Accepted Presentations

The purpose of this dissertation was to examine elements of leadership behaviors in online health and wellness communities, and be able to predict when leadership could occur in an online community. Communication behaviors of those who influence other members in terms of initiating comments, triggering replies, and conversations were analyzed to look for leadership characteristics. The research utilized a secondary dataset containing postings from participants across eight global online health and wellness communities on public social media websites: a) TEDMED, b) MyNetDiary, c) Nike+Fuelband, d) Forks Over Knives, e) Runner’s World, f) MyOptumHealth, g) America’s Health Rankings, and h) UHC TV. The observations took place over a six-month period, used content analysis, social network analysis (SNA), and inferential statistics to identify and predict the elements of leadership in online health and wellness communities. » Read More

Background: eHealth technology such as personal health records, web-based disease management programs, and mobile applications can support patient self-management and health care navigation. These tools, however, are frequently disease-specific in design. Optimization of eHealth tools for patients with multiple chronic conditions requires an understanding of challenges and technology needs specific to multimorbidity. Methods: We conducted a qualitative needs assessment of patients with multiple chronic conditions from an academic medical center and a Veterans Affairs facility. A screening questionnaire was used to identify 330 patients with ≥ 3 chronic conditions and with experience using health-related technology. » Read More

Objective:  Individuals are increasingly going online to obtain health information from both professionals and peers.   We sought to understand the health characteristics of persons who consume online health information and the specific types of health-related information they seek. We also sought to evaluate the characteristics of persons who engage with the internet for the purposes of consuming versus producing online health information, and specifically, whether healthier versus sicker persons engage with health information technology in these different ways. Study Design:  Data were obtained from the Pew 2012 Health Survey, a telephone survey of 3,014 English- or Spanish-speaking adults living in the United States.  We used multiple logistic regression to examine the association between sociodemographic and health characteristics and the consumption or production of online health information. Sociodemographic variables included age, sex, race and education. » Read More

While a minority of patients consider clinical trials as part of their treatment options, clinicaltrials.gov receives >112 million pageviews per month.  Almost half of them are patients or their caregivers.  Yet clinical trials struggle to find patients and many trials do not complete.   Trial sponsors try many avenues and approaches to reach patients for THEIR trial. » Read More

Introduction : In the last two decades there has been a major shift toward more minimally invasive laparoscopic surgeries (MIS). MIS has proven benefits for patients over traditional open surgery, such as less postoperative pain, shorter hospital stay and faster recovery time. However, the costs and infrastructure requirements of MIS remain high and limit the availability of best practice to those who can afford it or have access to its facilities. Currently, laparoscopic surgery requires a dedicated operating room that houses costly equipment such as laparoscopic cameras, video-processors, monitors, and cables. » Read More

Background: Currently, there are over 100,000 Americans awaiting deceased donor kidney transplants. Despite the overwhelming demand, only about 15,000 kidney transplants occur each year. With rates of deceased donation stagnant, live donor kidney transplant is the only area for expansion of the organ supply. Unfortunately, many patients with end-stage renal disease report significant barriers to identifying a live donor. » Read More

Background:  Fall is one of the leading causes of morbidity and mortality. It has serious consequences, particularly in senior population, including decline in physical and cognitive abilities, and worsen chronic illnesses, behavioral and socioeconomic issues. Real-time fall detection and automatic notification to a healthcare/homecare provider may facilitate rapid medical response, mitigate the effects of the fall, and reduce the medical costs. HealthPatch ® is a disposable biosensor worn on the chest that detects falls in real-time using posture angle, acceleration of chest and vital signs. The performance of fall detection in a large clinical study conducted in both controlled and free-living conditions is presented. » Read More

Background:   Home sleep monitors have evolved to complement the expensive laboratory based polysomnography (PSG) for screening of moderate-to-severe sleep apnea syndrome (SAS). However, the success rate of home tests has been found to be low due to many limitations including low compliance, obtrusive sensor attachments, and complex procedures.  HealthPatch ® is a disposable biosensor worn on the chest that remotely monitors ECG, acceleration, vital signs and actigraphy measures, and has been found to be very useful in numerous clinical applications. U.S. Food and Drug Administration has cleared HealthPatch clinical-grade patient monitor for in hospital and home use.  The study presents the efficacy of wireless patch sensor for screening of moderate-to-severe SAS.  Methods:  An overnight PSG study recruited 85 volunteers (age: 21−80 years, female/male: 41/44 and Apnea-hypopnea Index (AHI): 0.1−87.7) of healthy and SAS patients, and was conducted at California Sleep Institute, Palo Alto, CA, USA. » Read More

It has ben well established that failure to communicate effectively with patients leads to poorer clinical outcomes. In the face of this seemingly obvious truth the reading and computing competence required for understanding many of the most popular sources of disease state and treatment information available to consumers continues to rise. This study presents the historical trend for a number of authoritative and popular web content outlets focusing on type 2 diabetes. Low complexity and fast methods of establishing critical determinants of patient capability are presented and their application in a pilot program targeting persons with type 2 diabetes receiving Medicaid are discussed. 

Research in Progress Will a tablet-based intervention encourage more reliable HIV risk reporting by young patients and facilitate testing?   Background: Many of those most at risk for HIV may not report risk factors (including substance use and sexual behavior) that greatly increase their likelihood of HIV infection. Some may not disclose risk or engage in any discussion of HIV because they fear consequences of stigma. Others may decline HIV testing because they, perhaps erroneously, believe they are not at risk. Existing data show young people face increased HIV risk, and risk is further elevated for people who live or socialize in areas with high HIV prevalence. » Read More

Improving the diagnosis and treatment of autoimmune diseases (and other complex chronic diseases) is a major unmet medical need that calls for a re-framing of clinical trials using new digital tools and big data.  New techniques, such as immune repertoire sequencing, phenotype/genotype, microbiome and other -omics and biometric data offer new ways of understanding the delicate dance of the immune system and how it goes awry in autoimmune diseases. Advances in the collection, storage, manipulation and analysis of large data sets are fundamental to this understanding.  Yet, the clinical trial process has not yet made much use of these new sources of data. Furthermore, digital advances: mobile, social, apps, APIs, cloud, are only beginning to be applied to make clinical trials faster, cheaper, and more informative. How can we re-imagine clinical trials, asking new and better questions, using iterative thinking, to help those with autoimmune disease? How can we rally patient communities to encourage data donation to a central autoimmune registry? Case studies may include, MMRF, Genetic Alliance, Open Medicine Institute, Clinipace, Cliniops, Transparency Life Science, ePatientfinder and others  

Background: People with type 2 make up 90-95% of all people with diabetes. Failure to self-manage this condition can lead to serious complications -- heart disease, stroke, kidney disease, blindness, and amputations (CDC, 2014). Ongoing metabolic management is imperative to prevent sever complications and increased mortality, it is the goal of self-management. There is a strong relationship between social support and illness self-management for the adult with diabetes (Nicklett and Liang, 2009). Evidence indicates that social support is associated with adherence to diabetes self-management activities, improved outcomes and reduced mortality in older adults with type 2 diabetes. A diabetes online community (DOC) may provide the social support necessary to promote engagement and self-management activities for the person over 65 with type 2 diabetes. » Read More

Background:  The ‘artificial pancreas’ (AP) is a new treatment for diabetes which allows for the automatic control of blood glucose levels by replicating some of the functions of a healthy pancreas. The system wirelessly links a continuous glucose monitor (CGM) and insulin pump, both body-mounted, with a tablet-mounted algorithm in order to calculate and administer the optimal amount of insulin required at any given time. Following successful lab-based studies, researchers at the University of Cambridge are now carrying out research on the safety, efficacy, and feasibility of the AP system for pregnant women with Type 1 diabetes in the home setting. This research is important because of potential gaps between lab-based efficacy and real-world effectiveness – gaps which may emerge because of variations in users’ wider attitudes towards science, medicine and (especially) technology. » Read More

Background Patient empowerment has become a central focus in healthcare research and practice. Instead of viewing patients as passive recipients of expert advice, empowered patients are becoming active partners in the health management process. Enabled by web 2.0 technologies, patients seek information and share their personal experiences online with peers and healthcare professionals. This paper argues that these shared experiences are invaluable resources for healthcare institutions, but are currently not being fully harnessed. » Read More

Background:  My name is Rajiv Sethi and I am currently a 4th year medical student. I recently completed a project entitled ‘MBBS Curriculum 2020 Review’ with Professor Stuart Carney, Dean of Medical Education at King’s College London. This involved a review of the preparation for practice theme; the transition from medical student to internship year. This is an important area in healthcare education with impact on patient safety. » Read More

Patients who participate in clinical trials generously contribute their data to advance medicine. But because of standard clinical research practices, this contribution doesn’t come easily. For example, many patients do not know clinical trials are a healthcare option, and if they do, they have no easy mechanism to find an appropriate trial. To participate in a clinical trial, patients must travel to a local research site (if there is one) and disrupt their lives to complete trial requirements. » Read More

Background The rapid and ongoing digitalization of society leads to an exponential growth of both structured and unstructured data, so-called Big Data. This wealth of information opens the door to the development of more sophisticated personalized health technologies. The analysis of log data from such applications and wearables provides the opportunity to personalize and to improve their persuasiveness and long-term use. However, aren’t there any boundaries when using this data as input for data-driven patient-centered feedback systems? If not technologically, then perhaps ethically? Can we simply gather and connect all the information we can find on the Internet and the patients’ health records without question, in order to increase the match between the system, its users and the context? Methods In our current research, we use big data sets from digital platforms and wearable technologies to support self-care, used by patients with chronic diseases like diabetes, heart failure, COPD and mental health problems and their caregivers. We apply machine learning techniques (algorithms) to identify patterns and user-profiles in the log data sets from real-time use of technologies across Europe. » Read More

Background: Psychosocial factors among cancer patients have gained increased interest during the last decade (1 8, 9, 4). The idea is that psychosocial factors, such as personality traits and coping strategies, influence the outcome of cancer. The outcomes of cancer can be related to the stresses brought on by diagnosis, side effects of their treatments, emotional distress, the impact of cancer on daily life, depression etc (5,8). Our research questions are: 1)      What personality traits influence outcomes for cancer patients? 2)      What coping strategies influence outcomes for cancer patients? 3)      How are personality traits related to coping strategies? Method: The research design for this study is a meta-analysis. » Read More

Background:  Chronic disease management is the biggest health care problem facing the United States today. In 2012, one in two American adults had at least one chronic condition, and 26% of the population had multiple chronic conditions, accounting for 84% of US health care costs. Chronic diseases especially affect older adults and often result in dramatic health decline, hospitalization, complex treatments, and high cost. Recognition of small changes in health conditions facilitates early interventions when treatment is most effective, prevention of dramatic decline is still possible, and costs can be controlled. In a previous pilot study, we showed significant differences in health outcomes for an intervention group of 21 seniors with a sensor-based early illness recognition system, compared to 20 seniors receiving normal care. » Read More

Background: Children receiving stem cell transplants must be hospitalized in isolation for one to several months, while facing the realities of life-threatening illness and intensive medical treatment. It is a time of significant emotional and psychological distress, leaving many children with post-traumatic stress symptoms well past hospitalization. There is a lack of understanding of the patient emotional experience, and few proven interventions that address the issue of emotional wellbeing for this population.  To this end, using a form of design probes, we are performing a needs assessment, collecting perspectives from patients and families concerning their emotional needs and stressors in the clinical isolation environment. Design probes are research tools that have been effectively used by designers to engage target user populations in playful, reflective activities that help them share personal views on a particular topic. They have been especially useful in situations where direct questioning is ineffective, or in emotionally strained environments. » Read More

Background:  Social networking sites (SNSs) such as Facebook enable information sharing and the co-creation of new knowledge shaped by personal experience. As such, SNSs have been heralded as a new source of ‘patient empowerment’ that fosters democratisation of healthcare and self-management expertise through social media use. Critics, on the other hand, point out that this promissory view of an active, responsible ‘e-patient’ further extends the reach and power of medicine and marketisation of healthcare.  However, in advocating SNSs, academic and policy communities have neglected to consider how individuals already employ social media to perform and negotiate health and illness identities. In contrast, in this study we approach SNSs as an important source of data on discursive practices and situated experience in relation to diabetes self-management. » Read More

Background Technological change often causes temporal institutional instability in many industries or fields, because it challenges existing roles and rules of the game. Digital technologies fostered even the creation of entirely new markets (i.e. digital commerce or online advertising). Digital Health emerges as an interstice between multiple fields and therefore it brings together multiple stakeholders, with competing expectations, demands, values and rules of the game. » Read More

BACKGROUND :  The CDC reports risk of diagnosed diabetes is significantly higher in ethnic minority populations compared to non-Hispanic white adults.  Additionally, in less than a decade, prevalence of Type 2 Diabetes and prediabetes more than doubled among US adolescents.   The purpose of this study is to evaluate the impact of a school based health program in which Family Medicine residents train healthy at-risk adolescents to become diabetes self-management coaches for family members with diabetes.   Ethnic minority communities have historically been disempowered and distrustful of the medical system, and we hypothesize that for this reason teaching ethnic minority youth to develop the skills and attributes necessary to be “e-patients” is particularly important. The Stanford Youth Diabetes Coaches Program (SYDCP) aims to utilize the most relevant technologies in combination with the in-person benefit of physician interaction to support at-risk high school students and their families to become equipped, enabled, empowered and engaged  in their health and health care decisions.   METHODS : The pilot study includes 97 adolescents from three San Francisco Bay Area high schools serving primarily ethnic minority youth of low socio-economic status.  Physicians came to schools once a week for eight weeks and trained 49 adolescents to become coaches using web-based program curriculum focused on health knowledge, communication, problem-solving, and self-management skills.  Each student coached one family member with diabetes.  Printed program materials were available in Spanish and English.  Student coaches and 48 non-participant students completed pre- and post- test intervention questionnaires, and 15 student coaches and 9 family members with diabetes were randomly selected to give in-depth interviews after participation.  Linear regression was used to determine differences in knowledge and psychosocial assets on pre- and post-tests between student coaches and non-participant students, and NVIVO to analyze interview transcripts. RESULTS : After controlling for initial score, gender, grade, and ethnicity, student coaches improved from pre- to post-test significantly compared to non-participants on knowledge, belonging, and worth scales . Student coaches reported high satisfaction with the program.  Articulated program benefits included improvement in diet, increased physical activity, improved relationship between student coach and family member, and appreciation for having physicians in the classroom. CONCLUSION: Overall, this program can increase health knowledge and psycho-social assets (worth and belonging) of at-risk youth and holds promise to promote health literacy and healthy behaviors among at risk youth and their families.  The SYDCP utilizes the inherent altruism of teens to help their family members and the aspirational goals of physicians in training to help communities realize a diabetes education and prevention system that is accessible, sustainable and reproducible - even for under resourced communities.  Lessons learned include 1) web-based curriculum needs to include more engaging technology leveraging best practices as developed by colleagues in the School of Education; and 2) curriculum format needs to maximize time for physician/student interaction and discussion.  Next steps will include: significant revision of teaching modules to incorporate “blended” learning; communication with students via SMS texting; and use of Stanford Open Ed X platform to promote and prolong program engagement and make  content widely available. » Read More

Background:   The high cost of identifying, recruiting, screening, and assessing eligible participants for neuroscience clinical trials is a major obstacle to developing effective treatments.  The BrainHealthRegistry.org (BHR), launched in 2014, offers a unique approach to facilitate clinical trials for brain diseases.  The BHR captures online detailed, longitudinal health and lifestyle information and measures of cognitive function from a large cohort of registrants.  The overall goal is to accelerate development of new treatments for brain diseases. Methods: After registration and consent, BHR participants complete a series of questionnaires, including measures of demographics, overall health, medication use, memory, family history of brain disease, mood, sleep, diet, and exercise. Participants also complete online neuropsychological tests (NPTs), including the Cogstate Brief Battery and the Lumos Brain Performance Test.   All tasks are completed online with no supervision. » Read More

Background:  Asthma is the most common chronic condition affecting those under the age of 18, and account for an estimated $56 billion in healthcare costs annually. The Asthma Control Test (ACT) is a reliable and valid means of detecting changes in asthma control over time, but its utility has been limited to date, mostly due to its mode of administration during scheduled office visits by paper format. Improving the accessibility of the ACT, administering it more regularly, and using automated scoring to provide instant feedback on current status and trends may be useful in gauging success of therapeutic interventions and identifying deteriorations of asthma control. We know that 95% of adolescents are online; 81% use some type of social media, and 67% report that they use social media at least once a day. » Read More

Background: Digital behavior change interventions with social networks are common and have shown much promise in improving health outcomes. For interventions that have existed for several years, data analytics can give insight on demographic and psychographic characteristics of registrants, as well as patterns of use. Research methods in disciplines other than healthcare can assist in understanding relationships and trends. For example, in economics, it has been established that consumers are attracted to shopping malls with well-known anchor stores. » Read More

Background: Conventional healthcare research has long been conducted as linear, static analyses, which is not representative of the complex, real-life scenarios that define healthcare systems. For example, downstream effects of interventions can happen in inter-connected realms of healthcare and possibly over long periods of time but are often not accounted for. Also, analyses are usually conducted on averages over a spectrum of demographics and culture. In real-life, individual demographics are known to play a key role in healthcare studies. Now, with electronic health records, big data has the potential to advance healthcare research significantly. » Read More

Background:  Several statistical models are used to predict future healthcare costs, engage patients to improve care  and avoid deterioration in their health. These models were created in the 1990s, and aside from occasional updates, they have not changed much. Recent research using other sources of data and advanced predictive analytics show a large increase in the ability to predict who is at-risk of future clinical problems, and may be a better, scalable way to determine appropriate patient engagement services, and improve both population health management and personal health management. Predictive models used to estimate future healthcare needs are usually financially focused and based on age, gender, diagnoses and sometimes medications of individuals in populations used to develop the models. » Read More

Background:  Patient falls are major problems in hospitals both for patients and the hospital.  Falls dramatically reduce patient health and safety and dramatically increase the cost of healthcare.  Foresite’s Patientcare is a passive monitoring system that uses infrared imaging and decision tree learning algorithms to drastically reduce patient falls, thus increasing patient health and safety while reducing the cost of healthhcare. Patient falls are among the eight preventable conditions not reimbursed by CMS (Medicare and Medicaid) and insurance companies.  There are millions of hospital patient falls every year costing hospitals billions of dollars in unreimbursed expenses.   This does not take into consideration falls of elders in their living environment which are significantly larger issues and are greatly reduced by another Foresite product, namely Eldercare. The goal of our study was to 1) identify which patients are most likely to fall in hospitals and 2) reduce the number of falls in hospitals. » Read More

Background: Health information technologies — such as telemedicine — have been identified as important tools in advancing the patient-centered medical home (PCMH) by streamlining communication, boosting access, and decreasing time delays in seeing a specialist from months to minutes. Within mental health, studies show that telepsychiatry can help patients gain better access to specialists. However, telepsychiatry (STP), which traditionally uses synchronous, live two-way videoconferencing, has scheduling issues, cost limitations, and administrative barriers — similar to in-person care — that have prevented wide-scale use of this technology. A novel method, asynchronous telepsychiatry (ATP), a virtual mental health visit, is a more rapid, efficient, and administratively simple way for primary care providers to gain access to psychiatric expertise —supporting a collaborative model of care. ATP is an emerging technology in the field of mental health that supports PCMH and in particular helps PCP's better manage patients with comorbid physical conditions and mental illness. » Read More

Research in Progress Background:  Healthcare providers typically use live interpreters to communicate with patients who either do not speak English or who have limited English proficiency. With the Affordable Care Act (ACA) encouraging uninsured patients to obtain health insurance, the anticipated demand for language interpretation will increase, as the proportion of LEP patients for Medi-Cal and Healthy Families will increase to 41% by 2019. However, a shortage of interpreters exists because medical interpretation incurs a typical $30 to $50 per hour overhead cost, there is a 35% decrease in earning potential for medical interpreters versus government or scientific and technical interpreters, and using live interpreters increases doctor-patient encounter times by 57% versus phone interpreters. The quality of live interpretation can also vary as there are legally and professionally no mandated requirements for certification or quality control. » Read More

Background :  Healthcare conference participants use of social media, and Twitter in particular, have grown to become a significant part of the conference experience with 1,159,093 tweets for 2013. In our prior research analysis with data from 2013, we observed a recent trend to promote patient inclusive conferences. That analysis concluded that 65 out of 100 conferences were found to have one or more patients in its top 100 influencers by mentions. Those conferences with more patients were found to have a stronger social performance with higher average number of tweets, larger reach with a higher average number of participants and a more dynamic conversation with a higher average tweets per participant. In this follow up study, we will analyze this social dataset to find reasons why patient inclusiveness has such a positive effect on conferences. » Read More

Hearing loss is a condition that does not discriminate; it is a condition that affects people of all ages, ethnicities, and economical backgrounds. Often, hearing loss is stigmatized as a disability for the elderly; however, this perception ignores the importance of optimal hearing in children and young adults, who, although they encompass a smaller population, are faced with greater challenges in regards to socialization and developing a strong self-image in their formative childhood years. From an economical standpoint, it is also a common misconception that hearing assistive technology is reserved for the rich, given that a pair of basic hearing aids can cost anywhere from $3500 to $7500. The fact of the matter is, there have been many studies outlining the drastic effects hearing loss has on a person and from these studies, many NGOs and government organizations have implemented programs that provide hearing aids and rehabilitative services to those in need, often at no cost. » Read More

Unlike the performance sportswear industry, the multi-million-dollar medical apparel industry has not been pushing at the research edge of medical garments and textile technology. In most cases, medical garments meet basic requirements – they clothe the professional in a recognizable way but offer little by way of protection for the patient or the clinician. This is particularly evident in the case of professional apparel for physicians despite evidence indicating that contemporary physician garments can harbor contaminants and facilitate the transfer of these contaminants from patient to patient. Healthcare Associated Infections (HAIs) are among the most serious problems facing modern medical care and conceptualizing medial garments that will reduce or eliminate the transfer of HAIs is a motivating factor for this research. » Read More

Background:  Peer-to-peer health networks such as online discussion forums have created new ways for people, especially those living with a long term condition, to access health information. There have however been concerns about the quality of information, and the ability of the public to understand and evaluate that information [1, 2]. The term “apomediation”[3] has been used to describe the shift from professionals as the information gatekeepers, to individual-led signposting or use of technology-based solutions such as bookmarking.  This abstract presents the findings of a study analyzing how people using online discussion boards adopt this apomediation role, the types of information they share, and how they share this information. Methods:  Four discussion boards for people living with diabetes were selected for inclusion in the study, based on the volume and frequency of new posts. » Read More

Today’s mobile phones (especially smartphones) are becoming powerful platforms for communicating, computing and sensing.  Mobile health “apps” have generated great interest as a means to improve self-tracking in health and disease. At the same time, smartphones can also enable new paradigms in clinical research. Potential benefits of smartphone-facilitated clinical research include longitudinal, more continuous data collection; novel phenotyping through passive and active measurements; access to a broader, more geographically distributed pool of participants; and using communication tools to foster participant engagement. Equally important, smartphone apps can help participants benefit from their own study data to an unprecedented extent, and contribute to a new culture of clinical research participation that is more centered on participants. This panel includes leaders from academic medicine and industry to discuss recent momentum in smartphone-based clinical research. » Read More

Participation and engagement in clinical research are the main cause of delays in the development of new treatments.  Solvers from the William Tennent – Lilly High School Challenge show us a way to humanize research participation to generate an emotional connection among volunteers and patients at large who have a stake in seeing better treatments become a reality.

Grasp the ever-advancing practices of additive manufacturing in medicine... from empowering patients and doctors with greater visualization abilities in diagnostics to custom surgical models and life-saving implants. Meet patient pioneers exploring cutting-edge technologies in their quest to empower their own engagement with paths of care. Understand the impact of a production process capable of delivering mass customized solutions. » Read More

With the increasing burden of chronic diseases such as obesity and diabetes, there is a strong need for a low cost solution that can be scaled for the masses. Games for health is touted as that solution. A major benefit is that they can improve the delivery of care across the healthcare continuum while also increasing reach and patients buy in. Successful health games are based on theoretical frameworks, which require the successful implementation of game elements. » Read More

Personality factors have gained increased interest in cancer research during the last decade. The patient´s personality seems to influence coping strategies related to the outcome of cancer, such as reaction to the diagnosis, side effect of treatments and the impact of cancer on daily life. The main challenge will be to support clinicians in identifying vulnerable patients who are likely to have poorer coping strategies and therefore poorer cancer outcomes. 

OBJECTIVE: Choosing health insurance is a complex and often confusing task.  Consumers who make a poor health plan choice miss out on the opportunity to save money in the best case or fall into financial crisis in the worst case.  The design of the ACA’s health insurance marketplaces and the data they present to consumers influence complex health plan choices. We compared the choice environments of the public state-based marketplaces (SBMs) and HealthCare.gov (HC) in the fourth open enrollment period (OEP4) to the third (OEP3), plus exchange websites run by private companies. We also compared total cost estimates (TCEs) for various plans from the public exchanges to estimates on private exchanges for a uniform consumer. TCEs sum the monthly premium with expected cost-sharing (deductible, copays) based on a consumer’s expected health care use. » Read More

Over 1,500 mobile apps assist in the management of diabetes. Meta-analyses suggest diabetes apps improve A1c by -.49%. To our knowledge, no study has evaluated a diabetes app with passive data tracking on a smartphone and smartwatch with in-app support from a Certified Diabetes Educator (CDE). Over 250,000 people with diabetes and pre-diabetes worldwide use the One Drop | Mobile app. » Read More

Mining Audio Cues from PTSD Interview Recordings (MACPI) is a web based prototype system. This innovative tool is designed and developed to assist clinicians in conducting diagnostic analysis of PTSD interviews. It enables automatic transcription and phonetic indexing of the interview recordings so that the interview recordings can be accessed and analyzed with search and retrieval for systematic, quantitative, and correlational analysis. The interviews can be conducted in the office or via telephone. » Read More

Intro: You’ve been given a diagnosis. The disease is serious, but you have serious medical professionals working on it. You say, ‘I think I’ll have a look for myself.’ You research incessantly, and are now another addition to many a physician’s worst fear: patients who think they know better than the doctors, themselves. But what happens if and when you actually do know better? Pt 1: Once thought to be a disease of reproductive organs, Polycystic Ovarian Syndrome is now known to be triggered by metabolic means. » Read More

The adoption rate of technological innovation has exponentially accelerated with the time span between invention and commoditization shrinking from decades to years. Considering the rise of cheap storage and computing power, enterprises are now experiencing similar speed gains to that of smartphones and their related burgeoning app stores. Health care, however, has been the exception. The health care industry can increase the pace of innovation to match the pace of other industries and decrease compliance burdens by leveraging cloud computing. » Read More

With nearly every purchase the answer to “How much does that cost?” is a simple one. If you want to find the best prices on a pair of shoes, all it takes is a search engine and a few keystrokes. Consumers expect to be able to easily determine and compare the cost of goods. So, when it comes to their healthcare, patients rightly expect a straightforward answer to how much it will cost them. » Read More

The first objective or mission of Top20Health.com is to be a better way of doing information processing in healthcare for patients, students, and physicians with a global perspective. That is, the first objective is to provide the best health care directory as a useful service.  Top20health.com is part of Top20.com which is a general internet directory with a network of over 600 websites and the long term business objective is to be one of the top 3 or 4 “go to” alternatives to the search engines. Top20Health.com is a curated (hand selected) open access (free) internet directory for healthcare.  The problem is now not one of access to information, but one of information overload and selection. » Read More

Wearable health technology makes medicine a triangular collaboration between physicians, patients, and machines.  This triangle changes the business and clinical practice of healthcare by moving medicine out of the doctor’s office, into an omnipresent, virtual stage where health and wellness care is available anywhere and everywhere, 24/7, through multiple and diverse channels, with the consumer/patient holding the remote.  This workshop focuses on what business (and clinicians) must do to adapt to the changes in our medical future that wearable health technology brings.  Specifically, we will discuss 4 key trends: 1.  Telemedicine : Patients will no longer “visit doctors,” but will understand that they are “wearing their doctor on their sleeves.”  Physicians will be seen as disease care experts, but patients will be self-reliant for prevention, wellness, and fitness .  By integrating quantifiable self-data into medical decision-making, patients will claim more responsibility for their own health; they will focus on preventative self-care and lifestyle changes; and they will view physicians as experts who may only rarely be required—i.e., for treatment of advanced conditions when self-care fails.  Understanding the telemedicine legal landscape will be crucial to meet this changing marketplace.   2.  Mobile care : Medicine will be driven by consumerization and appification .  Consumerization—the movement from organization-driven offerings to consumer-driven priorities (such as, in healthcare, yoga, herbal medicine, and alternative therapies) will not only make patient-centered care the dominant paradigm, but also will increase the market share for complementary and integrative medical approaches.  Appification—the reduction of in-person, clinical care to online or mobile visits—will further reduce the intimacy of physical relationship between doctor and patient, and additionally drive exploration of pluralistic approaches to care.  Obamacare, along with diminishing Medicare and private pay reimbursement, will drive physicians to develop health care products (from dietary supplements to medical devices and mobile medical apps) as a way to garner patient revenue.  Overall, healthcare will move from the service to the product sector.  Understanding key FDA rules will be critical. 3. » Read More

February 2015 marked the launch of Heal, a revolutionary means of getting medical attention on demand.  Based in Santa Monica, California, Heal's app and business were created in only three months. Patients simply open the app and request an adult medicine doctor or a pediatrician. Within one hour, the doctor arrives with a medical assistant and equipment. A flat fee covers the visit, and patients can begin an ongoing, personalized relationship with their favorite Heal doctors. » Read More

LabCures was founded in November 2013 in San Francisco's Bay Area. Our mission is to organize U.S. research labs in the health sciences to one website and make them universally accessible to the world. LabCures is taking the scientific enterprise online and empowering people to find, fund, and share current disease research that matters to them - direct to the lab. » Read More

The pervasiveness of social media networks combined with new health monitoring devices and an increasing understanding of the importance of social influence on chronic disease has created a situation where health can be integrated into and change our self-identity, our social relationships and our relationship with our communities both local and global, on-line and in-person to a much greater extent than in the recent past. Health has always played a role in social interaction and culture, to the extent that rules have had to be explicated barring health talk from conversation. 1 The TMI (too much information) dining table conversation, falling into details of health ailments or procedures, is a common comedic trope. Lately, communication technologies such as social networks have become more intimately intertwined with our health, changing our cultural rituals, who we interact with and even how we perceive ourselves in the social structure. » Read More

Telemedicine may just be the biggest trend in digital health in 2015. As a partner focused on digital health investments at venture capital firm AMV, I spend a lot of time crisscrossing the country chatting with leading healthcare providers and insurers about their technology needs. By far the area they are most interested in is telemedicine. For hospitals, expanding telemedicine is a way to cut costs while providing consumers with the convenience they crave. » Read More

Today, surgical simulation exists as a valuable tool for surgical training and task rehearsal by reducing the need for cadaver specimens, allowing trainees to receive structured performance assessment, and facilitating repetitive deliberate practice. Nevertheless, simulation platforms are inherently limited by the number of programmed and designed cases/scenarios available for practice, and the anatomy within the virtual environment will invariably differ from that which is subsequently encountered in the operating room. To address these limitations, we have developed CardinalSim – a validated patient-specific virtual surgical rehearsal platform capable of rendering a patient’s preoperative imaging data into a 3-dimensional virtual model upon which a procedure can be rehearsed prior to the actual operation. In its current form, CardinalSim allows a surgeon to explore a particular patient’s anatomy quickly and efficiently in a surgically meaningful manner using a haptic interface, providing valuable insights into the anatomic and physical complexities expected at the time of actual surgery. » Read More

Engaged patients are willing and able to self-manage and self-advocate. Engaged patients also have better outcome and cost less. To improve engagement it is important to have patients properly informed and motivated, especially for those living with chronic illnesses. Dr.Google is helpful, but it is not the ideal tool for long term engagement as many don’t have time, expertise or interest to sift through information. » Read More

The proper goal for any healthcare delivery system should be to improve the value of care delivered to patients. It is not the number of different services provided, or the volume of services delivered, that matters. It is the value of the care that is important. There are two factors that substantially contribute to decreased value in healthcare: unstructured health data and health care costs. » Read More

Despite advances in the use of mobile and digital health technology, there is still an enormous gap between delivery, adoption and long-term use of digital health interventions. Much of the work of the last few years has focused on short-term outcomes (<= 3-6 months ) and the initial uptake of digital health technology.  MEMOTEXT has shown that by collecting disparate sources of data from patient self-report, claims-data, wearables and EMRs, our personalized and evidence-based digital health interventions can achieve long term adoption and significant changes in patient behaviour. Validated in a number of clinical and commercial settings MEMOTEXT has spent the last few years creating a development methodology, building personalization algorithms and improving adherence to medications, blood-glucose testing, and overall treatment adherence.  With a case study approach, we can demonstrate that the use of multi-dimensional data from patient self-report (e.g. mood, quality of life, perceptual barriers to adherence) combined with objective data sources (e.g prescription claims  data, real-time blood glucose levels) can extend digital engagement over the long-term. MEMOTEXT has live pilot implementations in place with stakeholders including Pharmacy Benefit Management (PerformRx), Health plans (GreenShield Canada), pharmaceutical manufacturers (Genentech) and providers (Johns Hopkins University) to demonstrate the efficacy of employing a two-tiered data driven digital health intervention. 

A presentation about an iterative design-thinking approach to develop an entertainment oriented therapy based on neuropsychology, will show how emerging technology platforms such as HealthKit, Google Fit & Wearables are being harnessed to drive health outcomes. This talk will share a case study of the therapeutic value and health outcomes measured during clinical trials of fooya - a mobile health App available via the App Store and the Google Play Store. The goal is to share insights within the underlying design premise that one of the first steps to behavior change in individuals, is achievable by raising awareness to promote self-efficacy through vicarious reinforcement and conditioning. The case study will focus on user data generated by middle school campers across the country during the 2014 ExxonMobil Bernard Harris Summer Science Camp. » Read More

Advanced technology on various industries are helping us to develop better x-ray systems for usage. We are developing innovative x-ray devices to use. We have a core team of 4, and we have 2 patents on hold up to now, which will be 4 in the end of this year.  We are developing new generation x-ray systems with lower dose, tremendously improved imaging abilities, with easy usage and low cost.   Our medical direct x-ray system has many features depending on our core platform technology SyncBox (patented); about multiple energy x-ray; which helps us to observe soft tissues on x-ray like never happened before; also with various developments we are trying to provide functional data acquisition, and able to observe complex tissue degenerations such as meniscus, hernia. By able to provide this information we are aiming to reduce MRI and CT usage  ,and support the health system with better, cheaper and faster diagnostics.   Our innovative technology  based on system optimization, image processing, and controlling all the hardware and software through out a single platform (SyncBox). » Read More

Medical decisions are stressful. When people receive a diagnosis of a serious illness such as cancer, people usually feel overwhelmed; many experience things like cancer-related anxiety or in some cases, even Post-Traumatic Stress Disorder. Fueled by fear, people often rush into decisions without the proper time to absorb information and understand their options. Other times, with a chronic condition like diabetes, people often reach a decision point when an additional medication is needed. » Read More

Scholarly content represents the leading edge of humanities knowledge.  With over 5,000 new papers published across 27,000 online journals daily, many scholarly articles simply never reach their intended audience and consequently fail to generate the impact they deserve.   TrendMD was founded by physician-scientist Dr. Paul Kudlow, and leading open access publisher of JMIR Publications, Dr. Gunther Eysenbach, with the simple goal of connecting the right content to the right audience. The two joined forces with Alan Rutledge, a talented software engineer, to create a personalized recommendation engine that allows us to distribute scholarly content across online journals and blogs and push content directly to its intended readers.   When a publisher installs our free recommendations widget on their journals and blogs, we start promoting their content across our network and send them new and interested visitors. » Read More

Since the 1950s, the majority of innovations in mental health have been focused on the development of pharmaceuticals. But with  nearly 1-in-5 Americans suffering from mental health illnesses  and the cost of developing new drugs  now exceeding $2.5 billion , the medical community is searching for new ways to understand, manage and treat behavioral health conditions. This includes management on both the individual and population levels. Additionally, today’s mental health patients have remarkably few tools to help them understand and manage conditions on their own—a surprising fact in an era defined by self-service and consumer apps.  At Ginger.io, we empower patients to better manage their own mental health condition, and we empower providers to deliver better mental health care. » Read More

The rise of mobile technology and digital health has created an opportunity for employers to offer personalized, dynamic benefits designs that maximize employee health and minimize health care costs. Jiff creates simple, unique experiences that reward employees for making healthy choices. Through the platform, employees can choose to use their own consumer tracking devices and mobile apps, or ones issued by their companies, to participate and earn rewards.  Using examples from well-known companies, Jiff CEO Derek Newell will demonstrate how its real-time data collection on a wide range of employee health metrics can help employers measure the results of their employee health programs and prove their value with real financial savings. These measurable savings include company health care expenditures and a reduction in employee health care premiums. » Read More

President Obama kicked off 2015 with the Precision Medicine Initiative outlining a vision of data-driven science to improve health outcomes.  Over the past few years, we have witnessed breakthroughs in the mapping of the human genome, which kickstarted this genomic journey to personalized medicine. We continue to blaze new trails as healthcare providers, businesses, consumers and the government all play critical roles in the era of medical discovery. Technology has been a key driver to medical advances in key fields such as biopharma, wearables and diagnostic-testing, and will be a key component to the overall success of the president’s initiative.   Genetically-defined therapies have shown some success over the years, in oncology and cystic fibrosis for example, but what will be required for targeted therapies to become the norm in modern medicine? The simple answer to a complex undertaking is a combination of collecting, integrating and analyzing a range of data types – no small task, and one that is ripe for innovation with technology. » Read More

Every healthcare organization is aware of patients using mobile devices to manage their diseases/treatments, search for information and discuss their conditions. To address this healthcare organization started developing their own mobile applications. However custom developed applications have the following issues: - high development costs; - slow to market; - high support costs; - inability to quickly respond to changes in fast moving mobile space; - overload of mobile applications for patients - in many cases patients have to install more than 5 applications to manage one disease; - mobile applications are not personalized to each patients' needs resulting in overload of irrelevant information. These are some of the reasons that dictate a different approach to mobile applications development strategies. » Read More

A rare disease is defined as a condition affecting less than 200,000 patients in the US.  There are 7000 such diseases impacting 30 million patients and families in this country alone.  We are building a platform that will allow patients with rare diseases and their caregivers to foster micro-communities, log real time home care data and input full EHR family & personal histories.  With this we not only remove the barriers of isolation that often come with any disease, let alone a rare one, but we provide a platform for crucial data that was not previously collected in a structured way, particularly along the vertical of one disease. With that we're building a data analytics engine that highlights commonalities and perhaps some environmental & genetic causes of the disease otherwise not discovered for the purposes of treatment and acceleration of diagnosis. We can now provide vital information to clinicians & researchers, that was not accessible until this point.  They now have access to patient behavior and symptoms in real-time, outside of the clinical environment--- making the communication between provider and patient more engaged, more empowered and more reciprocal.  

Creation Pinpoint® is the first service dedicated to providing business intelligence and competitive insights from live conversation among healthcare professionals in public social media channels. This unrivaled service is built on proprietary technology that is currently monitoring more than 150,000 influential healthcare professional social media sources and profiles among a wider index of over half a million healthcare professional profiles. Launched in 2013 by Creation Healthcare in London, UK, the service is now used to inform the strategies of more than half the world’s largest pharmaceutical companies as well as NGOs including the World Health Organization.  In this presentation, Paul Grant will share how insights obtained through the service are shaping and informing strategies throughout the healthcare industry, and more generally influencing the provision of medical information in traditional offline and online activities. After setting up a rationale on why it is important that healthcare professionals are discussing clinical matters online, the presentation will give practical examples and case studies of the educational benefits for any team looking to deliver value to healthcare professionals as a customer group.

Patients have critical information that healthcare professionals need to deliver the best care. So, how can we improve the communication of this information? Shift Health, a full service health IT company based in Toronto, Canada, envisions the patient-experience movement as an opportunity to address patient/provider communication – a fundamental interaction to the provision of effective care – by targeting a ubiquitous health care tool: the patient questionnaire. Traditional clinical questionnaires reinforce inequality in therapeutic relationships. They are not designed to engage patients and are seriously limited by poor uptake, survey fatigue and complexity. » Read More

CancerIQ is democratizing access to precision medicine cancer care.  We make hereditary cancer risk assessment faster and cheaper, so that patients can get direct access to care, so that more providers can screen for genetic risk factors, and so that specialists can scale care to patients at lower costs.   For our poster presentation, we will demonstrate our platform and discuss our unique approach to patient-centered design.  In order to ensure that our product resonates with patients, we partnered with ePatient designer and founder of Brave Bosom, Andrea Downing.   The NIH has outlined a new strategic vision for the 21st Century, which will shift the focus of research toward medicine that is Predictive, Personalized, Preemptive, and Participatory (NIH 4P’s). This strategic vision has great potential to be realized within cancer care through use of genomic technologies, which are rapidly becoming faster, cheaper, and more scalable.  Yet, great barriers to widespread adoption of genomic-based cancer prevention strategies include limited knowledge in a rapidly evolving field, a growing shortage of cancer specialists and genetic counselors, complicated and fragmented care delivery systems, and mounting pressures to reduce cost. Despite lowered costs of DNA sequencing and increasingly powerful informatics tools, practitioners are unable to meet the needs of millions of patients newly diagnosed with cancer globally, and unable to serve family members at risk. » Read More

In the face of the mounting pressures on healthcare systems in all countries, new solutions are urgently needed. Governments in developing countries will be unable to continue to deliver quality services to all of their citizens with existing resources and traditional methods. We propose through a new kind of business models to increase the quality of African HealthCare systems, by offering a free Big Data Health platform, able to collect genes, Behavioral data and health data, and process it with Machine Learning algorithms that can search and discover, behind patterns. Our Business Model is built on Doctors in Developed countries paying Platform utilization fees for Emerging countries MD’s. » Read More

A 55-year-old man with a history of heart disease is driving to work on a Monday morning when his mobile phone rings. It’s his care manager with a message: A pattern from the continuous streams of data from his wearable biometric device indicates that he is in the early stages of heart failure decompensation and is likely to be hospitalized in 14 days without an intervention. The care manager goes on to say not to worry - his cardiologist increased the dose of his diuretic in an intervention that has a 94% chance of stopping the decompensation within 48 hours.   This is a fictitious example of “remote patient intelligence,” but the breakthrough technology for collecting and analyzing actionable medical data – for individuals as well as whole populations – is finally here. » Read More

Doctors are limited to only 15 minutes per patient. Patients feel they are not listened to. Important symptoms are missed, errors occur, and health care quality suffers. In the absence of a miracle – creating more time – what can patients and doctors do to make the 15 minute visit more worthwhile? Inspired by the empowered patient movement and informed by the principles of primary care medicine, we will present our strategies for making the most of the 15-minute visit. » Read More

Ask any successful entrepreneur for tips on what made them so and they will respond: “Know your customer!” Know what makes them tick. Know their needs and wants. Know their pain. It has also been said that, “Customers think of problems, while entrepreneurs think of solutions.” So why do some patients become healthcare entrepreneurs while others do not? And why should more patients get involved in healthcare startups?  We are entering a new era in healthcare where patients are beginning to increasingly and visibly take charge of their health and the health of their family members. » Read More

Interventions which integrates mobile phone health services (mHealth) and social influence have been found to be both effective and well liked by users. However, a review of 34 health behaviour interventions utilizing mobile text messaging by Buhi et al.(2012) identified a gap in youth-focused mHealth interventions; the demographic with the highest smartphone ownership. Our presentation focuses on the findings from the smartphone application (app), GoalPost (http://goalpost.it/), which utilizes social influence, persuasive technologies and expert advice to aid smoking cessation. GoalPost was developed in partnership with Quitline New Zealand and New Zealand Smokefree (a branch of New Zealand’s Health Sponsorship Council), in consultation with the North American Quit Consortium and the British Journal of Tobacco Cessation. » Read More

How do you nurture relationships amongst patients and providers online? How do you encourage one-to-one and one-to-many conversations? The aim of this tutorial is to guide participants through best practices in online community management, using examples from real online patient communities. This tutorial is suitable for online community managers, both new to, and experienced with, social networks in health. Participants will learn practical ways to increase patient engagement for improved health outcomes. The tutorial will also cover the value of extending the clinicians reach beyond the physical setting and engaging with patients in the comfort of their home. » Read More

As healthcare continues to witness an exponential explosion of data, tools and technology, we run the risk of equating technology with patient engagement. But data and technology can only enable engagement, not ensure it. Engagement must start first and foremost with the individual.  Understanding the context in which a person is making a decision or taking an action is key, particularly when you are offering a technology service or tool that is unfamiliar. Contextual issues include competing responsibilities, finances, skills/abilities/knowledge and emotional state, among others. » Read More

According to SAMHSA and the CDC, more than 1 in 4 Americans will experience some form of mental illness in any given year, with national expenditures now over $240 billion. However, behavioral health has lagged compared to other areas in advancing technology into the workflow of providers and ultimately assisting in serving patient needs. Given the increase in digital health solutions on the market, digital behavioral health is now in a position to expand treatment and accessibility of recovery-related services in ways that augment or complement traditional systems of care delivery. Ranging from teletherapy to digitizing outcomes measurement, providers can now utilize technology across their entire population of patients. » Read More

There is needless psychosocial distress in the cancer experience. Per the US Institute of Medicine's "Cancer Care for the Whole Patient" report (2008), attention to patients' psychosocial needs is the exception in cancer care today. Our experience bears this out. Many cancer survivors and caregivers expect distress as an inherent part of their cancer story and are reluctant to seek help. » Read More

Imagine the challenges faced by a child or adult with autism who shares the same desires you have, to be a better version of yourself, to thrive and to reach your potential. Perhaps you know a person who faces such challenges. Perhaps you are a parent who is faced with adjusting your expectations and becoming a caregiver in the most extreme sense. What cutting edge technology can help you and your child with autism, both immediately and long-term? Invirtua’s virtual reality software creates a computer-generated “digital puppet” in a 3D environment, an animated character that can be brought to life in real time by either the therapist, the parent or the person with autism, so that it can interact and express itself with emotions, personality and body language. » Read More

Whether due to perceived stigma, lack of information, or lack of easy access to high quality, affordable care options, unaddressed or undiagnosed cases of mental illness are a pervasive issue today in both the US and on a global scale. In this country alone, according to the American Psychiatric Association (APA), approximately 50 million Americans—or 22 percent of the population—have a mental health problem that is serious enough to interfere with their normal, daily functioning. But despite the crippling effect that mental illness and behavioral health related sickness have on quality of life—and both the indirect and direct costs associated across the healthcare ecosystem—all too often, patients do not seek treatment. But it no longer has to be this way. » Read More

In 2012 Health & Parenting set out to make a pregnancy app to help mothers-to-be enjoy their pregnancy and provide pertinent information in one helpful daily guide.  Their app, Pregnancy+ , has over 3 million annual downloads, very high ranking and reviews in the App Store, and is the most popular independent pregnancy app world wide. The team's core goal is to make the journey of pregnancy more enjoyable, educate mothers with what to expect, and help them make better use of their time spent with healthcare professionals. Co-founder John Miles is from a design background and spent many years in the video game industry working for Electronic Arts. His approach to medical apps puts UX (user experience) and engagement as a high priority. » Read More

GeriJoy's specially-trained remote care team interacts with patients through a capitivating virtual avatar and expert system, providing 24x7 coaching, reporting, and personalized engagement to ensure that care plans are executed correctly and to report patient progress and urgent alerts to clinical managers for better informed interventions. Pilot Health Tech NYC recently awarded a total of $1 million to a handful of innovative pilot projects, and Pace University, Mount Sinai Queens Hospital, and GeriJoy were selected as award winners, to leverage GeriJoy's patient engagement platform to mitigate delirium in older adult acute care inpatients, as well as to reduce readmissions through post-discharge health coaching. Sanford Chamberlain Medical Center in South Dakota also has a  Statewide Health Improvement Program grant to reduce cardiac and diabetes related readmissions through GeriJoy's post-discharge patient engagement and coaching program. Results  will be presented from these pilot studies and there will be a brief explanation and demonstration of GeriJoy's unique patient engagement and reporting platform.

Several studies have reported negative impact of immobility on health. as Dr. James Levine of Mayo Clinic describes it, "We lose two hours of life for every hour we sit." In clinical environments, sedentary behavior is commonly treated through the use of exercise and posture correction. However, this type of intervention is generally limited by patient's motivation to participate. » Read More

ONC has announced a 10-year roadmap for electronic health record interoperability. Why wait? Tools exist today that solve for interoperability and are capable of rolling out a patient-centered health information exchange layer that connects diverse EHRs to create a patient-controlled longitudinal health record. Flow Health’s core offering and related applications are provided free of charge to patients and their caregivers, health care providers and payors. Existing data standards are leveraged in order to enable the free flow of information, to enable clinical insights and better care management. Flow Health enables patient-centered collaboration by solving several intransigent problems: (1)   Ensuring patient identity matching across providers (2)   Creating a universal clinical data architecture that accommodates data from multiple sources, and tracking provenance of each data element (3)   Managing patient-centered consent so that the patient controls who sees what Flow Health has an installed user base of 9000 physicians, and deals are in place that will double that number in the near term. » Read More

ONC has announced a 10-year roadmap for electronic health record interoperability. Why wait? Tools exist today that solve for interoperability and are capable of rolling out a patient-centered health information exchange layer that connects diverse EHRs to create a patient-controlled longitudinal health record. Flow Health’s core offering and related applications are provided free of charge to patients and their caregivers, health care providers and payors. Existing data standards are leveraged in order to enable the free flow of information, to enable clinical insights and better care management. Flow Health enables patient-centered collaboration by solving several intransigent problems: (1)   Ensuring patient identity matching across providers (2)   Creating a universal clinical data architecture that accommodates data from multiple sources, and tracking provenance of each data element (3)   Managing patient-centered consent so that the patient controls who sees what Flow Health has an installed user base of 9000 physicians, and deals are in place that will double that number in the near term. » Read More

Dr. Shawn DuBravac is Chief Economist and Haed of Research of the Consumer Electronics Association (CEA), the U.S. trade association representing more than 2,000 consumer electronics companies, which owns and produces the International CES, the world’s largest gathering place for all who thrive on the business of consumer technologies -- with an ever-increasing attention to the health and medical application of wearables, quantified self, 3D printing, sensors, and big data. DuBravac is the author of Digital Destiny: How the New Age of Data Will Transform the Way We Work, Live, and Communicate (Regnery, 2015), which explores how the world’s mass adoption of digital technologies portends the beginning of a new era for humanity in the realms of economics, health, travel and culture. As Chief Economist and Head of Research for the Consumer Electronics Association, Dr. » Read More

Despite all the advances introduced into healthcare over the last 20 years, the biggest X factor in successfully treating patients is still the patients themselves. If the patient is not engaged, then it is unlikely their condition will improve. This is especially true of patients with one or more chronic illnesses, which describes nearly 1 out of 2 adults in the U.S. according to the CDC.  In this presentation, “Empowering Providers to Engage Patients,” Phytel Vice President of Innovation Russell Olsen will briefly describe the vast need for improving patient engagement, and then discuss the analytics, tools and automation providers need to find and engage the right patients at the right time – on a population scale. At the heart of the problem is the need to make it exponentially simpler for providers to reach out and encourage the sickest patients to take better care of themselves. » Read More

The future of the EHR (Electronic Health Record) is ... the PHR ( Personal Health Record). It’s a provocative notion to suggest that within a decade of the healthcare industry’s induction of its ERP system, the EHR will give way to PHRs (despite multiple failed attempts at PHR innovation by leading technology companies like Google and Microsoft). I’ll extrapolate from other industries where supply chain participants have been disintermediated by "the rise of the consumer." Just like banking’s nondescript ERP systems have been relegated to the back office, while disruption advances the consumer's front-line through innovations in novel payment systems, medicines own EHR will become a shadow of itself, which currently absorbs scarce resources and budgets. » Read More

Necessity is the mother of invention. Many of today’s common consumer products were simply the results of an individual inventor identifying a “pain point” and invent the remedy. But what about life’s true pain points -- issues such as arthritis, hearing loss, or hospital-acquired infections? Where will the solutions for these and hundreds of other ailments come from? Medical-device innovation is a multi-billion dollar industry with researchers and product developers searching for ways to improve patient care and quality of life. But an often overlooked source for inspiration are those who live or work on the front lines of health care who and who have the necessary insight and expertise to add to the invention process. » Read More

Rapid prototyping by additive manufacturing — otherwise known as 3D printing — stands poised to revolutionize healthcare in everything from regenerative medicine to cancer research by facilitating cost-effective technological innovation on a scale never before thought possible. In many ways, the revolution has already begun. Knee implants and hearing aids are already being manufactured. In 2013, a team at Princeton printed a bionic ear. » Read More

President Obama announced the Precision Medicine Initiative during his 2015 State of the Union address, with the goal of making DNA data more useful for personalizing medical treatment to a particular patient. It’s clear that genetic screening will play an increasingly important role in healthcare in the future. In truth, information about a patient’s DNA already drives many medical decisions, sometimes in surprising ways. How have we gotten here? What barriers – technological, logistical and ethical – has the genetic testing industry already overcome to become part of routine medical care for some specialties? What challenges still remain in order for the field to live up to the expectations laid out in the Precision Medicine Initiative? Laura Martini, Director of Product Design at Counsyl, a health technology company providing genetic testing and counseling services, will discuss the medical genomics landscape as seen through the lens of her role doing user-centered design at a commercial testing lab. » Read More

The lifeblood of any successful company stems from a sustained stream of commercially viable innovations, both incremental and breakthrough. In some industries — namely retail and consumer products — companies have long recognized the power of partnering with other brands as a means to develop new and unique products, generate renewed excitement, and reach new customers. These partnerships often make the brands involved seem more distinctive, more interesting, and more newsworthy — and, most importantly, infuse a new line of interesting products into the marketplace that cannot be replicated elsewhere. The practice of co-branding now extends to industries ranging from cosmetics, hotels, restaurants, fashion, household products, and charities, to name only a few. The one industry in which co-branding partnerships have not yet taken a strong hold, however, is healthcare. » Read More

The need for scalable delivery of mental health care is now a major public health priority. For the 20 percent of Americans who suffer from a mental illness there are significant barriers to accessing quality mental health care and stigma continues to shroud seeing a “shrink”. Current models of care delivery are unlikely to ever meet the enormous need for psychological services.  The emergence of mobile applications (apps) for mental health identification and treatment is potentially game changing. Apps can deliver consistent, evidence-based, and responsive treatments to individuals with unprecedented privacy, convenience and affordability. » Read More

Continued advancements in genomics are shepherding a new era of personal and familial health information. But how are patients navigating this new space focused on probable risks?  How does the experience of genetic screening shape a patient’s understanding of their own genetics and that of their family? Matthew Maher, a Product Designer at Counsyl, a health technology company providing genetic testing and counseling services, will discuss the challenges and opportunities in designing a patient experience that educates and informs, ultimately translating statistical risks into better patient outcomes.

Why does one medication work for you but not for someone else?  A branch of science known as pharmacogenetics promises to help physicians prescribe medicines based on patients’ unique genetic characteristics that affect their response to specific medications. These tests are changing how physicians think about and prescribe medications for an array of complex conditions, such as mental health, pain and cardio metabolic diseases. Millennium Health CEO Brock Hardaway can describe the potential for pharmacogenetic testing to improve and save lives while also reducing costs associated with prescribing the wrong medication. The company is a leader in developing new genetic tests for a variety of conditions and in achieving faster turnaround times—48 hours or less—to help doctors make more timely diagnoses and treatment decisions. » Read More

Visualizing large-scale disconnected data in health care is becoming one of the biggest challenges in the big data community. Challenges arise from the heterogeneous and unstructured nature of data as well as complex relationships between different entities. Modeling the data correctly in health care industry helps in answering important questions such as professional health care network analysis for better connectivity and referrals, analyzing sales data for predictive analysis of accounts and sales reps, and providing extensive insights into clinical trials.  These problems can be addressed by integrating disparate, heterogeneous data sources for deriving analytics and meaningful insights from the data. » Read More

The patient experience is consistently a top concern for healthcare leaders.  When thinking about how to improve, advances in clinical care and environment are often the focal point. However, in an era of rising patient responsibility, the patient financial experience is often an overlooked component.  Billing is the last impression left on a patient and can potentially be one of the most damaging.  Worse, there is a correlation between higher patient responsibility and bad debt, not to mention the many patients (insured or otherwise) who avoid needed care due to the costs. A prominent McKinsey study shows 74% of patients are willing and able to pay given the right conditions.  A more consumer friendly approach to billing has the potential to ensure patients have the right expectations from the start, clearly understand their benefits and bill, and have a convenient means to pay including financial assistance. Healthcare leaders face an important opportunity to close a significant gap. » Read More

How do you get your foot in the door with large healthcare systems when there is little access and few success stories? Entrepreneurs often lack the resources to go from a high-potential concept to a built-out service in market. However, the barriers to entry are not as insurmountable as one might think. Part of athenahealth’s core strategy is to help innovators connect with those in need of solutions. Mandira Singh, who heads athenahealth’s  More Disruption Please (MDP)  program, will reveal her tricks of the trade, including how to position a Health IT company to sell into the behemoths of enterprise, how to lower the sales cycle, and ways to effectively spend marketing and sales dollars. This will be a working session so bring ideas to pitch. » Read More

A piece that I wrote for The Huffington Post was picked up by the American Society for Reproductive Medicine, and I think that it is a great anecdotal introduction to the reality of living with endometriosis. I have written and researched chronic pain — particularly as it relates to endometriosis—as an independent writer, journalist and scholar and feel that Medicine X would be a prime platform to begin having this discussion. Endometriosis, at present, has no cure. It is chronic, progressive, likely linked to autoimmune disorders and can quite malevolently rip a woman of her fertility. » Read More

Imagine a world where you own a digital camera, but you are forced to use the software that comes with the camera in order to access the pictures. Worse, if you want to share the pictures with Grandma, you have to give her a proprietary image viewer in order to view the camera’s proprietary image format.  We would never stand for that, right? Now imagine that you have type 1 diabetes. You live with a life-changing chronic disease that demands constant attention. Your pancreas has stopped producing insulin, so in order to survive you must administer precise doses of insulin throughout the course of the day. » Read More

I believe that pediatrics is a special field of medicine. Discussions need to occur on how we can make it easier for parents and caregivers of medically complex children communicate with their child's medical providers. Be it email, patient portal, and the like, it is a discussion that needs to occur. How quickly should providers respond? There is many questions as to how this can be achieved.  Also discussions on parent engagement in the process of care for these children is a very important topic that can be discussed. » Read More

Yelp, TripAdvisor, Facebook...there are myriad ways for consumers to provide feedback on goods and services, however, in healthcare, these same social media sites do not provide healthcare providers with meaningful, actionable data so that they can actually respond to patients' feedback.  Enter RateMyHospital® ( www.ratemyhospital.com ).  With RateMyHospital®, we set up an ADT (admission, discharge, transfer) feed with the hospital.  We are notified when a patient is discharged from the inpatient setting or checks out of the outpatient practice and text that patient a HIPAA-secure link to a patient satisfaction survey on their smartphone.  This consumer-friendly survey is based on a 5-star rating scale and takes less than a minute to fill out. » Read More

Many disruptive technology and sociological factors today combine to allow patient powered research projects to take the helm at seeking solutions to the medical problems that impact patient lives. Patient powered research is research that is driven by patients and holds their interests at the center. The technological forces that fuel these changes include the computer advancements that allow big data research, which draws upon the 3Vs: volume (vast data pools), velocity (quick research), and variety (types of data). In addition to being able to compile and analyze individual medical data on a large scale, these advances allow research to leave the ivory towers of academia and travel down the tributaries to patient organizations, which may hold the keys to the kingdom in big data—patient engagement and consent. » Read More

Four million babies are born each year in the United States yet women are not receiving important safety information from their obstetricians about exposure to toxic chemicals as part of their prenatal education. Research from UCSF’s Program on Reproductive Health and the Environment shows that OBS lack the tools to discuss toxic exposures with pregnant patients and aren’t counseling pregnant women on toxic chemical risks. OBs are missing a ripe opportunity when women are poised to make important changes in their lifestyle and behavior for the health of their pregnancy and baby.   A growing body of research shows that many reproductive and health problems are caused by exposure to chemicals that are widely dispersed in our environment and with which we come into contact on a daily basis. » Read More

  The widespread availability of sequencing is creating an explosion of “one of a kind” disorders.  Patients are being told in record numbers: “You are the first and only we’ve ever seen.”  Not long ago, the diagnosis and discovery of these “black swan” disorders would have been devastating.  But, social media and precision medicine are making it possible to fight and win against even the rarest diseases.  Dr. Might paints a vision of precision science and medicine at the fringes of human knowledge through the story of his son — the first patient ever diagnosed with the novel disorder N-glycanase (NGLY1) deficiency.  Might’s targeted use of social media for case-finding made it possible to find undiagnosed and misdiagnosed NGLY1 patients as far away as India in mere months rather than years.  Two and a half years later, a tight-knit community of  26 NGLY1 cases has established a global, patient-driven research coalition that is rapidly bringing the disease to heel through breakthroughs in the cell biology of the disorder.  Early therapies have already been identified and trials for targeted treatments are within striking distance.  Ultimately, the NGLY1 community seeks to discover more than a cure for N-glycanase deficiency; it is also discovering a sustainable, scalable model for understanding, treating and curing the rarest of diseases.   Through the lens of NGLY1 deficiency, the talk will illustrate a rare disease roadmap: it will briefly discuss going from undiagnosed to “one of a kind,” and then focus on answering two questions: how do you create a patient community from scratch, and how can small patient communities drive the science?  While the examples of steps on the roadmap are drawn from the NGLY1 community, the action items are general, so that other patients and communities figuring out how to take the “next step” on the road to understanding and treatment may do so as well.

The potential of precision medicine is tantalizing.  We see news about technologies, tests, and new therapies every day.  When people receive a cancer diagnosis, however, they are stunned that the power of personalized medicine is just out of reach.  This insight led us to develop a new company, Cure Forward, a website that helps patients play a more active role in care planning through effective access to, and use of, their molecular profiling test data.  We envision a future where patients will be able to work with their doctor to find a test, receive their test results electronically, and put them to purposeful use, including finding trials trials through a multi-sided marketplace.  In this talk, we will describe the Cure Forward product and the story and philosophy behind it.  At this three-month inflection point, we’ll also describe what is happening in this new community.  We’ll share data and insights on participation by patients and clinical trial recruiters, and we’ll candidly assess the success and prospects of the program.  Most of all, we’ll assess whether mobilization of individual consumers is an effective catalyst for widespread adoption of genomics in cancer care and increased patient participation in clinical research.

The explosion of self-tracking apps and devices is de facto evidence we have been underestimating the ePatient’s ability to take control of their health in a meaningful way. These first steps toward empowering the ePatient have produced a lot of data, with very little analysis. The proliferation of health trackers merely beg the democratization of science for better health, which have yet to deliver analysis. This void dooms these magnificent tools when they are relegated to a drawer after six months, when they lose their ability to prove long-term value as ambassadors to health. Enter the DIY ePatient: In order to change the paradigms of delivery of treatment, meaningful use, and collaboration, we must empower the ePatient with tools that, like bionic limbs, give them a digital reach that can mitigate their need for assistance. It must necessarily begin with defining a new democracy in health care delivery, which recognizes that in leveraging technology, we can also leverage science, to improve treatment rates and better outcomes. » Read More

BACKGROUND :  The Administration on Aging reported in 2012 that 15.8% of those over 65 were having difficulty living independently.   At the same time, families are becoming more physically distant as the children move around the country.  This has created a need for long-distance children and remote caregivers to be able to access the information they need in the locations their loved ones reside, in order to provide assistance when they cannot be there to physically provide help.     Aging Projects, Inc. (API) was created as an easy-to-navigate website to provide information about maintaining the safety and quality of life to those aging at home. » Read More

  Privacy is an ambiguous, powerful concept that, while meant to protect us, can shut down meaningful conversation and innovation. Discussions of privacy often happen within silos, missing opportunity for translation across professional and personal lines. This interdisciplinary panel will unpack the meaning of privacy in health care, expand the audience’s understanding of its nuances and practical applications, and inspire people to build health systems based on trust, freedom, and discovery.   Through flipping the panel, the panelists will tap into the expansive collective knowledge of their social networks to inform and guide the discussion in the months leading up to conference. » Read More

When I was 17 years old I had my first episode of psychosis, was hospitalized and diagnosed with schizophrenia.  I was told I would always be sick.  My treatment team advised me to take high dose antipsychotic medications for the rest of my life and to avoid stress.  The treatment and the prognosis of doom surrounding my diagnosis were as disabling as the illness. » Read More

The psychosocial and psychological aspects of living with chronic illness and trauma all too often get overlooked due to time constraints within healthcare, a focus on the immediate problem at hand, and an inability to ever fully understand another person's life.  This will be a candid discussion including a cross section of disease patients: Diabetes, Amputee, Rheumatoid Arthritis, and Rare Disease. Each panelist will discuss life outside of the physician's office and dealing with the stigmas of their diseases. Topics will include: friendships with "healthy" people, family, intimacy, stress on caregivers, and questions posted by Twitter prior to the conference.  As well as how each demographic deals with the fatigue of being a patient 24/7. While each patient deals with the specifics of their disease, this discussion will highlight the commonality of being a chronic patient. » Read More

All over the world, patients’ voices are being heard more and more in healthcare and are increasingly seen as an important stakeholder in discussions on healthcare design and delivery. But what about medical research? Can patients add value beyond being research subjects?  In this panel we will discuss how patients’ opinions, knowledge, and experiences can make the whole research process better; from formulating the research questions, to designing, recruiting, and implementing the research as well as disseminating the research results. We will draw from our experience of different initiatives, like PCORI and NIHR. Members of the panel are: Michael Seres is a long term patient having become the 11th person in the UK to undergo a rare bowel transplant and now coping with high grade B cell Lymphoma. » Read More

It’s still lonely in the world of autoimmune disease. Twenty years after the promising biologicals of the 1990s, we need big data to advance further. Despite $4B in digital health funding, autoimmune diseases have been wallflowers at the party. But we aren’t just standing around: the community is generating a digital pandemonium of self-help advice, especially dietary. » Read More

Tom Ferguson coined the term e-patients to describe individuals who are  equipped, enabled, empowered and engaged  in their health and health care decisions.  Our hypothesis is that developing the skills and attributes necessary to be an e-patient is particularly important in under-served, ethnic minority communities and that as part of the Stanford Youth Diabetes Coaches Program , high school students can be taught to develop these skills for themselves and support their families to acquire them as well.   The CDC reports that compared to non-Hispanic white adults, the risk of diagnosed diabetes was significantly higher in minority populations.  Additionally, in less than a decade, the prevalence of Type 2 Diabetes and prediabetes has more than doubled among US adolescents.   Efforts to address this through education are predominantly healthcare-centric, traditionally where patients and community members passively receive information from experts.  What if we could seamlessly integrate knowledge transmission and skill building into each person’s life cycle?  What if we could leverage the inherent altruism of teens to help their family members and the aspirational goals of physicians in training to help their communities to set up a diabetes education and prevention system that was accessible, sustainable and reproducible even for under resourced communities? In our research we have partnered family medicine residency programs with high schools in low income, ethnic minority, at risk communities to bring residents into the high schools to teach students to become diabetes self-management coaches for their family members.  The goal of the project is to create web-based, innovative, effective, scalable, technology-enhanced curriculum to support sustained participation of high school students and their families, incorporating the best practices of secondary education with the most current theories of behavior change for health improvement. The curriculum emphasizes health literacy, goal setting for health improvement, and intra-family social support for engaging in healthy behaviors.   Participating residents learn how to work in partnership with high schools and gain an enhanced understanding of the communities they serve.  After residency graduation, the web based curriculum would be easy to access, efficient to use, and fun to continue to teach wherever they might practice.  And the high school students, empowered by regular personal interactions with physicians at their schools, internalize and share with their families the realization that diabetes prevention and self-management coaching are part of daily life, like the other life skills they are being taught, not a stand-alone body of technical knowledge, dependent on an expert for access.  This approach is cheap, leverages strengths in low-income ethnic minority communities, benefits the whole family, and provides experience in community health for physicians in training.  Ultimately, the program has the potential to support the development of equipped, enabled, empowered and engaged  patients in communities that have historically been dis-empowered and distrustful of the medical system.

Patient engagement. Patient-centered. Patient empowerment. These phrases have become ubiquitous synonyms. » Read More

With increasing attention being paid to patient centricity and implications for protocol design, sponsors are incorporating many innovative approaches to improving the participant experience during a clinical trial. Mobile patient engagement platforms are a key element to this strategy. Such platforms offer a myriad of features to better engage patients, including contextually relevant access to content, compliance and med adherence tools, patient diaries, site communication tools, and enhanced data capture and PROs. Mobile patient engagement platforms, or maybe better yet, mobile patient-experience platforms, are designed to lead to improved compliance, retention, and overall more predictable outcomes. This presentation will share insights learned from Centros' deployment of its mobile engagement platform during clinical trials and examine how these can be applied to improve protocol design and overall patient centricity. The presentation will also explore how Centros' rapid prototyping capability can be used to inform this process in real-time, including a case study from a large pharmaceutical company. » Read More

Persons suffering from depression, posttraumatic stress disorder, bipolar disorder, schizophrenia, and other psychiatric diseases have difficulty with today’s fragmented mental health system. What if mental health support could be more accessible, optimize wellness, enable global reach, and empower all patients? Technologies to make this a reality already exist: smartphones and wearable devices.  90% of Americans have access to a cell phone, and a majority of psychiatric patients own smartphones, providing a portal for consumers who may not want to seek in-person help or may face barriers to mental healthcare. But challenges abound in clinically validating and integrating this new paradigm of mental health into our existing systems. We will discuss our research in combining physiological, psychological, and behavioral metrics and real-time capturing of data.  We will review how data analysis techniques can monitor, assess, and treat mental illness — from mild everyday stress to serious cognitive disorders. » Read More

            As people age they are engaging increasingly with technology in order to manage their health, better understand illness, and make informed choices about care.  Evolving technologies allow older adults and their families to take hold of their health and health care more actively, and today people can connect readily with others who share similar challenges.  Electronic medical records can enable fully transparent relationships among patients, families and providers. And technology is even helping both providers and patients with the most complex health problems understand the likely course of a disease. This panel will highlight efforts to harness innovative technologies that support the needs of the largest segment of health care utilizers: older adults, who soon will represent one in five Americans.             Amy Berman lives well with stage IV cancer and is a Senior Program Officer with the John A. » Read More

A collaborative chronic care network (C3N) is a peer-produced learning health system. It is a platform that facilitates collaboration among patients, clinicians, and researchers to produce information, knowledge, and know-how to improve health and health care.  Like other network production systems, a C3N is composed of active agents self-organizing to fix problems important to them, using tools that make the work easier to do and platforms that enable aggregation of learning. Key features of a C3N are a culture of collaboration between and among patients and clinicians, as well as tools to make collaboration easier to do. The prototype C3N is ImproveCareNow, which has grown from 7 to more than 70 care centers and has improved the remission rate for youth with Inflammatory Bowel Disease from 60% to 80% without new medications. » Read More

In 2015, the Patient Centered Outcomes Research Institute (PCORI) will spend $460 million on research of importance to patients and caregivers. All awardees must have a component of patient engagement to involve patients in the execution of the project. However, there is little mentioned in the literature on patient engagement from the patient’s perspective.  The purpose of our panel discussion is to share as patient partners and research investigators the surprises, benefits of patient engagement, challenges encountered, and a model for successful integration. Our goal for this panel discussion is to encourage patients and researchers to adopt a patient partner model, learning from our experiences. » Read More

As the web has become a principle source of health information for individuals in the developed world, recent clinical literature has increasingly looked towards the potentials of social media applications for communicating health information. This medical research has focused particularly on the potential for sites s such as Facebook to function as vehicles for delivering novel clinical interventions to patients with chronic health problems. In doing so, it has neglected to consider how individuals already employ social networking sites to perform and negotiate their identities as people with long-term illnesses. In contrast, this patient-centered study examines the role of social media in the lives of people with type 1 and type 2 diabetes and the different practices they employ in their ongoing representation of life with a long-term condition. The study is based on an ongoing observation of 19 Facebook profiles created and maintained by people with diabetes, and includes analysis of both individual (status updates) and group contributions to a number of UK diabetes support groups. The results reveal a range of concurrent practices and activities such as displaying lay expertise and providing advice, demonstrating integration into wider diabetes-related networks, and adopting a critical position in relation to the norms of diabetes control. » Read More

At the age of 39, as a healthy nurse, mother and wife with no history of breast cancer in my family, being diagnosed with the disease shattered my world. In an instant, I found myself moving from the side of the hospital bed as a clinical care nurse, and into the bed as a patient.  As an effort to share my unique perspective - as a health care professional with firsthand patient experience - I launched my award winning blog, www.thesilverpen.com . It quickly became clear to me that people are hungry for peer-to-peer content and connection to help guide and support them from diagnosis through recovery. In April 2014, my blog was turned into a book, The Silver Lining, A Supportive and Insightful Guide to Breast Cancer. » Read More

50 Seniors from a high end senior home are each provided an iPad mini and connected health devices to self track their health. They are connected to their caregivers, mainly the pharmacist, doctor and nurses associated with the residence. Other parameters are tracked including nextgen biosensors and genomics in order to adjust their medication therapy. Our presentation shall provide findings from the project which lasts over several months in 2015. » Read More

We’ve all heard a lot about “patient engagement” but what value is it really providing to patients? Is it really about engagement when in the end, patients don’t care what you call it, they just want the ability to be more autonomous in their care?     Through our workshop we would like to explore the following questions/topic areas:  How can we design for autonomy- what does it look, feel, behave like? How do we find the balance between dependence and independence? What can we learn from those who are bending the system to achieve this now? What systems can be created to support them? What’s missing altogether? How can we speed the spread of best practices?  In this workshop we’ll work together with e-Patients who will co-facilitate this session to help us think and create around these topic areas.   Our e-Patient co-facilitators will kick-off the workshop ahead of time by asking their communities to give examples of where the healthcare system has failed to give them autonomy and workarounds they’ve used to have more autonomy. We’ll use these learnings to jumpstart the workshop then open up the floor to our participants to hear about personal experiences they’re willing to share. From this we’ll build a picture of the current landscape of challenges and opportunities to design for autonomy. » Read More

What does a truly patient-centered, digital health startup company look like? How does such a company find an ePatient Advisor? Is it really possible to co-design with patients? This session will provide answers to those questions and more. An ePatient and a patient-centered app meet in the #MedX tweetstream, and the rest is co-design history: As is often the case these days, it all started with Twitter. At Medicine X 2014, Liza Bernstein's remarks in contribution to Ann Becker Schutte’s panel about mental health were tweeted by Rachel Crooks and seen by Jon Brilliant, Chief Financial Officer of CanSurround , a fledgling startup at the intersection of mental health, oncology and technology. “ @jabrilliant RT @rachelcrooks_ : Mental health looks invisible, but it’s not - mental and physical health are intertwined @itsthebunk #MedX  10:57 AM - 7 Sep 2014” Jon who was following Medicine X from the East Coast sent her a tweet: “ @jabrilliant @itsthebunk , I would like to share with what we are doing at http://www.CanSurround.com  if you have some time. » Read More

On January 30th, President Obama announced a new Precision Medicine Initiative to revolutionize how we treat and prevent disease.  The role of the ePatient, and patient-centered design is more important than ever.  This panel discussion will look at ways in which this initiative will change precision medicine, and how ePatients can make an impact.  We will explore the following:: Why are concepts of equal access to data important?  Why does every ePatient need to understand that access to our own genomic data should be our right? . » Read More

For 48 hours, I live-tweeted the reality of my chronic disease, creating an unfiltered insight into living life as a chronic patient. Using the hashtag #ChronicLife, and registering it through Symplur, I utilized their tools to bring quantifiable meaning to the narrative.  What began as an experiment by one patient, turned into a movement of honesty, communication, and education  - and is still ongoing. While much of the conversation initially appeared status quo to the patients, other stakeholders that viewed the tweets all unanimously said they were profoundly changed from the experiment. By the end of the 48 hr period, even the patients were changed (for the better) as unforeseen insight was gained that will affect all research in healthcare social media.  From this talk, attendees will learn how real-time honest patient narrative created permission for other patients to improve communication in all aspects of their lives, and permission for other stakeholders to participate in healthcare social media on a new level.  This talk will look at why the narrative was greatly altered amongst a large number of patients within a 48 hour period, and how our current research into social media might be failing to grasp an accurate view of patients.  Then we’ll look at lessons learned and how we might apply them to improving the landscape of healthcare.

A cancer diagnosis changes life in an instant. A patient and their family must make urgent life or death decisions with no maps or reviews to guide them. The Web is full of disorganized, out of date and contradictory information. Even physicians are often faced with conflicting expert opinions and a shortage of actionable data buried within a tsunami of research. » Read More

Six months ago, I suffered a rare kind of heart attack, called a Spontaneous Coronary Artery Dissection (SCAD) while swimming across a lake in Idaho.  No one was more surprised than I was to find myself in the role of a heart patient, for I do not fit anyone’s profile of one: I am fit, athletic, had just completed a sprint triathlon two weeks before and have none of the typical cardiovascular disease risk factors.  Although the last 6 months have sometimes been sad, confusing and scary, I am heartened (pun intended!) to have made strides as an educated, engaged patient, an involved member of the SCAD community and as a new researcher of SCAD patients’ psychosocial experiences of this little-understood and often fatal heart condition. The proposed presentation covers a bit of my personal experience, lessons learned, emerging research interests and broader health care lessons.  The structure of the presentation would flow as follows:   My story Here’s a link to an earlier piece I wrote about my SCAD: http://thesocietypages.org/girlwpen/2014/09/29/our-hearts-our-selves-our-research-agenda/ The use of social media in gathering and disseminating information about lesser-known health conditions Social media is an increasingly important, though imperfect, source of health information and support for patients, especially for conditions that are unusual and where both the care and population are widely and sparsely distributed.  It is how I started accessing much of the literature on SCADs and found the SCAD Alliance. We will also be distributing our patient survey (discussed below) over social media. » Read More

Just as doctors receive little training as to how to talk to patients about death and thus avoid the conversation to patients’ and caregivers’ detriment, there exists a major gap in doctors’ willingness and ability to talk with patients and caregivers about intimacy and illness. Reclaiming intimacy after an acute medical event is regarded much the same as resuming any physical activity such as riding a bike, gardening or climbing stairs. These mundane tasks do not carry the same weight—they do not require intimacy’s physical and emotional exposure. They do not carry the burden of a body changed—a body that surgery has scarred; a body that healing has fatigued physically, mentally and emotionally. » Read More

Cancer is the second leading cause of death in the U.S.  Considering about half of all men and one-third of all women in the US will develop cancer during their lifetimes , the disease unfortunately is something most Americans have come in contact with, either personally or through a loved one or close friend.  Cancer can grow and mutate rapidly.  However, every cancer patient’s disease is different from a genomic level.  This has led to the personalized treatment movement and has led to patients taking an active role in determining with their physicians the right therapies at the right time.  For decades, the medical community has been fighting this widespread killer with traditional tissue biopsies. However, patients and their oncologists have a new tool to fight the disease: a non-invasive blood test (called liquid biopsy) that uses cutting-edge cancer genomic technology to provide real-time insights into how the disease is mutating and growing. By educating themselves on the latest tests and technology available today, patients can have their blood examined before, during and after treatment to ensure the chemo and radiation is delivering the right medicine at the right time. This is giving patients a better level of understanding into the disease’s evolution in their own body and an unprecedented opportunity to get the adaptive care they need to effectively fight the disease. » Read More

When patients seek access to a doctor, it is almost always for 1 simple reason: to get better.  That’s usually where the simplicity ends.  What does “getting better” mean to an individual patient? For some, it may mean finding a cure to their ailment, while for others it may mean being able to get out of bed in the morning to have breakfast with their families. Whatever the definition, getting better means improving a patient’s quality of life, i.e. his/her “standard of health, comfort, and happiness” (ref: Google dictionary).   As electronic and other nontraditional health services expand, access is also expanding, and patients are becoming more actively involved in their healthcare.  What was once a passive system of paternalistic care delivery has now become a world of shared decision-making and patient directed care.  As providers of these services, we presume these services result in a positive impact on patient’s lives – how could it not?  After all, patients are now able to know more about their healthcare, more easily access their own data, and interact with world-renowned physicians.  While improving access, these services may also improve quality of care, and reduce the cost of health care. However, are we actually helping our patients achieve their goal of getting better (whatever that may mean)?  In other words, how do these expanding services impact patient’s quality of life?   At Grand Rounds, we are starting to work on answering these types of questions.  Through our Office Visit and Expert Opinion services, we offer patients access to top quality local physicians and remote experts.  Our mission is centered on giving patients the tools they need to improve their health care, and results in improving each patient’s quality of life.  As we expand our patient reach, we have begun spending numerous hours on understanding the impact of our work on patient’s – not just in terms of dollars saved (see Figure 1), but also in terms of if we are truly achieving an improved quality of life.  By introducing metrics into our current and ongoing follow-up processes, we have started to gain insight into these previously untouched areas. » Read More

With the implementation of the ACA requirements for mental health parity, the increase in mental health, trauma, and substance abuse diagnoses in a range of populations, and the relative paucity of mental health clinicians trained to deliver evidence-based therapies, the gap between demand and supply of mental health care has arguably never been higher.  This gap is especially apparent among veterans, who face additional, sometimes self-imposed, barriers to accessing mental health care: the perception that mental health treatment is poorly aligned with the Veteran’s needs and experiences, as well as logistical or psychological challenges that arise between treatment sessions and foster attrition. The urgent need for new approaches to effectively mitigate these barriers is driven in part by the size of the population in need.  Approximately 1 in 4 Veterans who receive care in VHA have a confirmed diagnosis of a mental disorder. [i] After more than three years, 75% of OEF/OIF/OND Veterans with psychiatric diagnoses had not engaged in minimally adequate mental health treatment in VHA. E-tools for patient self-management are rapidly emerging, but have typically been designed for empowered, techno-literate users and focus on wellness issues such as diet and fitness.  Fewer digital self-management tools specifically designed for challenging populations and difficult conditions have been tested. In light of these realities, EDC in collaboration with Boston University and VA’s NCPTSD developed a novel, veteran-centric digital tool, VetChange; a veteran-directed adaptation of an evidence-based therapy for co-occurring PTSD and problem drinking.  Vet Change extends and applies promising approaches to patient self-management in a novel design, using the virtuous cycle of “hook-actions-rewards-investment” [ii] demonstrated in technology product development, and applying innovative persuasive technology techniques to deliver triggers for behavior change when motivation is high and the threshold for action is low. » Read More

  Research shows that the design of hospitals can have a positive or negative effect on patient satisfaction, recovery times, readmission rates, staff productivity and family comfort. As the healthcare industry prepares to spend $200 billion on healthcare facilities between now and 2020, architect Joan Saba argues designers and their clients should take a balanced approach in the creation of new facilities, one that values aesthetics and LEAN processes without wasting precious resources on superficial elements. Using case studies of hospital designs for Massachusetts General Hospital in Boston and Seattle Children’s Hospital in Washington State – plus research into how big data, robotics and the rapid pace of technological innovation effects healthcare and hospital design – Ms. Saba will outline five design strategies hospitals should implement to ensure their environments support performance, healing, comfort and experience. » Read More

An electrified conversation is rising in our society about how we will care for each other as life approaches completion. Rather than collectively continuing to avert our gaze, we are turning our attention directly at the truth of our mortality and beginning to address the human, social, and economic impact of our fragmented and disease-directed healthcare system.  The recent 2014 Institute of Medicine report, Dying in America, is a wholesale call-to-action for more and better care for people approaching death. Too often we provide inadequate support for quality of life, generate a distressing patient experience, and low value: high cost healthcare that can exploit people with serious illness rather than serve them.  In rural America, this is magnified by primary and specialty provider shortages, the burden of travel for patients, and inadequacies in basic skills of symptom control and reality-based communication about the truth of aging and the limitations of medical technology.  The cost is avoidable suffering, loss of trust, provider burnout, and a mountain of wasted money.  As the approaching wave of aging Americans brings the impact of their demographics, they also bring a new sensibility and empowerment to decision-making.  They want guidance, not guidelines. The medical specialty of Palliative Care brings person-centered care to people with serious illness by attention to exquisite symptom control, effective communication and planning, and shared decision-making with a disciplined focus on the quality of life defined by that person and their family.  This teamwork is interdisciplinary, time intensive, and poorly compensated in the fee-for-service system. » Read More

What to do about the "Three Trillion Dollar" health care crisis? Today, over 70% is spent on management of chronic diseases and the number is growing. The Affordable Care Act finds its stakeholders unprepared: Patients see their premiums and co-pays rise; Providers have difficulties shifting from Fee-for-Services to Quality Payments; and Payers are pressured to enter ACO’s but only few have been successful so far. Pure capitation looms which will accelerate further the downward spiral of quality of care without really solving the problem. In 2012, a small group of UCLA providers pioneered a brand new approach for chronic disease management: Value-Based Health Care. » Read More

There is a coming revolution in medicine!  Perhaps you have heard about it?  It's all over the news.  In reality, ’revolution' might be the wrong word for what’s coming.  Maybe something more like 'systematic improvement through technical advancements, clinical validation, and data-driven diagnosis.’  But that does not flow off the tongue quite as easily.  It’s wrong to think of this as a revolution for several reasons.  For one thing, medicine is a slow moving beast, and revolutions are fast.  We should not expect fast changes.  For another, the romantic idea of a revolution must have a bad guy, an old regime, an antagonist just holding things back.  But here there is no villain.  For the most part our field is filled with good intentions.  There are certainly many important changes afoot.  History will show that one of the most important changes is the drive toward actionable data-driven medicine.  The need is undeniable.  In the future, your health care provider will be less well trained, younger, less experienced.  She will be less likely to have the wisdom of the ages, that ability to diagnose you and treat you, almost instinctively.  This model no longer works, if it ever did.  Intuition is great, except when it isn't .   Health care consumers will no longer accept a system where life itself  can depend on whether you had access to a top doctor. In the future, there will be no magazine issues with glossy photos proclaiming your city's "top doctors."  There will be no need.  In the future, everybody will have access to a data-driven diagnosis and treatment plan, because the data will speak the truth. And where will this data come from?  From you of course.  Mostly from your molecules.  Sometimes from your DNA, but most importantly from your blood.  Blood has always been the gold standard for diagnosis, and that will not change.  But the answers will become more immediate, more complete, and more actionable.  Answers will need to arrive at the point of care, right along with vital signs and equally fast.  The price for these answers will be a simple finger stick followed by rapid spectroscopic chemical analysis. » Read More

In 2013, a 16-year-old patient at UCSF was given 39 Septra (a common antibiotic) tablets, instead of the one he should have received. He suffered a grand mal seizure and spent 10 days in the intensive care unit as a result. This error is all the more remarkable because it occurred in one of America's top hospitals, despite – check that, because of – state of the art computerized order entry and bar coding systems. The error is described in my new book, "The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age," which will be published in April and has already had pre-launch sales of approximately 10,000 books. In the presentation, I will describe this remarkable case and how problems such as alert fatigue, poor user interfaces, and overtrust in technology open up the opportunities for new kinds of harm. » Read More

Sweden is known around the world for IKEA, the Nobel Prize and social welfare. The Swedish government has taken a clear position in the area of e-health and the future of connected healthcare. In this workshop we will present a number of ongoing Swedish projects and initiatives with one common goal: enabling patients and citizens to take a more active role in managing their own health. The aim is to optimize patient work, particularly in care processes relating to chronical diseases. » Read More

Background:  Many older adults age unsuccessfully and develop conditions such as depression which may exacerbate the effects of normal aging or dementia.  In addition, neurological and physical limitations deprive increasing numbers of older adults of functional independence which necessitates extended care services.  These individuals may benefit from Reminiscence Therapy, that consists of a semistructured review of past activities, events and experiences of personal significance aided by videos, pictures or music, and has been shown to aid psychological well-being.  Furthermore, if these individuals are trained to use the many technological tools available to help manage the effects of debilitating chronic conditions, they may be able to sustain more years of independent living in their community.  The purpose of our pilot case study was to examine the feasibility of a learning procedure using Adobe Voice © digital storytelling software on the iPad to help facilitate reminiscence and promote better technological aptitude and utilization for an older adult. Pilot Procedure:  We piloted our procedure on a WWII veteran in his 90’s who had no prior experience with computers and conducted two 90 minute sessions with the veteran. We first trained the participant on how to interact with an iPad (pre-loaded with free Adobe Voice digital storytelling software) using a standard touchscreen interface. We then guided the participant on use of the software to create meaning-making narratives with recordings of his own voice.  Music and Creative Commons license-free graphics and photographs are used to enhance the reminiscence and narratives. » Read More

Our healthcare system is undergoing a major technology revolution. So many truly amazing innovations are now available through this new technology. But if we are honest, the impact on patients and doctors often falls FAR short of the promises being made. The bottleneck is often the user experience of the digital tools being offered—many of which inspire resentment, avoidance and at best, indifference.  The mantra underlying this this talk is “Technology as the enabler; Design is the engager”. » Read More

Prescription painkiller abuse is an epidemic and a serious public health problem in the United States.  In 2013, 16,235 drug overdose deaths were related to opioid analgesics (1).  For every drug abuse death, there were 10 treatment admissions for abuse, 32 emergency department visits, and 130 patients who abuse or are dependent on prescription medications (2,3,4).  The estimated cost of prescription opioid abuse in the United States in 2007 was $55.7 billion, of which 46% was attributed to workplace costs, 45% to healthcare costs, and 9% to criminal justice costs (5).  Despite new laws and guidelines to curve abuse, the continued growth of painkiller overdose in part reflects the lucrative business of painkillers for the healthcare industry.  According to IMS Health, in 2011, U.S. sales of prescription painkillers amounted to $9 billion.  In one “pill-mill” in Florida, a physician had the potential to earn roughly $37,500 a week, or $1.95 million a year by prescribing such painkillers indiscriminately (6).  Between the pharmaceutical industry, the opium fields in India and Turkey, and the thousands of pharmacies and doctors offices, there is plenty of profit to be shared.  United States holds 5% of the world population, yet it consumes 80% of painkillers in the world. Physicians are the current gatekeepers of painkiller prescriptions.  Due to increasing abuse and pressure by the Drug Enforcement Administration, a recent survey showed that nearly half of the primary care physicians were less likely to prescribe painkillers today compared to a year ago (7).  Unfortunately, the major casualty of war against painkiller abuse is the good patient with pain who can be difficult to discriminate from a painkiller abuser. » Read More

Healthcare professionals have discovered the immense value of public social media for peer-to-peer networking, collaboration, and for sharing health information and content on the Internet.   Likewise, patients have found (and in some cases founded) communities for sharing or learning about personal experiences with treatment, management of disease, and living ‘well’.   In recent years, technology developers have also contributed great advances in the ability to diagnose or monitor individual health issues, through mobile devices or other ‘smart’ sensors and applications.   Yet for some communities, access to such ‘connected’ resources is limited. » Read More

Background In the U.S., one in five patients is readmitted within 30 days of discharge resulting in more than $41 billion in losses to Medicare annually.( 1) It is estimated that over 836,000 patients each year are readmitted under “preventable” circumstances with a potential savings of $17 billion.( 2) Moreover, patients view readmission as a failure of the healthcare system.( 3) The emergency department (ED) is at the forefront of this problem because it is where decisions about readmissions and early, expensive testing are made, yet it is often where the least information is available about the patient.( 4-6) While several products have attempted to reduce readmissions with at-home monitoring, a significant opportunity to reduce preventable readmissions exists at the very moment the patient arrives at an ED. track ER , a mobile health solution, is designed to intervene at this moment to improve information exchange. Aims To reduce preventable readmissions and redundant testing in the ED within 30 days of discharge by catalyzing information exchange in real time from the previous inpatient team that discharged the patient to the ED team actively caring for the patient. The mobile technology has the ability to: 1. » Read More

Innovative mobile and web applications designed to support evidence-based behavioral health practices are having a disruptive influence on mental health service delivery systems around the world. These technologies can provide a means of scaling up behavioral health services at the population level by shifting tasks related to monitoring and tracking patient progress from licensed providers to paraprofessionals, care managers or coaches. They also have the potential to improve the efficiency of traditional clinician-delivered services by automating some of the more routine aspects of psychotherapy, thereby allowing therapists to achieve similar client outcomes with less hours of direct client contact.  Although it is seldom cited by American companies working in this space, much of the innovative research on the use of these technologies to improve mental health services has been conducted in Europe and Australia.  For example, The Improving Access to Psychological Therapies (IAPT) initiative in the UK National Health Service has embraced the use of web applications as a first line intervention for individuals with mild-to-moderate depression and anxiety.  In the IAPT model “low-intensity workers” are trained to support clients who are working through “Computerized Cognitive Behavioral Therapy (CCBT) programs like Beating the Blues ( http://www.beatingtheblues.co.uk/ ) and Fear Fighter ( http://www.fearfighter.com/ ).  Similarly, Australian researchers have demonstrated how clinicians, peer counselors, and even tech support personnel, can play a critical role in facilitating engagement with, and deriving benefit from, web and mobile mental health programs (e.g. » Read More

We are setting up a GP advice service with Dr Jacques Mizan form Southwark CCG using DefinitiveDx to share and discuss cases with specialists at Evelina Children’s Hospital (with Dr Claire Lemer ), Imperial and Chelsea and Westminster. Both the GPs and specialists want to reduce the number of unnecessary referrals from primary to secondary care. GPs, like Jacques, are using DefinitiveDx to share cases and get specialist advice so they can continue to manage patients in primary care. This is much better for patients and reduces the healthcare costs. » Read More

Introduction:  The International Medical Corps have sent Emergency Response teams to the outbreak of Ebola in Sierra Leone, Liberia and Guinea. Their teams care for patients, operate Ebola treatment centres and implement training programs. The returning volunteers can share their real experiences at Stanford Medicine X to help other healthcare professionals and businesses learn from this epidemic and be better prepared for the next epidemic. In a “talk show” style round-table event the volunteers can give a view point that is under represented by the media once the interest in an epidemic passes. » Read More

One of the most critical aspects to delivering remarkable care comes through engaging patients with their needs and preferences. Novant Health has been successful in encouraging its patients to become more engaged in their health care through several of the most innovative, affordable and convenient options available. During this presentation, presenters from Novant Health will discuss a unique, but effective, strategic approach for building an online patient experience around the patient instead of around the patient portal technology. Furthermore, presenters will also outline how a patient-centered strategy instead of technology-centered engagement strategy helps build the foundation for provider engagement—a vital component to empowering connectivity and authentic relationships. Further discussion will look at the speakers' perspectives, as two practicing providers, on the importance of focusing on innovation to keep patients interested in new features. The health care industry has traditionally been a laggard in regards to technology adoption and typically only pilots new technology instead of implementing it. » Read More

Introduction:  Cardiopulmonary bypass (CPB) involves transferring over the functions of the heart and lungs from the patient to a bypass machine that is managed by a specialist – the perfusionist.  This allows the surgeons to operate on the heart in many ways that would have been impossible otherwise.  Once the operation is complete, the work is transferred from the machine back to the heart and lungs of the patient – this requires that the anesthesiologist, perfusionist, and surgeon communicate efficiently and effectively. The Targeted Problem:  Cardiothoracic anesthesia is challenging and exciting, particularly for first rotation anesthesiology residents.  While it varies somewhat from institution to institution, the cardiac operating rooms introduce new medications, workflows, and members of the OR team.  There is a dynamic that exists between a seasoned anesthesiologist, perfusionist, and surgeon that is like a well-oiled machine.  As a result, this often leaves the anesthesiology resident quite confused at best. Current anesthesia textbooks often provide some information about CPB, hidden amongst chunks of text within a broad chapter on anesthesia for cardiac surgery that approaches 100 pages.  As this is usually the first real-life exposure to CPB, anesthesiology residents often lack an understanding of the overall process of CPB, making assimilation of this knowledge difficult. The Proposed Solution:  Many different learning modalities were reviewed and assessed for the optimal platform to present this material.  Ultimately, the iBooks / iBooks Author platform was chosen for several reasons.  Foremost, it provides an interactive tool that allows learners to engage learning.  It also allows residents nationwide access to the modules via an individual file on a protected server or the iBooks store. » Read More

  In partnership with the Alaska Native people, Southcentral Foundation (SCF) developed the customer-owned and -managed, relationship-based Nuka System of Care and transformed its health care delivery system into an integrated customer-centric model. The success of this approach is largely due to the co-located, multidisciplinary integrated care teams, which consist of the primary care provider, the case manager, the certified medical assistant, and the case management support. This efficient, collaborative unit functions in approximately 3 feet of modular space, elbow-to-elbow, in constant communication around the electronic health record. Other disciplines, shared across several pediatric/primary care teams, are seamlessly woven into the teams such as behavioral health consultants, dieticians, the pharmacists, and, midwives. » Read More

Today, surgical simulation exists as a valuable tool for surgical training and task rehearsal by reducing the need for cadaver specimens, allowing trainees to receive structured performance assessment, and facilitating repetitive deliberate practice. Nevertheless, simulation platforms are inherently limited by the number of programmed and designed cases/scenarios available for practice, and the anatomy within the virtual environment will invariably differ from that which is subsequently encountered in the operating room. To address these limitations, we have developed CardinalSim – a validated patient-specific virtual surgical rehearsal platform capable of rendering a patient’s preoperative imaging data into a 3-dimensional virtual model upon which a procedure can be rehearsed prior to the actual operation. In its current form, CardinalSim allows a surgeon to explore a particular patient’s anatomy quickly and efficiently in a surgically meaningful manner using a haptic interface, providing valuable insights into the anatomic and physical complexities expected at the time of actual surgery. » Read More

During the 2014 War in Gaza, called “Operation Pillars of Defense” in Israel, the Palestine Children’s Relief Fund (PCRF) mobilized efforts to address the expanding mental health needs of the children affected by the six-weeks of violence.   As an initial step, the PCRF felt it was necessary to conduct a needs assessment to determine the nature of psychological symptoms impacting Gazan children exposed to the war.  With the use of innovative technology, five PCRF social workers were trained to obtain data from 1072 children living in Gaza during the war, looking at both traumatic event exposure and mental health symptoms.  This data was acquired as a first pass to launch a clinical intervention program within the organization with a goal of increasing mental health treatment for children suffering from intense trauma symptoms as a result of the war. » Read More

Background :  Systematically collecting and recording treatment intervention, outcome, and side effect data and using this data to inform mental health treatment decisions – also known as measurement-based care - is essential to excellent patient care. Routine recording and tracking of mental health treatments and their outcomes into the electronic medical record (EMR) improves outcomes for individual patients, improves overall quality of care, and significantly enhances efficacy and implementation research efforts. But measure-based care is difficult to achieve without the right tools to assist providers in this task. Tools in use in many medical systems are not routinely used by providers because they are time consuming to use, impede workflow, and do not collect data that providers and patients find clinically useful.  Many tools are developed with insufficient input from provider and patient stakeholder at all stages of the software development process. » Read More

Defined as the MISSION 2020, the main objectives of the Hepatitis Prevention, Control, and Elimination (HPCE) Program in Mongolia are straightforward yet very ambitious: : To eliminate cancer-causing hepatitis C virus in Mongolia by 2020  . To reduce mortalities related to liver cirrhosis and liver cancer by 50% in Mongolia by 2020 . Prevention, early diagnosis and treatment of infected patients are three pillars of infectious disease control. Viral hepatitis is not only an infectious disease, but also it is the main cause of deadly liver cirrhosis and liver cancer. » Read More

As we work to improve healthcare experiences, services, devices and more, most of us do so as members of teams and organizations. As such, in order to be productive and execute on the innovative ideas we have, we must collaborate with others. This collaboration requires us to share our work; to communicate our ideas with one another and to collect other’s thoughts in order to know whether our creations are meeting the objectives we seek.  But often we wrestle with collecting this feedback. We get comments that are less than helpful because they seem irrelevant or unclear. » Read More

Recent months have seen substantial advances in techniques for computer vision and image recognition. From Google demonstrations on YouTube videos to Baidu’s Deep Mind project, the machine learning technique known as “deep learning” has suddenly made it possible for computers to achieve image recognition accuracies far beyond prior capabilities. Indeed, Microsoft researchers in February published a paper reporting an error rate of just 4.94% on the popular ImageNet image set—this is below the estimated human error rate of 5.1%. In this talk, I share how we and others are applying many of the same computational advances towards medical imaging, the challenges of doing so, and the rewards of success. » Read More

Background Idiopathic pulmonary fibrosis (IPF) is a progressive and debilitating pulmonary disease with a median survival of three to five years. PatientsLikeMe (PLM) is an online, patient-powered research network with a community over 3500 patients with IPF. PLM allows patients to share structured (conditions, symptoms, treatments) and unstructured (community forums, qualitative reports) data with other patients and researchers to accelerate research. The objective of this pilot program was to understand the’ willingness to use wearable devices and usage patterns, specifically activity monitors and pulse oximeters, as part of disease self-monitoring within a subset of patients with IPF in the PLM community. » Read More

Following lessons learned from attending Medicine X and the IDEO challenge the CoPilot project was born.  Patient and provider representatives from three healthcare systems (Johns Hopkins, Sibley Hospital and Bon Secours) convened in the nations capitol to develop collaborative plans for improving the patient experience. We will present the Bon Secours system experience. Our team consists of 3 patients, chosen to represent different age groups and healthcare experiences; 4 nurses from different levels of patient care and one physician. » Read More

While almost any clinician or engineer can recall a case study in the last five years that highlights a remarkable application of additive manufacturing to a medical challenge, far fewer would be able to accurately discuss how and how soon such technology would be translated into the standard of care. This is because the technology has reached a pivotal point in its development. Thus far, the efforts to advance medical 3d printing have focused on the highly technical challenges of imaging conversion, fabrication techniques and biocompatible materials. While challenging and expensive, highly skilled multidisciplinary teams have achieved remarkable results with the technology. » Read More

The concept of disruption has become something of a mantra within data-driven health innovation. Eric Topol refers to technology’s ability to drive the the “creative destruction” of medicine (2012) and to social media as turning “medicine upside down” (2015). Clayton Christensen and his co-authors have used disruption to talk about an “innovator’s prescription” for medicine (2008). Disruption itself has itself become a powerful way that Silicon Valley talks about the capacity of technology to change the social forces that slow industry growth or hinder innovation.  From Techcrunch’s “Disrupt” conference to medical school-sponsored hackathons, health innovators are adopting disrupt as word to describe the change they seek. » Read More

Increasingly, the challenges for health care in the 21st century are health concerns that escape the identification of single causes known from the big epidemics of the past. Modern day conditions come from interplay over time of e.g. behavior, mental states, lifestyle, social context, environment, genetic predisposition with causes and effects often removed in time and location. To paraphrase Tolstoy: “All healthy people are alike; each unhealthy person is unhealthy in each their own way.” Unfortunately, current health care practice lacks the incentives, resources, methods, and tools for dealing effectively with these kinds of complex, individual conditions. » Read More

Adverse events happen in medicine, and their impact is felt not only by the patient and the patient’s loved ones, but also by the physicians and other medical team members caring for the patient.  These medical professionals who suffer after-effects are called “second victims”.   Patients who are cared for subsequently, while the team is still impacted by the earlier adverse events, may be subject to distracted care and medical errors, and have been called “third victims”.  Savvy patients have begun asking about caregivers’ mental state.  Patients often ask if we are well-rested, where we trained, if we have a lot of experience with procedures and other team members. And people intuitively know that death or near-death experiences (even when vicarious) are impactful, even for seasoned professionals.   Do our patients have the right to decide whether or not they wish to be on the receiving end of our best efforts after a catastrophe?  Do we have an obligation to inform patients?  How can we deliver best care to our patients, and best support ourselves and our colleagues?  Medicine is losing many excellent doctors and nurses, either due to career change or even suicide, as a result of this unspoken epidemic.

This presentation will pose a question that should be simple but is not: who is using my healthcare information? In the first half we will discuss the myriad ways healthcare data is being manipulated through distribution, analysis and profiling outside of the healthcare profession and community, much of it through mHealth, web applications, targeted advertising and marketing.  The second half will address security best practices on both sides of the coin – the ePatients on one side and technology professionals on the other. The intention is to discuss mitigating strategies that are unique to each, and the transparency that is needed in order to better align the goals of both sides: 1. The ePatients and consumers who need to ensure the integrity and security of their own health and identity information, in order to guard against medical record and identity theft. Specific strategies for safeguarding one’s personal data will be presented, such as identifying social engineering tactics and understanding how to lock down privacy controls in social media. » Read More

It’s still lonely in the world of autoimmune disease. Twenty years after the promising biologicals of the 1990s, we need big data to advance further. Despite $4B in digital health funding, autoimmune diseases have been wallflowers at the party. But we aren’t just standing around: the community is generating a digital pandemonium of self-help advice, especially dietary. » Read More

All knowledge is some form of information, however not all information is knowledge. It is important that patients are equipped with the proper resources and tools in order to distinguish between what is knowledge and what is information in making decisions regarding their health care. Knowledge is defined as information utilized and mobilized to produce a result. Information rather is defined as a collection of data that in itself has no practical purpose until it is processed and mobilized into a coherent language that can be utilized as a resource. » Read More

Patients who are eager to participate in clinical research usually discover – far too late – that the demands of trial participation are surprisingly too great to bear. And so many decline. Solvers from the William Tennent – Lilly High School Challenge showcase their multimedia approach to help improve the understanding of trial participation in a meaningful, timely way.

Brian Loew created Inspire with the goal of improving patient engagement through the creation of a trusted, health-focused social network. Today, Inspire's 85 health association partners and over 360,000 members provide fertile ground for medical research, patient insight and health advocacy. Brian believes that patient contributions to medical progress have been historically undervalued, and great progress may result from fully valuing contributions to medical research derived from the active involvement of patients.

Digital health is an evolving term that is broadly used to describe the convergence of digital technologies with health, healthcare, and wellbeing1,2. Technologies used in digital health are unique and usually distinct from traditional hospital-based IT systems and include: wearable sensors, Internet of Things (IoT), telemedicine, mobile connectivity, social networking, and cloud-based computing systems which are leveraged in a manner designed to improve health. In this article, we attempt to make a case for digital health in the context of perioperative medicine. We propose a framework of four pillars of digital health that provide opportunities for innovation and improvement of perioperative medicine in the 21st century: 1) patient engagement, 2) behavior change, 3) prediction and prevention, 4) connection. » Read More

How might we use design thinking to advance patient safety? We’ve been on a journey exploring that question – from the creation of our Innovence Lab at TRA Stanford, to building an interdisciplinary team from across Stanford University and our adult and children’s hospitals and then using design thinking to tackle the thorny issue medication safety. In this session, we’ll share our journey, the innovative ideas that sprang to life along the way, our lessons learned and future directions.

Background: Not long ago, bed rest was considered therapeutic. Today we’re much more sensitive to the potential complications associated with bed rest and the medical community is quickly stepping away from this outdated practice. Patient immobility has been linked to a number of serious and costly hospital complications, including pressure injuries, pneumonia, falls, blood clots, and muscle deconditioning. Each year, billions of unreimbursed health care dollars are spent treating complications related to patient immobility. » Read More