Archive for: March 2012

Positive Deviance Research Continues to Impact Health Care System

Mar 23, 2012, 9:53 AM, Posted by Pioneer Blog Team

We are proud to see that an earlier grant supporting research into how positive deviance can be applied to methicillin-resistant Staphylococcus aureus (MRSA) prevention in hospitals continues to influence the way health care systems approach and solve challenges.

An article in last week’s Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report profiles the AtlantiCare Regional Medical Center, which participated in the CDC Hemodialysis BSI Prevention Collaborative to reduce bloodstream infections (BSIs). The medical center implemented the positive deviance method, identifying individuals within an organization who have overcome seemingly intractable problems and spreading their solutions throughout, to engage staff members in BSI prevention interventions. For example, a nurse developed a mnemonic device to meet the hand hygiene compliance that she then shared with other nurses. The program found that collaborative interventions and the use of positive deviance were associated with significant reduction in BSIs. 

Curt Lindberg, project director on a 2006 Pioneer grant to Plexus Institute to study the effect of using positive deviance to prevent hospital-acquired infections, recently served as a positive deviance coach at AtlanticCare. In his earlier research, Lindberg and other investigators developed a pilot program at six hospitals to control and reduce the rate of MRSA, one of the most virulent hospital-acquired infections in the United States. The study showed that MRSA infections rates declined by 73 percent in four of the six pilot units.

Read more about the results of the grant and learn about Pioneer’s work researching the growing problem of antibiotic resistance.

Life Purpose May Help Reduce Heart Attack Risk

Mar 21, 2012, 10:29 AM, Posted by Pioneer Blog Team

Evidence continues to emerge that our psyche influences heart health.

In a new study published in the Journal of Behavioral Medicine, researchers working under a Pioneer Portfolio grant found that having a sense of purpose in life may help protect older adults with coronary heart disease from heart attacks. The article, “Purpose in Life and Reduced Risk of Myocardial Infarction among Older U.S. Adults with Coronary Heart Disease: A Two-year Follow-up,” comes from researchers at the University of Michigan and the Harvard School of Public Health.

Researchers surveyed more than 1,500 older adults with coronary heart disease and followed up after two years to investigate the association between the occurrence of a heart attack and the degree to which participants had a sense of purpose in their lives, which is typically conceptualized as a person’s sense of directedness and meaning. The study found a significantly reduced risk of heart attack among participants who reported a higher sense of meaning, regardless of socio-demographic differences. Each unit increase in purpose was associated with a 27 percent reduction in the likelihood of a myocardial infarction.

This finding is notable because adults with coronary heart disease, which is the leading cause of death among Americans, are five to seven times more likely to experience a heart attack. Most research focuses on preventive and risk factors contributing to coronary heart disease, and not on resilience factors that help promote health and longevity. The study flows from our work in Positive Health, an emerging concept that explores whether people have health assets that can be strengthened and lead to a healthier life. In contrast, traditional medicine focuses on health risk factors for disease and treatment if it occurs.

In addition to life purpose, the study investigated the association of other positive and negative psychological factors, including optimism, positive affect, anxiety, cynical hostility, and depression with risk of experiencing a heart attack. The study found that all these factors were significantly associated with myocardial infarction rates, but the sense of meaning in one’s life exhibited a protective effect on cardiovascular health above and beyond the presence of these other factors.

Researchers also noted that when people have a strong feeling of meaning in their lives, their will to live may encourage heart health-promoting behaviors, such as exercising, healthy eating, adhering to medical advice, and abstaining from excessive alcohol consumption or smoking.  

Learn more about our work in Positive Health.

Meet the Innovations for Health Competition Finalists!

Mar 19, 2012, 3:19 AM, Posted by Pioneer Blog Team

Last year, the Pioneer portfolio partnered with Ashoka Changemakers to launch the Innovations for Health: Solutions that Cross Borders competition to find health care solutions from anywhere in the world that have the potential to be applied in other countries to improve health and health care.

After nearly 400 entries from 73 countries, we’re pleased to announce the finalists, and share a blog post with more details from Ashoka Changemakers. Stay tuned for the winners announcement on April 16!

Feeling Optimistic after SXSW

Mar 15, 2012, 3:21 AM, Posted by Steve Downs

On Tuesday I had the privilege and the pleasure of serving as a judge on the health panel at the South by Southwest Accelerator. It's a great gig, getting to hear pitches from three startup companies that had been winnowed down from a field of dozens. And the companies were terrific—each is tackling an important challenge with imaginative solutions and great technology.

First up was Simplee. Simplee is positioning itself as the Mint.com of health care expenses. They've developed a service that reads through your insurance company accounts and displays your medical expenses in dashboard form—how much each family member has spent toward their annual deductible, for example.  They also explain the unexplainable—the "explanation" of benefits (EOB) statements we always get from our insurance companies, showing you what insurance covers, what you have to pay out of pocket, and why.  I'm on record (at last year’s Heath 2.0 conference) as saying that if Simplee can pull this off, co-founder Tomer Shomal should get a Nobel prize. While maybe not getting to that level of hyperbole, anyone who has regularly waded through these EOBs can relate to what I'm saying. They're starting with this basic problem of tracking and explaining expenses, but have the potential to go much further—facilitating bill payments, offering context-sensitive preventive reminders, and, as they get enough data, enabling comparison shopping for medical procedures. Best of all, you can try it today—Simplee.com.

Ginger.io then came on. As I've written before, I believe that the data we can capture about our day-to-day lives (observations of daily living) can greatly inform the care we receive and, as researchers start to mine it, it will become the source of new knowledge about what makes us healthy or sick. (Pioneer's Project HealthDesign has been focusing on this opportunity for the last couple of years and will soon have some research results to share.) Ginger.io focuses on a particular slice of this data—the data stored on our smartphones. They can capture social activity (calls, texts), geographic movement (GPS) and physical movement through accelerometers. Their twist is that they're really smart about processing the data and finding meaning in it. They're able to establish a behavioral signature and then identify any deviations from it, which can be important feedback for the user but also potentially for a clinician trying to improve a patient's health. Ginger.io is a spinoff from Sandy Pentland's lab at MIT (see his Pioneer- funded paper on reality mining) and by focusing on the smartphone data, they're avoiding the challenge of getting people to record anything—it's all passively collected. Currently, they're working through researchers and early adopter physicians.

The third and final presenter was Medify, which is working to bridge the gap between very high health information resources like WebMD and the medical literature. They have a robust natural language processing operation that is "reading" (crawling?) all the medical literature and coding it (i.e. intervention, disease, study population, conclusions and other attributes). The user can then get a summary along the lines of 15 studies on a total of 3,000 subjects, five of the studies showed that the intervention was safe and four showed that it was effective. You can then drill down and look at more detail and other dimensions like freshness of the research. I'm not doing it justice with this summary— you need to see it for yourself to get a feel for it. The key is that it takes the complexity of the literature on any given condition and/or treatment and starts to tame that complexity, which, as anyone who has gone Googling in search of deeper medical knowledge can attest, is a big deal. Like Simplee, you can use Medify today at medify.com.

Three exciting companies—each with the potential to bring great value to important challenges in health and health care in very different ways. In the end, the winner was... Ginger.io. Congrats to Anmol and Karan for the win, but also to the teams at Simplee and Medify for their creativity, ingenuity and terrific progress so far. These companies, along with seven other excellent candidates, are cause for optimism.

Congratulations to Scott Johnson, an Inspirational Innovator

Mar 14, 2012, 4:28 AM, Posted by Nancy Barrand

Tonight in Washington, Scott Johnson, the CEO of the Myelin Repair Foundation (MRF), will be honored as the recipient of the prestigious Gordon and Llura Gund Leadership Award from Research!America. The Pioneer Portfolio congratulates Scott and the MRF on what has been truly pioneering and inspiring work.

Scott, an engineer by training, is a Silicon Valley entrepreneur who has lived with multiple sclerosis since 1976. His keen desire to improve treatment led him to start MRF in 2004. Though RWJF does not fund biomedical research nor focus on specific diseases, we saw MRF’s Accelerated Research Collaboration model as pioneering a new approach to biomedical research – one that had the potential to speed the process of discovery.

With the help of RWJF’s support, MRF piloted the Accelerated Research Collaboration model. The model re-engineers the painfully slow and siloed research enterprise into a collaborative venture to accelerate discovery and move more potential candidates into the pipeline for development of new treatments. From 2005 to 2008, MRF researchers produced 50 peer-reviewed articles, pinpointed 19 new pathways and therapeutic targets for myelin repair, identified 24 new tools for neurological disease research, and filed applications for nine patents, with eight additional applications in the works.

In the process, MRF’s work shifted the field of MS research to focus on myelin repair as the more promising avenue to slow progression of the disease and develop treatments. But as significantly, his fresh view of the biomedical research process – based on how it can and should work, not how it has been traditionally conducted – will shift the future.

The RWJF Pioneer Portfolio is proud to have supported such innovative and life-changing work, and we congratulate Scott Johnson on receiving this much-deserved honor.