Usually, detecting cancer is done through a combination of physical exams, imaging tests, blood tests, and biopsies. A biopsy, where a tissue sample is taken and examined under a microscope. This process is time-consuming and often relies on parts of the health system working together quickly, which does not always happen. Some cancers, like brain, pancreatic, and ovarian cancers, are difficult to detect, which can slow diagnosis even further.

By contrast, liquid biopsies can detect cancer more quickly. This type of testing looks at bodily fluids (typically blood) for evidence of cancer cells by finding biomarkers that are shed by cancer cells into the bloodstream. Liquid biopsy technology is advancing fast and with new technologies emerging, such as using light to detect these signals. This is a similar approach to that used when small swabs are passed over luggage and analysed at airport security.

By combining this spectral analysis with artificial intelligence (AI), it is possible to speed up cancer detection at a significantly lower cost. At the forefront of this revolution in cancer detection is Dr. Holly J. Butler. Dr Butler is the co-founder and CTO of Dxcover, the company behind the award-winning multiomic spectral analysis platform. Grounded in biophotonics and driven by an unwavering dedication to improving patient outcomes, Dr Butler is striving to bring about a new era of non-invasive diagnostics; one where a couple of drops of blood and a beam of light might one day save millions of lives.

Dr Butler, alongside an award-winning leadership and research team, has been developing methods to analyse blood samples using infrared spectroscopy. What they discovered was a way of ‘reading’ the biochemical fingerprint of disease in a standard blood test. This research became the foundation of an award-winning proprietary platform that leverages a unique combination of AI and spectral analysis to detect patterns in small blood amounts, allowing clinicians to find cancer earlier, more accurately, and far more affordably than many existing techniques.

The potential is enormous. Unlike conventional liquid biopsies, which rely on picking up fragments of tumour DNA, this platform is more wide-ranging in its approach. It uses a multiomic strategy – looking at proteins, lipids, metabolites, and more – through a process known multiomic spectral analysis. It translates to even tiny tumours, sized at just 0.2 cm, being capable of leaving a detectable trace. And it’s all done with just nine microlitres of blood.

Dr Butler’s drive to transform scientific ideas into reality started early. After her Ph.D., she took on a Scottish Enterprise-funded project to translate laboratory-based research into clinical diagnostics. Her entrepreneurial endeavours were making waves as early as 2017 – she was ‘Young Entrepreneur of the Year’ at the Scottish Women’s Awards and received the Women in Innovation award at the Global Game Changers Awards. She has continued to be a vocal advocate for women in STEM and an active mentor to early-career scientists and entrepreneurs via the Strathclyde Inspire network in the intervening period.

“I’ve always been drawn to problems where science can make a real, tangible difference in people’s lives,” she says. “To me, early detection for the most difficult to detect cancers is one of the biggest, most urgent problems we face – and one we hope to solve.”

Dr. Butler’s role in bringing this innovation along is as much practical as it is strategic. She is part of a team that spans lab operations, data, software, quality and regulatory affairs, pushing the science to clear the bars for real-world medical use. “You can’t just invent a technology,” she says. “You need to prove that it works, scale it with safety, meet stringent quality specifications, and prove how it fits into clinical pathways. That is the challenge.”

For Dr Butler, it is about the impact on lives. “Cancer still kills nearly 10 million people a year,” she says. “The difference between early or late detection can be life and death. We want to make early detection routine – not something that’s just for some individuals or comes too late.”

Now pursuing an Executive MBA, Dr. Butler is expanding her leadership credentials. “Science gave me the means to innovate,” she says. “But the MBA is teaching me to lead, to strategise, to build something that can last.”

That ecosystem, she hopes, will be one where innovation and inclusion go hand-in-hand. She’s particularly passionate about ensuring that diagnostic breakthroughs become accessible across communities. “We’re aiming for a future where your GP can run a test like this early—long before you’re even referred to a specialist,” she explains.

Dr. Butler’s work remains patient-centred and personal. “Every time we detect a cancer that would have been missed – that’s the goal,” she says. “And every time we improve the technology is a step closer to a world where fewer people have to hear the words, ‘if only we’d caught it sooner.'”

The post Shining a Light on Early Cancer Detection appeared first on Medika Life.

Results from the AQUA clinical trial found that using the QbTest alongside a standard clinical assessment for ADHD resulted in faster diagnostic decisions being made for a more significant proportion of people within six months of their first assessment appointment when QbTest results were available, compared with when they were not. It also resulted in clinicians being able to rule out ADHD in more cases.

“The evidence we have to date, further cemented by the recent NICE recommendation to the NHS, highlights the importance of objective ADHD testing in improving overall ADHD care,” shared Dr. Angela LaRosa, a Charleston-based developmental and behavioral pediatrician. “As a specialist in developmental and behavioral pediatrics, incorporating objective ADHD assessments in my practice has been crucial for increasing access to care, and we now have better data for making informed care decisions, including treatment optimization and monitoring.”

QbTest is an FDA-cleared, market-leading computer-based test with motion tracking that measures core ADHD symptoms—inattention, impulsivity, and hyperactivity. The results are analyzed and presented in an easy-to-read visual report comparing them to a normative control group of the same age and sex at birth who do not have ADHD.

“ADHD diagnosis rates are rising globally, with the CDC reporting a 16% increase from 2016 to 2022,” said Mikkel Hansen, Chief Medical Officer at Qbtech. “The increase in demand has put a severe strain on healthcare systems, leading to significant delays in diagnosis that are having far-reaching effects on children and their families. Our objective tests add necessary safeguards to the diagnostic process and enable clinicians to complete a comprehensive assessment effectively and efficiently. We’re honored to be recognized by NICE and excited to further our work with the NHS to improve access to ADHD care in the UK and with similar organizations worldwide.”

Qbtech’s objective ADHD testing technology is used by more than 12,000 clinicians across 44 states in the U.S. and at the national level by organizations such as the NHS in England in over 120 sites. The company has been documented in more than 40 independent studies, showing benefits across the patient care pathway, including improved access to care, elevated clinician confidence, better identification of treatment effects than self-rating, and standardization of care across multiple disciplines.

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About Qbtech

Founded in 2002, Qbtech is a privately-owned Swedish company that has developed leading solutions and products for improving the identification, diagnosis, treatment, and follow-up of patients living with ADHD. Qbtech has operations in 14 countries and has offices in Stockholm, Houston, and London. Qbtech is an award-winning company recognized for its innovation, most recently winning the 2022 HSJ Partnership Award for the ‘Best Mental Health Partnership with the NHS.’ For more information about Qbtech, visit www.qbtech.com.

The post National Institute for Clinical Excellence Recommends QbTest to Aid Diagnosis of ADHD in Youth appeared first on Medika Life.

In this context, I am pleased to report that we have one more colorectal cancer screening tool.

The U.S. Food and Drug Administration has approved Guardant Health’s blood test for detecting colorectal cancer.

Current Colorectal Screening Change

Colorectal cancer screening typically involves stool-based tests or optical/visualization tests, each aiming to detect the disease before symptoms arise.

Recognizing an increasing risk in younger adults, the U.S. Preventive Services Task Force updated its guidelines in 2021, lowering the recommended screening start age from 50 to 45.

This decision stemmed from mounting evidence revealing a concerning rise in colorectal cancer cases among adults under 50.

Statistical modeling further supported this change, indicating that initiating screening at 45 could potentially extend lifespans compared to the previous starting age of 50.

Colorectal Screening Summary

Here are the recommendations in graphic form:

Colorectal cancer screening encompasses various methods, broadly categorized into stool-based tests (like fecal occult blood test (FOBT), fecal immunochemical test (FIT), and FIT-DNA) and optical/visualization tests (such as sigmoidoscopy, colonoscopy, and virtual colonoscopy).

These diverse screening tools play a crucial role in detecting colorectal cancer before the onset of symptoms, significantly improving survival rates through early diagnosis and timely treatment.

Here’s a link to the many ways you can screen:

Colorectal Cancer: Screening

www.uspreventiveservicestaskforce.org

Colorectal Cancer Screening Blood Test: FDA Approval

Previously limited as a test with a self-pay price of $895, Shield’s U.S. Food and Drug Administration approval marks a significant milestone.

This pivotal decision paves the way for potential Medicare coverage, making this groundbreaking blood test for colorectal cancer screening accessible to a wider population, particularly older adults.

Blood Test Accuracy

While Guardant Health’s Shield blood test, which detects tumor DNA in the bloodstream, has shown promise with an 83 percent effectiveness in identifying colorectal cancers, it primarily excels in detecting later-stage cancers.

The test’s lower sensitivity for early-stage polyps (13 percent) necessitates regular screenings at least every three years, starting at age 45.

It’s important to note that a positive result does not equate to a diagnosis requiring further confirmation through a colonoscopy.

This test marks the second approved blood one for colon cancer screening, following Epigenomics’ Epi proColon, which faces challenges regarding its accuracy and insurance coverage.

My Take

This landmark decision opens the door for potential Medicare coverage in the United States, making colorectal cancer screening more accessible and affordable for older adults.

Do I think this blood test will replace colonoscopies?

No, but hopefully, it will boost the suboptimal screening rates in the United States.

Colonoscopy Is The Gold Standard

Beyond detecting tumors, colonoscopies play a preventive role by removing precancerous polyps.

However, the inconvenience of scheduling and preparation deters some individuals.

Guardant Health’s Shield blood test offers a simpler alternative with a straightforward blood draw.

The New Blood Test Available Soon

The company aims to make this screening option available soon. Hopefully, we will see increasing adherence to recommended colorectal cancer screening guidelines for healthy adults aged 45 to 75.

Shield is not the first blood for colorectal cancer screening. Epigenomics’ Epi proColon was approved in 2016.

However, the proColon test is not often used. Its accuracy is suboptimal, and there is a lack of insurance coverage in the U.S.

Summary

In conclusion, Guardant Health’s recent approval of its blood test for detecting colorectal cancer marks a significant milestone in improving accessibility to screening options for older adults.

While this blood test offers a simpler alternative to colonoscopies, I should note that colonoscopies remain the gold standard for detecting tumors and preventing the development of precancerous polyps.

It’s important for you to consider discussing colorectal cancer screening options with your healthcare providers to make informed decisions regarding your health.

The evolving landscape of colorectal cancer screening provides hope for increased adherence to recommended guidelines, ultimately contributing to improved early detection and patient outcomes.

As an oncologist, I would love to see fewer patients.

Please don’t get me wrong: I am not directly advocating for this particular new blood test; rather, I am pleased with any reasonable maneuver that nudges folks who don’t get recommended colorectal cancer screening.

What has been your colorectal cancer screening experience?

The post The Future of Cancer Screening Is Here: A Simple Blood Test You Can Take at Your Doctor’s Office appeared first on Medika Life.

Amid her surprising news, she discovered the Vancouver, Washington-based Pink Lemonade Project, a source of peer support and empowerment for breast cancer patients. Through their guidance, she rediscovered the strength within and built a new community of friendships.

This is the story of how Lisa Heathman turned medical lemons into “pink lemonade” and how she continues to navigate the maze of breast cancer decisions, drawing on the support of the patient advocacy community created by the Pink Lemonade Project. Her guiding mantra: “Get busy living or get busy dying.”

Gil Bashe:

I‘m going to jump in, and we’re going to explore your story because it is unique to you, and unfortunately, it’s not unique to women. It’s become a medical self-health tradition for women to have an annual mammogram, and I imagine that’s something you’ve been practicing for some time.

Lisa Heathman:

I always made a point of getting my mammogram. I got them regularly, and the diagnostic center always used to send me that letter afterward saying I have dense breast tissue, so the scan techniques were not nearly as accurate. A routine mammogram looks dark, and then if there’s anything alarming, it looks white. On a woman with dense tissue, everything looks white. It’s hard to find an anomaly in it because of the white-on-white. That is core to the problem. Because even though I was getting those mammograms regularly, they didn’t see the problem.

Bashe: 

You know, for women who have dense breast tissue, and it’s not a small number. It affects cardiovascular scans and mammograms – leading to the danger of false negatives.  I hear about this too often. 

Heathman: 

It’s pretty darn common.

Bashe: 

It’s the equivalent of going through the motions but not having a mammogram; It’s a public health risk worthy of greater awareness and physician-patient conversation.

Heathman:

Exactly. According to my doctor, I’m doing what I needed to happen from a self-care standpoint; there wasn’t a family history. My grandmother did have breast cancer, but my grandmother is just one-quarter of my genes. My physician didn’t regard me as particularly high risk. So when I kept getting those notifications that the screening tool wasn’t wholly accurate (and we talked about this for two years in a row), he told me not to worry.  Accessing advanced screening is challenging; the insurance companies wouldn’t cover it. That meant I had to get the screening and pay out of pocket. On top of that, I would have had to do that every year. We’re talking about thousands of dollars out of pocket.  

Bashe:

Insurance is a little bit like the law of averages. They think, “We’re not going to cover this because the chances of her having breast cancer are pretty slim, and if we cover it for her, we’ll set a precedent, and we’ll have to cover it for everyone. Let’s pretend we’re going through the motion of doing breast cancer screening.” 

Then boom, something happens.  There is something suspicious when you call up. I imagine your doctor said, “Well, come on in, and we’ll talk about it.”

Heathman:

Something you said reminded me of something I think is essential to share. And then, I’ll get to how I found my cancer. The other thing that’s recommended is that women do self-exams.

First of all, I breastfed both my kids, and I always had trouble in my left breast with clogged milk ducts and all kinds of lumpiness, nothing hard, nothing like they always used to say. If you’re feeling anything that feels like a pea or a pebble, that’s alarming. You need to be checked out. But if everything feels like it always has, you’re probably fine.

It always felt normal. My left breast was lumpy because it had been lumpy ever since I breastfed my kids. Nothing felt odd, and I never did have that hard stone or pea-shaped shot that they always say it feels like.

Bashe: How did this surprising discovery unfold?  How was this discovered?

Heathman:

How I found my breast cancer was a stroke of luck, which doesn’t sound like a stroke of luck when I tell you this story. My partner Tom and I went mountain biking. We were on a camping trip up near McCall, Idaho, mountain biking almost every day. One day, we decided to take the mountain bikes up to this lake – there was supposed to be great fishing up there. It’s five miles on the single track. There was one place near the lake where you had to cross a creek on a little bridge, and I fell off the bridge into the water! Fortunately, it was September, so the water level was relatively low, but the bike fell on top of me and pushed me into a tree trunk. I dislocated my shoulder.

When I got back to Portland, I told my doctor what had happened, and we decided that I should do a course of physical therapy because it was still painful. The physical therapist and I worked on this for about a month. Instead of getting better, the symptoms got worse. My physical therapist said I should get an MRI.

I had to see the doctor for an MRI, and he said: “It’s been a year since I’ve seen you, so you might as well just come in.”

That was the luckiest thing ever because when I went in 10 days later, he did the usual check of the lymph nodes. He was doing the examination and said, “How long have you had this lump under your left arm?” I said I didn’t know I had a lump under my left arm. I can hardly reach it right now because my right shoulder was so screwed up from the accident. He said, “I feel a lump under your left arm, and we need to get you in for an ultrasound.” That was the beginning of the odyssey of finding out I had breast cancer; it was just a stroke of luck.

Bashe:  I don’t know if it’s a stroke of luck, but it’s like, “How I dislocated my shoulder and saved my life.”  From the moment your doctor said, “What’s this lump underneath there?” What went through your mind?

Heathman: 

Honestly, I was not terribly concerned, and I’ll tell you why. I’ve always been very active and very healthy, and nothing traumatic or awful health-wise has ever happened to me. I first talked to my physician sister, and she said, “Well, it could be many different things. Let’s not get too worried.”

So I wasn’t upset. I was like, I’m sure it’s nothing, I’m sure it’s nothing, but it wasn’t nothing. I went in for the ultrasound. I was lying on the table, and it was quiet. I remember thinking I was tired. I could almost take a nap. She went away after she was done and was gone for a long time. I thought, well, that’s odd. Then the doctor came in, sat down, and asked me all these questions. “Have you been feeling okay? Are you losing any weight?” All of a sudden, I began to perspire profusely. Suddenly, I thought nervously, “Oh goodness, oh gosh. What is happening here?” My stomach was immediately nervous. “Uh oh. This is not nothing.”

All of a sudden, I was very, very afraid. I had never had cause from a health standpoint to be so scared. I was terrified, like we were not talking about a nothing thing here at all. He sent me then for a biopsy, I believe.

Bashe:

Did he say at any point you might be looking at cancer?

Heathman:

He did. That was the root of all those questions: are you feeling okay? Have you been losing any weight? I feel fine. And no, I have not lost weight. But I was just terrified. Suddenly, it was like it was real. I went in for the biopsy next, and it came back positive for cancer. I then had an MRI, where they could first visualize it. That was the first time anyone had seen that there was a tumor in my breast. It appeared pretty good-sized and had probably been growing there long.

Bashe:

The challenge with the diagnostic system, particularly the mammogram, is that we get into a “check the box” mindset, as opposed to the need for your doctor, other doctors, to say that if someone has dense breasts, we have to reject the mammogram approach, have a diagnostic procedure, and ensure coverage. At least reimburse women for the scan every other year.

Heathman:

You could alternate. Over the years, I’ve often thought, you know, it would have been great if every other year I had a mammogram one year and an ultrasound another year, and they could have alternated. Ultrasounds are not expensive; they’re standard.

Bashe:

A part of it is that the payor contracts with the radiology center to have mammograms done at a base price. Let’s say the insurance company will tell you to go to one of three radiology labs in your area. They’ve created a volume discount price. That discount takes precedence over your specific physiological or biological needs. That’s the challenge we face in the payor system: health for everyone, but not necessarily health for you.

Heathman:

Health for the average baseline. I learned from the Pink Lemonade Project that in the Northwest, one in seven women will be diagnosed with breast cancer at some time in their lives. Nationally, it’s one in eight. That’s many women.

Bashe:

How did you get involved with the Pink Lemonade Project?

Heathman:

That’s an interesting story. When I was first diagnosed, one thing that seemed right was to join a support group, so I did.

It was through my hospital, and I hadn’t even lost my hair yet. I was super early in the process. I think I lost my hair after my second or third chemotherapy round, but I was in the support group even before that –  just diagnosed. I remember my first support group meeting, which was not a Pink Lemonade support group meeting. It was just through the hospital.  It wasn’t completely satisfying, but of the eight women, one woman, Susan (Susan Stearns), well, we hit it off and became friends.

Susan got the job of CEO of the Pink Lemonade Project. I was introduced to Pink Lemonade through her and her fortune in working with this amazing organization, which drove the conversation and possibility.

Bashe:

The personal connection was very important here.

Heathman:

There’s a silver lining in this cloud, and that silver lining was Susan and the Pink Lemonade Project. They’re based in Vancouver, Washington. I live across the river in Portland, Oregon, and Susan Komen is a well-known breast cancer charity in Portland. What a lot of people don’t realize is that Susan Komen is no longer providing local support. They are only a national nonprofit now. The local programming in almost every community had to be pulled.

It is up to local organizations like the Pink Lemonade Project to pick up the slack and provide those programs locally that Susan Komen could no longer fulfill. Organizations like the Pink Lemonade Project must create opportunities and support for women seeking local support.

Bashe:

You had some difficult decisions to make then. You’re diagnosed with breast cancer. It sounds like chemo and radiation were part of the decision-making process, maybe more. Tell me a little bit – not about the medical stuff; I understand that, but the sense of how you felt at that moment and what role the Pink Lemonade Project played in getting your perspective. It sounds like you’re very self-aware and in touch with other people, but you’re now in what I’ll call an “extreme situation.”

You enjoy bicycle riding, fishing, hiking, skiing, and the great outdoors. Your sister is also an official hand-holder. You have a medical guide at your beck and call. Tell me what role the Pink Lemonade Project played in your life and what role you played in their life.

Heathman:

From the standpoint of an organization like the Pink Lemonade Project, I was very fortunate that I didn’t need to take advantage of some of the programs that Pink Lemonade delivers to women or people with breast cancer — because men get breast cancer, too, as you know.

Pink Lemonade provides practical support, transportation to appointments, treatment options, care for lymphedema and swelling after the lymph nodes have been removed, support groups, and valuable information, such as whether a woman needs a wig because she’s lost all her hair. I took advantage of some of the things that the Pink Lemonade Project provides.

I do have a good employer, a car, and good insurance. I had all those things covered. I have a really good support system. You could argue there wasn’t much I needed. What I found that I took advantage of was the support groups. They have a metastatic breast cancer support group. It’s geared mainly toward women who have a stage 4 cancer diagnosis, such as me. They are women who are in many ways in the same boat that I am in, and their questions are the same questions that I have, and the kinds of experiences they have are the same kinds of experiences I have.

Many women are older, have retired, and are no longer working. But not all of them – many of them are young women who are raising families. Many of them are younger women who are still working, trying to have a career while they’re going through treatment. That was important to me because I am still working, and I continue to work through treatment, but it hasn’t always been easy.

Having other women to bounce ideas off and get good advice was unbelievably important. The other important thing about being involved with an organization like the Pink Lemonade Project is that you are surrounded by women and people who hear what’s on the cutting edge of treatment. When you have a stage four diagnosis, your doctors, you, as the patient, and your family must understand that the breast cancer community, the medical community, is constantly coming to the table with new treatment ideas and new treatment options.

In time, treatments may stop working for a person, and they may need to go to whatever the next treatment is. And that’s incredibly important for someone with a stage four diagnosis because the treatment that I’m on may not always work. So that’s important, too.

Bashe:

As we spoke, I remember the first time you had a very reflective way of looking at this. You know you have a philosophical strength about life and being present. I also sensed you were quizzical about the future. There’s an authentic presentation when you speak. I’m curious if that mindset is present in your conversations with other members of the Pink Lemonade community and if the conversation is equally sharp.

Heathman:

That’s why there’s such a striking difference between the people I’m now talking to within support groups and that first experience, which was very negative and unsupportive.

The women in the support groups are very practical. It’s odd, but you rarely encounter a person in these support groups saying “Woe is me” or wringing their hands. By and large, they have been the most positive, gracious, giving, extraordinary women, people, but mainly women, and that’s what I needed in a support group. I needed to be surrounded by other people going through the same situation but meeting it with this: “We’re going to get through this.”

One of my favorite movies is The Shawshank Redemption, and Tim Robbins, one of the main characters, says a line that goes something like, “Get busy living or get busy dying.” I think about that all the time – here I am, and this is what I’ve got to get through today or this week, or this surgery or that treatment; I’m going to get busy living because it’s the only choice I have.

I’ve been surrounded by people making that same choice, which I needed in a support group. There’s no Pollyanna; not many women say this is not a big deal. It’s a huge deal. But they’re practical about it; maybe we’re all good at compartmentalizing it. This is a bucket that’s over here. This is another bucket that’s today. This is another bucket that’s tomorrow. I am still determining what the future will bring, but worrying about it doesn’t change it.

Bashe:

The sharpened sense of mortality creates a vibrancy about life. You might not have taken special vacations beforehand, saying, “Oh, I don’t know if I want to spend the money right now.” Now you say, “I think we will take that vacation. I want to go there and see that. I want to do that with you.” Does that play out from time to time? I don’t know about 20 years from now, but I do know right now.

Heathman:

It’s an excellent question. My version of vacation is being able to get outdoors and do the things I love, whether skiing, biking, hiking, or fishing. You’re right—I find it easier to say yes to those things because I don’t tend to talk myself out of them like, “Oh, you shouldn’t” or “It’s too expensive.” Life is short.

Those kinds of things are things that I need to experience, things that I need to do. This sharpened sense of mortality goes beyond just thinking about time away or vacations. It just factors into my overall decision-making. Are we going to build that addition on the house? My car was eight years old. Am I thinking maybe it’s time to get a new car? And it’d be easy to say I might not need that new car. Does that make sense? But if I decide that I don’t need that new car, I’ll not be getting busy living.

Bashe:

That line you shared about the Shawshank Redemption is true – “Start living.” You can think about the clock stopping, running out of line, the click, click, click. The clock is still working, and I don’t want to break down on the side of the highway. Why not enjoy the new car now?

Heathman:

Exactly. Why not do it now? Because you may not have forever. And to your point, Gil, we all imagine ourselves immortal until we have a significant health crisis. It’s too terrifying to think of the alternative, and most of us don’t until we have to. But in no way has it consumed me. I’m not going to say I never think about it. I think about it. I’ve even explored some things that are specific to that. But it isn’t as though I’m consumed by it. I don’t live my life like that.

Bashe:

“I’m here, and I need just to enjoy the fact that I know I could be elsewhere, so to speak, but I have a certain sense of strength and understanding that lean into the here and now.”

Heathman:

Some days are hard. There are things about being in treatment that are hard, and sometimes challenging things happen that are work-related or what have you. Then, I’ll join a support group, and I’ll be able to talk about what is happening. Someone will have had a similar experience, and someone else will have a funny thing to say about it.

Before long, I found that I was happy I was here and that they were here. There have been times when someone was not there. In particular, one woman is no longer a part of our support group because her cancer came back, and it came back with a fury, and she died. I still miss her. She was such an incredibly kind, caring, altruistic person. In support groups, you meet people who may show you something you didn’t see, something that feels like someone making your day better.

Bashe:

Well, they say you’re exceptional, and those that do are beyond spot on. The reality is that you’re in the midst of an adventure in which the ending has not been written, and you are very present about where you are and what you’re feeling, but you’re very much in harmony with other people. The support group, I think, the Pink Lemonade Project community, has brought out something that was always within you: the understanding that we need each other.

Heathman:

Absolutely. If there is a silver lining in all of this—and some days, it’s hard to find one—I have a much different understanding of others and what others want and need. It’s changed me. There’s no getting around the fact that cancer has changed me, and I think that cancer has changed me for the good as well.

I cannot say enough about my experience. Again, it is not always pleasant, and it’s not fun, but I feel so supported. I think back to that woman that night who I met who had nothing good to say about her employer, and I think, Oh, honey, I wish you’d had a very different experience, like I’ve had, of what real support feels like because I think she was bitter.

Bashe:

You know, it’s a two-way street. You’re an incredibly inspiring, uplifting person who understands and speaks about the importance of patient support groups like the Pink Lemonade Project.

Your experience is distinctly unique. You are an incredibly inspiring person, and the fact that you welcomed this special community into your life speaks volumes about your ability to recognize this level of life challenge is difficult enough – but going it alone adds another complexity to the health struggle. I think many people need people like you, Lisa; they need to read about people like you because it gives them a sense of hope for this day and tomorrow. Thank you for this time.

We often read about people confronting cancer diagnoses and their worries about therapy and survival. We read about varied patient advocacy and support communities. Lisa Heathman and the Pink Lemonade Project offer another perspective—how friendship forged through this difficult journey leads to better medical and emotional care. A key lesson is that people with dense breast tissue should take advantage—advocate for advanced screening!

You can connect with the Pink Lemonade Project, which offers support to men and women, through its website and follow its updates on social media.

The post A Cycling Accident Saved My Life appeared first on Medika Life.

Ninety Nations Are Expected to be Represented At HIMSS

Among those 90 countries will be Israel, well-known for its outstanding health system, novel engineering acumen and always-on entrepreneurial engine. Israeli startups have been instrumental in developing breakthrough technologies and treatments, from telemedicine to augmented intelligence, precision medicine, and virtual and medical imaging. These innovations continuously improve health within Israel, home to Sheba Medical Center, one of Newsweek’s leading global hospital systems. They are exported globally, contributing to the country’s economy and worldwide standing as a top business development partner.

When the war broke out in early October 2023, Israeli attendees planning to attend the Las Vegas HLTH meeting either rushed home to reunite with family members or canceled plans to travel.  HIMSS24 Orlando will be the reboot after six gut-wrenching months when the Israeli Innovation Las Vegas HLTH Pavilion was largely vacated and war broke out.  These resilient innovators will travel to Orlando for their long-awaited plans to connect with the global health information community.

A Private Equity Firm that Champions its Portfolio Companies Globally

eHealth Ventures Group (eHV), an Israeli-headquartered private equity firm with some $1 billion under management, is planning a special HIMSS delegation of 10 of its portfolio companies – enterprises that range from start-ups to in-market companies rubbing shoulders with some of the world’s most prestigious biopharmaceutical and health system players. Some companies joining eHV Partner Ophir Shahaf focus on improving health system use of information and operations; some apply the practice value of AI and GenAI to functions where sufficient human capital is unavailable; others are pioneering new ways to address pressing medical conditions.  All come to Orlando to meet and exchange ideas with US-based colleagues during HIMSS.

Hear Medika Life Editor Gil Bashe’s exclusive interview with eHealth Venture Partner Ophir Shahaf on Healthcare Now Radio: LISTEN HERE.

From Information to Clinical Innovation Israeli Innovators Head to HIMSS

• Coronary artery disease (CAD) is a progressive condition that often remains asymptomatic for years, leading to delayed diagnosis and treatment. AccuLine has developed an accurate and non-invasive exam for the early detection of CAD to prevent millions of heart attacks. The user-friendly exam includes a four-minute measurement of vital signs, safely replacing traditional ergometry. This approach addresses the limitations of existing tools in terms of accuracy, invasiveness, and cost. The company has demonstrated promising clinical results with high precision and cost-effectiveness, supported by strategic partnerships with industry leaders, including Intratech, Sanolla, NovaSight, Lumenis, and Johnson & Johnson.

“In the fragmented health ecosystem, where patients may encounter barriers to accessing specialized care, the technology bridges this gap by offering a standardized and accessible diagnostic solution for CAD, ensuring equitable access to timely cardiac care regardless of geographic location or setting,” said Moshe Barel, Acculine CEO. Streamlining the diagnostic process and providing immediate results can accelerate time-to-care, enable clinicians to initiate prompt intervention, and improve patient outcomes.”

• Agamon Health is an imaging patient workflow management platform that leverages GenAI to connect providers and patients and coordinate the next steps in care management. By seamlessly coordinating interactions among radiologists, referring providers, nurse navigators, and patients, Agamon facilitates early diagnosis, enhances care quality, and boosts operational efficiency. Its platform accuracy has been honed, drawing from more than 20 million radiology reports, and has demonstrated a 55 percent increase in patient adherence and a 10-time return on investment.

“Care gaps are a common and unfortunate part of the health systems in the US because the system is siloed – from clinical and technical perspectives. In radiology, 20 percent of all radiology reports require some follow-up, and more than 60 percent of those patients don’t circle back, said Steve Linowes, Agamon HealthUS General Manager. This happens for several reasons. In many instances, referring providers aren’t connected to the health system that conducted the original radiology procedure, so there isn’t an easy way to communicate or have them order the follow-up procedure. This impacts more than 80 million patients annually and represents billions of dollars in lost revenue to health systems.”

• Insight Axis introduces a diagnostic tool designed for better management of neuropsychiatric disorders and improved psychiatric diagnosis and treatment. Led by a team of experts in electrophysiology, neuroscience, and mathematics, Insight Axis offers an AI-based platform that assesses treatment responsiveness, predicts medication compatibility, and characterizes disorders based on brain signatures. With no known biomarkers available for psychiatric disorders, Insight Axis provides clinicians with objective data from standard EEG tests integrated into its Quantum Physics and AI-based platform. This innovative system, backed by solid IP, promises to transform the approach to psychiatric care, ensuring more accurate diagnosis and personalized treatment recommendations.

• Thousands of neurosurgeries are performed globally daily. Each requires neuromonitoring coverage, and a specialized neurophysiologist oversees the surgeon to prevent potential nerve injuries. However, there is an insufficient number of these professionals to oversee each surgery, increasing nerve damage and paralysis risks for patients undergoing surgery without surveillance. Nervio created the world’s first autonomous neuromonitoring solution, reducing dependence on these high-demand professionals and potentially making neuromonitoring oversight available in every OR globally.

“Why does this matter to health systems, providers and patients?  A particular worry is post-injury post-spine surgery, a clinical concern now monitored using 30-year-old technology,” reflects Nervio CEO Ariel Weinstein, a long-standing entrepreneurial leader. “To increase physician and patient confidence, Nervio has created an expert-trained AI system that mirrors the vigilance of expert oversight. This technology reduces stress, risk and operating costs.”

• NimBio has developed an AI-based disease management platform to transform the treatment of immune-mediated inflammatory Diseases (IMIDs). With its focus on Inflammatory Bowel Diseases (IBD), NimBio is developing flare-up prevention technology through a 100% non-invasive remote inflammation management platform. This advanced technology, including a wearable sensor and AI-based predictive algorithm, predicts flare-ups before they occur, enabling intervention and treatment. NimBio collaborates with clinical and business partners, including Mayo Clinic and AMGEN, as it collaborates within the medical and therapeutic community to secure a unique place, timing, and perfect IMID treatment.

• Through automated data collection and its ultra-lightweight real-time locating system, QLOG enables hospitals to easily track equipment, medical supplies, and patients. By increasing visibility with its data automation solutions, QLOG helps healthcare organizations reduce costs, control processes, and assets, and improve safety and quality of care. The result is 45 percent better equipment utilization, 65 percent less supply loss and waste, and 90 percent improved compliance and safety. Leading health institutions are already deploying the QLOG in Israel and throughout Europe.

“QLOG looks to improve the way healthcare operates. We are proud to be making an impact, redefining the communication channels between the organization and the workforce, and defining how healthcare is managed,” said Dr. Amit Lehavi, QLOG founder and CEO, in announcing a successful funding round. “Our Healthcare Operations Platform displays remarkable financial impact and quality improvements across Israel and Europe. This has a direct positive influence on patient care by reducing nurse burnout and improved retention.”

• RespirAI Medical has designed an AI-powered wearable platform for long-term, at-home monitoring of chronic respiratory diseases. The device is based on a bio-coupling novel marker – measuring synchronization among breathing and walking, detecting COPD flare-ups before they flare out of control. Beyond COPD management, the platform offers health professionals the potential to identify additional respiratory and cardiac complications early and personalize medication management for these conditions.

“The RespirAI solution can improve clinical outcomes for health professionals managing chronic respiratory diseases,” says CEO Nimrod Bin-Nun. “By facilitating early detection of lung function changes and exacerbations, the RespirAI platform enables proactive intervention, reducing hospitalizations, alleviating symptom severity, and saving patient’s lives. The remote monitoring feature enhances patient convenience and lowers healthcare costs, minimizing the need for in-person visits,” he added.

• Chronic lower back pain (CLBP) impacts millions worldwide. Current care methods often focus on symptomatic relief or invasive procedures, overlooking the root mechanical imbalances contributing to CLBP. This fragmented approach leads to prolonged suffering, high healthcare costs, and limited access to adequate care. Symetrify addresses this gap in care by targeting the neuro-mechanical root cause of CLBP, providing efficient and non-invasive treatment that accelerates time-to-care decisions and improves patient outcomes. Software-based, Symetrify provides therapeutic effects while enhancing treatment capacity and efficiency for providers, focusing on patient engagement, follow-up, and retention.

“The workplace setting faces significant challenges with chronic lower back pain (CLBP), impacting millions. Current care methods often focus on symptomatic relief or invasive procedures, overlooking the root mechanical imbalances contributing to CLBP,” says Dana Chanan, CEO. “This approach leads to unnecessary suffering, high health costs, and reduces access to effective care. Symetrify addresses this gap by targeting the neuro-mechanical root cause of CLBP, providing non-invasive treatment to accelerate time-to-care decisions and improve outcomes.”

• Yonalink provides electronic data collection solutions (EDC) for clinical trial sponsors, hospitals, and contract research organizations, enabling the post-COVID ideal of decentralized clinical trials to become a reality. Its platform integrates data collection from patients’ medical devices, wearables and electronic health records (EHRs). It replaces manual processes to improve trial efficiency and reduce staff burnout—Yonalink pioneers EHR-to-EDC data streaming from a global network of more than 7000 medical centers. By simplifying data capture, management and transfer, Yonalink reduces the burden on clinical trial teams.

“By automating the data collection and management process and enabling remote data monitoring from any electronic health record, Yonalink makes clinical trial access available to any patient, anywhere,” reports Iddo Peleg, Yonalink CEO and Co-founder. “The system eliminates errors caused by manual data transfer, frees time for study staff to focus on more critical tasks, and provides sponsors with real-time data oversight to keep trial timelines on track.”

• The economic impact of migraine-related productivity loss is significant, with indirect costs to the US economy ranging from $22 billion to $78 billion annually due to missed workdays and diminished on-the-job efficiency.  Wizermed is developing a solution for migraine attack prediction before onset. Its AI-based platform, Migraine Predict, utilizes smartwatch technology to detect, predict, and manage migraines effectively. The platform can provide a daily “migraine forecast,” accurately predicting whether the next day will likely be migraine-free or if an attack is imminent. This reduces the anxiety and stress associated with the unpredictability of migraines, gives people a greater sense of control of their migraines, and enables earlier, proactive intervention to minimize the impact of a migraine.

“The capacity to foresee and alleviate the impact of imminent attacks holds significant potential for enhancing the well-being of migraine sufferers, who often feel their condition dominates their lives,” reinforces Wizermed Founder and CEO Guy Attar. “This solution empowers individuals with the means to reclaim control over their quality of life. Furthermore, this solution benefits employers by enhancing workplace productivity, reducing absenteeism, and fostering higher employee satisfaction. Notably, there’s potential to decrease the frequency and intensity of attacks, a critical consideration given the substantial prevalence of migraine sufferers in the population,” he adds.

While conflict prevails, many wonder how this impacts Israel’s innovation engine and access to investment.  According to the Israeli business publication The Israeli Business News – The Globes, “Israeli startups raised $500 million in January 2024, drawing from companies’ press announcements.”  The Globes estimates this figure might be even higher as many Israeli companies keep their investment news under the radar screen.

Overall, global investment in digital health, including health information, is down year-to-year from the exuberant COVID years. That trend is confirmed by Galen Growth, one of the world’s leading market intelligence firms; raising half a billion in month one of 2024, the Israeli health innovation sector shows resilience and strength.  HIMSS is an excellent opportunity to meet with these companies and others from the “Start-Up Nation,” whose ideas and intentions are to improve human health worldwide.

The post HIMSS – Global Meeting Ground for Health Info Innovators to Secure Partnerships and Advance Care appeared first on Medika Life.

AI video monitoring systems offer hospitals a powerful tool to observe patients constantly, even when a staff member is not in the room. The AI watches the video, extracts movement patterns, and can identify key actions to understand trends and moments. Then, by creating workflows using this information, hospitals can improve what they know about their patients, reduce staff pressure on what happened when they were not in the room and enhance overall efficiency.

By continuously monitoring patients, these systems can become a trusted part of the bedside team – reducing clinician anxiety from the unknown of what is happening with one patient while occupied with others.

Observe, Recognize and Act: The Power of Human + AI in Patient Safety

Upon examining ECRI’s safety concerns, three core themes emerge timely intervention, adequate clinical support, and efficient care coordination. The absence of these aspects can compromise patient safety, leading to inadequate care and potential harm. In this respect, AI has a crucial role to play by aiding healthcare providers in time-critical decision-making. This kind of AI, augmented by virtual providers to support the bedside team, can improve efficiency and serve as a guardian angel for patients and their teams.

Combating Violence Against Healthcare Staff

AI’s ability to instantly identify aggression towards healthcare staff via video monitoring and predictive analysis can mitigate and diffuse potential safety issues before they escalate. In addition, by tracking how a patient is moving over time and changes in their patterns, video monitoring can help identify patients whose risk levels have risen. Combined with low-cost, ubiquitous video, providers can check in virtually anytime –  providing quicker responses to patients and reducing the potential for hazardous interactions.

Virtual Provider as the Guardian Angel of the Bedside Team

Often, clinicians are thrust into work beyond their competencies or scope of practice –  a situation that leads to professional burnout and dissatisfaction. This is particularly acute with nursing shortages that have led to less experienced nurses being put into more difficult situations than previous generations.

A virtual nursing system powered by AI could provide much-needed assistance, especially when nurses have to adapt to different unit requirements. A virtual nurse can offer real-time assistance regarding medication information or mentoring for specific procedures or other unit-specific details. By empowering the virtual nurse with AI that watches all patients, a more experienced virtual nurse can be directed to patients facing more precarious situations – like a static patient in bed who has not had a care in the last two hours (increasing their risk for pressure injury).

Also, virtual nurses can act as a secondary verification mechanism, reducing the possibility of medication errors directly related to three of the top ten safety concerns.

Optimizing Care Coordination

Gaps in care coordination for patients with complex medical conditions can have serious consequences. The attention to detail needed typically guides such patients to ICU settings. However, it is becoming more common that patients in step-down units have similar characteristics but with a fraction of the attention.

Continuous AI video monitoring can track a patient’s movement, location, care activity and related trends, making it more straightforward to monitor patients transitioning from higher acuity settings more closely virtually. This enhanced monitoring, paired with simplified virtual consultations, creates better care coordination between the teams where the patient is and where they came from. Similarly, it helps to ensure that critical care is not omitted from the patient’s journey.

Conclusion

Navigating patient safety concerns in today’s healthcare landscape is a daunting task. But with the integration of AI and human expertise, we can confidently address these challenges. AI not only enhances patient safety and care quality, but it also alleviates the burden on healthcare staff, improving their work lives. As the healthcare industry evolves, adopting AI will be instrumental in overcoming patient safety challenges and achieving optimal care outcomes.

The post Look Deep! Pressure and Risk in the Health Setting appeared first on Medika Life.

In her first book, Fragmented: A Doctor’s Quest to Piece Together American Health Care, published by W. W. Norton, Dr. Yurkiewicz explores one of medicine’s daunting challenges – how patients, payers, policymakers, and providers must navigate the sea of medical record information that can be used to accelerate or become an obstacle in medicine’s primary mission – to heal.

Suppose we continue to avoid addressing the pitfalls of health-sector fragmentation. In that case, it will continue to increase costs, result in unnecessary hospital visits, negatively impact patient adherence and care disparities, and, even worse, lead to death.

Other bestselling books champion the concept of patient centricity – with information used to address medical needs swiftly.  But what information is available and how it is accessed remains a human function – a system-wide hurdle.  The desire to be healed and the readiness of healers to answer that call still faces a significant challenge – fragmentation.

“There’s an unspoken assumption when we go to see a doctor: the doctor knows our medical story and is making decisions based on that story. But reality frequently falls short. Medical records vanish when we switch doctors. Critical details of life-saving treatment plans get lost in muddled electronic charts. The doctors we see change according to specialty, hospital shifts, or an insurer’s whims. Physician Ilana Yurkiewicz calls this phenomenon fragmentation, and, she argues, it’s the central failure of health care today.” [W. W. Norton]

Medika Life offers readers this exclusive interview with Dr. Ilana Yurkiewicz, an award-winning author and dedicated physician with expertise in internal medicine, oncology and hematology, who unites the story of patients and physicians working to overcome one of the more significant challenges modern medicine faces. In her book, which outlines how information goes unshared, she highlights how “Critical details of life-saving treatment plans get lost in muddled electronic charts. The doctors we see change according to specialty, hospital shifts, or an insurer’s whims,” providing a much-needed perspective.

The Journey of a Physician-Author – To Illuminate and Heal

Gil Bashe: Congratulations on your work. Fragmented is a word I’ve used to describe the health ecosystem. You eloquently bring it all together in your book. You have been a journalist since your undergraduate years and now combine your love of medicine with writing. Could you give me some insight as a clinician, as a physician why you also wanted to be an author?

Ilana Yurkiewicz: I’ve always had those two careers going on in parallel. I knew from an early phase when I was in college that I wanted to become a doctor. I was always interested in both the sciences and the humanities. My interests were in combining them to make science and medicine accessible to everyday people.

I was a writer and an editor for the Yale Scientific Magazine, and since then, I’ve written in long and short form. I see the skill set I use in medicine and journalism as overlapping. When I counsel patients, I try to take complex ideas and break them down into information nuggets that people can understand. I do that when I’m in the exam room and when I write.

Bashe: In your book, you demonstrate a unique superpower to hone in on the patient you’re with. Is the real challenge about lack of access to information uniformly, not giving the clinical staff sufficient time to absorb patient information or a combination?

EMRs are Not a Book – They Remain a Puzzle

Yurkiewicz: It’s a very insightful question with a very long answer, but the short answer is that it is a combination. The electronic medical record (EMR) is not currently written in a format that is readable and meaningful to most providers. We first have the issue of interoperability, which addresses sharing records between different facilities. Sometimes I work in my clinic or the hospital, and I don’t have access to records from a doctor’s office down the street. So one issue is that records go unshared.

The second issue, though, is that even when all of the data is technically there – even if it’s all in the EMR – the EMR, as it stands, could be more organized. It’s little bits of discrete data put in different tabs that providers have to click, click, click, click through, trying to find a meaningful narrative themselves. I often tell my patients that the EMR is not written like a book. There’s no beginning, middle, and end. There are a ton of redundancies. A recent study showed that about 60% of doctors’ notes are identical to their previous notes.

To understand a patient’s full story, you are doing a lot of digging and clicking. You are trying to put pieces together manually to create a useful narrative about a patient that can help you make decisions. That process is labor-intensive and error prone.

Thirty percent of primary care doctors report missing findings even if all the information is in the EMR, because they’re clicking through so many tabs and need to know where something will be stored. So that’s problems one and two: how the EMRs are shared and organized. Issue number three, then, is time. You can imagine clicking through, say, 30 tabs to find one piece of data you’re looking for and then clicking into outside records and trying to collate them takes time.

When I meet a new patient in the clinic, if I’m doing it right, it takes about 30 minutes to do the preparation part of collating all the data into a narrative where I can think about next steps. And I’m only given 30 minutes per appointment.

So all this work starts accumulating for doctors, and we’ve gotten to a place where it’s unsustainable. We don’t have the time even if all the data is in one place. We need more time to sort through it in a meaningful way. I’ll add that one more study recently said that if primary care doctors did everything they’re supposed to do in a day, they would be working 26 to 27-hour days.

The Challenge of Navigating the Fragmented Health Ecosystem

Bashe: In the book, you discuss your interactions with patients across institutions like Cleveland. I wanted to get your read on the bigger fragmentation of the health system. When you think of information fragmentation, you say, ‘How does a patient navigate all this?’ How do you navigate the fragmentation as a clinician? You’re an expert in knowing the system and a visitor to the system. What do you think about that? I’m not asking you for the prescription to resolve fragmentation, but I think the readers would value your perspective on how patients must navigate the system.

Yurkiewicz: How do people do it? With incredible difficulty. Doctors do it with great difficulty, and patients do it with even more difficulty.

All sides need to communicate in a way that can help patients make the best decisions for themselves. At the same time, the cruel twist of irony is that patients are the ones who are currently expected to do all of the work of navigating the healthcare system, and inequalities fester. Some patients have become experts at navigating insurance and their different clinics and teams of doctors. They have learned to advocate for themselves by sending just the right message with phrasing that will push their doctors to communicate well. But not everybody can do that. And nor should they have to.

Recently one of my patients in her late 60s was diagnosed with mild cognitive impairment, which is a precursor to dementia. She lives by herself. She has no family to help her with day-to-day tasks, including navigating the medical system. She came to see me for a first appointment. I started running through a list of medical issues we had to address, and by the end, I gave her a to-do list. I wrote instructions down and said, ‘You call this number; you go to the lab in this location. Then you have to print out this data and bring it to the next place.’

I went through all these steps, and then she asked me them again. By the third ask, my heart was breaking as I knew she could not follow these steps; I could see the gulf of fragmentation enveloping her. I knew she would fall through the cracks if we didn’t change the approach. I simplified the list and put the highest-priority items on it. I said, ‘This time, do one and two, then come back to see me in a month, and we can try to address three and four.’

Tragically, our system is set up to let people like her fall through the cracks. The people who don’t have family members – patient advocates – are often unable to navigate this complicated system.

The Vulnerable Patient – Struggling to Understand and Be Understood

Bashe: Perhaps the most vulnerable and costly patients suffer because of the fragmentation. Now we have systems being created on systems that are being created on systems. What are your thoughts on how that addresses the spiraling fragmentation? Or are we just really adding to or splintering the fractured system? Is it getting further and further away from being pieced together, and are we seeing the rise of information anxiety or any hope of a cure for this fragmentation?

Yurkiewicz: We are seeing an explosion of fragmentation. We now have diagnoses and treatments for things that, 50 years ago, we never thought we could diagnose and treat. But the devil is in the details, and a patient’s ability to do well through a disease depends so much on what is often ignored – logistical hurdles.

The focus in the mainstream is often on treatment innovation rather than the details of whether the medication regimen is appropriately transferred from one doctor to another. Suppose the details of that life-saving treatment plan are written in a way in the EMR that everybody can see and access. Of course, it’s wonderful that we can treat illness better. But without an equal investment in connecting these logistical pieces, we are getting an explosion of information fragmentation, and patients can’t get the most out of these treatments.

I think in our public and political discourse, we need to emphasize equal investment in making sense of the information we already have and connecting it between doctors’ offices, between hospitals, and between one doctor to another within the same hospital.

The Power of Generalists and Specialists in Collaboration

Bashe: You’re focused on the human experience in medicine and oncology. You see medicine as the journey of a person – a patient – from their diagnosis, treatment, and then ideally post-treatment and dealing with the survivor experience. You’re also seeing your clinical journey through the eyes of the patient experience. How does that help you pinpoint fragmentation and help patients?

Yurkiewicz: Internal medicine is designed to look at the big picture.  I trained first in internal medicine and afterward in oncology and hematology. When I was done with all that training, which was 14 years, including undergrad, med school, residency, and fellowship, I decided to open a primary care practice focusing on cancer patients and survivors.

My job is to take care of the whole patient. I’m privileged to take care of their cancer and everything resulting from their illness and treatment even years later.

In my training, I learned to look at a fragment of a patient’s narrative from the specialist lens. So when I was in internal medicine, my vantage point was very different from when I was in oncology. When I became an oncology fellow, I felt like I had crossed this invisible line where my training told me to look for clues suggesting cancer or a blood problem.

And so I learned how to look for those clues and hone in on a patient’s needs using my specialist lens. I’ve had to retrain myself to take a step back and look at the big picture. I try to see the whole patient and embrace how their concerns fit together.

Neither Hope nor Hype – Cautious Optimism

Bashe: You were already a great writer of magazine articles and op-eds. You were published in Scientific American a few times. The book is coming out, and certainly, people in the health system will read the book very carefully realizing how significantly fragmentation impacts care and cost. Try to project that people will read your book a year from now.  What do you hope will be achieved through their experience of reading your words?

Yurkiewicz: There is a one-year goal and a longer-term goal. In one year, I want the book to help empower patients and family members to navigate the system better. I am an optimist, but unfortunately, I don’t think fragmentation in health care will be solved in one year. There are many factors and many incentives that make it very complex.

I’m hoping that in 20 years, my book will be closer to obsolete. Over the years, we can start to tackle each one of the factors of fragmentation toward a more sustainable healthcare system.

Bashe: Medicine is becoming increasingly specialized. Once upon a time, of course, gastroenterologists were gastroenterologists. Now you have clinicians at Stanford who only deal with the upper GI; others deal with the lower GI. You have cardiologists who are interventionalists. Others deal with lipids and so forth. Specialties pushed them to be experts. Are we getting to that level in medicine where doctors are becoming skilled in a tiny piece of the human body and patient experience?

Yurkiewicz: I once heard from a colleague in the sciences that we’re learning more and more about less and less until we know everything about nothing. And I wish that did not apply to medicine, but we’re heading in that direction because we promote specialization and sub-specialization.

For many reasons, it often leads to greater financial reward and respect within the medical hierarchy to become an expert in something narrow. And while specialization itself is not necessarily a problem, problems can arise when we have to reconcile different narratives that doctors tell themselves about a body part or an organ system.

Sometimes, no one person is looking at the whole patient, seeing if we can put the different narratives together into a unifying diagnosis or a unifying treatment plan.

I share in my book one story about a woman that I took care of in the hospital. She had leukemia and was very immunosuppressed due to chemotherapy, and she had an issue brewing in her lungs. She was gasping for air while I had to increase her oxygen support every day to the point that I had a frank conversation with her about whether she would want to go on a ventilator if her oxygen levels continued to worsen.

We had three teams of doctors on the case. There were infectious disease doctors, pulmonary (lung) doctors, and hematologists who specialized in her cancer. Each team came up with a perfectly reasonable assessment from their vantage point.

The infectious diseases team said, ’We’ve already treated her for most infections, so just throwing on an additional treatment is not going to help her. We’ve treated her with antibiotics and antifungals for a long time. We’ve treated the most highly likely things.’ And then the pulmonary doctors said, ‘Well, she already went to bronchoscopy. That didn’t reveal the diagnosis, so we shouldn’t do another one that’s going to be low yield, and it’s going to be risky because her platelets are low, and taking a biopsy could cause her to bleed.’

Meanwhile, the hematology team said, ‘She’s immunocompromised from chemotherapy. There’s no way to speed that up.’ Every single one of those analyses was perfectly sound. However, you put them all together, and we had a patient deteriorating before our eyes. Three narratives added up to say we should stay the course, which didn’t feel like a narrative that was the right one yet.

I share in the book what ended up happening to this patient, where I decided to treat empirically for the unlikely possibilities after each team ruled out the likeliest ones.

I don’t share this story to toot my own horn. But sometimes it takes somebody to take that step and say these reasonable assessments from each specialist’s point of view do not add up to a reasonable conclusion when taken together. An internist is trained to look for that big picture, but the empowering fact is that it can be a specialist who takes those proactive steps to look at what other specialists say about their patients and consider whether it adds up to a reasonable conclusion. It can even be patients and their family members at the bedside who advocate for their teams to come together and reconcile their assessments.

Again, it was not specialization itself that caused this problem. But we have to take that extra step to ensure that specialists reconcile their clinical narratives in a way that makes sense for the patient.

How to Obtain Fragmented

The public health urgency in the shadow of the pandemic continues to reveal serious vulnerabilities. We see inequitable access to care and lopsided disease and mortality burden among diverse communities as another tragic manifestation of racial injustice. We read about an increasingly fragmented care-delivery system splintering even further as new technologies such as AI and ChatGPT create expectations that physicians should see more patients daily – not dedicate more time to each patient.

Dr. Yurkiewicz’s book is a welcome, first-hand objective look at this struggling health system dedicated to helping patients while awash in information.  Her candid expression of the patient and provider journey is vital in helping unite the disparate pieces.

Dr. Ilana Yurkiewicz’s book Fragmented: A Doctor’s Quest to Piece Together American Health Care, published by W. W. Norton, is available via the publisher, Amazon, and where all major books are sold.  Follow Dr. Yurkiewicz on Twitter and LinkedIn.

[Special thanks to Carolyn Neugarten, editorial assistant, Medika Life, for her keen eyes and comments. Coming from a healthcare household, her interest in journalism and social action accelerated the publication of this interview.]

The post The Book Fragmented is a Key Step Toward Navigating America’s Ailing Health System appeared first on Medika Life.

A panel of licensed healthcare professionals preferred ChatGPT responses 79% of the time and rated ChatGPT responses as higher quality and more empathetic. Gulp. Understandably, some doctors are not happy with this study. And many were not pleased with me for not diving deeper into the complexities inherent in the research in my initial LinkedIn post. Message heard. Understood!

The news headlines and the initial study callouts overplay the immediate importance of ChatGPT in the physician-patient relationship. Physicians do not fair poorly.  However, the authors provide an inflection point that should not be ignored and must be acknowledged – Communication is Part of the Care and Cure! Physicians must be trained and have time to deal with patient curiosity and urgencies. #Patientexperience is different. They do not want to sit idle or silent. They are curious and concerned.

As generations have become more familiar with technology in their day-to-day lives, perhaps they place more trust in machines’ “unbiased nature” over humans. That assumption has led to the rise of “#misinformation.” We believe our Twitter feeds if we don’t explore the facts further. But, our screens reduce the press of needing to engage with people at the moment – they give us time to think and check in with this “on-call” information aggregator. To let the information sink in without being confronted about the next step. Doctors are too often pressured into an eight-minute per-patient provider reimbursement model. It’s not their fault – it’s the system that they must co-exist within. But that tilted system leads to the consumer seeking – needing – alternatives. If so, even imperfect ChatGPT4 and beyond will be a go-to.

There are changes afoot that we need to make happen sooner rather than later by moving minds, systems, and behaviors so that life-sustaining and life-saving approaches to patient care may eventually tip the scale of human survival toward health and wellness. However, we see data from a human perspective – sometimes self-interests or emotional needs for control. ChatGPT is the aggregate of data and human input. It is not divorced from us but a faint mirror of the human experience.

Yes, this study is worth reading. Yes, many have criticized its design and the intent of the authors. Yes, many are fearful that machines may replace physicians. But, the latter assumption is doubtful. Reading between the lines reinforces that, as industry colleague Ritesh Patel often says, “If it moves, digitize it!” People get their information in ways that are quick and convenient. That is a reality everyone in the health community must face!

The medical community and health communicators must rise to the moment if they want to harness this technology. Learn about ChatGPT and how it operates – its prompts. Also, read words from experts on the digital health news platform Medika Life including the insightful words by innovation theorist John Nosta. John will rock your boat; however, often, he points to where this is going.  Read the words of Tom Lawry, former head of Microsoft’s AI team, author of the best-seller Hacking Healthcare, and a global counselor on the practical application of AI.

Almost one year ago, I penned a piece titled: Health Possibilities We Cannot Afford to Block. There were 10 ideas/technologies included in that piece – #1 was #AI. That’s the heart of ChatGPT. Fixing one part of the healthcare puzzle is encouraging – but is it transformational? What can we do to make things work better for patients? Medicine can harness the power of ChatGPT to make it work even better for patients seeking healing solutions. Perhaps we can give physicians more time to help patients feel their doctors have and always are among their greatest advocates. We can also bring technology companies and leading medical associations together to talk about ChatGPT influence on trusted people-to-people connections, particularly with physician-patients.

Why do consumers turn to machines instead of people for medical counsel?  Well, we haven’t been able to clone or at least develop teaching models drawing upon the many outstanding physicians who demonstrate incredible patience and empathy for patient woes and questions – doctors like WebMD’s John Whyte and NHS’s and Microsoft’s Junaid Bajwa—many answers to consider. Among the most important are skill, collaboration and empathy.

Consumers may feel that devices are better listeners and work with them in partnership. We should expect this outcome due to the fragmented health ecosystem that consumers must navigate with difficulty. We must recognize that ChatGPT’s interest and popularity among health information seekers didn’t just happen. It is possible to realize that these same information seekers feel they are not getting what they seek.

Keep learning! This is not the end of humanity and the beginning of the Matrix – where people, software and machine battle for survival. The world will be changing in amazing ways in the short years ahead. Collaboration and communications go hand-in-hand as essential tools for healing.

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The deaths of small children do not move us beyond tears and platitudes to policy action. What will? We are lost if we don’t demand a significant change in gun access policy after reading how a two-year-old wandered lost and frightened after both parents were shot and killed. After people going food shopping in Buffalo were slain. After people going to relax at a club in Colorado Springs were brutally murdered. How about the deaths at Walmart in Chesapeake, Virginia? Empathy drained. Courageous political action is tossed aside for preferred partisan politics.

Past policies passed in the bi-partisan Senate move are weak compromises.  They are face-saving actions for both major parties, not life-sparing policy moves that will reduce the death toll from gun violence. We need to make a move that will save lives, requiring a complete ban on automatic weapons. The Senate’s bipartisan gun deal includes additional mental health funding, increased school safety, more crisis intervention programs, and incentives for states to align juvenile records in the National Instant Criminal Background Check System. But automatic, high-powered velocity weapons – weapons of war – continue to be accessible.

High-Powered Weapon Purchases Are Climbing

In 1994, President Bill Clinton signed an assault-weapons ban, which resulted in the reduction of the AR-15 and similar semiautomatic rifles sales. The Ban only covered a 10-year window, in which mass shootings were down dramatically. When the assault-weapons ban expired 10 years later, gun manufacturers filled the production pipeline and sales rose. Recently – and tragically – the AR-15 has been at the scene of almost every mass shooting to hit the headlines in recent years. It’s design – the spin of the bullet – and firepower make killing as easy as pressing the trigger again and again until its 30-bullet magazine is spent.

The United States is witnessing a record year of gun violence – more than 600 mass shootings in 2022. The pressure is on lawmakers to enact meaningful reforms. But, little action is expected to curb this continued slaughter of the innocent.

Weapons of War are Designed for One Purpose – to Kill

For six years as a military paratrooper and combat medic, I carried an M-4, the preferred weapon of war for infantry entering combat.  The M-4 is a smaller, more convenient version of the M-16.  These are the weapons of war used in past mass shootings.  Some express misguided comfort that the A-15 is semi-auto only, and the M16 is fully automatic. But in combat situations, soldiers rarely fire on automatic. Few do, for every bullet counts.  Let’s stop calling these rifles “automatic.”  They are weapons created for war – weapons of war to wound and kill others.

Civilians are the Victims of this Gun-Epidemic War

We must heed the words of the onsite physician first responder in Highland Park, Dr. David Baum: 

“The people who were (killed) were blown up by that gunfire … blown up. The horrific scene of some bodies is unspeakable for the average person. I’ve never served, but those are wartime injuries. Those are what are seen in victims of war, not victims at a parade.”

Dr. Roy Guerrero, a healer of children who rushed to Uvalde Memorial Hospital after the massacre of 19 children and two teachers at Robb Elementary School in Texas, testified during a congressional hearing on gun violence:

“I chose to be a pediatrician. I chose to take care of children. “Keeping them safe from preventable diseases I can do. Keeping them safe from bacteria and brittle bones, I can do. But making sure our children are safe from guns, that’s the job of our politicians and leaders.”

The words of Drs Baum and Guerrero echo a simple truth: our politicians are too removed from the steady death toll and its horror to fulfill their responsibilities in protecting the nation. America is at war within itself. Our political leaders decline to call for a ceasefire despite rising body count.  Let’s call these weapons what they are – weapons of war. 

The AR-15-styled weapon was used in the Sandy Hook massacre, the Aurora theater massacre, the San Bernardino massacre, Marjory Stoneman Douglas High School in Parkland, FL, mass murder in Buffalo, NY, Uvalde, Texas, Highland Park, IL and the most recent shootings. What’s the difference between the AR-15 and its military counterpart, the M16?  They are assault weapons that hold a 30-bullet magazine and offer users the same firepower. Their killing capacity, like their power, is equal.

Congress must hold some responsibility for the murders around the nation. If its members cannot agree to protect the nation’s youngest citizens who sit in classrooms eager to learn to read, count, and play team sports, then they can either sharpen their empathy skills and feel people’s pain or consider their time in public office as a failure.

Congress Must See the Wounds of the Dead and Suffering

How can Congress show a higher degree of responsibility – a heightened connection to people’s enduring pain – physical and psychological?  Look and remember!  Each day, they should begin their sessions looking at the actual photos of those shot – the wounded and killed.  They should learn about their injuries, urgent care, and rehabilitation.  Also, each purchase of an AR-15 should require liability insurance.  Where there is no economic impact, death becomes cheap. For almost certain, once insurance companies are paying out claims, something is likely to change.

With less than 5 percent of the world’s population, the US has almost 50 percent of the world’s civilian-owned guns. The US ranks number one in firearms per capita. Our nation also has the highest homicide-by-firearm rate among the world’s most developed nations. Forget the reasons used to explain-away mass shootings; at the scene of each of these horrific acts are often weapons of war.

Americans need patriotic public service advocates in Washington, DC, who place the survival of its citizens at the forefront of their efforts.  Weapons of war, such as AR-15s, have no place in people’s home arsenals. Its bullet’s caliber rips its target apart – going in small and exiting the size of a fist. Members of Congress and their staff must be required – regardless of their political party affiliation– to see the destructive path of an AR-15 caliber bullet after every mass shooting – see the faces and hear the screams of the families impacted until those cries echo in their heads.  They must identify with the continued horror the first responders will likely experience for years.

Years after my military service, I remember the faces of the wounded and dead. I remember stemming blood from their gunshot wounds.  I hear their voices calling for distant mothers or asking if they will die. What was training and instinct – the ability to separate from the swirl around me and perform under fire – now is a movie reel that plays in my head. 

I cherish life, my role as a healer, and now, my responsibilities as a health communicator. But each moment in harm’s way was never about policy; it was about survival. Now, we are all in harm’s way wherever we go. Congress, you must transcend your political differences and imagine the cries of children murdered, calling hopelessly beforehand for their parents unable to reach out. Ban assault weapons. Ban weapons of war.

[This post was originally published on July 22nd and has now been updated to reflect the recent shootings the continued lack of Federal government action to guard its citizens’ safety.]

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A Duke University professor of bioscience, Dr. Nita Farahany, has published a book on the subject, and what it reveals may be intellectually exciting, but also seriously concerning. The broad scope of the book’s topic I’ve summarized below, along with some additional information.

Two distinct businesses, Meta and Neuralink, are investigating the potential for using innovative technology to reveal people’s thoughts. The ultimate aim of both businesses—which are addressing it in different ways—is to create tools that can record and decipher the neural activity of the brain.

Meta, formerly known as Facebook, is looking into the development of brain-computer interfaces (BCIs) that allow for the direct recording of neural activity from the brain. Scientists want to create a wearable gadget that can record electrical signals produced by brain activity and convert them into digital signals that a computer can understand.

Users will talk to digital systems with their minds thanks to the device, which works like a keyboard or mouse. Even though we don’t know all of the details about their technology yet, it is thought that their device would accurately read brain activity by using electrodes and machine learning algorithms.

On the other hand, Neuralink is investigating the creation of a brain implant that can communicate with the brain directly. The implant consists of a tiny chip that is placed into the skull and coupled to electrodes that are inserted into the brain. It is currently being tested on animals. The ability of the electrodes to pick up neural activity lets the brain and digital systems talk to each other in both directions and makes certain parts of the brain work.

Neuralink’s goal is to create a tool that can treat neurological conditions like Parkinson’s and Alzheimer’s, but the technology can also divulge private thoughts. The idea of the “thought police” is becoming a reality. It has shades of the book “1984” only this one is a definite reality.

Though they are both still in the early phases of research, Meta and Neuralink’s technologies have the power to completely change the way we interact with digital systems and disclose private thoughts. But this technology also brings up important ethical and legal questions about how these devices can be used and abused.

One of the biggest worries about brain-computer interfaces is that they could spy on people. Devices might be able to reveal private information like opinions, thoughts, and emotions if they can accurately read cerebral activity. They might employ this information in criminal investigations or even to influence people. As a result, there might be a need for legal action to control the use of such devices and safeguard people’s privacy.

The potential for such technology to be abused is another worry. For instance, there would be a risk of cyber-attacks or hacking if a brain-computer interface were used to control a digital system like a car or an airplane, which may have disastrous effects. Also, this technology could make mind-controlled soldiers or other mind-controlled laborers, which would take away people’s freedom and be against human rights. Are we headed for the world of Total Recall?

The development of brain-computer interfaces has the potential to completely change how we use digital systems and reveal our deepest thoughts. However, it also raises important ethical and legal questions. It is crucial to carefully weigh the possible advantages and risks of such technology and to make sure that moral and legal frameworks are in place to safeguard people’s liberty and privacy.

Obviously, one of the problems with this technology is the lack of understanding in legal circles about it. If people in Congress can’t follow explanations of current technology, how will they respond to highly complex systems?

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