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"content": "\u003cp>\u003cem>Author \u003cspan class=\"il\">Anica\u003c/span> John is an entrepreneur and advises Silicon Valley tech companies on business strategy and marketing. She recently worked at Smilables, an infant wearables startup.\u003c/em>\u003c/p>\n\u003cp>I'm seven months along with my first child and feeling inundated with information and advice on baby products.\u003c/p>\n\u003cp>It’s no wonder, because registering for a baby shower can be daunting. I found myself stunned by the sheer volume of strollers and car seats (which, when put together are billed as “travel systems”), cribs and hundreds of other baby products.\u003c/p>\n\u003cp>Alongside these staples, I'm evaluating a new wave of devices that can now gather important health and wellness data about your baby.\u003c/p>\n\u003cp>Here's what I have learned so far:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some of the most popular startups in the space are producing new, high-tech baby monitors. These gadgets are a significant improvement on traditional baby monitors with scratchy audio outputs or grainy video. One company, \u003ca href=\"http://www.sproutling.com/\" target=\"_blank\">Sproutling\u003c/a>, produces a wearable baby monitor that delivers vital sign information on a sleeping baby. A similar device from \u003ca href=\"https://www.owletcare.com/\" target=\"_blank\">Owlet\u003c/a> comes in sock form.\u003c/p>\n\u003cp>But these startups don’t track the most important measure for a child’s long-term success: Brain development.\u003c/p>\n\u003cp>\u003cstrong>Can an App Support Your Baby's Brain Development?\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://spock.fcs.uga.edu/ext/pubs/chfd/FACS01-7.pdf\" target=\"_blank\">Studies have shown \u003c/a>that stimulating a newborn baby’s brain helps to create neural connections that will be vital to future brain development.\u003c/p>\n\u003cp>Traditionally, new parents have been coached to meet this need through general advice centered around attentiveness. For example, you'll often see infant care websites that instruct parents to “sing songs,” or “express joy and interest in your baby.”\u003c/p>\n\u003cp>While these are helpful reminders, concerted efforts on brain development tend to fall by the wayside.\u003c/p>\n\u003cp>Fortunately, during my research, I discovered a new category of technology products that addresses this problem.\u003c/p>\n\u003cp>\u003ca href=\"http://babysparks.com/\" target=\"_blank\">BabySparks\u003c/a> is a smartphone app that provides hundreds of activities for parents to perform with their babies, all of which look a lot like playing. Caregivers can decide to do activities based on the specific needs of their babies or follow a daily program recommended by the app based on the child's age and development characteristics.\u003c/p>\n\u003cp>The app also has a milestone feature that provides parents an objective understanding of how their baby should be progressing in each of the developmental areas.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The key is to choose products that increase the chances of caregivers interacting with infants.\"\u003c/aside>\n\u003cp>Another startup, \u003ca href=\"http://www.versame.com/\" target=\"_blank\">Versame\u003c/a>, is developing a device that encourages caregivers to expose their infants to more words. Research indicates that the window for language development closes early. For example, infants over six months have difficulty recognizing sounds they have not heard repeated often.\u003c/p>\n\u003cp>Even more poignant is Stanford professor Anne Fernald’s assertion during a TED talk that, for babies, conversation is “\u003ca href=\"https://www.youtube.com/watch?v=IpHwJyjm7rM\" target=\"_blank\">nourishment for the brain\u003c/a>.” [Skip to the bottom to watch the video in full.]\u003c/p>\n\u003cp>Versame’s hardware product can be worn directly by the baby, attached to the crib or placed in the nursery, and counts the number of words a child hears. Caregivers can check the data on their smartphone at any point during the day and adjust the attention they give to each child accordingly. The goal is to inspire powerful positive behavior changes.\u003c/p>\n\u003cp>\u003cstrong>Realistic Goals for New Technologies \u003c/strong>\u003c/p>\n\u003cp>But my research showed that infant brain development products have a controversial history.\u003c/p>\n\u003cp>Such products have received criticism in the past. In 2007, the \u003ca href=\"http://en.wikipedia.org/wiki/Baby_Einstein\" target=\"_blank\">University of Washington claimed\u003c/a> that \u003ca href=\"http://www.kidsii.com/babyeinstein/\" target=\"_blank\">Baby Einstein\u003c/a> products adversely affected baby brain development by encouraging infants and toddlers to sit in front of televisions and watch educational DVDs or videos. While a subsequent lawsuit forced the researchers to retract their statements, the incident led the \u003ca href=\"https://www.aap.org/en-us/Pages/Default.aspx\" target=\"_blank\">American Academy of Pediatrics\u003c/a> to issue a recommendation against any screen time for children under two years of age.\u003c/p>\n\u003cp>So what's the best choice for a new parent?\u003c/p>\n\u003cfigure id=\"attachment_1815\" class=\"wp-caption alignleft\" style=\"max-width: 445px\">\u003cimg class=\" wp-image-1815\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/monkey-nanny-800x600.jpg\" alt=\"It's important to choose products that increase caregivers' interactions with an infant \" width=\"445\" height=\"334\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny-320x240.jpg 320w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny.jpg 1024w\" sizes=\"(max-width: 445px) 100vw, 445px\">\u003cfigcaption class=\"wp-caption-text\">New products are a step ahead of nanny cams \u003ccite>(Jim Champion)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The key is to choose products that increase the chances of caregivers interacting with infants. New parents, nannies, and other caregivers are often overwhelmed with caring for the basic needs of newborns and infants. In my opinion, using technology that provides constructive ways to interact with children this age can improve the number and quality of these interactions.\u003c/p>\n\u003cp>As a future working mother, the most compelling feature of these interactive baby educational products is that I can give my nanny specific assignments that can have a positive impact on my child’s development.\u003c/p>\n\u003cp>In the past, many working parents relied on nanny cams and an intuitive sense of how a hired caregiver would respond to our child’s needs. Now these new products provide metrics for measurement that allow us to set goals for improvement (“I’d like my child to hear 1000 more words each day,” or “I’d like her to do three more motor skills exercises this week.”).\u003c/p>\n\u003cp>This kind of tracking, if executed well, gives new tools to parents and caregivers, and may ultimately democratize early infant education through its effectiveness and simplicity.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[youtube http://www.youtube.com/watch?v=IpHwJyjm7rM]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Author \u003cspan class=\"il\">Anica\u003c/span> John is an entrepreneur and advises Silicon Valley tech companies on business strategy and marketing. She recently worked at Smilables, an infant wearables startup.\u003c/em>\u003c/p>\n\u003cp>I'm seven months along with my first child and feeling inundated with information and advice on baby products.\u003c/p>\n\u003cp>It’s no wonder, because registering for a baby shower can be daunting. I found myself stunned by the sheer volume of strollers and car seats (which, when put together are billed as “travel systems”), cribs and hundreds of other baby products.\u003c/p>\n\u003cp>Alongside these staples, I'm evaluating a new wave of devices that can now gather important health and wellness data about your baby.\u003c/p>\n\u003cp>Here's what I have learned so far:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some of the most popular startups in the space are producing new, high-tech baby monitors. These gadgets are a significant improvement on traditional baby monitors with scratchy audio outputs or grainy video. One company, \u003ca href=\"http://www.sproutling.com/\" target=\"_blank\">Sproutling\u003c/a>, produces a wearable baby monitor that delivers vital sign information on a sleeping baby. A similar device from \u003ca href=\"https://www.owletcare.com/\" target=\"_blank\">Owlet\u003c/a> comes in sock form.\u003c/p>\n\u003cp>But these startups don’t track the most important measure for a child’s long-term success: Brain development.\u003c/p>\n\u003cp>\u003cstrong>Can an App Support Your Baby's Brain Development?\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://spock.fcs.uga.edu/ext/pubs/chfd/FACS01-7.pdf\" target=\"_blank\">Studies have shown \u003c/a>that stimulating a newborn baby’s brain helps to create neural connections that will be vital to future brain development.\u003c/p>\n\u003cp>Traditionally, new parents have been coached to meet this need through general advice centered around attentiveness. For example, you'll often see infant care websites that instruct parents to “sing songs,” or “express joy and interest in your baby.”\u003c/p>\n\u003cp>While these are helpful reminders, concerted efforts on brain development tend to fall by the wayside.\u003c/p>\n\u003cp>Fortunately, during my research, I discovered a new category of technology products that addresses this problem.\u003c/p>\n\u003cp>\u003ca href=\"http://babysparks.com/\" target=\"_blank\">BabySparks\u003c/a> is a smartphone app that provides hundreds of activities for parents to perform with their babies, all of which look a lot like playing. Caregivers can decide to do activities based on the specific needs of their babies or follow a daily program recommended by the app based on the child's age and development characteristics.\u003c/p>\n\u003cp>The app also has a milestone feature that provides parents an objective understanding of how their baby should be progressing in each of the developmental areas.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The key is to choose products that increase the chances of caregivers interacting with infants.\"\u003c/aside>\n\u003cp>Another startup, \u003ca href=\"http://www.versame.com/\" target=\"_blank\">Versame\u003c/a>, is developing a device that encourages caregivers to expose their infants to more words. Research indicates that the window for language development closes early. For example, infants over six months have difficulty recognizing sounds they have not heard repeated often.\u003c/p>\n\u003cp>Even more poignant is Stanford professor Anne Fernald’s assertion during a TED talk that, for babies, conversation is “\u003ca href=\"https://www.youtube.com/watch?v=IpHwJyjm7rM\" target=\"_blank\">nourishment for the brain\u003c/a>.” [Skip to the bottom to watch the video in full.]\u003c/p>\n\u003cp>Versame’s hardware product can be worn directly by the baby, attached to the crib or placed in the nursery, and counts the number of words a child hears. Caregivers can check the data on their smartphone at any point during the day and adjust the attention they give to each child accordingly. The goal is to inspire powerful positive behavior changes.\u003c/p>\n\u003cp>\u003cstrong>Realistic Goals for New Technologies \u003c/strong>\u003c/p>\n\u003cp>But my research showed that infant brain development products have a controversial history.\u003c/p>\n\u003cp>Such products have received criticism in the past. In 2007, the \u003ca href=\"http://en.wikipedia.org/wiki/Baby_Einstein\" target=\"_blank\">University of Washington claimed\u003c/a> that \u003ca href=\"http://www.kidsii.com/babyeinstein/\" target=\"_blank\">Baby Einstein\u003c/a> products adversely affected baby brain development by encouraging infants and toddlers to sit in front of televisions and watch educational DVDs or videos. While a subsequent lawsuit forced the researchers to retract their statements, the incident led the \u003ca href=\"https://www.aap.org/en-us/Pages/Default.aspx\" target=\"_blank\">American Academy of Pediatrics\u003c/a> to issue a recommendation against any screen time for children under two years of age.\u003c/p>\n\u003cp>So what's the best choice for a new parent?\u003c/p>\n\u003cfigure id=\"attachment_1815\" class=\"wp-caption alignleft\" style=\"max-width: 445px\">\u003cimg class=\" wp-image-1815\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/monkey-nanny-800x600.jpg\" alt=\"It's important to choose products that increase caregivers' interactions with an infant \" width=\"445\" height=\"334\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny-320x240.jpg 320w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/monkey-nanny.jpg 1024w\" sizes=\"(max-width: 445px) 100vw, 445px\">\u003cfigcaption class=\"wp-caption-text\">New products are a step ahead of nanny cams \u003ccite>(Jim Champion)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The key is to choose products that increase the chances of caregivers interacting with infants. New parents, nannies, and other caregivers are often overwhelmed with caring for the basic needs of newborns and infants. In my opinion, using technology that provides constructive ways to interact with children this age can improve the number and quality of these interactions.\u003c/p>\n\u003cp>As a future working mother, the most compelling feature of these interactive baby educational products is that I can give my nanny specific assignments that can have a positive impact on my child’s development.\u003c/p>\n\u003cp>In the past, many working parents relied on nanny cams and an intuitive sense of how a hired caregiver would respond to our child’s needs. Now these new products provide metrics for measurement that allow us to set goals for improvement (“I’d like my child to hear 1000 more words each day,” or “I’d like her to do three more motor skills exercises this week.”).\u003c/p>\n\u003cp>This kind of tracking, if executed well, gives new tools to parents and caregivers, and may ultimately democratize early infant education through its effectiveness and simplicity.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/IpHwJyjm7rM'\n title='//www.youtube.com/embed/IpHwJyjm7rM'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Jane Maier was one of a select group of patients invited in early 2012 to help \u003ca href=\"http://www.partners.org/\">Partners HealthCare\u003c/a>, Massachusetts’ largest health system, pick its new electronic health record system – a critical investment of close to $700 million.\u003c/p>\n\u003cp>The system, which is now being phased in, will help coordinate services and reshape how patients and doctors find and read medical information. The fact that Partners sought the perspective of patients highlights how hospitals increasingly care about what their customers think.\u003c/p>\n\u003cp>“It’s such a great experience,” Maier said. “They treat us as a member – a partner – in their review process.”\u003c/p>\n\u003cp>Patient advisory councils, like the one Maier belongs to, often serve as sounding boards for hospital leaders – offering advice on a range of issues. Members are usually patients and relatives who had bad hospital experiences and want to change how things work, or who liked their stay and want to remain involved.\u003c/p>\n\u003cp>For Maier, it all started in 2009 when she had surgery at\u003ca href=\"http://www.brighamandwomens.org/\"> Brigham and Women’s Faulkner Hospital\u003c/a>, a Partners facility. Her husband wrote to the hospital’s CEO, praising her experience. The couple was then invited to speak at a hospital leadership retreat, sharing with top executives both the good and the not-so-good, and Maier was recruited to serve on a new patient advisory panel.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This hunt for patient perspective, which is becoming more and more common, is fueled in part by the health law’s quality-improvement provisions and other federal financial incentives, such as the link between Medicare payments and patient satisfaction scores.\u003c/p>\n\u003cp>“It’s a change in culture,” said Jayne Hart Chambers, senior vice president for quality at the \u003ca href=\"http://fah.org/\">Federation of American Hospitals\u003c/a>, which represents for-profit hospitals.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Data from 2013 suggested that 40 percent of hospitals had some kind of patient council, said Mary Minniti, a program and resource specialist at the\u003ca href=\"http://www.ipfcc.org/\"> Institute for Patient and Family Centered Care\u003c/a>, a Maryland-based nonprofit organization. Though councils appear to have become more common in the past few years, experts say it’s too early to know whether they typically improve hospital practices.\u003c/span>\u003c/p>\n\u003cp>“A lot of hospitals right now are very concerned because of the direction of [Medicare] payments,” said Carol Cronin, executive director of the nonprofit Informed \u003ca href=\"http://www.patientinstitute.org/\">Patient Institute\u003c/a>, an advocacy group. “They’re very concerned about patient experience and patient satisfaction.”\u003c/p>\n\u003cp>But it’s not just federal incentives. Patients have greater expectations as they shoulder larger shares of health care costs, said Richard Evans, chief experience officer at \u003ca href=\"http://www.massgeneral.org/\">Massachusetts General Hospital\u003c/a>, another Partners facility. This, he added, leads hospitals to focus on customer service.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Initially, nobody knew who we were and we had to sell ourselves\"\u003cbr>\n\u003ccite>Andy DeVries, patient advisory council at Spectrum Health \u003c/cite>\u003c/aside>\n\u003cp>Cronin, who has had a relative stay for an extended time in the hospital, volunteers on the patient advisory council at Johns Hopkins Hospital in Baltimore.\u003c/p>\n\u003cp>She was struck, she said, by the “meaty” topics the group addresses. Hopkins’ medical researchers have even pitched their projects to the council to find out what patients and families think are worthy of scientific investigation.\u003c/p>\n\u003cp>To have an impact, though, these groups can’t operate in isolation.\u003c/p>\n\u003cp>Patient and family advisory councils are useful if they have the ear of hospital leaders, Minniti said. But the groups also have to be integrated into decision making.\u003c/p>\n\u003cp>Andy DeVries joined the first patient advisory council at Michigan’s Spectrum Health about 10 years ago, after he was hospitalized with life-threatening injuries from a motorcycle accident.\u003c/p>\n\u003cp>“Initially, nobody knew who we were and we had to sell ourselves,” said DeVries, who now serves on one of Spectrum Health’s 13 patient groups.\u003c/p>\n\u003cp>Now, by contrast, his group offers input “any time there’s something new that involves patient or family care,” adding that the panel of patient advisers has tackled issues ranging from beefing up the facility’s security to how the hospital should give patients billing information. He’s even worked with the human resources department on what to look for when hiring doctors and nurses.\u003c/p>\n\u003cp>Such feedback led to marked increases in patient satisfaction scores, said Deborah Sprague, Spectrum Health’s program manager for patient and family services.\u003c/p>\n\u003cp>For instance, she said, a member of the orthopedics and neuroscience patient council noticed slow responses when he pushed the call button in his hospital room, a problem staff hadn’t noticed. The council worked with hospital employees to speed up response times. After the fix, positive patient assessments of the hospital jumped.\u003c/p>\n\u003cp>Maier, from the Faulkner council, recalled a time when hospital executives asked for help with patient complaints regarding nighttime noise levels. Late-night talking by staff was keeping patients awake.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Council members are often “middle-aged and older, white and English-speaking, and a lot of women.\"\u003cbr>\n\u003ccite>Deb Wachenheim, health quality manager at Health Care For Ally\u003c/cite>\u003c/aside>\n\u003cp>The group discussed potential nighttime “quiet times” and other strategies to minimize noise without keeping doctors from doing their jobs.\u003c/p>\n\u003cp>Once changes were made, patient satisfaction scores went up, Maier said — and a council member noticed a definite improvement the next time he was a patient.\u003c/p>\n\u003cp>Meanwhile, \u003ca href=\"http://www.medstarhealth.org/\">MedStar Health\u003c/a>, which serves the District of Columbia and Maryland, has targeted advisory panels’ efforts to improve both the quality and safety of its care. The system has emerged as a model for finding ways to incorporate patients’ opinions, which was noted in a report from the American Hospital Association.\u003c/p>\n\u003cp>In one recent case, said David Mayer, MedStar’s vice president of quality and safety, patient advisers helped brainstorm ways to soothe the confusion and stress that often sets in when people have been in the ICU for more than a day. When implemented, the ideas led to reduced instances of patient confusion – known as delirium – which is linked to more destructive behavior, like patients trying to leave the room or bed before they should.\u003c/p>\n\u003cp>But even as the role of patient advisory committees grows, recruiting members continues to be a challenge. Finding people from diverse backgrounds with both the inclination and time to serve can be tricky, Cronin said.\u003c/p>\n\u003cp>As a result, council members are often “middle-aged and older, white and English-speaking, and a lot of women,” said Deb Wachenheim, health quality manager at the Massachusetts-based advocacy group Health Care For All.\u003c/p>\n\u003cp>For some hospitals and health systems, though, these panels are just the beginning. Massachusetts General puts patients on various policy setting committees, and Faulkner has a non-voting patient board member.\u003c/p>\n\u003cp>“As we continue to evolve,” Maier said, “the hospital looks to us more and more.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Digital+Tools+For+Health+Come+With+%27Hope%2C+Hype+And+Harm%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jane Maier was one of a select group of patients invited in early 2012 to help \u003ca href=\"http://www.partners.org/\">Partners HealthCare\u003c/a>, Massachusetts’ largest health system, pick its new electronic health record system – a critical investment of close to $700 million.\u003c/p>\n\u003cp>The system, which is now being phased in, will help coordinate services and reshape how patients and doctors find and read medical information. The fact that Partners sought the perspective of patients highlights how hospitals increasingly care about what their customers think.\u003c/p>\n\u003cp>“It’s such a great experience,” Maier said. “They treat us as a member – a partner – in their review process.”\u003c/p>\n\u003cp>Patient advisory councils, like the one Maier belongs to, often serve as sounding boards for hospital leaders – offering advice on a range of issues. Members are usually patients and relatives who had bad hospital experiences and want to change how things work, or who liked their stay and want to remain involved.\u003c/p>\n\u003cp>For Maier, it all started in 2009 when she had surgery at\u003ca href=\"http://www.brighamandwomens.org/\"> Brigham and Women’s Faulkner Hospital\u003c/a>, a Partners facility. Her husband wrote to the hospital’s CEO, praising her experience. The couple was then invited to speak at a hospital leadership retreat, sharing with top executives both the good and the not-so-good, and Maier was recruited to serve on a new patient advisory panel.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This hunt for patient perspective, which is becoming more and more common, is fueled in part by the health law’s quality-improvement provisions and other federal financial incentives, such as the link between Medicare payments and patient satisfaction scores.\u003c/p>\n\u003cp>“It’s a change in culture,” said Jayne Hart Chambers, senior vice president for quality at the \u003ca href=\"http://fah.org/\">Federation of American Hospitals\u003c/a>, which represents for-profit hospitals.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Data from 2013 suggested that 40 percent of hospitals had some kind of patient council, said Mary Minniti, a program and resource specialist at the\u003ca href=\"http://www.ipfcc.org/\"> Institute for Patient and Family Centered Care\u003c/a>, a Maryland-based nonprofit organization. Though councils appear to have become more common in the past few years, experts say it’s too early to know whether they typically improve hospital practices.\u003c/span>\u003c/p>\n\u003cp>“A lot of hospitals right now are very concerned because of the direction of [Medicare] payments,” said Carol Cronin, executive director of the nonprofit Informed \u003ca href=\"http://www.patientinstitute.org/\">Patient Institute\u003c/a>, an advocacy group. “They’re very concerned about patient experience and patient satisfaction.”\u003c/p>\n\u003cp>But it’s not just federal incentives. Patients have greater expectations as they shoulder larger shares of health care costs, said Richard Evans, chief experience officer at \u003ca href=\"http://www.massgeneral.org/\">Massachusetts General Hospital\u003c/a>, another Partners facility. This, he added, leads hospitals to focus on customer service.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Initially, nobody knew who we were and we had to sell ourselves\"\u003cbr>\n\u003ccite>Andy DeVries, patient advisory council at Spectrum Health \u003c/cite>\u003c/aside>\n\u003cp>Cronin, who has had a relative stay for an extended time in the hospital, volunteers on the patient advisory council at Johns Hopkins Hospital in Baltimore.\u003c/p>\n\u003cp>She was struck, she said, by the “meaty” topics the group addresses. Hopkins’ medical researchers have even pitched their projects to the council to find out what patients and families think are worthy of scientific investigation.\u003c/p>\n\u003cp>To have an impact, though, these groups can’t operate in isolation.\u003c/p>\n\u003cp>Patient and family advisory councils are useful if they have the ear of hospital leaders, Minniti said. But the groups also have to be integrated into decision making.\u003c/p>\n\u003cp>Andy DeVries joined the first patient advisory council at Michigan’s Spectrum Health about 10 years ago, after he was hospitalized with life-threatening injuries from a motorcycle accident.\u003c/p>\n\u003cp>“Initially, nobody knew who we were and we had to sell ourselves,” said DeVries, who now serves on one of Spectrum Health’s 13 patient groups.\u003c/p>\n\u003cp>Now, by contrast, his group offers input “any time there’s something new that involves patient or family care,” adding that the panel of patient advisers has tackled issues ranging from beefing up the facility’s security to how the hospital should give patients billing information. He’s even worked with the human resources department on what to look for when hiring doctors and nurses.\u003c/p>\n\u003cp>Such feedback led to marked increases in patient satisfaction scores, said Deborah Sprague, Spectrum Health’s program manager for patient and family services.\u003c/p>\n\u003cp>For instance, she said, a member of the orthopedics and neuroscience patient council noticed slow responses when he pushed the call button in his hospital room, a problem staff hadn’t noticed. The council worked with hospital employees to speed up response times. After the fix, positive patient assessments of the hospital jumped.\u003c/p>\n\u003cp>Maier, from the Faulkner council, recalled a time when hospital executives asked for help with patient complaints regarding nighttime noise levels. Late-night talking by staff was keeping patients awake.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Council members are often “middle-aged and older, white and English-speaking, and a lot of women.\"\u003cbr>\n\u003ccite>Deb Wachenheim, health quality manager at Health Care For Ally\u003c/cite>\u003c/aside>\n\u003cp>The group discussed potential nighttime “quiet times” and other strategies to minimize noise without keeping doctors from doing their jobs.\u003c/p>\n\u003cp>Once changes were made, patient satisfaction scores went up, Maier said — and a council member noticed a definite improvement the next time he was a patient.\u003c/p>\n\u003cp>Meanwhile, \u003ca href=\"http://www.medstarhealth.org/\">MedStar Health\u003c/a>, which serves the District of Columbia and Maryland, has targeted advisory panels’ efforts to improve both the quality and safety of its care. The system has emerged as a model for finding ways to incorporate patients’ opinions, which was noted in a report from the American Hospital Association.\u003c/p>\n\u003cp>In one recent case, said David Mayer, MedStar’s vice president of quality and safety, patient advisers helped brainstorm ways to soothe the confusion and stress that often sets in when people have been in the ICU for more than a day. When implemented, the ideas led to reduced instances of patient confusion – known as delirium – which is linked to more destructive behavior, like patients trying to leave the room or bed before they should.\u003c/p>\n\u003cp>But even as the role of patient advisory committees grows, recruiting members continues to be a challenge. Finding people from diverse backgrounds with both the inclination and time to serve can be tricky, Cronin said.\u003c/p>\n\u003cp>As a result, council members are often “middle-aged and older, white and English-speaking, and a lot of women,” said Deb Wachenheim, health quality manager at the Massachusetts-based advocacy group Health Care For All.\u003c/p>\n\u003cp>For some hospitals and health systems, though, these panels are just the beginning. Massachusetts General puts patients on various policy setting committees, and Faulkner has a non-voting patient board member.\u003c/p>\n\u003cp>“As we continue to evolve,” Maier said, “the hospital looks to us more and more.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Smartphones, Vinegar and the Future of Cervical Cancer Screening",
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"content": "\u003cp>100 years ago, cervical cancer reigned as the leading cause of cancer death for women in the United States\u003c/p>\n\u003cp>Then,\u003ca href=\"http://weill.cornell.edu/archives/blog/2011/06/george-papanicolaou-development-of-the-pap-smear.html\">\u003cspan style=\"color: #1155cc\"> a doctor at Cornell University\u003c/span>\u003c/a> began conducting studies on the sex cycle of guinea pigs and in 1915 realized that a similar “smear” technique could be applied to the study of human vaginal cells. A few decades of disinterest and skepticism later, the Pap smear became the standard cancer screening test for women. Today, \u003ca href=\"http://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=76\">\u003cspan style=\"color: #1155cc\">the cervical cancer death rate has plunged by more than 50 percent and ranks 14th in frequency in the United States.\u003c/span>\u003c/a>\u003c/p>\n\u003cp>This is far from the case in developing countries, where \u003ca href=\"http://www.womendeliver.org/assets/CervicalCancer_final.pdf\">\u003cspan style=\"color: #1155cc\">cervical cancer is the most common cancer\u003c/span>\u003c/a> and the leading cause of cancer deaths among women. \u003ca href=\"http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/cervical-cancer-statistics\">\u003cspan style=\"color: #1155cc\">Over 85 percent of cervical cancer cases occur\u003c/span>\u003c/a> in the developing world and these staggering rates are largely due to the lack of screening. Pap smears are rare and less than five percent of women receive any cervical cancer screening at all.\u003c/p>\n\u003cp>However, new research and innovations in cervical cancer screening are helping to increase its breadth and frequency in many of the world’s poorest countries. Moreover, these new approaches are actually more accurate, convenient, and cost-effective than the traditional Pap smear, not to mention less unpleasant. They let doctors and their patients bypass the Pap smear altogether, while the Pap smear’s dominance in the U.S. remains strong.\u003c/p>\n\u003cp>\u003cstrong>No Place for the Pap\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many women may be surprised to learn that the Pap smear only detects cancer about half of the time but repeating the test on a regular basis increases the chances of finding cancer since the disease is slow to develop.\u003c/p>\n\u003cp>Repeating the test regularly is often not an option in developing countries where a number of barriers -- time, money, distance, transportation, children, agricultural cycles, social stigmas -- prevent women from visiting health clinics. Paps also take a hefty amount of resources to administer and read.\u003c/p>\n\u003cp>“The Pap test is hard to implement in low resource settings because it requires expensive machines, labs, and trained technicians, as well as for women to make the trips to clinics,” said Dr. José Jerónimo, the senior adviser for women’s cancers in a reproductive health program called \u003ca href=\"http://www.path.org/our-work/reproductive-health.php\">PATH\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"http://www.path.org/\">PATH\u003c/a> is an international nonprofit dedicated to accelerating health innovation in the developing world. The organization has a number of initiatives aimed at making cervical cancer screening and prevention more prevalent in under-resourced areas. A key part of its approach is a low-tech effort called “VIA”, which stands for visual inspection with acetic acid.\u003c/p>\n\u003cfigure id=\"attachment_2125\" class=\"wp-caption aligncenter\" style=\"max-width: 446px\">\u003cimg class=\" wp-image-2125\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Unknown-4-800x450.jpeg\" alt=\"Many new technologies are deployed first in developing countries \" width=\"446\" height=\"251\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-800x450.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-400x225.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-1180x664.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-768x432.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-320x180.jpeg 320w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4.jpeg 1920w\" sizes=\"(max-width: 446px) 100vw, 446px\">\u003cfigcaption class=\"wp-caption-text\">Many new technologies are deployed first in developing countries \u003ccite>(TeamLiveLonger )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This method involves swabbing the cervix with a 3 to 5 percent vinegar solution during a speculum exam, waiting for one minute, and then observing the cervix to see if white areas appear. In addition to being inexpensive and easy to administer, VIA also provides immediate results. It allows a patient to immediately receive guidance on next steps if the test is positive.\u003c/p>\n\u003cp>However, like the Pap, the vinegar technique only identifies 50 to 60 percent of precancerous cases, which is why PATH helped develop \u003ca href=\"http://www.path.org/news/press-room/147/\">a new molecular test called careHPV\u003c/a> that was developed and field tested for use in low-resource settings.\u003c/p>\n\u003cp>CareHPV can detect DNA from 14 cancer-causing types of HPV in 2.5 hours without extensive lab facilities, using an affordable machine the size of a toaster oven that runs on electricity or a battery. Women can collect their own samples using a small brush, without the need for a pelvic exam.\u003c/p>\n\u003cp>This approach is ideal for environments where health care resources are limited and testing is often administered by community health workers who visit people’s homes, as well as in places where stigmas against pelvic exams persist.\u003c/p>\n\u003cp>Dr. Jerónimo said that simply by allowing women to collect the sample themselves, coverage increases by 4 times.\u003c/p>\n\u003cfigure id=\"attachment_2124\" class=\"wp-caption aligncenter\" style=\"max-width: 443px\">\u003cimg class=\"wp-image-2124\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Unknown-2-800x533.jpeg\" alt=\"A group of medical students learn how to send images \" width=\"443\" height=\"295\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-800x533.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-400x266.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-1180x786.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-768x511.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-320x213.jpeg 320w\" sizes=\"(max-width: 443px) 100vw, 443px\">\u003cfigcaption class=\"wp-caption-text\">A group of medical students learn how to send images \u003ccite>(TeamLiveLonger )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Texting, Calling, and Cervical Cancer Screening\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.mobileodt.com/\">MobileODT\u003c/a> is a startup that makes a mobile colposcope, a long-range, Internet-connected magnifying glass that plugs into smartphones. The device provides a high-resolution image of cervical tissue, which can then be securely transmitted for diagnostics.\u003c/p>\n\u003cp>[Skip to the bottom to a video of how a mobile colposcope works.]\u003c/p>\n\u003cp>“There are very few labs or specialists in developing countries who are able to correctly assess cervical cancer at its early stages,” said MobileODT chief executive and cofounder Ariel Beery.\u003c/p>\n\u003cp>“What we seek to do is enable those same health workers who are already in the field to use a tool they use everyday — a mobile phone — to better visualize the cervix and collaborate with experts to process those images with greater accuracy.”\u003c/p>\n\u003cp>The advanced prototype of the mobile colposcope is currently being piloted in Kenya, Haiti, Mexico, Botswana and the U.S.. The startup ultimately hopes to use the data it collects to develop algorithms that are able to assess the risk of cervical cancer at any stage of the viruses’ development.\u003c/p>\n\u003cp>\u003ca href=\"https://www.indiegogo.com/projects/teamlivelonger-battling-cervical-cancer-in-haiti\">TeamLiveLonger\u003c/a> is another startup leveraging smartphone technology to combat cervical cancer, although its goal is to increase the feasibility of Pap smears, rather than replace them.\u003c/p>\n\u003cp>Founder Lou Auguste is of Haitian descent and worked as a first responder after the 2010 earthquake. There, he learned that Haitian women have the highest rate of mortality from cervical cancer in the world, with 54 per 100,000 women dying from the disease each year.\u003c/p>\n\u003cp>“Most women in Haiti have never been tested for cervical cancer or they don’t catch it before it is too late,” Auguste said.\u003c/p>\n\u003cp>“Doctors know how to perform pap smears but we realized there were only 5 pathologists in the whole country, so we needed to figure out a system for sending slides for consultations abroad.”\u003c/p>\n\u003cp>TeamLiveLonger developed an adaptor that connects a smartphone to a microscope to acquire images of slides. Its mobile technology then stitches the images together to produce a whole slide and securely transfers the images via a service called BitTorrent Sync (which enables the app to transfer large files over bad Internet connections) to a pathologist in the U.S. for analysis and diagnosis. TeamLiveLonger also built an electronic health record for mobile devices that makes it easy for health workers to keep cases updated and know when people come back to the clinic to receive results or treatment.\u003c/p>\n\u003cp>The Pap smear may not be the best method of screening for cervical cancer but it does hold the dubious distinction of being the most prevalent one. Innovation after innovation has emerged in this space over the past 20 years but their adoption is much faster in the developing world without the entrenched legacy of the Pap smear to overcome.\u003c/p>\n\u003cp>While women in Haiti, India, Nicaragua and Uganda get screened for cervical cancer with a brush and a mobile phone, it looks like women in the U.S. will have to endure the speculum for the foreseeable future.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[youtube http://www.youtube.com/watch?v=Mm5ogJT-M9k]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>100 years ago, cervical cancer reigned as the leading cause of cancer death for women in the United States\u003c/p>\n\u003cp>Then,\u003ca href=\"http://weill.cornell.edu/archives/blog/2011/06/george-papanicolaou-development-of-the-pap-smear.html\">\u003cspan style=\"color: #1155cc\"> a doctor at Cornell University\u003c/span>\u003c/a> began conducting studies on the sex cycle of guinea pigs and in 1915 realized that a similar “smear” technique could be applied to the study of human vaginal cells. A few decades of disinterest and skepticism later, the Pap smear became the standard cancer screening test for women. Today, \u003ca href=\"http://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=76\">\u003cspan style=\"color: #1155cc\">the cervical cancer death rate has plunged by more than 50 percent and ranks 14th in frequency in the United States.\u003c/span>\u003c/a>\u003c/p>\n\u003cp>This is far from the case in developing countries, where \u003ca href=\"http://www.womendeliver.org/assets/CervicalCancer_final.pdf\">\u003cspan style=\"color: #1155cc\">cervical cancer is the most common cancer\u003c/span>\u003c/a> and the leading cause of cancer deaths among women. \u003ca href=\"http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/cervical-cancer-statistics\">\u003cspan style=\"color: #1155cc\">Over 85 percent of cervical cancer cases occur\u003c/span>\u003c/a> in the developing world and these staggering rates are largely due to the lack of screening. Pap smears are rare and less than five percent of women receive any cervical cancer screening at all.\u003c/p>\n\u003cp>However, new research and innovations in cervical cancer screening are helping to increase its breadth and frequency in many of the world’s poorest countries. Moreover, these new approaches are actually more accurate, convenient, and cost-effective than the traditional Pap smear, not to mention less unpleasant. They let doctors and their patients bypass the Pap smear altogether, while the Pap smear’s dominance in the U.S. remains strong.\u003c/p>\n\u003cp>\u003cstrong>No Place for the Pap\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many women may be surprised to learn that the Pap smear only detects cancer about half of the time but repeating the test on a regular basis increases the chances of finding cancer since the disease is slow to develop.\u003c/p>\n\u003cp>Repeating the test regularly is often not an option in developing countries where a number of barriers -- time, money, distance, transportation, children, agricultural cycles, social stigmas -- prevent women from visiting health clinics. Paps also take a hefty amount of resources to administer and read.\u003c/p>\n\u003cp>“The Pap test is hard to implement in low resource settings because it requires expensive machines, labs, and trained technicians, as well as for women to make the trips to clinics,” said Dr. José Jerónimo, the senior adviser for women’s cancers in a reproductive health program called \u003ca href=\"http://www.path.org/our-work/reproductive-health.php\">PATH\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"http://www.path.org/\">PATH\u003c/a> is an international nonprofit dedicated to accelerating health innovation in the developing world. The organization has a number of initiatives aimed at making cervical cancer screening and prevention more prevalent in under-resourced areas. A key part of its approach is a low-tech effort called “VIA”, which stands for visual inspection with acetic acid.\u003c/p>\n\u003cfigure id=\"attachment_2125\" class=\"wp-caption aligncenter\" style=\"max-width: 446px\">\u003cimg class=\" wp-image-2125\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Unknown-4-800x450.jpeg\" alt=\"Many new technologies are deployed first in developing countries \" width=\"446\" height=\"251\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-800x450.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-400x225.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-1180x664.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-768x432.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4-320x180.jpeg 320w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-4.jpeg 1920w\" sizes=\"(max-width: 446px) 100vw, 446px\">\u003cfigcaption class=\"wp-caption-text\">Many new technologies are deployed first in developing countries \u003ccite>(TeamLiveLonger )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This method involves swabbing the cervix with a 3 to 5 percent vinegar solution during a speculum exam, waiting for one minute, and then observing the cervix to see if white areas appear. In addition to being inexpensive and easy to administer, VIA also provides immediate results. It allows a patient to immediately receive guidance on next steps if the test is positive.\u003c/p>\n\u003cp>However, like the Pap, the vinegar technique only identifies 50 to 60 percent of precancerous cases, which is why PATH helped develop \u003ca href=\"http://www.path.org/news/press-room/147/\">a new molecular test called careHPV\u003c/a> that was developed and field tested for use in low-resource settings.\u003c/p>\n\u003cp>CareHPV can detect DNA from 14 cancer-causing types of HPV in 2.5 hours without extensive lab facilities, using an affordable machine the size of a toaster oven that runs on electricity or a battery. Women can collect their own samples using a small brush, without the need for a pelvic exam.\u003c/p>\n\u003cp>This approach is ideal for environments where health care resources are limited and testing is often administered by community health workers who visit people’s homes, as well as in places where stigmas against pelvic exams persist.\u003c/p>\n\u003cp>Dr. Jerónimo said that simply by allowing women to collect the sample themselves, coverage increases by 4 times.\u003c/p>\n\u003cfigure id=\"attachment_2124\" class=\"wp-caption aligncenter\" style=\"max-width: 443px\">\u003cimg class=\"wp-image-2124\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Unknown-2-800x533.jpeg\" alt=\"A group of medical students learn how to send images \" width=\"443\" height=\"295\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-800x533.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-400x266.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-1180x786.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-768x511.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Unknown-2-320x213.jpeg 320w\" sizes=\"(max-width: 443px) 100vw, 443px\">\u003cfigcaption class=\"wp-caption-text\">A group of medical students learn how to send images \u003ccite>(TeamLiveLonger )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Texting, Calling, and Cervical Cancer Screening\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.mobileodt.com/\">MobileODT\u003c/a> is a startup that makes a mobile colposcope, a long-range, Internet-connected magnifying glass that plugs into smartphones. The device provides a high-resolution image of cervical tissue, which can then be securely transmitted for diagnostics.\u003c/p>\n\u003cp>[Skip to the bottom to a video of how a mobile colposcope works.]\u003c/p>\n\u003cp>“There are very few labs or specialists in developing countries who are able to correctly assess cervical cancer at its early stages,” said MobileODT chief executive and cofounder Ariel Beery.\u003c/p>\n\u003cp>“What we seek to do is enable those same health workers who are already in the field to use a tool they use everyday — a mobile phone — to better visualize the cervix and collaborate with experts to process those images with greater accuracy.”\u003c/p>\n\u003cp>The advanced prototype of the mobile colposcope is currently being piloted in Kenya, Haiti, Mexico, Botswana and the U.S.. The startup ultimately hopes to use the data it collects to develop algorithms that are able to assess the risk of cervical cancer at any stage of the viruses’ development.\u003c/p>\n\u003cp>\u003ca href=\"https://www.indiegogo.com/projects/teamlivelonger-battling-cervical-cancer-in-haiti\">TeamLiveLonger\u003c/a> is another startup leveraging smartphone technology to combat cervical cancer, although its goal is to increase the feasibility of Pap smears, rather than replace them.\u003c/p>\n\u003cp>Founder Lou Auguste is of Haitian descent and worked as a first responder after the 2010 earthquake. There, he learned that Haitian women have the highest rate of mortality from cervical cancer in the world, with 54 per 100,000 women dying from the disease each year.\u003c/p>\n\u003cp>“Most women in Haiti have never been tested for cervical cancer or they don’t catch it before it is too late,” Auguste said.\u003c/p>\n\u003cp>“Doctors know how to perform pap smears but we realized there were only 5 pathologists in the whole country, so we needed to figure out a system for sending slides for consultations abroad.”\u003c/p>\n\u003cp>TeamLiveLonger developed an adaptor that connects a smartphone to a microscope to acquire images of slides. Its mobile technology then stitches the images together to produce a whole slide and securely transfers the images via a service called BitTorrent Sync (which enables the app to transfer large files over bad Internet connections) to a pathologist in the U.S. for analysis and diagnosis. TeamLiveLonger also built an electronic health record for mobile devices that makes it easy for health workers to keep cases updated and know when people come back to the clinic to receive results or treatment.\u003c/p>\n\u003cp>The Pap smear may not be the best method of screening for cervical cancer but it does hold the dubious distinction of being the most prevalent one. Innovation after innovation has emerged in this space over the past 20 years but their adoption is much faster in the developing world without the entrenched legacy of the Pap smear to overcome.\u003c/p>\n\u003cp>While women in Haiti, India, Nicaragua and Uganda get screened for cervical cancer with a brush and a mobile phone, it looks like women in the U.S. will have to endure the speculum for the foreseeable future.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Imagine walking into a restaurant, and you're handed a menu with no prices.\u003c/p>\n\u003cp>At this hypothetical restaurant, you're told that the cost of the meal will fluctuate based on where you sit, and who happens to serve you. And you'll only receive a detailed copy of the bill four weeks later, when it arrives via fax machine.\u003c/p>\n\u003cp>Welcome to the U.S. health care system.\u003c/p>\n\u003cp>For physicians like Dr. Pat Basu, analogies like this one are far from perfect. But they are a useful way to describe to people how the U.S. health system really works.\u003c/p>\n\u003cp>Basu is no ordinary doctor. He works as the chief medical officer at \u003ca href=\"http://doctorondemand.com\">Doctor on Demand\u003c/a>, a startup that connects patients to doctors online. Previously, he \u003ca href=\"http://radiology.stanford.edu/blog/archives/2010/07/basu-named-whit.html\">advised \u003c/a>the White House on health care policy and reform. Given his background, he is often invited to speak at medical industry conferences.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But unlike many of his peers, Basu gravitates to consumer-friendly analogies and tries to refrain from using jargon.\u003c/p>\n\u003cp>We met for coffee this week to chat about the lack of price transparency in health care, and how the average American would react to a restaurant that kept customers in the dark about its prices.\u003c/p>\n\u003cp>On a whim, I shared the analogy with my Twitter followers late Tuesday evening.\u003c/p>\n\u003cp>https://twitter.com/chrissyfarr/status/590724373478252544\u003c/p>\n\u003cp>I was floored by the volume and breadth of responses, which ranged from laugh-out-loud funny to downright depressing. I highlighted a few, although I recommend \u003ca href=\"https://twitter.com/chrissyfarr/status/590724373478252544\">perusing the thread\u003c/a> in its entirety.\u003c/p>\n\u003cp>https://twitter.com/djbressler/status/590824168674955264\u003c/p>\n\u003cp>https://twitter.com/matthewscd/status/590726687396126720\u003c/p>\n\u003cp>https://twitter.com/statesdj/status/590728967461699586\u003c/p>\n\u003cp>https://twitter.com/OnerousLetterLi/status/590725122908106753\u003c/p>\n\u003cp>\u003ca href=\"https://twitter.com/chrissyfarr/status/590724373478252544\">Read the rest here.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Why the Lack of Price Transparency?\u003c/strong>\u003c/p>\n\u003cp>As Dr. Basu explained, it's long been a struggle for consumers to find out in advance how much their doctor visits and procedures will cost. Unlike restaurants, health care institutions shy away from publishing their prices, as it depends on who's footing the bill.\u003c/p>\n\u003cp>Some web-based tools do a decent job of providing cost estimates (\u003ca href=\"http://blogs.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cem>KQED\u003c/em> launched its own service, \u003cem>PriceCheck\u003c/em>, which relies on data aggregated from California-based readers)\u003c/a>.\u003c/p>\n\u003cp>But for most patients, price is still a gamble. As one recent study found, \u003ca href=\"http://www.washingtonpost.com/national/health-science/a-blood-test-can-cost-from-10-to-10000-in-calif-hospitals-according-to-a-study/2014/08/16/aba02472-24ae-11e4-8593-da634b334390_story.html\">the price of a blood test in California\u003c/a> can range from $10 to $10,000, depending on the hospital.\u003c/p>\n\u003cp>https://twitter.com/RS_Flinn/status/590932990487728128\u003c/p>\n\u003cp>Unfortunately, improving price transparency isn't a simple proposition. The debate has raged for decades among health care policymakers and academics -- \u003ca href=\"http://www.thefiscaltimes.com/Articles/2014/09/18/Why-Health-Care-Price-Transparency-May-Not-Work\">some have argued that it may not work\u003c/a> well in practice.\u003c/p>\n\u003cp>But for most consumers, who aren't knee deep in D.C. politics, it is unclear why they can compare prices online for a steak dinner or a new television -- but not for a critical medical procedure.\u003c/p>\n\u003cp>\u003cstrong>The Trouble With Jargon \u003c/strong>\u003c/p>\n\u003cp>The health care industry needs to a better job of reaching people on social media, and helping them understand the status quo.\u003c/p>\n\u003cp>Much of the available literature on the price transparency topic is confusing and downright boring. And at health care conferences, which I frequently attend in the pursuit of clear answers, speakers spew out incomprehensible medical jargon.\u003c/p>\n\u003cp>I've often wondered: Do these \"industry insiders\" actually understand each other? Or are they nodding along for appearances sake?\u003c/p>\n\u003cfigure id=\"attachment_2231\" class=\"wp-caption alignright\" style=\"max-width: 366px\">\u003cimg class=\"wp-image-2231\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/money_2.jpg\" alt='I suggested renaming my panel to \"Show me the money!\"' width=\"366\" height=\"198\">\u003cfigcaption class=\"wp-caption-text\">Forget reimbursement. \"Show me the money!\" \u003ccite>(Proverbs66.com)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2014, I was asked to interview a panel of medical experts at a conference on the topic of \"reimbursement.\" Half-joking, I suggested that we would have done a better job of filling the room by amending the description to \"show me the money.\"\u003c/p>\n\u003cp>\"So...What even is reimbursement,?\" I asked the panel.\u003c/p>\n\u003cp>Crickets.\u003c/p>\n\u003cp>That opening question was met with a minute or so of excruciating silence. Eventually, several of the speakers piped up, each giving me a slightly different answer.\u003c/p>\n\u003cp>Dr. Jordan Shlain, a physician I bumped into at a recent health-tech conference, had a similar experience when he asked an audience of 400 people if they understood the meaning of the term \"patient engagement.\" Two hands went up.\u003c/p>\n\u003cp>I strongly agree with Shlain, \u003ca href=\"https://www.linkedin.com/pulse/20141028232337-30819-cracking-open-medical-jargon-case-1-patient-engagement\">who shared this experience in a blog post\u003c/a>, that if we want patients to participate in important, ongoing policy discussions about the future of health care, we need to cut down on our use of jargon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If analogies resonate with people and prompt a discussion about health care, bring 'em on.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003ca href=\"https://twitter.com/chrissyfarr/status/590724373478252544\">Read the rest here.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Why the Lack of Price Transparency?\u003c/strong>\u003c/p>\n\u003cp>As Dr. Basu explained, it's long been a struggle for consumers to find out in advance how much their doctor visits and procedures will cost. Unlike restaurants, health care institutions shy away from publishing their prices, as it depends on who's footing the bill.\u003c/p>\n\u003cp>Some web-based tools do a decent job of providing cost estimates (\u003ca href=\"http://blogs.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\">\u003cem>KQED\u003c/em> launched its own service, \u003cem>PriceCheck\u003c/em>, which relies on data aggregated from California-based readers)\u003c/a>.\u003c/p>\n\u003cp>But for most patients, price is still a gamble. As one recent study found, \u003ca href=\"http://www.washingtonpost.com/national/health-science/a-blood-test-can-cost-from-10-to-10000-in-calif-hospitals-according-to-a-study/2014/08/16/aba02472-24ae-11e4-8593-da634b334390_story.html\">the price of a blood test in California\u003c/a> can range from $10 to $10,000, depending on the hospital.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Unfortunately, improving price transparency isn't a simple proposition. The debate has raged for decades among health care policymakers and academics -- \u003ca href=\"http://www.thefiscaltimes.com/Articles/2014/09/18/Why-Health-Care-Price-Transparency-May-Not-Work\">some have argued that it may not work\u003c/a> well in practice.\u003c/p>\n\u003cp>But for most consumers, who aren't knee deep in D.C. politics, it is unclear why they can compare prices online for a steak dinner or a new television -- but not for a critical medical procedure.\u003c/p>\n\u003cp>\u003cstrong>The Trouble With Jargon \u003c/strong>\u003c/p>\n\u003cp>The health care industry needs to a better job of reaching people on social media, and helping them understand the status quo.\u003c/p>\n\u003cp>Much of the available literature on the price transparency topic is confusing and downright boring. And at health care conferences, which I frequently attend in the pursuit of clear answers, speakers spew out incomprehensible medical jargon.\u003c/p>\n\u003cp>I've often wondered: Do these \"industry insiders\" actually understand each other? Or are they nodding along for appearances sake?\u003c/p>\n\u003cfigure id=\"attachment_2231\" class=\"wp-caption alignright\" style=\"max-width: 366px\">\u003cimg class=\"wp-image-2231\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/money_2.jpg\" alt='I suggested renaming my panel to \"Show me the money!\"' width=\"366\" height=\"198\">\u003cfigcaption class=\"wp-caption-text\">Forget reimbursement. \"Show me the money!\" \u003ccite>(Proverbs66.com)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2014, I was asked to interview a panel of medical experts at a conference on the topic of \"reimbursement.\" Half-joking, I suggested that we would have done a better job of filling the room by amending the description to \"show me the money.\"\u003c/p>\n\u003cp>\"So...What even is reimbursement,?\" I asked the panel.\u003c/p>\n\u003cp>Crickets.\u003c/p>\n\u003cp>That opening question was met with a minute or so of excruciating silence. Eventually, several of the speakers piped up, each giving me a slightly different answer.\u003c/p>\n\u003cp>Dr. Jordan Shlain, a physician I bumped into at a recent health-tech conference, had a similar experience when he asked an audience of 400 people if they understood the meaning of the term \"patient engagement.\" Two hands went up.\u003c/p>\n\u003cp>I strongly agree with Shlain, \u003ca href=\"https://www.linkedin.com/pulse/20141028232337-30819-cracking-open-medical-jargon-case-1-patient-engagement\">who shared this experience in a blog post\u003c/a>, that if we want patients to participate in important, ongoing policy discussions about the future of health care, we need to cut down on our use of jargon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If analogies resonate with people and prompt a discussion about health care, bring 'em on.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>http://www.kqed.org/.stream/anon/radio/science/2015/04/20150420Sciencedementia.mp3\u003cbr>\nBy 2025, 7 million Americans will have Alzheimer’s disease, according to \u003ca href=\"http://www.alz.org/facts/overview.asp\">one recent estimate\u003c/a>. Millions more will suffer from dementia caused by other diseases, such as Parkinson’s, frontotemporal dementia or just regular aging.\u003c/p>\n\u003cp>Together, these diseases may become the most expensive segment of the so-called “silver tsunami”—80 million baby boomers—that will be crashing into the American medical system over the next 10 years or so.\u003c/p>\n\u003cp>The cost of caring for Alzheimer’s patients alone is expected to triple by 2050, to more than $1 trillion dollars a year.\u003c/p>\n\u003cp>That huge cost doesn’t include the burden on caregivers like Maria Martinez. She visits her parents’ small apartment in San Rafael almost daily to care for her mom, Aurora, who has Alzheimer’s.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Of caregivers, approximately 50 percent develop a major depressive illness.”\u003ccite>Bruce Miller,UCSF behavioral neurologist\u003c/cite>\u003c/aside>\n\u003cp>Martinez is an only child with a partner and a full-time job as an occupational therapist. But nearly every day she spends at least a couple of hours with her parents, managing a long list of responsibilities that are critical to their ability to live independently.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A local day program, \u003ca href=\"http://www.lifelongmedical.org/news-a-events/media-center/93-adult-day-health-care.html\">LifeLong Medical Care’s Marin Adult Day Health Center\u003c/a>, has been a lifesaver for her family, Martinez says. But still, she is constantly checking up on things.\u003c/p>\n\u003cp>“Does [Aurora] have a doctor’s appointment? Are there enough diapers? Clothing? Laundry. Financial stuff, I manage that too,” says Martinez.\u003c/p>\n\u003cp>She bathes her mother, manages upkeep on the apartment, does much of the shopping and fills prescriptions for both of her parents.\u003c/p>\n\u003cp>Especially in the early stages of Aurora’s illness, practical concerns loomed large. Sometimes she would wander in the middle of night. Her husband—Maria’s father—took to sleeping on the floor in front of the front door, worried Aurora might end up falling in the street and being hit by a car.\u003c/p>\n\u003cp>Eventually, Martinez installed a lock at the top of the door, where Aurora couldn’t reach it, and a wind chime, to serve as an alarm.\u003cbr>\nhttps://vimeo.com/101243425\u003cbr>\nMartinez says right now her family is managing well, all things considered. But there have been times when she couldn’t help but note the impact her mother’s illness has had on her own life.\u003c/p>\n\u003cp>“You can fall into that [state] where, ‘Oh my goodness, I’m feeling deprived,’” she says. “You have to snap out of it.”\u003c/p>\n\u003cp>\u003cstrong>The Second Patient\u003c/strong>\u003c/p>\n\u003cp>Bruce Miller, who directs the \u003ca href=\"http://memory.ucsf.edu/\">Memory and Aging Center\u003c/a> at UC San Francisco, says for every person with dementia he treats, he finds himself caring for two patients: the one with dementia and the adult child or spouse who cares for them.\u003c/p>\n\u003cp>“You see it immediately when the patient walks in,” he says.\u003c/p>\n\u003cp>“Of caregivers, approximately 50 percent develop a major depressive illness,” Miller says. “Ten percent say that in the time they give care, they develop a serious medical problem because of the caregiving.”\u003c/p>\n\u003cp>Overburdened caregivers can make bad decisions about how to care for their sick parent or spouse, he says.\u003c/p>\n\u003cp>“We’re getting multiple calls around small problems,” Miller says. “The caregiver is so overburdened that they don’t know what to do next. This adds a huge burden to the medical system.”\u003c/p>\n\u003cp>\u003cstrong>Better, Cheaper Dementia Care\u003c/strong>\u003c/p>\n\u003cp>This spring, UCSF, along with the \u003ca href=\"http://www.unmc.edu/\">University of Nebraska Medical Center\u003c/a> is beginning a $10 million study, funded by the federal government’s \u003ca href=\"http://innovation.cms.gov/\">Centers for Medicare & Medicaid Innovation\u003c/a>, to try and improve this situation.\u003c/p>\n\u003cp>UCSF and Nebraska researchers are using the money to develop a \u003ca href=\"http://www.ucsf.edu/news/2014/06/115476/dementia-care-%E2%80%9Cecosystem%E2%80%9D-bring-online-respite-caregivers\">dementia “ecosystem,”\u003c/a> which aims to ease the strain on caregivers while, reducing costs for caring for the growing number of dementia patients.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I know for sure no one’s gotten the data and proven that [this technology] works, proven that it improves peoples’ health, improves caregiver burden.”\u003ccite> Katrin Schenk,Physics teacher\u003c/cite>\u003c/aside>\n\u003cp>The study will enroll 2,100 patients at the two sites. Each patient will have a “navigator,” a nonmedical staff person who will coordinate care and triage calls, so minor issues don’t land patients in the ER. All care will be coordinated through an Internet “dashboard” developed by Salesforce.\u003c/p>\n\u003cp>Some patients will also receive a set of activity trackers and sensors, which will be placed around the house or worn on the patient’s wrist. Much like Martinez’s wind chimes, the idea is to see whether sensors can detect when a patient is wandering off or, conversely, when they’ve been inactive for too long.\u003c/p>\n\u003cp>A couple weeks ago, in a sunny conference room at UCSF, techies and doctors—almost all of whom have had family members with dementia—sat around a table, brainstorming other ways technology might be applied to dementia care.\u003c/p>\n\u003cp>“There’s safety issues like leaving the stove on,” suggests Katrin Schenk, who teaches physics at Randolph College in Virginia.\u003c/p>\n\u003cp>“You could easily put in a temperature sensor that knows: they went in there and turned on that burner,” Schenk says. “It’s been on for two hours; someone needs to do something.”\u003c/p>\n\u003cp>Or, she continues, what about the roughly one-third of dementia patients who also have diabetes? Could Bluetooth-enabled blood-sugar monitors allow family members and medical staff to check up on them remotely?\u003c/p>\n\u003cp>\u003cstrong>A Compromise Between Safety and Independence\u003c/strong>\u003c/p>\n\u003cp>If this all sounds intrusive, says Kate Possin, a neuropsychologist at UCSF, consider the alternative: anxious adult children and parents who end up in nursing homes sooner than they want to.\u003c/p>\n\u003cp>“This may be a compromise for them in their minds,” Possin says. “‘If I use this system, then my son who lives three hours away feels comfortable and safe with me living at home a little bit longer.’”\u003c/p>\n\u003cp>A handful of tech start-ups are making the same case. In San Francisco, \u003ca href=\"http://www.mylively.com/\">Lively\u003c/a> markets a system of networked sensors and a watch that can pick up on activity around the house and let family members or care providers know if there’s a worrisome change.\u003c/p>\n\u003cp>These kinds of products—which let doctors and caregivers check up on patients remotely—have what Katrin Schenk calls “face validity.” They make sense, for some cases.\u003c/p>\n\u003cp>But do they help in the long run?\u003c/p>\n\u003cp>That’s one question UCSF and the University of Nebraska Medical Center want to answer.\u003c/p>\n\u003cp>“I know for sure no one’s gotten the data and proven that [this technology] works,” Schenk says, “proven that it improves peoples’ health, improves caregiver burden.”\u003c/p>\n\u003cp>“Reduces hospitalizations,” adds Possin.\u003c/p>\n\u003cp>“Delays the entrance into a nursing home,” finishes Schenk.\u003c/p>\n\u003cp>Researchers will also want to see whether sensors and other technologies are helpful for people in later stages of dementia, like Aurora Martinez, or whether they just create more hassle.\u003c/p>\n\u003cp>Possin says they hope to have some preliminary results next January.\u003c/p>\n\u003cp>\u003cem>To learn more or to participate in the UCSF Care Ecosystem, please see tiny.ucsf.edu/CareEcosystem or contact Project Manager James Fraser \u003ca href=\"mailto:james.fraser2@ucsf.edu\">\u003cspan class=\"s2\">james.fraser2@ucsf.edu\u003c/span>\u003c/a>, (415) 353-4078\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>http://www.kqed.org/.stream/anon/radio/science/2015/04/20150420Sciencedementia.mp3\u003cbr>\nBy 2025, 7 million Americans will have Alzheimer’s disease, according to \u003ca href=\"http://www.alz.org/facts/overview.asp\">one recent estimate\u003c/a>. Millions more will suffer from dementia caused by other diseases, such as Parkinson’s, frontotemporal dementia or just regular aging.\u003c/p>\n\u003cp>Together, these diseases may become the most expensive segment of the so-called “silver tsunami”—80 million baby boomers—that will be crashing into the American medical system over the next 10 years or so.\u003c/p>\n\u003cp>The cost of caring for Alzheimer’s patients alone is expected to triple by 2050, to more than $1 trillion dollars a year.\u003c/p>\n\u003cp>That huge cost doesn’t include the burden on caregivers like Maria Martinez. She visits her parents’ small apartment in San Rafael almost daily to care for her mom, Aurora, who has Alzheimer’s.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Of caregivers, approximately 50 percent develop a major depressive illness.”\u003ccite>Bruce Miller,UCSF behavioral neurologist\u003c/cite>\u003c/aside>\n\u003cp>Martinez is an only child with a partner and a full-time job as an occupational therapist. But nearly every day she spends at least a couple of hours with her parents, managing a long list of responsibilities that are critical to their ability to live independently.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A local day program, \u003ca href=\"http://www.lifelongmedical.org/news-a-events/media-center/93-adult-day-health-care.html\">LifeLong Medical Care’s Marin Adult Day Health Center\u003c/a>, has been a lifesaver for her family, Martinez says. But still, she is constantly checking up on things.\u003c/p>\n\u003cp>“Does [Aurora] have a doctor’s appointment? Are there enough diapers? Clothing? Laundry. Financial stuff, I manage that too,” says Martinez.\u003c/p>\n\u003cp>She bathes her mother, manages upkeep on the apartment, does much of the shopping and fills prescriptions for both of her parents.\u003c/p>\n\u003cp>Especially in the early stages of Aurora’s illness, practical concerns loomed large. Sometimes she would wander in the middle of night. Her husband—Maria’s father—took to sleeping on the floor in front of the front door, worried Aurora might end up falling in the street and being hit by a car.\u003c/p>\n\u003cp>Eventually, Martinez installed a lock at the top of the door, where Aurora couldn’t reach it, and a wind chime, to serve as an alarm.\u003cbr>\nhttps://vimeo.com/101243425\u003cbr>\nMartinez says right now her family is managing well, all things considered. But there have been times when she couldn’t help but note the impact her mother’s illness has had on her own life.\u003c/p>\n\u003cp>“You can fall into that [state] where, ‘Oh my goodness, I’m feeling deprived,’” she says. “You have to snap out of it.”\u003c/p>\n\u003cp>\u003cstrong>The Second Patient\u003c/strong>\u003c/p>\n\u003cp>Bruce Miller, who directs the \u003ca href=\"http://memory.ucsf.edu/\">Memory and Aging Center\u003c/a> at UC San Francisco, says for every person with dementia he treats, he finds himself caring for two patients: the one with dementia and the adult child or spouse who cares for them.\u003c/p>\n\u003cp>“You see it immediately when the patient walks in,” he says.\u003c/p>\n\u003cp>“Of caregivers, approximately 50 percent develop a major depressive illness,” Miller says. “Ten percent say that in the time they give care, they develop a serious medical problem because of the caregiving.”\u003c/p>\n\u003cp>Overburdened caregivers can make bad decisions about how to care for their sick parent or spouse, he says.\u003c/p>\n\u003cp>“We’re getting multiple calls around small problems,” Miller says. “The caregiver is so overburdened that they don’t know what to do next. This adds a huge burden to the medical system.”\u003c/p>\n\u003cp>\u003cstrong>Better, Cheaper Dementia Care\u003c/strong>\u003c/p>\n\u003cp>This spring, UCSF, along with the \u003ca href=\"http://www.unmc.edu/\">University of Nebraska Medical Center\u003c/a> is beginning a $10 million study, funded by the federal government’s \u003ca href=\"http://innovation.cms.gov/\">Centers for Medicare & Medicaid Innovation\u003c/a>, to try and improve this situation.\u003c/p>\n\u003cp>UCSF and Nebraska researchers are using the money to develop a \u003ca href=\"http://www.ucsf.edu/news/2014/06/115476/dementia-care-%E2%80%9Cecosystem%E2%80%9D-bring-online-respite-caregivers\">dementia “ecosystem,”\u003c/a> which aims to ease the strain on caregivers while, reducing costs for caring for the growing number of dementia patients.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I know for sure no one’s gotten the data and proven that [this technology] works, proven that it improves peoples’ health, improves caregiver burden.”\u003ccite> Katrin Schenk,Physics teacher\u003c/cite>\u003c/aside>\n\u003cp>The study will enroll 2,100 patients at the two sites. Each patient will have a “navigator,” a nonmedical staff person who will coordinate care and triage calls, so minor issues don’t land patients in the ER. All care will be coordinated through an Internet “dashboard” developed by Salesforce.\u003c/p>\n\u003cp>Some patients will also receive a set of activity trackers and sensors, which will be placed around the house or worn on the patient’s wrist. Much like Martinez’s wind chimes, the idea is to see whether sensors can detect when a patient is wandering off or, conversely, when they’ve been inactive for too long.\u003c/p>\n\u003cp>A couple weeks ago, in a sunny conference room at UCSF, techies and doctors—almost all of whom have had family members with dementia—sat around a table, brainstorming other ways technology might be applied to dementia care.\u003c/p>\n\u003cp>“There’s safety issues like leaving the stove on,” suggests Katrin Schenk, who teaches physics at Randolph College in Virginia.\u003c/p>\n\u003cp>“You could easily put in a temperature sensor that knows: they went in there and turned on that burner,” Schenk says. “It’s been on for two hours; someone needs to do something.”\u003c/p>\n\u003cp>Or, she continues, what about the roughly one-third of dementia patients who also have diabetes? Could Bluetooth-enabled blood-sugar monitors allow family members and medical staff to check up on them remotely?\u003c/p>\n\u003cp>\u003cstrong>A Compromise Between Safety and Independence\u003c/strong>\u003c/p>\n\u003cp>If this all sounds intrusive, says Kate Possin, a neuropsychologist at UCSF, consider the alternative: anxious adult children and parents who end up in nursing homes sooner than they want to.\u003c/p>\n\u003cp>“This may be a compromise for them in their minds,” Possin says. “‘If I use this system, then my son who lives three hours away feels comfortable and safe with me living at home a little bit longer.’”\u003c/p>\n\u003cp>A handful of tech start-ups are making the same case. In San Francisco, \u003ca href=\"http://www.mylively.com/\">Lively\u003c/a> markets a system of networked sensors and a watch that can pick up on activity around the house and let family members or care providers know if there’s a worrisome change.\u003c/p>\n\u003cp>These kinds of products—which let doctors and caregivers check up on patients remotely—have what Katrin Schenk calls “face validity.” They make sense, for some cases.\u003c/p>\n\u003cp>But do they help in the long run?\u003c/p>\n\u003cp>That’s one question UCSF and the University of Nebraska Medical Center want to answer.\u003c/p>\n\u003cp>“I know for sure no one’s gotten the data and proven that [this technology] works,” Schenk says, “proven that it improves peoples’ health, improves caregiver burden.”\u003c/p>\n\u003cp>“Reduces hospitalizations,” adds Possin.\u003c/p>\n\u003cp>“Delays the entrance into a nursing home,” finishes Schenk.\u003c/p>\n\u003cp>Researchers will also want to see whether sensors and other technologies are helpful for people in later stages of dementia, like Aurora Martinez, or whether they just create more hassle.\u003c/p>\n\u003cp>Possin says they hope to have some preliminary results next January.\u003c/p>\n\u003cp>\u003cem>To learn more or to participate in the UCSF Care Ecosystem, please see tiny.ucsf.edu/CareEcosystem or contact Project Manager James Fraser \u003ca href=\"mailto:james.fraser2@ucsf.edu\">\u003cspan class=\"s2\">james.fraser2@ucsf.edu\u003c/span>\u003c/a>, (415) 353-4078\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>In Silicon Valley, the archetypical startup founder is brilliant, young, hyper-ambitious to a fault, and rarely shows weakness.\u003c/p>\n\u003cp>But in reality, many founders are struggling.\u003c/p>\n\u003cp>Entrepreneurs often shout from the rooftops about their personal and company milestones, whether it's a new investor or technical hire. But under all that bravado and outward confidence, many entrepreneur will face a lot of anxiety, stress and pressure to succeed.\u003c/p>\n\u003cfigure id=\"attachment_1799\" class=\"wp-caption alignright\" style=\"max-width: 2880px\">\u003cimg class=\"size-full wp-image-1799\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/7cupsoftea-team.jpg\" alt=\"The 7 Cups of Tea team on a company outing \" width=\"2880\" height=\"1835\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team.jpg 2880w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-400x255.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-800x510.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-1180x752.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-768x489.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-320x204.jpg 320w\" sizes=\"(max-width: 2880px) 100vw, 2880px\">\u003cfigcaption class=\"wp-caption-text\">The 7 Cups of Tea team on a company outing \u003ccite>(7 Cups of Tea )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I've been through two startups and it's rough,\" said Glen Moriarty, a trained psychologist and the founder of \u003ca href=\"http://www.7cupsoftea.com/\">7 Cups of Tea\u003c/a>, a website and app that connects entrepreneurs with peers, who act as confidential listeners.\u003c/p>\n\u003cp>\"Founder life is incredibly challenging, but we rarely talk about it.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That's why 7 Cups of Tea launched a \u003ca href=\"http://www.7cupsoftea.com/startups/\">program\u003c/a> to support the emotional health of founders of other startups. 7 Cups of Tea's team is deeply embedded in the startup network. It was among the first health companies to graduate from \u003ca href=\"https://www.ycombinator.com/\">Y Combinator\u003c/a>, the accelerator program based in Mountain View, Calif.\u003c/p>\n\u003cp>It takes advantage of a growing trend for digital services that connect people with online health support. 7 Cups of Tea specializes in matching people with trained listeners who\u003ca href=\"http://www.7cupsoftea.com/listener/becomeListener.php\"> complete its online course\u003c/a>. Other apps like \u003ca href=\"http://www.doctorondemand.com/\">Doctor on Demand\u003c/a> and \u003ca href=\"http://mdlive.com\">MDLive\u003c/a> offer on-demand access to doctors and therapists -- all that's required is an Internet connection.\u003c/p>\n\u003cp>Here's how it works: Register via the 7 Cups of Tea website or app, and connect to one of thousands of confidential listeners, who communicate with you via text message. Or alternatively, sign up for a group chat session with a featured expert.\u003c/p>\n\u003cp>I logged in one evening to a public 7 Cups of Tea session, where Charlie Hoehn, author of \u003ca href=\"http://www.amazon.com/Play-It-Away-Workaholics-Anxiety/dp/0615918174\">Play It Away: A Workaholic’s Cure for Anxiety\u003c/a>, responded to concerns raised by startup founders, many of whom were anonymous. The experience is similar to a Reddit \"Ask Me Anything\" (AMA).\u003c/p>\n\u003cp>Some founders shared tips (\"In my experience, leaving the environment I am in really helps. So I leave office and go to a coffee shop or a library\"); others asked Hoehn questions (\"If the focus on my startup is what is causing all the anxiety, how can I balance it with focusing on other things like family or hobbies?\").\u003c/p>\n\u003cp>After an hour or so of monitoring the discussion, it seemed clear that startup founders didn't have many alternative spaces to discuss such topics as work-life balance, and dealing with both anxiety and depression.\u003c/p>\n\u003cp>Popular Q&A site \u003ca href=\"http://quora.com\">Quora\u003c/a> is one of the few alternative online destinations for founders to share their real feelings and connect with peers. \u003ca href=\"http://www.quora.com/What-is-it-like-to-be-a-start-up-founder\">When a user posed the question,\u003c/a> \"What's it like to be a startup founder,\" over two-dozen people responded. The answers were surprisingly frank: One founder likened it to the experience of raising a child; calling his startup an act of \"creation.\"\u003ca href=\"We%20rarely%20hear%20about%20it%20in%20the%20press,%20or%20in%20pitch%20meetings.%C2%A0\"> \u003c/a>Another admitted that he thought about his startup an unhealthy amount: Every waking moment, including while spending time with his family or in the shower.\u003c/p>\n\u003cfigure id=\"attachment_1856\" class=\"wp-caption alignleft\" style=\"max-width: 462px\">\u003cimg class=\" wp-image-1856\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM.png\" alt=\"A response to a question on Quora about the realities of startup life\" width=\"462\" height=\"197\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM.png 788w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM-400x170.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM-768x326.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM-320x136.png 320w\" sizes=\"(max-width: 462px) 100vw, 462px\">\u003cfigcaption class=\"wp-caption-text\">A response to a question on Quora about the realities of startup life\u003c/figcaption>\u003c/figure>\n\u003cp>Chatting with a therapist face-to-face is advisable for stressed-out founders. But the virtual approach offers a few benefits of its own, and may work best in concert with traditional therapy. For one thing, entrepreneurs can chat anonymously with peers in the startup world, who share similar experiences.\u003c/p>\n\u003cp>But will the majority of Silicon Valley entrepreneurs flock to a service like 7 Cups of Tea? At present, it has only reached a small percentage of the startup community. And will the key influencers embrace a culture of vulnerability and openness, rather than perpetuate long-standing myths about the dogged startup founder?\u003c/p>\n\u003cp>\u003cstrong>\"This shouldn't be a taboo subject\" \u003c/strong>\u003c/p>\n\u003cp>Brad Feld is one of the few venture capitalists who has \u003ca href=\"http://feld.com/archives/2014/10/founder-suicides.html\">spoken out about his personal struggle\u003c/a> with clinical depression.\u003c/p>\n\u003cp>In the wake of a \u003ca href=\"http://www.dailymail.co.uk/news/article-2781211/Mystery-three-suicides-tech-start-planning-bring-happiness-las-vegas.html\">series of suicides\u003c/a> that rocked the startup community, Feld called for more honest discussion about how intense it can be to start a company.\u003c/p>\n\u003cp>Colorado-based Feld is now one of the biggest advocates for \u003ca href=\"http://www.7cupsoftea.com/\">7 Cups Of Tea\u003c/a>'s startup program.\u003c/p>\n\u003cp>\"This shouldn't be a taboo subject,\" said Feld.\u003c/p>\n\u003cp>\"Founders are buried by the myth that leaders must be strong... and that emotional and mental health issues will negatively impact their ability to be effective, so they must suppress them if they want to succeed as an entrepreneur,\" he added.\u003c/p>\n\u003cp>For his part, Moriarty believes it can help to match up people who share a visceral understanding of the day-to-day stresses of running a company.\u003c/p>\n\u003cp>Aside from reaching out to entrepreneurs to sign up or act as counselors, Moriarty also hopes to convince venture capitalists to recommend 7 Cups of Tea to founders.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Not a lot of people understand that a startup isn't like grad school or a job, where hard work is often sufficient. With a startup, there is a lot of luck involved, regardless of your age and experience. A lot of things have to go right,\" said Moriarty. \"That's very stressful.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In Silicon Valley, the archetypical startup founder is brilliant, young, hyper-ambitious to a fault, and rarely shows weakness.\u003c/p>\n\u003cp>But in reality, many founders are struggling.\u003c/p>\n\u003cp>Entrepreneurs often shout from the rooftops about their personal and company milestones, whether it's a new investor or technical hire. But under all that bravado and outward confidence, many entrepreneur will face a lot of anxiety, stress and pressure to succeed.\u003c/p>\n\u003cfigure id=\"attachment_1799\" class=\"wp-caption alignright\" style=\"max-width: 2880px\">\u003cimg class=\"size-full wp-image-1799\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/7cupsoftea-team.jpg\" alt=\"The 7 Cups of Tea team on a company outing \" width=\"2880\" height=\"1835\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team.jpg 2880w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-400x255.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-800x510.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-1180x752.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-768x489.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/7cupsoftea-team-320x204.jpg 320w\" sizes=\"(max-width: 2880px) 100vw, 2880px\">\u003cfigcaption class=\"wp-caption-text\">The 7 Cups of Tea team on a company outing \u003ccite>(7 Cups of Tea )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I've been through two startups and it's rough,\" said Glen Moriarty, a trained psychologist and the founder of \u003ca href=\"http://www.7cupsoftea.com/\">7 Cups of Tea\u003c/a>, a website and app that connects entrepreneurs with peers, who act as confidential listeners.\u003c/p>\n\u003cp>\"Founder life is incredibly challenging, but we rarely talk about it.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That's why 7 Cups of Tea launched a \u003ca href=\"http://www.7cupsoftea.com/startups/\">program\u003c/a> to support the emotional health of founders of other startups. 7 Cups of Tea's team is deeply embedded in the startup network. It was among the first health companies to graduate from \u003ca href=\"https://www.ycombinator.com/\">Y Combinator\u003c/a>, the accelerator program based in Mountain View, Calif.\u003c/p>\n\u003cp>It takes advantage of a growing trend for digital services that connect people with online health support. 7 Cups of Tea specializes in matching people with trained listeners who\u003ca href=\"http://www.7cupsoftea.com/listener/becomeListener.php\"> complete its online course\u003c/a>. Other apps like \u003ca href=\"http://www.doctorondemand.com/\">Doctor on Demand\u003c/a> and \u003ca href=\"http://mdlive.com\">MDLive\u003c/a> offer on-demand access to doctors and therapists -- all that's required is an Internet connection.\u003c/p>\n\u003cp>Here's how it works: Register via the 7 Cups of Tea website or app, and connect to one of thousands of confidential listeners, who communicate with you via text message. Or alternatively, sign up for a group chat session with a featured expert.\u003c/p>\n\u003cp>I logged in one evening to a public 7 Cups of Tea session, where Charlie Hoehn, author of \u003ca href=\"http://www.amazon.com/Play-It-Away-Workaholics-Anxiety/dp/0615918174\">Play It Away: A Workaholic’s Cure for Anxiety\u003c/a>, responded to concerns raised by startup founders, many of whom were anonymous. The experience is similar to a Reddit \"Ask Me Anything\" (AMA).\u003c/p>\n\u003cp>Some founders shared tips (\"In my experience, leaving the environment I am in really helps. So I leave office and go to a coffee shop or a library\"); others asked Hoehn questions (\"If the focus on my startup is what is causing all the anxiety, how can I balance it with focusing on other things like family or hobbies?\").\u003c/p>\n\u003cp>After an hour or so of monitoring the discussion, it seemed clear that startup founders didn't have many alternative spaces to discuss such topics as work-life balance, and dealing with both anxiety and depression.\u003c/p>\n\u003cp>Popular Q&A site \u003ca href=\"http://quora.com\">Quora\u003c/a> is one of the few alternative online destinations for founders to share their real feelings and connect with peers. \u003ca href=\"http://www.quora.com/What-is-it-like-to-be-a-start-up-founder\">When a user posed the question,\u003c/a> \"What's it like to be a startup founder,\" over two-dozen people responded. The answers were surprisingly frank: One founder likened it to the experience of raising a child; calling his startup an act of \"creation.\"\u003ca href=\"We%20rarely%20hear%20about%20it%20in%20the%20press,%20or%20in%20pitch%20meetings.%C2%A0\"> \u003c/a>Another admitted that he thought about his startup an unhealthy amount: Every waking moment, including while spending time with his family or in the shower.\u003c/p>\n\u003cfigure id=\"attachment_1856\" class=\"wp-caption alignleft\" style=\"max-width: 462px\">\u003cimg class=\" wp-image-1856\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM.png\" alt=\"A response to a question on Quora about the realities of startup life\" width=\"462\" height=\"197\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM.png 788w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM-400x170.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM-768x326.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screen-Shot-2015-04-17-at-11.26.11-AM-320x136.png 320w\" sizes=\"(max-width: 462px) 100vw, 462px\">\u003cfigcaption class=\"wp-caption-text\">A response to a question on Quora about the realities of startup life\u003c/figcaption>\u003c/figure>\n\u003cp>Chatting with a therapist face-to-face is advisable for stressed-out founders. But the virtual approach offers a few benefits of its own, and may work best in concert with traditional therapy. For one thing, entrepreneurs can chat anonymously with peers in the startup world, who share similar experiences.\u003c/p>\n\u003cp>But will the majority of Silicon Valley entrepreneurs flock to a service like 7 Cups of Tea? At present, it has only reached a small percentage of the startup community. And will the key influencers embrace a culture of vulnerability and openness, rather than perpetuate long-standing myths about the dogged startup founder?\u003c/p>\n\u003cp>\u003cstrong>\"This shouldn't be a taboo subject\" \u003c/strong>\u003c/p>\n\u003cp>Brad Feld is one of the few venture capitalists who has \u003ca href=\"http://feld.com/archives/2014/10/founder-suicides.html\">spoken out about his personal struggle\u003c/a> with clinical depression.\u003c/p>\n\u003cp>In the wake of a \u003ca href=\"http://www.dailymail.co.uk/news/article-2781211/Mystery-three-suicides-tech-start-planning-bring-happiness-las-vegas.html\">series of suicides\u003c/a> that rocked the startup community, Feld called for more honest discussion about how intense it can be to start a company.\u003c/p>\n\u003cp>Colorado-based Feld is now one of the biggest advocates for \u003ca href=\"http://www.7cupsoftea.com/\">7 Cups Of Tea\u003c/a>'s startup program.\u003c/p>\n\u003cp>\"This shouldn't be a taboo subject,\" said Feld.\u003c/p>\n\u003cp>\"Founders are buried by the myth that leaders must be strong... and that emotional and mental health issues will negatively impact their ability to be effective, so they must suppress them if they want to succeed as an entrepreneur,\" he added.\u003c/p>\n\u003cp>For his part, Moriarty believes it can help to match up people who share a visceral understanding of the day-to-day stresses of running a company.\u003c/p>\n\u003cp>Aside from reaching out to entrepreneurs to sign up or act as counselors, Moriarty also hopes to convince venture capitalists to recommend 7 Cups of Tea to founders.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Not a lot of people understand that a startup isn't like grad school or a job, where hard work is often sufficient. With a startup, there is a lot of luck involved, regardless of your age and experience. A lot of things have to go right,\" said Moriarty. \"That's very stressful.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Meet the Man Leading California's $3M 'Precision Medicine' Initiative",
"title": "Meet the Man Leading California's $3M 'Precision Medicine' Initiative",
"headTitle": "Q&A | Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>\"Precision medicine\" may seem like a vague and futuristic term. But for President Obama and other policymakers, it represents the future of cancer treatment and care.\u003c/p>\n\u003cp>For decades, doctors would prescribe treatments that work for some or most people -- a \"one sized fits all\" approach. But precision medicine proposes that care providers treat patients on an individual basis.\u003c/p>\n\u003cp>This week, the state of California stepped up its efforts to deliver more targeted health care by setting aside $3 million for precision medicine.\u003c/p>\n\u003cp>The program relies on support from patients, caregivers and researchers, including doctors and nurses. Many health experts are already on board, as precision medicine could dramatically improve how we treat serious diseases, like cancer and diabetes.\u003c/p>\n\u003cfigure id=\"attachment_1760\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"size-full wp-image-1760\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg\" alt=\"A timeline of precision medicine milestones\" width=\"370\" height=\"1190\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg 370w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-187x600.jpg 187w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-367x1180.jpg 367w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-320x1029.jpg 320w\" sizes=\"(max-width: 370px) 100vw, 370px\">\u003cfigcaption class=\"wp-caption-text\">A timeline of precision medicine milestones \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Atul Butte, a physician and computational health buff, has stepped up to lead California's $3 million initiative. \u003cem>KQED's Future of You\u003c/em> discussed with Butte the goals for the program,called the \"California Initiative To Advance Precision Medicine,\" a few of the challenges, and the real benefits for people. This interview has been edited and condensed for brevity.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Do patients understand this \"Precision Medicine\" idea? How will you communicate this initiative to the general public?\u003c/strong>\u003c/p>\n\u003cp>Honestly, I don't think most people do. We are still trying to define the phrase, and figure out how best to describe it to the public. President Obama mentioned it earlier this year in a speech, and positioned it as a way for the country to try to solve cancer. I use phrases like \"imagine a Google Maps for health\" or \"a new molecular approach to thinking about disease\" -- and I tell people that now we're in a position to really do something.\u003c/p>\n\u003cp>\u003cstrong>The analogy of \"Google Maps for health\" is catchy. Did you come up with it? And what does it mean?\u003c/strong>\u003c/p>\n\u003cp>I actually borrowed the term from a \u003ca href=\"http://www.ucsf.edu/sites/default/files/legacy_files/documents/new-taxonomy.pdf\">\u003cspan class=\"s2\">2011 report from the Institute of Medicine\u003c/span>\u003c/a>. Susan Desmond-Hellman and \u003ca href=\"http://yamamotolab.ucsf.edu/\">\u003cspan class=\"s2\">Keith Yamamoto\u003c/span>\u003c/a> and others from UCSF were part of a committee to decide what the future of medical research would be. The committee collected health data in all sorts of layers, including a layer for cost of care, for genomics, or for medications. But we are not connecting the dots between these layers. The analogy the committee used is with Google Maps, which pulls together in its visualization traffic data, restaurant ratings, building data and more. You need that kind of data integration for Life Sciences and medicine also.\u003c/p>\n\u003cp>\u003cb>KQED \u003c/b>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/20/ucsf-white-house-search-for-better-treatments-for-disease/\">\u003cspan class=\"s2\">\u003cb>recently visited your new digs at the UCSF Mission Bay\u003c/b>\u003c/span>\u003c/a>\u003cb> to meet with U.S. Department of Health and Human Services Secretary Sylvia Burwell and discuss the government's plans for Precision Medicine. What new details have emerged since then?\u003c/b>\u003c/p>\n\u003caside class=\"pullquote alignright\">“We're not looking at tiny bits of human DNA anymore, but the whole genome.\"\u003c/aside>\n\u003cp>Well, our plans date back to well before your visit in March. Governor Brown mentioned 'Precision Medicine' in the 2014 State of the Union Address. A pot of money -- $3 million -- was put into the state budget. We've been thinking since then about how to leverage that money.\u003c/p>\n\u003cp>We now know that we're planning to use it in two ways. We will start by collecting data that is necessary for us to provide Precision Medicine. We will determine questions like: Who has the assets? Is it groups of patients or genomics companies?\u003c/p>\n\u003cp>The bulk of the money, however, will go to two research pilots. These pilots will be run at multiple sites across the UC Health System.\u003c/p>\n\u003cp>\u003cstrong>How will you pick the two pilots? Will you setup a committee to evaluate all the proposals? And which diseases are you focusing on first?\u003c/strong>\u003c/p>\n\u003cp>We envision that all ten of the UC campuses will put in proposals. We may also get entries from Stanford and other California medical schools, as well as private biotech companies. We'll put together a committee in the next few weeks to decide on the two that will receive funding.\u003c/p>\n\u003cp>We're hoping that different campuses will work together and exchange relevant data. For instance, if two of the UC schools are exceptionally great at taking care of patients with breast cancer, they could pool data to develop specific drug therapies.\u003c/p>\n\u003cp>Cancer is an obvious target for Precision Medicine, and a lot of people are talking about that. We could also help kids with rare diseases.\u003c/p>\n\u003cp>\u003cstrong>How will you deal with some of the challenges of sharing data across different medical institutions? As recent articles \u003ca href=\"http://ww2.kqed.org/futureofyou/broken-medical-records\">(including a two-part series from KQED) \u003c/a>have demonstrated, much of this data isn't stored in a format that computers can ingest. And as you gather this sensitive data, how will you protect it?\u003c/strong>\u003c/p>\n\u003cp>A lot of this data is structured, which makes it easier for a computer to sort. But some of it, like imaging studies and text-based medical reports, are very difficult to process. There are some tools we can use, but we envision that many more tools will be developed in the next few years, whether it's from academia or private companies.\u003c/p>\n\u003cp>Another thing to highlight is that we want to make sure patients are involved in the process. We will make sure the data is anonymized and de-identified. We don't need to know who these patients are. We'll also be adding ethics and privacy advocates on the committee.\u003c/p>\n\u003cp>\u003cstrong>$3 million is a drop in the bucket when it comes to health care. Are you disappointed that there aren't more funds for the initiative?\u003c/strong>\u003c/p>\n\u003cp>Frankly, I am thrilled there is any money at all. Money for science from state budgets is hard to come by! But there may be more money in the future, potentially from private investors.\u003c/p>\n\u003cp>\u003cstrong>Speaking of patients, how will people benefit from this initiative in real and tangible ways? The initiative seems quite vague in its scope.\u003c/strong>\u003c/p>\n\u003cp>Let's be clear: This is a modest sum of money that will be spent on short-term trials. Some patients might enroll in these studies, particularly as existing studies expand to more UC centers. Those who participate at the early stages can learn about genetics. But the experience will not change for the average Californian.\u003c/p>\n\u003cp>\u003cstrong>How did you get involved in this field of \"computational health sciences\"? Will there be a hot market for jobs like this, which combine computer science and medicine skill-sets?\u003c/strong>\u003c/p>\n\u003cp>I started my career as a computer scientist, and used to work as a contractor for big companies like Apple. I later attended medical school and trained as a pediatrician. My advisors convinced me to go to \u003ca href=\"http://web.mit.edu/\">The Massachusetts Institute of Technology (MIT) to earn a PhD. \u003c/a>After graduating, I set up a lab to figure out how to better use medical data.\u003c/p>\n\u003cp>I just moved over to UCSF from Stanford at the beginning of April to build out the Institute for Computational Health Science. We'll be recruiting heavily.\u003c/p>\n\u003cp>The field of bioinformatics has been important for some time, but the significance is new. We're not looking at tiny bits of human DNA anymore, but the whole genome. The scope is much bigger. Bioinformatics is absolutely the career of the future.\u003c/p>\n\u003cp>\u003cstrong>What brought you to UCSF after over a decade at Stanford?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Bioinformatics is absolutely the career of the future.\"\u003c/aside>\n\u003cp>I loved Stanford, but UCSF offered two things I couldn't get there. It's a major medical center with large patient populations and resources that are required to build out a whole program in computational health. We're going to build a new building -- you need a large set of resources for that. Also, I have this physician link across all the UC health campuses. That's 13 million patients! We can really learn a lot from them, while we work to improve the consistency of care across the UC system.\u003c/p>\n\u003cp>\u003cstrong>Do you have any plans for new research that would reduce inefficiencies and help keep health care costs under control? And how about pricing, which can wildly differ between California hospitals?\u003c/strong>\u003c/p>\n\u003cp>Yes, there are a lot of inefficiencies in our health care system. I think data might shed light on where we can improve. I am hopeful we can reduce health care costs. How can we remove the piece that isn't needed?\u003c/p>\n\u003cp>Pricing depends on a complicated system of players, including payers. If I can even partially solve the cost problem, I'll see that as a success. Pricing is a different story.\u003c/p>\n\u003cp>\u003cstrong>How will the private sector get involved with this initiative? And are you looking at involving digital health tools from Silicon Valley's startups?\u003c/strong>\u003c/p>\n\u003cp>Yes, we expect that private industry will want to get involved. I have been getting tons of emails already from companies.\u003c/p>\n\u003cp>We envision that these pilots will draw on resources from the tech world, like Apple's ResearchKit, which offers an interesting way to recruit patients. We would also encourage research teams to use new tools and partner with companies like Apple or Samsung to get more outcomes data on their patients. What are patients like at home? How healthy are their habits? We need more real-world data.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>I am definitely optimistic about the role of technology in health care. Computers and digitization really has helped. We just need to make sure people aren't being left behind as we move into this digital age, and that everyone makes these transition away from paper-based systems in a safe and effective way.\u003c/p>\n\n",
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"excerpt": "The state of California just launched a $3 million \"Precision Medicine\" initiative. The project's leader, Dr. Atul Butte, opens up to KQED about some of the key challenges, including efforts to safeguard patient privacy. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\"Precision medicine\" may seem like a vague and futuristic term. But for President Obama and other policymakers, it represents the future of cancer treatment and care.\u003c/p>\n\u003cp>For decades, doctors would prescribe treatments that work for some or most people -- a \"one sized fits all\" approach. But precision medicine proposes that care providers treat patients on an individual basis.\u003c/p>\n\u003cp>This week, the state of California stepped up its efforts to deliver more targeted health care by setting aside $3 million for precision medicine.\u003c/p>\n\u003cp>The program relies on support from patients, caregivers and researchers, including doctors and nurses. Many health experts are already on board, as precision medicine could dramatically improve how we treat serious diseases, like cancer and diabetes.\u003c/p>\n\u003cfigure id=\"attachment_1760\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"size-full wp-image-1760\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg\" alt=\"A timeline of precision medicine milestones\" width=\"370\" height=\"1190\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg 370w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-187x600.jpg 187w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-367x1180.jpg 367w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-320x1029.jpg 320w\" sizes=\"(max-width: 370px) 100vw, 370px\">\u003cfigcaption class=\"wp-caption-text\">A timeline of precision medicine milestones \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Atul Butte, a physician and computational health buff, has stepped up to lead California's $3 million initiative. \u003cem>KQED's Future of You\u003c/em> discussed with Butte the goals for the program,called the \"California Initiative To Advance Precision Medicine,\" a few of the challenges, and the real benefits for people. This interview has been edited and condensed for brevity.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Do patients understand this \"Precision Medicine\" idea? How will you communicate this initiative to the general public?\u003c/strong>\u003c/p>\n\u003cp>Honestly, I don't think most people do. We are still trying to define the phrase, and figure out how best to describe it to the public. President Obama mentioned it earlier this year in a speech, and positioned it as a way for the country to try to solve cancer. I use phrases like \"imagine a Google Maps for health\" or \"a new molecular approach to thinking about disease\" -- and I tell people that now we're in a position to really do something.\u003c/p>\n\u003cp>\u003cstrong>The analogy of \"Google Maps for health\" is catchy. Did you come up with it? And what does it mean?\u003c/strong>\u003c/p>\n\u003cp>I actually borrowed the term from a \u003ca href=\"http://www.ucsf.edu/sites/default/files/legacy_files/documents/new-taxonomy.pdf\">\u003cspan class=\"s2\">2011 report from the Institute of Medicine\u003c/span>\u003c/a>. Susan Desmond-Hellman and \u003ca href=\"http://yamamotolab.ucsf.edu/\">\u003cspan class=\"s2\">Keith Yamamoto\u003c/span>\u003c/a> and others from UCSF were part of a committee to decide what the future of medical research would be. The committee collected health data in all sorts of layers, including a layer for cost of care, for genomics, or for medications. But we are not connecting the dots between these layers. The analogy the committee used is with Google Maps, which pulls together in its visualization traffic data, restaurant ratings, building data and more. You need that kind of data integration for Life Sciences and medicine also.\u003c/p>\n\u003cp>\u003cb>KQED \u003c/b>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/20/ucsf-white-house-search-for-better-treatments-for-disease/\">\u003cspan class=\"s2\">\u003cb>recently visited your new digs at the UCSF Mission Bay\u003c/b>\u003c/span>\u003c/a>\u003cb> to meet with U.S. Department of Health and Human Services Secretary Sylvia Burwell and discuss the government's plans for Precision Medicine. What new details have emerged since then?\u003c/b>\u003c/p>\n\u003caside class=\"pullquote alignright\">“We're not looking at tiny bits of human DNA anymore, but the whole genome.\"\u003c/aside>\n\u003cp>Well, our plans date back to well before your visit in March. Governor Brown mentioned 'Precision Medicine' in the 2014 State of the Union Address. A pot of money -- $3 million -- was put into the state budget. We've been thinking since then about how to leverage that money.\u003c/p>\n\u003cp>We now know that we're planning to use it in two ways. We will start by collecting data that is necessary for us to provide Precision Medicine. We will determine questions like: Who has the assets? Is it groups of patients or genomics companies?\u003c/p>\n\u003cp>The bulk of the money, however, will go to two research pilots. These pilots will be run at multiple sites across the UC Health System.\u003c/p>\n\u003cp>\u003cstrong>How will you pick the two pilots? Will you setup a committee to evaluate all the proposals? And which diseases are you focusing on first?\u003c/strong>\u003c/p>\n\u003cp>We envision that all ten of the UC campuses will put in proposals. We may also get entries from Stanford and other California medical schools, as well as private biotech companies. We'll put together a committee in the next few weeks to decide on the two that will receive funding.\u003c/p>\n\u003cp>We're hoping that different campuses will work together and exchange relevant data. For instance, if two of the UC schools are exceptionally great at taking care of patients with breast cancer, they could pool data to develop specific drug therapies.\u003c/p>\n\u003cp>Cancer is an obvious target for Precision Medicine, and a lot of people are talking about that. We could also help kids with rare diseases.\u003c/p>\n\u003cp>\u003cstrong>How will you deal with some of the challenges of sharing data across different medical institutions? As recent articles \u003ca href=\"http://ww2.kqed.org/futureofyou/broken-medical-records\">(including a two-part series from KQED) \u003c/a>have demonstrated, much of this data isn't stored in a format that computers can ingest. And as you gather this sensitive data, how will you protect it?\u003c/strong>\u003c/p>\n\u003cp>A lot of this data is structured, which makes it easier for a computer to sort. But some of it, like imaging studies and text-based medical reports, are very difficult to process. There are some tools we can use, but we envision that many more tools will be developed in the next few years, whether it's from academia or private companies.\u003c/p>\n\u003cp>Another thing to highlight is that we want to make sure patients are involved in the process. We will make sure the data is anonymized and de-identified. We don't need to know who these patients are. We'll also be adding ethics and privacy advocates on the committee.\u003c/p>\n\u003cp>\u003cstrong>$3 million is a drop in the bucket when it comes to health care. Are you disappointed that there aren't more funds for the initiative?\u003c/strong>\u003c/p>\n\u003cp>Frankly, I am thrilled there is any money at all. Money for science from state budgets is hard to come by! But there may be more money in the future, potentially from private investors.\u003c/p>\n\u003cp>\u003cstrong>Speaking of patients, how will people benefit from this initiative in real and tangible ways? The initiative seems quite vague in its scope.\u003c/strong>\u003c/p>\n\u003cp>Let's be clear: This is a modest sum of money that will be spent on short-term trials. Some patients might enroll in these studies, particularly as existing studies expand to more UC centers. Those who participate at the early stages can learn about genetics. But the experience will not change for the average Californian.\u003c/p>\n\u003cp>\u003cstrong>How did you get involved in this field of \"computational health sciences\"? Will there be a hot market for jobs like this, which combine computer science and medicine skill-sets?\u003c/strong>\u003c/p>\n\u003cp>I started my career as a computer scientist, and used to work as a contractor for big companies like Apple. I later attended medical school and trained as a pediatrician. My advisors convinced me to go to \u003ca href=\"http://web.mit.edu/\">The Massachusetts Institute of Technology (MIT) to earn a PhD. \u003c/a>After graduating, I set up a lab to figure out how to better use medical data.\u003c/p>\n\u003cp>I just moved over to UCSF from Stanford at the beginning of April to build out the Institute for Computational Health Science. We'll be recruiting heavily.\u003c/p>\n\u003cp>The field of bioinformatics has been important for some time, but the significance is new. We're not looking at tiny bits of human DNA anymore, but the whole genome. The scope is much bigger. Bioinformatics is absolutely the career of the future.\u003c/p>\n\u003cp>\u003cstrong>What brought you to UCSF after over a decade at Stanford?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Bioinformatics is absolutely the career of the future.\"\u003c/aside>\n\u003cp>I loved Stanford, but UCSF offered two things I couldn't get there. It's a major medical center with large patient populations and resources that are required to build out a whole program in computational health. We're going to build a new building -- you need a large set of resources for that. Also, I have this physician link across all the UC health campuses. That's 13 million patients! We can really learn a lot from them, while we work to improve the consistency of care across the UC system.\u003c/p>\n\u003cp>\u003cstrong>Do you have any plans for new research that would reduce inefficiencies and help keep health care costs under control? And how about pricing, which can wildly differ between California hospitals?\u003c/strong>\u003c/p>\n\u003cp>Yes, there are a lot of inefficiencies in our health care system. I think data might shed light on where we can improve. I am hopeful we can reduce health care costs. How can we remove the piece that isn't needed?\u003c/p>\n\u003cp>Pricing depends on a complicated system of players, including payers. If I can even partially solve the cost problem, I'll see that as a success. Pricing is a different story.\u003c/p>\n\u003cp>\u003cstrong>How will the private sector get involved with this initiative? And are you looking at involving digital health tools from Silicon Valley's startups?\u003c/strong>\u003c/p>\n\u003cp>Yes, we expect that private industry will want to get involved. I have been getting tons of emails already from companies.\u003c/p>\n\u003cp>We envision that these pilots will draw on resources from the tech world, like Apple's ResearchKit, which offers an interesting way to recruit patients. We would also encourage research teams to use new tools and partner with companies like Apple or Samsung to get more outcomes data on their patients. What are patients like at home? How healthy are their habits? We need more real-world data.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>I am definitely optimistic about the role of technology in health care. Computers and digitization really has helped. We just need to make sure people aren't being left behind as we move into this digital age, and that everyone makes these transition away from paper-based systems in a safe and effective way.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Digital Tools for Health Come With 'Hope, Hype and Harm'",
"title": "Digital Tools for Health Come With 'Hope, Hype and Harm'",
"headTitle": "Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>Dr. Robert Wachter has long been an advocate for patient safety and a keen observer of trends in medicine.\u003c/p>\n\u003cp>Years ago, Wachter coined the term \"\u003ca href=\"http://www.hospitalmedicine.org/Web/About_SHM/Industry/Hospital_Medicine_Hospital_Definition.aspx\">hospitalist\u003c/a>\" and predicted the rise of these doctors who specialize in caring for hospitalized patients.\u003c/p>\n\u003cp>Wachter, associate chairman of University of California, San Francisco's department of medicine, has a new book out: \u003cem>\u003ca href=\"http://www.amazon.com/dp/0071849467/\">The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine's Computer Age\u003c/a>. \u003c/em>In it, he turns his attention to the rise of technology in health care, and the risks and rewards as we digitize everything from medical records to office visits. Here is an edited and condensed version of our recent conversation about it.\u003c/p>\n\u003cp>\u003cstrong>As I read your book I couldn't help thinking about the elderly. Many older people aren't tech savvy. They're intimidated by looking up information on computers and sending email to their doctors. They're also bigger health care users than many younger people. What needs to be done to help them get and stay engaged as technology advances?\u003c/strong>\u003c/p>\n\u003cp>It's an important question. It's not natural for them the way it is for the next generation and beyond. But most older people are at least using email and know how to surf the Web. Silicon Valley has woken up and realized this is a huge market. As consumer-oriented tech companies enter the health care field, I think they're going to design tools and technology and ways of interfacing that make it seamless for the people who need to become engaged. This will allow older patients to at least do the basic stuff, like renewing their medications, the stuff that's just incredibly annoying in the paper world.\u003c/p>\n\u003cfigure id=\"attachment_1711\" class=\"wp-caption alignright\" style=\"max-width: 313px\">\u003cimg class=\" wp-image-1711\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7.jpg\" alt=\"Dr. Robert Wachter writes that computers have crowded out eye contact between the doctor and patient, in his latest book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age.\" width=\"313\" height=\"457\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7.jpg 799w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7-400x584.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7-411x600.jpg 411w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7-768x1121.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7-320x467.jpg 320w\" sizes=\"(max-width: 313px) 100vw, 313px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Robert Wachter writes that computers have crowded out eye contact between the doctor and patient, in his latest book, \u003cem>The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age.\u003c/em> \u003ccite>(Susan Merrell/University of California, San Francisco)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>In your book, you talk about moving away from fee-for-service payments to doctors and hospitals and toward payments based on a population of people, adjusted for their baseline health. From a patient perspective, will that change how they pay for their care? At the most basic level, could that finally mean the end of incomprehensible \"explanation of benefits\" insurance forms, for example? \u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>I wish I were more hopeful. Of all the nuts we have to crack, this is the one I'm least optimistic about.\u003c/p>\n\u003cp>If everybody is in an accountable care organization or the like, providers get a single payment when they treat someone. But as long as they're still doing an adjustment for the relative sickness of the patients, the organization will need to account for all of the details. And I'm afraid the patient may also still see a confusing itemized bill, unless we can get to a point in which you've paid for the year and you're done.\u003c/p>\n\u003cp>The movement away from piecemeal payments is hopeful, and so are the digitization of health care and the entry of Silicon Valley companies with a consumer sensibility. I guess the question is: Do all of those trends — when woven together — lead to something that's more user friendly? When it comes to clinical care, I think the answer is yes. I see how we can get to a much happier place, with better care through digital medicine, in five to seven years. But the idea that you could get a simple, clear insurance bill that you pay with one click... that still feels like a moon shot to me. So maybe in 10 to 15 years.\u003c/p>\n\u003cp>\u003cstrong>To what extent can technology really help people comparison shop for health care? To date, we've seen that it seems to work best for procedures like colonoscopies or MRIs, where the service performed is fairly comparable. Could people really comparison shop for cancer treatment? Would we want them to?\u003c/strong>\u003c/p>\n\u003cp>Sure, why not? Some of this comes down to your fundamental belief in capitalism and the market. But we do have to pay some attention to fundamental differences between health care and other markets. For example, in health care, we can't accept haves and have-nots, while we readily accept this with other luxury goods. That said, I'm pretty convinced that if you create an environment where patients have the information they need to make those decisions, that the market will help them make good choices.\u003c/p>\n\u003cp>The area I worry about is the science. How do we really know that one doctor or hospital is better than another? Most aspects of quality measurement are not very advanced.\u003c/p>\n\u003cp>Another real challenge is fragmentation. If I get my colonoscopy at one place because it's the best and cheapest but it's in a different system than the one my primary care doctor is in, that's a problem if the electronic records don't talk to each other. As a patient, I've got to think about the advantage of receiving the cheapest procedure compared to the negative consequences of no one doctor having a complete view of my health.\u003c/p>\n\u003cp>\u003cstrong>Do you think the federal health law requirement that people have health insurance positively affects their engagement in their own health care or the health care system?\u003c/strong>\u003c/p>\n\u003cp>I think everybody should have health insurance. The system works better and people have better health and health care with universal insurance. And the law was the most politically feasible way to make that happen, so I support it. When people have health insurance, it creates a connection to a system that is largely mediated through a primary care doctor. To have 40 to 50 million people floating outside the system – able to access the system only episodically and when they're very ill – is crazy.\u003c/p>\n\u003cp>Has having insurance increased their engagement? Yes, but at a level that's pretty wimpy. Now you can see a primary care doctor to manage your blood pressure in an office visit every six months, but is that the level of engagement we should aspire to? Nowhere near it. The hope is that by having everybody part of an organized health care system, now it's in the interest of the system to have engaged patients – since that engagement should lead to fewer office visits, ER visits, and hospitalizations. But this is the sort of thing that takes years, if not decades, to develop.\u003c/p>\n\u003cp>\u003cstrong>What about initiatives like OpenNotes that allow patients to read their doctors' electronic notes about their care? How do they change the patient-doctor relationship?\u003c/strong>\u003c/p>\n\u003cp>OpenNotes illustrates the democratization of the health care system, which is going to challenge all of the system's fundamental underpinnings. Digitization is an enabler. It's changing the relationship between doctors and their patients from an extraordinarily paternalistic one to one that is more democratic. In the new world, a patient's choice is no longer just, \"Do I see doctor A or B?\" but \"Do I even need to see a doctor at all?\" OpenNotes is part of this trend.\u003c/p>\n\u003cp>As wonderful as patient sharing access to their information is, along with new tools to self-manage and things like telemedicine that allow patients to receive care outside the traditional system, in a world of high copays you are going to see some patients making some very bad choices. In the old days, the sick patient had to go see a doctor. Now they can go to MinuteClinic. Or they can Google their symptoms. I wouldn't want to turn back the clock, but it raises the question, \"When is self-management a bad choice?\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>As health care finally goes digital, some people believe that it's no different than travel or banking. But no one is getting harmed by using TripAdvisor or Fidelity. I think you could argue that health care is fundamentally different.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Digital+Tools+For+Health+Come+With+%27Hope%2C+Hype+And+Harm%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Robert Wachter has long been an advocate for patient safety and a keen observer of trends in medicine.\u003c/p>\n\u003cp>Years ago, Wachter coined the term \"\u003ca href=\"http://www.hospitalmedicine.org/Web/About_SHM/Industry/Hospital_Medicine_Hospital_Definition.aspx\">hospitalist\u003c/a>\" and predicted the rise of these doctors who specialize in caring for hospitalized patients.\u003c/p>\n\u003cp>Wachter, associate chairman of University of California, San Francisco's department of medicine, has a new book out: \u003cem>\u003ca href=\"http://www.amazon.com/dp/0071849467/\">The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine's Computer Age\u003c/a>. \u003c/em>In it, he turns his attention to the rise of technology in health care, and the risks and rewards as we digitize everything from medical records to office visits. Here is an edited and condensed version of our recent conversation about it.\u003c/p>\n\u003cp>\u003cstrong>As I read your book I couldn't help thinking about the elderly. Many older people aren't tech savvy. They're intimidated by looking up information on computers and sending email to their doctors. They're also bigger health care users than many younger people. What needs to be done to help them get and stay engaged as technology advances?\u003c/strong>\u003c/p>\n\u003cp>It's an important question. It's not natural for them the way it is for the next generation and beyond. But most older people are at least using email and know how to surf the Web. Silicon Valley has woken up and realized this is a huge market. As consumer-oriented tech companies enter the health care field, I think they're going to design tools and technology and ways of interfacing that make it seamless for the people who need to become engaged. This will allow older patients to at least do the basic stuff, like renewing their medications, the stuff that's just incredibly annoying in the paper world.\u003c/p>\n\u003cfigure id=\"attachment_1711\" class=\"wp-caption alignright\" style=\"max-width: 313px\">\u003cimg class=\" wp-image-1711\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7.jpg\" alt=\"Dr. Robert Wachter writes that computers have crowded out eye contact between the doctor and patient, in his latest book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age.\" width=\"313\" height=\"457\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7.jpg 799w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7-400x584.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7-411x600.jpg 411w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7-768x1121.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/wachter-2_enl-1940c2d5c1865e3563ca9ee326e802aa12d934c7-320x467.jpg 320w\" sizes=\"(max-width: 313px) 100vw, 313px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Robert Wachter writes that computers have crowded out eye contact between the doctor and patient, in his latest book, \u003cem>The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age.\u003c/em> \u003ccite>(Susan Merrell/University of California, San Francisco)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>In your book, you talk about moving away from fee-for-service payments to doctors and hospitals and toward payments based on a population of people, adjusted for their baseline health. From a patient perspective, will that change how they pay for their care? At the most basic level, could that finally mean the end of incomprehensible \"explanation of benefits\" insurance forms, for example? \u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>I wish I were more hopeful. Of all the nuts we have to crack, this is the one I'm least optimistic about.\u003c/p>\n\u003cp>If everybody is in an accountable care organization or the like, providers get a single payment when they treat someone. But as long as they're still doing an adjustment for the relative sickness of the patients, the organization will need to account for all of the details. And I'm afraid the patient may also still see a confusing itemized bill, unless we can get to a point in which you've paid for the year and you're done.\u003c/p>\n\u003cp>The movement away from piecemeal payments is hopeful, and so are the digitization of health care and the entry of Silicon Valley companies with a consumer sensibility. I guess the question is: Do all of those trends — when woven together — lead to something that's more user friendly? When it comes to clinical care, I think the answer is yes. I see how we can get to a much happier place, with better care through digital medicine, in five to seven years. But the idea that you could get a simple, clear insurance bill that you pay with one click... that still feels like a moon shot to me. So maybe in 10 to 15 years.\u003c/p>\n\u003cp>\u003cstrong>To what extent can technology really help people comparison shop for health care? To date, we've seen that it seems to work best for procedures like colonoscopies or MRIs, where the service performed is fairly comparable. Could people really comparison shop for cancer treatment? Would we want them to?\u003c/strong>\u003c/p>\n\u003cp>Sure, why not? Some of this comes down to your fundamental belief in capitalism and the market. But we do have to pay some attention to fundamental differences between health care and other markets. For example, in health care, we can't accept haves and have-nots, while we readily accept this with other luxury goods. That said, I'm pretty convinced that if you create an environment where patients have the information they need to make those decisions, that the market will help them make good choices.\u003c/p>\n\u003cp>The area I worry about is the science. How do we really know that one doctor or hospital is better than another? Most aspects of quality measurement are not very advanced.\u003c/p>\n\u003cp>Another real challenge is fragmentation. If I get my colonoscopy at one place because it's the best and cheapest but it's in a different system than the one my primary care doctor is in, that's a problem if the electronic records don't talk to each other. As a patient, I've got to think about the advantage of receiving the cheapest procedure compared to the negative consequences of no one doctor having a complete view of my health.\u003c/p>\n\u003cp>\u003cstrong>Do you think the federal health law requirement that people have health insurance positively affects their engagement in their own health care or the health care system?\u003c/strong>\u003c/p>\n\u003cp>I think everybody should have health insurance. The system works better and people have better health and health care with universal insurance. And the law was the most politically feasible way to make that happen, so I support it. When people have health insurance, it creates a connection to a system that is largely mediated through a primary care doctor. To have 40 to 50 million people floating outside the system – able to access the system only episodically and when they're very ill – is crazy.\u003c/p>\n\u003cp>Has having insurance increased their engagement? Yes, but at a level that's pretty wimpy. Now you can see a primary care doctor to manage your blood pressure in an office visit every six months, but is that the level of engagement we should aspire to? Nowhere near it. The hope is that by having everybody part of an organized health care system, now it's in the interest of the system to have engaged patients – since that engagement should lead to fewer office visits, ER visits, and hospitalizations. But this is the sort of thing that takes years, if not decades, to develop.\u003c/p>\n\u003cp>\u003cstrong>What about initiatives like OpenNotes that allow patients to read their doctors' electronic notes about their care? How do they change the patient-doctor relationship?\u003c/strong>\u003c/p>\n\u003cp>OpenNotes illustrates the democratization of the health care system, which is going to challenge all of the system's fundamental underpinnings. Digitization is an enabler. It's changing the relationship between doctors and their patients from an extraordinarily paternalistic one to one that is more democratic. In the new world, a patient's choice is no longer just, \"Do I see doctor A or B?\" but \"Do I even need to see a doctor at all?\" OpenNotes is part of this trend.\u003c/p>\n\u003cp>As wonderful as patient sharing access to their information is, along with new tools to self-manage and things like telemedicine that allow patients to receive care outside the traditional system, in a world of high copays you are going to see some patients making some very bad choices. In the old days, the sick patient had to go see a doctor. Now they can go to MinuteClinic. Or they can Google their symptoms. I wouldn't want to turn back the clock, but it raises the question, \"When is self-management a bad choice?\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As health care finally goes digital, some people believe that it's no different than travel or banking. But no one is getting harmed by using TripAdvisor or Fidelity. I think you could argue that health care is fundamentally different.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Digital+Tools+For+Health+Come+With+%27Hope%2C+Hype+And+Harm%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "9 Fresh Ways Medicine Makes Use of Social Media",
"title": "9 Fresh Ways Medicine Makes Use of Social Media",
"headTitle": "Contributor | Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>\u003cem>Author Emily F. Peters is founder of \u003ca href=\"http://www.uncommonbold.com/\">Uncommon Bold\u003c/a>, a San Francisco–based brand strategy studio. Reach her on Twitter: \u003ca href=\"https://twitter.com/EmilyFPeters\">@emilyfpeters\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Facebook has 1.3 billion users, more than 900 million people use Twitter, and an hour of video is uploaded to YouTube every single second. In the last decade, social networks have fundamentally changed the ways we connect, build communities and \u003ca href=\"http://giphy.com/search/ninja-cat\">share ninja cat GIFs\u003c/a>.\u003c/p>\n\u003cp>So much about health care seems perfectly matched for this modern landscape of social media: All those heart-wrenching stories of recovery against the odds, inspiring new robotic inventions, cases of doctors who just care too much and loads of “you’ll never believe” medical research.\u003c/p>\n\u003cp>But when it comes to social media, the health sector is just getting started.\u003c/p>\n\u003cp>\"Healthcare is habitually late to the party when it comes to marketing and communications, as it's a heavily regulated industry. Social media is no exception,\" said Amanda Changuris, a social media marketing analyst at Highmark and an advisor to the \u003ca href=\"http://network.socialmedia.mayoclinic.org/about-3/\">Mayo Clinic Center for Social Media.\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The good news is that there are now some truly excellent minds putting the medium through its paces for the benefit of patients, physicians and the public in general,\" said Changuris.\u003c/p>\n\u003cp>What can social media and medicine do? From organ donations to #FOMO (which stands for \"fear of missing out\"), here are nine ingenious examples of health care making the most of social networks:\u003c/p>\n\u003cp>\u003cstrong>Opening Operating Rooms to the World\u003c/strong>\u003c/p>\n\u003cp>If blood and gore doesn't make you squeamish, tune into live hospital video streams. Health organizations are tapping into our fascination with medicine and human anatomy by broadcasting surgical procedures via social media.\u003c/p>\n\u003cp>\u003ca href=\"http://www.swedish.org/landing-pages/cochlear-implant-and-hearing-loss-web-series\">The Swedish Medical Center in Washington State\u003c/a> ran a live broadcast of a cochlear implant surgery and followed up with emotional video of the patient listening to music for the first time. \u003ca href=\"http://www.memorialhermann.org/body-of-experts/c-section-twittercast/\">Memorial Hermann Hospital in Texas \u003c/a>showed a six-pound baby boy being delivered via cesarean section live from the OR on Twitter. \u003ca href=\"http://newsroom.ucla.edu/stories/ucla-live-tweets-surgery-to-implant-246356\">UCLA broadcast live on Vine \u003c/a>during brain surgery, showing the Parkinson’s patient playing country music guitar mid-operation.\u003c/p>\n\u003cfigure id=\"attachment_1550\" class=\"wp-caption alignleft\" style=\"max-width: 1280px\">\u003cimg class=\"size-full wp-image-1550\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/456343289_1280x720.jpg\" alt='A screenshot from a video intended to reduce fears about the \"snip\"' width=\"1280\" height=\"720\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720.jpg 1280w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-320x180.jpg 320w\" sizes=\"(max-width: 1280px) 100vw, 1280px\">\u003cfigcaption class=\"wp-caption-text\">A screenshot from a video intended to reduce fears about the \"snip\" \u003ccite>(YouTube/ World Vasectomy Day)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And in 2014, the doctors behind \u003ca href=\"http://www.worldvasectomyday.org\">World Vasectomy Day\u003c/a> took it a step further with a single-day live broadcast of 25 vasectomies. Over 10,000 viewers tuned in to the video stream of surgeries, international video interviews and short documentaries -- all as part of advocacy efforts to reduce fear of “the snip.”\u003c/p>\n\u003cp>\u003cstrong>Crowdsourcing Tough Medical Diagnoses\u003c/strong>\u003c/p>\n\u003cp>The average patient who signs up to a website called \u003ca href=\"http://crowdmed.com\">CrowdMed\u003c/a> has been sick for about eight years, spent more than $55,000 on medical expenses and still doesn’t have a diagnosis for their disease. The crowdsourcing startup helps patients reach a network of “medical detectives”— mostly healthcare professionals and medical students across 23 countries—with their tough medical cases.\u003c/p>\n\u003cp>\u003ca href=\"https://www.crowdmed.com/our-stories/julietta\">One patient, Juliette (pseudonym), \u003c/a>found a diagnosis and cure in just two weeks for a painful swelling condition that had kept her bedridden and undergoing surgery for two decades.\u003c/p>\n\u003cp>“Our 'medical detectives' spend an average of 11 hours per month solving medical cases on the network, which is more time than the average user spends on any other online social media,” said Jessica Greenwalt, co-founder of CrowdMed.\u003c/p>\n\u003cp>“They devote a lot of time to researching diagnoses and communicating with patients.”\u003c/p>\n\u003cp>\u003cstrong>Raising Millions for Clinical Research\u003c/strong>\u003c/p>\n\u003cp>When four-year-old Eliza O’Neill was diagnosed with a rare pediatric disease, her parents turned to social media with a poignant video. \u003ca href=\"http://www.gofundme.com/ElizaONeill\">They’ve now raised more than $2 million for Sanfilippo Syndrome\u003c/a> from 30,000 donors and are working with Nationwide Children’s Hospital in Ohio to speed clinical trials for a promising cure.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"800\" height=\"425\" src=\"https://www.youtube.com/embed/G0IY8qG7J-I?rel=0\" frameborder=\"0\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>Campaigns like Eliza's and\u003ca href=\"http://www.alsa.org/about-us/ice-bucket-challenge-faq.html\"> the ALS Ice Bucket Challenge\u003c/a> —which raised $115 million in just a few months -- prove just how potent a platform social media can be for raising funds and awareness. The social media model is now being used for everything from \u003ca href=\"http://fightcolorectalcancer.org/do-something/raise-awareness/strong-arm-selfie/\">#strongarmselfies\u003c/a> for colon cancer to \u003ca href=\"http://bigstory.ap.org/article/west-africans-get-creative-ebola-awareness\">buckets of soapy water for Ebola awareness.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Tapping into #FOMO for Public Health\u003c/strong>\u003c/p>\n\u003cp>UCLA studied using social networks to drive up peer pressure and combat the spread of AIDS. The Harnessing Online Peer Education \u003ca href=\"http://newsroom.ucla.edu/releases/combining-social-media-and-behavioral-psychology-could-lead-to-more-hiv-testing\">(HOPE) study\u003c/a> found that social media conversations could triple the request rate for at-home HIV tests in high-risk populations in just three weeks. The researchers are now focused on expanding the study’s lessons to combat substance abuse, depression and bullying.\u003c/p>\n\u003cp>“I think there’s a huge potential in social media—not necessarily because of social media itself, but because everyone uses it,” said Sean Young, executive director, UC Institute for Prediction Technology and UCLA Center for Digital Behavior and the primary investigator on the HOPE study.\u003c/p>\n\u003cp>“Researchers are typically behind the curve in terms of what people are using in technology. People who want to find sex partners, who want to find drugs, they’re going to use the most up-to-date technology to do that. Researchers need to stay ahead of the latest tech trends to keep up.”\u003c/p>\n\u003cp>\u003cstrong>Mining Social Data for Life-Saving Trends\u003c/strong>\u003c/p>\n\u003cp>The massive, real-time trove of public social media data is a potential gold mine for medical researchers. For example, University of Pennsylvania recently found that \u003ca href=\"http://pss.sagepub.com/content/26/2/159\">angry tweets were a strong predictor of fatal cardiac disease.\u003c/a> According to the study, the “model based only on Twitter language predicted [heart disease] mortality significantly better than did a model that combined 10 common demographic, socioeconomic and health risk factors, including smoking, diabetes, hypertension and obesity.”\u003c/p>\n\u003cfigure id=\"attachment_1551\" class=\"wp-caption alignright\" style=\"max-width: 432px\">\u003cimg class=\" wp-image-1551\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/EbolaTracking-1.jpg\" alt=\"Screenshot of a real-time Ebola tracking map from researchers at Northeastern \" width=\"432\" height=\"305\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1.jpg 1169w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1-400x283.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1-800x566.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1-768x543.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1-320x226.jpg 320w\" sizes=\"(max-width: 432px) 100vw, 432px\">\u003cfigcaption class=\"wp-caption-text\">Screenshot of a real-time Ebola tracking map from researchers at Northeastern \u003ccite>(Emily Peters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Researchers at Northeastern University created a real-time map tracking international \u003ca href=\"http://ebolatracking.org\">Ebola awareness\u003c/a> through tweets. In Italy, scientists improved on Google’s Flu Trends to create accurate \u003ca href=\"http://www.aiimjournal.com/article/S0933-3657(14)00004-9/abstract\">“syndromic surveillance”\u003c/a> of flu through Twitter. While the potential for social media in research is huge, there are emerging debates about the \u003ca href=\"http://sciencelife.uchospitals.edu/2014/10/21/a-tempting-source-of-data-social-media-is-uncharted-ethical-territory-for-medical-research/\">ethics and accuracy of using the data.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Direct Messaging Candidates for Clinical Trials\u003c/strong>\u003c/p>\n\u003cp>An estimated 30 percent of the work of a clinical trial is spent on patient recruiting, and difficulty finding patients is cited as the top reason that clinical research is delayed. Social media is changing this fast.\u003c/p>\n\u003cfigure id=\"attachment_1553\" class=\"wp-caption alignleft\" style=\"max-width: 385px\">\u003cimg class=\" wp-image-1553\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/2_other_patients.png\" alt=\"A graphic developed by PatientsLikeMe\" width=\"385\" height=\"385\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients.png 2048w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-400x400.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-600x600.png 600w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-1180x1180.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-768x768.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-320x320.png 320w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-96x96.png 96w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-128x128.png 128w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-75x75.png 75w\" sizes=\"(max-width: 385px) 100vw, 385px\">\u003cfigcaption class=\"wp-caption-text\">A graphic developed by PatientsLikeMe \u003ccite>(PatientsLikeMe)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In fact, \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/04/09/peds.2013-2966.abstract\">one study in the journal Pediatrics\u003c/a> found that 84 percent of patients for two recent pediatric rare disease trials were referred via social media. The patient social network \u003ca href=\"http://patientslikeme.com\">PatientsLikeMe\u003c/a> even has a tool to automatically match members to over 45,000 clinical trial opportunities. Patient recruitment via social networks could lead to quicker and more cost-effective research for cures.\u003c/p>\n\u003cp>\u003cstrong>Paging Doctors About the Conversation\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_1554\" class=\"wp-caption alignleft\" style=\"max-width: 460px\">\u003cimg class=\"wp-image-1554\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/171497-INFO.jpeg\" alt=\"A heat map of salaries for general surgeons by U.S. country\" width=\"460\" height=\"230\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO.jpeg 2400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-400x200.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-800x400.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-1180x590.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-768x384.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-320x160.jpeg 320w\" sizes=\"(max-width: 460px) 100vw, 460px\">\u003cfigcaption class=\"wp-caption-text\">A heat map of salaries for general surgeons by region. \u003ccite>(Doximity)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Strict privacy restrictions made social media a dangerous territory for medical professionals early on, but the healthcare sector is adapting quickly.\u003c/p>\n\u003cp>Professional networks such as \u003ca href=\"http://sermo.com\">Sermo\u003c/a>, \u003ca href=\"http://doximity.com\">Doximity\u003c/a> and \u003ca href=\"https://figure1.com/\">Figure 1\u003c/a> have created physician-only social spaces for collaboration. Doximity has gone so far as to crowd-source information on medical training and salaries to provide back to its doctor membership. \u003ca href=\"http://network.socialmedia.mayoclinic.org/social-media-residency/\">Mayo Clinic’s Center for Social Media\u003c/a> has been a leader in helping doctors and medical organizations to dip their toes in the social waters.\u003c/p>\n\u003cp>\u003cstrong>What's Trending? Organ Donations\u003c/strong>\u003c/p>\n\u003cp>When Facebook added a single organ donation question to their timeline, over 57,000 people announced their intentions to be donors, and 13,000 officially joined their state registry in a single day— \u003ca href=\"http://www.hopkinsmedicine.org/news/media/releases/the_facebook_effect_social_media_dramatically_boosts_organ_donor_registration\">an increase of 21 times\u003c/a> over normal registration rates, according to Johns Hopkins researchers. The long-term impact of Facebook’s organ donation campaign is still being studied, but it’s a hopeful step for the over 100,000 Americans currently on organ waiting lists.\u003c/p>\n\u003cp>\u003cstrong>Making Disease Awareness Personal\u003c/strong>\u003c/p>\n\u003cp>Lastly, a social media campaign made use of Facebook’s unique features to cleverly raise awareness of a terrible disease. In Holland, health advocates photoshopped people into pictures of events they never attended and then tagged them on Facebook. A followup message said, “Confusing, right? You’re now experiencing what it’s like to have Alzheimer’s disease.” Skip to the bottom for \u003ca href=\"https://vimeo.com/85254361\">a video\u003c/a> with details of their ingenious social campaign.\u003c/p>\n\u003cp>All the examples above took place in the past few years, which suggests that this potent combination of social media and medicine is still in its early days. Despite concerns about consumer privacy and some reticence from healthcare leaders, researchers, doctors, and patients have found fresh new ways to make the most of the social networks that connect us all.\u003c/p>\n\u003cp>[vimeo 85254361 w=500 h=281]\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Disclosure: Peters is a shareholder in Doximity having worked with them until February of 2015. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Author Emily F. Peters is founder of \u003ca href=\"http://www.uncommonbold.com/\">Uncommon Bold\u003c/a>, a San Francisco–based brand strategy studio. Reach her on Twitter: \u003ca href=\"https://twitter.com/EmilyFPeters\">@emilyfpeters\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Facebook has 1.3 billion users, more than 900 million people use Twitter, and an hour of video is uploaded to YouTube every single second. In the last decade, social networks have fundamentally changed the ways we connect, build communities and \u003ca href=\"http://giphy.com/search/ninja-cat\">share ninja cat GIFs\u003c/a>.\u003c/p>\n\u003cp>So much about health care seems perfectly matched for this modern landscape of social media: All those heart-wrenching stories of recovery against the odds, inspiring new robotic inventions, cases of doctors who just care too much and loads of “you’ll never believe” medical research.\u003c/p>\n\u003cp>But when it comes to social media, the health sector is just getting started.\u003c/p>\n\u003cp>\"Healthcare is habitually late to the party when it comes to marketing and communications, as it's a heavily regulated industry. Social media is no exception,\" said Amanda Changuris, a social media marketing analyst at Highmark and an advisor to the \u003ca href=\"http://network.socialmedia.mayoclinic.org/about-3/\">Mayo Clinic Center for Social Media.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The good news is that there are now some truly excellent minds putting the medium through its paces for the benefit of patients, physicians and the public in general,\" said Changuris.\u003c/p>\n\u003cp>What can social media and medicine do? From organ donations to #FOMO (which stands for \"fear of missing out\"), here are nine ingenious examples of health care making the most of social networks:\u003c/p>\n\u003cp>\u003cstrong>Opening Operating Rooms to the World\u003c/strong>\u003c/p>\n\u003cp>If blood and gore doesn't make you squeamish, tune into live hospital video streams. Health organizations are tapping into our fascination with medicine and human anatomy by broadcasting surgical procedures via social media.\u003c/p>\n\u003cp>\u003ca href=\"http://www.swedish.org/landing-pages/cochlear-implant-and-hearing-loss-web-series\">The Swedish Medical Center in Washington State\u003c/a> ran a live broadcast of a cochlear implant surgery and followed up with emotional video of the patient listening to music for the first time. \u003ca href=\"http://www.memorialhermann.org/body-of-experts/c-section-twittercast/\">Memorial Hermann Hospital in Texas \u003c/a>showed a six-pound baby boy being delivered via cesarean section live from the OR on Twitter. \u003ca href=\"http://newsroom.ucla.edu/stories/ucla-live-tweets-surgery-to-implant-246356\">UCLA broadcast live on Vine \u003c/a>during brain surgery, showing the Parkinson’s patient playing country music guitar mid-operation.\u003c/p>\n\u003cfigure id=\"attachment_1550\" class=\"wp-caption alignleft\" style=\"max-width: 1280px\">\u003cimg class=\"size-full wp-image-1550\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/456343289_1280x720.jpg\" alt='A screenshot from a video intended to reduce fears about the \"snip\"' width=\"1280\" height=\"720\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720.jpg 1280w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/456343289_1280x720-320x180.jpg 320w\" sizes=\"(max-width: 1280px) 100vw, 1280px\">\u003cfigcaption class=\"wp-caption-text\">A screenshot from a video intended to reduce fears about the \"snip\" \u003ccite>(YouTube/ World Vasectomy Day)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And in 2014, the doctors behind \u003ca href=\"http://www.worldvasectomyday.org\">World Vasectomy Day\u003c/a> took it a step further with a single-day live broadcast of 25 vasectomies. Over 10,000 viewers tuned in to the video stream of surgeries, international video interviews and short documentaries -- all as part of advocacy efforts to reduce fear of “the snip.”\u003c/p>\n\u003cp>\u003cstrong>Crowdsourcing Tough Medical Diagnoses\u003c/strong>\u003c/p>\n\u003cp>The average patient who signs up to a website called \u003ca href=\"http://crowdmed.com\">CrowdMed\u003c/a> has been sick for about eight years, spent more than $55,000 on medical expenses and still doesn’t have a diagnosis for their disease. The crowdsourcing startup helps patients reach a network of “medical detectives”— mostly healthcare professionals and medical students across 23 countries—with their tough medical cases.\u003c/p>\n\u003cp>\u003ca href=\"https://www.crowdmed.com/our-stories/julietta\">One patient, Juliette (pseudonym), \u003c/a>found a diagnosis and cure in just two weeks for a painful swelling condition that had kept her bedridden and undergoing surgery for two decades.\u003c/p>\n\u003cp>“Our 'medical detectives' spend an average of 11 hours per month solving medical cases on the network, which is more time than the average user spends on any other online social media,” said Jessica Greenwalt, co-founder of CrowdMed.\u003c/p>\n\u003cp>“They devote a lot of time to researching diagnoses and communicating with patients.”\u003c/p>\n\u003cp>\u003cstrong>Raising Millions for Clinical Research\u003c/strong>\u003c/p>\n\u003cp>When four-year-old Eliza O’Neill was diagnosed with a rare pediatric disease, her parents turned to social media with a poignant video. \u003ca href=\"http://www.gofundme.com/ElizaONeill\">They’ve now raised more than $2 million for Sanfilippo Syndrome\u003c/a> from 30,000 donors and are working with Nationwide Children’s Hospital in Ohio to speed clinical trials for a promising cure.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"800\" height=\"425\" src=\"https://www.youtube.com/embed/G0IY8qG7J-I?rel=0\" frameborder=\"0\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>Campaigns like Eliza's and\u003ca href=\"http://www.alsa.org/about-us/ice-bucket-challenge-faq.html\"> the ALS Ice Bucket Challenge\u003c/a> —which raised $115 million in just a few months -- prove just how potent a platform social media can be for raising funds and awareness. The social media model is now being used for everything from \u003ca href=\"http://fightcolorectalcancer.org/do-something/raise-awareness/strong-arm-selfie/\">#strongarmselfies\u003c/a> for colon cancer to \u003ca href=\"http://bigstory.ap.org/article/west-africans-get-creative-ebola-awareness\">buckets of soapy water for Ebola awareness.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Tapping into #FOMO for Public Health\u003c/strong>\u003c/p>\n\u003cp>UCLA studied using social networks to drive up peer pressure and combat the spread of AIDS. The Harnessing Online Peer Education \u003ca href=\"http://newsroom.ucla.edu/releases/combining-social-media-and-behavioral-psychology-could-lead-to-more-hiv-testing\">(HOPE) study\u003c/a> found that social media conversations could triple the request rate for at-home HIV tests in high-risk populations in just three weeks. The researchers are now focused on expanding the study’s lessons to combat substance abuse, depression and bullying.\u003c/p>\n\u003cp>“I think there’s a huge potential in social media—not necessarily because of social media itself, but because everyone uses it,” said Sean Young, executive director, UC Institute for Prediction Technology and UCLA Center for Digital Behavior and the primary investigator on the HOPE study.\u003c/p>\n\u003cp>“Researchers are typically behind the curve in terms of what people are using in technology. People who want to find sex partners, who want to find drugs, they’re going to use the most up-to-date technology to do that. Researchers need to stay ahead of the latest tech trends to keep up.”\u003c/p>\n\u003cp>\u003cstrong>Mining Social Data for Life-Saving Trends\u003c/strong>\u003c/p>\n\u003cp>The massive, real-time trove of public social media data is a potential gold mine for medical researchers. For example, University of Pennsylvania recently found that \u003ca href=\"http://pss.sagepub.com/content/26/2/159\">angry tweets were a strong predictor of fatal cardiac disease.\u003c/a> According to the study, the “model based only on Twitter language predicted [heart disease] mortality significantly better than did a model that combined 10 common demographic, socioeconomic and health risk factors, including smoking, diabetes, hypertension and obesity.”\u003c/p>\n\u003cfigure id=\"attachment_1551\" class=\"wp-caption alignright\" style=\"max-width: 432px\">\u003cimg class=\" wp-image-1551\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/EbolaTracking-1.jpg\" alt=\"Screenshot of a real-time Ebola tracking map from researchers at Northeastern \" width=\"432\" height=\"305\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1.jpg 1169w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1-400x283.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1-800x566.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1-768x543.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EbolaTracking-1-320x226.jpg 320w\" sizes=\"(max-width: 432px) 100vw, 432px\">\u003cfigcaption class=\"wp-caption-text\">Screenshot of a real-time Ebola tracking map from researchers at Northeastern \u003ccite>(Emily Peters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Researchers at Northeastern University created a real-time map tracking international \u003ca href=\"http://ebolatracking.org\">Ebola awareness\u003c/a> through tweets. In Italy, scientists improved on Google’s Flu Trends to create accurate \u003ca href=\"http://www.aiimjournal.com/article/S0933-3657(14)00004-9/abstract\">“syndromic surveillance”\u003c/a> of flu through Twitter. While the potential for social media in research is huge, there are emerging debates about the \u003ca href=\"http://sciencelife.uchospitals.edu/2014/10/21/a-tempting-source-of-data-social-media-is-uncharted-ethical-territory-for-medical-research/\">ethics and accuracy of using the data.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Direct Messaging Candidates for Clinical Trials\u003c/strong>\u003c/p>\n\u003cp>An estimated 30 percent of the work of a clinical trial is spent on patient recruiting, and difficulty finding patients is cited as the top reason that clinical research is delayed. Social media is changing this fast.\u003c/p>\n\u003cfigure id=\"attachment_1553\" class=\"wp-caption alignleft\" style=\"max-width: 385px\">\u003cimg class=\" wp-image-1553\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/2_other_patients.png\" alt=\"A graphic developed by PatientsLikeMe\" width=\"385\" height=\"385\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients.png 2048w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-400x400.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-600x600.png 600w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-1180x1180.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-768x768.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-320x320.png 320w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-96x96.png 96w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-128x128.png 128w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/2_other_patients-75x75.png 75w\" sizes=\"(max-width: 385px) 100vw, 385px\">\u003cfigcaption class=\"wp-caption-text\">A graphic developed by PatientsLikeMe \u003ccite>(PatientsLikeMe)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In fact, \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/04/09/peds.2013-2966.abstract\">one study in the journal Pediatrics\u003c/a> found that 84 percent of patients for two recent pediatric rare disease trials were referred via social media. The patient social network \u003ca href=\"http://patientslikeme.com\">PatientsLikeMe\u003c/a> even has a tool to automatically match members to over 45,000 clinical trial opportunities. Patient recruitment via social networks could lead to quicker and more cost-effective research for cures.\u003c/p>\n\u003cp>\u003cstrong>Paging Doctors About the Conversation\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_1554\" class=\"wp-caption alignleft\" style=\"max-width: 460px\">\u003cimg class=\"wp-image-1554\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/171497-INFO.jpeg\" alt=\"A heat map of salaries for general surgeons by U.S. country\" width=\"460\" height=\"230\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO.jpeg 2400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-400x200.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-800x400.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-1180x590.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-768x384.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/171497-INFO-320x160.jpeg 320w\" sizes=\"(max-width: 460px) 100vw, 460px\">\u003cfigcaption class=\"wp-caption-text\">A heat map of salaries for general surgeons by region. \u003ccite>(Doximity)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Strict privacy restrictions made social media a dangerous territory for medical professionals early on, but the healthcare sector is adapting quickly.\u003c/p>\n\u003cp>Professional networks such as \u003ca href=\"http://sermo.com\">Sermo\u003c/a>, \u003ca href=\"http://doximity.com\">Doximity\u003c/a> and \u003ca href=\"https://figure1.com/\">Figure 1\u003c/a> have created physician-only social spaces for collaboration. Doximity has gone so far as to crowd-source information on medical training and salaries to provide back to its doctor membership. \u003ca href=\"http://network.socialmedia.mayoclinic.org/social-media-residency/\">Mayo Clinic’s Center for Social Media\u003c/a> has been a leader in helping doctors and medical organizations to dip their toes in the social waters.\u003c/p>\n\u003cp>\u003cstrong>What's Trending? Organ Donations\u003c/strong>\u003c/p>\n\u003cp>When Facebook added a single organ donation question to their timeline, over 57,000 people announced their intentions to be donors, and 13,000 officially joined their state registry in a single day— \u003ca href=\"http://www.hopkinsmedicine.org/news/media/releases/the_facebook_effect_social_media_dramatically_boosts_organ_donor_registration\">an increase of 21 times\u003c/a> over normal registration rates, according to Johns Hopkins researchers. The long-term impact of Facebook’s organ donation campaign is still being studied, but it’s a hopeful step for the over 100,000 Americans currently on organ waiting lists.\u003c/p>\n\u003cp>\u003cstrong>Making Disease Awareness Personal\u003c/strong>\u003c/p>\n\u003cp>Lastly, a social media campaign made use of Facebook’s unique features to cleverly raise awareness of a terrible disease. In Holland, health advocates photoshopped people into pictures of events they never attended and then tagged them on Facebook. A followup message said, “Confusing, right? You’re now experiencing what it’s like to have Alzheimer’s disease.” Skip to the bottom for \u003ca href=\"https://vimeo.com/85254361\">a video\u003c/a> with details of their ingenious social campaign.\u003c/p>\n\u003cp>All the examples above took place in the past few years, which suggests that this potent combination of social media and medicine is still in its early days. Despite concerns about consumer privacy and some reticence from healthcare leaders, researchers, doctors, and patients have found fresh new ways to make the most of the social networks that connect us all.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Disclosure: Peters is a shareholder in Doximity having worked with them until February of 2015. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Activity trackers have become increasingly popular over the past few years, monitoring everything from how many steps you walk, to the quality of your sleep.\u003c/p>\n\u003cp>Now, \u003ca href=\"http://www.johnhancock.com/\">John Hancock\u003c/a>, a U.S.-based insurer, hopes that health conscious people will exchange activity data for lower life insurance premiums and other perks. Those who sign up for this program, \u003ca href=\"http://www.nytimes.com/2015/04/08/your-money/giving-out-private-data-for-discount-in-insurance.html?_r=1\">the first of its kind in the United States\u003c/a>, will receive a free Fitbit to track their activity levels.\u003c/p>\n\u003cp>This program may seem like a win-win: Insurers can sell their product to a new market of digitally savvy gadget lovers and in return, healthy consumers can access steep discounts.\u003c/p>\n\u003cp>[contextly_sidebar id=\"fjB5YrbknweMxVXOZvSYHihjPK91mn9O\"]\u003c/p>\n\u003cp>But privacy advocates fear that programs like these will result in auto, health and life insurers hedging their risks by monitoring your every move.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This is essentially a medical surveillance system,” said Jamie Court from Consumer Watchdog, a nonprofit that advocates for taxpayer and consumer interests.\u003c/p>\n\u003cp>“This may look like a carrot to lure new customers, but it’s ultimately a stick,” he said. Court fears that John Hancock’s program will slowly gain acceptance among young and affluent people, who frequently go to the gym. But over time, insurers will build tools that will be used to deny people coverage.\u003c/p>\n\u003cp>“If you’re hit by a car or something happens, insurance companies would go ahead and raise your rates. The more data they get, the more they can use it against us.”\u003c/p>\n\u003cp>In other words, privacy experts fear that there’s very little to stop a life insurance company from putting those who fail to stay active on a blacklist of sorts, which is akin to the experience of having a low credit score.\u003c/p>\n\u003caside class=\"pullquote alignright\">“No data is immune from a breach.”\u003ccite> Christine Sublett, health-technology consultant\u003c/cite>\u003c/aside>\n\u003cp>In response to privacy concerns, J\u003ca href=\"http://www.npr.org/blogs/thetwo-way/2015/04/08/398306430/john-hancock-hopes-youll-trade-activity-data-for-insurance-discounts\">ohn Hancock told the\u003cem> New York Times\u003c/em>\u003c/a> that its policyholders’ sensitive health data would not be sold to third parties. The firm stressed that the data will only be shared with Vitality, the corporate wellness company that it is partnering with for the initiative.\u003c/p>\n\u003cp>“I don’t buy it,” said Court, when informed about the company’s efforts to safeguard people’s health data.\u003c/p>\n\u003cp>“John Hancock works with financial affiliates. Would these organizations gain access to your health information?”\u003c/p>\n\u003cp>Moreover, Court said, there’s nothing stopping John Hancock from following in the footsteps of companies like Facebook and Google by regularly tweaking the fine print of its privacy policy, which few people notice.\u003c/p>\n\u003cp>Security experts also harbor concerns that insurers will not do enough to protect people’s valuable health and location data from hackers.\u003c/p>\n\u003cp>“No data is immune from a breach,” said Christine Sublett, a security expert who consults with health-technology companies.\u003c/p>\n\u003cfigure id=\"attachment_1476\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Devices-at-Best-Buy.jpg\">\u003cimg class=\"wp-image-1476 size-medium\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Devices-at-Best-Buy-800x533.jpg\" alt=\"(Arwen Curry/KQED)\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-320x213.jpg 320w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">John Hancock hopes gadget-loving consumers will flock to its new program. (Arwen Curry/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Health insurance giant Anthem \u003ca href=\"http://www.npr.org/blogs/thetwo-way/2015/02/05/383961185/hackers-strike-health-insurer-anthem-inc\">recently experienced a security breach\u003c/a> that left vulnerable more than 80 million people. In response to hacks like these, government agencies, like the Federal Trade Commission, \u003ca href=\"http://www.ihealthbeat.org/articles/2015/3/19/ftc-draft-data-protection-bill-should-cover-health-information\">have expressed fears\u003c/a> that companies are failing to adequately protect health information.\u003c/p>\n\u003cp>“Would it concern the average John Hancock customer that unauthorized people, like hackers, knew they were at the gym everyday at 5 a.m.,” said Sublett.\u003c/p>\n\u003cp>\u003cstrong>Incentives to Stay Healthy\u003c/strong>\u003c/p>\n\u003cp>But not everyone agrees that John Hancock’s program is a bad thing for consumers.\u003c/p>\n\u003cp>“I think it’s a great idea, as long as the program isn’t mandatory,” said Anica John, a San Francisco-based new mother-to-be who is currently researching life insurance policies. John, a consultant for Silicon Valley-based startups, said she is impressed by John Hancock’s plan.\u003c/p>\n\u003cp>“It’s a great incentive for me to go to the gym.”\u003c/p>\n\u003cp>Some behavioral economists believe that programs like these will do consumers a great service in the long-term, by keeping them healthy.\u003c/p>\n\u003cp>For its new program, John Hancock is teaming up with Vitality, a global wellness firm. Vitality works with employers, who have long-been tracking workers’ fitness habits and rewarding those who stay healthy.\u003c/p>\n\u003cp>Dan Ariely, a behavioral economist at Duke University, \u003ca href=\"http://www.psychologicalscience.org/index.php/news/releases/laying-money-on-the-line-leads-to-healthier-food-choices-over-time.html\">recently completed a study \u003c/a>exploring the factors that are most effective for increasing healthy behaviors, using a sample of more than 6,000 South African families from Vitality’s network.\u003c/p>\n\u003cp>According to Ariely, programs like John Hancock’s are a promising trend from a public health perspective, as long as the data doesn’t fall into the wrong hands.\u003c/p>\n\u003cp>“This concept is called immediate gratification,” said Ariely.\u003c/p>\n\u003cp>“In principle, we know we should do things for our long-term health, but it’s very hard to do. Sometimes we need a little extra pressure to stay healthy.”\u003c/p>\n\u003cp>But Ariely said many companies should do a better job of including low-income employees in their programs. Many people who work several jobs may not have much time to exercise, or have limited resources to buy and prepare healthy foods.\u003c/p>\n\u003cp>Those who have studied the John Hancock program fear that the plan in its current state would raise rates for low-income people and new mothers.\u003c/p>\n\u003cp>Bobbi Thomason, who researches such topics at Stanford University’s School of Management Science & Engineering, said some groups may not exercise regularly, as they juggle multiple jobs or have limited child care options. And some women may not be able to exercise for medical reasons before or after giving birth.\u003c/p>\n\u003cp>\u003cstrong>Will It Work?\u003c/strong>\u003c/p>\n\u003cp>Experts say it’s impossible to predict whether John Hancock’s program will prove successful in the U.S.\u003c/p>\n\u003cp>Similar programs introduced by auto insurers to reward safe driving, like the \u003ca href=\"http://www.pcmag.com/article2/0,2817,2326909,00.asp\">high-tech “Black Box”\u003c/a> that Progressive car insurance uses to monitor how people drive, have only gained limited acceptance, according to Court.\u003c/p>\n\u003cp>And some plans have been met with outright resistance. \u003ca href=\"http://www.wsj.com/articles/SB10001424127887323455104579014653816536802\">The “wellness” program at Penn State University prompted backlash\u003c/a>, after the news spread that workers were being forced to share detailed health information or risk paying penalties of up to $1,200 per year.\u003c/p>\n\u003cp>Overall, however, programs that leverage the latest wearable-tech to track people’s habits are fast-gaining acceptance.\u003c/p>\n\u003cp>“In our experience, some 60 to 85 percent of employees are willing to give up their health information to their employers, in exchange for discounts on their premiums,” said Derek Newell, chief executive of Jiff, a company that works with employers to design corporate wellness programs.\u003c/p>\n\u003cp>Privacy advocates are worried about this trend, given that regulation hasn’t kept up with the digital age.\u003c/p>\n\u003cp>Privacy laws haven’t evolved quickly enough to protect health information that is generated from a growing number of wearable devices, said Lee Tien at the \u003ca href=\"%5CUsers%5Cakissack%5CAppData%5CLocal%5CMicrosoft%5CWindows%5CTemporary%20Internet%20Files%5CContent.Outlook%5C7BEVRU6U%5Ceff.org\">Electronic Frontier Foundation\u003c/a>, a non-profit digital rights group based in San Francisco.\u003c/p>\n\u003cp>In the meantime, employers are forging ahead with corporate wellness programs. And \u003ca href=\"http://www.cio.com/article/2871753/wearable-technology/workers-want-employers-to-hand-out-wearables.html\">workers are increasingly demanding access to these devices\u003c/a>, without fully grasping the risks.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“These programs are creating norms of socially acceptable monitoring. This is a less obvious, but very real concern of ours,” said Tien.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Activity trackers have become increasingly popular over the past few years, monitoring everything from how many steps you walk, to the quality of your sleep.\u003c/p>\n\u003cp>Now, \u003ca href=\"http://www.johnhancock.com/\">John Hancock\u003c/a>, a U.S.-based insurer, hopes that health conscious people will exchange activity data for lower life insurance premiums and other perks. Those who sign up for this program, \u003ca href=\"http://www.nytimes.com/2015/04/08/your-money/giving-out-private-data-for-discount-in-insurance.html?_r=1\">the first of its kind in the United States\u003c/a>, will receive a free Fitbit to track their activity levels.\u003c/p>\n\u003cp>This program may seem like a win-win: Insurers can sell their product to a new market of digitally savvy gadget lovers and in return, healthy consumers can access steep discounts.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But privacy advocates fear that programs like these will result in auto, health and life insurers hedging their risks by monitoring your every move.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is essentially a medical surveillance system,” said Jamie Court from Consumer Watchdog, a nonprofit that advocates for taxpayer and consumer interests.\u003c/p>\n\u003cp>“This may look like a carrot to lure new customers, but it’s ultimately a stick,” he said. Court fears that John Hancock’s program will slowly gain acceptance among young and affluent people, who frequently go to the gym. But over time, insurers will build tools that will be used to deny people coverage.\u003c/p>\n\u003cp>“If you’re hit by a car or something happens, insurance companies would go ahead and raise your rates. The more data they get, the more they can use it against us.”\u003c/p>\n\u003cp>In other words, privacy experts fear that there’s very little to stop a life insurance company from putting those who fail to stay active on a blacklist of sorts, which is akin to the experience of having a low credit score.\u003c/p>\n\u003caside class=\"pullquote alignright\">“No data is immune from a breach.”\u003ccite> Christine Sublett, health-technology consultant\u003c/cite>\u003c/aside>\n\u003cp>In response to privacy concerns, J\u003ca href=\"http://www.npr.org/blogs/thetwo-way/2015/04/08/398306430/john-hancock-hopes-youll-trade-activity-data-for-insurance-discounts\">ohn Hancock told the\u003cem> New York Times\u003c/em>\u003c/a> that its policyholders’ sensitive health data would not be sold to third parties. The firm stressed that the data will only be shared with Vitality, the corporate wellness company that it is partnering with for the initiative.\u003c/p>\n\u003cp>“I don’t buy it,” said Court, when informed about the company’s efforts to safeguard people’s health data.\u003c/p>\n\u003cp>“John Hancock works with financial affiliates. Would these organizations gain access to your health information?”\u003c/p>\n\u003cp>Moreover, Court said, there’s nothing stopping John Hancock from following in the footsteps of companies like Facebook and Google by regularly tweaking the fine print of its privacy policy, which few people notice.\u003c/p>\n\u003cp>Security experts also harbor concerns that insurers will not do enough to protect people’s valuable health and location data from hackers.\u003c/p>\n\u003cp>“No data is immune from a breach,” said Christine Sublett, a security expert who consults with health-technology companies.\u003c/p>\n\u003cfigure id=\"attachment_1476\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Devices-at-Best-Buy.jpg\">\u003cimg class=\"wp-image-1476 size-medium\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Devices-at-Best-Buy-800x533.jpg\" alt=\"(Arwen Curry/KQED)\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Devices-at-Best-Buy-320x213.jpg 320w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">John Hancock hopes gadget-loving consumers will flock to its new program. (Arwen Curry/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Health insurance giant Anthem \u003ca href=\"http://www.npr.org/blogs/thetwo-way/2015/02/05/383961185/hackers-strike-health-insurer-anthem-inc\">recently experienced a security breach\u003c/a> that left vulnerable more than 80 million people. In response to hacks like these, government agencies, like the Federal Trade Commission, \u003ca href=\"http://www.ihealthbeat.org/articles/2015/3/19/ftc-draft-data-protection-bill-should-cover-health-information\">have expressed fears\u003c/a> that companies are failing to adequately protect health information.\u003c/p>\n\u003cp>“Would it concern the average John Hancock customer that unauthorized people, like hackers, knew they were at the gym everyday at 5 a.m.,” said Sublett.\u003c/p>\n\u003cp>\u003cstrong>Incentives to Stay Healthy\u003c/strong>\u003c/p>\n\u003cp>But not everyone agrees that John Hancock’s program is a bad thing for consumers.\u003c/p>\n\u003cp>“I think it’s a great idea, as long as the program isn’t mandatory,” said Anica John, a San Francisco-based new mother-to-be who is currently researching life insurance policies. John, a consultant for Silicon Valley-based startups, said she is impressed by John Hancock’s plan.\u003c/p>\n\u003cp>“It’s a great incentive for me to go to the gym.”\u003c/p>\n\u003cp>Some behavioral economists believe that programs like these will do consumers a great service in the long-term, by keeping them healthy.\u003c/p>\n\u003cp>For its new program, John Hancock is teaming up with Vitality, a global wellness firm. Vitality works with employers, who have long-been tracking workers’ fitness habits and rewarding those who stay healthy.\u003c/p>\n\u003cp>Dan Ariely, a behavioral economist at Duke University, \u003ca href=\"http://www.psychologicalscience.org/index.php/news/releases/laying-money-on-the-line-leads-to-healthier-food-choices-over-time.html\">recently completed a study \u003c/a>exploring the factors that are most effective for increasing healthy behaviors, using a sample of more than 6,000 South African families from Vitality’s network.\u003c/p>\n\u003cp>According to Ariely, programs like John Hancock’s are a promising trend from a public health perspective, as long as the data doesn’t fall into the wrong hands.\u003c/p>\n\u003cp>“This concept is called immediate gratification,” said Ariely.\u003c/p>\n\u003cp>“In principle, we know we should do things for our long-term health, but it’s very hard to do. Sometimes we need a little extra pressure to stay healthy.”\u003c/p>\n\u003cp>But Ariely said many companies should do a better job of including low-income employees in their programs. Many people who work several jobs may not have much time to exercise, or have limited resources to buy and prepare healthy foods.\u003c/p>\n\u003cp>Those who have studied the John Hancock program fear that the plan in its current state would raise rates for low-income people and new mothers.\u003c/p>\n\u003cp>Bobbi Thomason, who researches such topics at Stanford University’s School of Management Science & Engineering, said some groups may not exercise regularly, as they juggle multiple jobs or have limited child care options. And some women may not be able to exercise for medical reasons before or after giving birth.\u003c/p>\n\u003cp>\u003cstrong>Will It Work?\u003c/strong>\u003c/p>\n\u003cp>Experts say it’s impossible to predict whether John Hancock’s program will prove successful in the U.S.\u003c/p>\n\u003cp>Similar programs introduced by auto insurers to reward safe driving, like the \u003ca href=\"http://www.pcmag.com/article2/0,2817,2326909,00.asp\">high-tech “Black Box”\u003c/a> that Progressive car insurance uses to monitor how people drive, have only gained limited acceptance, according to Court.\u003c/p>\n\u003cp>And some plans have been met with outright resistance. \u003ca href=\"http://www.wsj.com/articles/SB10001424127887323455104579014653816536802\">The “wellness” program at Penn State University prompted backlash\u003c/a>, after the news spread that workers were being forced to share detailed health information or risk paying penalties of up to $1,200 per year.\u003c/p>\n\u003cp>Overall, however, programs that leverage the latest wearable-tech to track people’s habits are fast-gaining acceptance.\u003c/p>\n\u003cp>“In our experience, some 60 to 85 percent of employees are willing to give up their health information to their employers, in exchange for discounts on their premiums,” said Derek Newell, chief executive of Jiff, a company that works with employers to design corporate wellness programs.\u003c/p>\n\u003cp>Privacy advocates are worried about this trend, given that regulation hasn’t kept up with the digital age.\u003c/p>\n\u003cp>Privacy laws haven’t evolved quickly enough to protect health information that is generated from a growing number of wearable devices, said Lee Tien at the \u003ca href=\"%5CUsers%5Cakissack%5CAppData%5CLocal%5CMicrosoft%5CWindows%5CTemporary%20Internet%20Files%5CContent.Outlook%5C7BEVRU6U%5Ceff.org\">Electronic Frontier Foundation\u003c/a>, a non-profit digital rights group based in San Francisco.\u003c/p>\n\u003cp>In the meantime, employers are forging ahead with corporate wellness programs. And \u003ca href=\"http://www.cio.com/article/2871753/wearable-technology/workers-want-employers-to-hand-out-wearables.html\">workers are increasingly demanding access to these devices\u003c/a>, without fully grasping the risks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“These programs are creating norms of socially acceptable monitoring. This is a less obvious, but very real concern of ours,” said Tien.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Our geneticist, Dr. Barry Starr, weighs in on the current debate surrounding the latest gene-editing technique.\u003cbr>\n\u003c/em>\u003c/p>\n\u003cp>Ever since we've been able to alter DNA, there have been discussions about what this means for the human race. In some far off future, when we can make wholesale changes to human DNA, what will these changes do to each of us? And to society at large?\u003c/p>\n\u003cp>It turns out that the far off future isn’t so far off any more. With a new tool called \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/16/a-crispr-solution-to-bubble-boy-disease/\">CRISPR\u003c/a>, we are on the cusp of being able to easily change the DNA of a human embryo so the changes can be passed on to the next generation. We are so close in fact, that \u003ca href=\"http://www.nytimes.com/2015/03/20/science/biologists-call-for-halt-to-gene-editing-technique-in-humans.html?_r=1\">a group of scientists has advocated\u003c/a> that we stop and take a deep breath before we add any altered DNA to our gene pool.\u003c/p>\n\u003cp>[contextly_sidebar id=\"fDeS00Xmf7YhCIeT7x2jMeDL6uMua8Gz\"]\u003c/p>\n\u003cp>Part of the reason for this pause is because the technique has not been widely tested yet. It has only been around for a few years and so we definitely need to spend some time studying it. For example, what other changes happen elsewhere in the DNA when we make the selected change? How can we make sure any changes we make are in all of the cells not just some of them? These are just two of the potential questions for which we don’t yet have good answers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Despite issues like these, there is a real temptation to just barrel ahead and start using CRISPR to cure genetic diseases because it is such a powerful and easy technique. We need to resist that temptation until these technical issues have been resolved.\u003c/p>\n\u003cp>But even with a resolution, other problems will arise. Like the ethical concern over whether we should be tampering with human DNA at all. I leave the bioethicists to debate that one.\u003c/p>\n\u003cfigure id=\"attachment_1238\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/EugenicsPlaque.jpg\">\u003cimg class=\"size-full wp-image-1238\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/EugenicsPlaque.jpg\" alt=\"Some genetic engineering decisions are obviously bad ones. (Wikimedia Commons) \" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/EugenicsPlaque.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EugenicsPlaque-320x240.jpg 320w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Some genetic engineering decisions are obviously bad ones. (\u003ca href=\"http://upload.wikimedia.org/wikipedia/commons/c/c4/EugenicsMarker.jpg\">Wikimedia Commons\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Assuming the safety problem has been resolved and we decide, as a society, that changing human DNA is sometimes acceptable, the next issue will be what DNA to change. This is a more difficult discussion than you may think.\u003c/p>\n\u003cp>To me, a few changes are pretty obvious. If we can safely do it, we should change the DNA of an embryo that would die a terrible death after birth. For example, fixing a DNA difference in the HEXA gene that leads to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024672/\">Tay Sachs\u003c/a>--a genetic disorder that is fatal--seems like an obvious choice.\u003c/p>\n\u003cp>And of course at the other end of the spectrum there are changes that make most people squeamish. Examples of these might be changing an embryo’s DNA so he grows up to have blue eyes or red hair or some other physical trait. This smacks of \u003ca href=\"http://en.wikipedia.org/wiki/Eugenics\">eugenics\u003c/a> and rightly makes people uncomfortable.\u003c/p>\n\u003cp>But there are a whole lot of DNA edits in between these that are much less obvious. And some, like \u003ca href=\"http://ghr.nlm.nih.gov/condition/huntington-disease\">Huntington’s disease\u003c/a>, seem like Tay Sachs but if done incorrectly could have unexpected consequences.\u003c/p>\n\u003cp>\u003cstrong>Beware of Unknown Unknowns\u003c/strong>\u003c/p>\n\u003cp>Huntington’s disease (HD) is a really awful genetic disease (click \u003ca href=\"https://youtu.be/JzAPh2v-SCQ\">here\u003c/a> to see what it looks like in the later stages). It initially causes subtle personality changes, usually when a person is in his or her 30’s or 40’s. After that there is an inevitable decline in muscle control and a descent into various psychiatric disorders and dementia. Usually someone with HD is dead within 20 years of their first symptoms although it can happen much more rapidly in some cases.\u003c/p>\n\u003cp>We have a very good understanding of how HD works genetically. Certain changes in the HTT gene lead to the disease. But these changes are different than you might think.\u003c/p>\n\u003cp>Here is an image of the three categories of HTT genes you can have:\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/HTTgene.jpg\">\u003cimg class=\"aligncenter size-full wp-image-1229\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/HTTgene.jpg\" alt=\"HTTgene\" width=\"500\" height=\"162\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/HTTgene.jpg 500w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/HTTgene-400x130.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/HTTgene-320x104.jpg 320w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003c/a>\u003c/p>\n\u003cp>In this image, the blue rectangle is the HTT gene. The green, yellow and red boxes represent something in the gene called \u003ca href=\"http://en.wikipedia.org/wiki/Trinucleotide_repeat_expansion\">CAG repeats\u003c/a>. Basically, the DNA letters CAG are repeated the number of times listed in the box. So the green box has 10-35 repeats, the yellow has 36-39 and the red has 40 or more.\u003c/p>\n\u003cp>As you can see, only people with more than 35 of these repeats are at risk for HD. People with 36-39 repeats may or may not get the disease and most everyone with 40 or more ends up with HD.\u003c/p>\n\u003cp>So an obvious use of CRISPR would be to edit the HTT gene of embryos like this:\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/httCRISPR.jpg\">\u003cimg class=\"aligncenter size-full wp-image-1231\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/httCRISPR.jpg\" alt=\"httCRISPR\" width=\"300\" height=\"133\">\u003c/a>\u003c/p>\n\u003cp>Now this embryo won't develop HD. And because we reduced the number down to 10, his kids and grandkids probably won't be at risk for HD either because they are safe from something called anticipation.\u003c/p>\n\u003cp>In anticipation, the number of repeats can increase from one generation to the next. So someone with 34 repeats might have a child with 40 or more which means that child will probably develop the disease. Lowering the repeats to 10 makes it much less likely any future kids will get HD. But it might also decrease the chances of the child being a genius.\u003c/p>\n\u003cp>Recent research reviewed \u003ca href=\"http://www.economist.com/news/science-and-technology/21645713-could-key-evolution-human-brain-be-found-dreadful\">here \u003c/a>suggests that the more repeats you have, the more likely you are to do well on tests that are supposed to gauge intelligence. In protecting future generations from the risk of HD, we may be toying with their intelligence.\u003c/p>\n\u003cp>The reverse of this situation is even worse. Imagine we first discovered that extra repeats make it more likely someone will be clever. Now parents are adding repeats to their kids’ HTT genes with the end result that most of that generation comes down with HD!\u003c/p>\n\u003cp>This isn’t the only case like this either. As discussed \u003ca href=\"http://www.councilforresponsiblegenetics.org/GeneWatch/GeneWatchPage.aspx?pageId=226\">here\u003c/a>, studies showed that a certain version of the SERT gene leads to an increased risk of depression. With CRISPR you might be tempted to correct this gene. Which may be a mistake.\u003c/p>\n\u003cp>Later studies showed that this version of SERT is only an issue if the child is raised in poor conditions. Under the right conditions, this gene version actually increases the chances a person will be creative. Editing this gene might have consequences no one expected.\u003c/p>\n\u003cp>If the second set of studies had never been done, we wouldn’t know about the positive effects of this DNA difference. We would simply have fewer creative people in humanity’s future.\u003c/p>\n\u003cp>These are just a couple of the genes we know about. There are many others where we may not yet know the effects of genetic engineering.\u003c/p>\n\u003cp>\u003cstrong>To Edit or Not to Edit\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_1249\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/SCAfoy.jpg\">\u003cimg class=\"size-full wp-image-1249\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/SCAfoy.jpg\" alt=\"If we decide that changing human DNA is acceptable, then sickle cell anemia is an obvious candidate. (NHGRI)\" width=\"300\" height=\"179\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If we decide that changing human DNA is acceptable, then sickle cell anemia is an obvious candidate. (\u003ca href=\"https://www.genome.gov/dmd/img.cfm?node=Photos/Graphics&id=85241\">NHGRI\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>None of this necessarily means we should never change human DNA. Some genetic diseases like sickle cell anemia or cystic fibrosis \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/heterozygote-advantage\">served a useful role in the past\u003c/a> but are now just terrible, terrible diseases. It is hard to think of the downside of eliminating these DNA differences from the gene pool.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The bottom line is that if we decide it is OK to repair genetic problems in a way that can be passed down to the next generation, we need to be very careful and selective about which problems we fix. And in how many people we fix them in.\u003c/p>\n\n",
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"excerpt": "Just because scientists now have the ability to cure genetic diseases, with a new gene-editing technique, doesn't mean we always should, writes our geneticist, Dr. Barry Starr. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Our geneticist, Dr. Barry Starr, weighs in on the current debate surrounding the latest gene-editing technique.\u003cbr>\n\u003c/em>\u003c/p>\n\u003cp>Ever since we've been able to alter DNA, there have been discussions about what this means for the human race. In some far off future, when we can make wholesale changes to human DNA, what will these changes do to each of us? And to society at large?\u003c/p>\n\u003cp>It turns out that the far off future isn’t so far off any more. With a new tool called \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/16/a-crispr-solution-to-bubble-boy-disease/\">CRISPR\u003c/a>, we are on the cusp of being able to easily change the DNA of a human embryo so the changes can be passed on to the next generation. We are so close in fact, that \u003ca href=\"http://www.nytimes.com/2015/03/20/science/biologists-call-for-halt-to-gene-editing-technique-in-humans.html?_r=1\">a group of scientists has advocated\u003c/a> that we stop and take a deep breath before we add any altered DNA to our gene pool.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Part of the reason for this pause is because the technique has not been widely tested yet. It has only been around for a few years and so we definitely need to spend some time studying it. For example, what other changes happen elsewhere in the DNA when we make the selected change? How can we make sure any changes we make are in all of the cells not just some of them? These are just two of the potential questions for which we don’t yet have good answers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Despite issues like these, there is a real temptation to just barrel ahead and start using CRISPR to cure genetic diseases because it is such a powerful and easy technique. We need to resist that temptation until these technical issues have been resolved.\u003c/p>\n\u003cp>But even with a resolution, other problems will arise. Like the ethical concern over whether we should be tampering with human DNA at all. I leave the bioethicists to debate that one.\u003c/p>\n\u003cfigure id=\"attachment_1238\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/EugenicsPlaque.jpg\">\u003cimg class=\"size-full wp-image-1238\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/EugenicsPlaque.jpg\" alt=\"Some genetic engineering decisions are obviously bad ones. (Wikimedia Commons) \" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/EugenicsPlaque.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/EugenicsPlaque-320x240.jpg 320w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Some genetic engineering decisions are obviously bad ones. (\u003ca href=\"http://upload.wikimedia.org/wikipedia/commons/c/c4/EugenicsMarker.jpg\">Wikimedia Commons\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Assuming the safety problem has been resolved and we decide, as a society, that changing human DNA is sometimes acceptable, the next issue will be what DNA to change. This is a more difficult discussion than you may think.\u003c/p>\n\u003cp>To me, a few changes are pretty obvious. If we can safely do it, we should change the DNA of an embryo that would die a terrible death after birth. For example, fixing a DNA difference in the HEXA gene that leads to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024672/\">Tay Sachs\u003c/a>--a genetic disorder that is fatal--seems like an obvious choice.\u003c/p>\n\u003cp>And of course at the other end of the spectrum there are changes that make most people squeamish. Examples of these might be changing an embryo’s DNA so he grows up to have blue eyes or red hair or some other physical trait. This smacks of \u003ca href=\"http://en.wikipedia.org/wiki/Eugenics\">eugenics\u003c/a> and rightly makes people uncomfortable.\u003c/p>\n\u003cp>But there are a whole lot of DNA edits in between these that are much less obvious. And some, like \u003ca href=\"http://ghr.nlm.nih.gov/condition/huntington-disease\">Huntington’s disease\u003c/a>, seem like Tay Sachs but if done incorrectly could have unexpected consequences.\u003c/p>\n\u003cp>\u003cstrong>Beware of Unknown Unknowns\u003c/strong>\u003c/p>\n\u003cp>Huntington’s disease (HD) is a really awful genetic disease (click \u003ca href=\"https://youtu.be/JzAPh2v-SCQ\">here\u003c/a> to see what it looks like in the later stages). It initially causes subtle personality changes, usually when a person is in his or her 30’s or 40’s. After that there is an inevitable decline in muscle control and a descent into various psychiatric disorders and dementia. Usually someone with HD is dead within 20 years of their first symptoms although it can happen much more rapidly in some cases.\u003c/p>\n\u003cp>We have a very good understanding of how HD works genetically. Certain changes in the HTT gene lead to the disease. But these changes are different than you might think.\u003c/p>\n\u003cp>Here is an image of the three categories of HTT genes you can have:\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/HTTgene.jpg\">\u003cimg class=\"aligncenter size-full wp-image-1229\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/HTTgene.jpg\" alt=\"HTTgene\" width=\"500\" height=\"162\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/HTTgene.jpg 500w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/HTTgene-400x130.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/HTTgene-320x104.jpg 320w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003c/a>\u003c/p>\n\u003cp>In this image, the blue rectangle is the HTT gene. The green, yellow and red boxes represent something in the gene called \u003ca href=\"http://en.wikipedia.org/wiki/Trinucleotide_repeat_expansion\">CAG repeats\u003c/a>. Basically, the DNA letters CAG are repeated the number of times listed in the box. So the green box has 10-35 repeats, the yellow has 36-39 and the red has 40 or more.\u003c/p>\n\u003cp>As you can see, only people with more than 35 of these repeats are at risk for HD. People with 36-39 repeats may or may not get the disease and most everyone with 40 or more ends up with HD.\u003c/p>\n\u003cp>So an obvious use of CRISPR would be to edit the HTT gene of embryos like this:\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/httCRISPR.jpg\">\u003cimg class=\"aligncenter size-full wp-image-1231\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/httCRISPR.jpg\" alt=\"httCRISPR\" width=\"300\" height=\"133\">\u003c/a>\u003c/p>\n\u003cp>Now this embryo won't develop HD. And because we reduced the number down to 10, his kids and grandkids probably won't be at risk for HD either because they are safe from something called anticipation.\u003c/p>\n\u003cp>In anticipation, the number of repeats can increase from one generation to the next. So someone with 34 repeats might have a child with 40 or more which means that child will probably develop the disease. Lowering the repeats to 10 makes it much less likely any future kids will get HD. But it might also decrease the chances of the child being a genius.\u003c/p>\n\u003cp>Recent research reviewed \u003ca href=\"http://www.economist.com/news/science-and-technology/21645713-could-key-evolution-human-brain-be-found-dreadful\">here \u003c/a>suggests that the more repeats you have, the more likely you are to do well on tests that are supposed to gauge intelligence. In protecting future generations from the risk of HD, we may be toying with their intelligence.\u003c/p>\n\u003cp>The reverse of this situation is even worse. Imagine we first discovered that extra repeats make it more likely someone will be clever. Now parents are adding repeats to their kids’ HTT genes with the end result that most of that generation comes down with HD!\u003c/p>\n\u003cp>This isn’t the only case like this either. As discussed \u003ca href=\"http://www.councilforresponsiblegenetics.org/GeneWatch/GeneWatchPage.aspx?pageId=226\">here\u003c/a>, studies showed that a certain version of the SERT gene leads to an increased risk of depression. With CRISPR you might be tempted to correct this gene. Which may be a mistake.\u003c/p>\n\u003cp>Later studies showed that this version of SERT is only an issue if the child is raised in poor conditions. Under the right conditions, this gene version actually increases the chances a person will be creative. Editing this gene might have consequences no one expected.\u003c/p>\n\u003cp>If the second set of studies had never been done, we wouldn’t know about the positive effects of this DNA difference. We would simply have fewer creative people in humanity’s future.\u003c/p>\n\u003cp>These are just a couple of the genes we know about. There are many others where we may not yet know the effects of genetic engineering.\u003c/p>\n\u003cp>\u003cstrong>To Edit or Not to Edit\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_1249\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/SCAfoy.jpg\">\u003cimg class=\"size-full wp-image-1249\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/SCAfoy.jpg\" alt=\"If we decide that changing human DNA is acceptable, then sickle cell anemia is an obvious candidate. (NHGRI)\" width=\"300\" height=\"179\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If we decide that changing human DNA is acceptable, then sickle cell anemia is an obvious candidate. (\u003ca href=\"https://www.genome.gov/dmd/img.cfm?node=Photos/Graphics&id=85241\">NHGRI\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>None of this necessarily means we should never change human DNA. Some genetic diseases like sickle cell anemia or cystic fibrosis \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/heterozygote-advantage\">served a useful role in the past\u003c/a> but are now just terrible, terrible diseases. It is hard to think of the downside of eliminating these DNA differences from the gene pool.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The bottom line is that if we decide it is OK to repair genetic problems in a way that can be passed down to the next generation, we need to be very careful and selective about which problems we fix. And in how many people we fix them in.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Would you lead a more active lifestyle if it meant lower life insurance premiums? Insurer John Hancock and Vitality, a global wellness firm, are hoping the answer is yes. But there is a condition: They get to track your activity.\u003c/p>\n\u003cp>The practice is already employed in Australia, Europe, Singapore and South Africa, where Vitality is based.\u003c/p>\n\u003cp>The companies \u003ca href=\"http://www.prnewswire.com/news-releases/john-hancock-introduces-a-whole-new-approach-to-life-insurance-in-the-us-that-rewards-customers-for-healthy-living-300062461.html\">announced\u003c/a> the new plan Wednesday and posted a video on John Hancock's \u003ca href=\"http://www.jhrewardslife.com/\">website\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“You do not have to send us any data you are not comfortable with. The trade-off is you won’t get points for that.”\u003ccite> Michael Doughty, John Hancock president \u003c/cite>\u003c/aside>\n\u003cp>Here's how the program works: Once you sign up, John Hancock sends you a Fitbit monitor as \u003cem>one\u003c/em> way to track your fitness. You earn Vitality Points for your activities. As you accumulate points, your status rises — from bronze to silver to gold to platinum. The higher your status, the more you save each year on your life insurance premiums. The points also allow you benefits at stores like REI and Whole Foods as well as hotel chains like Hyatt.\u003c/p>\n\u003cp>\u003cem>The New York Times\u003c/em>, \u003ca href=\"http://www.nytimes.com/2015/04/08/your-money/giving-out-private-data-for-discount-in-insurance.html?_r=1\">which first reported on the announcement\u003c/a>, notes that the most active customers can earn discounts of up to 15 percent on their premiums. The company in a news release says:\u003c/p>\n\u003cblockquote>\u003cp>\"For example, a 45 year old couple (of average health) buying Protection UL with Vitality life insurance policies of $500,000 each could potentially save more than $25,000 on their premiums by the time they reach 85, with additional savings if they live longer, assuming they reach gold status in all years.\"\u003c/p>\u003c/blockquote>\n\u003cp>But as \u003cem>The Times\u003c/em> notes, if customers don't maintain their gold status for any reason, the premiums could increase by 1.1 percent to 1.6 percent each year. Those who reach platinum status will see premiums fall by about 0.30 percent each year, the newspaper adds.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>NPR's Chris Arnold tells our Newscast unit that privacy advocates worry that the plan will raise insurance costs for lower-income people juggling two jobs who don't have as much time to get to the gym.\u003c/p>\n\u003cp>John Hancock and Vitality say the information collected won't be sold and would only be shared with those entities that administer the program, \u003cem>The Times\u003c/em> reported, but some of it \u003cem>could\u003c/em> be used to create new insurance products.\u003c/p>\n\u003cp>And for those uncomfortable with sharing some data, Michael Doughty, John Hancock's president, told \u003cem>The Times\u003c/em>: \"You do not have to send us any data you are not comfortable with. The trade-off is you won't get points for that.\"\u003c/p>\n\u003cp>\u003cem>The Times\u003c/em> adds that the company hopes the program revitalizes life insurance sales in the U.S., which have stagnated for decades.\u003c/p>\n\u003cp>The concept of incentivizing behavior, while new in life insurance in the U.S., is not new to other sectors of the insurance industry. As Julie Rovner, who is with our partner Kaiser Health News, \u003ca href=\"http://www.npr.org/blogs/health/2014/12/09/369352885/wellness-at-work-often-comes-with-strings-attached\">reported last December\u003c/a>, wellness programs already exist in many workplaces. And, she reported, \"There's no real evidence as to whether these plans actually improve the health of employees.\" (You can see some of NPR's other coverage of wellness programs \u003ca href=\"http://www.npr.org/blogs/health/2014/12/02/367842386/government-says-bosses-cant-force-workers-to-get-health-tests\">here\u003c/a> and \u003ca href=\"http://www.npr.org/blogs/health/2014/07/02/327388276/targeting-overweight-workers-with-wellness-programs-can-backfire\">here\u003c/a>.)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In the auto industry, Progressive offers its customers a mileage-based tracking device called \u003ca href=\"http://www.cnet.com/news/gadget-helps-progressive-offer-insurance-discount/\">Snapshot\u003c/a>; those who opt-in can save up to 30 percent on their premiums. But as CNET \u003ca href=\"http://www.cnet.com/news/gadget-helps-progressive-offer-insurance-discount/\">notes,\u003c/a> \"not just how many miles you drive but also how you're driving them could affect your insurance rates.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=John+Hancock+Hopes+You%27ll+Trade+Activity+Data+For+Insurance+Discounts&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Would you lead a more active lifestyle if it meant lower life insurance premiums? Insurer John Hancock and Vitality, a global wellness firm, are hoping the answer is yes. But there is a condition: They get to track your activity.\u003c/p>\n\u003cp>The practice is already employed in Australia, Europe, Singapore and South Africa, where Vitality is based.\u003c/p>\n\u003cp>The companies \u003ca href=\"http://www.prnewswire.com/news-releases/john-hancock-introduces-a-whole-new-approach-to-life-insurance-in-the-us-that-rewards-customers-for-healthy-living-300062461.html\">announced\u003c/a> the new plan Wednesday and posted a video on John Hancock's \u003ca href=\"http://www.jhrewardslife.com/\">website\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“You do not have to send us any data you are not comfortable with. The trade-off is you won’t get points for that.”\u003ccite> Michael Doughty, John Hancock president \u003c/cite>\u003c/aside>\n\u003cp>Here's how the program works: Once you sign up, John Hancock sends you a Fitbit monitor as \u003cem>one\u003c/em> way to track your fitness. You earn Vitality Points for your activities. As you accumulate points, your status rises — from bronze to silver to gold to platinum. The higher your status, the more you save each year on your life insurance premiums. The points also allow you benefits at stores like REI and Whole Foods as well as hotel chains like Hyatt.\u003c/p>\n\u003cp>\u003cem>The New York Times\u003c/em>, \u003ca href=\"http://www.nytimes.com/2015/04/08/your-money/giving-out-private-data-for-discount-in-insurance.html?_r=1\">which first reported on the announcement\u003c/a>, notes that the most active customers can earn discounts of up to 15 percent on their premiums. The company in a news release says:\u003c/p>\n\u003cblockquote>\u003cp>\"For example, a 45 year old couple (of average health) buying Protection UL with Vitality life insurance policies of $500,000 each could potentially save more than $25,000 on their premiums by the time they reach 85, with additional savings if they live longer, assuming they reach gold status in all years.\"\u003c/p>\u003c/blockquote>\n\u003cp>But as \u003cem>The Times\u003c/em> notes, if customers don't maintain their gold status for any reason, the premiums could increase by 1.1 percent to 1.6 percent each year. Those who reach platinum status will see premiums fall by about 0.30 percent each year, the newspaper adds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>NPR's Chris Arnold tells our Newscast unit that privacy advocates worry that the plan will raise insurance costs for lower-income people juggling two jobs who don't have as much time to get to the gym.\u003c/p>\n\u003cp>John Hancock and Vitality say the information collected won't be sold and would only be shared with those entities that administer the program, \u003cem>The Times\u003c/em> reported, but some of it \u003cem>could\u003c/em> be used to create new insurance products.\u003c/p>\n\u003cp>And for those uncomfortable with sharing some data, Michael Doughty, John Hancock's president, told \u003cem>The Times\u003c/em>: \"You do not have to send us any data you are not comfortable with. The trade-off is you won't get points for that.\"\u003c/p>\n\u003cp>\u003cem>The Times\u003c/em> adds that the company hopes the program revitalizes life insurance sales in the U.S., which have stagnated for decades.\u003c/p>\n\u003cp>The concept of incentivizing behavior, while new in life insurance in the U.S., is not new to other sectors of the insurance industry. As Julie Rovner, who is with our partner Kaiser Health News, \u003ca href=\"http://www.npr.org/blogs/health/2014/12/09/369352885/wellness-at-work-often-comes-with-strings-attached\">reported last December\u003c/a>, wellness programs already exist in many workplaces. And, she reported, \"There's no real evidence as to whether these plans actually improve the health of employees.\" (You can see some of NPR's other coverage of wellness programs \u003ca href=\"http://www.npr.org/blogs/health/2014/12/02/367842386/government-says-bosses-cant-force-workers-to-get-health-tests\">here\u003c/a> and \u003ca href=\"http://www.npr.org/blogs/health/2014/07/02/327388276/targeting-overweight-workers-with-wellness-programs-can-backfire\">here\u003c/a>.)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In the auto industry, Progressive offers its customers a mileage-based tracking device called \u003ca href=\"http://www.cnet.com/news/gadget-helps-progressive-offer-insurance-discount/\">Snapshot\u003c/a>; those who opt-in can save up to 30 percent on their premiums. But as CNET \u003ca href=\"http://www.cnet.com/news/gadget-helps-progressive-offer-insurance-discount/\">notes,\u003c/a> \"not just how many miles you drive but also how you're driving them could affect your insurance rates.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=John+Hancock+Hopes+You%27ll+Trade+Activity+Data+For+Insurance+Discounts&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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},
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"id": "baycurious",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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},
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},
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
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"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"order": 1
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
},
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"meta": {
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"source": "WNYC"
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
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"source": "NPR"
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"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"hyphenacion": {
"id": "hyphenacion",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
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