Medication adherence is a big problem, and recent studies are bringing the actual costs and causes into sharper focus. At the same time, health care reforms such as electronic health records and prescriptions, as well as new incentives from the US government, have encouraged investors to tackle solutions to the problem. Questions remain about the impact of these reforms, but the companies profiled in this issue, HealthPrize Technologies, PillJogger, RxAnte and SentiCare, see an evolving climate in which their medication adherence technology solutions can turn into profitable businesses.

Now that transcatheter heart valves have been implanted in thousands of humans, it’s becoming clear where the problems lie. Vascular and bleeding complications, stroke and paravalvular leaks are the most troubling consequences. Most of the focus has been on improving the valves and the delivery systems, but now innovators are looking at the issue of access – the particular ways by which therapeutic devices enter the heart – and how it can be changed to improve outcomes. In this issue we profile Apica Cardiovascular, Entourage Medical and Inseal Medical.

Apica Cardiovascular is leading the field of transapical access and closure for structural heart disease. Its first product is a titanium coil that stabilizes the surgical access site in the apex of the heart to prevent bleeding during and after therapeutic interventions and provides for reaccess in the future. Also in the works are a large closure device for transfemoral access closure and a connector that aids in the delivery and implantation of newer, smaller, left ventricular assist devices through the Apica coil.