Latest / Morning Medical with Dr. Chow / AI in Healthcare, 'How to Be Well' Review, and Nova Scotia Health Records Update

Transcript

AI in Healthcare, 'How to Be Well' Review, and Nova Scotia Health Records Update · Morning Medical with Dr. Chow

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  Good morning and welcome to Morning Medical with Dr.
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  Chow.
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  I'm your host, Dr.
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  Chi-Ming Chow.
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  Today, we're diving into a topic that's been making waves in the healthcare sector: the
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  integration of artificial intelligence into clinical settings.
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  As we explore this subject, we'll take a closer look at how AI can be an asset to clinicians
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  and health systems, provided it's introduced in the right way.
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  Recently, at the Population Health Colloquium hosted by Thomas Jefferson University in
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  Philadelphia, several experts shared their insights on this topic.
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  They emphasized that while AI might initially seem like a threat to the workforce, it can
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  actually enhance healthcare delivery and improve job satisfaction if implemented
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  thoughtfully.
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  Dr.
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  Arshad Rahim, a senior vice president and chief medical officer for population health at Mount
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  Sinai Health System in New York City, shared his perspective during a panel discussion.
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  He noted that while AI might seem like a continuation of data mining practices we've
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  been doing for decades, the technology holds significant potential for scaling up routine
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  activities in healthcare.
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  Dr.
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  Rahim believes AI can augment team efforts, especially in areas like ambulatory care
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  management and patient outreach, without replacing human team members.
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  At Mount Sinai, AI is already being utilized in radiology.
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  The system performs the initial read on scans such as computed tomography scans and magnetic
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  resonance imaging scans, with radiologists then reviewing the AI's findings.
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  Dr.
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  Rahim shared an insightful comment from a respected radiologist in their institution: 'AI
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  will not replace radiologists, but a radiologist who knows how to work with AI will
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  be much more valuable to organizations.' This highlights the importance of embracing AI as a
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  tool to enhance, rather than replace, clinical expertise.
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  Other health systems are also exploring AI's potential.
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  Grayling Dwayne Yarbrough, vice president for population health at Sentara Healthcare in
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  Virginia Beach, mentioned that while they are just beginning to explore AI for clinical
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  decision-making, the journey is underway.
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  Meanwhile, at Kaiser Permanente, AI has been introduced at a rapid pace, particularly
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  ambient AI, which operates in the background without direct user interaction.
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  Stephen Parodi, executive vice president of the Permanente Medical Group in San Francisco,
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  shared that they rolled out ambient AI to 24,000 physicians in just one month.
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  This AI assists with tasks like transcribing patient encounters, significantly reducing the
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  time clinicians spend on documentation.
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  Dr.
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  Parodi noted that this has led to increased clinician satisfaction and improved patient
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  throughput, particularly in primary care settings.
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  Interestingly, patient acceptance of AI has been quite high.
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  Despite initial concerns about privacy and security, satisfaction surveys indicate that
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  patients appreciate the improved interaction with their clinicians.
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  They feel more heard and valued when their doctors can focus on them rather than on
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  computers.
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  The experience with ambient AI at Kaiser Permanente is opening up new possibilities for
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  AI applications in healthcare, including coding visits and reporting to regulatory bodies.
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  As Dr.
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  Parodi mentioned, the future might see AI assisting more directly in these tasks, further
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  streamlining healthcare processes.
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  As we continue to navigate the integration of AI in healthcare, it's clear that the
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  technology holds great promise if introduced and managed effectively.
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  While challenges remain, the potential benefits for both clinicians and patients are
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  significant.
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  Next, we'll be discussing a book review on 'How to Be Well' by Amy Larocca, so stay tuned.
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  Today, we're diving into a captivating book that explores the sprawling world of wellness.
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  Amy Larocca's 'How to Be Well: Navigating Our Self-Care Epidemic, One Dubious Cure at a Time'
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  takes us on a journey through the trillion-dollar wellness industry, shedding
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  light on its many facets, from stringent food plans to cultish exercise routines and even
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  medical quackery.
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  Larocca, a veteran journalist, offers a lively and humorous tour of this landscape, making it
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  both informative and entertaining.
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  The book opens with Larocca's personal experience with a colonic, which she describes
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  as 'the flossing of the wellness world.' She humorously recounts lying on an exam table,
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  feeling vulnerable, while her doctor disapproves of the procedure due to its risks,
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  such as rectal perforation.
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  This sets the stage for Larocca to question why society has come to view the body, particularly
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  women's bodies, as something unclean that needs solving.
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  Larocca delves into how the concept of wellness has ballooned into a $5.6 trillion global
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  industry.
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  She uses data, historical context, and pop culture references to explore this phenomenon.
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  From clean beauty and athleisure wear to the gospel of SoulCycle and the world according to
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  Goop, Larocca leaves no stone unturned.
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  She even attends a Global Wellness Summit in Italy, witnessing firsthand the industry's
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  reach and influence.
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  The book also touches on contemporary trends like micro-dosing and biohacking, weighing
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  their pros and cons.
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  Larocca's approach is comprehensive, though the latter part of the book tries to cover too much
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  ground at once, with chapters on the industry's relationship to politics, men, and the
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  environment.
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  However, when Larocca focuses deeply on topics like self-care, body confidence, and sex
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  positivity, her writing shines with authority and wit.
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  One of the key insights from Larocca's book is her debunking of the notion that 'feeling old'
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  can be avoided through expensive wellness routines.
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  She argues that aging is not a disease and shouldn't be treated as such.
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  Larocca sheds light on the rebranding of dieting as 'detoxification,' a trend that
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  promises to make us 'glow' but often aims to rid us of parts of ourselves.
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  Larocca is refreshingly candid about the financial motivations behind the wellness
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  industry.
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  She points out that these wellness entities, from stylists turned coaches to massive
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  corporations, are not altruistic.
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  Their primary goal is to keep consumers coming back and spending more money.
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  Larocca's insights remind us of the bottom line driving the wellness-industrial complex.
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  'How to Be Well' is a thought-provoking read that challenges us to question the motives and
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  practices of the wellness industry.
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  Larocca's blend of personal anecdotes, humor, and critical analysis provides a compelling
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  look at a sector that impacts many aspects of our lives.
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  As we navigate our own wellness journeys, it's essential to remain informed and critical of
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  the solutions presented to us.
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  The rollout of Nova Scotia's new $365-million electronic medical records system, known as One
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  Person One Record, has been delayed until December.
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  Originally set to go live at the IWK Health Centre by the end of August, the system's
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  launch has been pushed back to December sixth.
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  This decision affects the subsequent rollout planned for five additional hospital sites,
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  which was initially scheduled for November twenty-second.
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  Announced in February 2023 by Health Minister Michelle Thompson, the One Person One Record
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  system is a significant technological upgrade for the province.
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  The system is designed to allow health-care professionals across Nova Scotia to access
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  real-time information about patients in the acute-care system, streamlining the process and
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  improving patient care.
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  Dr.
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  Nicole Boutilier, executive vice-president of medicine for Nova Scotia Health, explained in a
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  memo to staff that re-evaluating the status of such a complex system is not uncommon.
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  The design and build of the system are expected to be completed this summer, but the delay is
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  necessary to ensure thorough training and preparation for the healthcare professionals
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  who will use it.
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  The One Person One Record system aims to replace or connect more than eighty existing
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  systems currently used to manage patient information.
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  This integration is crucial because many of these systems cannot communicate with one
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  another, requiring health-care professionals to use an average of five different systems to get
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  a complete picture of a patient's health information.
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  Despite the delay, the budget for the project remains unchanged.
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  An IWK spokesperson noted that significant progress has been made, and the adjustment in
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  the timeline allows for more comprehensive training and preparation, which are essential
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  for successful implementation.
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  Dr.
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  Shelly McNeil, president-elect of Doctors Nova Scotia, emphasized that delays in projects of
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  this magnitude are not unexpected.
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  Implementing a modern, hospital-based clinical information system is a substantial
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  undertaking, and ensuring that the system is implemented correctly is vital for improving
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  patient care.
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  All parties involved are committed to working hard to ensure that One Person One Record is
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  introduced effectively and efficiently.
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  Today, we're addressing a topic that's been buzzing on social media platforms: the use of
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  methylene blue as a mood booster and cognitive enhancer.
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  Despite the viral videos and claims, experts are cautioning against its use for these
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  purposes.
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  Methylene blue, first synthesized in the 1800s as a textiles dye, has found its way into the
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  spotlight as a supposed easy fix for mood improvement and cognitive enhancement.
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  However, experts emphasize that its real medical utility is limited to treating specific
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  conditions, most notably a rare blood disorder called methemoglobinemia.
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  The social media frenzy began when a video of U.S.
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  Health and Human Services Secretary Robert F.
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  Kennedy Junior went viral, showing him adding a blue liquid to a glass of water.
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  Joe Schwarcz, director of McGill University's Office for Science and Society, noted that it
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  was clear he was using methylene blue.
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  This led many health influencers, including podcasters like Joe Rogan, to promote methylene
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  blue as a cognitive enhancer and anti-aging solution.
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  Despite these claims, Schwarcz and other experts warn that taking methylene blue without
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  medical supervision is not advisable.
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  While it was originally used as a dye, methylene blue's medical applications are now
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  focused on treating methemoglobinemia, a condition where the blood cannot carry oxygen
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  effectively.
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  It is effective in restoring the balance of oxygenated and deoxygenated hemoglobin in the
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  blood.
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  Symptoms of methemoglobinemia include blue lips or fingertips, shortness of breath, confusion,
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  and even fainting.
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  Dr.
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  Emily Austin, a Toronto-based emergency physician, explained that while
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  methemoglobinemia is rare, it is crucial to have an approach to it in medical settings.
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  Some social media claims have suggested that methylene blue could prevent or treat
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  Alzheimer's disease.
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  However, Schwarcz clarifies that while methylene blue can stain and visualize tau
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  protein tangles characteristic of Alzheimer's, ingesting it does not improve symptoms.
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  Research shows that a derivative of methylene blue might slow Alzheimer's progression in
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  animals, but more studies are needed.
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  Moreover, people taking selective serotonin reuptake inhibitors, used for treating
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  depression, should avoid methylene blue.
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  According to Dr.
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  Austin, combining these can lead to serotonin toxicity, a condition with potentially serious
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  symptoms like changes in heart rate, blood pressure, and body temperature.
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  The spread of misinformation about methylene blue underscores a broader issue of scientific
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  literacy.
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  Schwarcz points out that many people lack an understanding of the underlying science,
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  leading to the rapid dissemination of misleading information.
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  He also criticizes public figures like Robert F.
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  Kennedy Junior for contributing to this misinformation spread.
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  As we wrap up today's episode, it's crucial to approach health information with a critical
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  eye, especially when it comes from social media.
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  Methylene blue has its place in medicine, but not as a casual supplement for mood or
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  cognitive enhancement.
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  Thank you for joining me on Morning Medical with Dr.
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  Chow.
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  Until next time, take care and stay informed.