Category Archives: Health

Technology and Measles: A Fatal Combination?

Guest post by Pooja Kapadia

 

Unless you have been living under a rock for the last week, you would have at least heard about the latest healthcare debate: to vaccinate or to not vaccinate a child against measles? What is interesting is that in 2000, the CDC declared that measles were officially eradicated from the US. This was after decades of vaccination promotion programs from the 1960s.  However, this preventable, deadly disease has again resurfaced.  According to the latest count 94 people are infected in the US, in over 8 states. This recent spread serves to remind us of the unintentional consequences of prolonged exposure to technology.

Technology has been touted for years as being the reason for new treatments and improvements in medicine. In fact, it is technology that enabled measles to be eradicated in the US. Before the creation of this vaccine, the CDC estimates that around 4 million Americans suffered from measles each year, leading to 500 deaths per year. With this vaccine, Americans recently lived in a world where the disease was but a distant memory, with most physicians with never having to treat, much less deal with the disease.  Other infectious diseases that also threatened infant and children lives, such as whopping cough and polio have also become less common due to advancements in medical technology.

These medical advances seemed to have jaded us to the fact that early childhood and infancy are dangerous times. We take for granted the importance that vaccinations have in not only improving, but also in saving lives. Melinda Gates gave a beautiful statement on this, stating, “ Women in the developing world know the power of [vaccines]. They will walk 10 kilometers in the heat with their child and line up to get a vaccine, because they have seen death. [Americans have] forgotten what measles deaths look like”.

Americans have become immune to advances in medical technology. Many people now believe that “too much” medical intervention is more dangerous then doing nothing at all. These people forget that not too long ago, many children commonly died from infectious diseases. According to HRSA, “The mortality rate for children aged 1-4 years declined from 1,418.8 deaths per 100,000 population in 1907 to 28.6 in 2007”. People seem to easily ignore the impact that medical interventions (aka vaccines) had in reducing these numbers.

I am not anti-technology. I think technology has obviously created remarkable advancements in medicine. I also think it has unintentionally benefitted health care, by creating an environment where people can readily share ideas and information about health and medicine. People can now join support groups for a number of diseases, get practical advice from patients who have the same condition, and make more empowered decisions about their disease and treatment plan. However, in the last week, it as been made obvious that technology also has unintentional consequences. By creating a world where the reality of infectious diseases and mortality are often a dream, technology has, ironically, given many people a chance to reject it.

Has the Influence of Harry Potter Spread to Medical Education?

As the semester comes to a close, it’s not unusual to see clusters of seniors chatting eagerly about how they’re going to spend their last summer before starting medical school. According to a study done in 2006 by the Mayo clinic, students that enter medical school with mental health profiles similar to their college peers. Although they spend their next few years training and studying on how to improve the health of others, they tend to disregard their own in the process. Reports show decreased attention to getting adequate sleep, meals, recreation and show higher rates of mental distress as student’s progress through medical school.  Sadly, the same study has also shown that depressed students are less likely to reach out for help because of the stigma surrounding mental illness.

With the worrisome consequences of depression in medical students including possible burnout and increased rate of contemplated suicide, it is important to contemplate how a change in culture within the medical school environment can be brought about to tackle some of the stigma surrounding mental illness.

So, what can we do to bring about this change?

Lisolette Dyrbe, M.D., and the lead author of the Mayo study, has encouraged a lot of conversation about the issue.

“It’s certainly important for the student to learn the right coping strategies, time management skills, and stress reduction techniques. All of that is important, but it is not the entire answer. We also have to look at school-level initiatives. There needs to be organizational change.” 

So, how are institutions responding?

Including pass/fail options for courses, reducing volume of course material, and giving students more opportunities to work and teach outside the hospital are just some of the ways that universities are working to lessens the stressful burden on patients. Many programs also provide mandatory resilience and mindfulness courses that teach coping mechanisms and stress management techniques. In addition, other universities have incorporated confidential web sites and hot lines for counseling, hired mental health experts, and have developed elective courses in health and wellness.

But, is this really helping?

Recent studies have examined these changes and have identified an important problem: students aren’t participating. Despite the good intentions of the universities and resources provided to the students, only a few seem to be taking advantage of these opportunities and these, more than likely, aren’t the ones that are in real need of care.

One program, though, has been able to show some success.

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The Student Wellness Program at Vanderbilt medical school, which provides a variety of health and wellness activities, has been seen to improve the health of students by effectively partnering and empowering the medical students themselves into organizing and promoting their own health and interests. The program has allowed the students to be divided into four “colleges,” similar to the Hogwarts houses in Harry Potter, that allow the students to connect and organize activities that provide an outlet outside of the classroom. Dr. Scott Rodgers, the associate dean of medical student affairs describes the aim of the program perfectly and outlines the importance of health and happiness for these students.

“It’s a challenge for anyone to stay healthy and happy. But when doctors are able to stay healthy and happy, that means patients get physicians who are more compassionate and selfless. They end up with doctors who really have the energy to invest time in them.” 

As undergraduate students pursuing careers in medicine, this discussion brings up some interesting conversations. What can we do to better prepare ourselves for medical school going forward? Are there ways that we can contribute to not only helping ourselves and our peers reduce stigma surrounding mental illness but also to improve health within the medical community?

 

sources: https://www.aamc.org/newsroom/reporter/jan2013/325922/stress.html; http://well.blogs.nytimes.com/2011/12/22/a-medical-school-more-like-hogwarts/?_php=true&_type=blogs&_r=0

 

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Final Thoughts about the Medical Media Arts Lab

 

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Last night was our final critique of our semester in Medical Media Arts Lab. It’s been a incredible journey being able to see a simple idea turn into a feasible project in just a few short months!

Here have been my three biggest takeaways:

1. Having a passion is so important. Many times throughout the semester I would feel discouraged or unmotivated, especially in the beginning when we were trying to figure out what exactly was the question we were trying to answer. Were we trying to make an exhibit to educate people about artificial heart technology or to tell the untold story of Dr. Akers’ contribution? After the first critique many of the comments expressed the same. But as Mijin mentioned in our presentation, it was the passion and excitement of the audience members during our first presentation that made us realize we had something bigger on our hands than we expected and helped us go back to the drawing board and see our problem in a different light. It was also encouraging each time we conducted an oral history interview with the individuals involved in the artificial heart project in the 1960’s. They each were so willing to share their story and eager to see it come to life in the present day, and the energy was contagious. Without a passion and an intrinsic motivation to continue, this project wouldn’t be happening.

2. Teamwork is essential. Our prototype and ideas honestly wouldn’t have come this far without the team I was in. Emily is an amazing speaker and hard worker, Mijin has valuable resources and skills with capturing stories from the past, and I contribute with my skills in digital media. This can be applied beyond the scope of our project into the subject of healthcare as well. All semester we’ve been talking about how to improve the communication, through whatever medium, between physician and patient. We’ve been talking about changing the conversation of the physician-patient relationship from the patient being a passive follower to the patient having an active voice and contribution to the dialogue about their healthcare. This can only happen if both the patient and doctor see themselves as a team rather than two opposing sides of a problem.

3. Start with Why. This is technically taken from Simon Sinek’s TED talk, but it’s been a common critique through the design process and practicing our presentations as well. Each time we’ve come up with a cool idea for a display we wanted to include in the exhibit, we were always stopped and asked “Why?” Would implementing this idea bring us closer to our goal, or do we want to add it because it looks cool? I saw the same principle applied in the other projects as well as they gave their final critiques. Many of the other teams designed a mobile app as part of their solution to their problem, but I liked how the ICU team recognized that although using an iPad to display information about rounds would be cool and in line with the digital health literacy trends of today, the current limitations of technology suggest that using a more traditional medium like a giant display screen would suit their problem’s needs a lot better.

I’m so thankful to my team members, our amazing problem-owners Dr. Grande-Allen and Dr. Igo, Dr. Ostherr and the teaching team, and all the individuals who helped us get to where we are today. I’ll be graduating this semester and moving to a different city so my contribution to our Artificial Hearts Project has come to an end, but it’s been an honor to be a part of this amazing process, and I can’t wait to visit when the exhibition opens!

This ER Wait Is Killing Me

Check out the website if you need a doctor’s help in the near future!

https://inquicker.com/

Promoting Patient-Centric Adherence: Emerging mHealth Technologies

Last night we had our final Medical Media Arts Lab presentations—a bittersweet culmination of all of the hard work we as a class have put forth throughout the semester. My group finally had the opportunity to present a detailed plan and accompanying visuals detailing our mobile app solution for improving patient-doctor communication regarding shared treatment plans for Type II diabetics. Professionals in the audience gave us some very valuable feedback and suggestions, which, should the project continue, would greatly improve our existing design and the user experience. Our app focuses on improving patient adherence by creating shared treatment plans that take both the patient and doctor’s needs into consideration. To enhance our design, it was suggested that we add a reward component that provides positive feedback to patients who follow their treatment plans, as well as include an avenue for patients to socialize in an effort to increase motivation and accountability. I assumed that these were components our team would need to develop; however, it turns out that mHealth startups have already started to explore these possibilities, both within the context of diabetes, and for chronic and other health conditions in general.

I came across these emerging businesses on the mHealth News website, outlined in an article entitled “Startups bolster adherence via social networking, mobile apps.” Ayogo and Get Real Health “offer a care coordination platform and mobile application, respectively, that seek to improve on…abysmal adherence statistics.” I was particularly interested in Ayogo, which utilizes a health behavior change and gamification platform called GoodLife to establish meaningful social interactions between patients, patients and their family members, and patients and their doctors around their health condition.

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The platform also utilizes psychological triggers and secondary applications to personalize the user experience. The specific mobile app used by Ayogo is called Empower, which “helps patients who are newly diagnosed with a chronic condition to take control of their treatment.” The app organizes the patient’s treatment plan into a ‘health habit curriculum’ that uses behavior change principles, self-reporting, social interactions, and a rewards system to encourage adherent patient behavior.

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The app tries not only to engage patients in their prescribed treatment plans, but also to actually establish new habits in the patient’s daily life by having them complete small activities or games each day that both facilitate the patient-reward system, but also help the program tailor to the patients’ needs. By actively engaging patients with the app through games, rewards, and social features, Empower, and more broadly Ayogo, helps patients improve adherence to their treatment plans.

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It seems that the only missing component is the facilitation of real-time patient-doctor communication about the treatment plan. This app offers what to me seems like a brilliant, innovative proposal to a problem common across nearly all chronic health conditions; however, our development offers that extra, crucial component addressing the in-person patient-doctor encounter. As we move forward, app developers should remain open to learning and growing from the work of other startups. Mobile health is a rapidly growing field that offers much opportunity for profit and competition. However, let us not lose sight of the key stakeholder—the patient. As the race for the next innovation commences, we need to make sure that all possibilities are considered, collaboration is encouraged, and innovation is allowed to reach its full potential.

http://www.mhealthnews.com/news/startups-bolster-adherence-social-networking-mobile-apps

http://ayogo.com/index.html

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