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STROKE: TOGETHER WE WILL MAKE A DIFFERENCE. Stroke Week 2017 – Rehabilitation

7 September 2017

At Medtronic, we are proud supporters of National Stroke Week 2017 (4 – 10 September). This week we will be sharing more information about the stroke care continuum. We will also hear what happens when stroke care is not as good as it could be – highlighting the importance of improving access to patients who need medical technology.

Spasticity can be a disabling consequence of stroke: review of several studies reported 17% to 42.6% of post-stroke patients experiencing spasticity.[1] Oral medications can be used to reduce muscle spasticity, but many post-stroke patients are unable to tolerate the side effects of these medications.3

Stroke Week_Fact 4

Medical technology is evolving rehabilitation:

  • Intrathecal baclofen (ITB) has emerged as a treatment option for post-stroke spasticity. This therapy uses an implantable infusion system to deliver baclofen – a muscle relaxant – directly to the spinal canal. This approach thereby avoids intolerable side effects of oral medications.

The power of data collection. Rehabilitation needs identified in the National Stroke Audit Rehabilitation Services 2016[2] have translated into recommendations in the new in the new Stroke Guidelines[3] – launched on Monday 4 September. A key focus area is the need for health professionals to strongly partner with stroke survivors and their families and carers.

[1] Dvorak et al. The Underutilization of Intrathecal Baclofen in Poststroke Spasticity. Topics in stroke rehabilitation 2011 vol:18 iss:3 pg:195 -202.

[2] Stroke Foundation: National Stroke Audit 2016.

[3] Stroke Foundation. Managing complications – DRAFT Clinical Guidelines for Stroke Management (2017). v1.0 published on 24.10.2016.

STROKE: TOGETHER WE WILL MAKE A DIFFERENCE. Stroke Week 2017 – Treatment

6 September 2017

At Medtronic, we are proud supporters of National Stroke Week 2017 (4 – 10 September). This week we will be sharing more information about the stroke care continuum. We will also hear what happens when stroke care is not as good as it could be – highlighting the importance of improving access to patients who need medical technology.

Stroke Week_Fact 3

 

TIME IS BRAIN: For individuals who have acute ischemic stroke caused by a blood clot, the key to effective treatment is early restoration of blood flow to the affected area of the brain. This can be facilitated with certain medication, or by using medical technology such as mechanical thrombectomy [MT], also known as endovascular clot retrieval [ECR].

In 2014-2015, five randomised controlled trials on MT were published reporting significant clinical benefits and improvement in functional outcomes in carefully selected patients with large vessel occlusions.[2]

As a consequence of these positive findings the 2015 American Heart Association Stroke guidelines were updated in 2015, with new recommendations made on the use of MT. This treatment is rapidly becoming the ‘standard of care’ for AIS patients and is often referred to as endovascular clot retrieval (ECR). The use of mechanical thrombectomy is discussed in the new Australian Stroke Guidelines[3] which were launched on Monday 4 September.

[1] https://strokefoundation.org.au/About-Stroke/Facts-and-figures-about-stroke.

[2]Goyal et al (2016). Endovascular thrombectomy after large vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. The Lancet April 2016;387 (10029):1723-1731.

[3] Stroke Foundation. Acute medical and surgical management – DRAFT Clinical Guidelines for Stroke Management (2017). v1.0 published on 24.10.2016.

STROKE: TOGETHER WE WILL MAKE A DIFFERENCE: Stroke Week 2017 – Detection

5 September 2017

At Medtronic, we are proud supporters of National Stroke Week 2017 (4 – 10 September). This week we will be sharing more information about the stroke care continuum. We will also hear what happens when stroke care is not as good as it could be – highlighting the importance of improving access to patients who need medical technology.

Stroke Week_Fact 2

Understanding the underlying cause is essential to determine the right treatment and avoid further strokes.

You’ll remember from yesterday: atrial fibrillation (AF) is a significant risk factor for stroke. Detection of AF is important, as this enables identification of patients who could benefit from therapy with oral anticoagulation (OAC) for secondary stroke prevention.

But AF can have no symptoms and be intermittent – this makes it hard to detect with traditional short-term electrocardiogram monitoring techniques.  AF detection is of particular importance in patients with cryptogenic stroke (CS), where the cause of stroke remains undetermined, despite multiple prior investigations. Identifying AF as the cause of stroke in CS patients is a key step in providing the correct treatment and avoiding another stroke.

Technology [among other therapies for example medication] is available that addresses, including Insertable cardiac monitors (ICMs) which enable long-term continuous monitoring optimising the detection of AF.[3] Then, the correct treatment strategy can be initiated.

The new Stroke Guidelines were launched on Monday 4 September. Learn more here.

Related News: Today, the health promotion charity hearts4heart released a white paper titled ‘Time to Change the Beat. Atrial Fibrillation: A Major Public Health Issue Requiring Immediate Attention and Action“. Read our blog post here. 

#strokeweek2017 #stroke

[1] https://strokefoundation.org.au/About-Stroke/Facts-and-figures-about-stroke

[2] https://strokefoundation.org.au/About-Stroke/Preventing-stroke/Preventing-a-second-stroke.

[3] Sanna T, Diener HC, Passman RS, et al. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. 2014; 370: 2478–2486; Brachmann J, Morillo CA, Sanna T, Di Lazzaro V, Diener HC, Bernstein RA, Rymer M, Ziegler PD, Liu S, Passman RS. Uncovering Atrial Fibrillation Beyond Short-Term Monitoring in Cryptogenic Stroke Patients: Three-Year Results From the Cryptogenic Stroke and Underlying Atrial Fibrillation Trial. Circ Arrhythm Electrophysiol. 2016 Jan;9(1):e003333.

hearts4heart tell the Federal Government: It’s ‘Time to Change the Beat’

5 September 2017

Read about the heart promotion charity heart4heart’s efforts to highlight the danger of Atrial Fibrillation. And their call to reform the Prostheses List to include non-surgically implanted medical technology.

Researchers at the New York-based Commonwealth Fund recently performed a study of 11 different national healthcare models and ranked Australia’s healthcare outcomes the best in the world, and Australia’s overall healthcare system second behind the United Kingdom’s National Health Service.[i]

Remarkable recognition. But, we shouldn’t be complacent. Some mechanisms within our healthcare service are inflexible and based on 20th century needs. They are in effect – but are they effective?

The Prostheses List is the list of surgically implanted prostheses, human tissue items and other medical devices that private health insurers must pay benefits for when they are provided to a patient with appropriate health insurance cover; they are provided as part of hospital treatment or hospital substitute treatment, and there is a Medicare benefit payable for the service.

This Prostheses List is a respected mechanism and provides peace of mind to Australians with private health insurance. However, it has been raised that it is behind modern times, out of pace with the speed of research, development and innovation in medicine and medical technology.

Medical innovation – particularly over the past 10 years – has led to the development of technology that can be used or applied within the human body and is then removed leaving little trace, other than potentially alleviated pain, restored health and/or extended life. This technology is embraced by healthcare professionals and patients who can use it, but it is foreign in the context of a Prostheses List which only factors surgically implanted products.

Take catheter ablation for Atrial Fibrillation [AF] as an example. Catheter ablation is a minimally invasive procedure in which the doctor threads a flexible thin tube [catheter] through the blood vessels to the heart to terminate (ablate) abnormal electrical pathways in the heart tissue. Following ablation, the catheter is removed. Catheter ablation therapy has been shown to be more effective than antiarrhythmic medication for improving the symptoms of AF. However, at present, the procedure is covered inconsistently across health funds because the associated devices are not implantable and are therefore not currently included on the Prostheses List.

If this confuses you – you aren’t alone.

Recognising this gap, hearts4heart, a health promotion charity are advocating for change to help improve outcomes for more than 400,000 Australians living with AF. On Tuesday 5 September hearts4heart released a white paper titled ‘Time to Change the Beat’ for the attention of the Federal Government.Heart4heart-white-paper-WEB-RES_Page_01

According to CEO and Founder, Tanya Hall, Atrial fibrillation (AF) is a major public health issue that requires immediate attention and action. Our ‘Time to Change the Beat’ white paper proposes tangible, achievable and meaningful strategies that should be introduced over the next five years to help reduce the burden of AF in Australia. This includes improved availability and accessibility of catheter ablation for patients with symptomatic AF.”

The white paper identifies four key strategies:

  1. Improved AF screening and detection in general practice and pharmacy.
  2. Increased consumer understanding of AF symptoms and self-detection, as well as the relationship between AF and stroke.
  3. Improve the management of AF in primary care.
  4. Improve availability and accessibility of catheter ablation for patients with symptomatic AF.

These strategies form their five year plan. More information is available here.

How you can help: The best first step is to be informed. Learn more about the four strategies above in the white paper to determine your opinions. You can share them on the hearts4heart facebook page, or on twitter using the hashtag #changethebeat.

About hearts4heart

hearts4heart is a health promotion charity who provide targeted educational programs, resources and services to assist patients, medical professionals, policy makers and the public to ensure early diagnoses and treatment of heart disease including arrhythmias. By raising awareness and providing these programs, they work towards early detection of heart disease, prevention and offer support and management strategies to those living with heart disease.

Disclaimer: Medtronic, alongside other industry partners, provided hearts4heart with an educational grant to support the development of this white paper. The content is independent of Medtronic.

[i] Eric C. Schneider, Dana O. Sarnak, David Squires, Arnav Shah, and Michelle M. Doty, Mirror, Mirror 2017 http://www.commonwealthfund.org/interactives/2017/july/mirror-mirror/

STROKE: TOGETHER WE WILL MAKE A DIFFERENCE Stroke Week 2017 – Prevention

4 September 2017

Medtronic is a leading partner across the stroke care continuum in Australia. What is the continuum? Prevention, Detection, Treatment and Rehabilitation.

At Medtronic, we are proud supporters of National Stroke Week 2017 (4 – 10 September). This week we will be sharing more information about the stroke care continuum. We will also hear what happens when stroke care is not as good as it could be – highlighting the importance of improving access to patients who need medical technology.

Stroke Week_Fact 1

Evolving stroke care: PREVENTION

Risk factors[1] for stroke include atrial fibrillation (AF), diabetes and high blood pressure (hypertension) – the most important risk factor for stroke.  AF causes an irregular heart beat and when blood flow in the heart is slow it can form clots – if these travel to the brain they can block an artery and cause a stroke.  Uncontrolled or untreated diabetes increases the risk of vascular disease: when artery walls become hard and narrow the risk of stroke increases. High blood pressure can cause clots and blood vessel weakening or breakdown: both can lead to stroke.

Some of the technologies used to address these risk factors include:

  • Pacemaker Therapy & Catheter or Surgical ablation to treat AF
  • Insulin pump and glucose monitoring therapy to treat diabetes
  • Renal Denervation for treatment resistant hypertension

More information on stroke risk factors are available from the Stroke Foundation website.

The new Stroke Guidelines GO LIVE on Monday 4 September. Learn more here.

Subscribe now so you don’t miss out on our other “Stroke Week” blogs for 2017.

[1] https://strokefoundation.org.au/About-Stroke/Preventing-stroke/Stroke-risk-factors (Accessed 21st August 2017)

NATIONAL SCIENCE WEEK – SCIENCE FOR LIFE

11 August 2017

It is our Mission to alleviate pain, restore health and extend life. At the moment we achieve this every two seconds with success delivered through timely access to technology for those who require it, and meaningful health outcomes for all.

Science plays a significant role in this goal – but not alone. Founder Earl Bakken worked closely with physicians and their patients at the University of Minnesota and other hospitals where he saw firsthand the life-and-death decisions that surgeons made every day. He knew how much they relied on Medtronic technology and the personal integrity of every employee. A dedication to quality has existed at Medtronic ever since.

Patients play a role in their health outcomes as well. Internet science is a major factor – particularly with the existence of 24/7 online health information – patients are more informed and engaged than ever.

This National Science Week we want to celebrate science, the difference it makes to the community, provide stories about some of our inventions and introduce you to members of our team. You can share your stories below, or on twitter. Tag #medtechscience, #natsciwk

MEET A MEMBER OF OUR TEAM: Paul O’Byrne

Paul Prof Photo

Role: Quality Systems Manager

Qualifications: Bachelor of Engineering Honours (Biomedical)

Tenure with Medtronic: Almost seven years

Can you tell us about the different ways science impacts the lives of patients with Medtronic therapies? The most obvious manifestation are the many scientists and other highly trained experts from many fields of study applying scientific principles and rigour to the design of Medtronic devices. But beyond the devices themselves, the impact of science on our patients is felt in numerous ways. From the design of clinical studies, through the control and execution in our manufacturing plants, to the submission of dossiers to our regulators, science is embedded in many parts of the Medtronic world and touches each of our patients.

What did you enjoy most about studying science? Thinking back to studying different sciences through school and university, the ability of science to answer the question ‘why?’ captures what I enjoyed most. It answered for me my many inquisitive questions in a logical and usually easy to understand manner. In university, I also came to admire the very scientific desire to pursue the answer when it wasn’t yet known.

What are the key learnings you have applied in your personal and professional life? Foremost, the importance of evidence-based decisions where possible. Extending from this, to take calculated risks, and to try to test and confirm a hunch before diving in. Also, that any situation, unlike a tightly controlled experiment, can usually never be explained by simply one rule or theorem – so don’t ignore the complexity and deal in absolutes.

Women in STEM – what’s your opinion? As with any pursuit, team or industry, diversity is key to pushing the envelope and going beyond what is currently being achieved. I fully support the work that is being done to encourage women to choose to study STEM and then stay in STEM research and careers. My degree class at Uni had about a 50-50 split by gender, but the majority of other engineering streams were far less diverse.

What is your advice to future scientists? Science wasn’t all that cool among my peers when it came to choosing classes at school or courses at Uni. But the world we experience every day is driven and largely defined by science in some capacity, so what could be cooler and more fulfilling than pursuing a career that could redefine some aspect of our world.

To learn more about National Science Week visit https://www.scienceweek.net.au/

SOMI Hackathon 2017 – Meet our Judge

11 August 2017

This weekend, our team member James Britton will be representing Medtronic as a Judge at the Society of Medical Innovation [SOMI] 2017 Hackathon.

SOMI is a student run organisation at the University of New South Wales, whose core belief is that students have the power to create innovations in medicine that will shape the way we live. It is open to students from all faculties and schools. According to President Jacqueline Kernahan, “The Hackathon aims to inspire creative problem solving through a competitive environment and foster the development of skills which can be applied to future projects. The winners will receive a monetary prize to put towards the further development of their product.”

We wish all presenters the very best. Here is a chance to meet our Judge!

James Britton

Hi James, what is your role at Medtronic? I am currently enjoying my time as the Senior Program Manager, Integrated Health Solutions (IHS) & Value Based Healthcare (VBHC) for our Asia Pacific region. IHS is our services business that solves healthcare market needs through innovative solutions that focus on efficiency and effectiveness of care, mostly within hospitals. Healthcare is transforming to remain sustainable – at the heart of value-based healthcare is a shift to put the patient back at the center of care – what’s best for the patient should drive the system. At Medtronic we are actively partnering to drive meaningful dialogue from thought-leaders across healthcare and how we can transform the incentive in health today to focus on meaningful outcomes to the patient relative to the costs to deliver these. I’ve been developing and executing on our IHS and VBHC strategy along with my team for about 3 years now, overall been working in healthcare almost 10 years starting my career engineering CT scanners.

What interests you most about medical innovation? Of all the industries, healthcare excites me most. To ‘innovate’ in healthcare, the product, service and/or methodology need to improve patient lives – that’s pretty awesome! In a nutshell, those that work in medical innovation will have the opportunity to look at the way healthcare is delivered today and provide solutions that improve patient outcomes for the long term. This is not only focused in the hospital setting but also on how we keep patients out of hospitals as well as deliver treatment effectively within the home care setting. There are tonnes of opportunity for innovation in healthcare and for us to improve patient lives in Australia. Then, we can leverage those best practices in other parts of the world.

What do you think is the key area to address/solve to help medical innovation thrive in Australia? Medical innovation – product or process – has the potential to drive better outcomes and improve costs to the healthcare system long term. But we need to think about how we measure those outcomes. Macroeconomic factors of the modern healthcare environment prioritise volume over value. To facilitate innovation and creative thinking we need to redesign this view and prioritise outcomes that matter to the patient.

You are a judge for the Society of Medical Innovation’s Health Hackathon. What are you looking forward to most? Really two big things: 1) I’ve always have had a passion for developing employees, whether that means their next promotion or supporting their decision to go back to school for additional education. I see a similar opportunity being a judge for this Hackathon; I get to learn more about the future pioneers of healthcare innovation, what are their values, drivers and career interests. 2) I think it’s going to be fun hearing everyone’s ideas!

Why do you think it’s important to support initiatives like the Hackathon? Transitioning a worthy idea into reality is tough – but it is also important if we want to advance society and drive innovation. Initiatives such as the Hackathon provide problem–solvers and innovators with the opportunity to showcase their idea, and an avenue to help realise it.

What is your advice for people looking for support of their ‘big idea’? Pin point what problem you’re solving and the economic value that will bring to a healthcare system. In today’s healthcare market, with an aging population, rise in chronic diseases and a unsustainable growth in healthcare spend as a percentage of GDP, any meaningful medical innovation will have to improve outcomes for patients or reduce costs to the healthcare system (or both!). Not so easy to do, but definitely possible. Once you have that, prototype and pilot your ‘big idea’ with the appropriate stakeholders so that you can test the impact. Then once you have some positive results work on a sustainable business model that allows for scalability.

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