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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Earlier this year, we put together a list of what we thought were the best medical apps for health care providers. Now at the end of 2018, we’re augmenting that list to give you a full picture of what we think are must-haves medical apps for those in primary care. Safe Motherhood Initiative: ACOG DII SMI Quick reference for common obstetric emergencies Many of us in family medicine practice full-scope ...

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Recently the Apple Watch’s latest feature went live – an electrocardiogram (ECG) app that monitors irregular heart rhythms. The internet is overflowing with reports from people didn’t know they had irregular heartbeats until they took their data to their doctors and received diagnoses of atrial fibrillation (AFib), a common cause of stroke. As neurologists who treat stroke patients, we welcome technology that enables patients to receive faster diagnoses and better treatment. ...

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Veterans do not only matter one day of the year. Beyond Veterans Day, it is not only important to reflect on the lives lost and the sacrifices made by those who served our country, but to ask: are we doing enough as a nation to give veterans the support and care that they need? Veterans deserve to be more than a political football. We discuss “supporting our troops” and “honoring ...

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Over the course of several years, IBM’s fledgling Watson for Oncology program has received a wide range of reviews. Among them is a harsh critique published by Gizmodo.  The article is filed under the keywords “AI,” “Watson,” “health,” “health care,” and “Doctor: This product is a piece of shit.” The last keyword is courtesy of a provider in Florida commenting on a highly publicized medication error. While the ...

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What I’m about to tell you is based on good insider information. But I also disclose that this is an amalgamation of a few reports of teledoc companies to me and their crony insurance companies, not a thorough analysis of the entire industry. I just assume there are other business models out there that look a little different, but I suspect the bottom line impact is about the same. Most large ...

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Among the many recurring topics, this year has been the impact of machine learning in our lives, especially the implications for our future work life. Prophecies range from ubiquitous utopian machine servants to a dystopian ravaging, hollowing out the work and economic standing of the middle and lower classes. “What can machine learning do? Workforce implications” by Erik Brynjolfsson and Tom Mitchell in Science provides some perspective on machine learning ...

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