Published by
Stanford Medicine

Author

Events, Medical Education, Medicine X, Patient Care, Stanford News, Technology

Stanford Medicine X: From an “annual meeting to a global movement”

Stanford Medicine X: From an "annual meeting to a global movement"

MedX_musical_finaleAs Medicine X came to a close Sunday, ePatient and American Idol participant Marvin Calderon Jr. gave a special vocal performance that moved audience members to their feet and ended in an explosion of colorful streamers falling from the top of the main auditorium at the School of Medicine’s Li Ka Shing Center for Learning and Knowledge.

The three-day event, which was attended by more than 650 people and watched via live webcast by several thousand more, is Stanford’s premier conference on emerging health-care technology and patient-centered medicine. The conference hashtag #MedX was a top-trending term on Twitter in the U.S. throughout the conference, with more than 48,000  tweets sent out between Thursday and Sunday.

Medicine X has historically examined how social media, mobile-health devices, and other technologies influence the doctor-patient relationship. But this year, the program also focused on how partnerships forged between health-care providers, patients and pharmaceutical industry would define the medical team of the future, amplify patients’ voices, and shape medical education. Along with the topics of relationships and connectedness, a number of key themes emerged over the course of the conference, including engagement, empathy, and the imp0rtance of  treating the whole person.

Daniel Siegel, MD, clinical professor of psychiatry at UCLA, touched on several of these themes during his opening talk about developing a healthy mind, an integrated brain, and empathetic relationships. “Our relationships give us a sense of being seen, of feeling felt, of feeling connected. Those are the fundamental ways we create well-being in our bodily lives,” he said. “We live in connection to each other… Relationship experiences that are stressful early in life can lead to medical problems later.”

Several sessions put a special spotlight on the importance of treating the whole person and the link between mental and physical health. Patients shared their experiences with depression and anxiety, and many revealed how they had to grieve the loss of their healthy self in order to accept their new life. They also spoke about how they felt weakened by their mental-health condition and struggled to be empowered, or proactive, in their health care. Gonzalo Bacigalupe, EdD, MPH, a psychologist and professor of counseling and school psychology at the University of Massachusetts Boston, told patients, “Maybe the ‘e’ in ePatient is not enough. Maybe you need a ‘c’ that stands for connected. If you are connected, then the burden that you are feeling can be shared.”

Larry Chu and patient - smallSentiments about the need to foster empathy in medicine were discussed in parallel panels and during coffee break chats. Emily Bradley, an ePatient with a rare type of autoimmune arthritis, told attendees at a session about invisible pain, “I don’t fault my loved ones for not understanding my pain. I don’t want them to understand and I’m glad that they don’t. I think what’s missing is empathy.” Liza Bernstein, an ePatient advisor and three-time cancer survivor, told attendees at the closing ceremony, “Empathy doesn’t need that much. All empathy needs is us.”

The conference also tried to keep a focus on all different types of patient populations – including those who underserved. “There is a disconnect between solutions being build and the needs of vulnerable populations,” said Veenu Aulakh, executive director of the Center for Care Innovation during a talk on the “no smart-phone” patient. “We need to be designing [solutions] for today, not the future, and the 91 percent of patients that have a text-enabled phone.”

Larry Chu, MD, executive director of the conference (pictured above with Bernstein), warmly greeted the audience each morning – and on Saturday had a special announcement:  the launch of Medicine X Academy, a new effort aimed at continuing to build community among all stakeholders in health care and filling important gaps in medical education. The initiative will include a second conference in 2015 titled Stanford Medicine X ED (currently scheduled for Sept. 23-24, 2015). Joining Chu on stage to talk about the initiative, Bryan Vartabedian, MD, a Baylor College of Medicine physician and a longtime speaker at the conference, told attendees that medical education is “ripe for disruption.” And he noted that Medicine X – which has evolved “from an annual meeting into a global movement,” was poised to take it on.

Speaking of a global movement, there was very much a sense during the weekend that what was happening was bigger than just a conference – with at least one panel moderator telling attendees, “This conversation doesn’t end when we leave the stage.” And Bernstein summed up the three days of panels, presentations and powerful Ignite talks from ePatients saying, “I leave here re-energized, recharged, re-inspired and I hope you do too. Stay in touch on Twitter and see you next year!”

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X explores the relationship between mental and physical health: “I don’t usually talk about this”, At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school, What makes a good doctor – and can data help us find one?, Medicine X aims to “fill the gaps” in medical education, Stanford Medicine X 2014 kicks off today and Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient
Photos by Stanford Medicine X

Chronic Disease, Medical Education, Medicine X, Mental Health, Parenting, Stanford News

Medicine X explores the relationship between mental and physical health: “I don’t usually talk about this”

Medicine X explores the relationship between mental and physical health: "I don’t usually talk about this"

standing o at MedX - smallThis year, Medicine X examined the relationship between physical and emotional well-being with three breakout panels. Psychologists and ePatients came together in two of the sessions to discuss depression in chronic illness and coping through online communities, as well as the topic of mental health and the whole person.

The conversations centered on five themes: how the uncertainty, fear and overall stress of living with a chronic illness, or being a caregiver, can lead to depression and anxiety; why patients’ desire to be empowered can prevent them from seeking help; why eliminating the stigma associated with mental health conditions is so important; the need to better integrate the training of future doctors and mental-health professionals; and ways patients can identify that they may need mental health services and how to find them.

Ann Becker-Schutte, PhD, a Kansas City-based psychologist who participated in both panels, told the audience, “Living with any of these illnesses, whether it’s rare or well-known, requires a lot of work. There is a burden of gilt, fear and shame that are all rolled into one. It’s not unusual for anyone facing these conditions to get tired and just say ‘I’m done’.”

Sarah Kucharski, a Medicine X ePatient advisor diagnosed with depression, anxiety and fibromuscular dysplasia, gave the audience insight into how depression can take over – explaining that she was shocked to learn during a therapy session that a recent string of major life events (getting married, having bypass surgery and buying a house) had elevated her score on the Holmes and Rahe Stress Scale to roughly 500. “I had no ideas that such things had a rating or that they could be cumulative,” she said. “As a result, I try to be more cognizant and slow down.”

Other ePatients spoke candidly and courageously about some for their darkest moments, with many saying it was challenging to discuss their experiences with depression and anxiety outside their inner circles. ”I don’t usually talk about this,” said Hugo Campos, an ePatient with an implantable cardiac defibrillator in his chest. “This will be particularly difficult to admit in public.”

Campos opened up about the severe depression he encountered during the month following a procedure to implant into his chest a cardiac defibrillator, which shocks the heart to control life-threatening arrhythmias and prevent sudden cardiac arrest. Since the device was implanted preventatively, he felt that by having the surgery he had somehow failed himself and continued to be unsure if the device was necessary. There was also anxiety and fear about the device spontaneously shocking him. He turned to his online community to learn how to cope with these feelings. “I felt I would be better of speaking with my peers online, rather than a professional who did not have an implantable device and didn’t know what I was going through,” he explained.

Scott Strange, who was diagnosed with Type 1 diabetes in 1970 and also struggles with chronic depression, also turned to the Internet for support. “My journey to acceptance started when I found my online community. Until I found them, I never really faced it.”

Strange talked about growing up with the knowledge that not properly monitoring his glucose and insulin levels could be fatal. He also addressed the shame and exhaustion that results from “busting your rear end and trying to do everything your doctor says” and not seeing an improvement in your health.

While some turned to their patient communities online, others turned to someone outside of their social networks. When the demands of being a caregiver began to overwhelm Erin Moore, the mother of a four-year-old son with cystic fibrosis (CF) and three other children, she opted not to discuss it with someone well-versed with her situation. “Initially I sought help outside of the CF community because I was aware of how many people rely on me for my strength and I didn’t want to admit a weakness.”

Continue Reading »

Medicine and Society, Medicine X, Patient Care, Technology

Relationships the theme of the day at Stanford’s Medicine X

Relationships the theme of the day at Stanford's Medicine X

Larry Chu long shot

Medicine X began today with a theatrical bang as quotes from past speakers filled the main presentation hall and flashed across on the stage against an electrifying soundtrack. In welcoming both old and new friends to the conference, Larry Chu, MD, associate professor of anesthesia at the School of Medicine and executive director of the conference, repeated a sentiment from last year’s event, saying, “You belong here with us – we all care about health care.”

Stanford’s premier conference on emerging health-care technology and patient-centered medicine, the event attracted more than 400 patients, health-care providers, technologists, researchers and entrepreneurs to engage in moon shot thinking about the future of medicine and health care. Several hundred more watched the conference webcast.

“We’ve seen information technologies transform lives in so many ways; now it’s time to harness this power to improve health,” Lloyd Minor, MD, dean of the medical school, told the audience in the morning. He encouraged attendees “to think big” and to use their time at Medicine X to identify collaborators to take their ideas from concept to reality.

Collaborations and relationships were the theme of the day, with sessions focused on how engaged patients and their doctors can become the medical team of the future, how the pharmaceutical industry and patients can work together in the drug discovery and clinical trial process, how chronic-disease patients use self-trackers as a sort of partner in their care, and how developers of digital technologies are collaborating with those who might not have an obvious voice. As one Twitter user commented, “Most common words at #medx conference so far: transparent, engaged, relationships, connected.”

Medicine X continues tomorrow and Sunday. If you’re unable to attend the conference in person, you can participate in plenary sessions virtually through a high-quality streaming 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 @SUMedicine feed or follow the hashtag #MedX.

More news about Stanford Medicine X is available in the Medicine X category. 

Previously: Stanford Medicine X 2014 kicks off todayCountdown to Medicine X: 3D printing takes shapeCountdown to Medicine X: Specially designed apps to enhance attendees’ conference experience and Countdown to Medicine X: How to engage with the “no smartphone” patient
Photo by Stanford Medicine X

Medicine X, Stanford News, Technology

Stanford Medicine X 2014 kicks off today

Stanford Medicine X 2014 kicks off today

Medicine_XMedicine X, Stanford’s premier conference on emerging health-care technology and patient-centered medicine, kicks off today on campus. The three-day event opens with a keynote from Daniel Siegel, MD, clinical professor of psychiatry at the University of California-Los Angeles, titled “Interpersonal Connection, Self-Awareness and Well-Being: The Art and Science of Integration in the Promotion of Health.” During the talk, he’ll discuss his approach to developing a healthy mind, an integrated brain, and empathetic relationships.

The conference is being held at the Li Ka Shing Center for Learning and Knowledge. This year’s program will spotlight the relationship between physical and mental well-being with three breakout panels. Additional presentations and panels will focus on the medical team of the future, the use of self-tracking tools to improve chronic disease patients’ health, opportunities for the pharmaceutical industry to partner with patients in the drug discovery and clinical trial process, and ways to connect with “no-smartphone” patients — those who don’t have the access or resources to fully engage with health-enhancing technologies.

If you’re unable to attend the conference in person, you can participate in plenary sessions virtually through a high-quality streaming 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 @SUMedicine feed or follow the hashtag #MedX.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Countdown to Medicine X: 3D printing takes shapeCountdown to Medicine X: Specially designed apps to enhance attendees’ conference experience, Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings, Countdown to Medicine X: How to engage with the “no smartphone” patient and Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation 
Photo by Medicine X

Parenting, Pediatrics, Public Health, Research

Examining the effects of family time, screen time and parenting styles on child behavior

boardgameAs kids head back to school, many parents may be wondering what they can do to boost their children’s academic achievement. Findings recently published in the Journal of Family Psychology suggest that limiting screen time, increasing family time, and choosing parenting styles that rely on positive reinforcement are among the things that can help children perform better in school.

For The Learning Habit Study, the largest study of its kind, more than 21,000 parents across the country completed a 108-question survey about their children and family life. Among the findings: three family activities – eating regular dinners, attending religious services, and playing board games – were “significantly related to reduced screen time among children, higher GPA, and fewer emotional problems; ” parenting styles involving disciplining children when they misbehave or underperform were associated with a negative impact on children’s academic success, sleep and focus; and students’ sleep quality and grades start to decline after just 45 minutes of screen time.

From a recent WebMD story:

The good news for parents is they can easily make positive changes at home, says Robert Pressman, PhD. He’s the director of research at the New England Center for Pediatric Psychology and the study’s lead author.

Have regular family dinners, for example. They tend to happen at expected times and include conversation and information sharing. Parents can also shift their own habits and parenting styles in response to the study’s findings.

“These are all things that parents can do to make a difference,” Pressman says. “I think it’s going to change everything in terms of how we are going to interact with patients,” he adds. “We have hard data now that we didn’t have before. As a clinician, I know that I will have a greater impact.”

Previously: With school bells ringing, parents should ensure their children are doing enough sleeping, Study: Too much TV, computer could hurt kids’ mental health, Does TV watching, or prolonged sitting, contribute to child obesity rates? and Paper explores effects of electronic media on kids’ health
Photo by woodleywonderworks

Nutrition, Obesity, Research, Stanford News

When it comes to weight loss, maintaining a diet is more important than diet type

When it comes to weight loss, maintaining a diet is more important than diet type

bathroom_scaleSelecting a weight-loss plan can be tricky. Everywhere you look, media reports bombard you with stories about how Jennifer Hudson lost 80 pounds by joining Weight Watchers, Sharon Osbourne shed 23 pounds on the Atkins diet, and other A-listers slimmed down on the Zone Diet. And then there’s that close friend who dropped three dress sizes after following the South Beach Diet. How do you determine which dieting plan is the most effective?

To answer this question, Edward Mills, PhD, a visiting associate professor at Stanford, and colleagues completed a network meta-analysis of 48 randomized trials of brand-name diets, which included a total of more than 7,200 overweight or obese adults. In addition to those mentioned above, researchers also evaluated six other diets: Ornish, Vulumetrics, Jenny Craig, Rosemary Conley, Biggest Loser and Nutrisystem. The diets were divided into three categories —  low-carb, low-fat and moderate macronutrient.

The diet that a person can maintain for the long term, or for as long as possible, is the most effective weight-loss plan

Overall, the study showed that if people stuck to their diets (no matter the type) they lost weight, but ultimately the “weight-loss differences between individual diets were minimal and largely unimportant,” according to Mills. The study authors concluded that the diet that a person can maintain for the long term, or for as long as possible, is the most effective weight-loss plan. They also found that exercise and behavioral support can enhanced weight loss.

Interested to know more about the research, I reached out to Mills, who explained how the evidence failed to support recommending a specific diet and discussed the potential of being able to combine diets to achieve lasting weight loss without having to maintain strict eating habits.

Why did you and your colleagues complete a comparison study of popular diets?

There is a massive weight-loss industry that promotes different diets that are marketed in different ways. Some diets are promoted as being more medical, such as the Ornish diet, while others target people according to lifestyle, for example the South Beach diet. With all the promotion of different diets occurring and people discussing what they believe works or does not work, we wanted to examine whether the clinical trial evidence demonstrated superiority of any particular diet, a strategy we are calling “evidence-based dieting.”

In the study, individuals on a low-carb and low-fat diet lost the most weight (8 kg over six months), compared to those who were not on any diet. Why are these diets not considered to be the most effective of those studied?

These diets do appear to offer the largest weight-loss benefits, but the difference between the different diets was so small that other issues begin to be more important. We looked at the diets using two different analyses. First, we grouped diets according to their type of diet, called a class, and then examined whether the individual diet resulted in different outcomes. Although we found differences according to the classes of diets, these were not really observed when we examined the individual diets. So at this point, we can’t recommend any particular diet over another. But those that are low carb or low fat are preferable.

What did you find most surprising about the study results?

What is most surprising about the results is that the individual diet a person chooses doesn’t seem to be the most important aspect of dieting, instead maintaining a diet is. Some people have a lot of difficulty adhering to a diet because they find the particular diet too difficult to maintain, such as avoiding carbs if they’re trying the Atkin’s diet. It appears that if all diets offer more or less the same benefits, then people should be able to switch between diets when they need to. This approach may be really helpful in adhering to dieting in general.

Continue Reading »

Research, Surgery, Technology

Replicating the sensitivity of human touch in robots

Replicating the sensitivity of human touch in robots

A piece published today in the New York Times examines the importance of replicating the sensitivity of human touch in designing the next generation of robots. Noting that the Stanford Artificial Intelligence Laboratory designed the first robotic arm in the 1960s, reporter John Markoff offers a look at ongoing research around campus, and elsewhere, involving robotics:

Consider Dr. Nikolas Blevins, a head and neck surgeon at Stanford Health Care who routinely performs ear operations requiring that he shave away bone deftly enough to leave an inner surface as thin as the membrane in an eggshell.

Dr. Blevins is collaborating with the roboticists J. Kenneth Salisbury andSonny Chan on designing software that will make it possible to rehearse these operations before performing them. The program blends X-ray andmagnetic resonance imaging data to create a vivid three-dimensional model of the inner ear, allowing the surgeon to practice drilling away bone, to take a visual tour of the patient’s skull and to virtually “feel” subtle differences in cartilage, bone and soft tissue. Yet no matter how thorough or refined, the software provides only the roughest approximation of Dr. Blevins’s sensitive touch.

“Being able to do virtual surgery, you really need to have haptics,” he said, referring to the technology that makes it possible to mimic the sensations of touch in a computer simulation.

Markoff goes on to discuss advances in haptics, “a science that is playing an increasing role in connecting the computing world to humans.”

Previously: Stanford surgeon uses robot to increase precision, reduce complications of head and neck procedures, CyberKnife: From promising technique to proven tumor treatment and Stanford researchers develop flexible electronic skin

Events, Medicine X, Stanford News, Technology

Countdown to Medicine X: 3D printing takes shape

Countdown to Medicine X: 3D printing takes shape

3D printed handFrom customizing lab equipment to assisting in surgical planning to developing models of proteins and pathogens, 3D printing is helping to reshape biomedical research and health care. This year, Medicine X (which kicks off one week from today) will explore the transformative force of the technology during a range of panels and demonstrations in the “3D Printing and the Future of Medicine” session.

During the session, attendees will have the opportunity to learn more about health-care related 3-D printing applications at the “3-D Experience Zone,” which will showcase technologies from leading manufacturers. Attendees can learn about surgical applications of 3D printing from 3D Systems; find out how 3D Hubs is creating a global community by connecting owners of 3D printers with those who want to utilize the technology; and see how Occipital’s 3D scanning hardware for the iPad is supporting patient care. Additionally, they can discover how Artec creates a 3D full-body scan in a mere 12 seconds and enjoy chocolate and candy from the ChefJet food printer.

The session will also feature two Saturday-afternoon panels titled “Diverse Distributed & Design-Driven” and “Innovation Implementation,” with the latter exploring:

…some of the challenges and issues to consider in this brave new world. Will the FDA approve printed food, pharmaceuticals, and medical devices? How can 3D printing startups include patients in their design process? What are the public health implications when almost anyone can print biomaterials from the comfort of their own home? And once we ensure public safety, how can we make 3D printing affordable and accessible for all?

Darrell Hurt, PhD, computational biologist and project lead for the National Institutes of Health 3D Print Exchange, is among the panelists, and Monika Wittig, director and co-founder of Live Architecture Network, will moderate the discussions.

“As a designer, I am thrilled that this conference continues to widen the view of valuable cross-disciplinary collaborations. This is decidedly the aspect that I found most profound during my first Medicine X experience,” said Wittig. “My hope is attendees leave this session feeling a heightened awareness of 3D design and production technologies and the many realms of potential engagement in health sectors including prototyping, globally-distributed production and mass-customized design.”

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience, Countdown to Medicine X: Global Access Program provides free webcast of plenary proceedings, Countdown to Medicine X: How to engage with the “no smartphone” patient and Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation
Image of 3D printed hand from Medicine X

Mental Health, Nutrition, Obesity, Research, Women's Health

Stressed? You could be burning fewer calories

Stressed? You could be burning fewer calories

cupcakesBad news, ladies: Findings (subscription required) recently published in Biological Psychiatry show that women who consumed comfort food while feeling stressed burned fewer calories than their zen-like counterparts.

In the study, Ohio State University researchers quizzed a group of women about what was causing stress in their lives before they ate a caloric meal consisting of eggs, turkey sausage, biscuits and gravy. Scientific American reports:

Turns out that the most stressed women had higher levels of insulin. Which slows down metabolism and causes the body to store fat. And that fat, if not burned off, accumulates in the body.

The women who had reported feeling stressed or depressed in the day before eating the meal burned 104 fewer calories during the seven hours following the meal than women who felt more mellow.

If eating high-calorie comfort food to alleviate stress becomes habitual, the result could be an average weight gain of 11 pounds per year.

So next time you’re feeling overwhelmed and exhausted, you might want to reconsider reaching for a cupcake.

Previously: Learning tools for mindful eating, Mindful eating tips for the desk-bound and Want to curb junk food cravings? Get more sleep
Photo by Class V

Autoimmune Disease, Chronic Disease, Health and Fitness, Research, Technology

Video game accessory may help multiple sclerosis patients reduce falls, boost brain connections

Wii_balance_boardNintendo’s Wii Balance Board has helped get people off the couch and moving as they play aerobic video games like Super Hula Hoop or Dance Dance Revolution. Now a study published this week in Radiology shows that the video game console’s balance board may help reduce multiple sclerosis (MS) patients’ risk of falls by rewiring their brains.

In a small study, researchers used an MRI technique called diffusion tensor imaging to analyze changes in the brain of MS patients that used the Wii Balance Board while playing video games for 30-40 minutes a day five days a week.

According to a recent Forbes post:

MRI scans in the MS patients in the study demonstrated significant growth of nerve tracts which are integral in movement as well as balance. It turns out that the changes seen on MRI correlated with improvements in balance as measured by an assessment technique called posturography.

These brain changes in MS patients are likely a manifestation of neural plasticity, or the ability of the brain to adapt and form new connections throughout life, said lead author Luca Prosperini, M.D., Ph.D., from Sapienza University in Rome, Italy.

”The most important finding in this study is that a task-oriented and repetitive training aimed at managing a specific symptom is highly effective and induces brain plasticity.”

“More specifically, the improvements promoted by the Wii balance board can reduce the risk of accidental falls in patients with MS, thereby reducing the risk of fall-related comorbidities like trauma and fractures,”

 added Prosperini.

Researchers cautioned that the improvements in balance did not persist after patients stopped playing the video games, suggesting that patients will need to continue their training in order benefit from the intervention.

Previously: Study analyzes video game-related injuries and Comparing the Wii Fit board to a clinical force platform
Photo by Joachim S. Müller

Stanford Medicine Resources: