Morning eHealth - POLITICO

A daily report on the intersection of health care and technology

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The Surgeon Will Skype You Now - Popular Mechanics

The surgeon, who has spent 15 minutes gently tearing through tissue, suddenly pauses to gesture ever-so-slightly with his tiny scissors. "Do you see what's on this side? That's nerves." He moves the instrument a few millimeters to the right. "And on this one? That's cancer."

Ashutosh Tewari is the head of the urology department at Mount Sinai Hospital in New York City. He is in the process of removing a patient's cancerous prostate, the walnut-sized gland in the delicate area between the bladder and the penis. This surgery—one of three that Tewari performs on an average day—takes place entirely within an area the size of a cereal bowl. Tewari's movements are deliberate and exact. Just a few wrong cuts could make the patient incontinent or unable to perform sexually for the rest of his life.

But Tewari is making those cuts from 10 feet away. With a robot.

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http://www.popularmechanics.com/science/health/a19208/the-surgeon-will-skype-you-now/?

NYTimes: New Online Tools Offer Path to Lower Drug Prices

Americans have come to rely on their smartphones to help them do seemingly everything, like hailing a taxi and comparing prices of dog food.

But when it comes to buying prescription drugs, consumers still find the process maddeningly antiquated.

Now, a few entrepreneurs say they are aiming to fundamentally change the way people buy drugs, bringing the industry into the digital age by disclosing the lowest prices for generic prescriptions to allow comparison-shopping.

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http://www.nytimes.com/2016/02/10/business/taming-drug-prices-by-pulling-back-the-curtain-online.html?

You can train your body into thinking it’s had medicine | Mosaic

Marette Flies was 11 when her immune system turned against her. A cheerful student from Minneapolis, Minnesota, she had curly brown hair and a pale, moon-shaped face, and she loved playing trumpet in her high-school band. But in 1983, she was diagnosed with lupus, a condition in which the immune system destroys the body's healthy tissues.

It ran rampant, attacking her body on multiple fronts. She was given steroids to suppress her immune system; the drugs made her face swell up, and her hair fell out onto her pillow and into her food. But despite the treatment her condition worsened over the next two years, with inflamed kidneys, seizures and high blood pressure. She suffered frequent headaches and her whole body was in pain.

By 1985, antibodies were attacking a vital clotting factor in Marette's blood, causing her to bleed uncontrollably. It got so bad that her doctors considered giving her a hysterectomy, because they were worried that when her periods started she might bleed to death. She took drugs including barbiturates, antihypertensives, diuretics and steroids but her blood pressure kept rising. Then her heart started to fail, and her doctors reluctantly decided give her Cytoxan, an extremely toxic drug.

Cytoxan is very good at suppressing the immune system. But it causes vomiting, stomach aches, bruising, bleeding, and kidney and liver damage, as well as increased risk of infections and cancer, and at the time its use in humans was experimental. Karen Olness, a psychologist and paediatrician now at Case Western Reserve University in Ohio, was helping Marette to cope with the stress and pain of her condition, and she was concerned that if lupus didn't kill the teenager, this new drug might. Then Marette's mother showed Olness a scientific paper she had seen. It claimed to have slowed lupus in mice – but with just half the usual dose of Cytoxan.

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http://mosaicscience.com/story/medicine-without-the-medicine-how-to-train-your-immune-system-placebo?

Manulife seeks to trade health data for insurance premium discounts - The Globe and Mail

Manulife Financial Corp. is bringing its fitness trackers and financial incentives to the Canadian market.

The country's largest life insurer has struck an exclusive agreement with wellness program provider Vitality Group to offer savings on life insurance premiums to customers who prove that they are taking steps to improve their health, such as getting vaccinated and going for cancer screenings.

This new type of insurance launched in the United States last spring through Manulife's subsidiary, John Hancock Financial Services, and now its coming north of the border.

Manulife aims to make insurance more fun for customers, with an app that offers encouragement and digital pats on the back, as well as a free wearable fitness tracker for signing up. Manulife is still determining which devices it will offer in Canada, but in the United States it partnered with Fitbit.

"Part of the program is helping [customers] to set goals, and then helping follow them on the goals," said Marianne Harrison, head of Manulife Canada. "Our strategy here in Canada is really around health and wealth, and trying to bring those things together."

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http://www.theglobeandmail.com/report-on-business/manulife-brings-fitness-and-health-monitoring-to-canadian-insurance-market/article28662603/

NYTimes: ‘The Good Death,’ ‘When Breath Becomes Air’ and More

These recent weeks have seen the publication of five books about death: one by a historian; two by hospice workers; one by a widow; one by a man who is dying himself. Several of them quote Dylan Thomas's "Do Not Go Gentle Into That Good Night" to advocate resilience, then map the fine line between denial and succumbing. In "Death's Summer Coat," Brandy Schillace complains, "The modern Westerner has lost loss; death as a community event, and mourning as a communal practice, has been steadily killed off." Examining rituals of bereavement across cultures and across time, she suggests that everyone else has been better at the rites of farewell than we are. Our postindustrial disavowal of mortality is described by Simone de Beauvoir, who wrote, "For every man, his death is an accident and, even if he knows it and consents to it, an unjustifiable violation." Schillace, a research associate at the Dittrick Museum of Medical History, points toward the confusion that has emerged in a technological age when brain death, heart death and other definitions becloud our understanding of expiry itself, observing that by current legal definitions, the same person could be alive under American law and dead under British law. We don't know what death means or even what it is.

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http://www.nytimes.com/2016/02/14/books/review/the-good-death-when-breath-becomes-air-and-more.html?

Five books explore the way we are shaped by our knowledge of mortality.