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Events, Medical Education, Medicine and Society, Stanford News, Technology

Stanford-hosted AMA Medical Student regional conference focuses on health-care technology

Stanford-hosted AMA Medical Student regional conference focuses on health-care technology

AMA photoStanford med students Nuriel Moghavem and Trishna Narula co-chaired an AMA Medical Student Section Regional 1 conference last weekend at the Li Ka Shing Center for Learning and Knowledge. Ninety students, including 40 from Stanford, participated in the two-day event, which involved meetings, breakout sessions with industry leaders and social outings, plus an optional trip to a local winery the following day. Moghavem shared his thoughts on the weekend’s proceedings in the Q&A that follows.

How did you decide to focus on healthcare technology innovation?

When we were putting together the proposal, we thought a lot about what makes Stanford different from other schools that might host this conference, and how we could add educational and inspirational value to the trips of students coming from other states. Stanford obviously has many things that set it apart, but we thought that the energy of the health tech field would really capture the imaginations of our attendees.

What were some key takeaways from the sessions?

Our keynote speaker was Atul Butte, MD, PhD, a giant in the field of big data analytics and [someone who is] incredibly knowledgeable about the process of bringing a medical discovery to the market. Everyone in that room was rapt and half probably left wondering why we all weren’t millionaires already. We then had some breakout sessions from telemedicine and technology startups that again pushed our attendees’ understanding about the future of medicine. I think the main takeaways were that technology is changing health care, and the “visibility” – if you think about it like driving a car in the fog – probably isn’t more than two to three years ahead. Technology has the promise to entirely overturn our idea of how health is fundamentally defined and approached in ways that we simply can’t anticipate at this time. It’s big stuff.

What took place at the AMA Leadership School Workshop?

The Leadership School is a national initiative to put tools in the hands of emerging leaders to empower them to expand their efforts. The workshop they led during our conference was an excellent morning icebreaker – asking attendees to share media related to their own personal “brand” (a favorite image, a Google search of themselves, etc.). Through the exercise, we all shared interesting personal details about our lives, interests, passions and hobbies, and we learned a valuable lesson in controlling one’s brand and online presence.

You are a busy medical student. Why do you feel it’s important to participate in leadership opportunities in your field?

As medicine becomes increasingly driven by public policy, it’s important that we cultivate a generation of leaders in medicine with the tools to engage in policy. This conference was, for us, an opportunity to get 70 of the brightest future physicians in our region (which spans from Hawaii to South Dakota!) in one room to discuss that very issue and to develop those skills. We don’t just think it’s important for emerging physician leaders to participate in policy matters, we think it’s critical for the future well-being of our community and perhaps our country for them to do so.

Co-organizer Trishna Narula later shared with me, “while this was a great opportunity for the AMA to benefit from the health technology hub at Stanford, it was also another large step for Stanford Med to push to the forefront of health policy and advocacy.”

Previously: Top 10 reasons I’m glad to be in medical schoolFuture doctors have a lot at stake, even if they don’t know it: A student’s take on the Affordable Care Act and Stanford Medicine X seeking students for leadership program
Photo by James Pan

Applied Biotechnology, Bioengineering, Cardiovascular Medicine, Stanford News, Technology

Heart devices get a mobile makeover

Heart devices get a mobile makeover


Emerging diagnostic heart devices are going mobile. And by leveraging advances in smartphones and sensors, they’re able to perform their functions better, faster and cheaper than traditional heart monitoring equipment.

For example, the CADence, shown above, detects blocked arteries from the surface of the chest by identifying the noisy signals of blood turbulence associated with blockages.

The Zio Patch, on the right, is a sensor that can be worn on the chest for up to 14 days to detect intermittent, irregular heartbeats, called arrhythmias. ZIO-150-90

Both of these amazing devices reveal the mysteries of the heart non invasively, and they provide more potentially life-saving heart data to physicians than conventional equipment.

Yet despite these advantages, adoption into the medical system has been slow.

In the new issue of Stanford Medicine magazine on cardiovascular health, I interview the entrepreneurs behind these inventions — the heart gadgeteers — and let them describe the hurdles that add years to the process of launching new medical devices into the marketplace.

Previously: Mysteries of the heart: Stanford Medicine magazine answers cardiovascular questions, New Johnson & Johnson CEO discusses medical device futures at Stanford eventStanford physician-entrepreneur discusses need to change FDA approval process and Is the United States losing ground as a leader of medical innovation?
Photos courtesy of AUM Cardiovascular, iRhythm Technologies

Behavioral Science, Events, Medicine and Society, Stanford News, Technology

The Dalai Lama talks business, compassion and happiness

The Dalai Lama talks business, compassion and happiness

One Christmas, my dad gave me and my siblings copies of the Dalai Lama‘s book The Art of Happiness – a quick read with a valuable missive. (“Be content with this book – you didn’t need other presents” was my takeaway.) I was reminded of this when reading about a recent visit – focused in large part on happiness – by His Holiness to Silicon Valley.

During his visit, which was co-sponsored by Stanford’s Center for Compassion and Altruism Research and Education (CCARE), the Dalai Lama gave a talk at Santa Clara University on business, ethics and compassion. As Stanford News reports from the event:

In his opening remarks, [James Doty, MD,] noted that stress, anxiety and depression are the greatest health care costs to businesses – he referred to an “epidemic of depression.” Companies do not pay enough attention to the well-being of its employees, he suggested.

“Is there a different approach?” asked Doty, referencing the effects of meditation and compassion on the brain. This type of research, he said, has stimulated a revolution in science. Being compassionate increases one’s health, well-being and longevity, he said.

The Dalai Lama talked about how to become a “happy person” and build a “happy community” where people spread love and compassion.

“Everyone has the right to be a happy person, but generally we have too much of an emphasis on material values,” he said.

Doty is director of CCARE, which studies the science of compassion. (The Dalai Lama is a founding benefactor of CCARE.) More from the article:

Doty said that researchers are especially interested in ways to integrate technology and well-being.

“We’re studying the development of interventions, including web-based or smartphone-based apps that support health and well-being by decreasing stress and anxiety in the workplace,” Doty said in an interview before the Dalai Lama spoke.

Previously: Are women more compassionate than men? What the science tells usHow practicing compassion could ease or eliminate chronic stress and How being compassionate can influence your health

Patient Care, Research, Stanford News, Technology

Automated safety checklists prevent hospital-acquired infections, Stanford team finds

Automated safety checklists prevent hospital-acquired infections, Stanford team finds

inserting central line - smallPilots, astronauts and workers in other high-risk industries follow rigorous safety checklists to help them avoid hazards. Checklists have shown potential to reduce risk in health care, too, but the challenge is figuring out how to incorporate them into physicians’ and nurses’ work flow.

A Stanford team has built a solution: an automated checklist that pulls data directly from patients’ electronic medical records and pushes alerts to caregivers. The checklist, and a dashboard-style interface they used to interact with it, caused a three-fold drop in the rates of a serious type of hospital-acquired infection, the team found. The work has just been published in Pediatrics.

From our press release about the study:

“Electronic medical records are data-rich and information-poor,” said Natalie Pageler, MD, the study’s lead author. Often, the data in electronic medical records is cumbersome for caregivers to use in real time, but the study showed a way to change that, said Pageler, who is a critical care medicine specialist at the hospital and a clinical associate professor of pediatrics. “Our new tool lets physicians focus on taking care of the patient while automating some of the background safety checks.”

Working in the pediatric intensive care unit at Lucile Packard Children’s Hospital Stanford, the researchers focused on bloodstream infections that occur via central lines, which are catheters inserted in major veins. The automated alerts were designed to help physicians and nurses follow an established set of best practices for caring for central lines. For example, alerts were generated when the dressing on a patient’s central line was due to be changed.

The drop in the rate of central line infections – from 2.6 to 0.7 infections per 1,000 days of central line use – not only protected patients from harm; it also saved money. The team estimated that the savings in the pediatric intensive care unit were about $260,000 per year.

Next, the researchers hope to adapt the automated checklists to other uses, such as helping to guide the recovery of patients who have received organ transplants.

Previously: More than a manual: Stanford’s crisis checklist helps those working in the OR, What health-care providers can learn from the nuclear industry and Sully Sullenberger talks about patient safety
Photo by Jocelyn Augustino/FEMA Photo Library

Cardiovascular Medicine, Research, Stanford News, Technology, Transplants

Mysteries of the heart: Stanford Medicine magazine answers cardiovascular questions

Mysteries of the heart: Stanford Medicine magazine answers cardiovascular questions

spring14_magazine-coverThe heart is a paradoxical organ. It declares its presence with that distinctive thump thump, yet its moment-to-moment condition is really hard to decipher. But as I learned while editing the just-published Stanford Medicine magazine special report “Mysteries of the heart,” new technologies and research are making it easier to assess heart health and diagnose disease. With heart disease the No. 1 cause of death worldwide, that’s good news.

The issue, published during American Heart Month, was supported in part by the Stanford Cardiovascular Institute. Among its contents:

  • A change of heart“: An interview with former vice president Dick Cheney on having “virtually everything done to me that you could do to a heart patient,” culminating with a transplant.
  • Fresh starts for hearts“: A feature on using stem cells to revolutionize cardiac care, and a family for which new treatments can’t come soon enough.
  • The ultramarathoner’s heart“: Visionary computer designer Mike Nuttall’s exploits as an ultramarathoner, despite having severe heart disease (online only).
  • Hiding in plain sight“: The story of a man born with high cholesterol — a surprisingly common but hidden and deadly condition.
  • Switching course“: A piece detailing the untangling of a heart surgery that saves babies, but threatens their lives in adulthood.
  • The heart gadgeteers“: A report on the new wave of heart- and fitness-monitoring devices, and why it’s hard to integrate them into the medical system.
  • Easy does it“: An article on an alternative to open-heart surgery to replace aortic valves.
  • Dear Dr. Shumway”: Catching up with a kid who in 1968 wrote to transplant pioneer Norman Shumway, MD, for advice — on his frog heart transplant.

The issue also includes articles on the use of big data in medicine, which will be the focus of the Big Data in Biomedicine conference May 21-23 at Stanford.

Previously: From womb to world: Stanford Medicine Magazine explores new work on having a babyFactoring in the environment: A report from Stanford Medicine magazine and New issue of Stanford Medicine magazine asks, What do we know about blood?
Illustration by Jason Holley


Twitter 101 for patients

I quite like this blog entry, from the Society for Participatory Medicine, on how patients are using Twitter to “seek and speak out.” Along with outlining how she used it during her bout with cancer (“I found information on just about every possible concern from ongoing clinical trials, to the latest medications, what foods to eat and why yoga was good for breast cancer patients”), the writer provides statistics, definitions, and guidance for the newbie Twitter user. A Twitter 101, if you will.

Previously: How using Twitter can benefit researchers, How, exactly, can Twitter benefit physicians?, What to think about when using social media for health information and How patients use social media to foster support systems, connect with physicians

Imaging, Stanford News, Technology

Stanford researchers develop web-based tool to streamline interpretation of medical images

Stanford researchers develop web-based tool to streamline interpretation of medical images

A web-based tool created by researchers at Stanford enables physicians and researchers to better interpret the wealth of data contained in medical images by capturing information in a way that is explicit and computationally accessible.

The tool, called electronic Physician Annotation Device (ePAD), was developed by the Rubin Lab at the School of Medicine and is available to download for free. Daniel Rubin, MD, an assistant professor of radiology, and his team initially designed ePAD in response to an unmet need in cancer imaging, but he says the tool can be used more generally quantitatively evaluate images and characterize disease. He told me:

The 20,000-foot view here is about information about images is recorded. Currently, images are recorded in narrative text form. But a narrative is a very opaque picture if you’re a clinician, or a patient, trying to understand how the picture has changed over time and determine the response of a disease treatment. However, if a radiologist is looking at images and all the information from prior studies, such as dates and abnormalities, is contained in a table and a graph shows the changes in time, then its easier for referring clinicians to understand and for computers to process.

The other aspect that is unique is that ePAD runs in a web browser. The huge advantage of doing this is the platform can be run anywhere, without needing to install software locally, or require an expensive workstation (such as we use in Radiology).

Rubin is currently in the process of launching a pilot project of the system at the Stanford Cancer Institute. As part of the project, ePAD will be used to assess treatment success for patients who are matched to clinical trials using a smart database. Clinicians and researchers at other institutions have also begun using the tool, and Rubin hopes to expand its reach to create a vast, searchable medical image database. “We’re very excited about ePAD because we think it has far reaching implications,” he said.

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Aging, Stanford News, Technology

Finalists announced for Stanford Center on Longevity’s Design Challenge

Finalists announced for Stanford Center on Longevity's Design Challenge

OLYMPUS DIGITAL CAMERAStanford Center on Longevity launched a design challenge last September to put student minds to the task of improving the daily lives of people with dementia and their caregivers and families. Now, Forbes reports, seven finalists have been named from among the 52 teams in 15 countries that submitted ideas for products and services that would help people with cognitive impairment live independently longer. From Forbes:

“Cognitive impairment affects people in such a personal way, the challenge brought out a lot of creativity,” says Ken Smith, Director of Mobility at the Stanford Center on Longevity.

The students who entered weren’t just studying design and engineering. They also came from fields such as nursing, psychology, fine arts and computer science. Dementia affects patients, families caregivers and health providers in a multitude of ways, so the inventions addressed the disease from a variety of angles.

The Design Challenge winner and runners-up will be announced on April 10, when the theme of next year’s challenge will be revealed.

Previously: Soliciting young minds to help older adults and A look at the benefits of an aging society
Photo by Kevin Poh

Emergency Medicine, Health Costs, Research, Technology

Can sharing patient records among hospitals eliminate duplicate tests and cut costs?

566748316_7b72d5b777A recent analysis of the impact of health information exchanges, which allow health-care providers to share patient records electronically and securely, shows the systems hold promise for reducing health costs and unnecessary care in emergency departments.

For the study (subscription required), University of Michigan researchers examined information on hospital health information exchange participation and affiliation from the Health Information Management Systems Society’s annual survey as well as data the  California and Florida state emergency department databases from 2007 through 2010. Both states were early adopters of health information exchanges. According to a university release:

The findings show that the use of repeat CT scans, chest X-rays and ultrasound scans was significantly lower when patients had both their emergency visits at two unaffiliated hospitals that took part in a [health information exchange]. The data come from two large states that were among the early adopters of [health information exchanges]: California and Florida.

Patients were 59 percent less likely to have a redundant CT scan, 44 percent less likely to get a duplicate ultrasound, and 67 percent less likely to have a repeated chest X-ray when both their emergency visits were at hospitals that shared information across an [health information exchange].

More research is needed to determine the value of health information exchanges on patient care and health-care costs. But in order to conduct future analysis, said study authors, more states need to report relevant data to the Healthcare Cost and Utilization Project system  to allow researchers to view the activity of individual patients across their different medical encounters, while preserving patient privacy.

Previously: Experts brainstorm ways to safely reduce health-care costs, U.S. Olympic team switches to electronic health records and A new view of patient data: Using electronic medical records to guide treatment
Photo by Tabitha Kaylee Hawk

Public Health, Research, Stanford News, Technology

Grant from Li Ka Shing Foundation to fund big data initiative and conference at Stanford

Grant from Li Ka Shing Foundation to fund big data initiative and conference at Stanford

big data speakerResearchers at the School of Medicine and Oxford University are currently developing ways to mine the vast amounts of biomedical data housed in public databases to speed the discovery of new drugs, improve patient care and reduce health-care costs.

Now, the Li Ka Shing Foundation has provided a $3 million planning grant to Stanford’s medical school to further this collaborative effort and fund the big data initiative. As my colleague Ruthann Richter explains in a release, the initiative aims to “solve large-number problems at a global scale to improve health worldwide.” She writes:

By assembling data on large populations, scientists can discern patterns that would not otherwise be apparent by studying an individual’s genes. For instance, they can determine whether a particular genetic variant is significant or just an artifact. And they can better determine what drugs are likely to have an impact on the activities of a particular gene.

Based on such findings, scientists aim to develop new medications and low-cost therapies. They also plan to develop a real-time mobile application with the ability to collect biometric and other health data, such as heart rate and blood pressure for patients with cardiovascular disease, to actively monitor patients recovering from surgery or to prevent an adverse health event from occurring. The scientists ultimately will combine this data with other health metrics, such as genomic-sequencing data and electronic medical records, and use bioinformatics analysis to predict which patients are at higher risk for certain diseases and which ones could benefit from earlier intervention.

The grant includes funding for the recruitment of new faculty working in the area of big data, a scholars program to train PhD students and postdoctoral scholars at both institutions, and the upcoming Big Data in Biomedicine conference.

Last year, some 300 leading figures from academia, industry, government and philanthropic foundations gathered at Stanford for the three-day conference, and more than 2,700 people logged in to the live stream. This year’s event will be held May 21-23.

Previously: Big data = big finds: Clinical trial for deadly lung cancer launched by Stanford study, Big laughs at Stanford’s Big Data in Biomedicine Conference and A call to use the “tsunami of biomedical data” to preserve life and enhance health
Photo from last year’s Big Data in Biomedicine conference by Saul Bromberger

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