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Behavioral Science, Chronic Disease, Health and Fitness, Medical Apps, Technology

Can cute cat texts motivate patients to take their medication?

Can cute cat texts motivate patients to take their medication?

Sammie resizedThe right kind of motivation is key when you have a difficult or mundane task at hand. For example, when I wanted to learn Spanish, I tried several top-rated, online language tools to no avail because they felt like work to me. Then, half as a joke, my boyfriend suggested an app that associates Spanish phrases with images of cats acting out the meaning of the words. The app was so silly I used it often, and — to our amazement — it actually worked.

So when I saw this story on MedCity News about a company that plans to use cat photos to motivate people to take their medicine, I knew they were on to something. As the story explains, the texts are part of an online assistant that will pair irresistibly cute cat images with health prompts so the reminders are memorable and fun.

The company, called Memotext, plans to pilot test this tool on Type 2 diabetes patients (followed by patients with other chronic illnesses) to gain insights on the patients’ state of mind when they skip or forget to take a medication. They also hope to learn more about what can be done to change patients’ behavior so they’re able to follow their medication regimen better.

“We’re not only asking whether you did something, but why did you do it,” said Amos Adler, the company’s founder and president. Based on what I’ve learned about motivation so far, I think a cute cat text or two probably can’t hurt.

Previously: “Nudges” in health: Lessons from a fitness tracker on how to motivate patientsStudy offers clues on how to motivate Americans to change and Understanding the science and psychology of how habits work
Photo courtesy of Anna MacCormick

Emergency Medicine, Pregnancy, Research, Surgery, Videos

Self-propelled powder moves against blood flow to staunch bleeding in hard-to-reach areas

Self-propelled powder moves against blood flow to staunch bleeding in hard-to-reach areas

If you nick your skin, it’s easy to stop the bleeding by applying a coagulant powder directly to the cut. Yet, bleeding wounds inside the body are beyond the reach of such blood-stopping powders.

Now, Christian Kastrup, PhD, an assistant professor at the University of British Columbia, and a team of researchers, biochemical engineers and emergency physicians, have developed a way to clot internal wounds by creating a self-propelled powder that moves against the flow of blood.

“Bleeding is the number one killer of young people, and maternal death from postpartum hemorrhage can be as high as one in 50 births in low resource settings so these are extreme problems,” Kastrup explained in a UBC press release. “People have developed hundreds of agents that can clot blood but the issue is that it’s hard to push these therapies against severe blood flow, especially far enough upstream to reach the leaking vessels. Here, for the first time, we’ve come up with an agent that can do that.”

To give blood-clotting powder a push, Kastrup and his colleagues added calcium carbonate to the coagulant powder. The carbonate forms porous micro-particles that latch onto the clotting agent (tranexamic acid). As the particles release carbon dioxide gas, fizzing and moving like mini-antacid tablets, they launch the clotting agent toward the source of bleeding.

More rigorous testing and development needs to be done before this agent is ready for use in humans, as the press release and study explain. But it’s possible that in the near future this powder could be used to treat otherwise unreachable cuts such as those in postpartum hemorrhages, sinus operations and internal combat wounds.

Previously: New obstetric hemorrhage tool kit released todayIn poorest countries, increase in midwives could save lives of mothers and their babiesTeen benefited by Stanford surgeon’s passion for trauma care
Video courtesy of UBC

Medical Apps, Medical Education, Medicine X, Patient Care

Engaging and empowering patients to strive for better health

Engaging and empowering patients to strive for better health
Nancy M-D on stageMedicine X yesterday featured a series of talks on a topic that is near and dear to the heart of many conference attendees: Empowering and engaging patients. Marty Tenenbaum, PhD, a former consulting professor of computer science at Stanford, began the session with a moving talk on how difficult and frustrating it was to find the right therapy after he was diagnosed with metastatic melanoma 17 years ago.

“I spent a lot of time in the stacks of Stanford reading medical journals. They all agreed on one thing, which was my dire prognosis. I thought, there’s gotta be something better than this,” he said. Tenenbaum’s ordeal prompted him to create a nonprofit, called Cancer Commons, which helps connect cancer patients to the therapies that have the best chance of curing them.

Howard Look, president and CEO of the app Tidepool, said it “was like crawling through broken glass” to get access to his daughter’s blood glucose data when she was diagnosed with type 1 diabetes in 2011. “We quickly discovered how hard it is to calculate the right dose of insulin,” Look said, driving the point home by showing a series of texts he once received from his daughter, Katie:

Katie: “Dad, I’m low. I’m 52 and dropping.”
Howard: “That’s okay, you have your juice boxes right?”
Katie: “I can’t find my juice boxes.”
Howard: “I’ll come get you.”
Katie: “I don’t know where I am.”

“This is a scary moment if you are a parent,” he said. “You might think that when the stakes are this high there must be a way to manage your diabetes with some sort of software or app. At the time, there wasn’t one.” This motivated Look to design an app that helps diabetic patients get and use to their blood glucose data effectively. “When you liberate the data, you empower the patient and enable them to engage however they want to engage,” Look said.

Next, Brian Loew, founder and CEO of Inspire, talked about the online community of patients and medical professionals in that social network. Many patients have reporting feeling more able to discuss certain issues with their doctors after first talking with their peers in Inspire, he said. “How do I travel with a wheelchair? How can tell my kids I have cancer?  These are questions that are often easier to ask of a person who has done or experienced it,” Loew explained.

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Events, Medicine X, Patient Care, Technology

At Medicine X, designers offer their take on why patient-centered design is top priority

At Medicine X, designers offer their take on why patient-centered design is top priority

Aaron Sklar at MedXAs a Medicine X veteran, I’m used to hearing patients talk about the importance of putting patients’ needs first. But yesterday afternoon, I got to hear about patient-centered design from designers.

At a session called “Fulfilling the promise of technology in health through human centered design,” Joan Saba, an architect who designs hospitals for NBBJ, used a personal story to illustrate how good design is essential to patient care. Her mother recently became sick and needed to stay at the hospital overnight, and “this is where she spent 24 hours,” she said. Sounds of ambulances wailing and doors slamming filled the lecture hall while an image of a bed surrounded by electrical cords and medical equipment lit up the screen. “Her room was right above the ambulance bay,” Saba explained.

With recent advances in technology, hospital rooms don’t need to look, sound or feel like this, said Saba. “So, what should a patient’s room look like now?” It being a calm place (unlike her mom’s room) is important, but there are other considerations, too: “Now we are thinking about it being a place for learning and information exchange.”

This desire to think about such an exchange, and improved doctor/patient communication, was echoed in the talk by Marc Katz, MD, MPH, chief medical officer of the Bon Secours Heart & Vascular Institute. He told the story of meeting patient-advocate Sarah Kucharski, who has the rare disease fibromuscular dysplasia and has endured many medical procedures, including a triple bypass surgery, back at the first Medicine X. “I go to several media conferences a year, and this was the first time I’d seen a patient present,” he recalled. “This was an eye-opening experience.”

Hearing about what Kucharski went through, prompted Katz to start querying other patients about their cardiac surgeries. “The biggest problem was communication — patients didn’t feel they understood what was happening [while at the hospital],” Katz said. So he helped develop Co-Pilot, a program that assigns a personal nurse to each patient. The program is still in its early stages but it seems to be paying off, Katz said: In a sample of about 150 patients, the Co-Pilot program reduced the duration of hospital stay and readmission, also, patients reported greater satisfaction.

After a talk from pain management expert Frank Lee, MD, on a project he started to increase transparency about the way patients’ prescription narcotic use is tracked and to hopefully, in turn, curb prescription painkiller abuse, speaker Aaron Sklar closed things off with a provocative statement. Sklar, managing director at Healthagen and co-founder of Prescribe Design, suggested it may be “time for technology to fade into the background.” What he meant is that it is the patient, not technology, that should be at the center of health-care design. “Actually we just coined a new term to describe this,” Sklar said. “D-patients: Patients that design.”

More news about the conference is available in the Medicine X category. Those unable to attend the event in person can watch via webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference; you can follow our tweets on the @StanfordMed feed.

Photo of Sklar courtesy of Stanford Medicine X

Events, Medicine X, Patient Care, Precision health, Public Health

At Medicine X, talking about owning one’s data and about patient-tailored health care

At Medicine X, talking about owning one's data and about patient-tailored health care

Matthew Might on stage - 560Health care that’s tailored to you and taking ownership of your health data were the themes of the morning yesterday at Medicine XLloyd B. Minor, MD, dean of the medical school, got the conversation rolling by defining precision health, and in a session that followed, several speakers shared stories that illustrated various aspects of this area.

In a presentation cleverly called “Can medical ‘selfies’ save us?” Steven Keating, a graduate student at MIT, began by explaining to attendees why it’s important to monitor your own health. Several years ago doctors detected a slight abnormality in Keating’s brain; they told him to “monitor it” and he took this advice to heart. He requested copies of his medical records, learned about the brain and paid close attention to how he was feeling, he explained. “Then I started smelling whiffs of vinegar,” he said.

Keating urged doctors to conduct an MRI and discovered he had a brain tumor (about the size of a lemon) that would need to be surgically removed. Keating told the audience that his interest and engagement in his own health care wound up saving his life.

Next, Claudia Williams, senior advisor for health innovation and technology at the White House Office of Science and Technology Policy, took the stage to discuss the Precision Medicine Initiative that was launched this January by President Obama’s Administration. The initiative, she said, is “about moving away from the one-size fits all approach and moving toward one that tailors [care] to your specifics.” To do this, the National Institutes of Health is now inviting people to join a cohort of one million individuals (or more) that will contribute biological samples and data to advance researchers’ understanding of heath and disease.

Many people have said they would participate in this initiative if they could get their own medical records back, Williams said. “Building trust and accountability” is a key part of this initiative, she said, noting that “If you want encrypted email data, you have the right to it.”

Having access to data from this initiative, especially genomic data, could help patients learn which drugs will be most effective for them and help people with rare diseases learn more about their illness, Williams told me during a post-panel interview.

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Events, Medical Education, Medicine X, Patient Care, Precision health, Technology

“No ordinary conference”: The magic that is Medicine X returns to the stage

"No ordinary conference": The magic that is Medicine X returns to the stage

Larry Chu welcoming attendeesMedicine X, Stanford’s popular conference on emerging technologies and medicine, returned to the stage today.

The conference, which was proceeded by the first-ever Medicine X | Ed, is now in its fourth year, and the momentum and magnitude of the event has steadily increased since it began.

Last year, more than 4,000 participants in 69 countries took part in the Medicine X experience via Twitter, making it the most-discussed academic conference in the world. Its past successes were reflected in the theme for Medicine X 2015: “Great Xpectations.”

After executive director Larry Chu, MD, welcomed attendees with a reminder that they “all belong here,” Lloyd B. Minor, MD, dean of the medical school, officially opened the conference with remarks that encouraged this engaged audience to take action and seize opportunities to improve health care. “This is no ordinary time in our history, and Medicine X is no ordinary conference,” he said. “We are here today to have discussions and generate ideas about how to leverage the power of information and the latest technology to improve health for people in our own communities and across the globe. Health care is truly the opportunity of our lifetime.”

Minor talking“Since last year’s Medicine X conference, Stanford Medicine has launched a bold new initiative — our vision to lead the biomedical revolution in precision health,” he said. “Precision health as the next generation of precision medicine: Precision medicine is about sick care, precision health is about health care.” Everyone participating in this event is an important part of moving this conversation forward, he explained.

Eric Topol, MD, chief academic officer at Scripps Research Institute and bestselling author, went on to give an opening keynote on ways we can use new technologies to democratize medicine and involve the patient in his or her own care. “We have views of the human being that we never had before,” Topol said, referencing smartphones and other technologies that people use to monitor their health metrics.

These new technologies are important because they’re interactive and easy for patients to use, and they allow patients to become more involved in their health care, Topol explained. He showed an image of the iconic black doctor’s bag. “These are vintage tools,” he said. “This is my bag,” he explained, pointing to an image of a several digital tools.

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Events, Medical Education, Medical Schools, Medicine X, Patient Care

Day One of Medicine X | Ed: Understanding and equipping today’s medical learner

Day One of Medicine X | Ed: Understanding and equipping today's medical learner

patient Dave on stageThe first day of Medicine X | Ed began with a suite of talks and technology demonstrations that focused on understanding and equipping today’s medical learner. The first grouping of talks, themed “meet the millennial learner,” explored how medical students learn and how technology and social media present new opportunities and challenges for these students.

Joseph Santini, PhD, kicked off the first set of presentations by discussing information barriers that disabled students, and patients, face. Santini gave his presentation in sign language, with subtitles and an interpreter so everyone could understand what he wanted to say. Unfortunately, he explained, these modes of communication aren’t always available for disabled students.

Many deaf medical students — and physicians — must pay for their own interpreters, he explained. This financial burden dissuades many deaf people from pursuing or remaining in the field of medicine. The recent shift from text-based communication to more audio and visual systems is also a challenge, Santini said. “Have you ever tried to watch videos on YouTube with automatic captioning?” he asked. We call it a crap shoot… The text is a jumble. Advances in these areas would be key.”

Speaker Dreuv Khullar, MD, a resident physician at Massachusetts General Hospital and Harvard Medical School, highlighted another challenge that medical learners face: A lack of time.

Khullar recounted a story from medical school. He was sitting with a critically ill patient when his pager buzzed. He wanted to stay with the patient, but he had eight more patients to see, and he was already late. He vowed to spend extra time with with patient the next day, but the patient died that night.

“It turns out that the most draining aspect of medical school is not the hours, it’s that you cannot be there for patients the way you thought you would be,” Khullar said. “I think of the countless opportunities for compassion that I squander for things that are less important… I think that next time [this happens] I will sit.”

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Imaging, Neuroscience, NIH, Research, Videos

Video reconstruction reveals stunning detail within a tiny section of brain

Video reconstruction reveals stunning detail within a tiny section of brain

Important discoveries in science are often called “big” breakthroughs, yet much of the information that makes these “aha” moments possible is found in the most diminutive of details. So it seems fitting that our first glimpse into the inner workings of the mammalian cerebral cortex arises from a tidbit of brain no bigger than a grain of sand.

For the first time, researchers have created a digital reconstruction of part of a mammalian cerebral cortex — the “rind” of the brain, about two to three dimes thick, that plays a central role in functions like memory, thought, language and consciousness.

This digitized rendering was created by NIH grantee Jeff Lichtman, MD, PhD, and his colleagues as part of the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. Francis Collins, MD, PhD, director of the National Institutes of Health, offers more details on how the film was made over on the NIH Director’s blog.

Previously: Exercise and your brain: Stanford research highlighted on NIH Director’s blogProcess that creates transparent brain named one of year’s top scientific discoveries and How CLARITY offers an unprecedented 3-D view of the brain’s neural structure

Events, Medical Education, Medicine and Society, Medicine X, Patient Care

Medicine X | Ed keynote speaker: “Networks are fundamental to what it means to be human”

Medicine X | Ed keynote speaker: "Networks are fundamental to what it means to be human"

Larry Chu's jacketToday marked the opening of the first-ever Medicine X|Ed conference, a two-day event dedicated to delving into important issues related to medical education in the digital world. The aim of the event is to help attendees understand the medical learners of today and to shed light on how technology and social media affect the way future doctors learn and interact with patients.

Larry Chu, MD, Stanford anesthesiologist and executive director of Medicine X|Ed and Medicine X, got the conference rolling, bounding onstage sporting a life-sized image of his dog, Zoë Chu, on the back of his suit jacket. “We want to create a culture of health where everyone is trusted and respected for their expertise,” he told attendees. “Join us in the future of imagining medical education…”

Chu’s infectious enthusiasm set the tone for the day of TED-style talks, learning labs and panel discussions that emphasized the value of shared knowledge and the importance of doctors and patients informing and educating one another. Howard Rheingold, the opening keynote speaker and bestselling author of several books, underscored the importance of networked patients with a simple yet powerful opening.

“I’m really happy to be here,” he told the audience. “I’m a cancer survivor, so I really mean that. I’m grateful to my oncologist and to a network of people online, some of whom I knew before, and many of whom I did not know before.”

“I was diagnosed with cancer in 2010,” he continued. “It was a kind-of an embarrassing cancer, anal cancer, but I knew I’d need to talk about it.”

Howard Rheingold on stageRheingold started a blog, called Howard’s Butt, where he could turn to other networked patients for information and support. “It became an important source of catharsis for me,” Rheingold explained. “I came back from a treatment, and I needed to get my feelings out. I’ve been cancer-free for 5 years, and [this experience] gave me a deep appreciation for the power of social media.”

“Networks are fundamental to what it means to be human,” Rheingold said. “When you face a crisis, you need to connect with other people. Technology enables this in a way that wasn’t possible before.”

Yet, networked patients face some pitfalls too, Rheingold cautioned. “Cyberchondria” (where patients Google their disease, and what they find online is worse than what they actually have) and overconfidence are two big issues. Networked patients need to learn how to separate the bad information from the good, and they need to evaluate how much they really know, he explained. “I call it crap detection,” Rheingold said. Being a networked patient, as well as being a doctor that works with the networked patient, takes time and practice, he said.

After his talk Rheingold told me, “Many doctors and physicians don’t get or understand the networked patient. But there’s an emerging group of physicians that are attuned to this.” He looked around at the packed conference hall and said, “By virtue of being here, people are interested… This is how things start.”

More news about the conference is available in the Medicine X category. Those unable to attend the event in person can watch via webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference; you can follow our tweets on the @StanfordMed feed.

Photo of Larry Chu (top) by Holly MacCormick; photo of Howard Rheingold courtesy of Stanford Medicine X

Genetics, In the News, Mental Health, Neuroscience, Research, Stanford News

Bright Young Mind: Stanford postdoc featured as a top young scientist

Bright Young Mind: Stanford postdoc featured as a top young scientist
100315_nobels_rajasethupathy_resizedYoung researchers don’t always get the accolades they deserve, so I was delighted to see a recent story that’s bucking this trend. This week Science News released its list of “10 scientists who are making their mark,” and Stanford neuroscientist Priya Rajasethupathy, MD, PhD, a postdoctoral research fellow in the lab of Karl Deisseroth, MD, PhD, was featured among them.

Rajasethupathy was nominated for this honor by another group of outstanding scientists: Science News polled 30 Nobel Prize winners to learn which young researchers are doing work that’s worth watching.

Rajasethupathy’s research on how memories are made and stored caught their eye because she’s found that long-term memories may leave lasting marks on DNA. (Her work “has been called groundbreaking, compelling and beautifully executed,” according to the piece.) By studying sea slugs, she and her colleagues have also identified a tiny molecule that may be involved in memory.

Now Rajasethypathy is expanding on this early work and investigating the neural circuits involved in memory recall. To do this, she’s exploring specific genetic mutations to see if they result in abnormal memory behavior. This work may offer insights into neurological disorders, she explains.

Previously: Exploring the role of prion-like proteins in memory disordersNo long-term cognitive effects seen in younger post-menopausal women on hormone therapy and Individuals’ extraordinary talent to never forget could offer insights into memory
Photo by Connie Lee; courtesy of Pryia Rajasethupathy

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