Best tech for pediatrics: 2016
This has been an outstanding year for medical technology and innovation. Here is Dr Schuman’s review of the best tech products for your practice.
Lice eradication technology
Wandering around the exhibit hall, I chanced upon the Lice Clinics of America (Larada Sciences; Salt Lake City, Utah) booth. I learned that parents can book a lice eradication appointment at 1 of more than 100 clinics in major cities nationwide. The clinics employ the AirAllé medical device (cleared by the US Food and Drug Administration [FDA]) that directs heated air to the hair and scalp. According to the website, the AirAllé achieves a 99% lice elimination rate and the company guarantees results. This process takes about 40 minutes and costs $175. It kills lice and dehydrates nits, rendering them incapable of hatching. At home, the parents use a nit comb to remove nits at their convenience. For a similar amount of money, parents can purchase a Home Treatment Kit that includes a special hair treatment device and comb attachment that looks like a hair dryer. The system heats the lice and nits to 138°F for 30 minutes. The final price has not yet been determined as of this writing.
Audiometer/OAE screener/tympanometer in one
Last year, I mentioned that Audiology Systems (Schaumburg, Illinois) markets the Madsen Alpha OAE screener that displays a cartoon interface to facilitate cooperation with young children you’d like to screen for hearing loss. When I visited Madsen’s booth at the NCE exhibit hall, I learned that the company also sells an all-in-one desktop screener that performs OAE screening, tympanometry, and audiometry. This is the Santiero Desktop system, which sells for about $7000. The device has a small footprint; thus it can be moved into the exam room with the patient for screening. It features a colored touch screen that walks the user through the testing process. If a patient refers on the OAE screening, the pediatrician can use tympanometry to detect serous otitis as a cause of the hearing loss. This is done with the same probe as the one used for OAE testing! Additionally, an integrated audiometer can be used to quantify the degree of hearing loss. Each test has a separate current procedural terminology code, and the system will pay for itself in a matter of months.
Improving respiratory diagnosis
I spent considerable time visiting the Vitalograph (Lenexa, Kansas) booth at the exhibit hall and learned about a variety of affordable devices that would interest pediatricians. An excellent article on spirometry in office practice appeared in Contemporary Pediatrics in March of this year. Spirometry is used to establish the diagnosis of asthma and to monitor treatment, and should be performed at diagnosis, 1 month after starting treatment, and every 6 months thereafter.
Vitalograph markets an affordable ($75) respiratory screener called the asma-1 that can be used by parents and patients to monitor response to therapy. It can be used to perform a peak flow measurement as well as a forced expiratory volume, and should be brought with the patient at follow-up asthma checks so the results can be viewed and discussed with the patient. I learned from the Vitalograph director of marketing that several practices loan patients the more advanced USB version of this device when treatment is started. At follow-up visits, the information can be viewed with PC-based software to facilitate patient discussion and can be incorporated into the patient record.
I was equally impressed by his demonstration of the Vitalograph micro spirometer that sells for just $895 and is a self-contained unit that requires no PC connection. It features a full-color touch screen and produces printed reports that are concise and useful. You can also use it to establish the diagnosis, which sometimes requires a response to a pre- and post-bronchodilator challenge. The average reimbursement for spirometry testing is about $78.
Lastly, Vitalograph markets the AIM system, which stands for Aerosol Inhalation Monitor. It is only $450 and is used to train patients how to correctly use both dry-powder inhalers and metered-dose inhalers. When patients use their inhalers correctly, they benefit by remaining symptom free. Physicians should be aware that practices can bill for asthma training, so if you treat a lot of asthmatics it is a worthwhile service to provide.