By Carmen Paun, Erin Schumaker, Daniel Payne and Evan Peng

With Ben Leonard

Ileana Hancu | Adam Lee, ARPA-H

What if revolutionizing cancer treatment starts in the operating room?

That’s a question Dr. Ileana Hancu, program manager at the Advanced Research Projects Agency for Health — the new agency tasked with funding high-risk, high-reward research — is seeking to answer. Her program, Precision Surgical Interventions, put out a call last month for research proposals to dramatically improve surgery.

“Surgery is the first avenue for treating cancer,” Hancu told Erin. “If it’s detected relatively early and you manage to take it out entirely, oftentimes that’s it — that person may be cured,” she said. “We tend to invest a lot of money in drugs, and obviously, there is a place for drugs, but if we significantly improve surgery that can go a long way toward treating this problem.”

The field itself may also be ripe for innovation. Surgeons often tell Hancu that their tools haven’t changed over the last 50 years. Female surgeons have even developed hand problems because their tools, designed for men, are too big, she said.

Hancu envisioned a few potential avenues for innovation:

— Bedside devices. A surgeon removes patient tissue and places it on a bedside device, which scans the tissue for cancer cells. Instead of waiting for lab results, the surgeon knows immediately whether to remove more cells or close up the patient.

— Inside-the-body imaging. Direct imaging of the inside of the patient’s body during laparoscopic surgery, which is performed through small incisions, could allow surgeons to remove cancer cells left behind during the initial procedure.

— Smart surgical tools. A scalpel or electrocautery tool could have a warning light to indicate when surgeons approach a nerve to prevent doctors from accidentally injuring patients.

Why it matters: Nearly two million Americans are diagnosed with cancer each year, according to the American Cancer Society. Accidentally damaging healthy tissue can mean more operations, pain and extended hospital stays. Those corrective procedures and treatments cost the U.S. more than $1 billion each year.

What's next? “We’re hopeful that in a timespan of five to seven years, the tools that we develop will be in ORs across the countries. We’re not developing esoteric projects that are going to put out nice papers in Nature,” Hancu said. “What we’re really going for is a difference in how health care is done.”

For interested researchers in fields like oncology, surgery and imaging technology, Proposer’s Day is Sept. 7.

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Brackley Beach, Prince Edward Island, Canada | Shawn Zeller

This is where we explore the ideas and innovators shaping health care.

Oh rats. New Yorkers can now track rodent activity at any address in the city, thanks to a color-coded, interactive rat map run by the New York City health department.

Share any thoughts, news, tips and feedback with Carmen Paun at [email protected], Daniel Payne at [email protected], Evan Peng at [email protected] or Erin Schumaker at [email protected].

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Today on our Pulse Check podcast, host Kelly Hooper talks with Daniel about his reporting on the potential effects of the availability of weight-loss drugs on bariatric surgery, like increased patient awareness and demand for weight-loss procedures overall.

The World Bank is encouraging developing countries to embrace health technology. | AFP via Getty Images

The World Bank had a message for ministers at the G-20 health ministers’ summit over the weekend: Introducing digital solutions to health care systems doesn’t have to be expensive.

The bank presented a new report at the meeting in India explaining how countries, no matter their income levels, can use technology to improve their health care systems and expand access to care without breaking the bank.

Governments need to invest in three priority areas, the report says:

— Introduce digital solutions backed by evidence to tackle the biggest problems of a health care system and focus on the needs of patients and providers.

— Connect the dots among regulators, governance and infrastructure to ensure patients know their data is safe and health workers use digital solutions transparently.

— Continue investing in digital health solutions over the long term and train health workers and patients to use them.

Why it matters: Many countries don’t make evidence-based decisions on health: Some use less than 5 percent of health data to improve health, the World Bank said. And with tight budgets worldwide and rising health care needs, improving health is getting harder, not easier, it said.

The report’s recommended investments could help save up to 15 percent of health care costs, the bank said.

The World Health Organization and the Indian government, which chaired the G-20 meeting, announced a new Global Initiative on Digital Health meant to help countries fast track the digital transformation of their health systems.

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Blumenauer's bill to expand high-deductible insurance plan benefits has divided fellow Democrats. | Mariam Zuhaib/AP Photo

A push led by House Republicans to allow insurers offering high-deductible health plans to cover more expenses is gaining momentum in Congress — and dividing Democrats.

Floor votes on two bills are expected after Congress’ August recess, Ben reports.

The Ways and Means Committee approved legislation by Republican Brad Wenstrup of Ohio and Democrat Earl Blumenauer of Oregon to permit the plans to cover chronic care services before patients hit their deductibles on a strong bipartisan vote in June.

The committee also approved a bill by two Republicans, Michelle Steel of California and Adrian Smith of Nebraska, and two Democrats, Susie Lee of Nevada and Brad Schneider of Illinois, that would allow plans to cover telehealth costs pre-deductible.

Why so? The proposed changes reflect the new state of play on health care for Republicans who have turned away from efforts to repeal Obamacare but see high-deductible plans as a way to boost market forces in the system.

The proposed changes would retain another benefit Republicans favor: High-deductible plans aim to discourage people from seeking unneeded care, reducing health care costs, which lowers inflation.

They also appeal to some Democrats as a way to make access to care more affordable.

Even so: Skeptical Democrats, including Ways and Means Health Subcommittee ranking member Lloyd Doggett (D-Texas), worry the plans would still pose financial and medical risks for low-income employees who can’t afford to pay their deductibles and would skip care as a result.

Doggett believes the legislation would mainly benefit the wealthy — the plans come with health savings accounts with major tax advantages — and undermine the Affordable Care Act by offering inadequate coverage.

The marketplace: The plans already enroll more than 60 million people.

A quarter of employers offer high-deductible plans with health savings accounts, up from 10 percent in 2009, and the percentage of workers using the plans has doubled in the past decade, according to the health care research group KFF, which includes a broad swath of large and medium-sized employers in its survey.

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