-year pilot program for acute hospital care at home.

Explain how this works.

- So yeah, now we're advancing the idea of tele-health, these virtual interactions, to a more acute patient population.

So rather than just a clinic visit that you would have, rather than turning that into a virtual visit, we're actually now taking patients that would otherwise be hospitalized in the hospital and we're taking them to their home.

And we're doing this all virtually in the comfort of the patient's home.

- So how will this work?

Obviously, you have to have an internet connection here but what if you need IVs and monitors and these sorts of things?

Do you set them up at the home, like in one stop?

- Well, that's exactly right, Ted.

So everything that we do here in the hospital setting, we're also, I mean, we also made arrangements to do those same things at the patient's home.

So nursing for IV therapy, wound care, physical therapy, occupational therapy, phlebotomy for blood draws, we have paramedics for rapid response needs, radiology to do x-rays.

Anything that we do in the hospital setting, we're going to be doing in the patient's home.

- I noticed there was also a requirement for a landline in case a storm comes through and you lose power.

- So the default setting for our technology system is to use the patient's own home internet.

However, we do have a cradle that connects through a cellular connection and has a battery backup system with it.

So if you do lose power, it still has connection to our command center and we can still communicate with the patient.

- Interesting.

And again, we're talking 24/7 care here, just like as if you were in the hospital.

- Exactly.

We have nurses in the command center in Florida that check in on the patients periodically throughout the day.

They're available 24/7, overnight as well.

And so just like in the hospital setting, when the nurse hops into the patient's room to check on them and see how things are going, the same thing is happening virtually through the command center back into the patient's home.

- You referred to this earlier, but give me a better idea of what kind of patients would be best suited for this.

- So right now, we're focusing on a traditional medical patient.

So these would be people with heart failure, exacerbations, pneumonia, we're starting to get into some COVID patients as well, cellulitis, which would be a skin infection.

These are some of the typical diagnoses that we're focusing on at this point.

- What about cancers?

- So cancer would certainly be an option as well.

Depending on the patient's need with regard to cancer, we do see a lot of patients in the hospital for pain control.

We haven't yet taken that to advanced care at home, but we do foresee that in the future as an option.

- Now, proponents say that the patients can actually recover faster by way of this kind of tele-health.

Do you agree?

And why would that be the case?

- I think so because the patients are going to be more mobile in their home.

In the hospital setting, we see that patients really want to just kind of lay in bed and not do anything.

And at home, they have to get up and be around a little bit more.

And that activity is really good for them and good for their recovery.

And also, they're in a familiar environment, they're around their loved ones.

And so I think all of that together helps not only with their quicker recovery, but also it helps with patient satisfaction.

- Yeah, but in the hospital, there's a sanitary kind of, cleanliness and keeping things sterile is a big point.

At home, you got dogs, you got people, you got all sorts of things going on.

How do you monitor that?

- Well, certainly, that's something that we all face on a daily basis.

However, I would say that there's a lot of things around the hospital that we also don't want, right?

A lot of resistant infections and things like that.

And so, there's actually times when we would prefer to not have people in the hospital because of the risk of being there.

And so, I think that when you take that all in balance, I think that the benefit is to the patient and to being in their home if possible.

- It sounds like a benefit as well to hospitals, as far as the cost of care.

Could this save hospitals money?

And in turn, could that lower health costs?

- So at this point with our program, we're focusing mostly on getting it up and running and making sure that we're doing so safely.

That being said, we are seeing a small cost savings already.

Once we have the program more matured, we anticipate that then, we can start to focus on cost savings in a more robust fashion, and hopefully, we'll start to see more of it.

Like I said, even at this early phase, we are seeing some cost savings.

- You mentioned early phase, you started what?

September 13th, somewhere along those lines?

- Correct.

So our program overall at Mayo Clinic went live last summer in 2020 with Mayo Clinic in Jacksonville, Florida.

And they've been going for over a year now, and then, they also expanded to Northwest Wisconsin.

Here in Arizona, we went live on September 13th.

- And what are the early reactions so far?

- Everybody loves it.

The patient response has been great, which is exactly what we saw in the other programs as well.

And then, we also are seeing that it's safe, that the resources and the team that's involved is taking good care of these patients and that they're doing so safely and everything's going great.

- And I was going to say that, that is the big point here.

You got to make sure it's safe for the patient.

- Correct, so quality is a huge aspect of this program, as we compare quality numbers to a traditional brick and mortar hospital.

And then, there's going to be some other quality metrics that will be specific for the advanced care-at-home program.

But quality is always going to be number one.

And our Mayo-centered care is the idea that the patient is at the center of that care and that their needs come first.

And so, that's why quality and safety has to be first.

- Brave new world out there.

Dr. Chad Nelson, Mayo Clinic.

Thank you so much for joining us and great information.

We appreciate it.

- Thank you, appreciate it.

Have a good day.

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(upbeat music) - And that is it for now.

I'm Ted Simons.

Thank you so much for joining us.

You have a great evening.

(upbeat music)