Center for Connected Health Symposium

Lubna Hammoudeh

Fellow at BWH/PGY6

I greatly enjoyed attending the Center of Connected Health Symposium.

As a first-time attendee, it was interesting to see how technological developments in medicine significantly impact patients’ lives and help physicians move forward in future advances of healthcare, connecting care & discovery.  One such development stands out to me because in my field as radiation oncologist there is a big technological turn over in our machines & the ways to treat patients with multiple different set up that change rapidly from previous era for example after being simulated patients for planning relying on CT based machines now there is moving towards the use of MRI mapping instead.

This symposium gives us the opportunity to take part in the new era of health, reduce burnout on physicians by improve their satisfaction, practice efficiency, time saving, efficient practice and decrease the cost of healthcare.

One of the challenges in this era of a digital health system is the patient-physician relation which I believe is still the cornerstone in this zone of technological changes.  I believe this is the cornerstone because we as physicians & healthcare team have to focus on not losing patients’ trust, consider quality of care, continuous engagement with patients & understanding their concerns to have a valuable outcome. The conference touched on these themes ….

Attending this conference has impacted my thinking on implementing a mobile app which will assess radiation treatment toxicities to evaluate & assess patients’ disease outcome after completion of radiation course; this app that would incorporate a list of yes or no survey questions with the expected side effects including grading parameters for each one & according to score results observation vs. intervention will be decided to deal with different patients’ status.

An app like this was talked about at the conference.  Apps like these will be a great convenience to patients by avoiding extra trips to the hospital, it would also be cost effective and reduce medical team efforts. I would like to be a part of implementing this type of change and attending the conference helped give me the boost to do this.

We as radiation oncologists have also implemented a pre-encounter questionnaire by use of an iPad, we have been able to save time & employee workload in patient evaluation, this idea was similar to one that was shown in the conference that enable the patients to do pulmonary function test from their home & send the results to the clinic.

My future plan is to work on a project within my field of radiation oncology to generate a new modality of radiation that would improve and widen the treatment course and decrease radiation related toxicities which will in return benefit patients , this was highlighted clearly in the conference talks especially the topics that were related to pediatric patients with ADHD & autism using new tools that help them concentrate & deal with daily activities with less harm possible whether it is physical side effects or negative psychological impact.

The Live Music Capital of the World Welcomes the AAMC

Yan Emily Yuan

Resident in Internal Medicine at Brigham and Women’s Hospital

PGY-1

The Live Music Capital of the World Welcomes the AAMC

Austin, Texas is known for hosting performers and showcasing talents. Over the first week of November, a different stage was set: more than 4500 medical professionals—educators, administrators, leaders and influencers—gathered for the 2018 Annual Meeting of the Association of American Medical Colleges (AAMC). The signature tagline ‘Learn Serve Lead’ was both brightly displayed and boldly embodied by the plenary sessions and presentations across the multi-day conference.

Dr. Darrell Kirch, president and CEO of AAMC addressing conference attendees

The value of humanities training in medical education continues to be a topic of emphasis. In her talk ‘Innovations in Professional Moral Development,’ Dr. Gail Geller of the Johns Hopkins Berman Institute of Bioethics discussed the ‘tolerance of ambiguity’ as a key to cultivating resilience among medical trainees; she invited attendees to consider ways to use the arts and humanities to develop and hone this critical skill. At the focused lunch discussion, Dr. Stephen Schoenbaum of the Josiah Macy Jr. Foundation explored incorporating the principles of performing arts—acting, improvisation—to teach medical students how to engage in productive interactions with patients, other health professionals and each other. Dr. Schoenbaum referenced actor Dame Judi Dench, who says that acting is not about learning the lines but rather about understanding why the character is saying those lines in response to something that another character has said. As doctors, we are often searching for “the right thing” to say to our patients; perhaps, we should spend more time understanding why our patients are saying what they are saying.

Storytelling was not only a highlighted topic within medical education, but also in leadership training. In a standing-room-only conference hall, Dr. Alicia Monroe, Provost of the Baylor College of Medicine shared her experiences of utilizing storytelling to capture an audience. While an engaging story is helpful in sharing our successes, she has found even more power in using narrative to connect with others when “confronted with a mess.” To do this effectively, Dr. Monroe offers, tell a story “through the lens of values that matters to your listener.”

As an internal medicine resident with background in Narrative Medicine, the themes of this conference resonated strongly with my values of how to practice, teach, and lead in medicine. I was able to connect with former mentors and meet other medical educators who are passionate about operationalizing the humanities skillset within medicine. Our conversations highlighted the potential to develop innovative curricula for both students and trainees. More than ever, I am eager to incorporate medical education into my residency training and future career. I would advise future attendees to connect with other Boston-area attendees prior to the conference to share ideas and find opportunities to collaborate.

Link to interview with Judi Dench: https://www.youtube.com/watch?v=0Rnv2V3Drik

Connecting at Connected Health 2018

Lisa Rotenstein

Brigham and Women’s Hospital

PGY-2 in Internal Medicine

Connecting at Connected Health 2018

I recently had the chance to attend the 2018 Connected Health Conference in Boston. It’s the main event of the year for Boston techies interested in health. First and foremost, I enjoyed learning about the wide swath of technologies being developed to tackle almost every issue we have in delivery of modern healthcare – inability to access or own records, chronic disease management, care convenience, etc. It was a pleasure to meet entrepreneurs putting forth diverse solutions to these challenges.

One of the conference’s most memorable sessions was led by BWH iHub speakers, including Jose Elias, Brian Mullen, and Mark Zhang. This trio discussed what it’s like to undertake innovation in an academic medical center, including how internal innovation groups can help clinicians bridge their ideas with those of technical experts who are building solutions.  I also particularly enjoyed a panel on the “Uber Primary Care Experience” from entrepreneurs building non-traditional, tech-enabled primary care systems. Their reflections emphasized how to use technology to support primary care rather than building care around technology, although the latter often happens because of disconnects between tech companies and healthcare systems

My biggest takeaway from the conference had to do with the diverse opportunities for innovating outside of the EHR, particularly in terms of patient-facing technologies. While much of my exposure to technology in training has centered on Epic, the Connected Health Conference offered a vision of how we can move past this to apps, telemedicine, and connected wearables that enhance the doctor-patient relationship and accordingly, outcomes. The conference specifically exposed me to some app-based technologies that I can look towards implementing in my own primary care practice in the future. For example, Bradley Crotty’s group at the Medical College of Wisconsin uses an interesting application called Patient Wisdom, which allows patients to share stories about themselves and set an agenda for their next visit. Providers then access this information, enhancing their visits. The FeatForward mobile application (which encourages patients to increase physical activity) is well accepted by patients and its use is associated with weight loss and decreased cardiometabolic risk. I can see myself using similar applications in my own practice and have connected with the researchers behind this work.

Attending the conference furthermore allowed me to connect with both new and old contacts in health technology and strengthen mentoring relationships. Post conference, I have connected with important health technology figures including Adam Landman and Rushika Fernandopulle, while meeting new contacts in the vendor world who have implemented patient messaging and wearable applications across diverse health systems.

This conference strongly met my expectations and broadened my horizons of how I can collaborate with industry in the future to achieve healthcare improvement goals related to chronic disease management, and patient and physician engagement. 

AAMC in Austin TX: Keeping Medical Education Weird!

Jonathan D. Santoro, MD

Fellow: Pediatric MS and Neuroimmunology

Massachusetts General Hospital/Brigham and Women’s Hospital

PGY6

AAMC in Austin TX: Keeping Medical Education Weird!

"Dr. Duckworth speaking on the concept of "grit" and its application to medical education"

Although a first time attendee at the AAMC meeting, the conference provided a very broad exposure to the multiple types of medical education programming. As medical education is not as published on as other, more scientific, endeavors, this conference provided fantastic insight in to the variety of programs operating at multiple programs. Although I came to Austin to present a pilot program on disability education I walked away with many more ideas on how to successfully reach students and trainees, alternatives to PowerPoint and didactic lecturing, and most importantly how to conduct a better study design.

One of the more interesting takeaways from the conference that did not relate to my project was the amount of simulation-based learning that is currently being undertaken across the spectrum. I was previously under the impression that only procedures were beneficial to have simulation-based learning but attending this conference opened my eyes to the amount of programming that exists in behavioral interventions. I think this could be very influential in training on behavioral interventions, counseling, and mental health encounters.

Attending this conference will impact my current program in that I have multiple additional thoughts on how to better construct and sustain a disability education program. I would advocate that future attendees attend as a group as there is a lot to see even though this a medium-sized conference.

My First Connected Health Conference: Inspirations and Revitalizing the Human Element

Thomas Wang

MD resident in the MGH internal medicine program (primary care track)

PGY-1

My First Connected Health Conference: Inspirations and Revitalizing the Human Element 

As a technology enthusiast and a doctor in training, I was thrilled to have had the privilege of attending the Connected Health Conference right here in Boston. The conference in many ways easily met my expectations. I sat through dozens of highly stimulating sessions on how we can better use technology to improve patients’ lives and experiences engaging with the healthcare system. I saw first-hand dozens of new, innovation solutions currently being explored for a diverse range of patient populations.

One of the central themes that was brought up again and again during the conference was the focus on the human element and the patient experience. During Dr. Joseph Kvedar’s talk, one of the many keynote speakers and vice president of Partners Connected Health, he brought up the image “The Doctor”, an 1891 painting by Luke Fildes that demonstrates a Victorian doctor observing at the bedside of a critically ill child at home. During that era, society’s medical knowledge and technology paled in comparison to what we have existing today. Unlike the broad arsenal of pharmacological agents, imaging modalities, and electronic systems we have now, doctors at the time often had little to offer – hospitals were places were people went to die, antibiotics did not exist, and medical treatments often had no scientific evidence behind their use and often did more harm than good. The human element, however, has not changed much since then, and one can argue that in many ways the human element has now taken a much less significant role.

Back then and stretching all the way back to ancient times, doctors routinely made house visits and really knew the people in their communities; interestingly, this was often the most therapeutic and impactful part of their role, serving as a source of support and expertise, however limited, as patients and their friends and family suffered through health issues and moments of hardship. Nowadays, although we are still trained on the art of medicine (i.e. how to engage in compassion and empathy with patients), this has unfortunately become merely a small portion of our vast array of clinical responsibilities: placing dozens of orders in the electronic medical records per hour, typing up long notes that were designed more for billing than for readability, and engaging with consultants and other essential medical staff through hundreds of E-mails and in-basket messages a week. All of these responsibilities are crucial in advancing patient care, except for one thing: none of them involve directly engagement with the patient. 5-10 minutes, and if lucky 15-20 minutes, is the norm rather than the exception in direct provider face-to-face time with patients in the outpatient clinical setting. In the hospital, this can become as low as a few minutes per patient per day. Both providers and patients over the last few decades have become cogs in the wheel within the vast medical industrial complex that hospitals and healthcare systems have become. This is a fundamentally flawed system, and one of my larger passions and career interests stems from how we can improve the patient experience while navigating the healthcare system and to keep patients healthier in the community and reduce preventable re-hospitalizations. This passion originated from my own experiences engaging with patients and the healthcare system on my medical school rotations, and the sadness and frustration in seeing patients come in to the hospital again and again, each time sicker than the last. We do a lot to patients in the hospital, but how much are we really doing for these patients?

As such, I was pleasantly surprised by the focus on the human element, a recurrent theme during this conference. I completely agree that this is the right approach in this day and age when our responsibilities in taking care of patients are becoming increasingly dehumanized. Technology is merely a means to an end; it does not matter how advanced the technology is if it does not improve the patient’s experience. Just because something is expensive and cool does not mean it holds value.

During the few days of the conference, I loved hearing about the different approaches and philosophies of healthcare leaders of large institutions and disruptive companies and how they exploit technology to better connect patients and providers. I went through a great workshop hosted by Partners Healthcare Pivot Labs, in which we explored a case study on how we would sell and implement an A.I. solution for hospitals to help predict and potentially prevent re-admissions for patients with heart failure. We explored three central themes: the business case, workflow integration, and the data collection process itself.  We asked many important questions: would patients and providers trust this solution? Who is it for? Would hospitals even be interested? Who are the stakeholders and what are their incentives for engagement? How can we demonstrate value? I sat in an intellectually stimulating debate on the fundamental question: is telemedicine really even worth it? In other words, does it improve patient outcomes and is it cost effective? One can argue either way, and the literature and evidence as a whole is at best mixed.

I came away from this conference inspired and full of ideas, and this is exactly what I had initially hoped to take away. I see innovation and improvements in the healthcare system playing a large role in my future career, and I am glad to see the thought leaders in this space have the right intentions and are passionately engaged in confronting this balance between exploiting technology to improve efficiency and value of healthcare providers and not losing the human element, which ultimately is the key component of the greater recipe in determining the effectiveness of our interventions. For future trainees at this conference, I would encourage them to attend sessions that span a diverse range of topics, find workshops/lectures that interest them and challenge their assumptions and worldview, and talk with as many folks as they can! I had multiple great conversations during this conference and made many new connections. The whole itinerary was somewhat overwhelming at first, but a lot of the talks are very similar in their overall themes, so I would not feel discouraged if there was a session that you really wanted to attend but could not due to time constraints. I would definitely encourage future trainees to attend this conference if they can, and I am very glad they hosted it in Boston this year!