Navigating Healthcare – Patient Safety and Personal Healthcare Management

What can we learn from Robin Williams in life and in Healthcare

Posted in Depression, Health Reform by drnic on October 23, 2014

Like many people the death of Robin Williams

was sad on so many levels and while my connection with him was limited to the exposure I had through his canvas of work, I like others felt I knew him.

He was not only prolific in his work with a list of films, interviews and shows (and if you have NetFlix – here’s all the movies available there), but could often be found adding color and charisma in the most unusual places – in this story related by Christopher Reeve talkingabout his friendship as they walked past a lobster tank in a restaurant

One evening we went out to a local seafood restaurant, and as we passed by the lobster tank I casually wondered what they were all thinking in there. Whereupon Robin launched into a fifteen-minute routine: one lobster had escaped and was seen on the highway with his claw out holding a sign that said, ‘Maine.’ Another lobster from Brooklyn was saying, ‘C’mon, just take da rubber bands off,’ gearing up for a fight. A gay lobster wanted to redecorate the tank. People at nearby tables soon gave up any pretense of trying not to listen, and I had to massage my cheeks because my face hurt so much from laughing.”

Bet you wish you had been there to listen in!

 

The outpouring of grief, sadness and accolades was no surprise and while he may not be everyone’s favorite actor or character it is hard to imagine people feeling dislike for him.

He was a serious actor who’s work included playing characters with flaws Good Will Hunting

Insomnia

And a personal Favorite (for the teacher we all wanted to have – Captain, My Captain) The Dead Poet’s Society

But is best known for his comedic genius and unstoppable energy that could light up any room or interaction and turn even the most somber of moods into smiles and laughter

And his comedic view of what Lobsters were thinking in a tank as he demonstrated when he visitedhis longtime friend Christopher Reeve and making him smile for the first time after his accident

“As the day of the operation drew closer, it became more and more painful and frightening to contemplate,” wrote Reeve. “In spite of efforts to protect me from the truth, I already knew that I had only a fifty-fifty chance of surviving the surgery. I lay on my back, frozen, unable to avoid thinking the darkest thoughts. Then, at an especially bleak moment, the door flew open and in hurried a squat fellow with a blue scrub hat and a yellow surgical gown and glasses, speaking in a Russian accent. He announced that he was my proctologist, and that he had to examine me immediately. My first reaction was that either I was on way too many drugs or I was in fact brain damaged. But it was Robin Williams. He and his wife, Marsha, had materialized from who knows where. And for the first time since the accident, I laughed. My old friend had helped me know that somehow I was going to be okay.”

The friend we all want to have…?

With that in mind it can be hard to reconcile that character with someone who would take his own life:

  • How is it possible that someone with what appeared to be so much joy and happiness who was surrounded by friends and family find themselves in such a state of despair to take an irreversible path and commit suicide?
  • How is it possible that someone who outwardly seemed to have such a sharp insight into people and laughter who could make us all laugh at the most unlikely of issues or discussions could take his own life?
  • How is it possible that someone with such a storied and successful career could drop into a state of depression with so much to live for and so many people who loved him and end his own life?
  • How is it possible that a smart, intelligent and gifted individual with so many positive aspects to his life could see no alternative to ending his life and commit suicide?
We can be surrounded by people but be all alone

In what seems eerily insightful he talked about this in his “report to Orson” in the show Mork and Mindy in 1981 where Mork meets a famous celebrity (in this case it the famous celebrity is Robin Williams): “Mork Meets Robin Williams”. You can watch part of it here Mork learns about the nature of fame on Earth and the toll it takes on those who get swept up in it, or try this link

There has been some mention of Parkinson’s Disease and this may have had a contributing role. But the underlying challenge was his battle with depression. On many occasions he had shared his struggle with depression and substance abuse and the ongoing challenge he personally faced dealing with his disease.

The word depression is used frequently by people to describe their feelings and emotions but it has a very specific meaning in medicine and is used to describe a mood disorder:

Clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for a longer period of time.

Not to be confused with sadness which is a temporary feeling that is normally associated with some negative aspect of our lives or surroundings and passes

Our understanding of depression is still limited – our treatment of this disease is still in its infancy and mostly limited to broad-brush therapies that impact neurotransmitters that are implicated but not exclusively associated with depression. We have (mostly) moved past separating and isolating people from the general population (although some would argue that our prison system is the new version of the sanatorium). But our ability to treat or cure depression remains stubbornly missing.

Our understanding of the brain is limited and despite laudable attempts to jumpstart the process The NIH BRAIN Initiative progress however remains frustratingly slow and leaves our society with a subset of the population suffering from varying degrees of debilitating diseases of our brain including depression, mania and schizophrenia and many others.

So what did Robin Williams teach us in Life

Laughter is the best medicine

It is hard to pick a single moment from his incredible repertoire, so I picked 3: Mrs Doubtfire Explaining Golf  Or this medley tour of cultures and accents all done in less than 2 minutes Laugh and laugh loudly

Being different is not just OK its what makes life worth living

Endless compassion

and the real Patch Adams

What did Robin Williams Teach us in Death

We need empathy, compassion and tolerance in our society Empathy: The Human Connection to Patient Care Social Media can help link people but even with these digital connections humans may still feel disconnected and alone despite outward appearances to the contrary and connecting, engaging and reaching out is even more important today in our “connected” world

Suicide is painful – not only for the unnecessary loss of life but for the trail of despair it leaves behind for all the people wondering what if…. should have…. could have done….

I’ve experienced it with friends and still think about them. In fact I was reminded when I read about two more suicides in New York: Suicides At NYU And New York Presbyterian–2 Physician Interns Jumped To Their Deaths of two promising lives brought to a final and sad end.

Don’t let that be your legacy and reach out to someone today and remind them and yourself why life is great for both of you

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Speech and the Digital healthcare Revolution at #SpeechTek

Come join me in the conversation with my colleagues at the SpeechTek 2014 conferencein Marriott Hotel in Time Square, Manhattan New York.

The Panel: C103 – PANEL: The Digital Healthcare Revolution at 1:15 p.m – 2:00 p.m. The panel moderator Bruce Pollock, Vice-President, Strategic Growth and Planning at West Interactive and on Social Media @brucepollock

I will be joined by Daniel Padgett, Director, Voice User Experience at Walgreens and on Social Media at @d_padgett and David Claiborn, Director of Service Experience Innovation at United Health Group.

We will be discussing the opportunities and challenges associated with the current digital healthcare revolution and of course how speech plays an essential role in integrating this technology while maintaining the human component of medicine that we all want. Rather than Neglecting the patient in the era of health IT and EMR

We have progressed from the world of Sir Lancelot Spratt

And the Doctor need to look at the patient not the technology perhaps in a cooperative Digital Health world like this

Is this future of Virtual Assistant Interaction good, desirable

Demo Video 140422 from Geppetto Avatars on Vimeo.

We will be discussing

  • What are the biggest obstacles to digital healthcare becoming a reality?
  • Where do speech technologies bring the most value to healthcare?
  • How will health providers, insurers, and payers provide patient support in the world of digital healthcare?

Perhaps the emerging Glass concepts improve this interaction as they are exploring in Seattle

Join us for analysis of the state of digital healthcare today and predictions for its future.

In the end

People forget what you said and what you did but they remember how you made them feel

Come join the discussion as we explore the digital technology and how it should be used in healthcare and how speech can help

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Wearable Technology – An Exploding Segment

Posted in #mHealth, bigdata, Healthcare Technology, HealthIT, Personal Health by drnic on October 1, 2014

I attended a Wearble Technology conference today in Pasadena California: Wearable Tech LA

There was a wide range of technologies and innovations – everything from the mind monitoring by IntraXon’sMuse headband. Here’s their online demo video

One of the more interesting concepts takes the challenge we have all faced mastering the mechanics of walking, exercise, running and in some cases rehabilitation by placing sensors in the sole of shoes – Plantiga who have taken force analysis for our feet to a whole new level

The technology takes the static Force Plate sensor and turns into a continuous assessment 3-D tool offering an opportunity to apply this in specific sports and to help rehabilitate people who have been injured or have mechanical challenges (the side effect of capturing all this data is actually creating more comfortable shoes as they now have built in suspension and springs).

Better than this concept!

It might take a while to arrive in healthcare but in the meantime may well show up as another input device for the X-box or PS3 for a more realistic interface.

There was sensors to be placed all over the body for respiration, heart rate, muscle movement, acceleration/deceleration and even some to be ingested

A major challenge highlighted by several speakers facing all of the wearables genre was the issue of battery life

(and ironically it was the same problem I faced as I tried to capture and post social media)

The opening keynote was from Nadeem Kassam – CEO of BioBeats (Founder of Basis which is now an Intel company). His journey was one of classic rise from poor neighborhood in South Africa where he started his entrepreneur sporty selling oranges

He focused on three lessons – the first an essential learning point for everyone especially those facing healthcare challenges

Nothing is stronger than habit

He also suggested that those looking to succeed with innovation should:

  • Look for innovation outside of your industry, and
  • Don’t throw a big team or money at innovation

His story behind this was a classic one of engineers told to build a product who came back with his wearable watch that was a huge device that weighed down his arm and had a velcro battery pack under the arm!

He ended up finding his greatest engineers on Craigslist who’s references and Resume was a cardboard box full of devices that he had built.

The new concept of “Adaptive Media” which is bridging the divide between human emotion, data and the media we consume and should adapt to our mood based on our emotion. His new company has done some interesting research programs including an experiment with machines designed to allow people to hear their own heartbeat and have it set to music in Australia. When people heard their heartbeat for the first time it created a deeply emotional experience and many were moved to share very personal life stories.

They took this a step further and worked to gather heartbeats worldwide – a clever BIGData gathering exercise that amassed large quantities of rate, rhythm and details of millions of people around the world.

His overriding point was

We have to make health fun and engaging – merging it with entertainment to help people achieve what we all want – long tail of healthy life
 

There was a fascinating blend of the Entertainment industry and Hollywood and a slew of companies taking different approaches to these devices:

Epihany Eyewear tries to make wearables fashionable as well as functional (I’d say it not so much as fashion but blending into society)

Optivent with  powerful wearable glass – but no mention of the interface They probably had the most fun concept video

Les lunettes d’Optinvent voient plus grand que les Google glass from Rennes, Ville et Métropole on Vimeo.

Enlightened design had the most impressive on stage display with a jacket that had lapels that constantly changing color

Janet Hansen – Founder & Chief Fashion Engineer, Enlightened Designs

Sporting her jacket with lapels that constantly changed color

Sports and Wearable

Given the excitement over the last month wight he World Cup it was fascinating to hear from Stacey Burr from Adidas who revealed that most if not all the teams were using technology to help them train and track in extensive detail – she suggested that there is not a single team or sport that is not using wearable technology in some form or another.

You can see some of the gear below

GPS enabled ECG/EKG monitoring Units plug into the back around the neck area
 
Paired with watches to offer players feedback
Digital insides of a ball used to sense how well it is struck

These are the professional versions used by major teams but Adidas is releasing commercial versions that will be available to the general public but lack the GPS capability and the analysis tools they offer

Surprisingly the leaders from a sports and country standpoint are Rugby and Australia and New Zealand who are “light years ahead” of wearable tech in sports

They are ahead in Psyching out their opponents too!

Sensoria demonstrated an exciting interactive future for sports and wearables where we challenge ourselves, other people and are coached by virtual assistants

Sensoria Fitness Shirt with Heart Rate Sensors from Heapsylon on Vimeo.

One of the highlights:Seeing Dick Fosbury of the “Fosbury Flop” Olympic Gold Medal Winner from Mexico 1968 and it turns out he is a Cancer Survivor, has an aneurysm and fully engaged in the intersection between healthcare and wearable technology

Neil Harbisson – Co-Founder, Cyborg Foundation

who was born totally color blind was definitely at the edge of wearable technology. He has an implanted device that turns color into sound and this is directly fed into his brain. He described that it took 5 weeks for the headaches to stop with this sudden input of data and then 5 months before it just became part of him and he now sees in color. Here’s his TED Talk: I listen in Color http://embed.ted.com/talks/neil_harbisson_i_listen_to_color.htmlHe also has a permanent internet connection in his brain so people cane send him colors and images directly (he joked the address is private – but I did wonder given the ease with which spammers seem to find new addresses how he protects this destination from spam!)

I don’t wear technology I am technology, I can’t tell the difference between the software & my brain

The healthcare focused panel: Emerging Wearable 2.0 Health Platforms:

The furthest along and well know was probably Misfitwearables (Sonny Vu, CEO) who try and make sensors “disappear” but still simple sensors

OMSignal (Jesse Slade Shantz – Chief Medical Officer) was the most interesting as they are trying to change the monitoring from attached sensors to using fabric that can be loose fitting but can capture physiological information.

Breathometer(Charles Michael Yim – CEO) focus on analyzing your breath and have a range of products directed at health (over and above their simplistic alcohol breathalyzer available today) that assessed fat burning (using acetone) and asthma

NeuroSky(Stanley Yang – CEO) offer a system that other manufacturers can integrate into their wearables. Typically found in mobile phones or headsets

LUMO(Monisha Perkash – CEO & Co-founder) offering a discreet sensor that is designed to help improve your body posture and works as a tracker.

It’s an exciting future with some fascinating technology to come – one thing for sure – with ubiquitous technology comes ubiquitous complexity and your voice will become an essential tool for successfully managing and navigating. Dragon Assisatnt is one of several tools built to assist in using and navigating technology that is reinventing the relationship between people and technology

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