Latest / Morning Medical with Dr. Chow / Telemedicine & COVID-19, AI Risks, TikTok Tanning Trend, and Post-Wildfire Mental Health

Transcript

Telemedicine & COVID-19, AI Risks, TikTok Tanning Trend, and Post-Wildfire Mental Health · Morning Medical with Dr. Chow

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  Good morning and welcome to another episode of Morning Medical with Dr.
• 0:04
  Chow.
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  I am your host, Dr.
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  Chi-Ming Chow.
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  Today, we are diving into some fascinating and timely topics in the medical world.
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  Let's start with a discussion on the promise of artificial intelligence in healthcare.
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  Artificial intelligence is rapidly expanding across various sectors of healthcare, finding
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  its way into workflows industry-wide.
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  From assisting clinicians during telemedicine visits to transcribing entire conversations
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  between doctors and patients, AI is proving to be a valuable tool for many stakeholders.
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  One of the most promising areas is AI-enabled computer vision, which could be a game-changer
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  for patient care.
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  Narinder Singh, the CEO and cofounder of LookDeep Health, has been working with AI for
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  years.
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  LookDeep Health is a virtual sitting, virtual nursing, and virtual care company.
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  Singh has an extensive background, having worked in Accenture's Center for Strategy
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  Technology, held a corporate strategy position in the office of the CEO at SAP, co-founded
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  Appirio, served as president of Topcoder, and was vice president of engineering at
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  webMethods.
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  In a recent interview, Singh discussed how AI can help increase capacity in telemedicine, the
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  risks posed by generative AI for hospitals and health systems, and the role AI is playing in
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  scribe technologies.
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  Let's dive into some of the key points from that conversation.
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  First, Singh pointed out that while telemedicine removes the burden of distance
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  from healthcare interactions, it does not necessarily increase the capacity for these
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  interactions.
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  He noted that patient acuity is rising and many hospitals are staff-constrained.
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  The population over 65 years old in the United States grew five times faster than the total
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  population from 2010 to 2020, highlighting the rising age and associated acuity of patients
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  that hospitals will care for in the future.
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  Singh mentioned that telemedicine has had many successes at a project level but has had a
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  limited impact on care at a macro level, except during the COVID-19 pandemic.
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  During the pandemic, seamless access via telemedicine created flexibility that enabled
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  the healthcare system to adapt.
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  However, it did not expand resource capacity.
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  Tele-capabilities can bridge great distances but do not change the underlying units of work
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  necessary to provide care.
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  This is where AI comes into play.
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  AI can expand observational capacity rather than just impacting decision-making.
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  For example, a nurse who covers six patients might only spend one to two hours in any given
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  patient's room.
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  Doctors might only spend a few minutes per day in an individual patient's room.
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  This means that most of the time, a patient is without the watchful eye of a provider.
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  AI-enabled computer vision can allow healthcare providers to have eyes on every patient all the
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  time, helping to allocate the clinical attention of nurses and doctors more
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  appropriately.
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  Singh envisions a world where AI acts as a guardian angel for patients and their
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  caregivers.
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  AI can identify potential issues and alert healthcare professionals before small problems
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  become big ones.
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  This is not just about efficiency; it is about fundamentally changing the way we deliver care.
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  AI can provide that extra layer of support, ensuring that no patient is left unattended,
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  even for a moment.
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  It is not about replacing human touch but augmenting it, making our healthcare system
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  more responsive, resilient, and ultimately, more human.
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  However, Singh also cautioned about the risks posed by generative AI.
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  While generative AI can streamline prior authorizations, patient coding, and
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  interactions between insurance and healthcare providers, it could also complicate disputes
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  and require more human adjudicators to resolve them.
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  This could lead to an increase in administrative work rather than a reduction.
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  Singh highlighted that in a hospital setting, the complexity of care and the lack of defined
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  visits mean that AI tools are not always effective.
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  The allure of a magic solution to remove tedious work and integrate into clinical
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  workflows is tempting but naive.
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  Generative AI is not a golden ticket; it does not yet address the need to synthesize defined
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  sets of information and repeatedly draw the same conclusions from them.
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  To overcome these risks, Singh suggested that hospitals and health systems should secure
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  patient health information, ensure checks and balances on AI outputs, evaluate models within
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  and outside their scope, and avoid alienating their workforce with premature claims of
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  replacing their roles.
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  Hospitals need to focus on pragmatic applications of AI and enforce rigorous
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  evaluation and demand repeatability in clinical scenarios.
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  Singh also observed a significant increase in investment in transcription companies, with
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  more than a half dozen raising over $30 million in recent years.
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  AI is playing a pivotal role in these scribe technologies by improving the accuracy and
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  efficiency of transcriptions.
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  Real-time transcription with higher accuracy and at a lower cost is now possible, making
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  these solutions more accessible to healthcare providers.
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  However, Singh noted that the rapid pace of AI advancements means that the cost of developing
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  competitive transcription solutions has likely dropped by 95 percent.
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  This could lead to commoditization of the category and desperate over-promising to meet
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  investor expectations.
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  Despite these risks, the potential benefits of AI in reducing administrative burdens and
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  allowing doctors to focus more on patient care are significant.
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  In summary, AI holds huge promise for healthcare, from expanding observational
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  capacity in telemedicine to improving transcription accuracy and efficiency.
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  However, it is crucial to navigate the risks and challenges carefully to fully realize its
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  potential.
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  By focusing on pragmatic applications and rigorous evaluation, we can make our healthcare
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  system more responsive, resilient, and human.
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  TikTok’s latest harmful trend encourages people to chase high ultraviolet index readings to
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  achieve a tan.
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  Being outside for long periods when the ultraviolet index is high can put you at risk
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  for skin cancer and premature aging.
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  Experts explain the purpose of the Ultraviolet Index Scale and how to stay safe in the sun.
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  Getting a tan is something many people strive for during summer months, and TikTok users are
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  following the advice of influencers pushing “Ultraviolet Index Tanning.” This is a
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  dangerous trend that encourages people to go in the sun during high ultraviolet index readings
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  to achieve a tan.
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  While these influencers are misinformed and spreading harmful health information, many of
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  their videos are getting millions of views.
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  Dr.
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  Morgan Rabach, a board-certified dermatologist and co-founder of LM Medical, told Healthline,
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  “Targeting a high ultraviolet index is opposite of what people should be doing.” In fact, the
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  Ultraviolet Index Scale was created by the United States Environmental Protection Agency
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  to help people make smart, healthy choices about sun exposure, not as a means to garner a
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  tan.
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  The indexes range from zero to eleven and indicate the following: zero to two means low
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  exposure and no protection is needed, three to seven means moderate to high exposure and
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  protection is needed, and eight and above means very high to extreme exposure and extra
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  protection is needed.
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  “Now tweens are targeting the highest indexes to get tan fast, seeking outside time when the
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  index is at its highest moments eight and above,” said Dr.
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  Rabach.
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  The reality is the higher the ultraviolet index reading, the less time it takes for the skin to
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  get burned and the greater the risk of harm from ultraviolet exposure — that includes harm
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  to the skin and eyes.
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  Dr.
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  Monalisa Tailor, a primary care doctor at Norton Medical Group, told Healthline, “If it’s
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  a ultraviolet index higher than six, your risk of sunburn and skin cancer is much higher.
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  High ultraviolet index is not how we want to get a tan.”
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  Over thirty-three thousand sunburns land people in the emergency room each year, according to
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  the National Cancer Institute.
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  Moreover, sunburns, especially those that occur in youth, increase the risk of developing skin
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  cancer like melanoma in the future.
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  Experiencing five or more blistering sunburns between the ages of fifteen and twenty
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  increases melanoma risk by eighty percent and nonmelanoma skin cancer risk by sixty-eight
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  percent.
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  “We are currently seeing a rise in skin cancers in individuals who were born in the
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  nineteen-eighties and nineteen-nineties.
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  It was not common practice when they were younger to wear sunscreen unless they were at
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  the beach or the pool,” said Dr.
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  Tailor.
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  Not using sunscreen regularly has increased this group’s risk of skin cancers later in
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  life, she added.
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  “Skin biopsies hurt.
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  There are so many sensory nerves on the skin.
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  The more we avoid a skin biopsy for the future, the better we will feel,” said Dr.
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  Tailor.
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  In addition to cancer concerns related to tanning, people should also be concerned about
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  the sun’s ability to cause wrinkles and early signs of skin aging.
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  Sun exposure can lead to wrinkles, too.
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  In addition to skin cancer, sun exposure in childhood can affect the way skin ages for the
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  rest of your life.
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  According to the Environmental Protection Agency, up to ninety percent of skin changes
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  that are often thought to be the cause of aging are actually caused by the sun.
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  Over time, getting too much sun can make skin thick, wrinkled, and leathery.
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  When the sun causes the skin to prematurely age, this is called photoaging, photodamage,
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  solar damage, or sun damage.
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  When exposed to ultraviolet light, the skin’s DNA changes at a cellular level, and it may
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  take many years before damage to the skin is noticed.
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  Dark patches on the face, called melasma, and freckles are also caused by the sun.
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  The sun can also affect the eyes.
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  Ultraviolet light ages eye structures, causing corneal damage, cataracts, and macular
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  degeneration, which causes blurred or reduced vision.
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  Getting sun has benefits, such as stimulating the production of Vitamin D, which may help
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  decrease the risk of certain cancers, such as colon and ovarian.
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  It can also boost the mood-enhancing hormone serotonin and may help some people with skin
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  conditions like eczema and psoriasis.
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  But protecting yourself from the sun is key to reaping its benefits without all the potential
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  harm.
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  While spending time in the sun, consider the following: Stay outside for less than thirty
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  minutes with a ultraviolet index between three and five.
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  Wear a water-resistant, broad-spectrum sunscreen with a sun protection factor of at
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  least thirty.
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  The numbers in sun protection factor refer to the amount of time it would take to burn your
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  skin.
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  “So, a sun protection factor of thirty would take you thirty times longer to burn than if
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  you were not wearing sunscreen, and a sun protection factor of fifty would take you fifty
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  times longer to burn,” said Dr.
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  Rabach.
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  However, this varies depending on the person.
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  Reapply sunscreen.
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  Regardless of the sun protection factor number, apply enough sunscreen thirty minutes before
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  going outside and reapply it every two hours.
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  “Sometimes, people use the higher sun protection factors and think they are protected
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  longer, which is true, but it causes them to not reapply, and they wind up getting burned,”
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  Dr.
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  Rabach said.
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  Wear protective clothing like a hat, ultraviolet shirts or jackets, and sunglasses.
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  Use tinted sunscreens and bronzers to get a tanned look rather than staying in the sun for
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  extended hours.
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  Following the release of the "Barbie" movie last summer, search queries about gynecology
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  surged while searches for actual appointments remained stagnant, a cross-sectional study
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  found.
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  At the end of the movie, Margot Robbie in the titular role of Barbie walks into an office
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  building and declares, "I'm here to see my gynecologist." In the first week after the
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  movie's release, online search volume rose by 51.3 percent for terms referring to
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  gynecologists and by 154.1 percent for the definition of the word gynecologist, reported
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  Anupam Jena, MD, PhD, of Harvard Medical School in Boston, and colleagues in a JAMA Network
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  Open research letter.
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  But searches related to seeking gynecologic care did not change, nor did searches for
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  broader health terms, which the authors wrote supports "the assumption that the observed
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  increase in gynecologist-related searches may have been influenced by the film's release and
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  not other factors."
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  Co-author Eva Senechal, BS, of McGill University in Montreal, told MedPage Today that
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  the team was inspired by the sheer impact of the "Barbie" movie, which became one of the
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  highest grossing movies ever.
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  "Are people learning more about women's health because of the 'Barbie' movie?" Senechal asked
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  herself, especially because so many young people saw the movie.
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  For them, "Barbie's" ending line may have been the first time they heard of gynecology, and
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  the results highlighted that many people in the "Barbie" audience didn't know what a
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  gynecologist is or what they do.
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  Ultimately, authors concluded that their "results suggest that 'Barbie's' closing line
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  may have spurred interest in gynecology, further suggesting the potential influence of
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  popular films on health literacy and awareness."
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  Nikki Zite, MD, MPH, of the University of Tennessee Graduate School of Medicine in
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  Knoxville, who was not involved in the study, said that this research "is a good reminder
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  about the potential impact that movies can have," adding that she "laughed and cheered
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  during that closing scene."
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  "We also know that media and legislative events impact internet searches -- for example, the
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  increase in searches for vasectomy or female permanent contraception after the Dobbs
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  decision in June of 2022," Zite said.
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  Melissa Simon, MD, of Northwestern Medicine in Chicago and director of the Center for Health
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  Equity Transformation, who also was not involved in the study, pointed out that the
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  "Barbie" movie was released just over a year after Roe versus Wade was overturned.
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  "Barbie going to a gynecologist and taking care of herself and exercising her self-agency to
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  obtain a healthcare appointment for her gynecologic health I think is an important
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  message," especially on the big screen, Simon said.
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  However, no cause-and-effect conclusion can be drawn from the study data or methodology, she
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  cautioned.
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  Following the release of the "Barbie" movie, researchers analyzed search trends for
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  thirty-four queries about gynecology.
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  The queries were categorized as relating to the gynecologist, gynecologist definition, or
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  gynecologist appointment, while another group of more general search terms served as
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  controls: women's health, doctor, and doctor's appointment.
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  Using Google Trends and Glimpse, the researchers compared weekly search trends for
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  the year prior to and three months following the movie's July 21, 2023, release date.
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  "Other than 'Barbie's' release, there were no major events during this period that may have
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  led to widespread changes in search interest in gynecology," the researchers noted.
• 16:43
  With the townsite in Jasper National Park evacuated due to a wildfire and many waiting to
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  hear what has happened to their homes, psychologists say there are things people can
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  do to cope and process the significant mental health and emotional impacts of the fire.
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  About 25,000 people were evacuated before flames entered the community late Wednesday,
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  with Parks Canada confirming multiple buildings in the mountain town were impacted and
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  firefighters were combatting structural fires.
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  Alex Bierman, a University of Calgary sociology professor, told Global News that while people
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  do not know the status of their homes, a major challenge with these kinds of situations stems
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  from the loss of control.
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  “What people who are going to be uprooted from their homes will experience likely is a strong
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  sense of powerlessness,” he said.
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  Experts say this can be accompanied with intrusive thoughts, a sense of reliving the
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  event or emotional numbness, or even in the short term, feelings of anxiety, confusion or
• 17:47
  disruption of sleep.
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  Dr.
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  Katy Kamkar, a clinical psychologist in Toronto, says people should not ignore how they
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  are feeling as they look to cope with the stress and grief.
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  “It is always helpful to acknowledge our feelings and allowing ourselves to feel and
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  express our emotions,” she said.
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  Wildfires can disrupt the connections and support networks as well, either through
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  separation or isolation.
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  Bierman notes wildfires often cause a loss of social connection from the network of people
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  you have created a bond with.
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  But Kamkar says it is that isolation people should try to avoid as communication with
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  others, such as loved ones and community members, can help with healing.
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  “Talking to family, friends, support groups, in terms of our experiences, our feelings, it is
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  very helpful and crucial for our emotional recovery and to know that we are not alone,”
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  Kamkar stresses.
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  She added it can be helpful when coping with the stress to lean into structure, a form of
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  routine that may help provide a sense of normalcy, as can practicing self-care through
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  exercise, meditation and having access to healthy meals and staying hydrated.
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  Returning home can also be a daunting prospect for those who do not know if their home is
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  still there.
• 19:12
  Adults are not the only ones dealing with wildfire impacts, though.
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  Children can struggle, too.
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  Diana Martin, senior director of counselling with Kids Help Phone, told Global News that
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  when it comes to talking with children it can be helpful to limit how much information they
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  are accessing to reduce worry, but to still talk with them about how they are feeling — but
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  do so by asking generally, not specifically.
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  “If a parent was to just ask a little bit more open and, you say, ‘What are you feeling,’ that
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  can open up for a young person to actually say in their own words,” Martin said.
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  Martin added parents and caregivers can help ease worry by talking with them about what the
• 19:56
  family’s plan is, what is going to happen if they need to leave, and stress that they are
• 20:01
  together.
• 20:02
  She acknowledges children may still have questions that cannot be answered, like if the
• 20:07
  home is gone, but says there are things that you can still do.
• 20:11
  “What I think could be helpful is acknowledging that there are some things we do not know yet
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  and because you cannot really make a promise in that situation, that everything is going to be
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  okay when you get home or that everything will be the same,” she said.
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  “But you know, ‘here is what we do know, we are together, here is what we do know, there are
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  people that are going to help,’ and focusing on those kinds of things could be helpful.”
• 20:38
  As Jasper residents try to process what is happening, Bierman adds sometimes breaking
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  situations down may help with coping even as so many unknowns remain.
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  “Events can seem overwhelming when we take them as a whole,” he said.
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  “I think for people who are experiencing a great loss, often times it is important to take
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  things as a part than as a whole …
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  do not try to attack the entire problem at once.”
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  That is all for today’s episode of Morning Medical with Dr.
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  Chow.
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  Thank you for joining me as we explored these important topics in the world of health and
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  medicine.
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  Remember, whether it is the promise of AI in healthcare, the risks of ultraviolet index
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  tanning, the influence of popular culture on health literacy, or coping mechanisms for
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  dealing with natural disasters, staying informed is key to making better health
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  decisions.
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  Have a great day and stay healthy.