To make remote monitoring devices interoperable, we must examine a variety of use cases and the current evidence of their effectiveness. The presentation is from the January 2020 IHE Connectathon in Cleveland, Oho.
Patient Engagement is more that an patient portal
Connected Health tools are available to enhance engagement
Personalization is needed to engage
How patient engagement technologies fit with population health
Helping those lacking health and digital literacy and access
The future is bright for Personal Connected Health
Patient Engagement is growing in importance as consumer expectations of healthcare providers change and as portals and other technologies improve. Early studies show affects on outcomes for patient engagement technologies
The Internet of Things (IoT) is the latest buzzword out of the interface between information technology and business. As technologies like Bluetooth and sensors enable connections between devices and networks, innovation has brought connections between devices and a human interface. In healthcare, this has been termed the Internet of Medical Things or Healthy things. Medical devices and consumer health devices generate data which can be analyzed, synthesized and displayed for the consumer and healthcare provider to get a broader picture of one’s health. Everything from fitness devices to glucose monitors can give us information about our current health status as never before. How this will integrate into a clinician’s workflow is a new journey of discovery as medical practice catches up with these innovations.
Personal connected health is currently characterized by limited thought leadership, insufficient coordination and collaboration, and a lack of awareness and understanding of the full potential by all stakeholders: public, providers, policymakers, industry and patients. The Personal Connected Health Alliance is defining the the field of personal connected health to inspire market and policy innovation, research and collective action for sustained adoption of personal connected health technology. The vision is better health and well being for all through increased personal responsibilities and connectivity as well as improved care delivery enabled by technology.
5 Business Strategies to Grow Your Telehealth EnterpriseVSee
To carry on the discussion in real life, join us at Telehealth and Secrets to Success Conference, Sept 20-22, Silicon Valley:
https://goo.gl/95zHZG
For more information of the presentation such as recording and transcript, please visit: https://vsee.com/blog/5-business-strategies-to-grow-like-zocdoc/
For other webinars:
https://vsee.com/webinars/
Or join our Linkedin Group: https://www.linkedin.com/groups/Telehealth-Failures-Secrets-Success-13500037/about
Or Join our Facebook Group:
https://www.facebook.com/groups/tfssgroup/?ref=group_cover
Patient Engagement is more that an patient portal
Connected Health tools are available to enhance engagement
Personalization is needed to engage
How patient engagement technologies fit with population health
Helping those lacking health and digital literacy and access
The future is bright for Personal Connected Health
Patient Engagement is growing in importance as consumer expectations of healthcare providers change and as portals and other technologies improve. Early studies show affects on outcomes for patient engagement technologies
The Internet of Things (IoT) is the latest buzzword out of the interface between information technology and business. As technologies like Bluetooth and sensors enable connections between devices and networks, innovation has brought connections between devices and a human interface. In healthcare, this has been termed the Internet of Medical Things or Healthy things. Medical devices and consumer health devices generate data which can be analyzed, synthesized and displayed for the consumer and healthcare provider to get a broader picture of one’s health. Everything from fitness devices to glucose monitors can give us information about our current health status as never before. How this will integrate into a clinician’s workflow is a new journey of discovery as medical practice catches up with these innovations.
Personal connected health is currently characterized by limited thought leadership, insufficient coordination and collaboration, and a lack of awareness and understanding of the full potential by all stakeholders: public, providers, policymakers, industry and patients. The Personal Connected Health Alliance is defining the the field of personal connected health to inspire market and policy innovation, research and collective action for sustained adoption of personal connected health technology. The vision is better health and well being for all through increased personal responsibilities and connectivity as well as improved care delivery enabled by technology.
5 Business Strategies to Grow Your Telehealth EnterpriseVSee
To carry on the discussion in real life, join us at Telehealth and Secrets to Success Conference, Sept 20-22, Silicon Valley:
https://goo.gl/95zHZG
For more information of the presentation such as recording and transcript, please visit: https://vsee.com/blog/5-business-strategies-to-grow-like-zocdoc/
For other webinars:
https://vsee.com/webinars/
Or join our Linkedin Group: https://www.linkedin.com/groups/Telehealth-Failures-Secrets-Success-13500037/about
Or Join our Facebook Group:
https://www.facebook.com/groups/tfssgroup/?ref=group_cover
Digital Health at UNC Chapel Hill CaDHRI Needs Assessment Reportcadhri_unc
A report on the current state of the digital health ecosystem at UNC Chapel Hill and the needs of researchers who are exploring digital health research opportunities. This needs assessment was performed by the Carolina Digital Health Research Initiative (CaDHRI).
Creating large scale telehealth network : A story from the USA by Adam Darkins, Vice President, Medical Affairs & Enterprise Technology Development, Medtronics, USA
Leveraging emerging standards for patient engagement pchamHealth2015
Patients are playing an increasingly important role in creating relevant healthcare data about themselves using mobile devices and applications. It is important this data can move with them securely throughout a healthcare ecosystem. The increased use of medical devices and mobile applications opens the dialogue around open source and non-proprietary standards with complementing policies.
Alan McDermott, Regional Director Patients and Information, NHS England
Masood Nazir, National Clinical Lead, Patient Online NHS England
Trevor Fossey, NHS England Patient Working Together Group
General information and trends in continuing medical education (CME), based on Accreditation Council for Continuing Medical Education (ACCME) 2012 Annual Report data and general market analysis for trends impacting education participation.
Digital Health at UNC Chapel Hill CaDHRI Needs Assessment Reportcadhri_unc
A report on the current state of the digital health ecosystem at UNC Chapel Hill and the needs of researchers who are exploring digital health research opportunities. This needs assessment was performed by the Carolina Digital Health Research Initiative (CaDHRI).
Creating large scale telehealth network : A story from the USA by Adam Darkins, Vice President, Medical Affairs & Enterprise Technology Development, Medtronics, USA
Leveraging emerging standards for patient engagement pchamHealth2015
Patients are playing an increasingly important role in creating relevant healthcare data about themselves using mobile devices and applications. It is important this data can move with them securely throughout a healthcare ecosystem. The increased use of medical devices and mobile applications opens the dialogue around open source and non-proprietary standards with complementing policies.
Alan McDermott, Regional Director Patients and Information, NHS England
Masood Nazir, National Clinical Lead, Patient Online NHS England
Trevor Fossey, NHS England Patient Working Together Group
General information and trends in continuing medical education (CME), based on Accreditation Council for Continuing Medical Education (ACCME) 2012 Annual Report data and general market analysis for trends impacting education participation.
In 2024, navigating the realm of healthcare requires staying ahead of the curve, especially in the realm of remote patient monitoring (RPM). "A Comprehensive Guide to Remote Patient Monitoring in 2024" serves as your indispensable roadmap in this dynamic landscape. This guide offers a comprehensive exploration of the latest trends, technologies, and best practices reshaping RPM, equipping both healthcare providers and patients with the knowledge to thrive in this rapidly evolving field.
As the cornerstone of modern healthcare delivery, remote patient monitoring has transformed the way healthcare is administered, particularly in the wake of global health challenges. With insights gathered from leading experts and practitioners, this guide delves into the myriad benefits of RPM, from facilitating proactive disease management to enhancing patient engagement and satisfaction. Moreover, it highlights the pivotal role of the remote patient monitoring provider in optimizing RPM solutions, ensuring seamless integration, data accuracy, and actionable insights for healthcare stakeholders.
In "A Comprehensive Guide to Remote Patient Monitoring in 2024," readers will discover the latest advancements in RPM technology, including wearable devices, IoT sensors, and telemedicine platforms, revolutionizing the delivery of care beyond traditional healthcare settings. Furthermore, the guide explores regulatory updates and reimbursement policies shaping the adoption and expansion of remote patient monitoring initiatives globally. By offering practical strategies for implementation and success, this guide empowers healthcare organizations to harness the full potential of RPM, driving improved patient outcomes, reduced healthcare costs, and enhanced quality of care.
Whether you're a healthcare provider seeking to optimize your remote patient monitoring strategy or a patient interested in leveraging RPM for personalized and convenient healthcare services, this guide is your definitive resource. Stay informed, stay empowered, and embrace the future of healthcare with "A Comprehensive Guide to Remote Patient Monitoring in 2024." Let this guide be your compass as you navigate the transformative landscape of remote patient monitoring, guided by insights from industry leaders and experts, and fueled by the promise of improved health outcomes and enhanced patient experiences.
How Interconnectivity Is Enabling The Future Of Patient-Driven HealthKent State University
Connected health and remote patient monitoring, combined with interactive patient engagement apps, have a tremendous potential to transform chronic disease management for patients to manage at home allowing them to live their lives with independence. But deploying such programs, and managing the IoT assets they often depend on, can pose a host of challenges at both the provider and the patient level.
With @Atreja at the NODE Health Conference - Digital Medicine http://digitalmedicineconference.com/ on the events and studies which moved the field forward
Data Science Deep Roots in Healthcare IndustryDinesh V
Data Science transforms the healthcare industry with impeccable solutions that can improve patient care through EHRs, medical imaging, drug discovery, predictive medicines and genetics and genomics.
Helping you understand the market opportunities of mobile health & medica...Damon Lightley
This presentation aims to help healthcare, pharma and medical device organisations to better understand how mHealth (mobile health) and medical apps can help to tackle the current healthcare challenges facing us all.
What you need to know about Meaningful Use 2 & interoperabilityCompliancy Group
Does this describe you?
·You are constantly challenged to stay abreast of the latest information on EHR integration and HIE interoperability, Meaningful Use stages, the Direct Project, clinician and patient portals, just to name a few.
·You walk a fine line between adopting health information technology for the good it can bring patient outcomes…….and for the good incentive dollars it can mean to your organization.
·You play a key role in ensuring your organization can attest for meaningful use.
Join Andy Nieto, Health IT Strategist at DataMotion where he’ll explain the key role that interoperability plays in Meaningful Use Stage 2 attestation including:
- What does interoperability really mean
- Why you can’t ignore interoperability
- How to achieve interoperability and make it meaningful
- What you need in order to attest
The true clinical, economic and social value of remote patient monitoring is yet to be exploited. Trusts have been challenged to do more with less, but telehealth has suffered from expensive, proprietary systems, existing in isolation with too little thought given to security. The purpose of this study is to investigate whether cost-effective remote patient monitoring can promote pro-active self-management and can avoid expensive emergency admissions. Successful deployment is dependent on scrutiny of
the details of the challenge and the solution.
The MediPi project is a clinically lead, open-source platform aimed at providing a secure, extensible, low cost, remote patient monitoring solution. Patients with Heart Failure, COPD and Diabetes were given Raspberry Pi based touchscreen units and asked to submit daily measurements from their homes using blood pressure cuffs, pulse oximeters, scales, thermometers and subjective yes/no questionnaires about how they felt. The MediPi Concentrator server API allows any registered clinical system secure access to the data, for clinicians to view trends, set thresholds and respond directly to the patient. Clinician’s reports showed that patients were receptive to the technology and keen to actively manage their care, with anxiety reduced in 34% patients. The cost of the monitoring per patient was lower than other studies with potential for further savings. The MediPi system proved robust but Bluetooth communication issues with certain physiological devices prevented the study from reporting on downstream economic savings.
The COVID-19 pandemic introduced many weaknesses in the existing US healthcare system. However, it also created opportunities for innovation in technologies revolutionizing the healthcare industry. The mRNA vaccine was the most important innovation, improving patient care and changing healthcare forever. However, another technological advancement, the digital health passport, demonstrated the benefits emerging technologies can have in health. The controversy around a digital health passport is evident and leads to deeper discussions around health data privacy and innovation.
The digital health passport in many ways was just a Beta technology used to easily show required proof of vaccination. For many, it was a product of convenience. However, some certainly saw it as an invasion of privacy. What if there was the potential to vastly increase the functionality of such a “health passport” to include all the relevant points of your medical history while also ensuring that no person without permission could see that information?
This would involve an individual holding a portable health record on a digital wallet using blockchain technology. The portable health record would include all medications a patient is currently prescribed and taking, those he or she is allergic to, lab work results, and both prior and existing diagnoses. It could expand to hold a patient’s full medical record from birth, but in early stages some of the greatest advantages would be for those with multiple medications and/or chronic illnesses (Refer to Exhibit 1 for Image). Some may ask why this would provide any advantages considering Electronic Health Record (EHR) systems are becoming more widespread, hold vast amounts of data, and functionality is ever increasing.
The issues lie in the current EHR/EMR infrastructure within the United States. As of 2019 the three largest players, EPIC, Cerner, and Medtech, controlled nearly 70% of the hospital market. Each has built a vast network of partnerships and found ways to expand products and offerings. The result: an oligopoly made up of siloed, independent companies protecting their piece of the pie. This has created a major issue—lack of interoperability between players ...
The COVID-19 pandemic continues to present challenges to healthcare practices. This presentation covers the reinstatement of elective surgeries in a few states, the greater adoption of remote tracking, and new developments with the FCC’s Telehealth Program.
It also goes over the technology CareOptimize has developed to help streamline COVID-19 monitoring and reporting, its genesis, and how this utility can help your practice post-pandemic.
Building Consumer-Facing Health Devices and Apps and Doing it RightKent State University
For the HIMSS Delaware Valley Chapter. solve a problem; prototype, pilot, adopt and scale. FDA regulations, evidence, health behavior change, data integration
Building Consumer-Facing Health Devices and Apps and Doing it RightKent State University
Presentation to the Medical Capital Innovation Competition in Cleveland 4/23/18 including the regulatory pathway, importance of evidence and data integration.
PCHAlliance conducted a systematic review of published literature to gather the available data on health outcome measures, reviewing over 1,450 citations. Fifty-three randomized controlled studies and trials were selected for analysis, on topics related to mobile technologies, remote patient monitoring, web-based counseling and other personal connected health technologies. This publication aims to set an initial baseline for the current body of evidence in personal connected health in key areas, namely behavior change and self-care, remote patient monitoring, remote counseling and mental health, as well as more broadly through key condition-specific studies.
Download the paper here: http://www.pchalliance.org/personal-connected-health-state-evidence-and-call-action
Registries are a powerful informatics tool for research and public health. As both commercial payers and the Centers for Medicare and Medicaid Services work to shift incentives shift toward value based-purchasing, demand for reliable, accessible data on populations is growing. The purpose of this poster is to define accountable care organizations (ACOs), explain the importance of registries in managing data for ACOs, and discuss specific informatics requirements unique to accountable care registries.
The HIMSS Connected Health Conference took place on November 8-11, 2015 at the National Harbor in Washington, DC. It included Mobile Health, Cybersecurity and Population Health topics.
My presentation to the Personalized Medicine meet of the American Cancer Society Cancer Action Network on August 11, 2015 at the HIMSS Innovation Center in Cleveland, Ohio.
Leaders have a strong core of content marketing/education
Cautious experimentation by provider organizations
The Rise of e-Patients
Social Media’s role in patient engagement
Mobile devices impact
Where to we go from here?
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Personal Connected Health: Patient Generated Data Use Cases
1. THE PRESENTATION TITLE GOES HERE
1
Personal Connected Health:
Patient Generated Data Use Cases
1
John Sharp
Director, Thought Advisory, HIMSS
2. THE PRESENTATION TITLE GOES HERE
“
An examination of the current
state and projection of the
future state of PGHD reveals
the opportunities, challenges,
and calls to action for the main
health care stakeholders, as
well as supporting stakeholders.
2
ONC PGHD Report, 2017
5. The Rise of the Data-Driven Physician –
Stanford Medicine 2020
5
6. Remote Patient Monitoring
Why Now?
6
• Better technology including
miniaturization of sensors
• Pervasive wireless networks including
home networks
• Smart phones enabled with Bluetooth
• Growth of wearables -consumerization
• Incentives – CPT codes for
reimbursement, value-based care,
financial penalties
• Regulatory changes – FDA approvals
7. 7
Who Sees the Data?
• Providers need data in a format that they can interpret and act on
• Within the EMR context
• Outside the EMR – within a ACO or Chronic Disease Management
system
• Patients – See the data in ways that they can interpret and take action
• Usually through and app or small dashboard on the device
• Device/app companies
• Only to provide technical support
9. Atrial Fibrillation
Apple Heart Study
The Apple Watch and corresponding Heart Study app uses
photoplethysmography to intermittently measure blood flow
activity
and detect subtle changes that might indicate an irregular
heartbeat.
• 419,297 people self-enrolled in the study
• A pulse notification was received by 2,161 participants (0.52 %)
• While the watch and corresponding app "offers promise," its
accuracy is still far short of more traditional and currently
used monitoring techniques.
• No interoperability – those who got notifications were instructed
to contact the study doctor.
9
10. Apple Watch Study - Implications
10
• Recruitment of people using
wearables shows potential for large
sample sizes
• Concerns about false positives
• May be more effective focusing on
those with heart disease
• Lack of interoperability – particularly
moving data to the EMR
for effective disease management
• Future application to diagnostics and
symptom identification
through wearables
New Apple Studies
• Women’s Health Studies
• Heart and Movement
Study
• Hearing Study
11. Home-Based Cardiac Rehabilitation Program
11
• Compliance with cardiac
rehab is poor
• Requires weeks of outpatient
rehab appointments
• Often means a caregiver
transporting the patient daily
• Drop-out is high
12. 12
Kaiser – Samsung partnership
• Samsung smartwatch that pairs via Bluetooth
with an Apple or Android smartphone
• The watch sends reminders to the patient to
exercise, collects
patient activity data and continuously displays
the patient heart rate during exercise
• uploaded via the smartphone into the patient's
chart (via FHIR?)
Home-Based Cardiac Rehabilitation Program
13. Incentives – CMS will not pay for readmission
within 30 days
The hope is that more intensive monitoring in
the community can identify decompensation
early, support adherence to lifestyle and medication,
and prompt intervention
Now included in guidelines by the European Society of
Cardiology and the American College of Cardiology, with caution about
limited evidence
The potential is great. “RM will find an important place for those living with HF
and the professionals advising them.”
13
Heart Failure
16. • People living with the Type 1 rarely have to seek professional
assistance
• Their blood glucose concentrations can easily be incorporated
into data platforms that can be accessed by patients, their carers
and their healthcare professionals at any point in time and from
anywhere there is internet access to the cloud-based server.
• For those requiring insulin, there are now patches that monitor
blood glucose every few minutes, and wirelessly communicate
with an insulin pump to help ensure stable blood glucose control.
16
Diabetes
19. Standards should include consideration of:
• data safety and privacy (data storage, use and sharing
policies must be made transparent to users of the app)
• effectiveness
• user experience/adherence
• data integration (via APIs using open standards)
Towards a consensus around standards for smartphone apps
and digital mental health, World Psychiatry. 2019 Feb; 18(1): 97–98.
19
Mental Health
20. 1. What seems obvious to an engineer (or informatics manager) may not be obvious to a
patient.
2. What seems quick and easy may strike the patient as burdensome.
3. Questionnaires developed for research may not be appropriate for clinical practice.
4. Many words used by doctors and researchers can be replaced by something simpler
5. Don’t ask questions for clinical care unless you are prepared to act
6. A subgroup of users can cause a great deal of additional work
7. Watch patients use your tool and ask about their experiences.
8. Patient trust is hard to gain and easy to lose
20
Interfaces for collecting data from patients:
10 golden rules – JAMIA Jan. 2020
21. • There are now several use cases for collection of PGHD via remote
monitoring and apps
• Initial evidence of clinical improvement is mixed
• Implementation of remote monitoring needs more standardization to scale
• Reimbursement is now available through CMS which will incentivize RPM
• Data transfer can be via Bluetooth
to a mobile platform or direct to cloud
• Data integration is enabled via APIs
21
Summary
22. Your health is not a number. Be
careful when evaluating your health.
Your habits are more than numbers
to be hacked.
22
“
Chris Dancy, The World’s Most Connected Person
Don’t Unplug