Category Archives: Medical technology

Apr 3 2014
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RWJF Scholars in the News: Medical debt disparities, nurses providing primary care, technologies that maximize time with patients, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

In a study of women diagnosed with breast cancer, RWJF Physician Faculty Scholars alumna Reshma Jagsi, MD, PhD, found that Black and Latina patients were more than twice as likely as White patients to have medical debt and to skip treatments due to concerns about costs. Jagsi tells Reuters that “our findings suggest that racial and ethnic minority patients appear to be more vulnerable, as are those who are too young to qualify for Medicare, those who lack prescription drug coverage, those who reduce their work hours after diagnosis, and those with lower household income at the time of diagnosis.”

Expanding nurse practitioners’ role in primary care could help meet new demands on California’s health care system, as millions of previously uninsured residents gain coverage under the Affordable Care Act, according to Susan Reinhard, RN, PhD, senior vice president of the AARP Public Policy Institute. “We should make sure that the nurse practitioners can use every ounce of their talent for what is needed,” she tells the AARP Bulletin. “Consumers should have a choice of different clinicians who will suit their preferences and their needs.” Reinhard is chief strategist for the Center to Champion Nursing in America, a partnership of AARP, AARP Foundation, and RWJF and co-director of the Future of Nursing: Campaign for Action.

At a recent information technology summit, Ann O’Brien, MSN, RN, an RWJF Executive Nurse Fellow, discussed her work with Kaiser Permanente to leverage new health care technology to maximize nurses’ valuable time providing patient care. O’Brien explains that “you have to look at what can enable small amounts of change,” because saving seconds with each repeated use of rapid sign-on technology, for example, can mean gaining extra minutes in a day for a nurse to provide direct care, FierceHealthIT reports.

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Jan 30 2014
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Human Capital News Roundup: HIV treatment for ex-offenders, ‘healthy’ fast food myths, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Making new medical device technology quickly available is important, but research suggests there is a risk associated with swift Food and Drug Administration approval of implantable heart devices. Aaron Kesselheim, MD, JD, MPH, recipient of an RWJF Investigator Award in Health Policy Research, told USA Today that the medical community should be wary of the expedited review process because it can compromise product safety and effectiveness. The Boston Globe also covered Kesselheim’s research.

Health Canal featured a study co-authored by RWJF Health & Society Scholars alumna Chyvette Williams, PhD, MPH, that examines gender differences in HIV treatment outcomes among recently released prisoners. Williams and colleagues found that women were considerably less likely than men to attain any of the three optimal HIV treatment outcomes six months after release from jail, and thus had significantly more negative health outcomes.

Despite media campaigns promoting healthy eating, customers at fast food restaurants such as Subway do not necessarily make better food choices, according to a Medical Daily article. Citing research from Lenard Lesser, MD, MSHS, an RWJF Clinical Scholar alumnus, the article states that people consume nearly as many calories, and as much sugar, carbohydrates, and sodium from Subway as they would at another fast food restaurant. Lesser’s research was also covered by WNCN. Read more about Lesser’s research.

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Oct 31 2013
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Human Capital News Roundup: The cost of disposable diapers, toxins in fish, fast food calories, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

WNYC in New York City broadcast an interview with RWJF Community Health Leader Joanne Goldblum about families reusing disposable diapers due to economic hardship. Goldblum, who is founder and executive director of the National Diaper Bank Network, conducted a study that shows how the practice leads to a range of problems for families living in poverty.

When it comes to digital health and new ways to deliver care, the focus should be on the consumer and improving outcomes, not on the technology, according to experts at a recent Connected Health Symposium in Boston, Massachusetts. Mobile Health News reports that Propeller Health (formerly Asthmapolis) CEO David Van Sickle, PhD, MA, an RWJF Health & Society Scholars alumnus, pressed for greater emphasis on outcomes.  Read more about Van Sickle’s work here and here.

An American Thoracic Society panel of experts, including RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) grantee Richard Mularski, MD, is calling for better care for those who suffer severe shortness of breath due to advanced lung and heart disease. The Annals of the American Thoracic Society reports that the panel recommends patients and providers develop individualized actions plans to keep episodes from becoming emergencies, Medical Xpress reports.

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Aug 26 2013
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Ode to My Favorite Gadget – This One Saves 99,000 Lives Per Year in the U.S. Can Your iPhone Do That?

Timothy Landers, RN, CNP, PhD is a 2012-2015 Robert Wood Johnson Foundation Nurse Faculty Scholar and an assistant professor at The Ohio State University.

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A piece of technology that has transformed modern health care—and our careers—is the underappreciated hand sanitizer dispenser.

Nearly every field of nursing and medicine depends on advances in the prevention and treatment of infection. For example, it is now possible to perform extended surgeries on the brain or heart while controlling the risk of later death from infection. Combined with infection prevention activities, it is now possible to give immune-suppressing drugs to cancer patients who would otherwise certainly die of an infection at some point in their disease process. One hundred years ago, patients with trauma often died of infectious complications several days after the acute injury. 

Advances in every field of medicine depend on good infection control. And good infection control depends on good hand hygiene. And good hand hygiene depends on the hand sanitizer dispenser.

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Aug 7 2013
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Health Care Transformation in the Context of Caring

Ann O’Brien, MSN, RN, is national director of clinical informatics for Kaiser Permanente - National Patient Care Services & KP Information Technology. She is a Robert Wood Johnson Foundation Executive Nurse Fellow (2011-2014).

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I had the honor of hearing Donald Berwick, MD, present last week at the American Hospital Association Leadership Forum in San Diego. In fact, I registered for the conference to hear his keynote address. He brings the unique perspective of both of his previous roles: president and CEO of the Institute of Healthcare Improvement (IHI) and, most recently, director of the Centers for Medicare and Medicaid Services. 

But more importantly he knows the secret of how to transform care. In fact, we can go back to the 2001 Institute of Medicine (IOM) report, Crossing the Quality Chasm: A New Health System for the 21st Century for the six aims of health care improvement:  safe, effective, patient centered, timely, efficient and equitable. Berwick was on that IOM committee and expressed concern last week with the progress we have made in meeting those goals over 12 years.

Health information technology (IT) has been touted as a way to promote safety, efficiency, quality and patient-centered care. But these benefits have yet to be realized because there has not been large scale adoption of electronic medical records (EMR) and enabling technology to achieve these goals.

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Aug 6 2013
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A Doctor and Mother of a Premature Baby Helps Test a Mobile App for Parents of Special-Needs Infants

Nwando Eze, MD, MPH, is a neonatal fellow and mother of two practicing in Orange, California. When she was a pediatric resident, she helped test Estrellita, a smartphone app designed to support parents of infants with special health needs.  Estrellita is supported by the Robert Wood Johnson Foundation (RWJF).

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I smile as I note the increase in weight Ozuli has had in the last month.  Having spent two-and-a-half months with Ozuli in the neonatal intensive care unit (NICU), I learned quickly that weight gain with minimal to no other problems was as close to an ideal situation as any parent could ask for in the NICU.

Ozuli was born two months early at 29 weeks unexpectedly.  I was in my second year of pediatric residency and had a three-year-old already and had no problems with my previous pregnancy. So it was quite a surprise when at 29 weeks I began contracting intermittently and the contractions didn’t stop until Ozuli was born. I was put to sleep for the delivery and so did not get to see her until the next day, which just happened to fall on Mother’s Day. That day was the beginning of our two-month journey in the NICU—a journey I found to be the scariest and yet most blessed time in my life.

A few weeks before we were discharged, I agreed to enroll in a study testing a mobile health application that allowed parents of preterm infants to record ongoing health-related information about their infants. I was given a smartphone with the app in which I was to record events like daily diaper counts, daily weights, how fussy Ozuli was that day, my own daily moods, doctor’s appointment times, and follow-up visits.

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Aug 6 2013
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How the 'Change My Steps Challenge' Changed Me

Aneesah Gilbert participated in the "Change My Steps Challenge,” organized by Robert Wood Johnson Foundation Clinical Scholar Chileshe Nkonde-Price, MD, to address the fact that heart disease rates are increasing among Black women.

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At age 26, I came to the realization that I wasn’t getting any younger. With this being so obvious, you’re probably sarcastically wondering: How did she figure that out? Well, I will tell you the story. One winter morning I awakened to my left arm so numb I thought it was not my own. My arm was numb because I’d slept on it all night (I had slept this way from birth up until this point).

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I visited my doctor and discussed this tragedy, he laughed as he does normally to all my hypochondriac symptoms. After he had a good chuckle he told me that because of my weight (all 210 lbs. of me), the blood flow was being cut off in my arm and caused it to go numb. He then told me that my weight could cause a number of issues I did not want to experience at 26 years of age. I went home, grabbed my computer, typed in the search bar ‘DIET’ and began my stretch of unsuccessful attempts at losing weight. I came up with this personal fact: There is no diet or exercise that will work for me if I am not willing to work for it.

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Aug 5 2013
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Ode to My Favorite Gadget: A Heart ECG at Your Fingertips!

Kathleen Hickey, EdD, FNP-BC, ANP-BC, FAAN, is a nurse practitioner in cardiac electrophysiology, an assistant professor at the Columbia University School of Nursing, and an alumna of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program. Hickey is president of the International Society of Nurses in Genetics.

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As a cardiovascular nurse practitioner, there have been many instances when a patient has reported an intermittent and sporadic racing of the heart, chest pressure or other vague symptom. If I had only an ECG (electrocardiogram) when that was happening, I thought to myself on many occasions.

But as most practitioners know, in the real world such episodes rarely occur while the patient is right in front of them. Rather, symptoms occur when the patient is at home, at work, has just left the provider’s office, or is on vacation!

The widespread use of smart phones has resulted in a plethora of gadgets, gizmos, and associated health care applications—but one I can’t live without is the AliveCor heart recorder and application that is now compatible with the iPhone.

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May 20 2013
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Big Data and the Great Challenges of Health and Medicine

Timothy Landers, RN, CNP, PhD, is an assistant professor at The Ohio State University and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar.

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The Great Challenges Program is an ongoing effort by the TEDMED community to provide innovative, interdisciplinary perspectives on the most complex and challenging issues in health care. A year-long dialogue facilitated through social media tools and panels of experts continued at the annual gathering of TEDMED 2013.

One of the themes of TEDMED 2013 was the creative and thoughtful use of big data and small data to improve health and health care.

Small data includes individual level information specific to an individual or circumstance. In small data, “n=ME.” A vast amount of individual level information is now routinely collected. However, a large volume of data is not required for small data to be useful—in the words of one TEDMED speaker, it’s not the volume of the data, but the complexity of existing data. Data must be available and accessible in order to be useful as well.

Big data refers to patterns of data and information available at the population level. The goal of big data is to use information and take a “macroscopic” view of health. It includes the ability to recognize patterns that are not obvious or readily apparent. Big data analysis permits us to go from pieces of data to collective wisdom, a theme of TEDMED 2013.

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May 15 2013
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Will Dr. Robot Open New Doors for Nurses?

Olga Yakusheva, PhD, is an associate professor of economics at Marquette University. Richard C. Lindrooth, PhD, is an associate professor at the University of Colorado Anschutz Medical Campus. Both are grantees of the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative.

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Technological innovation is rapidly transforming patient care. A new generation of innovations will potentially change the most fundamental aspect of the patient experience – patients’ interactions with physicians and nurses. The FDA recently approved the first autonomous telemedicine robot for use in acute care hospitals. Even more advanced technologies, some capable of processing up to tens of millions of pages of plain medical text per second, are being tested and may soon be used to diagnose conditions and recommend treatment, with limited input from clinicians.

"We suggest that nurses should embrace rather than fear these innovations."

This new technology has the potential to perform several tasks more efficiently than clinicians, albeit with some limitations. It can quickly and effectively sift through large amounts of information and, based on a complex set of guidelines, create a probability-weighted list of diagnoses and recommendations. The result will be purely evidence-based and free of human cognitive decision-making biases.  The technology can drastically speed diffusion of new research and guidelines through electronic dissemination, similar to automatic software updates, and make most novel treatment regimens instantly available to patients.

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