Empowered Patient Podcast

Karen Schatten, the Associate Director of the National Board of Physicians and Surgeons, is encouraging consideration of alternative paths for continuous certification for board-certified physicians and surgeons. Since 2000, a bureaucratic process has been mandated for this ongoing education. NSPAS aims to modernize and disrupt this process by offering an alternative path for continuing education that addresses physician burnout and provides relevant training to stay current in their medical specialties. Karen explains, "The reason why the bureaucracy persists is, despite it not being really proven and physicians really having to collectively protest it, that requirement we now know after studying it for a number of years is it is actually more expensive. It's more burdensome. It creates a lot of irrelevant administrative burdens. Those forced programs are not a great match for physicians and what they do in day-to-day practice. It's often not clinically relevant and plays a critical role in exacerbating physician burnout and loss. So, we set out to change this sort of old-school thinking. That's what we exist to do, to provide that competition and choice in that continuing certification market for physicians." "It's the problem of the monopoly on continuous certification. So, the same organization that provides the initial board certification exams also reports to the entire world who is board certified. The problem has come into play for physicians and worsened access to care issues because if physicians refuse their part two or continuing certifications, the organization has, since about 2012, listed physicians as not certified in these databases." "What's important to NBPAS is we've concerned ourselves with putting forth what we know works and what is evidence-based. The continuing education program that has a monopoly control over physician's livelihood has not been proven to impact patient outcomes and physician-led care. So what we've tried to do and how we've tried to forward our continuing certification pathway is to get accepted by all the major national accrediting bodies in the United States." #NBPAS #PhysicianShortage #PhysicianBurnout #BoardCertification #MedicalCredentialing #Healthcare NBPAS.org Download the transcript here

Phoebe Souza is the clinical lead for mental health at OncoHealth, a digital telehealth platform focusing on personalized oncology-specific support for patients with cancer and their caregivers. Advanced care planning is how individuals can communicate their wishes for care that aligns with their values. Phoebe highlights the role of healthcare providers, including oncologists, in initiating conversations about advanced directives to ensure patients understand their options. She emphasizes all individuals over 18 should document their desires for medical care in the event they are unable to do so themselves. Phoebe explains, "Advanced care planning, also called ACP, is an umbrella term that includes both communication skills, so conversations with loved ones and a person's medical team, as well as completing documents such as an advanced directive, and that helps a person make plans about their future healthcare. An advanced directive and a care plan serve as a roadmap for medical providers and loved ones to ensure that an individual's wishes are honored if they are seriously ill and unable to communicate what they would want in terms of care." "I think of the ACP as being appropriate for any person with any health status over the age of 18, and as humans, we live with vulnerability. It's great to be proactive about writing down and communicating the type of care that you would want, and you would not want in certain situations. It aligns with our values, and it's an act of care and a gift for those who would be making those decisions for us. Specifically, for individuals living with a serious illness, it's critical to think about what type of care aligns with what they imagine for them and aligns with their quality-of-life goals." "OncoHealth, more broadly, is supporting different ways to support individuals and families who are living with both the emotional and physical symptoms of cancer. One aspect of that is working to empower individuals and families to think about how to advocate for their needs and their care while receiving cancer treatment. We offer, specifically looking at our mental health team, opportunities to work closely with a mental health therapist to explore the emotional side and empower those skills for communicating their needs to their medical team." #OncoHealth #Healthcare #AdvancedCarePlanning #ACP #PatientEmpowerment #PatientCare #MentalHealth #Oncology #Cancer oncohealth.us Download the transcript here

Dr. Stephanie Lahr, President of Artisight, is promoting the concept of Smart Hospitals and ambient technology's role in improving healthcare delivery. Hospitals can use sensors, cameras, speakers, microphones, and screens to address the increasing complexity of patient care while allowing clinicians to focus on patient care. These technologies are designed to integrate seamlessly into the clinicians' workflow with a focus on process automation and applying AI to drive the convergence of technology and medicine. Stephanie explains, "A Smart Hospital is a hospital that is equipped with sensors and other kinds of elements that can capture information based on what's happening in real-time and leverage that information in real-time to help automate communication, automate documentation, and send signals. So, in your own home, you might think about a smart home where your thermostat has different elements that can sense when there's no one in the house, and it will change the temperature to be more economical." "Those kinds of things we can do in a hospital by having sensors, things like cameras, speakers, microphones, potentially temperature sensors, and other things that capture information in real-time and then can do something with that information. We can leverage technology to a greater degree in hospitals, knowing that we want to have that information, but historically, what we've done is capture that information through manual means." "When a patient is wheeled into an operating room for a surgical case, it is a requirement currently that an individual goes over to a computer system and marks a box that says the patient has now entered the room. We need to track closely how long a patient is in an OR for a variety of quality purposes. What a Smart Hospital would do, is allow sensors, things like computer vision to capture that ambiently in the space, so when the camera senses and sees that a patient in a bed is entering an operating room, we can automate that documentation." #Artisight #AI #VirtualNursing #SmartHospitalPlatform #SmartHospital Artisight.com Download the transcript here

Dr. Steve Marcus, CEO of Cantex Pharmaceuticals, emphasizes the importance of the RAGE receptor in diseases like cancer and inflammation. Their lead compound, azeliragon, blocks the activation of the RAGE receptor and shows effectiveness in inhibiting cancer metastasis and enhancing the impact of radiation. Clinical trials are underway for breast cancer, pancreatic cancer, glioblastoma, and COVID-19. This approach addresses the cancer cells and the microenvironment in which they reside to reduce disease progression and alter the immune environment. Steve explains, "RAGE is a receptor on the surface of cells that sends signals to the cell that can either enhance or harm health. When over-activated, RAGE has been implicated in a wide range of inflammatory diseases and cancers. In cancer, in particular, over-activation of RAGE has been associated with both the invasiveness of cancer, with the progression of cancer, and with metastasis of cancer." "Azeliragon blocks the binding of anything that can activate RAGE. The molecules, the proteins that bind to RAGE, are collectively called ligands, ligands meaning something that ligates or binds to the receptor. What azeliragon does is it binds to the receptor. It binds to the portion of the receptor that accepts the ligands and, therefore, blocks the binding of all the ligands. So it's a little bit like if you imagine a lock and the key, and it's almost like putting gum inside the keyhole so the key won't fit in. It's the same type of thing whereby by binding to the receptor, none of the ligands can bind to it." "One of the attractive things about azeliragon is that it's a capsule. It's a pill taken by mouth. Originally the drug was developed for Alzheimer's disease, and we're repurposing it as a treatment of cancer. In those early clinical trials in Alzheimer's disease, it was remarkably safe. Patients had very little, if any, side effects from the drug. It was comparable to the placebo arm of the clinical trial. The drug is taken once a day by mouth. In the early clinical trials, it was taken for as long as 18 months every day. Another attractive thing about this is that the tumor will be exposed to the drug every day because the person is taking the drug every day." #Cantex #RAGE #RAGEReceptor #Azeliragon #PancreaticCancer #Glioblastoma #Cancer cantex.com Download the transcript here

Alex Nemiroff, General Counsel at Praxis Precision Medicines, focuses on developing life-altering treatments for pediatric patients with epilepsy, particularly those with genetic epilepsies known as Developmental Epileptic Encephalopathies- DEEs. Praxis targets specific gene mutations SCN2A and SCN8A with therapies that precisely target the source of the disease. Lead drug candidate PRAX-562 is a precision small-molecule treatment that inhibits seizure-causing activity, and PRAX-222 is a type of RNA therapy that shows potential for complete disease modification. Alex explains, "There are a number of types of epilepsy. At Praxis, we focus on a few. We have a broader focal epilepsy program, and then we have a number of programs targeting these genetic epilepsies that are referred to as DEEs, Developmental Epileptic Encephalopathies. These are epilepsies that start in infancy, and they're tied most commonly to a mutation in a gene that is known to cause epilepsy. Specifically, we have at Praxis right now in the clinic, programs aimed at mutations in the SCN2A and SCN8A genes. So these are SCN2A DEEs and SCN8A DEEs." "What we've tried to do, and it's been the goal of Praxis since its inception, since I got connected to this company, is to target these mutations as close to their source as possible. The name is Praxis Precision Medicines very intentionally because what we believe these medicines are doing is precisely targeting the source of the disease. Relatively speaking, as close as we can get. These are not gene therapies. What we have in our pipeline right now and in the clinic are RNA therapies, which are these antisense oligonucleotide therapies, and then also small molecules that are more precisely targeting key components of the diseases." "This is a big part of where the problem lies because the treatments that exist today, for the most part, are not precise to the specific cause of the disease. What we see with these genetic epilepsies- and again, specifically, we're focused on SCN2A and SCNA8A – there are no treatments other than the ones that Praxis are developing that target these mutations specifically. So what a doctor has to do, and what they did in my son's case and all of these other patients' cases, is they just start throwing these broad-based anti-epileptic medications at the child, and essentially, it's a trial and error process." #Praxis #Epilepsy #PediatricEpilepsy #SCN2A #SCN8A #CNS praxismedicines.com Download the transcript here

Arnon Chait, President and CEO of Cleveland Diagnostics, discusses the role diagnostics play in accurately identifying those patients most at risk for cancer. The current PSA and related tests are used to diagnose prostate cancer to determine if additional diagnostics are necessary. By identifying the stage and treatment options with a more specific blood test and AI-aided identification, doctors and patients can make better informed decisions about further testing or imaging. Arnon elaborates, "A long time ago, in the late '80s and more in the '90s, a new test called prostate-specific antigen came to the market. It is a simple blood test, which is great and offered a glimpse at the important information for the first time. Before that, it was never available to either a PCP, to a private GP or a urologist, whether you have potentially prostate cancer or not." "The biggest issue in the industry today, and in the clinical world especially, is what to do with the information. Because some of this information requires downstream diagnostics tests, further diagnostics are highly invasive. So now you ask how accurate they are, and what is the false positive rate? So the key thing to ask always when you have new technology is, what is the cost to the entire system of this technology?" "We want to find and focus on technology that can look at very, very few markers, but in a correct way. Instead of, for example, looking at DNA, which is information available in your body but is very far from the disease itself. Some of it, namely information in DNA, may say something about cancer but may not. So, it's not that specific." #ClevelandDiagnostics #CDx #ProstateCancer #ProstateCancerAwareness #IsoPSA #Diagnostics #MedTech clevelanddx.com Download the transcript here

Lora Sparkman, an RN and VP and Partner of Clinical Solutions, Patient Safety, and Quality at Relias, highlights the high maternal mortality rate in the US and the factors that contribute to it. Lora emphasizes the need for standardization of definitions and a better understanding of the social determinants of health that influence the success of a pregnancy, including the need for pre-pregnancy and post-pregnancy healthcare. Digital technology is bringing advancements to healthcare education and helping overcome geographic barriers to improve outcomes and reduce maternal morbidity and mortality. Lora explains, "In some cases, we're getting our hands around the real story versus some variation across states and definitions, and how death was categorized, those types of things. Putting that all behind us, there's been a lot more work and effort at the federal and national levels to standardize definitions and categories." "There's been kind of a shift we've seen over the last couple of years, which is we've been very focused on the death rate, again, but that's kind of like, what's leading up to that? Why are we having so many deaths? We're starting to understand and see that we need to focus on pre-pregnancy health, general health, and access to healthcare during pregnancy. Severe maternal morbidity affects about 50,000 to 60,000 women each year. Those numbers are growing." "No matter where pregnant people are getting their care, our aim and the work that we've been doing at Relias is focused on standardization of using care delivery and protocols and making sure that physicians, nurses, midwives, or anyone who is caring for pregnant people, are utilizing evidence-based guidelines, are aware of the latest evidence-based in research in areas like hypertension, and obstetric hemorrhage, and substance use disorder in pregnancy." #Relias #Nurses #MaternalMortality #MaternalMorbidity #Pregnancy #WomensHealth #ClinicalTraining #SDOH Relias.com Download the transcript here

Mei Mei Hu, the CEO and Co-Founder of Vaxxinity, focuses on an approach to vaccines that aims to break immune tolerance to get the body to produce the antibodies to target self-antigens causing chronic conditions. Initial trials are being conducted to slow the progression or prevent the onset of Alzheimer's, Parkinson's, and hypercholesterolemia. Motivating this effort is the desire to democratize health and make transformative medicines available to a larger population at a lower cost. Mei Mei explains, "Interestingly, in 1900, the average global life expectancy was 32. Today, when you hear someone died at 79, you're like, oh my gosh, what happened? We get these two bonus lifetimes now, and those three lives total for three main reasons. The first is the Green Revolution feeding us all. The second is hygienic plumbing, and the third is vaccines. But when we think of vaccines, they're usually crying babies or kids pre-COVID. What they did was able to banish the biggest diseases of our early lives." "What we're looking to do now at Vaxxinity is do the same thing but for the diseases plaguing us in our second and third lives. That's why we go after things like Alzheimer's, Parkinson's, hypercholesterolemia, which is a leading cause of heart disease. We're going after big population health things, and the best way to do them is with a vaccine approach." "One of the main attributes of a vaccine is that it trains your body to attack pathogens or causes of disease. In our case, we're just teaching your body to produce drugs that help neutralize things like cholesterol, plaques, or CGRP, which is the culprit of migraines. That's what we mean when we talk about creating a vaccine for a chronic condition." #Vaxxinity #Vaccine #Parkinsons #Alzheimers #ChronicDiseases #ClinicalTrials #DemocratizeHealth vaxxinity.com Download the transcript here

Dr. Karlene Kerfoot, Chief Nursing Officer at symplr, points out the challenges nurses and doctors face when dealing with technology in the workplace. The disparate systems and lack of data integration make it difficult for clinicians to perform necessary duties and have moments that matter: time to provide the kind of care patients require. Karlene highlights the potential for AI and robots to alleviate some of the inefficiencies in the workflow and the need for frontline staff to be part of the decision-making process to ensure advanced technology solutions meet real needs. Karlene explains, "We do have to deal with the technology to make it easier for people to work. For example, the nurse manager, when they want a staff and schedule, sometimes they have to go through six to eight disparate systems that don't talk to each other. So they have to go into one system and then out, and another system and out, and another system and out. So, at the end of the day, they're quite fatigued and have a lot of technology burden. They don't have time to do what they're supposed to do, which is look at the quality of work with patients and help new nurses." "We have to run those systems by the people who use them because often, when you say to physicians, "Here's a great system." They say, "Well, that's not the way I think. That doesn't work for me." Or if you say to a nurse, "Here's a great system for you." They say, "Well, it doesn't work because we have to do all these workarounds because it doesn't really include everything we want." "We had a little funeral for all the fax machines and put a big black curtain over them so people couldn't use them, and we said, "It's dead." And so that, in a funny way, sort of forced people to see if they could use the computer and not use paper and not use fax machines." #symplr #MomentsThatMatter #Burnout #HealthcareTech #PatientCare #Nurses #HealthTech symplr.com Download the transcript here

Retired Brigadier General Dr. Steve Xenakis is Executive Director of the American Psychedelic Practitioners Association, a group of clinicians who are interested in developing and promoting the mainstream use of psychedelic and plant medicines for the treatment of mental health conditions. APPA works to educate practitioners on best practices and explores AI's potential role in identifying patients who could benefit from psychedelic therapies. Steve explains, "This is a multidisciplinary group. As the treatments unfold, we're seeing it's multidisciplinary. We have psychiatrists, psychologists, social workers, advanced nurse practitioners, and physician's assistants because it's a team approach. When we look at the best treatments and therapies, these people come together. They can collaborate in terms of not only prescribing the medications but also conducting the therapy and supporting the patients who come to them for help." "They've come into this organization because they realize that to promote these treatments and therapies there needs to be a pathway to mainstream them into US healthcare. For many, for the past several decades, a number of practitioners have been using these medicines compounds and treatments. Still, they've had to be in the so-called underground because, since 1972, the use of MDMA and psilocybin has been illegal. And only recently have we seen ketamine be used. And there are other substances." "As we think about it, and particularly with the momentum with MDMA and psilocybin in getting approval from the FDA, there's an interest in now bringing this out upfront and getting them into US healthcare and to go through what the processes are to get that done. That's how this organization has come together and been conceived." #APPA #AmericanPsychedelicPractionersAssociation #MentalHealth #Psychiatry #Psychedelics #AlternativeTherapy #PTSD #MDMA #Psilocybin #AI appa-us.org Download the transcript here