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Virtual Reality coming to a Hospital near you
Virtual Reality is picking up tremendous speed and it is easy to see why. It’s potential is tremendous. In the following slides you will see once again the exponential trend in technology and its implementation impact on different fields. From a device created by Ivan Sutherland in 1965, which was so heavy that it needed to be attached to the ceiling to the Oculus Rift prototype created in a garage by Palmer Luckey (18) who then sold it for 2 billion dollars to Facebook.
Observe the number of devices created, in addition, they are now being incorporated to brain computer interfaces. This opens a whole new field for research potential, medical education, and therapeutic treatments. Imagine what this could do in a nursing home, cardiac rehabilitation? Virtually Teleporting patients to a beach, museum, or the rehab center?
The speed in which this and other technologies get incorporated into our profession is directly proportional to the number of individuals trying to do so. One of the beauty’s of VR is that anyone can experiment with it if they so please for 5-30dlls. Just get google cardboard and download the app to your android phone and see what the big fuzz is about. Got an iphone? No worries, this technology is soon to arrive to iOS also. Apple plans here, seems it will be available in the iPhone 6s.
I am currently working on interesting projects that I will mention later, but I wanted to create a small introduction since I have been getting a lot of questions!
Social Media DOES impact number of Views in a Scientific Article
A recent article was published in Circulation “A Randomized Trial of Social Media from Circulation” that concluded “A social media strategy for a cardiovascular journal did not increase the number of times an article was viewed”. Social Media use involved postings on the journal’s Facebook and Twitter feeds.
Social Media is not about just posting, sharing and retweeting. There are many variables that play an important role on how social media would impact a particular outcome. 1) Who is doing it? 2) How many followers the individual have and what type of followers are they. 3) Timing is key, there are studies out there showing when is the correct time to use Twitter, Facebook, Linkedin, WordPress in order to get the most traffic. 4) In addition, articles should not only be available to physicians. We live in an empowering world, with intelligent patients that also want to learn about medical advances and many are more than fit to understand our articles even without a medical degree, this I guarantee. Therefore cost is definitely an issue and this is the reason why sometimes the summaries made in blogs regarding a particular article get thousands of more views than the original content.
Social Media is not just about posting, there is truly an interesting art behind it. From eloquent titles to intriguing eye captivating graphics. An fantastic platform that not many physicians are aware of is Reddit. This is a precious resource if you know how to use it properly but watch out there are also dark corners involved. In reddit just choose your particular field of interest (called a subreddit) and dig in. The Subreddit SCIENCE is particulary interesting, full of intelligent individuals who offer amazing knowledge in their discussions. Yes, also a lot of trolls but an interesting “world” nevertheless.
My point? Well my point is that Social Media does affect number of views and even though I congratulate the authors efforts I do not necessarily agree with them . Below you have an example of an article I was following in http://reddit.com/r/science. In the morning and then 6 hours later. It was coincidentally an article AHAJournals “Adherence to a Mediterranean Diet and Prediction of Incident Stroke”
Just from reddit, this article got at least 133 views (people can upvote and downvote and article, number goes up and down depending on this). Now look 6 hours later how many people actually LIKED the post 3123. This means that thanks to reddit this article got at least 3123 views of which some of this individuals went to share the article in their own personal social networks.
This is just one example of how Social Media DOES impact how our findings and articles get seen.
Holidays are great but they can also be bad for your HEART!
In 2004, Phillips et al, published an article in Circulation (@circaha) that found an increased mortality around Christmas and New Year. We can even appreciate a a trend upwards since Thanksgiving. For cardiac and noncardiac diseases, a spike in daily mortality occurs during the Christmas/New Year’s holiday period. This spike persists after adjusting for trends and seasons and is particularly large for individuals who are dead on arrival at a hospital, die in the emergency department, or die as outpatients
Holidays are a season in which we gather with family and friends. We enjoy good food, a couple of drinks. People with cardiovascular disease, or heart failure, crossing the thin red line of “balance” can be easily done.
Why does this happen? Some proposed but not tested possibilities
1) Respiratory Diseases: Did you get your flu shot? Respiratory disease increase in winter, and on individuals with underlying diseases, this can tip them over the age. Pneumonia, Upper Respiratory Tract infections, leading to decreased oxygenation, increased cathecolamine surge, leading to ischemia, etc.
– In summary! Get you flu shot if you have not done so
– Stay warm 😉
2) Emotional Stress
– Relax, and meditate. I can not prescribe you medication but I can recommend you some apps
– HeadSpace
– Mindfulness app
– Buddhist Meditation Trainer
– Buddhify 2
3) Changes in Diet and Alcohol consumption
– We might tend to indulge ourselves in these days. Remember that family members with history of heart failure, heart attacks, underlying hypertension, might not do so well with the task holiday foods. Increased Salt in foods in addition to quantity intake can predispose patients for increased water retention, causing a Heart Failure exacerbation and thus hospital admission
– They can eat everything, but with moderation
– Alcohol consumption as well as coffee and caffeinated drinks are important. We also see a trend in these parties for energy drinks mixed with alcohol. THIS IS HORRIBLE COMBO which can lead to the Happy Holiday Syndrome. In brief, arrhythmia.
Potential Mechanisms for the “Merry Christmas Coronary” and “Happy New Year Heart Attack” Phenomenon
1. Inappropriate delay in seeking medical attention
2. Reduced levels of healthcare staffing or fewer staff members who are familiar with individual patients during holiday on-call schedules
3. Increased emotional stress
4. Overindulgence (eg, increased intake of food, salt, fats, alcohol) <—– WATCH OUT
5. Increased respiratory problems (eg, upper respiratory infection, influenza, particulate matter generated from wood-burning fireplaces)
6. Colder weather, leading to increased vascular resistance, coronary spasm, hemostasis and thrombus formation, O2 demand
7. Decreased hours of daylight
8. “Postponement of death” concept
Relevant Articles:
1) Cardiac Mortality Is Higher Around Christmas and New Year’s Than at Any Other Time The Holidays as a Risk Factor for Death
2) The “Merry Christmas Coronary” and “Happy New Year Heart Attack” Phenomenon
Medical Records were not meant to be “Sugarcoated”
I have spoken recently with several doctors that are changing the way they write their notes and thus relevant patient information. Why? Simple, a great thing is happening, patients are beginning to embrace digital health , learning more about their diseases/conditions and accessing, studying and understanding their medical records.
Here is the kicker…Sometimes in life we hear others addressing personal issues that even though they are true, they are uncomfortable to hear. Some can easily ignore them, others may feel insulted and/or aggravated. This is extremely important to YOU, yes you who is reading this, since you now have easy access to your Medical records.
Medical records are not meant to be a story. They were not made to be easy on our ears. They are scientific data used to capture facts. They are the mixture of years of training, medical knowledge, experience, and a patient-doctor relationship.
Why is this important? A chart might say; Mr. X is a delightful, pleasant individual, who exercises daily and is very involved with his health. Fantastic right? Well yes but the opposite is true. Mr. X can also be obese 57 year old individual, with a 20 pack year history who is not compliant with his medications. Mr. X mentions that he has no money for his medications but yet he is able to buy a pack a day of cigarettes. The latter, mentions facts that are not pleasant to hear but may be the truth.
I am now encountering physicians, being contacted by their patients, arguing that they do not appreciate being called obese in the note. They do not appreciate hearing that they are not compliant when obviously they are not. Since physicians do not want to aggravate more people then they reword or simply refrain from placing particular information in the chart. Information that other physicians will find valuable because it can change the way they will address the case.
Bottom line is, when WE encounter this situation, before WE get angry we have to reflect and ask ourselves, “Is this true?”
I have modified my lifestyle thanks to comments like this. Comments that were not easy to digest but the truth nonetheless.
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September 27, 2014
* EDIT1: If you would like to engage on a conversation regarding this post, it has been posted in reddit http://www.reddit.com/r/medicine/comments/2hkzag/are_we_entering_the_era_of_sugarcoating_medical/
* EDIT 2: Thanks to Dr. Jack Minas for sharing “Interview with Eric Topol: Do Docs & Patients See Eye-to-Eye?” Interesting comment here “54% of patients say they own their medical records vs 39% of doctors who say they own them. Although there is confusion on the part of doctors and patients, but some medical associations are pretty clear that the records belong to physicians. Check this out: The Texas Medical Association states, “Although the medical record contains patient information, the physical documents belong to the physician. Indeed, the medical record is a tool created by the physician to support patient care and is an asset of the practice.”
Christian Assad, MD Interventional Endovascular Cardiology
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