Addressing Critical Gaps in Diabetes Management and Injection Technique with Dr. Eden Miller Diabetes Nation

Dr. Eden Miller is an osteopathic board-certified family practitioner, a type 1 diabetic, and Founder of the nonprofit organization Diabetes Nation. The guidelines for injection technique have not been updated in 10 years, and poor injection can lead to improper medication absorption and other complications. The recently released FITTER Forward Guidelines address established approaches for clinicians and patients to improve injection practices, especially for those using injectable therapies such as insulin or GLP-1 agonists.  This initiative was brought together by embecta, which worked with Dr. Miller and other experts to revise the guidelines. Eden explains, "So the FITTER Forward Guidelines are taking the concept of injection technique and injection instruction, and giving it a fresh new look, a new peering back into something that many of us as clinicians kind of feel that we have nailed down. But what we have found with looking into communicating with patients, how to do injections, and how to maximize their technique, we needed to revisit it. So we convened a consensus of experts across many different disciplines of medicine, as well as engineers. We took a look at the data, took a look at the person who's using injection techniques, especially in the field of diabetes, either with insulin or with non-insulin agents. We gave it a fresh new look to help clinicians empower their patients to achieve the best possible results with injectable therapies." "I think it spans the gamut. We always want to start people out on the right foot. The FITTER Forward Guidelines and resources are going to be a great way for our clinicians to freshen up. So when they do have a new patient who is very naive to injection technique, they may have a lot of barriers or preconceived ideas that really get in the way. They think it's going to hurt. They think it's hard to do. They don't know what to do with clothing. They think they have to go into the bathroom to get it done. So we have opportunities both for new users, but we also have the opportunity to go back to established users. " #FITTERForward #Diabetes #Embecta #InjectionTechnique DiabetesNation.com embecta.com Download the transcript here

Dr. Jay Anders, Chief Medical Officer at Medicomp Systems, discusses the issue of dirty data — inaccurate and inconsistent medical data — and its origins, as well as how technology can be used to maintain correct health records. These kinds of errors can lead to incorrect diagnoses, inappropriate treatment, and negative consequences for patients, providers, and payers. AI and other technologies are being leveraged to help identify and flag inconsistencies, providing stakeholders with the tools to prioritize accuracy over efficiency.  Jay explains, "What we do at Medicomp is a clinical knowledge engine with a knowledge graph that's built in that helps clinicians document, sort data, and clean up data. That engine was developed 46 years ago, and it's been done over again in different iterations for those 46 years. We're now incorporating new technologies inside of it to make it more efficient. But we handle medical data in documentation, presentation, and cleanup."   "Well, dirty data has been around since physicians got a chisel and a hammer and etched it in a rock. Because if you think about the old days of dictation, when physicians didn't follow what they dictated or read it very carefully, things got into that medical record that may or may not be correct.  What I mean by dirty data is, does the documentation of that patient's data actually represent what's going on with the patient?" "The other thing that happens, and it's happening more now with ambient listing technologies and other things, is that a family history of a terminal disease will all of a sudden be applied to the patient that's in front of you. So my father had Alzheimer's, now I have Alzheimer's, and it gets into the medical record that way. Gender changes. I have seen this back in the days of dictation, where he turns to her and back and forth again in the same note, which is obviously not correct. So when I say dirty data, that's the kind of thing I'm talking about. Basically, it's incorrect or misconstrued, and it gets propagated through the medical record, and with interoperability, that medical record tends to follow you everywhere you go now, and getting rid of some of that is a daunting task at best."  #Medicomp #MedAI #MedicalRecords #PatientInformation #EHR medicomp.com Download the transcript here

Doug Ryan, CEO of Arineta, describes the advancements in cardiac CT imaging technology and how their ultra-fast scanning is revealing more accurate and higher-quality imaging of the heart. Using wide-area coverage and deep learning image reconstruction, the Arineta platform can detect arterial occlusions and coronary plaque buildup, which is a significant risk factor for sudden cardiac events and is often missed when relying solely on calcium scoring. The development of a mobile cardiac CT scanning unit is improving access to this technology, particularly in rural and underserved areas. Doig explains, "What you're trying to do is to stop the most complex organ inside the human body. The human heart translates, rotates, and beats somewhere between 60 and 100 beats per minute. So you really need advanced CT technology that comprises a great many areas, but the most important things are coverage speed and the ability to reconstruct it very quickly." "You're using advanced algorithms like our DLIR, our deep learning image reconstruction, which focuses on high-contrast, high-spatial, low-noise reconstructions that can then be put into what we call a multiplanar format. So you can look at these coronary arteries from all angles and do the diagnostic." "So it's actually a combination of several things. Ultra FAST is, of course, very important because you are literally trying to stop a bird mid-flight and get an accurate picture of it, but it's also the ability to encompass and see the entire heart in a single rotation. So, one of the secrets of the SpotLight and SpotLight Duo is both the ultra-fast rotation and the wide area coverage that we get with our detector system." #Arineta #CTImaging #CardiovascularDiagnostics #Cardiology #DeepLearningImageReconstruction   Arineta.com Download the transcript here    

Kory Daniels, Chief Information Security Officer at Trustwave,  highlights the unique cybersecurity challenges facing the healthcare industry, particularly in this environment of funding constraints and the increasing sophistication of cyberattacks. Healthcare data is highly valuable to cybercriminals, who can use it for ransomware attacks, identity and insurance fraud, and other nefarious purposes. AI can be part of both the attack and the solution, helping to build in more cyber resilience and awareness about vulnerabilities. Kory explains, "Healthcare is a prime target for cyberattacks for a very fundamental reason. When human lives are at risk due to a criminal objective—which is to make money—they view organizations where human lives are at risk as a greater potential and opportunity. Facilitation of ransomware payments: Ransomware is one of the largest tactics that criminals use to achieve financial gain, but it's not the only tactic they use to achieve financial gain. So, they're looking to exploit the fear and uncertainty, putting patient lives at risk and adding complexity to patient care through their nefarious actions. But also, healthcare data is very attractive for cybercriminals, and just criminal activity in general. And why that is, is that criminals are looking at healthcare data even more so—it's more valuable than driver's license data." "Look at the opportunity of what you can do with healthcare records, and what can you do with PII, Personally Identifiable Information. Threat actors are tapping into this data in several different ways to achieve the additional financial gain above and beyond targeting a healthcare organization with a ransomware attack." "But they're also committing fraud, and fraud toward healthcare insurers, and looking at submitting false claims, fraud against the prescription drug industry in terms of soliciting and looking to obtain prescription drugs through nefarious means, but utilizing data and identity data that comes from hospital and healthcare records. There are a variety of different ways that we've just scratched the surface on, which make the healthcare industry such a desirable target for those seeking to achieve financial gain in the criminal industry." #Trustwave #Cybersecurity #CyberAttacks #HealthcareSecurity #HealthcareIT #CISOInsights trustwave.com Download the transcript here

Matt Brown, VP of Telehealth at Advisory Services at CHG Healthcare, discusses the current state and future of telehealth, including the rapid adoption during the COVID-19 pandemic, the role of technology and AI in enhancing telehealth experiences, and how telehealth can help address physician and nurse burnout. Improved internet access, mobile device usage, and consumer preferences for convenience have driven the increasing telehealth usage for initial visits, follow-up appointments, and chronic care management.   Matt explains, "We are the nation's largest staffing agency. So, we're actually the founders of what's known as the locum tenens marketplace. CHG has been a pioneer in bringing physician services into remote and rural locations across the United States for the past four years. And over the last 10 years or so, we've continued to innovate on top of that physician-led experience and started to bring technology operations, as well as consulting services and telehealth, into the marketplace. So think of us as providing a broad array of staffing services, but also on top of that, technology and operations, and consulting that help the largest health systems in the country manage their physician workforce."   "It's been widely adopted since the pandemic. If you think about coming out of the pandemic, a lot of our health systems and hospitals were really forced to do a few things. One, they really had to upgrade a lot of their infrastructure and technology. So that meant that they were bringing broadband access into their hospitals. They started to think about how they could deliver care to their patients more remotely. And as they were doing a lot of these technology upgrades, they also started to address patients more like consumers. So I think that there was a big shift that started to take place in consumer services, starting to look like healthcare services."   "About that same time, you had a number of very large retail-focused, consumer-focused companies start to enter into the healthcare marketplace. So these are folks like Amazon, you have CVS and Walgreens, and now you've had a number of companies like Hims and Hers, and all of those are entering into the healthcare ecosystem through telehealth as a channel. So, as we've seen this increased infrastructure, this improvement in infrastructure, as well as consumerization of healthcare, continue to accelerate after the pandemic, and now we have more of this consumer-centric focus coming from a retail perspective."   #CHFGHealthcare #MedAI #DigitalHealth #PatientAccess #Telehealth #PhysicianBurnout #ClinicianBurnout CHGHealthcare.com Download the transcript here

Dr. Chuck Link is the Executive Chairman of Syncromune, a company developing a novel immunotherapy approach for solid tumors by delivering the therapy into the tumor and surrounding lymph nodes to stimulate a systemic immune response. Their complex drug has four different components with varying levels of activity that activate the immune system and counteract immune suppression. This in situ immunotherapy technology, SYNC-T, was tested in a phase 1 trial for metastatic castration-resistant prostate cancer, which showed high response rates and a favorable safety profile with low rates of serious side effects and minimal autoimmune toxicity.   Chuck explains, "So, SYNC-T is a technology in which you put a needle directly into a tumor that can be done by a urologist in the prostate cancer situation, or by an interventional radiologist. That needle then the tip of it freezes, and does a freeze fracture. Think of a Coke bottle rupturing like in the freezer. And what that does is release the antigens from that patient's own specific tumor. So, it's personalized because the tumor proteins and antigens are used to create a vaccine effect that's released directly from the cancer." "The tumor microenvironment is basically within the tumor itself, and there are immune suppressive mechanisms that the tumor has evolved to protect it from the immune system. I like to think of it as a castle, multiple levels of defense where you have the castle itself, and then you have a castle wall, and then you have a moat, and then an army in front of the wall. So the cancer has multiple immune-suppressive mechanisms that are activated to defeat the immune system, even though cancer has a lot of abnormal, mutated proteins that the immune system should attack and destroy. So what SYNC-T accomplishes is it basically hits solutions for all four of those types of defense simultaneously to make it more difficult for the castle, in this case, the tumor, to protect itself." #Syncromune #Immunotherapy #MetastaticSolidTumors #Cancer #ProstateCancer syncromune.com Download the transcript here

David Sontag, CEO and Co-Founder of Layer Health, describes the environment of chart reviews in healthcare and how AI and large language models can be used to analyze a patient's medical record to extract key clinical details. Applying natural language processing to medical records has been challenging due to the complexity of the language and the longitudinal nature of the data. This large language approach from Layer can enhance clinical decision-making, quality measurement, regulatory compliance, and patient outcomes. David explains, "Every patient will have experienced a chart review at some point. Whether it's when they've come home from a medical visit and go to their electronic medical record to look at the notes written by their providers. Or it's been experienced in the patient room, in the doctor’s room, watching a clinician review the past medical records to try to get a better context of what's going on with that patient, so that's from the patient’s perspective." "The same thing happens everywhere else in healthcare. So, chart review is the process of analyzing a patient's medical record to extract key clinical details. You can imagine going through clinical notes, lab results, imaging reports, and medical history, trying to create that complete and accurate picture of the patient's health. And it's used everywhere for measuring quality, for improving the financial performance of health system providers, and for regulatory compliance."   "Some aspects of natural language understanding from patients' medical records have been attempted for well over a decade, and these approaches have been typically very surface-level. So look at a single note, try to answer a relatively simplistic question from that note, but the grand challenge has always been one of how do we mimic the type of reasoning that a physician would do where they would be looking at a patient's longitudinal medical record across many notes trying to piece together data from not just from the unstructured but also the structured data."  #LayerHealth #ClinicalAI #AIinHealthcare #MedicalChartReview #PrecisionMedicine #ClinicalResearch #LLMsinHealthcare layerhealth.com Download the transcript here

Alexandra Paul is the Vice President of Strategic Partnerships at Accolade, a company that provides comprehensive healthcare for its members by integrating digital health solutions and leveraging AI. The company focuses on addressing the healthcare needs of underserved communities, such as truck drivers, and provides 24/7/365 access to virtual care. The Experience Store and WayFinding navigator utilizes AI and large language models to deliver real-time, chat-based guidance and personalized treatment options based on plan benefits.   Alexandra explains, "What's really important for us is ensuring that we are targeting the right buyer who can help us really get in front of members to help them navigate a complex healthcare experience. Our core foundation is being the one place to go for health and care. And so, whether that's through a health plan offering or whether that's through an employer benefit offering, we've truly become kind of that front door experience and what we call WayFinding, which is our AI-powered solution to help members get the right care."  "We're very excited about the Experience Store that we just launched, and a big part of that is making sure that we tap into technology. So, as we think about how we can provide this comprehensive care experience and this one place to go for health and care for members, we have been heavily focused on investing in AI and technology systems that make this care experience easier. A lot of that is really just thinking about large language models. So, members in their chat function can type in a question that AI in the new world, which feels so much like a person, can answer and provide real-time guidance to that member."  #Accolade #DigitalHealth #HealthcareBenefits #Healthcare #PersonalizedCare #HealthTech  accolade.com Download the transcript here

Julio Martinez-Clark, Co-Founder and CEO of Bioaccess, a Latin American MedTech CRO that works with US-based medtech and biopharma startups to conduct their first-in-human trials outside the US to accelerate development and recruitment. Data from overseas clinical trials conducted to international standards is considered valid and can support conversations with investors, strategic partners, and the FDA. Drawing on resources in the Balkans, Latin America, and Australia, clinical trials can get faster approvals, more easily recruit patients, and benefit those living in the communities where clinical trials are conducted.   Julio explains, "The mission is to accelerate global clinical trials, and the type of clients is mostly us. Occasionally, we have European clients, but they're mostly San Francisco-based, Boston-based, San Diego-based, Minnesota-based, or Boston-based companies that are looking to execute a first-in-human clinical study outside of the United States. And for many reasons, Latin America is an obvious choice, at least for the exploratory phase. When they're looking for different countries, they usually explore Eastern Europe, Australia, and Latin America. And we help these companies, which have been predominantly US-based MedTech startups. More recently, we have expanded to biopharma as well. But let's talk with the conversation on MedTech startups, and their struggle to conduct these first inhuman trials in the United States. They seek help when they want to go overseas, and they call for us to help them find investigators and to recruit patients and to get past approvals, etc." "There is one single thing, which is that these companies are startups. Getting this type of trial approved is really, really difficult and expensive. And the timeline to get them approved is really uncertain. So when you have a startup that has investors backing the company and they have a business plan, they have some milestones, it is difficult to predict when you're going to hit these milestones, and you need to keep the investors happy. So if you don't have a solid business plan, then you are not going to be able to raise more funds to continue your operation and development."  #BioAccess #GlobalTrialAccelerators #DigitalHealth #PrecisionMedicine #LATAMTrials #BalkansClinicalResearch #AustraliaCTN #AANVISA #ALIMS #MINSA #TrialAcceleration #FirstinHumanTrials #ClinicalTrials #MedTechInnovation #Biopharma #MedTech #PatientRecruitment #CRO bioaccessla.com Download the transcript here

Nicole Clark, Co-Founder and CEO of the Adult and Pediatric Institute for Health and Wellness, a comprehensive, personalized psychiatric practice that takes a holistic approach to mental health, looking at the interconnection of physical, cognitive, and emotional health. Nicole has two daughters with autism, which has informed the Institute's focus on serving the autism community, especially in these times of changes in the definition of autism spectrum disorder. Services include psychiatric and autism evaluations, medication management, education, and early intervention for children and adults and their family members.  Nicole explains, "We're a comprehensive psychiatric practice, and we're kind of unique in that we have fully blended behavioral and mental health therapy. We see an individual as a whole person. They're not just one piece of their identity. They have multiple pieces of their identity. And so we don't like to only focus on a singular issue. We like to look at the person as a whole, and so we see the entire family. We see ages 18 months when we're doing autism evaluations, all the way up to 65 years old. And we offer psychiatric evaluations, autism evaluations, medication management, and different therapy modalities." "A lot of the time, we are treating someone's anxiety, or maybe we're treating their ADHD, or maybe we're treating bipolar depression, the other illnesses that are kind of stemming from that stomachache, especially with kids, the headaches, the 'I'm always feeling sick.” I don't want to go to school." "Or in adults-- the chronic stomachaches, the heart disease, all of these issues tend to start to resolve when you can treat the mind and when you can work on the mental health side of things, because these are real problems and these are real issues, physiological issues, heart disease. A heart attack, that's real. We know that is real. Well, what is causing that? Well, maybe it's being caused by elevated cortisol levels over an extended period of time because you have unresolved trauma, anxiety, or depression. And so, it's becoming a more collaborative approach to healthcare, which I love."  #PEDSInstitute #PsychiatricCare #MentalHealth #PediatricHealth #Autism #AutismDiagnosis #AutismAwareness pedsinstitute.com Download the transcript here