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BOSTON – An array of potentially transformative technological innovations in gastroenterology with related effects on systemic health – including metabolic diseases – are showing promise at different stages of clinical testing, and gastroenterologists need to make sure they are not left behind in this opportunity to make a positive impact on patient health, according to an overview of recent medtech successes and coming trends presented at the 2017 AGA Tech Summit.
“Innovation in GI tech is continuing at a substantial pace because of the sustained interest among investors, entrepreneurs, and established industry players and the many opportunities and unmet needs,” Jay Pasricha, MD, MBBS, director of the Johns Hopkins Center for Neurogastroenterology, Baltimore, said in an interview. The obstacle for gastroenterologists is willingness to adapt.
The rapid, transformative changes in bariatric endoscopy provide an immediate example, according to Dr. Pasricha. There has been enormous innovation in this area with more devices coming. He suggested that meaningful participation in this growing field not only involves a commitment to mastering the technical challenges of available devices but also to providing comprehensive care.
“There needs to be a commitment to what might be described as the bookends of treatment. This means screening and appropriate selection of candidates for specific procedures and providing the follow-up and supportive care that lead to good outcomes. In other words, do it right or don’t do it,” Dr. Pasricha said.
He considers endoscopic approaches to weight loss — balloons, gastric restriction, or other strategies — emblematic of a flexion point in gastroenterology that has the potential to result in increasing polarization in the specialty. Those who adapt to deliver the advances in care permitted by new technology will participate in advancing the field. Those who do not may cede advanced procedures to those specialists who step in.
The AGA Obesity Practice Guide, for example, provides gastroenterologists with a comprehensive, multi-disciplinary process to personalize innovative obesity care for safe and effective weight management, including the use of endoscopic and surgical procedures. The accompanying episode-of-care framework helps gastroenterologists understand how to operationalize obesity management for financial success (www.gastro.org/obesity).
Endoscopic mucosal resection of localized cancers, an area in which technological innovations are also promising, is another opportunity for gastroenterologists. According to Dr. Pasricha, “Innovations with the potential to leapfrog over traditional procedures are very feasible from a technical perspective, but which specialists will be the ones who collaborate on these interventions to make them a reality?”
While acknowledging that the current reimbursement structure does not incentivize complex and potentially time-consuming procedures over bread-and-butter procedures such as screening colonoscopy, Dr. Pasricha maintained that innovation in these areas represents the future. Eventually, advances in technology will simplify complex procedures, but Dr. Pasricha suggested that gastroenterologists should be leading disruptive technologies to ensure a place in delivery of next generation solutions.
In a broad survey of the likely directions, Dr. Pasricha provided examples of several frontiers in which technological innovation has a potential role. Efforts to harness the microbiome, for example, include devices with the potential to improve bowel function. Vagal stimulators in various forms have the potential to address pathology along the gut-brain axis.
“Devices designed to modify gut-brain signaling are not just relevant to GI diseases but are being pursued for much broader indications, such as those relating to mood and cognitive function,” Dr. Pasricha reported.
Casting a large net to touch on the science and economics of medtech innovations across a wide variety of unmet needs in gastroenterology, Dr. Pasricha described a common barrier. At the stage when new devices are introduced, innovators are faced with obstacles, including uncertain reimbursement and potential medico-legal risk, yet innovations depend on finding a path.
“Who is going to make the leap?” asked Dr. Pasricha, describing several areas of device innovation in which “people are testing the waters with no one yet willing to jump in.” He made the point that in fields relevant to their expertise, gastroenterologists should be participating in opportunities that may lead to better patient care.
“Otherwise, we may end up in an unhappy compromise – a small subset of technically advanced GI docs will compete with a larger and growing cadre of surgeons who are becoming increasingly skilled in flexible endoscopy,” Dr. Pasricha explained.
“But, in either scenario, the cognitive components of what represents best care for a given patient, which is the epitome of personalized medicine, may get short shrift,” he added. He envisions a worst case scenario in which screening colonoscopy is replaced by a pill or a fecal test, “and our specialty is not ready for taking care of all the other unmet needs because we have been complacent.”
Still, there are large areas in which opportunities abound, such as motility and functional disorders, that represent a huge socioeconomic and clinical burden, according to Dr. Pasricha, who believes advances in this field should be embraced.
For entrepreneurs pursuing medtech overall and in GI diseases specifically, Dr. Pasricha had some specific advice. He suggested that efforts should not be restricted to the development of new devices or other solutions but should include developing a context for the innovation, such as training of those who will employ the innovation, creating awareness among physicians who will refer, and helping to ensure reimbursement.
“All stakeholders need to invest in the growth of their markets and not just in the technology,” Dr. Pasricha said. He emphasized that one of the most important roadblocks are the gatekeepers who fail to refer patients to specialists capable of implementing a new procedure.
However, he believes that there is enormous room for successful innovation in GI medtech.
“The future remains bright. The gut, the gut-brain axis, and the gut-metabolic axis are all keys to unlocking the potential for endoscopic interventions to impact so many chronic diseases,” Dr. Pasricha maintained. “It’s up to us to recognize this and take ownership of this space. This conference as always serves to highlight these opportunities and potential road maps to that future.”
BOSTON – An array of potentially transformative technological innovations in gastroenterology with related effects on systemic health – including metabolic diseases – are showing promise at different stages of clinical testing, and gastroenterologists need to make sure they are not left behind in this opportunity to make a positive impact on patient health, according to an overview of recent medtech successes and coming trends presented at the 2017 AGA Tech Summit.
“Innovation in GI tech is continuing at a substantial pace because of the sustained interest among investors, entrepreneurs, and established industry players and the many opportunities and unmet needs,” Jay Pasricha, MD, MBBS, director of the Johns Hopkins Center for Neurogastroenterology, Baltimore, said in an interview. The obstacle for gastroenterologists is willingness to adapt.
The rapid, transformative changes in bariatric endoscopy provide an immediate example, according to Dr. Pasricha. There has been enormous innovation in this area with more devices coming. He suggested that meaningful participation in this growing field not only involves a commitment to mastering the technical challenges of available devices but also to providing comprehensive care.
“There needs to be a commitment to what might be described as the bookends of treatment. This means screening and appropriate selection of candidates for specific procedures and providing the follow-up and supportive care that lead to good outcomes. In other words, do it right or don’t do it,” Dr. Pasricha said.
He considers endoscopic approaches to weight loss — balloons, gastric restriction, or other strategies — emblematic of a flexion point in gastroenterology that has the potential to result in increasing polarization in the specialty. Those who adapt to deliver the advances in care permitted by new technology will participate in advancing the field. Those who do not may cede advanced procedures to those specialists who step in.
The AGA Obesity Practice Guide, for example, provides gastroenterologists with a comprehensive, multi-disciplinary process to personalize innovative obesity care for safe and effective weight management, including the use of endoscopic and surgical procedures. The accompanying episode-of-care framework helps gastroenterologists understand how to operationalize obesity management for financial success (www.gastro.org/obesity).
Endoscopic mucosal resection of localized cancers, an area in which technological innovations are also promising, is another opportunity for gastroenterologists. According to Dr. Pasricha, “Innovations with the potential to leapfrog over traditional procedures are very feasible from a technical perspective, but which specialists will be the ones who collaborate on these interventions to make them a reality?”
While acknowledging that the current reimbursement structure does not incentivize complex and potentially time-consuming procedures over bread-and-butter procedures such as screening colonoscopy, Dr. Pasricha maintained that innovation in these areas represents the future. Eventually, advances in technology will simplify complex procedures, but Dr. Pasricha suggested that gastroenterologists should be leading disruptive technologies to ensure a place in delivery of next generation solutions.
In a broad survey of the likely directions, Dr. Pasricha provided examples of several frontiers in which technological innovation has a potential role. Efforts to harness the microbiome, for example, include devices with the potential to improve bowel function. Vagal stimulators in various forms have the potential to address pathology along the gut-brain axis.
“Devices designed to modify gut-brain signaling are not just relevant to GI diseases but are being pursued for much broader indications, such as those relating to mood and cognitive function,” Dr. Pasricha reported.
Casting a large net to touch on the science and economics of medtech innovations across a wide variety of unmet needs in gastroenterology, Dr. Pasricha described a common barrier. At the stage when new devices are introduced, innovators are faced with obstacles, including uncertain reimbursement and potential medico-legal risk, yet innovations depend on finding a path.
“Who is going to make the leap?” asked Dr. Pasricha, describing several areas of device innovation in which “people are testing the waters with no one yet willing to jump in.” He made the point that in fields relevant to their expertise, gastroenterologists should be participating in opportunities that may lead to better patient care.
“Otherwise, we may end up in an unhappy compromise – a small subset of technically advanced GI docs will compete with a larger and growing cadre of surgeons who are becoming increasingly skilled in flexible endoscopy,” Dr. Pasricha explained.
“But, in either scenario, the cognitive components of what represents best care for a given patient, which is the epitome of personalized medicine, may get short shrift,” he added. He envisions a worst case scenario in which screening colonoscopy is replaced by a pill or a fecal test, “and our specialty is not ready for taking care of all the other unmet needs because we have been complacent.”
Still, there are large areas in which opportunities abound, such as motility and functional disorders, that represent a huge socioeconomic and clinical burden, according to Dr. Pasricha, who believes advances in this field should be embraced.
For entrepreneurs pursuing medtech overall and in GI diseases specifically, Dr. Pasricha had some specific advice. He suggested that efforts should not be restricted to the development of new devices or other solutions but should include developing a context for the innovation, such as training of those who will employ the innovation, creating awareness among physicians who will refer, and helping to ensure reimbursement.
“All stakeholders need to invest in the growth of their markets and not just in the technology,” Dr. Pasricha said. He emphasized that one of the most important roadblocks are the gatekeepers who fail to refer patients to specialists capable of implementing a new procedure.
However, he believes that there is enormous room for successful innovation in GI medtech.
“The future remains bright. The gut, the gut-brain axis, and the gut-metabolic axis are all keys to unlocking the potential for endoscopic interventions to impact so many chronic diseases,” Dr. Pasricha maintained. “It’s up to us to recognize this and take ownership of this space. This conference as always serves to highlight these opportunities and potential road maps to that future.”
BOSTON – An array of potentially transformative technological innovations in gastroenterology with related effects on systemic health – including metabolic diseases – are showing promise at different stages of clinical testing, and gastroenterologists need to make sure they are not left behind in this opportunity to make a positive impact on patient health, according to an overview of recent medtech successes and coming trends presented at the 2017 AGA Tech Summit.
“Innovation in GI tech is continuing at a substantial pace because of the sustained interest among investors, entrepreneurs, and established industry players and the many opportunities and unmet needs,” Jay Pasricha, MD, MBBS, director of the Johns Hopkins Center for Neurogastroenterology, Baltimore, said in an interview. The obstacle for gastroenterologists is willingness to adapt.
The rapid, transformative changes in bariatric endoscopy provide an immediate example, according to Dr. Pasricha. There has been enormous innovation in this area with more devices coming. He suggested that meaningful participation in this growing field not only involves a commitment to mastering the technical challenges of available devices but also to providing comprehensive care.
“There needs to be a commitment to what might be described as the bookends of treatment. This means screening and appropriate selection of candidates for specific procedures and providing the follow-up and supportive care that lead to good outcomes. In other words, do it right or don’t do it,” Dr. Pasricha said.
He considers endoscopic approaches to weight loss — balloons, gastric restriction, or other strategies — emblematic of a flexion point in gastroenterology that has the potential to result in increasing polarization in the specialty. Those who adapt to deliver the advances in care permitted by new technology will participate in advancing the field. Those who do not may cede advanced procedures to those specialists who step in.
The AGA Obesity Practice Guide, for example, provides gastroenterologists with a comprehensive, multi-disciplinary process to personalize innovative obesity care for safe and effective weight management, including the use of endoscopic and surgical procedures. The accompanying episode-of-care framework helps gastroenterologists understand how to operationalize obesity management for financial success (www.gastro.org/obesity).
Endoscopic mucosal resection of localized cancers, an area in which technological innovations are also promising, is another opportunity for gastroenterologists. According to Dr. Pasricha, “Innovations with the potential to leapfrog over traditional procedures are very feasible from a technical perspective, but which specialists will be the ones who collaborate on these interventions to make them a reality?”
While acknowledging that the current reimbursement structure does not incentivize complex and potentially time-consuming procedures over bread-and-butter procedures such as screening colonoscopy, Dr. Pasricha maintained that innovation in these areas represents the future. Eventually, advances in technology will simplify complex procedures, but Dr. Pasricha suggested that gastroenterologists should be leading disruptive technologies to ensure a place in delivery of next generation solutions.
In a broad survey of the likely directions, Dr. Pasricha provided examples of several frontiers in which technological innovation has a potential role. Efforts to harness the microbiome, for example, include devices with the potential to improve bowel function. Vagal stimulators in various forms have the potential to address pathology along the gut-brain axis.
“Devices designed to modify gut-brain signaling are not just relevant to GI diseases but are being pursued for much broader indications, such as those relating to mood and cognitive function,” Dr. Pasricha reported.
Casting a large net to touch on the science and economics of medtech innovations across a wide variety of unmet needs in gastroenterology, Dr. Pasricha described a common barrier. At the stage when new devices are introduced, innovators are faced with obstacles, including uncertain reimbursement and potential medico-legal risk, yet innovations depend on finding a path.
“Who is going to make the leap?” asked Dr. Pasricha, describing several areas of device innovation in which “people are testing the waters with no one yet willing to jump in.” He made the point that in fields relevant to their expertise, gastroenterologists should be participating in opportunities that may lead to better patient care.
“Otherwise, we may end up in an unhappy compromise – a small subset of technically advanced GI docs will compete with a larger and growing cadre of surgeons who are becoming increasingly skilled in flexible endoscopy,” Dr. Pasricha explained.
“But, in either scenario, the cognitive components of what represents best care for a given patient, which is the epitome of personalized medicine, may get short shrift,” he added. He envisions a worst case scenario in which screening colonoscopy is replaced by a pill or a fecal test, “and our specialty is not ready for taking care of all the other unmet needs because we have been complacent.”
Still, there are large areas in which opportunities abound, such as motility and functional disorders, that represent a huge socioeconomic and clinical burden, according to Dr. Pasricha, who believes advances in this field should be embraced.
For entrepreneurs pursuing medtech overall and in GI diseases specifically, Dr. Pasricha had some specific advice. He suggested that efforts should not be restricted to the development of new devices or other solutions but should include developing a context for the innovation, such as training of those who will employ the innovation, creating awareness among physicians who will refer, and helping to ensure reimbursement.
“All stakeholders need to invest in the growth of their markets and not just in the technology,” Dr. Pasricha said. He emphasized that one of the most important roadblocks are the gatekeepers who fail to refer patients to specialists capable of implementing a new procedure.
However, he believes that there is enormous room for successful innovation in GI medtech.
“The future remains bright. The gut, the gut-brain axis, and the gut-metabolic axis are all keys to unlocking the potential for endoscopic interventions to impact so many chronic diseases,” Dr. Pasricha maintained. “It’s up to us to recognize this and take ownership of this space. This conference as always serves to highlight these opportunities and potential road maps to that future.”
FROM THE 2017 AGA TECH SUMMIT