Improving Health

Technology and Patient Care

Supercomputing

NIH-funded supercomputing instruments enabled researchers to determine the efficacy of four COVID 19 vaccines. Advanced computations conducted using these instruments helped inform timely decisions on the initial authorizations of COVID-19 vaccines, which later received FDA approval and were critical to saving lives during the COVID-19 pandemic.

Image credit: Shutterstock

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  • NIH supports cost-effective investments in cutting-edge instruments like supercomputers that are shared among multiple researchers to maximize their benefit nationwide.
  • Supercomputing, a type of high-performance computing that uses multiple central processing units, allows researchers to perform numerous complex calculations simultaneously.
  • Researchers use supercomputers to analyze and visualize many different biomedical data sets, from the intricate structures of proteins to complex genetic characteristics across global populations.
  • This technology paves the way for supercomputing to be used in future public health emergency responses.
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Collaborative Care

NIH-supported research has informed clinical care guidelines by demonstrating the effectiveness of collaborative care—a service delivery model for treating mental/behavioral health conditions in primary care settings—for treating depression, and it has paved the way for collaborative care services in routine practice, as seen today.

Image credit: Daniel Soñé/NCI

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  • NIH-supported clinical trials demonstrated improvements in quality of care and depression outcomes with collaborative care techniques. 
  • This research also led to the development of billing codes to reimburse providers for services furnished through the collaborative care model in Medicare and a growing number of commercial and public payers.         
  • Collaborative care has also been shown to be effective for treating PTSD, anxiety, alcohol use disorder, opioid use disorder, and co-occurring medical conditions.
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Mobile Health

NIH has supported the development of many behavioral interventions that are now available via popular health-focused smartphone applications. These apps, used by millions of users across the U.S., serve as digital health interventions ranging from reminding people to take medications to engaging in mindfulness practices.

Image credit: Daniel Soñé/NCI

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  • Smartphone apps are becoming increasingly popular as digital interventions in almost all sectors of healthcare. 
  • NIH funds the development, testing, and implementation of mobile health interventions like smartphone apps.
  • For example, Calm, Inc., is scientifically advised by NIH awardees and contains guided meditations and sleep-promoting sounds.
  • NIH also supported development of the FODMAP Diet app, which empowers people to shop for groceries, cook meals, and manage their food consumption to alleviate irritable bowel syndrome (IBS) based on ingredients that may trigger their symptoms.
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Liver Transplants

The first successful human liver transplantation was performed by an NIH grantee in 1967. Liver transplants are now routinely used to save the lives of people whose livers fail due to disease or injury, with over 7,000 performed in the U.S. per year.

Image credit: Donna Beer Stolz, University of Pittsburgh

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  • The survival rate within the first year after a liver transplant is now up to 86%.
  • Common reasons for needing a liver transplant are alcoholic liver disease, cancers that start in the liver, fatty liver disease, and cirrhosis caused by chronic hepatitis C.
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Knee Surgery

NIH supported research on a new approach to surgically repair tears of the anterior cruciate ligament (ACL) by using a patient’s own tissue. This has led to changes in clinical practice, with surgeons no longer using donor tissue in young athletes.

Image credit: iStock

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  • This NIH-supported research was conducted in large multisite studies, making the results more generalizable.
  • ACL tears remain one of the most severe knee injuries, and a fully torn ACL cannot heal on its own.
  • ACL reconstruction surgeries using the patient’s own tissue, called autografts, experience better outcomes and are less likely to rupture and require additional surgery than surgeries using cadaver donor tissue. This difference in re-tear risk is most significant for competitive athletes under the age of 25.
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Automatic Blood Counter

Anyone who has had diagnostic blood testing done has likely benefitted from use of an automatic blood counter, which was developed by NIH-supported researchers in the 1950s and is widely used to this day in hospitals and labs around the world.

Image credit: Linda Bartlett/NCI

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  • In 1957, the Coulter Model S, an automatic blood counter, was developed at the NIH Clinical Center.
  • The automatic blood counter allows hospital laboratories to characterize and count human blood cells, leading to countless diagnoses and treatments.
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Functional Brain Imaging

NIH-funded researchers pioneered imaging techniques of the living human brain, including positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). These are widely used in healthcare settings today to detect and diagnose a range of brain disorders, from epilepsy to Alzheimer’s disease and related dementias.

Image credit: National Institute on Deafness and Other Communication Disorders, NIH

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  • Beginning with the work of NIH-funded researchers in the 1960s and 1970s, development of functional brain imaging enabled a paradigm shift in understanding brain disorders—such as addiction, epilepsy, and Alzheimer’s disease—as biological in origin and thus treatable with medication.
  • Functional brain imaging is now essential in detecting and managing major disorders of the brain and is a standard part of care for diseases such as schizophrenia, epilepsy, drug addiction, and dementia.
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Global Health

An NIH-funded cellphone application for clinicians caring for HIV patients in Uganda has been harnessed for different diseases and on multiple continents to improve public health. For example, in the U.S., the app has helped increase adherence to tuberculosis treatment from 50% to 90%, saving lives.

Image credit: NIH

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  • Within six years of its development, the NIH-supported platform—called emocha, which stands for electronic mobile comprehensive health application—was deployed in 20 countries, including India, South Africa, Bolivia, and Australia, and expanded its portfolio of applications.
  • The app allows health workers to use cellphones to control dengue; screen for HIV, cancer, or diabetes; track the insects that transmit Chagas disease; and more.
  • In the U.S., this app has supported tackling the opioid epidemic and treating diseases such as tuberculosis.
  • In 2022, emocha was rebranded as Scene.
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Ommaya Reservoir

In 1963, researchers at the NIH Clinical Center invented the Ommaya reservoir, a device placed under the scalp that provides direct access to cerebrospinal fluid (CSF). This device is used to this day in hospitals across the world to diagnose and treat a range of cancers and infections.

Image credit: NIH

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  • Named for its inventor, the Ommaya reservoir comprises two parts: a reservoir to hold liquid that sits on top of the skull under the scalp, and a catheter that is connected to the reservoir and placed in an open space within the brain, called a ventricle.
  • This device is used by doctors to get sterile access to CSF samples for diagnostic tests or to deliver medications to the CSF. 
  • It is used to diagnose and treat a range of conditions such as cancers and infections, including brain tumors, leukemia, lymphoma, and meningeal disease.
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Osteoporosis

The osteoporosis treatment romosozumab was developed thanks to foundational work supported by NIH to understand the mechanisms of bone formation. Approved by FDA in 2019, this medicine is prescribed to prevent bone fractures, which are common in people with osteoporosis.

Image credit: RCSB Protein Data Bank www.rcsb.org/3d-view/jsmol/2kd3, created by Alisa Machalek (NIAMS)

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  • Osteoporosis is a bone disease that develops when bone mineral density and bone mass decreases, or when the quality or structure of bone changes. This can lead to a decrease in bone strength that can increase the risk of fractures.
  • NIH-funded work helped to establish proteins as therapeutic targets for osteoporosis and other skeletal diseases. 
  • Romosozumab is an antibody treatment that increases bone formation through inhibiting sclerostin, a protein that regulates bone metabolism.
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References

Supercomputing

  1. Gilbert PB, et al. Science. 2022;375(6576):43–50. PMID: 34812653.
  2. Gilbert PB, et al. N Engl J Med. 2022;387(24):2203–2206. PMID: 36507702.
  3. Supercomputing Technologies Funded by ORIP Helped Spur Approval of COVID19 Vaccines and Save Lives: https://orip.nih.gov/about-orip/research-highlights/supercomputing-technologies-funded-orip-helped-spur-approval-covid-19
  4. Article: FDA Takes Additional Action in Fight Against Covid-19 By Issuing Emergency Authorization for Second Covid-19 Vaccine: https://www.fda.gov/news-events/press-announcements/fda-takes-additional-action-fight-against-covid-19-issuing-emergency-use-authorization-second-covid
  5. FDA Vaccines and Related Biological Products Advisory Committee Meeting Brief: https://www.fda.gov/media/152953/download

Collaborative Care

  1. Katon WJ, et al. Gen Hosp Psychiatry. 2006;28(3):185-8. PMID: 16675360.
  2. Katon W, et al. Gen Hosp Psychiatry. 2010;32(5):456-64. PMID: 20851265.
  3. Kroenke K, et al. J Gen Intern Med. 2017;32(4):404-410. PMID: 28243873.
  4. Lee-Tauler SY, et al. Psychiatr Serv. 2018;69(6):628-647. PMID: 29716446.
  5. Angstman KB, et al. Med Care. 2015;53(1):32-7. PMID: 25464162.
  6. VA/DoD Clinical Practice Guidelines: Management of Major Depressive Disorder. 2022. https://www.healthquality.va.gov/guidelines/MH/mdd/
  7. VA/DoD Clinical Practice Guidelines: Management of Posttraumatic Stress Disorder and Acute Stress Reaction. 2017. https://www.healthquality.va.gov/guidelines/mh/ptsd/
  8. Article: Wider Implementation of Collaborative Care Is Inevitable: https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2019.6b7
  9. California Healthcare Foundation. Cracking the Codes: State Medicaid Approaches to Reimbursing Psychiatric Collaborative Care. 2020. https://www.chcf.org/wp-content/uploads/2020/09/CrackingCodesMedicaidReimbursingPsychiatricCollaborativeCare.pdf
  10. Article: Reps. Lizzie Fletcher And Jaime Herrera Beutler Introduce Bipartisan Legislation To Invest In and Improve Mental Health Care: https://fletcher.house.gov/news/documentsingle.aspx?DocumentID=3444
  11. Druss BG, et al. Med Care. 2011;49(6):599-604. PMID: 21577183.
  12. US Burden of Disease Collaborators, et al. JAMA. 2018;319(14):1444-1472. PMID: 29634829.
  13. Greenberg PE, et al. J Clin Psychiatry. 2015;76(2):155-62. PMID: 25742202.
  14. Belsher BE, et al. Psychiatry. 2018;81(4):349-360. PMID: 30332346.
  15. Schoenbaum M, et al. JAMA. 2001;286(11):1325-30. PMID: 11560537.
  16. Engel CC, et al. JAMA Intern Med. 2016;176(7):948-56. PMID: 27294447.

Mobile Health

  1. Calm.com: https://www.calm.com
  2. Monash University FODMAP Diet App: https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/
  3. Hansen WB, et al. JMIR Mhealth Uhealth. 2019;7(7):e14655. PMID: 31359866.
  4. Article: Discover the top 5 mHealth apps landing NIH research grants: https://www.ama-assn.org/practice-management/digital/discover-top-5-mhealth-apps-landing-nih-research-grants
  5. Han M, et al. Healthc Inform Res. 2018;24(3):207-226. PMID: 30109154.
  6. Kernebeck S, et al. World J Gastroenterol. 2020;26(29):4182-4197. PMID: 32848328.

Liver Transplants

  1. Starzl TE, et al. Ann Surg. 1968;168(3):392-415. PMID: 4877589.
  2. Definition & Facts of Liver Transplant: https://www.niddk.nih.gov/health-information/liver-disease/liver-transplant/definition-facts

Knee Surgery

  1. ynch TS, et al. J Am Acad Orthop Surg. 2015;23(3):154-63. PMID: 25667401.
  2. MOON Knee Group: https://acltear.info/
  3. MARS Group. Am J Sports Med. 2014;42(10):2301-10. PMID: 25274353.
  4. MARS Group. J Orthop Res. 2020;38(6):1191-1203. PMID: 31840832.

Automatic Blood Counter

  1. Breacher G, et al. American J Clin Path. 1956;26: 1439-49. PMID: 13394550.

Functional Brain Imaging

  1. Farreras, IG, et al. (eds). Mind, brain, body, and behavior: foundations of neuroscience and behavioral research at the National Institutes of Health (Vol 62).IOS Press. 2004. 
  2. Profiles in Science: Louis Sokoloff: https://profiles.nlm.nih.gov/spotlight/nl
  3. Dr. Louis Sokoloff Oral History 2005: https://history.nih.gov/display/history/Sokoloff%2C+Louis+2005

Global Health

  1. Article: Tech designed for Africa helps US fight disease, save money. https://www.fic.nih.gov/News/GlobalHealthMatters/september-october-2017/Pages/emocha-mobile-app.aspx
  2. Scene Health: https://www.scene.health/

Ommaya Reservoir

  1. Ommaya AK. Lancet. 1963;282: 983-84. PMID: 14059058.

Osteoporosis

  1. Osteoporosis: https://www.niams.nih.gov/health-topics/osteoporosis
  2. Article: FDA approves new treatment for osteoporosis in postmenopausal women at high risk of fracture: https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-osteoporosis-postmenopausal-women-high-risk-fracture

This page last reviewed on December 8, 2023