Health | Medical Futures Lab

Apr 17 2014

Culture, e-patient, Education, Health, Humanities, Humanity, Medicine

Instant Access to Yourself

With our constant obsession with technological advancements and the fashionable desire to be the first owner of the newest products, we must remember what we already have. And this isn’t just a banal platitude about being grateful for what we have. Even though the answers to the world’s problems seem to lie in the continued miniaturization of sensors and further embedded systems, have we forgotten what is already available to us? Perhaps we should shift the focus from finding the most sophisticated devices to becoming more proficient with what already exists.

In the summer of 2013, I took a psychiatry course at the Geffen School of Medicine at UCLA. The course had the rather grandiose title: “Personal Brain Management,” yet that was exactly what the physician taught. It turns out that by having a greater control of what we think and how we think can protect us from a wealth of illnesses. The only technological advancement I needed to supplement my project was a thermometer, yet that was enough.

Photo Credit: stress-relief-tools.com

My independent project focused on utilizing biofeedback for Mindfulness-Based Stress Reduction (MBSR). MBSR advocates that practicing mindfulness meditation can help reduce stress and promote greater mental and physical health. By using a simple stress thermometer, I was able to increase my awareness of my body temperature. While such a physiological marker may seem to be beyond our control, managing our internal thermostat is surprisingly possible. Roughly speaking, more relaxed states are correlated with increased body temperature, and the thermometer served as a means to quantify these changes.

With just a crude thermometer in hand, I was able to cultivate my relaxation response (in contrast to the familiar stress response). At the end of a six-week trial, I found that I was better able to control my body temperature, and I scored significantly lower on a battery of stress measures. For my project, I did not need a smartphone or the newest Nike product or the most sensitive sensors. I needed myself and 30 minutes of my day. And am I really so important that I cannot sacrifice the entirety of 30 minutes to myself?

Photo Credit: clintonpower.com.au

In our constant and desperate search for what is new, let’s not forget that we have instant access to ourselves. While innovative electronic devices can help us organize data and take measurements, let’s not get carried away with their seemingly whimsical promises. It is as much our duty to discover and invent as it is to make more effective use of what already exists. By remembering that the first generation of iPhones was released in 2007, we become aware of the humbling reality that perhaps society can function without a supercomputer in hand.

While simple and sophisticated mobile health applications can encourage patients to become more empowered, decreased reliance on digital technology is in its own right just as empowering. My project at UCLA showed me that I could become more self-sufficient and cultivate my body’s natural capacity to heal with a minimalist approach to technology use.

Apr 15 2014

Health, Humanity, Medicine

Taking Heart Transplants to the Next Level…But Should We?

This is so crazy how relevant this is to our project, but I saw this news story shared on my Facebook newsfeed: Link here because I can’t embed the video for some reason.

While we’re working on telling the story of artificial hearts in the Texas Medical Center, at the same time researchers in the Texas Heart Institute right here in Houston are taking heart transplants to the next level. Bypassing even a total artificial heart transplant, they are now using stem cells to manipulate pigs’ hearts into hearts that can work in humans. In the video, you can see so far they have successfully been able to transforms the cells the pig’s heart into a mold of a human heart and the next step is to insert cells inside the heart so that it will properly perform the pumping functions. It was crazy how the reporter was able to hold this modified heart (still white from being grown by stem cells) and squeeze it like it was a toy.

However, the meat of the piece started when the reporter started questioning Dr. Doris Taylor, the head researcher, on the ethical implications of conducting this stem cell research. I was surprised at how quickly Dr. Taylor defended her work, probably because this was a commonly asked and attacked question. Instead of thinking about the lives that may be lost by using stem cells, she reasoned that because she had the ability and the tools able to save lives, even if those tools were stem cells, it would be “morally wrong not to go forward using those tools”.

I noticed in this video how they utilized emotional (ethos) and moral (pathos) appeal to convince the viewer to support the stem cell research. The beginning of the news piece features a young woman who, suffering from a terminal heart disease, waited and eventually received a traditional heart transplant from a dying man. I was kind of confused at first because I thought the news piece was going to be more of this young woman’s story but instead turned into a news story about stem cell research. However, they brought her back at the end of the piece and asked her if she would support someone getting a heart made out of stem cells, and with tears in her eyes, the patient talked about how lucky she was to get a heart and how if it was possible in any way for others in need to get the same she was all for it. Now, I do have my own opinions about whether it’s morally right to conduct stem cell research and I won’t be sharing it here, but to me it was an obvious storytelling tactic to get viewers to sympathize and support stem cell research.

The concept of ethical conduct in research and treatment has been an ongoing issue for the physician. Dr. Akers faced similar concerns and backlash when he performed testing of artificial hearts on animals and in society today the hot topic is the consequences of using stem cells. I am not a medical student, but I have heard that when a student first enters medical school they must recite the Hippocratic Oath that states they will vow to take care of the patient as best they can and do no harm to them. But for the physician (and the government), is the best way possible a solution that involves stem cells and should stem cell research be considered unfairly taking a life from another to save someone else? Or is it indeed is morally wrong not to use whatever means possible to save a person’s life?

Apr 10 2014

Culture, Health, Medicine, Technology

A Vital Change

Google recently announced a project in which they plan to develop contact lenses that measure a person’s blood glucose level. The project is very much in the early stages of development but it indicates the potential for furthering involvement of technology in healthcare. It is imperative that the healthcare industry supports technological innovations such as this that will improve patient care. Technology must be viewed in the same way as medication in how beneficial it can be to global health.

Google describes the project as a potential game changer for diabetes treatment. The function of the contact lens is to measure glucose levels in tears, thereby making it easier for diabetes patients to determine their blood glucose level. At the moment, a patient must draw his or her blood which can be a difficult and painful process. What ends up happening is that patients fail to regularly check their blood as often as they should and develop further complications as a result. How the data from the lens is made known to the patient is not currently established. Some have suggested a series of blinking lights in the lens that notify the wearer when it is time to take insulin. Another approach is to somehow transmit the data to the user’s smartphone where it is displayed in an application and stored on a secure Google server. In the latter solution it would also be possible to send this stored information to the patient’s physician, providing them with updates on the patient’s progress and insulin usage. A cutting-edge solution to treat diabetes more effectively is vital considering it is one of the fastest growing diseases in the world.

In this modern age of technology and rapid development of new and exciting products that better quality of life the healthcare industry must be more open and supportive of innovation in patient care. Not to say that it is currently averse to the prospect but there exists a lot of red tape and inefficiencies that slow progress. The industry must be willing to adapt as quickly as the rest of the economy in order to realize vital improvements that will help patients today. The laggard mentality and outdated ideals prevalent in the healthcare system must adapt to the current culture of innovation and ubiquitous use of high-tech devices. This will ensure projects such as the Google contact lenses become tangible products.

Apr 06 2014

Communication, e-patient, Health, Technology

Mindful mHealth

In the past several years, there has been increased discussion about bringing medicine into the technological era, and out of the darkness of paper methods and inefficiency. Words and phrases like “media,” “digital,” and “mobile technologies”are becoming more and more linked to healthcare. Because we do live in the age of technology, a time when nearly every person in America owns a cell phone (91%) and uses the internet, such a movement seems not only favorable, but necessary. As we push medicine into the digital age, we applaud new, innovative uses of advanced technology for testing, treating, and tracking—for features that allow the new age of “ePatients” to take control of their health.

One of the most “fashionable” new technologies is the mobile app. Apps allow patients to use their mobile phones to track their diet, exercise, blood pressure, etc. With so many emerging uses, smartphones provide a promising avenue to increased ePatient activity. As a result, when people think of patient-centered health media, the first thing that comes to mind is generally mobile apps—or is it?

When I say “people,” this is a very biased demographic. I am a Rice University student in a Medical Media Arts class. While my peers come from very diverse backgrounds, our current lifestyle places us in a specific demographic—that of educated young people who are exposed to mobile technology, specifically smartphones, on a daily basis. Those developing mobile health technologies generally come from similar backgrounds, in that they are most likely very familiar with smartphone usage, and quite possibly own smartphones themselves. For a significant portion of the population, this is not the case.

According to Pew Research, only 58% of Americans own a smartphone. While this is more than half of the population, this still means that roughly 131.8 million Americans (42%) do not own a smartphone or have access to mobile applications.

One of the many advantages of mobile technology is its ubiquitous nature and its potential to bridge health disparities by reaching large, diverse populations. However, if all of our focus is placed in a sector of mHealth that such a significant portion of people do not have access to, we are only compounding health disparities with a technological one.

While I believe that mobile applications are a very promising avenue of healthcare, I think that other mobile phone capabilities should continue to be utilized. For example, while only 50% of cell phone owners download mobile apps, 81% send and receive text messages. Text messaging is a simple, low-cost technology, which can be utilized with or without a smartphone, and has consistently been in greater use than mobile apps.

While text message-use is beginning to level-out, mobile app usage is still increasing. However, until the transferral to mobile apps is complete, the “non-app” population should not be ignored. Text message-based mHealth campaigns have already been developed, such as Txt4health, SmokefreeTXT, and text4baby. All of these services promote positive health behaviors by sending text message reminders to patients in the program. We should use these programs as models while we consider avenues that promote patient-centered healthcare and patient engagement, and be mindful of who we are trying to reach and how to best reach them. While mobile applications are a promising platform, which should definitely be utilized, we also have to ensure that we make mobile technologies the solution and not the problem in addressing health disparities.

Mar 22 2014

1 Comment

Communication, e-patient, Electronic Medical Record, Health

Medical Data Fingerprints

Cancer and cancer treatment leaves a trail of digital data. I’ve been thinking about this digital trail today, and the different forms it took for me during my diagnosis and chemotherapy.

MyMDAnderson

Patient Report on myMDAnderson

This is my personal MD Anderson portal. Though I never bothered to check on my documents very often, they are are available online, like pictures in a scrapbook. Looking back on them now, I’m intrigued by sheer the volume of the data MD Anderson collects on me. There are patient reports for every meeting and consultation, notes on every interaction.

During my first echocardiogram, the technician applied gel on my chest and asked an innocent question: “so, you’re an Ecology and Evolutionary Biology major?” I was instantly taken aback. I had never seen the man in my life or mentioned my major. But everything I told my oncologist had been stored for future reference, even the information I considered mundane. I often think about this interaction when we talk about how doctor-patient interactions should improve. The question about my major was unsettling to me rather than indicative of warmth and caring. It implied a greater, almost sinister, system of knowledge that I had not considered before then. Though the question was intended to be intimate, it “revealed the trick” and made the interaction seem alien and forced.

Texts

Cellphone picture taken while prepping for a CT scan.

I sent many messages, both in text and photograph form, in the earlier stages of diagnosis. They weren’t really to alert my friends and family to my progress, and they weren’t really to stave off anticipation and fear with regards to treatment, at least not consciously. I just had an obsessive desire to share the new events and experiences that were occasionally humorous, as in the case of the apple-flavored barium swallow, or the nurse who assured me that the radioactive glucose used during PET scans was “just a bit of sugar water, like they give to hummingbirds.” It turned out that image texts were the most immediate and easy way for me to convey information, and what I usually used. The trail of texts did die off towards the end of my treatment, however. I was tired. I felt I had less to say. This is in line with what I’ve heard from many current and former patients: when you’re feeling sick, you don’t want to interact with technology and others.

Google Searches

This one is less obvious, but still there and very important. I was constantly researching my diagnosis, symptoms, side effects of chemo and biotherapy. These will influence my future search results in ways I may not necessarily anticipate now.

Many communication problems in medicine require tailoring the solution to the individual patients. Some may want warm and caring doctors, others want their physicians clinical and direct. Some may engage eagerly with apps, while others have trouble mustering the motivation to get out of bed. These sorts of digital trails provide several unique perspectives: the medical and physiological angle, the relationship angle, the personal and introspective angle. How can we harness and combine these perspectives to create better solutions? And how can we respect privacy and patient concerns while we do so?

Medical Futures Lab

Category Archives: Health

Instant Access to Yourself

Taking Heart Transplants to the Next Level…But Should We?

A Vital Change

Mindful mHealth

Medical Data Fingerprints

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