Empowered Patient Podcast

Dr. Anupam Jena is an economist, a physician, a podcaster, and the Joseph P. Newhouse Professor of Healthcare Policy at the Harvard Medical School. He's also the co-author, along with Dr. Christopher Worsham, of the newly published book Random Acts of Medicine: The Hidden Forces that Sway Doctors, Impact Patients, and Shape Our Health. Anupam, also known as Dr. Bapu, combines his medical training with curiosity about cause and effect to explore explanations for failures and successes in providing healthcare and how chance occurrences affect our health. Of particular interest is the power of natural experiments to enhance understanding of the effect of a treatment or drug within a larger universe than traditional randomized clinical trials.   Bapu elaborates, "One of the benefits of these natural experiments is that they are more generalizable. They tell us what might happen in a real world because you're exactly right. If a clinical trial is performed, it may be performed in a very particular geographic area, in a very particular type of patient that is not the same as the type of person who might take that medication in the real world." "I don't think that we should be making whole-scale treatment decisions without randomized trials. So those are the gold standard, and we need them to be there. They provide an important foundation." "But it's also important to know that they do have some limitations because we might not be able to do a randomized trial on every population person that we care about. That's where the natural experiments come in. I think they really are complements and not substitutes because once we have a sense that this medication does work based on randomized trials, then we can do natural experiments to say, "Well, they might work better or not as well in these particular populations of people." "So it's no surprise to people that randomness or chance does affect our health in ways that we can appreciate. For example, a child drowns in the swimming pool because, just by chance, someone gets distracted in the moment, or someone is hit by a car. Again, totally random events. In many cases, a cancer, when there are no risk factors, that's unpredictable and it's a chance event." #RandomActsofMedicine @DrBapuPod @AnupamBJena @DoubledayBook    Random Acts of Medicine Download the transcript here

Will Cantrell is the Director of Product Solutions at InteliChart, a SaaS-based service providing digital tools to providers and EHR partners. Their focus is on the workflows of staff and clinicians and the patient experience in a telehealth environment or in-person appointment. InteliChart integrates existing systems with innovative technology to facilitate scheduling, reduce clinician stress, encourage preventative care, and better manage chronic diseases. Will explains, "We focus more on workflows for staff to move in between patient visits, initiate sessions, put patients back in waiting rooms, move them between providers, and the patient experience is our primary focus. We can spend a lot of time building that in, not just to a telehealth workflow but into the entirety of the patient journey, and trying to bring that back to the patient portal, which is the hub of engagement for us. So, the patient gets more of a seamless experience through all their touch points." "You don't have to worry about travel time and shifting between rooms, so you have some savings there as well. The nice thing about telehealth, too, is if the patient queues up early into the waiting room, and you're early, you can grab that patient and start to have that visit with them early, at least from our dashboard. Once you go through that, you can move on to the next patient, who is early. So you have some room there to make gains and have advantages from a time savings over in-office visits." #InteliChart #PatientEngagement #Telehealth #Telemedicine #HealthIT #HealthOutcomes InteliChart.com  Download the transcript here

Dr. Björn Mellgård, VP and Global Program Lead of rare genetics and hematology at Takeda, is passionate about finding a cure for cTTP, congenital thrombotic thrombocytopenic purpura.  This ultra-rare disease, caused by an enzyme deficiency, presents in early childhood and results in life-threatening blood clots. With their investigational drug TAK-755, a recombinant enzyme, the volume is very small, and the infusion takes four to five minutes and is a replacement therapy to allow patients to avoid daily symptoms and acute episodes. Björn explains, "What happens then is that we have our coagulation system, and many people have heard about bleeding disorders, mainly probably hemophilia, where you lack certain factors which are important to make the blood clot. TTP is on the other side of the spectrum, and the deficiency we're talking about, this ADAMTS13 enzyme, is also importantly involved in blood coagulation." "But the effect is when you don't have this enzyme present. The blood has a tendency to spontaneously form blood clots in the circulation. And these blood clots then tend to lodge in critical organs such as the brain, the heart, and the kidney, and the patients then suffer symptoms based on that." "So, our drug then represents a recombinant enzyme. So, it's a recombinant protein that is produced in a laboratory. It's exactly the same as we have in our bodies. And this kind of replacement therapy has been used for a long time. And I mentioned hemophilia as an example where Takeda and also other companies have recombinant factor VIII in that case. So, the principle behind this treatment is to give the patient what they're missing. That's pretty straightforward in some sense."  #Takeda #cTTP #TAK755 #RecombinantEnzyme #RareDisease Takeda.com Download the transcript here

Steve Taddei, Co-Founder and Lab Director of HearAdvisor created to provide unbiased, scientifically-based analysis of over-the-counter hearing aids. With recent legislation allowing hearing aids to be sold directly to consumers and online, there is a need for a clear understanding of the features and benefits of available audio-enhancing technology. Using a life-like mannequin equipped with microphones, HearAdvisor can perform repeatable experiments to test the hearing aids across several categories and rank them for different purposes. Steve explains, "Selecting devices that we found to perform best was quite a process, and I would like to say that HearAdvisor is an independent lab. We are not owned by any hearing aid company. We're kind of three hearing technology nerds or just audiology nerds, people who love sound, acoustics, and hearing. We saw this problem, we came together, and we used as best as possible, the scientific approach to make recordings of all these devices. These recordings emulate, as best as possible, what an individual may experience in the real world." "So, multi-talker situations where you have one, two, or three people speaking, with various types and levels of background noise. We make recordings with all the technologies, and we measure their performance through several different metrics. We don't need to get into all of them, but for example, algorithms that predict how well an individual with hearing loss might be able to hear speech in background noise." "Then we have an industry-standard mannequin, and the mannequin's name is KEMAR. It's an acronym for the product, but this mannequin emulates the average size shape of a human head and body, and it has little microphones where the eardrums are. So it's very similar and when we make recordings from our eight-speaker array, as it's called through our mannequin KEMAR, it emulates you sitting in that environment."  #HearAdvisor #HearingHealth #PatientAccessibility #HearingAids #OTCHearingAids #OvertheCounterHearingAids Hearadvisor.com Download the transcript here 

Dr. Zereana Jess-Huff, Senior VP of North American Operations at United We Care, a digital behavioral health company, created Stella. This advanced generative AI solution recognizes 40 human emotions and speaks 29 languages. Accessed through mobile apps and WhatsApp, this resource is interactive and available 24/7 to address daily stress issues and clinical diagnoses.  A clinician-led self-paced, asynchronous video-based clinical program is available, as is coaching and resource material. Zereana elaborates, "Stella is designed to meet and treat you where you're at on a behavioral health spectrum because, as individuals, we move up and down the spectrum at any given point in our lives. Stella is targeted to be able to treat the wide spectrum, and the solution as a whole is a full stack solution, which again allows us to treat the user from subclinical up to hospitalization in terms of treatment." "So we are working on avatars right now. The intention is to create human-like faces that come in a number of nationalities and different ethnicities. So essentially, you can create your own avatar for Stella based on what you're most comfortable with and what you would like your therapist to look like. Stella, again, is not a therapist, but Stella is somebody talking to you, and so we felt it was important to give Stella a face. We just wanted users to be able to relate to that face." "As the therapist is talking and as the user is talking, AI is essentially analyzing what the user utters. We call them utterances. So based on that, the AI can tell when the patient is disengaging in session. The AI can tell when somebody's decompensating, it can recommend when a therapist should switch course. So there are so many possibilities in terms of how AI will work to give behavioral health so much more power in sessions."  #UnitedWeCare #DigitalMentalHealth #MentalHealth #DrZereana #AI #GenerativeAI unitedwecare.com  Download the transcript here

Dr. Fahar Merchant, President, CEO, and Co-Founder of Medicenna Therapeutics, talks about the role cytokines play in managing the immune system, activating the system, or dampening the immune response depending on the circumstances.  When the system is out of balance, pathogens and cancers can attack, or autoimmune diseases can occur. MDNA11 is an engineered cytokine or superkine which can be used to effectively deliver drugs to treat a range of solid tumors. in addition, MDNA11 is being fused with a checkpoint inhibitor to both stimulate the immune system and reverse the exhaustion of cancer-fighting immune cells. Fahar elaborates, "Engineered cytokines, or superkines, essentially have been designed so that these molecules are much more effective, they're much safer to administer, and therefore have better outcomes than naturally occurring cytokines. So naturally occurring cytokines tend to be rather small. They clear the kidneys very, very quickly, so they're not in the bloodstream for long enough."  "The other thing is that some of these cytokines can be very toxic when administered in large quantities. Scientists at Stanford University looked at these cytokines. We'll talk about three cytokines, interleukin-2, interleukin-4, and interleukin-13, and thus engineered them in such a way that they can be much more effective, more potent, but at the same time much safer as well. So that's why we call them engineered. That's why we call them superkines because they are much more potent, much more powerful, than our own naturally occurring cytokines floating in our bloodstream." #Medicenna #Oncology #Cancer #Superkines #Cytokines #IL2 #Immunotherapy  Medicenna.com Download the transcript here

Dr. Sachin Dev is a former physician and previous Gartner analyst, currently overseeing innovation and transformation in RGP's healthcare practice. Sachin points to the changes during the pandemic that were required for telehealth solutions to meet the needs of patients and providers. The technology necessary to build these systems into hybrid environments must take advantage of generative AI and automation with a focus on value-based care.  Sachin explains, "When we look at it from our technology standpoint, we have seen some significant development in the technology. When we look at all the different innovations, especially in the healthcare industry, both on the payer and provider side, in the last two or three years since the pandemic, we have come along very well from a technology standpoint." "But, one thing that is lacking is the adoption. That's where, again, there's a big delta when we look at what kind of technology we have available today as to how that technology is utilized to improve patient care. There are a number of reasons why we lag from an adoption standpoint because, obviously, there's some financial pressure across our organizations." "When we look at our healthcare system, many organizations still have some sort of legacy tools or technology that they're currently using. It's a pretty big lift for the organizations to be able to get to a point where they're able to utilize all these new buzzwords or the high technology such as ChatGPT, generative AI, automation, hyper-automation in a way where they can translate the value of that technology in terms of patient care. Again, that has a significant impact on how that technology can be leveraged and utilized to further improve our patient care and the patient experience." #DigitalTransformation #RevenueCycleManagement #PatientExperience #HealthInnovation #HealthcareLeaders rgp.com Download the transcript here 

Dr. Paulo Garcia, Co-Founder of Kytopen, is developing systems to refine the types of payloads, including RNA, DNA, and CRISPR-Cas RMP, that can be delivered to primary T cells, primary Natural Killer cells, and CD34 stem cells. To maximize the number of successfully engineered cells, the Flowfect Discovery technology, using a non-viral approach, automates the process of cell engineering and gene delivery into cells while dramatically reducing the time to produce the cells. Paulo explains, "One of the key differentiating aspects of our technology is that we are using a continuous fluid flow format for the engineering of our cells. This fluid flow contributes to the delivery of these payloads to the different cells. And to put it into perspective, the flow rates that we use are quite large. They are in the tens of milliliters per minute. And if you translate that into a throughput of cells, you're talking about being able to process anywhere between 1 to 2 billion cells in 30 seconds. And these are large quantities of cells that have the possibility of being able to be then used not only in an autologous setting but also in an allogeneic setting in which many cells have to be administered to the patients in the different doses that are required." "No technology currently processes at the high-volume rates we're talking about. And generally, what is done today is a batch process. There are non-viral techniques, and there are viral techniques, but what is required is for these cells to be introduced into a bioreactor divide, let them grow to the relevant numbers, and then they can be administered to the patients. And with a process that leverages the throughput of the Flowfect technology that Kytopen is developing, you can really reduce the time these processes take. And that is the vein-to-vein time, and reduce it to numbers that are measured in days as opposed to in weeks or months." "Right now, our goal is to shrink the time that it takes from discovery to process development and into clinical manufacturing with the Flowfect technology that leverages different types of energy, mechanical energy, electrical energy, and buffer chemistry to give the best outcome and chance of the cells to be engineered and modified for the therapeutic applications of our partners." #Kytopen #CellTherapy #ClinicalManufacturing #CellEngineering Kytopen.com Download the transcript here

Tuvik Beker, CEO, and Ranit Aharonov, CTO of Pangea Biomed, have designed ENLIGHT, a computational platform driving precision oncology that matches cancer tumors with available therapies. Drawing on an understanding of synthetic mortality and synthetic rescue, this approach focuses on how the interaction between genes increases or decreases the tumor cell's fitness and the likely response to a drug. Determining which populations might benefit most from a drug opens the door to new treatments for common and rare diseases. Tuvik explains, "When we match therapies to patients, just according to the pure genetic characteristics of the tumor, sometimes we miss potential therapies, and sometimes we give patients therapies that do not work very effectively. To solve that, we developed ENLIGHT, which looks at the broader characteristics of the tumor, not just at the target gene, but multiple interactions, and that way, we can find potential therapies that are missed by the current guidelines and common biomarkers." Ranit elaborates, "So when we search for these interactions between genes, we look at a lot of available cancer data. We have a large database of a lot of cell lines that were treated and human tumors, and we know the survival of the patients and so on, but we don't need to know anything about what drugs they got. Our algorithms allow us, by looking at a lot of correlations between different activations of genes and survival and what happens to cells, we are able to find what are the pairs in the entire genome of genes that their co-activation affects the fitness or the tumor survival. And by knowing this, you can think of it as a sort of vulnerability map of tumors." "One of the things I haven't yet described and I think wouldn't have happened without this revolution is that we can now move a step further. When we look at a patient's tumor, we don't necessarily need to measure the RNA expression or the activation of genes directly. We can look at the tumor through a microscope using standard histopathology slides, the ones with the bluish and pinkish coloring that have been used for decades and are really available everywhere." #PrecisionsMedicine #Oncology #PrecisionOncology #RareDisease #Biotech #Startup #AI #MachineLearning pangeabiomed.com Download the transcript here

Gloria Caulfield is the Vice President of Strategic Alliances for Tavistock and Executive Director of the Lake Nona Institute, which is part of the Lake Nona Life Sciences Innovation and Wellness Community. Lake Nona is a planned city within Orlando, Florida, that is focused on the health and well-being of the citizens who live and work there.  One of the key economic drivers is the health and life sciences innovation cluster which includes the University of Central Florida College of Medicine, a VA Medical Center, and the Nemours Children's Hospital, a state-of-the-art pediatric healthcare system. Gloria explains, "There is no question that it's a collaborative community when you're building something this new and this unique. We have leaders of these institutions that have come from all different parts of the country to bring their careers here to focus on building this new ecosystem. It fosters a spirit of collaboration, which starts with Tavistock. Tavistock as the developer, we chair research councils and CEO councils and communication councils, and just a wide range of things to bring key leaders together just for that purpose." "One that I'll mention that's unique is the Lake Nona Performance Center, and the Lake Nona Performance Center is a medically integrated fitness facility. Again, going back to my initial comment that this whole community was built and designed with people, optimizing health and human potential is really at the forefront of our focus. This performance center is a nexus of multiple things. There's clinical care delivery, there's fitness services, there's sports performance, there's mind/body practices, all under one roof." "This community is the sum of the parts. We have these big anchor organizations, which I've mentioned. We have innovation centers. One of those is the leAD Accelerator. It's a joint venture between Tavistock Group, which owns Lake Nona, and the Adi Dassler family, the founders of Adidas. It was set up and explicitly designed to support some of the best young companies in the health and sports tech arena."   #LakeNona #Healthcare #Innovation #Community #LifeSciences #Wellness #SportsMedicine #HealthcareInvesting Tavistock.com Download the transcript here