Category Archives: Healthcare

How 3-D Printing Is Changing Health Care

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Recent advances have made the technology more useful for planning surgery and creating drugs

The Mayo Clinic printed a model of a patient’s pelvis to plan surgery to remove a rare tumor that had spread to the base of the spine.
The Mayo Clinic printed a model of a patient’s pelvis to plan surgery to remove a rare tumor that had spread to the base of the spine. PHOTO: MAYO CLINIC

A year ago, an 11-year-old girl named London Secor had surgery at the Mayo Clinic to remove a rare tumor located in her pelvis. In the past, surgeons would have considered amputating one of Ms. Secor’s legs, given that the tumor had spread to the bone and nerves of her sacrum and was encroaching on her hip socket.

That didn’t happen this time, however, due largely to advances in 3-D printing.

Before the surgery, Mayo printed a 3-D model of the girl’s pelvis, scaled to size and showing her bladder, veins, blood vessels, ureters and the tumor. Members of the medical team were able to hold the model in their hands, examine it and plot a surgical approach that would allow them to remove the entire tumor without taking her leg.

“There is nothing like holding a 3-D model to understand a complicated anatomical procedure,” says Peter Rose, the surgeon who performed the operation on Ms. Secor, an avid swimmer and basketball player from Charlotte, N.C. “The model helped us understand the anatomy that was altered by the tumor and helped us orient ourselves for our cuts around it.”

The pelvis model was one of about 500 3-D-printed objects created at the Mayo Clinic last year. It’s part of a web of organizations racing to find ways to use 3-D printing to improve health care.

Some research institutions, including the Mayo Clinic, have set up on-site printing labs in partnership with such makers of 3-D printers as Stratasys , 3D Systems and Formlabs. General Electric Co. and Johnson & Johnson are diving in, too, with GE focused on 3-D printers and translating images from various sources into 3-D objects, and J&J focused on developing a range of materials that can be used as “ink” to print customized objects.

Using data from MRIs, CT scans and ultrasounds, as well as three-dimensional pictures, 3-D printers create objects, layer by layer, using materials ranging from plastics to metal to human tissue. Beyond organ models, the printers are being used in health care to create dental and medical implants, hearing aids, prosthetics, drugs and even human skin.

Research firm Gartner predicts that by 2019, 10% of people in the developed world will be living with 3-D-printed items on or in their bodies, and 3-D printing will be a central tool in more than one-third of surgical procedures involving prosthetics and implanted devices. According to research firm IndustryARC, the overall market for medical 3-D printing is expected to grow to $1.21 billion by 2020 from about $660 million in 2016.

Though the industry is young, Anurag Gupta, a Gartner vice president of research, says 3-D printing in health care “could have the transformative impact of the internet or cloud computing a few years ago.”

The technology of 3-D printing has been around since the 1980s, but recent advances in software and hardware have made it faster, more cost-efficient and of higher quality. Five years ago, the 3-D printers made by Stratasys could print in one or two materials and one or two colors. Now they can print six materials simultaneously and create more than 360,000 combinations of textures and colors to better mimic materials ranging from soft tissue to bone, paving the way for wider adoption.

The rise of customized medicine, in which care and medicine is tailored to individual patients, also has helped fuel growth of 3-D printing in health care, as more patients and doctors seek out customized medical devices, surgical tools and drugs.

One of the areas in which the technology may hold particular promise, experts say, is in the manufacturing of drugs in the dose and shape best suited to certain groups of patients. Aprecia Pharmaceuticals recently launched a 3-D printed epilepsy drug called Spritam, a high-dosage pill that dissolves quickly with a small amount of water and in a shape that is easy to swallow.

Printing whole organs, such as livers and kidneys, remains the Holy Grail, but that is more than a decade away, says Gartner’s Mr. Gupta. Printing smaller pieces of human material, however, has already begun.

Researchers at the University Carlos III of Madrid, along with the Spanish biotech company BioDan, have printed human skin to eventually help burn victims and others suffering from skin injuries and diseases. The process involves a 3-D printer that deposits bioinks containing cells from an individual as well as other biological molecules to create a patch of skin. Like the real thing, this printed skin consists of an external layer, the epidermis, and the thicker, deeper layer, the dermis.

Organovo Holdings Inc. of San Diego prints pieces of liver and kidney tissue to test new therapies and the toxicology of early-stage drugs. Johnson & Johnson is working with Aspect Biosystems Ltd. to develop bioprinted knee meniscus tissue. And 3D Systems is developing 3-D-printed lung tissue with United Therapeutics Corp.

While entry-level 3-D printers used by hobbyists can cost a few hundred dollars, industrial 3-D printers used by hospitals can range from $10,000 to $400,000 for those that print plastics and polymers.

Another hurdle for hospitals is the “hidden cost” of operating 3-D printers, says Jimmie Beacham who leads GE Healthcare’s 3-D printing strategy. Engineers are required to transform dense digital images from MRI, CT and ultrasound scans into information that can be printed into a 3-D model. What’s more, printing a 3-D object doesn’t yet happen with the click of a button. It took 60 hours for Mayo Clinic to print Ms. Secor’s pelvis and tumor, for example.

Still, 3-D printing can lead to cost savings in other areas, say experts such as Jonathan Morris, a Mayo radiologist. Allowing surgeons to practice on 3-D models of a specific patient’s organs before surgery can significantly reduce time in the operating room. Printing implants and prosthetics on demand and on location means fewer middlemen in the supply chain and less waste. And given the better fit of customized implants from 3-D printers, patients may not have to replace them as often.

The Mayo Clinic and a half dozen other cutting-edge research hospitals have blazed the path in terms of creating 3-D printing labs on site. Now some larger city network hospitals are beginning to purchase their own 3-D printers, while smaller hospitals and doctors can order 3-D models for complicated surgeries on a case-by-case basis from 3-D printing companies.

Hospital Looks to Virtual Reality in Emergency Situations

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LEO LUTERO in PSFK
11 MAY 2015
Hospital Looks to Virtual Reality in Emergency Situations

Patients and medical professionals will soon be setting aside diagrams and photos in exchange for VR goggles. Content developer Next Galaxy Corporation and the Miami Children’s Hospital has recently forged a multi-year deal for creating immersive virtual reality (VR) instructional content.

Virtual emergency situations will help train individuals in executing procedures such as cardiopulmonary resuscitation (CPR) that could potentially save lives. With the technology, learners will have a more realistic exposure to emergency situations.

Using eye-gaze control, gestures and voice commands, the system aims to provide real-time feedback that will give participants corrective pointers to help them carry out procedures more accurately. The system will even congratulate learners who do well during the lessons.

The training modules will be released as an application for smartphones and will be compatible with Current VR devices such as the Google Cardboard, Gear VR, VRONE and the Oculus Rift.

Next Galaxy‘s Founder and President Mary Spio shares:

In addition to being one of the nation’s most esteemed hospitals for its clinical outcomes, MCH is building a legacy as a pioneer in healthcare with its unabated efforts to connect, educate and reinvent the healthcare experience.

ceek next galaxy corp.jpg

Next Galaxy Corporation develops a wide assortment of VR content for the future. The company’s flagship product, CEEK, is a social VR hub that aims to become the epicenter of VR experience.

The Miami Children’s Hospital is a 289-bed nonprofit facility and is South Florida’s only licensed hospital specialized for children. Miami Children’s Hospital’s President and CEO Dr. Narendra Kini shares:

We are very excited about the new partnership with Next Galaxy to leverage the power of Virtual Reality to create innovative and impactful medical learning experiences. Through our MCH Virtual Reality education, we are breaking new ground with leading technologies and look forward to transitioning our extensive training library from two-dimensional to three-dimensional immersive content for the benefit of patients and the entire healthcare community.

VR Hospital image from Next Galaxy

Wearable Tech: Healthcare Win

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InformationWeek: HEALTHCARE // MOBILE & WIRELESS
7/28/2014
While most businesses still view wearable computers as little more than toys, healthcare has embraced them. Check out these interesting examples.

Recovery and therapyAfter surgery, you often face a recovery period that involves physical therapy. Along comes Google Glass again, this time with an app from a company called Wearable Intelligence. The app guides a therapist through a specific set of exercises for a specific patient, with exact instructions on such things as amount of flexion and limb rotation. The app also uses the camera to record video of the exercise, and even gives a check mark 'OK' when all steps have been accomplished. This should help reduce misapplied therapies, and help new therapists rapidly gain the right skill sets.</p>
<p>Image credit: wearableintelligence.com<br />

Recovery and therapy
After surgery, you often face a recovery period that involves physical therapy. Along comes Google Glass again, this time with an app from a company called Wearable Intelligence. The app guides a therapist through a specific set of exercises for a specific patient, with exact instructions on such things as amount of flexion and limb rotation. The app also uses the camera to record video of the exercise, and even gives a check mark “OK” when all steps have been accomplished. This should help reduce misapplied therapies, and help new therapists rapidly gain the right skill sets.

Image credit: wearableintelligence.com

Night-Vision Contact Lenses That Use Infared Technology May Soon Be Possible, Researchers Say

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Those night-vision devices used by hunters and soldiers may soon get a lot smaller — small enough, in fact, to be built right in to contact lenses.

That’s the word from University of Michigan researchers, who say they’ve created the first-ever full-spectrum infrared light detector that works at room temperature. Conventional night-vision devices require bulky built-in cooling units to work properly.

Night-vision technology makes it possible to see light that is imperceptible to our eyes, and heat that radiates from the bodies of people and animals in the dark.

“We can make the entire design super-thin,” Dr. Zhaohui Zhong, assistant professor of electrical and computer engineering at the university, said in a written statement. “It can be stacked on a contact lens or integrated with a cell phone.”

The key to the new technology is a lightweight and super-strong form of carbon known as graphene. Ordinarily, graphene absorbs only about 2.3 percent of light that hits it — not enough to generate a usable infrared signal. But by combining two layers of graphene with an insulator, the researchers were able to boost the signal dramatically. Sensors made of sandwiched graphene can detect the full infrared spectrum, in addition to visible and ultraviolet light.

Zhong and his team have yet to integrate their technology into contact lenses, but he says the technological pathway to such devices is clear.

“If we integrate it with a contact lens or other wearable electronics, it expands your vision,” Zhong said. “It provides you another way of interacting with your environment.”

And wearable night-vision contacts are just one possible application of the new technology. Infrared devices are also used to identify gas leaks, help doctors find blood vessels and even allow art historians to see sketches under layers of paint.

“Our work pioneered a new way to detect light,” Zhong said in a statement. “We envision that people will be able to adopt this same mechanism in other material and device platforms.”

A paper describing the research was published online March 16 in the journal Nature Nanotechnology.

UC Davis taps Ginger.io for psychotic illness study by passively using smartphones

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By: Aditi Pai | Mar 10, 2014 in mobihealthnews

UCDavisGingerioUniversity of California Davis’ Early Diagnosis and Preventive Treatment (EDAPT) Clinic is launching a study in partnership with mobile health company Ginger.io. The 12-month study follow 120 young people who are in the early stages of psychotic illness. Only youth who are enrolled in the UC Davis or City of Sacramento (EDAPT) clinics are eligible to participate.

UC Davis received $588,000 from the Robert Wood Johnson Foundation to fund this study.

All of the children in the study will receive the Ginger.io app that passively collects data from users’ phones including information on their movement throughout the day, call patterns, and texting patterns. Users can also actively record information about how they are feeling each day. If the app senses that something is off with the user, it will automatically notify the user’s family and physician.

This system makes it easier for physicians to gain insights into how a patient is doing on a day-to-day basis and helps users recall information from the week as sessions.

“We are trying to identify the early warning signals that someone is struggling, so we can intervene earlier and hopefully prevent relapse,” Tara Niendam, assistant professor in the Department of Psychiatry and Behavioral Sciences and director of operations for the EDAPT Clinic said in a statement. “If an individual is having a bad week, we can reach out to them quickly, rather than waiting for them to call us or come in to the clinic for their next appointment.”

Niendam added that there were many warning signals that the study could identify. One metric might be whether forgetting a dose of medication could trigger an increase in symptoms or how the number of arguments a user has with family members affects his or her mood.

If study participants do not have smartphones, UC Davis will provide phones via a partnership with T-Mobile USA.

Ginger.io has partnered with multiple other organizations in the past including Sanofi US DiabetesC3N’s IBD Pilot, and UCSF’s Health eHeart initiative.

Ginger.io’s spokesperson Stephanie Wilson told MobiHealthNews in an email that the app is “currently part of the care solutions at Kaiser Permanente and Novant Health and contributes to core research at UCSF, Cincinnati Children’s, and MIT Medical. Ginger.io also recently launched Mood Matters, making the technology directly accessible to people living with depression.”

Healthcare’s Innovation Imperative: Ten Truths Small Business Needs To Know

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Key Points:

Inflection points insist on healthcare innovation. Here’s what’s on the horizon:

  • Clinical Models are changing                                      
  • Insured population is growing
  • Marketing target shifting                                               
  • Deductibles and out-of-pocket expenses on the rise
  • New Data Thresholds for studies are emerging         
  • Cost Transparency is coming
  • Decision Making support tools are in demand
  • The smart phone will see you now
  • Data Transparency will be the new normal:
  • Cost, convenience, quality, and consumer preference will have a significant influence on how and where care is delivered.
    ________________________________________________________________________
Kerry A. Dolan in Forbe
3/20/2014

The greatest danger in times of turbulence is not the turbulence; it is to act with yesterday’s logic.” Peter Drucker

In a period of massive change, franchises die and are born, previously unimagined models emerge, and incumbents that are too focused on “protecting share” find themselves closing their doors. The healthcare industry represents nearly a fifth of U.S. GDP and it is going through such a period of dramatic change as we speak.  The product companies that dominate the marketplace today find themselves cash rich but growth poor.  At the same time an army of inventors and visionaries in biotechnology, medical devices, diagnostics, health care services, healthcare IT, and consumer health fields are eager to provide a new model for the future.

Healthcare venture funding is extremely tight, entrepreneurship remains a technically sophisticated pursuit, and “evolutions masquerading as innovations” abound. But smart entrepreneurs who harness the dazzling new tools we now have at our disposal have everything to gain if they focus on creating offerings aligned with the emerging value system. Their products and companies will be highly sought after by today’s market leaders… some will overtake existing market leaders entirely.  And patients will benefit tremendously.

Our mandate as health care investors and entrepreneurs must be to channel our time, capital, and expertise exclusively into companies that will thrive in the face of extreme scrutiny, forcing inadequate, expensive legacy systems and interventions into rapid obsolescence.

Inflection points insist on innovation. Here’s what’s on the horizon:

Clinical Models are changing: Fee-for-service, volume-based care models of the past will be replaced by results-driven models. For institutions and individuals providing care to patients this will mean a sharper focus on prevention, minimizing readmissions, better care coordination etc. For companies that market pharmaceuticals and medical devices this will mean being part of a “total care” integrated solution that goes beyond an individual pill or device.

Insured population is growing: The “disappearance” of an uninsured population will increase the number of people who access care. As utilization increases, expenditures will rise, even if prevention becomes more commonplace. As a result, overall costs will receive more scrutiny and payors will exercise more negotiating leverage. In some cases this will result in new price pressure on a specific product. In other cases it will mean less price sensitivity if a new product can show it lowers the total costs of treating a condition.

Marketing target shifting: In the past, physicians were the dominant focus of pharmaceutical and device company marketing efforts. Now, physician sales forces are shrinking, marketing methods are changing, and the targeted audience is shifting. On the one hand, technology has enabled more efficient, lower cost “virtual detailing”; on the other hand it requires a sophisticated understanding of real time, crowd-driven and social tools. With patients-as-consumers and institutional payors demanding more evidence of the value of a service or product, the importance of messaging tailored for these audiences is difficult to overstate.

Deductibles and out-of-pocket expenses on the rise: Insurance reform will result in larger deductibles for more individuals. As consumers pay more out-of-pocket and become more aware of direct costs, they will become more sensitive the ways they access health care. The ability to make a direct value proposition to consumers will be a competitive advantage, if not a competitive necessity for product and service providers.

New Data Thresholds for studies are emerging: Placebo/sham-controlled trial data has been the standard for demonstrating safety and efficacy of new therapeutic interventions. With a new focus on value, there is demand for data that compares new interventions against existing standards of care. Additionally, there is more interest in data that measurably demonstrates enhancements to quality of life, convenience, compliance and adherence improvements, and holistic reductions in disease burden. In the service of this demand, new data sets will complement standard sets including patient reported outcomes data, unstructured data, quantified-self data, and “the Internet of Things” data generated by medical devices, supplies, and even drugs. As these data sets grow, Big Data techniques will transform the raw data into useful information with applications we haven’t even begun to imagine.

Cost Transparency is coming: Health care cost transparency is nonexistent today, both at the level of patients and surprisingly at the level of providers.  Tools are now being built and incentives are being put in place to allow cost transparency along with value tracking and optimization.  In the not-too-distant future, purchasers will view the absence of such data as inconceivable and intolerable.

Decision Making support tools are in demand: Decision-making around a patient’s diagnosis and the optimal course of therapy has been driven by a combination of clinician observations and instinct. Physicians reach conclusions by integrating inputs from the physical examination, family history, and lab/imaging data, all in the physician-specific context of past experience, medical training, and emerging science s/he may have had the chance to review. Increasingly, doctors and patients expect systematic, up-to-date integration of an increasingly exhaustive set of inputs to support decision making. Furthermore integrating case-specific information real time in validated ways into reference data sets will bridge the time and expense gap between the metaphorical “R&D bench and bedside”.

The smart phone will see you now: Health applications and accessories enabled by smart phones, wireless connectivity, and telepresence technologies will expand access, improve efficiency, and increase convenience for patients and providers. They will also allow better data generation, data tracking, data portability, and data organization.

Data Transparency will be the new normal: Institution-specific paper files are becoming a thing of the past as electronic, ubiquitous, patient-accessible records become the new standard. In parallel, patients and clinicians are seeking more clinically-focused annotations in the records in the place of claims-focused coding.

Cost, convenience, quality, and consumer preference will have a significant influence on how and where care is delivered. Within large clinics and hospitals we are already seeing consumer-focused practices like same-day appointments, private waiting rooms, and concierge-like care navigation services. We will also see more care move out of centralized institutions into alternate settings: walk-in clinics in drugstores and airports, self-administered at home lab tests, virtual house calls.While such services and technologies are desirable for their ability to improve patient satisfaction, their ability to drive efficiency, broaden access, reduce costs, and improve outcomes is even more compelling.

A mathematician turned life sciences entrepreneur and venture capitalist, Ashley Ledbetter Dombkowski, Ph.D., has invested in the private and public market healthcare sectors for more than 15 years. She is a Managing Director at venture capital firm Bay City Capital, was on the board and executive team at 23andMe, ahd has co-founded numerous companies including Epizyme and iPierian.

6 Promising Medical Applications of 3-D Printing

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Posted in Printing Services by Brian Buntz on December 11, 2013

Additive manufacturing, more commonly called 3-D printing, can be used to make everything from surgical guides and medical device prototypes to batteries.

Some of the most inspiring applications of the technology, however, can be found in new applications of the technology to treat previously unmet clinical needs.

 

1. Printing Tissue. The manufacturing process involves creating a object or objects through a machine that adds successive layers of materials (the “ink” of 3-D printing), versus the more traditional methods of using molding and machining. 3-D printing has shown promise in the area of creating tissue and organs, with ink comprised of living cells.

Check out this demonstration video from Cornell University about 3-D printing a human ear:

2. Prosthetics. Among the medical applications of 3-D printing that has seen the most progress is its use to product custom prosthetic limbs. One of biggest problems with traditional prosthetics is that they often don’t perfectly fit patients’ limbs. The ability of 3-D printing to make objects of practically any shape, using specifications from a computer program, solves this issue.

One of the most touching examples of how 3-D printing has shifted the standard of care can be found in the case of Emma, a young child who had been diagnosed with a condition known as arthrogryposis, which prevented her from lifting her arms. At birth, Emma was only capabple of moving her thumb and had trouble learning how to walk.

To help Emma, researchers Tariq Rahman and Whitney Sample of Nemours/Alfred I. duPont Hospital for Children used 3-D printing to create a custom exoskeleton. 3-D printed using ABS plastic on a Stratasys system, the exoskeleton enabled Emma to gain control over her arms. The researchers were able to produce a series of exoskeletons to fit Emma as she grew. At the age of four, Emma referred to the exoskeleton as her “magic arms.”

3. Custom Exoskeletons. 3-D printing is also well suited to making customized prosthetic hands. Recently, CBS aired a segment featuring a 12-year-old with a bright new prosthetic hand capable of grabbing and holding objects. The boy’s father reached out to a mechanical-hand innovator named Ivan Owen, who had previously used 3-D printing to develop a custom prosthetic for a child. The first time the 12-year old used the hand was, in the child’s words, “pretty awesome.” The end result was the fraction of a cost of traditional prosthetics.

4. Personalized Airway Splint. 3-D printing has also proved lifesaving in the case of a baby named Kaiba Gionfriddo who had difficulty breathing. As a six-week old, Kaiba would turn blue after stopping breathing. Doctors gave him a small chance of surviving.

University of Michigan researchers were able to save his life by developing a custom airway splint to replace Kaiba’s crushed windpipe. A CT scan enabled the team to design the device.

5. Bone Scaffolds. It even has potential to produce bone-like implants for reconstructive surgery that then act as scaffolds for real bone cells, which multiply and take over the implant as real bone as the implant dissolves away. A British company known as Oxford Performance Materials has even developed a product known as Osteofab that was used earlier in the year to replace 75% of U.S. patient’s skull. The product has received 510(k) clearance from the FDA.

6. Cardiac Models. 3-D printing is also helping designers better envision the parts of the body they are building devices for.

It can be used to produce extremely accurate models for cardiovascular applications, as in the case of the HeartPrint service from Materialise. Traditionally, engineers have used blown glass for rigid parts or silicone for compliant models, which offer limited accuracy. The HeartPrint service makes use of CT or MRI data to create realistic models. “It allows you to take medical image data and select different regions of the body, whether be soft tissue or bone, and create accurate 3D representations from it,” said Peter Verschueren, global cardiovascular business development manager at Materialise (Brussels, Belgium) in an interview with MPMN.

The HeartPrint 3-D printing service from Materialise enables engineers to do benchtop testing on cardic new devices. Shown here is a 3-D printed model of the heart.
The HeartPrint 3-D printing service from Materialise enables engineers to do benchtop testing on cardiac new devices. Shown here is a 3-D printed model of the heart.

Brian Buntz is the editor-in-chief of MPMN. Follow him on Twitter at @brian_buntz and Google+.

Doctor On Demand Launches To Bring A $40 (Virtual) House Call To Healthcare

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Posted in TechCrunch by

Adam Jackson and former Stanford physician and White House fellow Dr. Pat Basu want to help modernize healthcare by bringing the house call back — mobile-style. To do that, today, they’re officially launching Doctor On Demand, a service that aims to connect consumers to a licensed U.S. physician via app an on iPhone, Android or tablet — from anywhere.

Well, in saying “anywhere,” that’s the eventual goal. For now, at launch, the service is available in 15 U.S. states for a price of $40 per video call — a price the co-founders believe puts Doctor on Demand on par with most insurance co-pays and cheaper than most urgent care. The idea is to make a quality, experienced physician available to any consumer for just $40.

Because this model is not without its antecedents, Doctor on Demand is looking to remove as much friction as possible from the process, allowing patients to connect with a doctor in real and pay with their Health Care Spending Account, Flexible Spending Account or any major credit card. The other, ancillary benefit (so to speak) of this is the ability to reduce wait times at doctor’s offices and practices across the country, and allow patients to receive quality medical care from the comfort of their couch.

To do that, Doctor on Demand uses a HIPAA-secure network and synchronous video chat to allow patients to communicate with doctors. However, there is a caveat: Doctor on Demand is to be used for “non-emergent clinical issues that do not immediately require a direct presence, lab work or imaging.”
While this limits the network’s utility to some degree, it still covers a significant portion of medical issues. For instance, you could talk to a doctor about symptoms of common colds, fevers, coughs, sinus infections, allergies, upset stomachs, fevers, rashes, eye problems and so on. You can even get your prescription refilled, and upload high-res images during the call so that, say, a busy parent can give the doctor a sense of how their child’s symptoms appeared at their worst.

Jackson and Basu tell us that, through partnerships with health systems, their network of physicians has grown to 1,000 nationally and are overseen by Basu himself — the co-founder and CMO (Chief Medical Officer). They are also in the process of putting together a multidisciplinary team of doctors, so that, eventually, when one signs on to Doctors on Demand, they will be able to be routed immediately to a specialist (say an Ear, Nose and Throat doctor) based on the keywords they input from the start.

But today, the team includes the support of people like former U.S. Senate Majority Leader Tom Daschle, who serves on the company’s board of directors and co-founder Jay McGraw, an Emmy Award-winning executive producer of The Doctors. To support its launch in 15 states today (which, by the way, include California, Florida, Georgia, Illinois, Indiana, Michigan, Mississippi, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, Virginia and Washington), Doctor on Demand has raised $3 million in seed funding from Venrock, Andreessen Horowitz, Google Ventures, Lerer Ventures, Shasta Ventures and Athena Health CEO Jonathan Bush.