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Apple ResearchKit: A Doctor's View

The most important announcement today from Apple WAS NOT the Apple Watch. In my opinion, iPhone, Apple HealthKit, and Apple ResearchKit will revolutionize medical research in ways that we don't even understand yet.

During the announcement, the challenges of medical research were described. First, it's difficult to recruit research subjects. Secondly, when when you find research subjects, it is difficult to gather comprehensive data - only snapshots in time. Finally, research subjects only give information (one way communication), and often do not hear back from the research team. (Video above from The Verge)

With 700 million iPhones sold already, Apple saw an opportunity to assist the medical research community with the creation of Apple ResearchKit. ResearchKit is a software framework made specifically for medical research. With ResearchKit, universities and medical institutions hope to accumulate lots of data, more accurate data, and interact with research subjects in ways that have never been done before.

There are already five Apple ResearchKit Apps that were released today:

Parkinsons Disease: App is called "mPower"; University of Rochester, Xuanwu Hospital, Capital Medical University, Sage Bionetworks
Diabetes: App is called "GlucoSuccess"; Massachusetts General Hospital
Heart Disease: App is called "MyHeart Counts"; Stanford Medicine, University of Oxford
Asthma: App is called "Asthma Health"; Mount Siani Hospital; Weill Cornell Medical College
Breast Cancer: App is called "Share The Journey"; Dana-Farber Cancer Institute, UCLA School of Public Health, Penn Medicine, Sage Bionetworks

During this presentation, Apple addressed patient privacy: "You decide whether to participate. You decide how the data is shared. Apple will not see your data."

Skeptics to this technology have also raised concerns, like in a readwrite article entitled, "Apple's ResearchKit Is A Nice Idea, But It's Built On Sand." It states that companies are already data mining apps like MyFitnessPal, and how can we trust Apple will not do the same. This tech industry article also states that the present Apple HealthKit software is "horribly buggy" that it doesn't "even come close to our expectations for Apple products."

My take? Well, I think that iPhone, HealthKit, and ResearchKit are important in three ways:

Moves Medical Research Closer To The Mainstream: Apple has an uncanny way of moving products and ideas from the edge, to mainstream. What mp3 player were you using before iPod? What phone were you using before iPhone? And, are you even wearing a watch right now?
The Acceleration Of The Research Cycle: Especially those in the medical industry know how painfully long it takes from the idea for a research project to its completion - sometimes many years. If ResearchKit delivers on its promise, better treatments will come to market faster, and that is better for everyone.
Engaged Patients plus Interactive Medical Teams equals Better Medicine: What everyone is looking for is better communication between patients, families, and the medical team. Imagine the synergy that will be created with the right app technology, engaged patients, and interactive medical teams. Just mind blowing.

I'm excited about the potential of iPhone, HealthKit, and ResearchKit. ResearchKit will be available next month. If you haven't downloaded the five apps, they are available now. So check them out. The potential here is limitless...

Learn about ResearchKit, an open source software framework that makes it easy for researchers and developers to create apps that could revolutionize medical studies, potentially transforming medicine forever. http://apple.co/researchkit

2015 Ten State Conference Day Two

This post shares some pics from Day Two of the Ten State Family Medicine Leadership conference. Topics for Day Two include Funding for Graduate Medical Education and Physician Burnout. In the afternoon, was the first ever event based on the television show "Shark Tank" in which state chapters pitch an idea to potential funders. Following the educational program, some attendees went to the Columbus Blue Jackets NHL game. What a successful event. Thanks to the staff of the Ohio Academy of Family Physicians for planning a great weekend!

2015 Ten State Family Medicine Leadership Conference

The Ten State Family Medicine Leadership Conference opened yesterday in Columbus, Ohio. It's always fun catching up with long time friends and making new friends. The topics of the presentations included an update on the Health Is Primary campaign and a discussion on the Comprehensive Primary Care Initiative. At the end of Day One was our "Best Of Ohio" reception which featured great food, great beverages, and fun games. There was even a visit from the Columbus Zoo. Check out the pics below, and I'll have more to say soon...

Spare A Rose: Save A Child

The International Diabetes Federation is an organization who provides life-saving diabetes supplies, medication, and education to children in developing countries. From February 1-14 is their annual "Spare A Rose: Save A Child" campaign.

The idea is simple. This year, purchase one less rose for Valentine's Day, and donate the value to children with diabetes. Your loved one still gets flowers, and the both of you show love to children around the world who need it.

Shout out to our pal Kerri Sparling who made me aware of the program, and who is passionate to spread the word about this fabulous program. Here is a portion of a blog post she wrote:

“We need you. Yes, you. You’re part of this, you know. If you are touched by diabetes in any way - the partner of, the friend of, the coworker of, the child of, the parent of, the neighbor of, a person with diabetes - please Spare A Rose.”

I can't even imagine what it's like being a child or a family in a developing country without insulin, or any other essential medication. We talk about ways to support those in need all the time in my Family Medicine community. I encourage my readers to not only consider supporting this program, but also help spread the word in the best way possible, namely, the social media way. We all know the power of social media. Let's use it for good, and help spread this message.

Five Lessons From 2015 #AAFPWC

For the past couple of days, I have been working with my friends in the Family Medicine Revolution (#FMRevolution on twitter) at the 2015 winter edition of the AAFP Committee meetings. AAFP, of course, stands for the American Academy of Family Physicians. For the twitter folk, I direct you to the #aafpwc hashtag (stands for AAFP winter committee cluster meetings. Photo above from Friday, February 6, 2015 which was Go Red For Women Day to raise awareness for Women's Heart Health)

During these meetings, we talk about how we can bring about change for the betterment of our patients and to advance the goals of our specialty. I always try to think of take away themes to share with all of you, especially when I'm stuck at the airport on a long layover trying to get home. Here are five things that have come to mind from the past 2 days:

All Advocacy Is Local - It's always great talking with Family Docs, Family Medicine Residents, and medical students. You've heard the phrase, "All Politics Is Local." The same thing can be said of all the local projects that these great people are doing. Of course, national initiatives are great. But, change really starts and is carried through from the grassroots. Kudos to my friends and colleagues who may not get the publicity, but their efforts are much appreciated.
What Is The Value of Membership - I serve on the Membership Committee for my organization. Membership organizations need members. Duh. But every physician organization discussed the challenges of the cost of membership, and how they are going up every year. And, every physician organization talks about how to retain their current members, and brainstorm about how to get more members. Showing the Value of Membership is not only the most difficult, but also it is the most important. How to do that? That's the hard part.
The Synergy Of Decision Making - One of the things that I love about serving on AAFP committees are the diversity of people and the diversity of ideas that are all in one room. The task is to get through the agenda to insure that the minority point of view to be heard, but the majority vote to rule. It's just so much fun hearing from all these people, and as we begin to understand more points of view around an issue, this makes it easier to come together to agree upon a decision. It may not be the best decision for that specific committee member, but it will end up being the best decision for the entire group.
It's All About Telling Stories - This is not a new idea, but came up in discussions about the Family Medicine Advocacy project called Health is Primary. I have said many times in the past, that we (in Family Medicine) have let others tell the Family Medicine story, and it's the wrong story. I'm excited that the "Health Is Primary Road Show" will be starting in the next couple of weeks. I also encourage you to check out the "Health Is Primary: Focus On Fitness And Nutrition."
Political Change Requires Resources - The use of money in politics is a necessary evil to try to bring out political change. I know people don't like that fact, but that's the way the game is played. To try to bring about legislative change, you need access to politicians. And to get access to politicians, you need resources, meaning money. This morning, there was a presentation about the Family Medicine Political Action Committee. According to the website, since it's formation in 2005, FamMedPAC has received $2.6 million in donations from more than 5000 members, including Family Medicine Residents and Medical Students.

"Never Doubt That A Small Group of Thoughtful, Committed Citizens Can Change The World; Indeed, It's The Only Thing That Ever Has" - This is a quote from Margaret Mead and is used often in advocacy work. I keep coming back to this quote when I start to get frustrated working in this broken health care system. Being around these great people and talking about common goals, really energizes me and gives me the strength to get back to work to help our patients. And, who knows, one of these days, I know in my heart that we can change the world...

The Karla Booker Interview

Thanks to Karla Booker, MD for being my guest on Episode 334 of the Mike Sevilla Radio Program recorded January 26, 2015 (I said 2014 in the podcast - sheesh). She serves at Gwinnett Medical Center's Director of Women's Health Education.

In a previous blog post, I shared how I became interested in the Karla and Kent story. It was a love story 40 years in the making. In the first part of the interview, Karla describes how they knew each other in their teens and twenties. In 2013, they became reacquainted through social media - specifically Facebook and Skype.

"He's the one who said, 'I Love You' first, and that was important to me," Karla said. As their courtship continued, they were on the track to getting married, when Kent became ill. The diagnosis was cancer, and the immediate future was unclear as more testing was done. The findings were more ominous, as it was found that the cancer had spread.

In the course of this early treatment, there seemed to be mild improvement, and this was the opportunity for the marriage ceremony to take place. Karla's voice lit up during this part of the interview as she described the wedding.

In the weeks following the wedding, Kent's cancer treatments were found to be unsuccessful, and the decision was made for hospice care. Karla describes a kind of "at peace" feeling that she and Kent had, as they knew his life was coming to a close. She was not there for his last breath, and she as ok with this, as she describes in this interview.

Karla and I then talk about Kent's love of butter pecan Haagen Dazs ice cream, as this was one of the only foods that Kent really desired towards the end. Karla challenged her friends to change their FB cover photos and profile photos to the Haagen Dazs ice cream. She also challenged her friends to post pictures to the FB Haagen Dazs page. Karla then challenged the company to make a donation to the American Lung Association, which was ultimately done.

The best part of the interview is the last 30 minutes, which you have to listen to. Karla and I have never met before, and as usual for me, it took me an hour of conversation until to really dive into things. I asked Karla if she had any regrets. I asked Karla what kind of "call to action" does she have to those familiar with her story. And, I asked Karla what she thought Kent's reaction to all of this would be. You'll have to listen to find out what she said.

Towards the end of the interview, we had a great conversation about self care as a caregiver, and self care as a physician. I really believe that self care as a physician is not something that is talked about enough. And, I hope to have more online and offline conversations with Karla about the topic of self care, because I think that it is an important to talk about more.

Thanks again to Karla for being on the program tonight. Thanks to everyone who listened live and who will listened to the archived podcast above. You can also click this link and listen and/or download the podcast. I really need to find the time to podcast more, and hopefully, I'll be able to go that soon...

TedxYoungstown 2015 Preview

Welcome to those of you who are visiting my website for the first time because of the TedxYoungstown 2015 event taking place January 23, 2015 on the campus of Youngstown State University.

A speaker's Dress Rehearsal is going to take place today. And, I'm very nervous about this. I have to tell you that this Tedx talk is the most difficult presentation that I have ever had to prepare. One reason is the time limitation. I have been given 12 minutes to share the best points about Social Media and Medicine. So, condensing my usual 60-90 minute remarks, was challenging, yet fun for me.

The night before the main event will be the Kickoff dinner where the organizers, the sponsors, and the speakers gather. I very much appreciate all the sponsors for the 2015 TedxYoungstown event. I encourage you to check out the sponsors page and show them some love.

Friday's TedxYoungstown 2015 event will be available via live video stream at this link. There were some technical struggles last year, but I know that they have been working on this. And, I think their use of the livestream platform will do them well.

For my fans out there, I'm scheduled to speak at 3pm Eastern Time on Friday, and you can check that out at the live video link. I challenged myself to use zero slides, and I have been able to do that. We'll see how that works out.

I'll be posting to my various social media accounts, like this website, twitter (including my almost 20,000 followers), Facebook, and instagram. I'll be using the twitter hashtag #TedXYo and also follow the TedXYoungstown twitter account and Facebook accounts for updates before, during, and following the main event!

TedxYoungstown will be held January 23, 2015 on the campus of Youngstown State University. Tickets and more information at TedxYoungstown.com - The 2015 theme is "Breaking Boundaries."

#FMRevolution Shows Love

““A brain tumor and cancer were no match for the couple’s wedding joy. Their love, 40 years in the making, would not be stopped by his diagnosis of a brain tumor and stage 4 lung cancer just four weeks earlier.” - Richmond Free Press, October 31, 2014”

In a world where there seems like there is so much negativity out there (especially on social media), there are things that happen that gives you faith in the world again. Karla Booker is someone who I don't know very well, and maybe met a couple of times. She is the Director of Women's health education at Gwinnett Medical Center in the state of Georgia. She is also a member of our Family Medicine community called #FMRevolution. The quote above is from her wedding with Kent Smith. I encourage you to read the entire article, which is a beautiful story of love.

Last week, their story took a tragic turn with the death of Kent Smith only 14 weeks following his cancer diagnosis. In the wake of sadness, comes recognition and celebration. It was only from my friends in the Family Medicine social media community that I learned that Kent enjoyed Haagen-Dazs butter pecan ice cream. I learned because friends of Kent and Karla have been posting photos of them with Kent's favorite ice cream (see below). It even got to the point where the Facebook page from Haagen-Dazs USA made their cover photo butter pecan. In addition on twitter, people have been using the hashtag #HaagenDazs4Kent

So, as you go through this week, think about Karla and Kent, send them your thoughts and prayers, and have some Haagen-Dazs Butter Pecan...

Health Is Primary storms into #CES2015

““We will be participating on a panel at the 2015 Consumer Electronics Show highlighting how we can reach out to that community of the people doing innovative technology, so that we can be a partner and collaborate with them in identifying and promoting those things that improve health” - Glen Stream, MD, Chair, Family Medicine For America’s Health”

If you're intrigued by technology like I am, you may have already been inundated by reports from this year's Consumer Electronics Show in Las Vegas. I always love hearing about the latest gadgets, and I'm always curious about any type of gadget applicable to health. However, this year, I am more curious because Family Medicine will also be at this year's show. They will be reaching out to the tech industry and hopefully partner with them on how to improve our nation's health.

About two months ago, in October 2014, I was fortunate to be at the press conference to announce the launch of the "Health Is Primary" campaign. This plan is also known as "Family Medicine For America's Health" where the eight leading Family Medicine organizations in the United States are collaborating to promote these seven strategies to improve the health of every American:

Show the values and benefits of Primary Care
Ensure every person will have a relationship with a trusted Family Physician or other primary care professional, in the context of a medical home
Increase the Value of Primary Care
Reduce health disparities
Lead the continued evolution of the Patient Centered Medical Home
Ensure a well-trained primary care workforce
Improve payment for primary care by moving away from fee for service and towards comprehensive primary care payment

At the October launch, Dr. Glen Stream revealed at the end of the press conference (around 50 minutes at this video) that the "Health Is Primary" team will be participating in a panel at #CES2015 (see quote above). I believe this panel will be Tuesday, January 6, 2015. When I heard this in October, I was very excited, and I'm still excited about this panel. I wish I could be there, and I hope someone is recording this panel to share with all of us.

So, as you are overwhelmed with press releases from #CES2015, I hope that you also keep your eyes open from the "Health Is Primary" team, and their experience there. In addition, "Health Is Primary" messaging will be targeting patients this month in the areas of Nutrition and Exercise. So stay tuned for that. I'm excited to be helping to spread the message using blog posts like this and using the #HealthIsPrimary hashtag. Help #FMRevolution spread the word out there on social media!

For too long, our health care system has been out of balance. Now is the time to embrace the values that make people healthy-the values of family medicine. Join us and, together, let's make America a place where Health is Primary.

Influenza Case Study: Me

Even I am not immune to influenza. In Northeastern Ohio, there have been more hospitalizations and school closings this year from influenza. And, let me tell you, as a Family Physicians who also sees patients in the hospital and in the office, we have seen a lot more respiratory illnesses versus last year.

No, I'm not one of those Dr. Oz hypocrites who skip the influenza vaccine. We already know the credibility of what Dr. Oz says. I received my quadrivalent influenza vaccine back in October. But, as been covered in the news, this year's flu shot is less effective because of virus mutation.

There is definitely a difference between a "common cold" and a real influenza infection. Symptoms of influenza include muscle aches, fever, cough, headache, fatigue, and nasal congestion. I woke up yesterday morning with, what felt like, every single muscle in my body aching. You feel like you can't sit still, because you want to try get up and "walk it off." Yet, you feel so fatigued that you don't want to move.

You feel so fatigued, that you want to lie down and sleep, but then the cough and nasal congestion keep you from lying flat. So, you have to resort to sitting up to try to take a nap. In addition, to try to keep from getting dehydrated, I've been trying to drink as much water as I can.

As recent as one week ago, there were articles written about short term shortages in the prescription influenza medication called tamiflu. I know that our office have had to call multiple local pharmacies to find the medication. Fortunately, I was able to start the medication right away. Just so you know, tamiflu works most effectively if started within 48 hours of symptoms. Prescription influenza medications decrease symptoms by 1-2 days.

In case you didn't know, you can be contagious for 1-2 days before showing influenza symptoms. The duration of the influenza infection is about 3-4 days. If left untreated, influenza can lead to complications like pneumonia.

The influenza vaccine is not perfect, but it is the best protection that we have against infection. Even if you have not received your flu vaccine yet, it is not too late. Those at highest risk for influenza infection include older people and younger people, those with chronic illnesses, those with weakened immune systems, and of course, health care workers.

I wrote this first hand account of my influenza infection, so that you will never have to go through this. Much has been written about potential ebola epidemic, but you should be more worried about influenza infection, especially in Northeastern Ohio, where hospitalizations from flu have increased 162 percent over one year ago. According to the CDC, annual deaths from influenza have ranged from 3000 to 49000. How many deaths in the United States have there been from ebola?

When you recognize the symptoms early, get to your doctor right away. Better than that, know your risk of influenza infection, and get vaccinated. There is still time. Flu season sometimes goes all the way into the spring.