Tech Transfer - University of Michigan

Improving Our Quality of Life

University of Michigan Health Technologies Move into the Marketplace - Three Featured at Software Council Meeting

by Suzanne Tainter

University of Michigan researchers have merged computer technology with healthcare needs to create new technologies that are moving into a wider marketplace through licensing to commercial ventures. Three technologies were featured at a recent Ann Arbor Software Council Meeting.

HealthMedia, Inc.

Victor Strecher, a UM professor of health education, started HealthMedia, Inc. to turn his laboratory's research results into products that improve health. Strecher runs the University's Health Media Research laboratory where research, now replicated in studies elsewhere, shows that tailoring messages for individuals results in more people changing their behavior to reduce health risks than does presenting more general information on health risks. This tailored delivery can be applied to stopping smoking, altering diets, reducing blood pressure and a host of other life choices that have an impact on health. The tailored messages can be provided at far less cost than group behavioral change programs, such as WeightWatchers or Smoke Stoppers, which few persons take advantage of.

HealthMedia, Inc. takes in information from individual users such as their health status, disease history, family disease history, and habits to create a risk profile for that person, and then connects that risk information to psychological factors such as motivations, confidence, barriers, and readiness to change. The result is a prescription for behavioral change tailored to that person's risks and preferences. For example, if a person must reduce fat in his diet but hates fish, then recipe suggestions from the HealthMedia information will not feature fish, despite its benefits in reducing heart disease. It is like having personal interviews with a physician, an epidemiologist, a psychologist, an exercise specialist, and a nutritionist but at one-twentieth the cost, said Strecher.

Changing behavior is the place to make a big impact on reducing morbidity, said Strecher, who is also the director of cancer prevention for the UM Comprehensive Cancer Center. In cancer prevention, researchers figure genes account for 20 percent of disease while behavior is responsible for 70 percent of illness. If behaviors such as smoking or eating fat-rich diets can be changed that would have impact on public health far beyond any gene therapies being contemplated. That is not to say the genetic approach should be abandoned, said Strecher. The human genome project raises the potential for determining an individual's genetic susceptibilities to disease. Ultimately, said Strecher, one's genetic profile could be matched with targeted lifestyle information to greatly reduce an individual's health risks.

The health information can be delivered in print, print combined with consultation with healthcare providers, via CDs or videotapes, on web pages or other delivery media. Strecher said it doesn?t matter which medium is used other than the individual's preference for obtaining information. It is the tailoring that makes the difference in the behavior change. He believes interactive TV will eventually be a good vehicle for tailored messages, tapping into the average American?s six to eight hours a day in front of the tube.

In his university professor role, Strecher often found businesses excited about his research results, but there was no way for them to use ideas from the laboratory with their employees or customers until HealthMedia, Inc. was formed. Strecher founded the company through the aid and financial backing of Rick Snyder of Avalon Investments who understood exactly what Strecher was trying to do. As a former executive at Gateway Computers, Snyder knew they customized computers for individuals. He realized that was what Strecher was doing with health information.

HealthMedia, Inc. licensed the tailoring technology from the University, and opened its doors in 1998. It now employs about 70 people. The University is also a shareholder in HealthMedia, Inc.

HealthMedia, Inc. aims to provide services to other businesses such as the auto manufacturers, or other large employers, and companies in the health business such as the insurance or pharmaceutical companies. For example, a blood pressure monitor manufacturer is working with HealthMedia, Inc. to provide personalized information on keeping one's blood pressure down. HealthMedia, Inc. created the Zyban Advantage Plan, a customized support plan for people using GlaxoWellcome's prescription drug, Zyban, to stop smoking. HealthMedia also provides current health information in up-to-date formats where users can select the topics they are interested in. It has developed a very successful website for Oxygen Media, www.thriveonline.com.

For information on HealthMedia, Inc. visit their website at: www.healthmedia.com

3D MSPECT

While Strecher had to start a company to get his research into practice, James Corbett, Professor of Internal Medicine and Director of Cardiovascular Nuclear Medicine, has been able to make his work widely available through non-exclusive licensing agreements to the major manufacturers of nuclear medicine imaging cameras. Corbett and Edward Ficaro, an assistant research scientist in nuclear medicine, have created software called 3D MSPECT that these cameras to display heart images used in the diagnosis of heart problems. The heart tests are made by first introducing a radioactive tracer into a patient's bloodstream, which is carried to the heart. The camera detects the position and amount of radioactive tracer in the heart chambers and heart muscle. SPECT stands for Single Photon Emission Computed Tomography. As the tracer decays it released photons, which are detected by the camera. Then a computer creates images and measurements of how much tracer appears in the heart tissue and chambers, which tells the cardiologist how much blood is reaching those tissues. The images are virtual "slices" of the heart. The individual slices can be stacked and assembled to create desired images. From these images, the cardiologist can determine if the patient has blocked heart arteries or damaged tissue. The cameras can also be used to get information on the wall motion of the heart and the volume of blood that the heart pumps. By comparing images when the heart is under stress with images at rest, the cardiologists can detect potential problems and prescribe further tests or treatments such as angioplasty or bypass.

What the cardiologist can determine from the SPECT scans depends upon how well the data from the camera can be imaged and interpreted. That is where the computer is essential, and that is Corbett?s contribution to the technology of cardiology. The 3D MSPECT software assembles the gamma camera data into images. The software lets the cardiologist compare a patient's information with images from normal hearts, manipulate the heart images to see them from different angles, to watch the heart in motion, and to measure the area of a defect. 3D MSPECT had a database of normal heart scans that the cardiologist can use to compare with a patient's scan, and it has a built-in database creator for cardiologists doing studies of various protocols or patient populations. Software like 3D MSPECT has been developed by a few other academic medical centers. Corbett thinks 3D MSPECT offers exceptional flexibility and ease of use for the cardiologist. ADAC, Picker, and Siemens have licensed the software thus far, and other major manufacturers are in discussions with the UM Office of Technology Transfer. The UM has obtained FDA approval of the software. For more information on 3D MSPECT see the website at: http://www.petnet.med.umich.edu/3dmspect/

CARDIAX

In the third technology showcased at the Software Council meeting, Sherlock Holmes joins UM medical specialists on a CD-ROM that aims to improve deductive skills in diagnosing cardiovascular problems. The multimedia CD is called CARDIAX and was developed by cardiologist Richard Judge, professor of internal medicine, and Chris Chapman, assistant manager of media, at the UM Medical Center?s Learning Resources Center. "There is a national perception that physicians are losing their skills, that doctors are not as good as they used to be," said Judge. The computer provides a non-threatening way for physicians to refresh and improve on their training, he explains. Judge likened his product to a batting cage used under the tutelage of an expert coach where a batter can keep his skills in top shape.

CARDIAX includes many pieces of information that the cardiologist must put together to arrive at the proper diagnosis, from videotaped interviews with the patient to test results that the physician must interpret, to consultations with other specialists. Visuals, motion, and sound are all provided via the computer. All that is lacking is the sense of touch, said Judge. When going through the case studies, each step of the way, the cardiologist must make choices, and the computer provides feedback on what is and is not a good choice, and why. Physicians learn about the importance of time, the pitfalls of jumping to early conclusions, and other ways to sharpen their diagnostic skills.

Judge took care to select case studies of common problems confronting cardiologists. His teaching model is one of "practice with expert feedback," and based on the idea that careful "bedside" observation is a necessary complement to medical testing.

Judge initially developed the product for medical students. Practicing physicians, physician assistants, clinical nurse specialists, nurse practitioners, and others also can use it for continuing medical education. It is now being distributed by 3M, a major manufacturer of medical equipment. Judge?s motivation was not in the marketing, but in the potential of the technology to increase a physician?s skills, he explains. He hopes to develop similar products on arthritis and other medical areas. For more about CARDIAX, check out the website at: http://www.med.umich.edu/lrc/cardiax/cardiaxnew/cardiax.html

The Ann Arbor Software Council aims to promote the growth, prosperity, and recognition of a world-class software industry in the Ann Arbor area. It is supported by the Ann Arbor Area Chamber of Commerce and in part by the UM Office of Technology Transfer.

The October program was put together by Deborah Alper, senior licensing specialist in the Office of Technology Transfer. Alper pointed out that 40 percent of the University's license agreements last year were information technology related. Of the six start-up companies established, four were IT companies.

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