Health care: Information tech must catch up to medical marvels
Michael Dowling, Northwell Health's CEO, believes we're entering the age of smart medicine.
- The United States health care system has much room for improvement, and big tech may be laying the foundation for those improvements.
- Technological progress in medicine is coming from two fronts: medical technology and information technology.
- As information technology develops, patients will become active participants in their health care, and value-based care may become a reality.
In his book Health Care Reboot, Michael Dowling, Northwell Health's CEO, argues that "[the United States] is constructing a solid foundation upon which the new American health care is being erected." To those steeped in news of health care's administrative bloat, under-performing primary care, and low levels of insurance coverage, such a thesis may seem bold, wishful, or downright delusional.
But Dowling does not ignore the health care system's need for improvement. Rather, he believes that contemporary trends can foster such improvement if we recognize their value. He cites advances and disruptions in areas such as consolidation, education, payment reform, and mental health to support his progressive view that "better, safer, and more accessible care" is coming.
Among those trends is big tech's move into health care, or as Dowling puts it, technology may soon move us into the age of smart medicine.
Medical tech marvels
Dowling sees big tech's stride into health care as coming from two fronts: medical technology and information technology. On the medical technology front, the technology available to doctors has accelerated at an unprecedented pace, resulting in tools and techniques that are "the stuff of Star Wars."
"Some of the most advanced technology tools ever developed in any field are in use to care for patients. Look at any modern operating room or intensive care unit, and the technology to treat patients and keep them alive is remarkable," writes Dowling.
To pick one of many examples, Northwell Health's Cohen Children's Medical Center was the first pediatric program on Long Island to institute ROSA, a "robotic operating surgical assistant." Before ROSA, children suffering epilepsy would have to undergo a full craniotomy to target and monitor areas of seizure activity. With ROSA's assistance, surgeons can get the same results through a minimally invasive procedure, reducing the risk of infection and strain on the patient.
Even technology not designed for therapy has been co-opted to play small, yet supportive, roles in quotidian treatment. A study out of the Children's Hospital Los Angeles found that virtual reality can help reduce a child's anxiety and stress during basic procedures such as a blood draw.
Information tech plays catch up
Photo: Sisacorn / Shutterstock
Dowling characterizes the information technology front as "less impressive," pointing to the well-known difficulties of onboarding electronic health records. Beyond concerns of cybersecurity and interoperability, such systems have caused widespread burnout and dissatisfaction among practitioners thanks to their time consumption and complicated workflows.
But progress is being made. Apple recently added a Health Records app to its iPhone, giving patients from 39 health systems access to their medical records.
"This existing new reality is that a fat file, that until recently was stored away unavailable to the patient, now sits in its entirety on the patient's phone," writes Dowling. "For patients with chronic conditions who make frequent use of medical services, this leap forward enables them, whether a mile from their doctor's office or a thousand miles, to track and share with their doctor essential data on blood pressure, heart rate, glucose levels, and scores of other important clinical markers."
But to succeed, this information must be gatherable, accessible, and understandable to any patient. Big tech will need to streamline such systems for maximum user-friendliness, all while keeping operations on a device with which patients and practitioners are intimately familiar.
That device will be the smartphone and tablet. 77 percent of Americans own smartphones. Among Americans over 65 years of age — the demographic most in need of such advancements — 46 percent own a smartphone, a number that is likely to climb.
Big tech's vision of integrating information technology with health care is some ways off. Much experimenting must be done, and big tech needs to better collaborate with traditional health care stakeholders. Even so, these incipient steps may lead to a framework where practitioners can gather more data more quickly and with greater ease, while patients become partners, not passive recipients, of their health care team.
Accelerating value-based care
In the United States, value-based health care exists today as a should-we, could-we debate topic. Big tech's entry into the field could push value-based care closer to practice. As noted on the health care blog Tech Prescribed, integrating improved data acquisition with AI-powered platforms could turn value-based care into a manageable venture.
"As a result, we will see the move to VBC accelerate even further as more firms turn a profit through this business model. Good news for docs — this will make you the primary customer for provider technology and really improve your user experience as a side effect," writes Colton Ortolf of Tech Prescribed.
The Northwell Health entity Pharma Ventures was created both in response to collaborating with big pharma and as a means to promote value-based care. Pharma Ventures was designed "to link drug prices to drug performance" and "to serve as a super-site for clinical trials." The goal is to drive down costs while simultaneously improving patient experience. Such an initiative is only possible due to Northwell's integrated systems and system-wide electronic health records.
Entering the smart age of medicine
For Dowling, health care in the United States is laying an important foundation for the medicine of tomorrow. We're moving away from the view that health care is something the patient receives at a medical facility. Soon, health care will see the patient take an active role alongside a team of health care providers.
"The new American medicine is proactive and has physicians working in teams with nurses and other caregivers to reach out to patients and guide them along a pathway to health and wellbeing," writes Dowling.
By creating new machines, proliferating information, and making that information easier to obtain, big tech's dive into health care will be a fundamental element in this upcoming paradigm shift.
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Vegans and vegetarians often have nutrient deficiencies and lower BMI, which can increase the risk of fractures.
- The study found that vegans were 43% more likely to suffer fractures than meat eaters.
- Similar results were observed for vegetarians and fish eaters, though to a lesser extent.
- It's possible to be healthy on a vegan diet, though it takes some strategic planning to compensate for the nutrients that a plant-based diet can't easily provide.
Comparison of fracture cases by diet group
Credit: Tong et al.<p>The results showed that vegans were especially vulnerable to hip fractures, suffering 2.3 times more cases than meat-eaters. Vegetarians and pescatarians were also more likely to suffer hip fractures, though to a lesser extent.</p><p>One explanation may be that non-meat eaters consume less calcium and protein. Calcium helps the body build strong bones, particularly before age 30, after which the body begins to lose bone mineral density (though consuming enough calcium through diet or supplement can <a href="https://ods.od.nih.gov/factsheets/Calcium-Consumer/" target="_blank">help offset losses</a>). Lower bone mineral density means higher risk of fracture.</p><p>Protein seems to help the body absorb calcium, <a href="https://www.bonejoint.net/blog/did-you-know-that-certain-foods-block-calcium-absorption/#:~:text=Historically%2C%20nutritionists%20have%20warned%20that,may%20increase%20intestinal%20calcium%20absorption." target="_blank" rel="noopener noreferrer">when consumed in normal levels</a>. The recent study, along with past research, shows that people who don't eat meat tend to have lower levels of both protein and calcium. When the researchers accounted for non-meat eaters who supplemented their diets with calcium and protein, fracture risk decreased, but still remained significant.</p>
Credit: Pixabay<p>Another explanation is body mass index (BMI). Non-meat eaters tend to have a lower BMI, which is associated with higher fracture risk, particularly hip fractures. In the new study, vegans with a low BMI were especially likely to suffer hip fractures. That might be because having more body mass provides a cushioning effect when people fall.</p><p>Still, the study has some limitations. For one, White European women were overrepresented in the sample. The researchers also didn't collect precise data on the type of calcium or protein supplementation, diet quality or causes of fractures.</p><p>Another complicating factor: Producers of vegan products, such as plant-based milk, are increasingly fortifying foods with nutrients like calcium and protein, so modern vegans are potentially at lower risk of deficiency.</p><p>The researchers wrote that their findings "suggest that bone health in vegans requires further research."</p>
Staying healthy on a vegan diet<p>So, does a vegan diet necessarily lead to worse bone health? Not necessarily. But it's safe to say that people who don't consume meat, dairy and eggs should be extra vigilant about consuming enough essential nutrients. That can be harder than it seems.<br></p><p>One major reason is that the body generally has an easier time absorbing nutrients from animal foods than plant-based products. So, while a salad could contain the same amount of calcium as a glass of milk, the body absorbs more calcium when you drink milk. What's more, there are some molecules and <a href="https://www.healthline.com/nutrition/7-nutrients-you-cant-get-from-plants#5.-Docosahexaenoic-acid-(DHA)" target="_blank">nutrients you simply can't get from plants</a>.</p><p>As such, many vegans round out their diets with supplements, including zinc, iron, iodine, long-chain omega-3s, and vitamins D, K-2, and B-12, to name a few. If you're on a vegan diet or considering making the switch, it's probably best to consult a dietician, and to make sure you maintain a <a href="https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html" target="_blank" rel="noopener noreferrer">healthy BMI</a>.</p>
Never made a turkey before? Don't worry, science can help.
- This year, many people will be making a Thanksgiving dinner for the first time. It's often harder than it looks.
- Luckily, an online calculator website has one just for thawing turkey, and can explain why you need to wait so long.
- The website has other calculators as well, for needs you didn't know you had.
How to thaw a turkey using science!<p> The Omni Calculator <a href="https://www.omnicalculator.com/" target="_blank" rel="noopener noreferrer">website</a> is home to calculators that can determine many things, including how <a href="https://www.omnicalculator.com/other/sunscreen" target="_blank" rel="noopener noreferrer">long you can be in the sun safely</a>,<a href="https://www.omnicalculator.com/other/sunscreen" target="_blank" rel="noopener noreferrer"> </a>to the odds of your town having a <a href="https://www.omnicalculator.com/other/white-christmas" target="_blank" rel="noopener noreferrer">white Christmas</a>. It now has a dedicated tool for finding how long it will take you to prep your <a href="https://www.omnicalculator.com/food/turkey-thawing" target="_blank" rel="noopener noreferrer">turkey</a> in time for a socially distanced holiday. The <a href="https://www.omnicalculator.com/food/turkey-thawing" target="_blank">Turkey Thawing Calculator </a>was created by Jagiellonian University cognitive science graduate Maria Kluziak with the help of Wojciech Sas, a Ph.D. candidate in molecular magnetism and nanostructures at the Institute of Nuclear Physics in Poland. </p><p>The fundamental problem is that you need to add heat to the frozen bird to unfreeze it without also encouraging the growth of bacteria. To do this, you have to put the turkey somewhere where it will heat up slowly and evenly. There is a trick, though; this can take a long time because of the amount of energy involved. Exactly how long you need to spend on it can be hard to determine if you've never done it before. </p><p>This is where practical, day-to-day science comes in. The processes of heating something are well-studied areas of thermodynamics which we use every day. <br> <br> As Kluziak tells Big Think: </p><p>"If you look closely, you'll notice how we're all surrounded by numbers. Yet most of the time people choose to go with their intuition while making day-to-day decisions. We, as scientists and experts in our own fields, are trying to build a world where people make better, more informed decisions backed by concrete science - Using physics to chill drinks, math to find out how much pizza to get, and even calculating how much groceries are enough to survive a quarantine. It works."</p>
So, how do I thaw a turkey?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDgwNjA0Ny9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY0NzI3NTQzN30.hr2xv0tzFU_12bA-wwKwBPv0Tou_ZcdMoF1VDlov-0k/img.png?width=980" id="07afc" class="rm-shortcode" data-rm-shortcode-id="522a8b8370fecb9dcb3bf483adea6fa5" data-rm-shortcode-name="rebelmouse-image" />
Credit: Omni Calculator<p> By slowly exposing the turkey to cool air or water, it heats up to a point where the bird is above freezing but not so warm that bacteria will start multiplying. Two of the safe ways to do this stand above all others; you can thaw it in the refrigerator or the sink.<br> <br> Using a refrigerator can take days; the calculator creators suggest a day for every four pounds of bird. Doing it with cold water in the sink is faster, needing only two hours per pound, but requires that you drain and refill the sink with new, cold water every thirty minutes. The ideal temperature during thawing shouldn't exceed 39°F/4°C.</p><p>"In our thawing model, we use a scientific approach, which is based on the use of heat transfer equations," the scientists write. "Since these types of problems are, in general, very complicated, we use some approximations, which allow us to estimate the thawing time with reasonable accuracy. As a result, you can see how the average temperature of the turkey changes in time." </p><p>You can learn more about the equations and get tips on using the calculator <a href="https://www.omnicalculator.com/food/turkey-thawing" target="_blank" rel="noopener noreferrer">here</a>. You can also learn why you shouldn't use a hairdryer or a tub full of hot water to do the job. <br> <br> One of the best parts of science is that its findings are often universally applicable. If you understand why something works in one case, you can use it everywhere else. Kluziak reminds us why this might be great for cooking:<br> <br> "The rules that govern the process of thawing are roughly the same for every kind of food, what's different are the numbers that determine the more specific things like thawing time. The general ideas remain the same regardless of the food, and I would say they are pure common sense. For example, if you're defrosting food, don't do it at room temperature to avoid bacteria - this is true every time!"<strong></strong></p><p><strong> </strong>Whoever said you'd never use the science you learned in high school at home didn't understand how often we use physics—this calculator remind us that it is everywhere. So fear not, ye first-time turkey chefs! Science can help you have your main course and eat it too. </p>
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