Telemedicine will eventually become a more prominent part of our clinical practice, with the incorporation of artificial intelligence (AI) and social media and networks, and integration with precision medicine in electronic health records. As clinicians and scientists, we should be thinking about where and how these four innovative strategies intersect, so that we can continue to not only contribute to the conversation and direction of these strategies, but also lead ...

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The Washington Post ran this headline: “’Horns’ are growing on young people’s skulls. Phone use is to blame, research suggests.” The headline is entirely correct except for a few minor points:

  • They’re not horns, which point up from the forehead. They’re more like little 1/2 inch nubs protruding downwards from the back of the skull.
  • They’re not new. There’s no comparison group to show that these are more or less ...

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I just did my first telemedicine video visit. The concept seems so strange, the idea of carrying out an "office visit" without the patient actually being in the office. Right now we have it structured so that when a patient calls up requesting to see me on a day when I am already fully booked (or, as is usually the case, overbooked), ...

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I want to share some thoughts about artificial intelligence, or as I prefer to call it “data analytics.” Fundamentally: How can we capture the capability of analytics to improve the care and outcomes of cancer patients? And more importantly: How can we harness this technology to help bring back the human touch in cancer care? Admittedly that’s a large focus covering lots of opportunities. Speak to one expert, and you will ...

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Amazon has opened a new health care frontier: Now Alexa can be used to transmit patient data. Using this new feature — which Amazon labeled as a “skill” — a company named Livongo will allow diabetes patients — which it calls “members” — to use the device to “query their last blood sugar reading, blood sugar measurement trends, and receive insights and Health Nudges that are personalized to ...

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Raise your glasses (of juice, water, champagne, or whatever you fancy) and join me in celebrating a dream come true: I'm officially a physician who practices medicine from home. To think that it was only four years ago that I was burnt out. It took having that eye-opening experience to take myself off the grid and begin practicing medicine on my own terms. I left nephrology to practice as a ...

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During a recent walk at Crystal Cove, a splendid California State Park with miles of pristine coastline, I encountered two young women sitting on a bench with a magnificent view of the ocean.  Yet their only view of interest was their cell phone screens.  One of them lifted her head long enough to say, “Your dog is cute,” then returned to the rapture of her device.  I thanked her and ...

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As a physician trying to keep up with all the new information about artificial intelligence, I want to know how machine learning and deep learning are impacting medicine now and to separate the hype from reality. Here's a look at some ways AI is being used successfully in health care and some ways it is not. AI has been validated for use in interpreting medical scans, pathology slides, and reading electrocardiograms. ...

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In many countries around the world, women giving birth still face substantial risks to their own lives and that of their baby. Women travel for days to reach facilities that are understaffed, unsafe, and unequipped to provide life-saving surgical care. They are pushed into financial catastrophe as a result of paying for surgical care, if they are able to afford it all, and they return home with little support in ...

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As we go through our careers, we are given the responsibility of educating the next generation of students and residents to become proficient and competent in medicine. In telehealth, which also requires training my colleagues, is it necessary? If so, what should be part of it? Part of the equivocation with this question of creating telehealth education is at the core of the practice: since I strongly stress that telehealth ...

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Telemedicine has been available now for a number of years. Despite being widely accessible, it still struggles to maintain a foothold in the minds of many traditional practitioners. There are many reasons for this, including gaps in knowledge related to billing and reimbursement for virtual visits, as well as varying levels of coverage by insurance providers. This is particularly cumbersome when it comes to Medicare patients, although there is hope ...

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When I was a child, I knew I would become a doctor. I liked science and taking care of people. We diagnose medical problems and prescribe treatment plans. Some of us perform surgeries and some focus on keeping you well. Despite this, I’m nothing special, and neither are you, my physician colleagues. Let me explain why by first taking a brief step back into the history of American health care. Since ...

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Telehealth, using video to have an acute medical care visit, puts some of the power of choice back into our patient’s hands. To best frame telehealth and its use cases, the National Quality Forum published a report in 2017, outlining the following four buckets which I find especially useful with evaluating programs and interventions:

  • access
  • cost savings
  • effectiveness
  • experience
This post is specifically about access and telehealth. I’m an emergency physician ...

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If you throw a pebble today, it's likely to land on an article that talks about how artificial intelligence and its brother — machine learning — are changing health care. Yes, I get it broadly. But I was curious to explore how exactly health care's trends are shaping a single medical specialty. I chose gastroenterology (GI) because I'm most familiar with the space. And here's what I found. Trend #1: Manipulating bacteria ...

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An important part of advancing medical research and drug development is making participation in clinical trials easier and more inclusive. To develop treatments that work on men, women, and children of all ages and different ethnicities we need to have clinical trial data that represents our diverse population. Right now, when the FDA approves a new drug we know that it will be effective in some – but not all ...

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For many months, artificial intelligence has been in my peripheral vision, just sitting there, ignored by me because it seemed too far in the future to be interesting now. And then, there were all these terms — Big Data, machine learning, data science — which circled the subject and, frankly, gave me a bit of a headache. Artificial intelligence is upon us, unleashed and unbridled in its ability to transform the world. ...

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I view medicine as a team effort. Doctors, nurses, technicians, and patients work together to promote and improve health. Recently some new members have joined the team:  My patients’ Fitbits, phones, and watches. For years, the pessimists out there have predicted that wearable technology would lead to mass hysteria. Patients would misdiagnose themselves as having heart attacks and strokes and fill the ER with blaring watch alarms but no actual symptoms. I’m ...

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I have been practicing telemedicine successfully for four years. In 2015, I had to beg doctors to work in telemedicine. Because so many doctors were wary of it, I started to get licensed in multiple states, and now, I have 15 state licenses. Well, what a difference a few years makes. Now, in 2019, I get six to seven Linkedin, Facebook, and Instagram messages a week from physicians asking ...

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I was in the hospital when I heard the word “apple.”  Without hesitating, I reached into my pocket to see if I had my phone.  But the person speaking was referring to the fruit, not the product.  This got me thinking: “Has technology and our products now become more important than our health?” Technology surrounds us and has become a large part of how we live on a daily basis. I’m ...

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The United States spends more of their GDP on health care than any other developed nation, and yet it produces some of the poorest outcomes — notably in the field of maternal and infant health. The advent of digital health has presented the opportunity for a paradigm shift in the delivery of care, and support from investors and policy-makers shows that as far as they’re concerned, digital ...

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