The Economist earlier this month reported slow progress for Choose and Book, the Internet system established by the UK's National Health Service to match patients and family doctors with healthcare providers. The magazine reported that only 40% of referrals are being made on the system, in contrast to the target of 90% referrals that the government had set for its use.

The site — www.chooseandbook.nhs.uk — says that it "gives patients a choice of place, date and time for their first outpatient appointment in a hospital or clinic. Patients can choose their hospital or clinic, and then book their appointment to see a specialist with a member of the practice team at the GP surgery, or at home by telephone or over the Internet at a time more convenient to them."

However, according to The Economist, UK physicians report that the system "is slow and hard to use." And it said that in June the acting chairman of the British Medical Association described the site as a chaotic shambles."

A key problem is one that currently is the target of ongoing discussion in U.S. healthcare: the lack of information concerning the quality of procedures, UK physicians themselves not able to determine how they rank against their peers.

Reportedly, that situation is changing. UK hospitals, since last year, have had to publish survival rates following heart surgeries, "along with the rates that, on Europe-wide calcuations, they would have expected given the particular patients they treated," according to The Economist.

The site provides a variety of services, a regular bulleting, "communiqués," links to other sites and, as of August, a link which enables patients to make suggestions for improving the service.

On Aug. 29, the NHS reported the appointment of Guy Dickie as the new head of the Choose and Book program. Dickie "brings with him a wealth of NHS knowledge and experience in establishing new services in both primary and secondary care . . . . His role will see him working with clinicians and the NHS to make Choose and Book the everyday method for referring patients," according to NHS Connecting for Health.

Dickie, previously ePrescribing Programme Manager and Prison Health IT Programme Manager at NHS Connecting for Health, said, "I want to lead the team which sees Choose and Book being used more often, so that it becomes the everyday method for referring patients and a widely used tool which supports critical NHS reform, such as helping to measure 18 weeks."

British to study systems for prevention of diabetes

Family lifestyles and their impact on the health of individual family members will be the focus of a new approach to preventing diabetes in the UK. In the first study of its kind in Britain, researchers from the University of Edinburgh and the University of Glasgow will test whether involving whole families in weight loss and fitness initiatives is effective in preventing the development of Type 2 diabetes among high-risk family members.

The £1 million Prevention of Diabetes and Obesity in South Asians (PODOSA) study will focus specifically on people of Indian and Pakistani origin, who are five times more likely to develop late-onset diabetes than the rest of the population.

Researchers will look particularly at families with at least one member who has a high risk of diabetes, possibly because they are overweight or do little exercise. The study, which is currently recruiting participants living in Edinburgh and Glasgow, will encourage all family members to adopt a healthy lifestyle with the aim that this motivates and supports those individuals at risk.

The study is funded by the National Prevention Research Initiative (London) and aims to recruit 300 families. Dieticians will visit them in their homes over the next three years and provide what is termed "culturally-specific" advice on nutrition and exercise.

Researchers hope to reduce the incidence of Type 2 diabetes by 50%, and said they believe that by focusing on high-risk families, they will find strategies that can be applied more widely.

Project leader Raj Bhopal, professor of public health at the University of Edinburgh, said, "Diabetes is increasing rapidly as we get more obese and less active. If we don't take urgent action, it will spread in epidemic proportions."

Bhopal said such a family-based approach has never been tested before, "but by involving the siblings and parents of at-risk individuals, we hope to provide a motivational and supportive strategy that could prevent diabetes not only in the UK, but on a global scale."

Diabetes currently affects an estimated 2 million people in the UK, of whom 90% have Type 2, or late-onset, diabetes that can lead to heart disease, stroke and blindness.

China promises increases in food/drug safety spending

According to a Reuters report, China has promised to spend more than $1.1 billion improving food and drug safety by 2010, and its regulators will be given stronger oversight powers. The expanded spending and strengthened oversight were reported in the wake of international fears over Chinese products.

China has been struggling to convince the world its produce is safe following a series of scandals over tainted pet food, toys, tires, toothpaste, medicine and fish. And results of a new poll show that U.S. consumers are "extremely wary" of products made in China, nearly two-thirds saying they would support a boycott of Chinese goods.

State Food and Drug Administration spokeswoman Yan Jiangying said the Chinese government has earmarked 8.8 billion yuan ($1.16 billion) for food and drug safety over the country's current Five Year Plan, which runs to 2010. Part of this would be spent on a large, new laboratory, she said, adding this was the first time the spending figure had been made public. Yan did not provide a comparison for previous years. "Once the Five Year Plan has been completed, the abilities and the base of the regulator will be substantially raised," Yan said. "There will be an enormous improvement in the system for guaranteeing food and drug safety for the public."

New rules would give the watchdog the power to seal factories and seize whatever materials they need when probing sub-standard goods, she added. Yan said her department also would take the safety message nationwide, starting out in the enormous countryside, home to 60% of the 1.3 billion Chinese population.

Amid assurances by the Chinese government that it is taking a responsible attitude toward food and drug safety, there has been little let-up in the barrage of bad news. Five pesticides were banned earlier this year, and the Agriculture Ministry was compiling a blacklist of companies still making them, the official China Daily said.

In rural China, farmers were improperly using chemicals and spraying them on crops just before they were gathered and sold, the report said. "As part of the government's food safety strategy, it will educate farmers how to properly use pesticides," the newspaper added.

GE Healthcare establishes first MRI training center in China

In other news from China, GE Healthcare (Chalfont St. Giles, UK) in August reported that it has co-founded China's first MRI Application Academy at its GE China Technology Center (Shanghai), citing a shortage of trained professionals specializing in MRI technology.

The company said that while the use of MRI in China is expected to escalate dramatically, hospitals continue to suffer from a shortage of technicians, physicists and radiologists specializing in the technology. Even with more than 2,000 MRI units having already been deployed across China, GE Healthcare said the ratio of equipment to population remains low, at 25 times less than the U.S. market.

The MR Application Academy was established by GE and the Chinese Society of Radiology and Chinese Society of Imaging Technology. The academy, which comprises the MR Education Center China, the Sino-U.S. MR Physics Center and the Sino-U.S. MR Molecular Imaging Center, will focus on advancing MR clinical application in China and promoting research using the technique. In addition, attention will be focused on its applications among the Chinese research and academic community, teaching hospitals, medical schools and universities.

More than 60 experts from China and the U.S. have been appointed as professors at the academy.

IgeaCare, Orange Business target U.S., Canadian 'tele' markets

Healthcare applications developer IgeaCare Systems (Richmond Hills, Ontario) and Orange Business Services, the business communications arm for the France Telecom Group (both Paris), said they will jointly deliver a suite of healthcare applications over a secure communications infrastructure to support the tele-homecare and telemedicine markets in the U.S. and Canada.

The companies said they are working together to enable healthcare providers to optimize the cost of home nursing with what they referred to as "the right mix of technology and hands-on care."

IgeaCare, which describes its operations as providing "advanced intelligent solutions for disease and wellness management," noted that Orange Business Services will provide "fully managed private networks, data center management, integration services and collaborative solutions."

With the combined technologies provided by the two firms, healthcare providers "will be able to monitor patients' health conditions at home and also reach colleagues, partners and customers with devices and applications they regularly use."

IgeaCare said its focus is on "driving improvements in home healthcare delivery by reducing overall costs, increasing resource utilization and enabling improvements in patient outcomes across a wide range of illness[es], while seeking to delay the onset of disease in those with chronic conditions."

It said software-based telemedicine solutions "provide an automated electronic record of care and track patient outcomes, making it possible for insurers/payers to implement pay-for-performance payment systems and integration of patient data into an electronic health record."

Clinical Data acquires genetic biomarker firm Epidauros

Clinical Data (Newton, Massachusetts) last month reported the acquisition of privately-held Epidauros Biotechnologie (Bernried, Germany), for e8.75 million (about $11.84 million) in cash.

The U.S. firm said Epidauros brings "an established portfolio of proprietary genetic biomarkers, expertise in genetic biomarker discovery, relationships with leading diagnostic companies, and a fast-growing pharmacogenomics services business."

Among the assets acquired is a "significant intellectual property portfolio," Clinical Data said, including biomarkers in genes relating to prominent drug transporters such as MDR1(1), OCT1(2), MRP1(3) and what it called "important" cytochrome P450 drug-metabolizing genes, such as CYP2B6(4) and CYP2D6(5).

Clinical Data said MDR1 encodes P-glycoprotein, a key protein involved in drug transport that is known to modulate drug disposition. It said the genes CYP2B6, OCT1 and MRP1 are implicated in the absorption, distribution and metabolism of many drugs that span a variety of therapeutic classes and indications, "and are likely to be important in both response and safety profiles for these drugs."

Drew Fromkin, president/CEO of Clinical Data, said that the purchase "will enhance [our] ability to bring valuable, proprietary pharmacogenetic tests to market. Epidauros' intellectual property portfolio holds great promise in critical areas related to drug transport and distribution. In turn, these genetic markers should play a significant role in better understanding drug response in individuals."

He added that the acquisition "also brings to us the assets, know-how and staff for which Epidauros is so well-respected. In particular, Epidauros will provide Clinical Data with additional scientific expertise, biotechnology partnering capabilities and a deep understanding of European clinical markets. Epidauros has grown its pharmacogenetic services business in support of the pharmaceutical and biotechnology industries and earned a reputation for excellence throughout Europe and the U.S.

Michael Lutz, PhD, CEO of Epidauros, will join Clinical Data's PGxHealth unit as senior VP of pharmacogenetic partnerships, which Clinical Data to advance "the combined abilities of the two companies and expand [our] clinical testing and targeted therapeutics programs."

Clinical Data's PGxHealth division focuses on genetic test and biomarker development to help predict drug safety and efficacy, thereby reducing healthcare costs and improving clinical outcomes. Its Cogenics division provides molecular and pharmacogenomics services to both research and regulated environments, and the Vital Diagnostics division offers in vitro diagnostics solutions for the clinical laboratory.

'Promising' results for clinical trial of Aspire

Physicians at Antwerp University Hospital (Antwerp, Belgium) reported that they successfully treated patients with obstructive sleep apnea (OSA) with a novel surgical procedure using the Advance System from Aspire Medical (Sunnyvale, California), consisting of an implant in the tongue and lower jaw to prevent upper airway collapse during sleep. The company termed preliminary results of this new procedure in these first 10 patients "promising."

Earlier this year, an Antwerp University Hospital team headed by ear, nose and throat surgeon Evert Hamans, MD, performed the procedure for the first time worldwide. A "significant improvement of apnea index was achieved in all the patients," Aspire said, with snoring and daytime sleepiness "significantly reduced."

OSA-related airway obstruction results in a shortage of oxygen and fragmentation of sleep. In Western Europe and the U.S., 4% of men and 2% of women suffer from OSA, according to the company. While Aspire acknowledge use of a ventilation mask during sleep is "effective," it said that many patients "find it intolerable and/or are non-compliant" and therefore seek alternative therapies.

The company said that other surgical treatments for OSA can be highly invasive and have high morbidity rates that result in long hospital stays. "The efficacy of these surgical treatments for moderate or severe OSA also is limited, [and] a lot of patients are not willing to undergo such surgery."

Aspire said that the Advance procedure is short, has a low morbidity and currently requires only one night of hospital stay. "The innovative aspects of this new procedure include the ability to prevent the tongue from obstructing the upper airway, the ability to adjust the implant to the need of the patient under local anaesthesia and the low morbidity of the procedure," the company says.

According to Aspire, the department of otorhinolaryngology and the sleep center at Antwerp University Hospital have "an international expertise in innovative research for surgical and non-surgical treatment of obstructive sleep apnea."

Mexican marketing being planned by Biomagnetics

Biomagnetics Diagnostics (Orangevale, California) said it has met with Hector Garcia, owner of Laboratorio De Patologia Clinica Vallarta, a chain of 23 clinics in the state of Jalisco, Mexico. Clayton Hardman, president and CEO of the U.S. firm, said that Laboratorio will assist with developing a marketing program for Biomagnetics' HTS-MTP system to private laboratories throughout Mexico.

He added that Dr. Luis Manuel Mora, an orthopedic surgeon in Mexico, will assist with distribution to laboratories, clinics and major hospitals.

"We are very excited about these new business relationships," Hardman said. "Their participation provides a depth of experience in both the public and private markets that will open not only the Mexican market but all other major markets throughout Central and South America."

The Mexican market for medical devices is estimated at $2.2 billion in 2007. Biomagnetics said its HTS-MTP system will provide the health industry with "substantial savings," allowing more health benefits to be provided without increasing the budget for healthcare.

Companies report winning CE marks or Health Canada okays

The following companies last month reported receiving CE mark or Health Canada approvals for new products:

• Endovascular technology firm ev3 (Plymouth, Minnesota) received CE-mark approval for its Axium Detachable Coil System for the endovascular embolization of intracranial aneurysms and other neurovascular abnormalities such as arteriovenous malformations and arteriovenous fistulae. It also is intended for use in the European Union for the treatment of peripheral vascular abnormalities.
• Endogun Medical Systems (Kiryat Shmona, Israel), a developer of solutions for minimally invasive fastening of soft tissue, reported receiving CE-mark approval for its single-incision, transvaginal EndoFast Reliant device for repair of pelvic organ prolapse and stress urinary incontinence (SUI).
• Spine and orthopedic biosurgery firm Orthovita (Malvern, Pennsylvania) reported receiving CE-mark approval for its Vitagel Surgical Hemostat product and Cellpaker plasma collection system. The approval allows the company to market Vitagel as a surgical hemostat in Europe.
  Vitagel is a composite liquid hemostat used in surgical procedures as an adjunct to hemostasis when control of bleeding by ligature or conventional procedures is ineffective or impractical. The Cellpaker plasma collection system is used in conjunction with Vitagel.
• Innocoll (Ashburn, Virginia) said its wholly-owned subsidiary, Innocoll Pharmaceuticals, has received a class IV medical device license for its CollaRx Gentamicin Surgical Implant from Health Canada, the Canadian regulatory authority.
  The company said it now is in a position to commercialize the Gentamicin implant in Canada, where it has been registered under the trade name, Collatamp G.
  Gentamicin Surgical Implant is a biodegradable, leave-behind surgical implant impregnated with the broad-spectrum aminoglycoside antibiotic, gentamicin.
  The product was developed using Innocoll's collagen-based CollaRx technology, and has been approved in 49 countries as either a medicinal product for the treatment and prevention of surgical site infections or as a medical device. It is currently in Phase III clinical development in the U.S. for the prevention of surgical site infections.