The 5th annual BRIght Futures Prize Competition features three compelling projects with the potential to solve vexing medical problems. The finalists, all BWH researchers and clinicians, were selected through a rigorous two-step scientific review process.
The BRIght Futures Prizes support investigators across the Brigham Research Institute (BRI) as they work to answer provocative questions or solve grand problems in medicine. Your vote will help decide which of these three projects will receive $100,000 towards their research.
Watch the videos, read the Q&A and vote for your favorite project.
David Levine, MA, MD
The Home Hospital
Collaborators: Jeffrey Schnipper, MD, MPH (BWH), Keren Diamond, RN, MBA (Partners HealthCare at Home), Kei Ouchi, MD, MPH (BWH), Bonnie Blanchfield, ScD (BWH), Adam Licurse, MD, MHS (BWH), Chuck Pu (Partners Population Health), Community Servings, EverBridge, Massachusetts Association of Community Health Care Workers, The Community Health Education Center, Partners HealthCare at Home, Partners Population Health Management, PhysIQ, Smiths Medical and Vital Connect.
When an older adult has to be hospitalized, it can be uncomfortable: they may not sleep well, there can be a lack of privacy, they may not like the food, it can be hard for family to visit. And sometimes, it can be more than just uncomfortable. They may fall in the hospital, catch an infection, become confused, or lose strength that is never regained, keeping them from returning home. Hospitalization can also be very expensive: Medical bills and time away from work put many Americans into debt.
We think there is a better option: “hospitalization” at home, where visits from doctors and nurses, treatment with medications, blood tests and monitoring all occur at home. For over a decade, the home hospital model has been practiced in Europe and Australia, where these patients have experienced the same level of safety and quality as traditional hospital stays, in addition to improved patient satisfaction and reduced costs. But this model has rarely been tried or rigorously tested in the U.S.
We plan to bring the hospital to the home for patients in the United States. We will ask carefully selected patients to participate in a randomized, controlled study, which is the best way to evaluate this model. Patients will benefit from state-of-the-art technology in their own home, including a remote vital-sign monitoring device that enables their doctor and nurse to check their heart rate, among other metrics, with a skin patch. Another technology will monitor patient activity and sleep tracking, which will allow us to test our hypothesis that patients move and sleep more at home. Patients will be able to video conference with health care providers and, best of all, doctors and nurses will visit patients in their homes. They won’t need to come to a hospital setting to receive world-class care. Lastly, patients will be in the ideal setting to receive the education and coaching from community health workers so that they’ll be able to take care of themselves once the acute illness is over.
We want to build a better model of care for ill adults in need of hospitalization. Some procedures will always need to be done in a hospital setting, but in certain cases, home may be the best place for a patient to receive care, monitoring and treatment. We believe receiving care at home puts the patient first, improves patient satisfaction, and reduces cost. Patients can sleep in their own bed, eat their own food and spend more time with friends and family. For many conditions, home hospital will transform our concept of safe, high-quality, cost-effective care.
Giovanni Traverso, MD, PhD
Ultrasound Device for Ulcerative Colitis
Collaborators: Robert Langer, ScD (MIT), Carl Schoellhammer, PhD (MIT)
Ulcerative colitis is a debilitating disease that causes severe inflammation of the gastrointestinal tract—specifically, the colon. Ulcerative colitis is a lifelong condition that affects almost 800,000 people in the U.S., with an additional 60,000 new cases diagnosed every year. Symptoms include abdominal pain, rectal bleeding and chronic diarrhea. More than twenty percent of patients eventually need to undergo surgery to remove part or all of the colon. The disease also carries a social stigma and can significantly diminish a person’s quality of life. Better treatment options are urgently needed.
Today, patients are often prescribed medicated enemas that require them to retain the medication overnight to maximize its absorption in the colon. Overnight enema treatment is an uncomfortable experience that a patient may have to endure nightly for weeks. While there are drugs that are highly effective at shutting down the inflammation that causes UC’s symptoms, these drugs are too large and delicate to be delivered directly into the colon. Instead, these drugs have to be injected, a delivery method that has many drawbacks.
We have developed a new device that uses ultrasound to deliver therapies directly to the site of disease through a brief enema, shutting down inflammation without the need for an injection or an overnight enema. Patients can use this device themselves in the comfort of their homes, enabling them to take back control of their disease and live happier, healthier lives.
By using ultrasound to gently propel medication into the tissue, significantly greater amounts of the drugs can be delivered directly into the tissue. And it only takes one minute—as opposed to several hours—for this device to administer medication. We also anticipate that we will be able to use our method to deliver a wide variety of drugs and new treatments as they become available—not just for treating ulcerative colitis, but also for other diseases.
This device will be easier and more convenient for patients to use, with better clinical outcomes for those who suffer from ulcerative colitis. Not only will our device reduce the burden of enema administration, but it will also enable patients to receive highly effective medications that currently may only be injected. This will reduce patients’ medical expenses, improve their outcomes and prevent the worsening of symptoms or the development of related diseases. Finally, the technology this device runs on has the potential to be used in treating a wide range of other diseases.
Tracy Young-Pearse, PhD
Collaborators: Christina Muratore, PhD (BWH, HMS), Philip DeJager, MD, PhD (BWH, HMS), David Bennett, MD (RUSH University Medical Center), Dennis Selkoe, MD (BWH, HMS), Scott Noggle, PhD (NYSCF)
Alzheimer’s disease is devastating for patients and their families. Unfortunately, it also is an incredibly common disease: More than 5 million Americans are living with Alzheimer’s. One of the reasons why we have not been able to successfully treat the disease is that by the time patients enter the clinic and are diagnosed, many of their brain cells have already died. Many doctors and scientists agree that early intervention, prior to the onset of memory loss and cognitive decline may be the key. But in order to intervene early, we must be able to predict who will develop the disease. Further complicating our efforts today is that Alzheimer’s disease can come in different forms, and some patients may respond to a given therapy while others may need a different kind of intervention. If we could predict who would respond to particular therapies, this could transform how we treat Alzheimer’s disease.
We want to understand why some people develop Alzheimer’s disease when others don’t so that we can intervene early to prevent disease progression in those who are at risk. Our idea is to take blood cells from individual people, turn these into brain cells in a dish, and use measurements from these cells to predict Alzheimer’s.
For this project, we first are making stem cells from blood samples from three groups of people: 1) those who lived to be in their 90s and 100s with excellent cognitive abilities and no signs of disease in their brain 2) those with Alzheimer’s disease who had plaques or tangles in their brain and 3) those who had plaques and tangles in their brain but who had excellent cognition.
Through a series of manipulations, we can efficiently turn these stem cells into brain cells in just a few weeks. From these living brain cells, we will acquire measurements of the proteins that accumulate and cause the disease, and develop predictive tools that will help us assess who is at risk of developing Alzheimer’s. In addition, we will examine which cells respond to a new therapy in clinical development.
If successful, our project could transform how we test new therapies for Alzheimer’s disease, allowing us to treat the disease before brain cells die. Importantly, it could also help us identify which treatment will be the most effective for which patients, and if no treatment exists for a given patient, test for new interventions that would work for them. Together, this could potentially mean reducing the suffering of the millions of families affected by this devastating disease.