Weekend Links

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We’ve hand-picked a mix of Massachusetts General Hospital and other research-related news and stories for your weekend reading enjoyment:

Creative Minds: A New Way to Look at Cancer

Better Patient-Provider Communication Needed for Obesity Care

Eugenics 2.0: We’re at the Dawn of Choosing Embryos by Health, Height, and More

6 Speaking Tips for Scientists and Engineers (editor’s note: Melissa Marshall, featured in this article, recently spoke to Mass General clinicians about how to effectively present scientific work. We were so impressed by her talk that we wanted to introduce her to our readers) 

Looking for a great book for the young scientist in your life? The long list of 2018 AAAS/Subaru SB&F (Science Books and Films) Prize winners for Excellence in Science Books has been released. Prizes are awarded each year in the following categories:

  • Children’s Science Picture Books
  • Middle Grade Science Books
  • Young Adult Science Books
  • Hands on Science Books

See the full list here

 

Top photo: courtesy of Tim Lahan, MIT Technology Review

Partners Healthcare to Introduce New Platform for Recording Patients Data

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Partners Healthcare is launching a new online system, Connected Health Integration Pathway (CHIP), to make workflow easier for clinicians as well as to provide an easy platform for patients to securely record and share their medical information with their care team. CHIP will be used to integrate patient-generated health data into Epic Hyperspace, which is Partners’ electronic health record system.

For instance, if a clinician wants a patient to record their blood pressure for the next 10 days, instead of maintaining a journal the patient can record and submit their readings directly to the system through their sphygmomanometer (blood pressure machine). Through CHIP, the data will be stored as a part of the patients’ medical history.

How does CHIP work for clinicians?

This system would work only if the provider invites their patients to record their medical readings. The invitation process happens within Epic, then the provider chooses what data they wish to see (weight, glucose, blood pressure, etc.)

How does CHIP work for patients?

Patients will receive invite and instructions through the existing Partners Patient Gateway (PPG). After accepting the terms and conditions, the patient will be directed to the Device Marketplace.

Through the Marketplace, patients can send data only from the listed available manufacturers and devices. The data collection begins when a patient authorizes the data pull.

It is important to note that a device can only be used by one patient and cannot be shared by multiple patients. But patients can use multiple devices from different manufacturers at any time.

Also, patients and providers can choose to stop data sharing any time.

CHIP is currently in the pilot mode, and is expected to be live in 2018.

The Partners Connected Health team creates and deploys mobile technologies in a number of patient populations and care settings, and is conducting innovative clinical studies to test the effectiveness of mobile health technologies in various clinical applications, including medication adherence, care coordination, chronic disease management, prevention and wellness. Visit www.partners.org/connectedhealth for more information.

Revolutionizing Care at Mass General

Four pillars of MGH

Massachusetts General Hospital was established to provide care to Boston’s sick, regardless of socioeconomic status—an innovative idea in 1811. In the words of our founder, Dr. John Warren, “When in distress, every man becomes our neighbor.” We then became the first teaching hospital for Harvard University’s new medical school and have been redefining excellence in health care ever since.

Today we remain committed to that mission through our four pillars: we provide exceptional patient care, perform more medical research than any other hospital, educate tomorrow’s brightest medical minds and maintain a deep-seated commitment to the community.

Watch for our #RevolutionizingCare series over the coming weeks as we highlight the ways our dedicated, talented staff are upholding our mission to care, investigate, educate and serve.

Boosting the Voice of the Patient in the Medical Decision Making Process

banner-healthdecisionsciencesIn medicine, many diagnostic questions can be answered in yes or no, black and white terms. Is the pain in your back and legs due to a herniated disc? Is your cholesterol too high?

When it comes to determining the best treatment plan for each patient, however, there are many more shades of gray.

For a herniated disc, is the best course of action to fix the disc via surgery, which could provide quicker relief but may cause a serious complication? Or is it better to manage the pain through physical therapy, which is less invasive than surgery, but may not solve the problem?

If you have high cholesterol, should you take statin drugs, which are effective but can cause side effects such as pain and muscle fatigue? Or to try improving your diet and exercising more, which is often easier said than done?

“In medicine, there are tradeoffs everywhere you look,” says Karen Sepucha, PhD, Director of the Health Decisions Sciences Center (HDSC) at Massachusetts General Hospital. “We can’t know what’s best for someone unless we know who that person is, what’s important to them, and how they might view the tradeoffs. Patients may make different decisions than their provider would when faced with the same situation.”

To acknowledge these tradeoffs and prompt more productive discussions between patients and their providers, the HDSC team has created a series of print, online and video-based decision aids for patients with conditions such as herniated discs, high blood pressure, depression, diabetes, breast cancer, prostate cancer, anxiety and more.

The goal of this approach, called Shared Decision Making, is to present the patient with an objective view of all treatment options, and discuss the pros and cons of each.

“It’s like being able to consult the best doctors and hear from a range of ‘experienced’ individuals who have chosen different approaches. You can learn what the different treatments are like and why folks might make different decisions based on what is most important to them,” Sepucha explains.

The HDSC team also works with clinicians and health care providers to assist them with implementing decision-making tools in their practices. According to Leigh Simmons, MD, an internal medicine physician at Mass General and member of the HDSC team, the process is not always easy.

Simmons explains that many clinicians who already feel strapped for time in their daily practice worry that their patient visits will become longer if they have to address all of the questions that a decision aid can raise.

In practice, however, patient visits tend to stay the same length when a decision aid is distributed beforehand, Simmons says. “It’s the nature of the conversation that changes.”

Clinicians find that they don’t have to spend as much time going through the basics of the medical problem or treatment plan, and can talk more about the pros and cons of each option to see what will work best for each patient. “We usually advise that using a decision aid may not necessarily save time, but it makes for a better conversation with their patients, which everyone likes more, Simmons says. “The questions that get asked are more advanced, and the visit is more productive.”

Another barrier that physicians have to confront is that when you give your patients high-quality information about reasonable treatment options, they may choose something you would not have chosen for them, Simmons says. “That is something we have to be aware of and be honest with ourselves as doctors, and we recognize that sometimes our patients know best about what is right for them.”

From a research standpoint, the HDSC team is working on strategies to determine if decision-making aids are increasing patient involvement and improving treatment outcomes, Sepucha says. “Are patients more informed, are they more engaged in the decision-making process and are clinicians doing a good job of matching the right patient to the right treatment?”

How we make decisions with our patients is important, and some of our research has shown that our patients who are well-informed and received their preferred treatment have better outcomes.”

For more information about the Health Decisions Sciences Program, please visit www.massgeneral.org/decisionsciences.

New Study Details the Risk of Blockages, Bleeding and Death Among Patients Who Receive Stents: Five Things to Know

Researchers wanted to better understand the long-term risk of blockages, bleeding events and death among patients who received a cardiac stent. Here are five things to know about the new study recently published in JAMA Cardiology:

  1. A stent is a small, wire mesh tube (pictured below) that can strengthen a weak artery or open a narrow or blocked artery. Patients who have received a cardiac stent are at greater risk for blockages in blood flow to the heart or brain (called ischemic events) as a result of their heart disease or from clotting inside the stent. The use of aspirin combined with other similar drugs (called dual antiplatelet therapy) to prevent these incidents in the first year after receiving a stent has become standard practice. However, while dual antiplatelet therapy decreases risk of ischemic events, it also increases risk of fatal bleeding or bleeding in vital organs (called bleeding events) when continued longer than one year.Stent
  2. This new study, led by Eric Secemsky, MD, MSc, a fellow in the Massachusetts General Hospital Division of Cardiology, looked at data from over 11,000 participants who underwent dual antiplatelet therapy for one year following the placement of a stent and had no ischemic or bleeding events. The participants were then randomized to either continue with the dual therapy for 18 months, or to receive aspirin plus placebo instead.
  3. Researchers found that taking both medications for a total of 30 months decreased ischemic risk (1.6% drop in ischemic events) while also increasing bleeding risk (0.9% increase in bleeding events). Overall, having either an ischemic or bleeding event severely increased risk of death – an 18-fold risk increase after any bleeding event and a 13-fold risk increase after any ischemic event.
  4. In a previous study, Secemsky developed a risk score that can help determine whether or not dual antiplatelet therapy should continue past the one-year mark. This tool, which is utilized by the American College of Cardiology, can help clinicians decide what treatment to prescribe. You can find it on the ACC website.
  5. With the understanding that both ischemic and bleeding events are associated with high risk of mortality, future efforts will focus on individualizing treatment and identifying patients who are likely to experience more benefit than harm from dual therapy.

Eric Secemsky, MD, MSc, a fellow in the Massachusetts General Hospital Division of Cardiology, is lead author on this study. Click here to learn more.

Investigating the Mechanisms Behind the Healing Power of Therapeutic Touch

Patients have reported that the practice of therapeutic touch helps with their pain, stress, anxiety and sleeping trouble during hospital stays. Massachusetts General Hospital nurse researcher Amanda Coakley, RN, PhD, is now investigating how the practice functions on a biological level.

READ MORE HERE