Once a week.
Subscribe to our weekly newsletter.
The COVID-19 pandemic is making health disparities in the United States crystal clear. It is a clarion call for health care systems to double their efforts in vulnerable communities.
- The COVID-19 pandemic has exacerbated America's health disparities, widening the divide between the haves and have nots.
- Studies show disparities in wealth, race, and online access have disproportionately harmed underserved U.S. communities during the pandemic.
- To begin curing this social aliment, health systems like Northwell Health are establishing relationships of trust in these communities so that the post-COVID world looks different than the pre-COVID one.
COVID-19 deepens U.S. health disparities<p>Communities on the pernicious side of America's health disparities have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.</p><p>"There is one common divide in American communities, and that is poverty," said <a href="https://www.northwell.edu/about/leadership/debbie-salas-lopez" target="_blank">Debbie Salas-Lopez, MD, MPH</a>, senior vice president of community and population health at Northwell Health. "That is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future wellbeing."</p><p>Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To pick one of many examples, <a href="https://www.npr.org/2020/09/27/913612554/a-crisis-within-a-crisis-food-insecurity-and-covid-19" target="_blank" rel="noopener noreferrer">food insecurity</a> reduces access to quality food, leading to poor health and communal endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and Type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.</p><p>The pandemic didn't create poverty or food insecurity, but it exacerbated both, and the results have been catastrophic. A study published this summer in the <em><a href="https://link.springer.com/article/10.1007/s11606-020-05971-3" target="_blank">Journal of General Internal Medicine</a></em> suggested that "social factors such as income inequality may explain why some parts of the USA are hit harder by the COVID-19 pandemic than others."</p><p>That's not to say better-off families in the U.S. weren't harmed. A <a href="https://voxeu.org/article/poverty-inequality-and-covid-19-us" target="_blank" rel="noopener noreferrer">paper from the Centre for Economic Policy Research</a> noted that families in counties with a higher median income experienced adjustment costs associated with the pandemic—for example, lowering income-earning interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for poorer families, who cannot easily alter their living circumstances, which often include more individuals living in one home and a reliance on mass transit to reach work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and health care, where maintaining physical distance can be all but impossible.</p><p>The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. "Our interpretation is that poorer people are less able to protect themselves, which leads them to different choices—they face a steeper trade-off between their health and their economic welfare in the context of the threats posed by COVID-19," the authors wrote.</p><p>"There are so many pandemics that this pandemic has exacerbated," Dr. Salas-Lopez noted.</p><p>One example is the health-wealth gap. The mental stressors of maintaining a low socioeconomic status, especially in the face of extreme affluence, can have a physically degrading impact on health. <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">Writing on this gap</a>, Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety, depression, and cognitive load. </p><p>"Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear," Sapolsky writes. "It is outrageous that if children are born into the wrong family, they will be predisposed toward poor health by the time they start to learn the alphabet."</p>Research on the economic and mental health fallout of COVID-19 is showing two things: That unemployment is hitting <a href="https://www.pewsocialtrends.org/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/" target="_blank" rel="noopener noreferrer">low-income and young Americans</a> most during the pandemic, potentially widening the health-wealth gap further; and that the pandemic not only exacerbates mental health stressors, but is doing so at clinically relevant levels. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/" target="_blank" rel="noopener noreferrer">the authors of one review</a> wrote, the pandemic's effects on mental health is itself an international public health priority.
Working to close the health gap<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc5MDk1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTYyMzQzMn0.KSFpXH7yHYrfVPtfgcxZqAHHYzCnC2bFxwSrJqBbH4I/img.jpg?width=980" id="b40e2" class="rm-shortcode" data-rm-shortcode-id="1b9035370ab7b02a0dc00758e494412b" data-rm-shortcode-name="rebelmouse-image" />
Northwell Health coronavirus testing center at Greater Springfield Community Church.
Credit: Northwell Health<p>Novel coronavirus may spread and infect indiscriminately, but pre-existing conditions, environmental stressors, and a lack of access to care and resources increase the risk of infection. These social determinants make the pandemic more dangerous, and erode communities' and families' abilities to heal from health crises that pre-date the pandemic.</p><p>How do we eliminate these divides? Dr. Salas-Lopez says the first step is recognition. "We have to open our eyes to see the suffering around us," she said. "Northwell has not shied away from that."</p><p>"We are steadfast in improving health outcomes for our vulnerable and underrepresented communities that have suffered because of the prevalence of chronic disease, a problem that led to the disproportionately higher death rate among African-Americans and Latinos during the COVID-19 pandemic," said Michael Dowling, Northwell's president and CEO. "We are committed to using every tool at our disposal—as a provider of health care, employer, purchaser and investor—to combat disparities and ensure the <a href="https://www.northwell.edu/education-and-resources/community-engagement/center-for-equity-of-care" target="_blank" rel="noopener noreferrer">equity of care</a> that everyone deserves." </p><p>With the need recognized, Dr. Salas-Lopez calls for health care systems to travel upstream and be proactive in those hard-hit communities. This requires health care systems to play a strong role, but not a unilateral one. They must build <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank" rel="noopener noreferrer">partnerships with leaders in those communities</a> and utilize those to ensure relationships last beyond the current crisis. </p><p>"We must meet with community leaders and talk to them to get their perspective on what they believe the community needs are and should be for the future. Together, we can co-create a plan to measurably improve [community] health and also to be ready for whatever comes next," she said.</p><p>Northwell has built relationships with local faith-based and community organizations in underserved communities of color. Those partnerships enabled Northwell to test more than 65,000 people across the metro New York region. The health system also offered education on coronavirus and precautions to curb its spread.</p><p>These initiatives began the process of building trust—trust that Northwell has counted on to return to these communities to administer flu vaccines to prepare for what experts fear may be a difficult flu season.</p><p>While Northwell has begun building bridges across the divides of the New York area, much will still need to be done to cure U.S. health care overall. There is hope that the COVID pandemic will awaken us to the deep disparities in the US.</p><p>"COVID has changed our world. We have to seize this opportunity, this pandemic, this crisis to do better," Dr. Salas-Lopez said. "Provide better care. Provide better health. Be better partners. Be better community citizens. And treat each other with respect and dignity.</p><p>"We need to find ways to unify this country because we're all human beings. We're all created equal, and we believe that health is one of those important rights."</p>
What is human dignity? Here's a primer, told through 200 years of great essays, lectures, and novels.
- Human dignity means that each of our lives have an unimpeachable value simply because we are human, and therefore we are deserving of a baseline level of respect.
- That baseline requires more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose.
- We look at incredible writings from the last 200 years that illustrate the push for human dignity in regards to slavery, equality, communism, free speech and education.
The inherent worth of all human beings<p>Human dignity is the inherent worth of each individual human being. Recognizing human dignity means respecting human beings' special value—value that sets us apart from other animals; value that is intrinsic and cannot be lost.</p> <p>Liberalism—the broad political philosophy that organizes society around liberty, justice, and equality—is rooted in the idea of human dignity. Liberalism assumes each of our lives, plans, and preferences have some unimpeachable value, not because of any objective evaluation or contribution to a greater good, but simply because they belong to a human being. We are human, and therefore deserving of a baseline level of respect. </p> <p>Because so many of us take human dignity for granted—just a fact of our humanness—it's usually only when someone's dignity is ignored or violated that we feel compelled to talk about it. </p> <p>But human dignity means more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose—a freedom that can be hampered by restrictive social institutions or the tyranny of the majority. The liberal ideal of the good society is not just peaceful but also pluralistic: It is a society in which we respect others' right to think and live differently than we do.</p>
From the 19th century to today<p>With <a href="https://books.google.com/ngrams/graph?year_start=1800&year_end=2019&content=human+dignity&corpus=26&smoothing=3&direct_url=t1%3B%2Chuman%20dignity%3B%2Cc0" target="_blank" rel="noopener noreferrer">Google Books Ngram Viewer</a>, we can chart mentions of human dignity from 1800-2019.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDg0ODU0My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY1MTUwMzE4MX0.bu0D_0uQuyNLyJjfRESNhu7twkJ5nxu8pQtfa1w3hZs/img.png?width=980" id="7ef38" class="rm-shortcode" data-rm-shortcode-id="9974c7bef3812fcb36858f325889e3c6" data-rm-shortcode-name="rebelmouse-image" />
American novelist, writer, playwright, poet, essayist and civil rights activist James Baldwin at his home in Saint-Paul-de-Vence, southern France, on November 6, 1979.
Credit: Ralph Gatti/AFP via Getty Images
The future of dignity<p>Around the world, people are still working toward the full and equal recognition of human dignity. Every year, new speeches and writings help us understand what dignity is—not only what it looks like when dignity is violated but also what it looks like when dignity is honored. In his posthumous essay, Congressman Lewis wrote, "When historians pick up their pens to write the story of the 21st century, let them say that it was your generation who laid down the heavy burdens of hate at last and that peace finally triumphed over violence, aggression and war."</p> <p>The more we talk about human dignity, the better we understand it. And the sooner we can make progress toward a shared vision of peace, freedom, and mutual respect for all. </p>
Northwell Health CEO Michael Dowling has an important favor to ask of the American people.
- Michael Dowling is president and CEO of Northwell Health, the largest health care system in New York state. In this PSA, speaking as someone whose company has seen more COVID-19 patients than any other in the country, Dowling implores Americans to wear masks—not only for their own health, but for the health of those around them.
- The CDC reports that there have been close to 7.9 million cases of coronavirus reported in the United States since January. Around 216,000 people have died from the virus so far with hundreds more added to the tally every day. Several labs around the world are working on solutions, but there is currently no vaccine for COVID-19.
- The most basic thing that everyone can do to help slow the spread is to practice social distancing, wash your hands, and to wear a mask. The CDC recommends that everyone ages two and up wear a mask that is two or more layers of material and that covers the nose, mouth, and chin. Gaiters and face shields have been shown to be less effective at blocking droplets. Homemade face coverings are acceptable, but wearers should make sure they are constructed out of the proper materials and that they are washed between uses. Wearing a mask is the most important thing you can do to save lives in your community.
Some experts may worry that AI will depersonalize health care, but others see its potential to deepen relationships.
- Today's rate of innovation and change has made it difficult for patients and physicians to effectively integrate technology into medical best practices.
- Experts agree that physicians need more time in their day to build bonds with patients.
- Dr. Eric Topol believes that artificial intelligence may help restore that time, creating what he calls "deep medicine."
Will AI replace doctors?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTU1Njc0Ni9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2ODIyNjM2NX0.Zfq8OiEdxz-HywQ3jyZekoBSIKq9dG36Xm8-v7NAxkk/img.jpg?width=980" id="b55f2" class="rm-shortcode" data-rm-shortcode-id="dcc521836bd087bf6fc1545deea7d8e2" data-rm-shortcode-name="rebelmouse-image" />
With AI taking on the routine work, doctors will have more time to be actively involved with patients and referring physicians.
Photo: Tom Werner/Getty Images<p>That may sound counterintuitive. Technology like EHRs have affected doctor-patient interactions, and when we speak of AI entering a job market, it's with premonitions of the robopocalypse. Consider America's roughly 2 million truckers, who may lose their jobs to <a href="https://www.theguardian.com/technology/2017/oct/10/american-trucker-automation-jobs" target="_blank">self-driving vehicles</a>.</p><p>Yet blue-collar jobs are not the only ones subject to AI takeover. Some jobs that require the most advanced education are more likely to become obsolete, according to entrepreneur <a href="https://bigthink.com/u/andrew-yang" target="_blank">Andrew Yang</a>. "Doctors, lawyers, accountants, wealth advisers, traders, journalists, and even artists and psychologists who perform routine activities will be threatened by automation technologies," he writes in <em><a href="https://www.amazon.com/War-Normal-People-Disappearing-Universal/dp/0316414212?SubscriptionId=AKIAJGTABWIBL2VADPUA&tag=bigthink00-20&linkCode=xm2&camp=2025&creative=165953&creativeASIN=0316414212" target="_blank">The War on Normal People</a></em>.</p><p>Day-to-day workplace routines will determine whether AI can perform a job, because the technology can perform routine tasks faster and more accurately than people, without needing a break.</p><p>To pick one example from medical practice, radiologists spend much of their time analyzing patient films. It takes years of education to develop that skill. Even then, certain diagnoses can be tricky and human deficiencies, such as confirmation bias and inattentional blindness, can lead to mistakes.</p><p>Deep learning could streamline the process of analyzing medical images. One day, AI may be able to read more medical images more quickly and compare them to a catalog exponentially larger than anyone could memorize. It may also detect anomalies too fine for detection by the human eye. And you only have to develop an AI once, as opposed to the extensive costs of training and maintaining human radiologists. </p><p>AI is unlikely to eliminate the need for radiologists, but rather it may enable radiologists to be more actively involved with patients and referring physicians as part of the care team. We're years away from AI becoming commonplace in radiology departments. However, the principles are sound and <a href="https://hbr.org/2018/03/ai-will-change-radiology-but-it-wont-replace-radiologists" target="_blank">the technology is already under development</a>. Some day, when AI can manage standalone diagnosis for routine cases, radiologists will be free to focus on the most challenging cases.</p>
AI will free up radiologists' time to work on the most challenging cases. Here, neuroradiologists in Paris operate on a patient affected with an arteriovenous deformation.
Photo GERARD JULIEN/AFP/Getty Images
Deep learning, deeper empathy<p>In <em><a href="https://www.amazon.com/Deep-Medicine-Artificial-Intelligence-Healthcare/dp/1541644638?SubscriptionId=AKIAJGTABWIBL2VADPUA&tag=bigthink00-20&linkCode=xm2&camp=2025&creative=165953&creativeASIN=1541644638" target="_blank">Deep Medicine</a></em>, Topol suggests that well-implemented AI can free physicians from repetitive tasks, providing more face time to meet, inform, reassure and follow up with patients. It can also minimize burnout and improve health care quality. Topol cites one study from the National Bureau of Economic Research that found for every extra minute a home visit lasts, risk of readmission was reduced by 8 percent.</p><p>The same gains may be possible with EHRs. Integrated AI can make it easier to log entries, consolidate records, and draw data from external sources such as a patient's smartwatch or mobile device.</p><p>"Human performance is unlikely to change materially over time. But machines will progressively outperform humans for various narrow tasks," Topol writes. "To take humans to the next level, we need to up our humanist qualities, that which will always differentiate us from machines." He calls deep learning's potential to support medical empathy and outcomes "deep empathy."</p>
A humane pairing<p>Busywork and routine labor so severely cut into physician schedules that <a href="https://www.nytimes.com/2017/11/14/well/live/the-patients-vs-paperwork-problem-for-doctors.html" target="_blank">Danielle Ofri</a>, an associate professor of medicine at New York University School of Medicine, has suggested imposing fines on hospitals that detract too much from patient face-time.</p><p>As the National Bureau of Economic Research survey suggests, health care is a field where literally every minute counts. </p><p>"Most importantly ... when people are sick, they need empathy," Topol told <em>Big Think</em> in an interview. "They need the person who is their doctor to be with them, to understand what they're going through, because being in pain and being sick is the loneliest thing in the world. And if you don't have a doctor that is empathic, that is the worst-case scenario. We've got to get that back."</p><p>But Topol indicates a caveat: Implementing AI in health care just as an efficiency tool would counteract potential gains in doctor-patient relationships. </p><p>Michael Dowling agrees. As he told <em>Big Think</em> in an interview: "A lot of publicity has been given to a lot of these [big tech] players. But the core of the care being delivered to people who are very sick is still being done at hospitals and doctors' and ambulatory sites."</p><p>And that core must be building a humane — and, indeed, human — doctor-patient relationship.</p>
Technology that enables telemedicine is set to change the medical field for patients, doctors, and investors.
- Digital technologies that disrupted industries like communication and transportation are steadily changing health care, too.
- Virtual health care will save consumers money while growing the industry by billions of dollars.
- Non-visit care combined with smartphone apps will give patients more power over their health care.
The future of telemedicine or virtual health care<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTQ1NjkzMC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzMzI0Mzk3NH0.OgOyKVhMJ8pXaOv8KJ6_G0OISfCPnINSoNjN0bzMiC4/img.jpg?width=980" id="e526a" class="rm-shortcode" data-rm-shortcode-id="ddd077edff9cfc77fbdb101d70b7cc9e" data-rm-shortcode-name="rebelmouse-image" alt="telemedicine consultation telehealth" />
Telemedicine allows A&E doctors at Dole Hospital – which doesn't have a neurology department – to obtain an immediate diagnosis for their patient by a neurologist in Besancon hospital, seen over the doctor's shoulder. This system allows doctors to exchange medical imagery and the patient's file.
(Photo by: BSIP/UIG via Getty Images)<p>Dr. Eric Topol of the Scripps Research Institute is an ardent proponent of increasing the role of technology, especially smartphones, in the way that health professionals conduct business. In his book, <em><a href="https://www.amazon.com/Patient-Will-See-You-Now/dp/0465040020?SubscriptionId=AKIAJGTABWIBL2VADPUA&tag=bigthink00-20&linkCode=xm2&camp=2025&creative=165953&creativeASIN=0465040020" target="_blank">The Patient Will See You Now</a></em>, he emphasizes that clinicians and medical organizations need to put technological solutions at the forefront of health care strategy and delivery.<em></em></p><p>Noting that "the culture of medical practice is famously conservative," Topol concedes that it will be a challenge, but the opportunities are too great to pass up.</p><p>Major players in the health care field are already implementing telemedicine. Dowling states in his book that:</p><p style="margin-left: 20px;"><em></em>At Kaiser Permanente, 52 percent of 'the more than 100 million patient encounters each year are now 'virtual visits,'' via text messages, calls, email, or video conferencing.<em></em></p><p>Dowling adds that health care technology falls within two primary categories: facilitating the delivery of care and consumer interactions.</p><p>Continuing technological advancements will spur non-visit health care and improve <a href="https://bigthink.com/Sponsored-by-Northwell-Health/value-based-health-care" target="_self"><u>value-based health care</u> </a>solutions. Companies such as Apple, Amazon, Facebook, Google, and Microsoft have already publicly expressed interest in continuing to grow their health care presence. For years, Apple has been consolidating medical records on iOS through extensive partnerships with major medical centers – including Johns Hopkins, Cedars-Sinai, and Geisinger Health System.</p><p>One of the more noteworthy entrants is Haven, a nonprofit collaboration between JP Morgan, Berkshire Hathaway, and Amazon. Haven's goal is to improve health care services and lower costs for the three companies while making primary care easier to access.</p>
Technological health care solutions in action<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTQ1NjkzNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYwOTMyMjE4NX0.4t8arm566JypaHJZ17abHPH0EWu9z7U7X63-NVKzbxo/img.jpg?width=980" id="d9aa5" class="rm-shortcode" data-rm-shortcode-id="a4282855965d4df1fe444ec522d2a4ea" data-rm-shortcode-name="rebelmouse-image" />
Erica Jensen, with her 5-month-old daughter, Charlee Jaques, by her side, video conferences with her doctor, Dr. Marie McDonnell, from her mother's home.
(Photo by Dina Rudick/The Boston Globe via Getty Images)<p>Amazon made another big splash last year when it announced that it had acquired <a href="https://techcrunch.com/2018/06/28/amazon-buys-pillpack-an-online-pharmacy-that-was-rumored-to-be-talking-to-walmart/" target="_blank"><u>PillPack,</u></a> an online pharmacy. PillPack is a high-profile example of a telemedicine solution that brings the Silicon Valley spirit into the medical arena. PillPack's digital pharmacy platform manages patient data and controls logistics for delivering and managing customers' medical needs.</p><p>Innovations continue to unfold every day. In April 2019, Northwell Health launched an <a href="https://www.northwell.edu/lenox-health-greenwich-village/news/northwell-health-opens-emergency-telepsychiatry-hub-reducing-er-wait-times" target="_blank"><u>Emergency Telepsychiatry Hub</u> </a>that provides around-the-clock mental health care. People in crisis no longer have to wait long hours during crucial times of need. Patients have benefited from drastically reduced waiting times to speak to someone who can help them – members of an expansive team that includes 23 psychiatrists and 9 behavioral health practitioners with master's level training</p><p>Already, the new telemedicine service has brought the wait time down 90 percent to an average of 45 minutes. Northwell is increasingly integrating these services to many of its hospitals and centers. Jonathan Merson, MD, medical director of Northwell Emergency Telepsychiatry Hub Program, stated, "It's a technology that has no boundaries and the goal is simple: No patient experiencing a behavioral health emergency should have to wait to be seen."</p>
Telemedicine will save billions<p>Telemedicine services are not only smart, they are also necessary. The American Association of Medical Colleges has already projected that there may be <a href="https://news.aamc.org/medical-education/article/new-aamc-research-reaffirms-looming-physician-shor/" target="_blank"><u>a shortage of some 40,000 primary care physicians</u> </a>(PCPs) in the coming decade. Increased virtual services will alleviate this shortage and allow already-overworked clinicians to focus on giving advanced care to patients in more critical situations.</p><p>Another consideration is the economic value of telemedicine services. <a href="https://newsroom.accenture.com/news/use-of-virtual-health-solutions-in-primary-care-could-save-10-billion-annually-accenture-finds.htm" target="_blank"><u>An Accenture analysis</u></a> found that the use of telehealth services could generate up to $10 billion annually over the next few years.</p><p>Without needing to expand the workforce, telemedicine can assist and augment medical professionals' activities. Personalization and efficiency will benefit the individual patient as the tools for controlling their own medical records and care plans allow them to become more engaged.</p>
What health conditions can be treated via telemedicine?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTQ1Njk0NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0MDg3ODE3N30.A10k4QWPIM5ASBNLva7ctj0dacbAdP2tEsahn3DEIfA/img.jpg?width=980" id="d1e58" class="rm-shortcode" data-rm-shortcode-id="69740317c9702c2462579bcd2376c6b2" data-rm-shortcode-name="rebelmouse-image" />
Telemedicine is being used by rescue services in Hesse, Germany, to better treat patients in urgent conditions.
(Photo by Arne Dedert/picture alliance via Getty Images)<p>Telehealth is also useful for people whose frailty or chronic condition make it difficult to visit a doctor's office. There have been significant developments in what some medical providers are calling <a href="https://healthpayerintelligence.com/news/payers-can-leverage-telehealth-for-chronic-disease-management" target="_blank"><u>remote patient monitoring tools.</u> </a>For example, smart phones or tablets of people with Type 2 diabetes can <a href="https://hbr.org/2018/04/virtual-health-care-could-save-the-u-s-billions-each-year" target="_blank"><u>automatically log</u> blood glucose <u>data</u> </a>from their monitoring device. Physicians can check these analytics any time and adjust treatment as needed.</p><p>Telemedicine is also more efficient than office visits or house calls for non-chronic health issues. A quick follow-up by video conference can ensure a patient is following their physician's directions. Medication management – confirming compliance with prescription doses and schedules, ensuring there are no troublesome side effects – is another helpful application of telehealth.<br></p><p>The technology that drives telemedicine is only in its infancy, but it will gain increasing prominence in the medical field and public sphere as innovations skyrocket and new startups enter the arena. As people grow accustomed to the ability to chat to their doctors without passing through a waiting room, to receive instant attention based on data from their medical devices, and to control their health from the palm of their hand, the life-saving convenience of telemedicine will be realized. That future is already under way. </p>
What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.
- Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
- Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
- Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.
Printing realistic, customized organ models<p>3D printers can take images from MRI, PET, sonography or other technologies and convert them into life-size, three-dimensional models of patients' organs. These models serve as hands-on visualization tools that help surgeons plan the best approaches for complex procedures. </p><p>They also allow doctors to customize patient-specific models prior to surgery. For example, Northwell employs 3D printing in <a href="https://www.northwell.edu/3d-design-innovation" target="_blank">several clinical applications</a>:</p><ul><li>Tumor resection models clearly highlight the tumor and surrounding tissue </li><li>Orthopedic models are useful for pre-surgery measuring and medical device adjustments</li><li>Vascular models identify malformations in organs, tumors, sliced chambers, blood flow, valves, muscle tissue, and calcifications</li><li>Dentistry oral implants and appliances can be created in just one day, significantly reducing wait periods for Northwell dentists and their patients</li></ul><p>Using realistic models not only delivers better health results but also shortens operating times. That gives patients less time under anesthesia, and hospitals potential savings of millions of dollars over just a few years. </p><p>Being able to visualize procedures before they occur also helps to comfort patients and their families. Take, for instance, the case of Barnaby Goberdhan, a man who discovered that his young son, Isaiah, had an aggressive tumor in his palate. Goberdhan met with <a href="https://www.northwell.edu/find-care/find-a-doctor/otolaryngology/dr-neha-ashwin-patel-md-11377044" target="_blank">Neha A. Patel, MD</a>, a pediatric otolaryngologist at Cohen Children's Medical Center, a Northwell Health hospital, to discuss the procedure and learn about it with help from a 3D-printed model. </p><p>"Having a 3D printed depiction of my son was really helpful when talking with the doctor about his surgery," <a href="https://www.northwell.edu/news/northwell-health-doubles-down-on-3d-printing-from-formlabs-to-provide-fast-realistic-3d-surgical-models" target="_blank">said</a> Mr. Goberdhan. "The doctor was able to do more than talk me through what they were going to do – Dr. Patel showed me. There is almost nothing more frightening and stressful than having your child go through surgery. There were several options Dr. Patel walked us through for the best way to preserve Isaiah's teeth and prevent additional cuts within his mouth. I wanted all of my questions answered so I could be less fearful and more prepared to talk my son through what he was about to face. I wanted Isaiah to feel prepared. With the 3D model, we both felt more at ease." </p><p>For years, 3D printing surgical models was prohibitively expensive. Now, more affordable systems such as <a href="https://formlabs.com/3d-printers/form-cell/" target="_blank">Formlabs' Form Cell</a> give more hospitals across the country access to the technology in order to produce realistic, patient-specific models, usually within one day. <br></p>
3D-printed prosthetics<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTM4Nzg0My9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYwODIyMzMzMH0.nbCR_5Ga21vVWDIVLlMmm4lEF1hooz6ukpxMhryGRH8/img.jpg?width=980" id="7a06e" class="rm-shortcode" data-rm-shortcode-id="a5f571636831d81a21219bba7a6d2556" data-rm-shortcode-name="rebelmouse-image" />
Credit: Northwell Health<p>While 3D-printed organs are a long way in the future, today's technology is well suited for manufacturing prosthetics. 3D-printed prosthetics are often remarkably more affordable and personalized than their traditional counterparts. That's a big deal for many families, especially those with children who outgrow prosthetics and are forced to buy new ones. </p><p>One recent breakthrough in 3D-printed prosthetics came when Dan Lasko, a former Marine who lost the lower part of his left leg in Afghanistan, wanted the ability to swim with his prosthetic leg. Wearing prosthetics in water has been possible for years, but they typically <a href="https://www.nytimes.com/2017/03/14/well/swimming-with-a-brand-new-leg.html" target="_blank">slow swimmers down</a>. No device had been able to go seamlessly from land to water or to help propel its wearer through the water. </p><p>To fix that, Northwell Health recently funded a project that developed <a href="https://thereturn.northwell.edu/" target="_blank">The Fin</a> – the world's first truly amphibious prosthetic. With The Fin, Lasko and his family can go straight into the pool from the locker room – or the diving board.<br></p>
3D bioprinting<p>For years, 3D printers have manufactured various products: phone cases, toys, and even operational guns. To produce these objects, the machines heat a raw material, typically plastic, and build the object layer-by-layer according to a particular design. </p><p>3D bioprinting, a young field developed by researchers with Northwell Health, may someday perform the same process but instead with living cells in a raw material called bioink. </p><p>Daniel A. Grande, director at the Orthopedic Research Laboratory in the Feinstein Institute for Medical Research, an arm of Northwell Health, said he and his team first pursued 3D bioprinting by modifying 3D printers so they'd accept living cells. </p><p>"My initial concept of 3D printing was early studies that looked at modifying ink-jet printers, where we incorporate a bioink that includes cells within a delivery vehicle," Grande <a href="https://youtu.be/oWnbUuJXtFc" target="_blank">says</a>. "That hydrogel can then be polymerized, or hardened, upon heat or UV-light stimulation, so that we can actually make a complex structure, three-dimensionally, that incorporates living cells. The hardened hydro-gel is then able to keep the cells alive and viable. It's also biocompatible, so it can be safely implanted in humans." </p><p>It's a promising enterprise, and it can radically change how we experience medical care.</p><p>"3D bioprinting's potential is almost limitless and has the potential to replace many different parts of the human body," <a href="https://theislandnow.com/news-98/3d-bioprinting-wins-northwell-health-medical-breakthrough-contest/" target="_blank">says</a> Michael Dowling, president and CEO at Northwell Health, and author of <em></em><a href="https://healthcare-reboot.com/" target="_blank"><em>Health Care Reboot</em></a>. "Researchers envision a future with 3D printers in every emergency room, where doctors are able to print emergency implants of organs and bones on demand and revolutionize the way medicine is practiced."</p><p>Dr. Todd Goldstein explains more about 3D bioprinting below: </p>
Taking care of our minds is an often neglected aspect of aging. What are we going to do about it?
- Studies have shown that depression can worsen in our old age.
- Other mental health concerns, too, are not only debilitating on their own but they can often make it more difficult to treat other health conditions.
- However, recent advances in how we treat mental health in the elderly are making a big difference. Here's how.
Percentage of older adults who claim they don't receive the social and emotional support they need by state, which can put individuals at risk for developing mental health conditions.
Centers for Disease Control and Prevention and National Association of Chronic Disease Directors. The State of Mental Health and Aging in America Issue Brief 1: What Do the Data Tell Us? Atlanta, GA: National Association of Chronic Disease Directors; 2008.