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Medicine X, Stanford News, Technology, Videos

Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation

Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation

A special Medicine X event on Sept. 4 will explore how patients, providers and entrepreneurs can help ignite innovation in the health-care industry. During the daylong symposium, James Hereford, chief operating officer at Stanford Hospital & Clinics, will be presenting crucial opportunities for innovation in medicine today, and challenging physicians, patients and entrepreneurs to collaborate and build partnerships in an effort to create impact and change.

In the above Medicine X film, Hereford discusses the importance of patient-centered care, the need to treat the whole person and not just the illness and how including patients in pivotal discussions is crucial to transform health care. “I don’t think the world should be defined around us,” said Hereford. “I think the world should be defined around our patients.”

The brief conversation offers a taste of the thoughtful commentary that attendees can expect at this event. Other speakers include: Robert Pearl, MD, executive director and chief executive officer of The Permanente Medical Group; Stanford radiologist Lawrence Hoffman, MD; Mark Tomaino, senior industry executive at Welsh, Carson, Anderson & Stowe; Vivian Lee, MD, PhD, chief executive officer of University of Utah Health Care; and Alexandra Drane, co-founder of Eliza Corp. For more information or to register for the symposium visit the conference website.

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

Previously: Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient, Medicine X Live! to host Hangout on design thinking for patient engagement and Quite the reach: Stanford Medicine X set record for most number of tweets at a health-care conference

Cardiovascular Medicine, Patient Care, Stanford News, Technology, Videos

“Liberated from LVAD support”: One patient’s story

“Liberated from LVAD support”: One patient’s story

One of the first things I noticed about Donna Jackson — 68 years old when I met her in 2011 — was her decisive nature. She had a schedule filled with activity, and regardless of how many people (many of her children, grandchildren, great-grandchildren, in-laws and friends live very near at hand) came to visit in her modest home in Central California, she was a certain force of calm. She was also someone who did not like restrictions on what she could do.

Back then, she was just a few months out from surgery at Stanford Hospital to implant a mechanical pump, a left ventricular assist device or LVAD, on her heart. She knew it had saved her life, but she chafed at the battery, back-up battery and controller she had to wear at all times. Before the surgery, she had been a regular at a water aerobics class, and she loved to swim with her grandchildren. Even in those early months, Jackson was leaning on her Stanford doctors to find a way to get her back in the water. She asked her cardiologist, Dipanjan Banerjee, MD, to consider allowing her to swim in a wetsuit.

Banerjee did her one better. It had become apparent to him that she could be one of that small percentage of LVAD recipients whose heart recovers after the rest that the LVAD gives it and who no longer need the device. (He had been waiting, he said, to find a patient “who can be liberated from LVAD support.”) By Spring 2013, a little less than three years after her LVAD implantation, Banerjee and Jackson’s surgeon, Richard Ha, MD, put Jackson in an even smaller percentage. She became the first person to have her LVAD deactivated by catheter in the most minimally invasive approach yet.

The challenge set by Jackson for her Stanford team — and its groundbreaking procedural response — appears today in the August issue of the Annals of Thoracic Surgery. The lead author of the paper is Sanford Zeigler, MD, a cardiothoracic surgery resident.  Ha, surgical director of the hospital’s Mechanical Circulatory Support Program is the paper’s senior author, and Banerjee, medical director of Mechanical Circulatory Support Program, is a co-author. As they explain in the paper, Jackson, nearing 71,  was a high surgical risk for complete removal of the implant — that would have required them to crack open her ribs again — a procedure that’s followed typically by a long and sometimes painful recovery.  So, her doctors instead threaded a slim plastic tube through a small incision to her femoral artery in the groin and up to her aorta, allowed them to plug the flow of blood to the LVAD. Then, they cut, cleaned and capped the wiring powering the LVAD so it no longer emerged from an opening in her abdomen. (The LVAD remains inside Jackson’s chest.)

The new catheter-based deactivation of the LVAD has value beyond Jackson’s way of life, as the paper explains. She inspired the team to begin research on how to predict which LVAD patients might be like her and reach a point where they no longer need the LVAD. “If we can find out which patients are going to recover sooner, we can be more aggressive with them so they can be liberated from the LVAD,” said Banerjee, “and many of these patients will not want or be able to tolerate a complete removal of the LVAD.”

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Events, Medicine X, Mental Health, Stanford News, Technology

Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient

Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient

Larry_ChuInnovative thinkers and thought leaders engaged in using emerging technologies to enhance health-care delivery and advance the practice of medicine will gather here in early September for Stanford Medicine X.

As Lloyd Minor, MD, dean of the School of Medicine, comments in a release today, Larry Chu, MD, associate professor of anesthesia at Stanford and executive director of the conference, “has made this the go-to event for e-patients, physicians and innovators who want to get together to map out the future of health care.” Chu also notes that the conference  “has distinguished itself through a singular commitment to inclusivity and by finding new ways to bring every voice and perspective into important conversations about health care.”

Now in its third year, Medicine X is building on this inclusive spirit by exploring a variety of new themes during its 2014 program. More from our release:

This year’s program will spotlight the relationship between physical and mental well-being with three breakout panels. Psychologist Ann Becker-Shutte, PhD, will moderate a session on how mental health affects overall health. A conversation about emerging technologies in mental health will be led by Malay Gandhi, managing director of Rock Health, a business accelerator for health-care technology startup companies. Additionally, patient advocate Sarah Kucharski will direct a discussion about depression caused by chronic disease and about coping through online communities.

“Mental health is imperative to address in the overall conversation about the future of health care,” said Chu. “We need to be thinking about the health of the whole person, not just a patient’s individual symptoms or disease.”

The three-day event will also feature panels on what the medical team of the future may look like; how patients with chronic diseases can use self-tracking tools to improve their health and support one another; ways for the pharmaceutical industry to partner with patients in the drug discovery and clinical trial process; and opportunities to connect with “no-smartphone” patients — those who don’t have the access or resources to fully engage with health-enhancing technologies.

Keynote speakers for this year’s conference, being held Sept. 5-7, include Daniel Siegel, MD, clinical professor of psychiatry at the University of California-Los Angeles; Barron Lerner, MD, PhD, professor of medicine and population health at New York University School of Medicine; and Charles Ornstein, a Pulitzer Prize-winning journalist and senior reporter at ProPublica.

For information about the program or to  register the Medicine X website. Last year’s conference sold out, and space is limited for this year’s event.

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

Previously: Medicine X Live! to host Hangout on design thinking for patient engagement, Quite the reach: Stanford Medicine X set record for most number of tweets at a health-care conference, Videos from Medicine X now available and “You belong here”: A recap of Stanford Medicine X
Photo of Larry Chu by StanfordMedicineX

Medical Apps, Sleep, Technology

Can sleep trackers help you get a better night’s rest?

Can sleep trackers help you get a better night's rest?

As the number of self-tracking gadgets grows, many people are beginning to experiment with monitoring lifestyle habits in an effort to improve their health. In fact, seven in ten American adults say they track at least one health indicator, according to data from the Pew Research Center’s Internet & American Life Project. But there has been some concern about the accuracy of such technology.

A recent CBS News segment took a closer look at the effectiveness of sleep trackers and outlined the differences in information collected by the devices and data collected by sleep specialists in a clinical setting. Stanford sleep expert Michelle Primeau, MD, also commented, “The reason why these devices are so good is [using them] puts greater emphasis on sleep.”

Previously: Why sleeping in on the weekends may not be beneficial to your health, The high price of interrupted sleep on your health, Exploring the benefit of sleep apps and Designing the next generation of sleep devices

Patient Care, Pediatrics, Research, Technology

How virtual visits can help children in the hospital reduce stress, speed up recovery

How virtual visits can help children in the hospital reduce stress, speed up recovery

Past research has shown that patients in the hospital experience less nerve-related pain and recover more quickly when they have visitors. Now findings recently published in Pediatrics show that virtual visits are equally beneficial.

In the study, researchers at the University of California, Davis Children’s Hospital analyzed the effectiveness of Family-Link, a program that provides webcams, laptops and Internet access to pediatric patients. Researchers assessed the anxiety levels of roughly 230 children who used the teleconferencing service and 135 who did not when they were admitted to the hospital and discharged using the Parent-Guardian Stress Survey. According to a Futurity post:

Overall, children who used Family-Link felt less stressed compared to those who did not use the program. The effect was even more pronounced for children who lived closer to the hospital and had shorter hospitalizations. This group experienced a 37 percent stress reduction when using Family-Link.

“This study shows that we have another tool to help children during their hospital stays,” says Yang. “The improvement in stress scores shows that Family-Link is really helping many children and might possibly be improving outcomes.”

Previously: Using the iPad to connect ill newborns, parents

Cancer, Imaging, In the News, Patient Care, Stanford News, Technology

New technology enabling men to make more confident decisions about prostate cancer treatment

New technology enabling men to make more confident decisions about prostate cancer treatment

To watch and wait, or operate? There’s quite a bit of confusion, and a variety of differing opinions from the medical community, regarding prostate cancer treatment – so it’s no wonder that some men question whether the treatment path they’ve chosen is the right one. A new technology at Stanford, though, is hoping to alleviate some of the confusion and help with the decision-making process.

By using a combination of ultrasound and MRI imaging, Stanford physicians can use the resulting 3D images to get a far more detailed look at the level of cancer and its aggressiveness than they were able to in the past. Patients, in turn, will be empowered with the knowledge to make more confident decisions about how, and whether, to proceed with treatment. ABC7 News recently aired a story on the new technology.

Previously: Six questions about prostate cancer screening, Ask Stanford Med: Answers to your questions on prostate cancer and the latest research and Making difficult choices about prostate cancer

Addiction, Emergency Medicine, Public Health, Research, Technology

Text messages after ER visit could reduce young adults’ binge drinking by more than 50 percent

Text messages after ER visit could reduce young adults' binge drinking by more than 50 percent

Bar_texting_0701414Researchers have demonstrated that text message programs can, among other things, help diabetes patients better manage their condition, assist smokers in kicking their nicotine habit, and encourage expecting mothers to get flu shots.

Now new findings published in the Annals of Emergency Medicine show that text messages can also be an effective tool for reducing binge drinking among young adults whose hazardous alcohol use has resulted in an emergency room visit. During a 12-week study, 765 patients who were treated in the emergency room and screened positive for a history of hazardous drinking were divided into three groups. The first group received text messages prompting them to respond to drinking-related queries and received text messages in return offering feedback aimed at either strengthening their low-risk drinking plan or promoting reflection on their drinking plan or decision not to set a low-risk goal. Another group received only text queries about their drinking, and the remaining individuals received no text messages.

A story published today on PsychCentral reports on the researchers’ results:

The group receiving both text message queries and feedback decreased their self-reported binge drinking days by 51 percent and decreased the number of self-reported drinks per day by 31 percent.

The groups that received only text messages or no text messages increased the number of binge drinking days.

“Illicit drugs and opiates grab all the headlines, but alcohol remains the fourth leading cause of preventable death in the U.S.,” said [Brian Suffoletto, MD, assistant professor in the Department of Emergency Medicine at the University of Pittsburgh School of Medicine].

“If we can intervene in a meaningful way in the health and habits of people when they are young, we could make a real dent in that tragic statistic. Alcohol may bring them to the ER, but we can do our part to keep them from becoming repeat visitors,” [he added].

Previously: CDC explores potential of using smartphones to collect public health data, Could better alcohol screening during doctor visits reduce underage drinking?, Personality-based approach can reduce teen drinking and The costs of college binge drinking
Photo by Anders Adermark

Chronic Disease, Research, Science, Stanford News, Technology

Stanford team develops nanotech-based microchip to diagnose Type 1 diabetes

Stanford team develops nanotech-based microchip to diagnose Type 1 diabetes

Dr. Brian Feldman?s M.D. hold a computer chip that he develop that will benefit diabetic patients at the Stanford School of Medicine,  on Thursday, July 4, 2014.  ( Norbert von der Groeben/ Stanford School of Medicine )

Years ago, when patients showed up at the doctor with excessive thirst, frequent urination and unexplained weight loss – in other words, the classic symptoms of diabetes mellitus – diagnosing them was usually just a matter of checking for high blood sugar. Yes, they needed to be treated for the correct form of the disease, but the two main types were found in different populations. So, in most cases, no lab test was needed to figure out whether someone had Type 1 or Type 2 diabetes; demographic factors were enough to make the distinction.

Of late, there’s been much more cross-over between the two groups. To treat patients correctly, it’s important to diagnose the right form of diabetes, but there’s a problem: The only test that does so is expensive, cumbersome and available only in hospitals.

So it’s great news that Stanford scientists are developing a new Type 1 diabetes test, described in a paper published online this week in Nature Medicine. The new nanotechnology-based microchip, which researcher Brian Feldman, MD, PhD, holds in the photo above, tests patients’ blood for the auto-antibodies that cause Type 1 diabetes. The new test is cheap, portable, and uses much less blood than the older diagnostic test. Unlike the old test, it requires no radioactive reagents and is simple enough to use in low-tech settings.

The test uses a nanotech enhancement (specifically, nano-sized islands of gold; hence the golden glow of the chip that Feldman is holding) to help detect auto-antibodies. In addition to diagnosing new patients, this technology will also enable better research into how Type 1 diabetes develops, as our press release explains:

…[P]eople who are at risk of developing Type 1 diabetes, such patients’ close relatives, also may benefit from the test because it will allow doctors to quickly and cheaply track their auto-antibody levels before they show symptoms. Because it is so inexpensive, the test may also allow the first broad screening for diabetes auto-antibodies in the population at large.

“The auto-antibodies truly are a crystal ball,” Feldman said. “Even if you don’t have [Type 1] diabetes yet, if you have one auto-antibody linked to diabetes in your blood, you are at significant risk; with multiple auto-antibodies, it’s more than 90 percent risk.”

Feldman’s team has started a biotech company to further develop the test and is seeking FDA approval for the new method. In addition, Stanford University and the researchers have filed a patent for the new technique.

Previously: A simple blood test may unearth the earliest signs of heart transplant rejection, Stanford microbiologist’s secret sauce for disease detection and One family’s story on caring for their children with type 1 diabetes
Photo by Norbert von der Groeben

Medicine and Society, Science, Stanford News, Technology

Residential learning program offers undergrads a new approach to scientific inquiry

Residential learning program offers undergrads a new approach to scientific inquiry

SIMILE studentsTwenty-two Stanford freshmen spent the last school year living, studying and socializing immersed in scientific inquiry. In its inaugural year, the residential education program SIMILE: Science in the Making Integrated Learning Environment drew interest from and selected a diverse group representative of the student body, many of whom don’t intend to become physicians or scientists or even plan to major in related fields. SIMILE students take pre-major requisites including writing, rhetoric and breadth requirements focused on the historical, cultural and social contexts of science. They also complete hands-on projects, attend field trips and regularly interact with faculty and guest lecturers in the program. Housed in the all-freshman Burbank House with ITALIC (Immersion in the Arts: Living in Culture), SIMILE students attend lectures and discussion sections in-house and have some shared activities with the new arts-focused residential academic program there.

A recent Stanford Report piece notes:

In the fall, Paula Findlen, [PhD,] a professor of Italian history and director of SIMILE, and Reviel Netz, a professor of classics, team-taught Inventing Science, Technology and Medicine. The class explored how those scientific fields emerged from the human desire to understand nature – empirically, mathematically and philosophically – and to control the environment.

Findlen said the program offered a “big picture view” of how human interactions have changed over the centuries, using history as the lens to understand the invention of science, technology and medicine.

“Fundamentally, SIMILE is a program about the history of knowledge,” she said.

Previously: Exploring global health through historical literatureThoughts on the arts and humanities in shaping a medical career and Intersection of arts and medicine a benefit to both, report finds
Photo by Jeremy Moffett

Parenting, Pregnancy, Technology, Women's Health

First-time moms often seek information online prior to first prenatal visit

First-time moms often seek information online prior to first prenatal visit

pregnant_laptopWhen I was eight weeks pregnant with my first child, I walked into my obstetrician’s office for my initial prenatal visit. I vividly remember being exhausted and sucking on watermelon lollipops for the entire two-hour appointment in an effort to relieve my morning sickness. While in the office, a nurse handed me a thick folder stuffed with various pamphlets and fact sheets on everything from nutrition to genetic testing – but much of the information reviewed wasn’t new to me. I’d already logged plenty of hours online reading about such topics.

So I was interested to read today about findings of a Penn State study showing that many other first-time moms also turn to “Dr. Google,” as well as social media, to find answers during the early weeks of their pregnancy. Women also continued turning to the Internet for information after their doctor visit and found traditional literature lacking. From a release on the study, which appears in the Journal of Medical Internet Research:

Following the women’s first visit to the obstetrician, many of them still turned to the internet—using both search engines and social media—to find answers to their questions, because they felt the literature the doctor’s office gave them was insufficient.

Many of the participants found the pamphlets and flyers that their doctors gave them, as well as the once-popular book What to Expect When You’re Expecting, outdated and preferred receiving information in different formats.

They would rather watch videos and use social media and pregnancy-tracking apps and websites.

“This research is important because we don’t have a very good handle on what tools pregnant women are using and how they engage with technology,” says [Jennifer Kraschnewski, MD]. “We have found that there is a real disconnect between what we’re providing in the office and what the patient wants.”

Noting the prevalence of misinformation online, Kraschnewski added, “We need to find sound resources on the Internet or develop our own sources” [to refer patients to].

Previously: Text message reminders shown effective in boosting flu shot rates among pregnant women and Examining the effectiveness of text4baby service
Photo by Adam Selwood

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