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techRHEUM
LISA TRABOCO, MD
PRA Annual Meeting
Davao, March 2019
u No financial arrangements with any of the
companies of the apps, sites and
hardware technology seen in this
presentation
Doc Emmett Brown
HOW MANY DEGREES OF SEPARATION?
3.57DEGREES OF SEPARATION
Acknowledgements
#MedTwitterPH
Berci Mesko, MD, PhD
@Berci
The Medical Futurist Blog
Brennan Spiegel, MD
@BrennanSpiegel
Cedar Sinai VR/AR Research
Suleman Bhana, MD
@DrBhana
Rheum Journal Club
Paul Sufka, MD
@psufka
Rheum Journal Club
Acknowledgements
Leonard Calabrese
@LCalabreseDO
Cleveland Clinic
Marjorie Stiegler
@DrMStiegler
Author: The Social Prescription
Dana Corriel
@DrCorriel
@SoMeDocs Founder
Marie Ennis-O’Connor
@JBBC
Mayo Clinic Social Media Advisory Board
#MedTwitter
“
”
Any sufficiently advanced
technology is indistinguishable
from magic.”
(author of 2001: Space Odyssey)
ARTHUR C. CLARKE
Profiles of the Future: An Inquiry into the Limits of the Possible
Themedicalfuturist.com
Berci Mesko, MD, PhD
@Berci
The Medical Futurist
Past Present Future
Past Present Future
IOT
René Theophile-Hyacinthe Laennec
Wikipedia.com
Past Present Future
Past Present Future
- Professional / Clinic Workflows
- CME / Academic Medicine
- The Internet Rx
Data Studio
Macros:
EHRs:
Professional/
Clinic Workflows:
Workflows:
3$/year, 44$ standalone
Docs Slides Sheets Forms
CME / Academe
(Self-learning
&/or Teaching):
CREATE YOUR PERSONAL LEARNING NETWORK
“Flipped Classroom”
• The Flipped Learning Global Initiative". The Flipped Learning Global Initiative. Retrieved 2 August 2016.
“Adaptive Learning”
CME / Academe
(Self-learning
&/or Teaching):
images.rheumatology.org
esor.eular.org
www.healio.com/rheumatology
theultrasoundsite.co.uk
www.tripdatabase.com
www.pmmonline.org
(Pedia-Rheuma)
rheumatologymindmap.com
Dr Alex Papou (UK)
acr18.rheumnow.com
rheumnow.live
Past Present Future
- Professional / Clinic Workflows
- CME / Academic Medicine
- The Internet Rx
Navigating Health Websites
themedicalfuturist.com
WHO
WHAT
WHEN
WHERE
WHY
National Center for Complementary or Integrative Health
nccih.nih.gov
made it
is it saying
was it made
is the information coming from
did they make the site
...BAKA SuspiciouS?
bit.ly/impormasyon101
For more information / (Tagalog) tutorial:
• BAKIT – bakit ginawa ang website? May produkto na binebenta?
• KAILAN – kailan ginawa? Ito ba ay napapanahon?
• ANO – ano ang sinasabi / ipinapangako? Mga pambihira o impossible ba?
• SINO – sino ang nagpapatakbo ng website? Mapagkakatiwalaan?
• SAAN – saan nanggagaling ang impormasyon? Sa mga (totoong)
scientists/researchers?
Internet Rx
u General Medicine:
u nlm.nih.gov/medlineplus
u mayoclinic.com
u Hopkinsrheumatology.org/rheumtv
u Creakyjoints.org
u Rheuminfo.com
u Arthritis.org/living-with-arthritis
u Selfmanagescleroderma.com/index.html
DON’T Reject, REDIRECT !
themedicalfuturist.com
Internet Rx
Jerico Gutierrez
@jericogutierrrz
DON’T Reject, REDIRECT !
Past Present Future
- Professional / Clinic Workflows
- CME / Academic Medicine
- The Internet Rx
Past Present Future
- What’s App in Rheuma?
- Patient Pocket Power?
MedCalX MedConvert MDCalc Sanford Guide MIMS
snp.io
Calculators, Guides
Evernote Dropbox
File Sharing
Handy Tools
References (non-pdf format)
Uptodate
GoToWebinar
CME Streaming
#healthxph 1/19/19
Harrisons
Kelleys
UP Med Webinars
Office Lens
Add data to Excel directly from a photo—
Using the Excel app, you can take a picture of a
printed data table on your Android device and
automatically convert the picture into a fully
editable table in Excel.
Koenigsbauer,	et	al;	New	to Microsoft	365 in	February—advancing	security	and	empowering	a	modern	workplace;	Retrieved	March	2,	2019
Spark Post Spark Video
ClipsPixabay
Content Creation
Bryan Vartabedian, MD
@Doctor_V
33charts.com
“Doctors are the first to complain…but the last to create”
• Infographics
• Info-videos
• Memes
• Inspirational Quotes for
Mental Health / Physician
Burnout
• Images Acronyms for Med
Education
#PSMIDVax
#PULMOCHAT
for @DrEdselSalvana
PODCASTS
RHEUMinations
@AdamJBrownMD @clevelandclinic
RHEUMnow Dr John Cush
EBRheum Dr Mike Putnam
The Curbsiders
Dr Matthew Watto
Dr Stuart Brigham
Dr Paul Williams
Dr Tony Sidari
Plenary Session @VPrasadMDMPH
Bedside Rounds @AdamRodman
listennotes.com
• Etymology of Gout?
• If Podagra is gout of the
toe/foot, what about the
shoulder? The knee?
• Which drug/ s was not
originally designed to treat
gout?
• What anti-gout drug can
we get from this flower?
Past Present Future
- What’s App in Rheuma?
- Patient Pocket Power?
Mobile health apps available in Apple iTunes &
Google Play stores
Account for half of all downloads
165,000
• IMS Institute, Patient Adoption of mHealth: Use, Evidence & Remaining Barriers to Mainsteam Adoption, 2015
• themedicalfuturist.com
36
apps.beta.nhs.uk
Other libraries:
• healthdirect.gov.au/health-and-wellbeing-apps
• healthhub.sg/apps
Devan, Hemakumar & Farmery, Devin & Peebles, Lucy & Grainger, Rebecca. (2018). Evaluation of Self-Management Support Functions in Apps for People
with Persistent Pain:A Systematic Review (Preprint). 10.2196/preprints.13080.
Stoyanov SR, Hides L, Kavanagh
DJ, Zelenko O, Tjondronegoro D,
Mani M. Mobile app rating scale: a
new tool for assessing the quality of
health mobile apps. JMIR Mhealth
Uhealth. 2015;3(1):e27. Published
2015 Mar 11.
doi:10.2196/mhealth.3422
MARS (Mobile App Rating Scale)
• engagement
• functionality
• aesthetics
• information quality
• subjective quality
Grainger R, Townsley H, White B, Langlotz T, Taylor WJ. Apps for People With Rheumatoid Arthritis to Monitor Their Disease Activity:A Review ofApps for Best Practice
and Quality. JMIR Mhealth Uhealth.2017;5(2):e7.Published 2017 Feb 21.doi:10.2196/mhealth.6956
SuperBetter
PainScale-PainDiary
Curable
Arthritis Power
Dr Iris Isip-Tan
@endocrine_witch
#Healthxph
Past Present Future
IOT
Tools
u FLIR
u Butterfly IQ
u Olloclip + Gosky Frame
u Wearable Tech
SULEMAN BHANA, MD
@DrBhana
TheRheumPodcast,
RheumJC, Tech Tools 2.0
BRENNAN SPIEGEL, MD
@BrennanSpiegel
BERTALAN MESKO, MD, PhD
@Berci
themedicalfuturist.com
FLIR
Chohnowksi. M; et al; Infrared thermal imaging in connective tissue disease; Reumatologia. 2017; 55(1):38-43
Lim, MJ, etc al; Digital thermography of the fingers and toes in Raynaud’s phenomenon. J Korean Med Sci 2014.Apr 29(4):502-6
$299 FLIR ONE
$399 FLIR ONE Pro
Venuturupalli, R.S, et al; Digital Medicine in Rheumatology: Challenges and Opportunites; Rheum Dis Clin N Am 45(2019) 113-126
Butterfly IQ
Around $ 2,000
www.butterflynetwork.com/clinical/msk
Olloclip + Gosky phone adapter mount
u Synovial Microscopy
u Nailfold Capillaroscopy
u Traditional image
capture equipment
($$$$$)
Venuturupalli, R.S, et al; Digital Medicine in Rheumatology: Challenges and Opportunites; Rheum Dis Clin N Am 45(2019) 113-126
Van Room, AM et al; Abnormal Nailfold Capillaroscopy is Common in Patients with CTD and Associated with Abnormal PFT: J Rheumatol. 2018 Dec 15
65 $
21x MACRO
Vs DermLite 495 $
25 $
Lens is specific to a certain iphone model
(lens for iphone 7 cannot be used for iphone x)
Wearable biosensors
u Can we take care of people remotely?
u the doctor’s office = an artificial environment
u Hawthorne effect = a form of reactivity whereby subjects
alter their behavior simply in response to knowing that they
are being studied
Brennan Spiegel, MD
@BrennanSpiegel
Wearable Biosensors and the Quantified Self Movement ;April 8, 2016
Oura
Ring
Wearable biosensors
”Passive monitoring” = powerful monitoring
Past Present Future
IOTIs the
Future
NOW?
VR / AR
Venuturupalli, R.S, et al; Digital Medicine in Rheumatology: Challenges and Opportunites; Rheum Dis Clin N Am 45(2019) 113-126
Torakeva, Julia; The Difference Between VR, AR, MR; Sofware Development Consultant on Quora; Feb 2, 2018
• Computer generated
• Displays
• Sensors
• User Input
Virtual Reality
Brennan Spiegel, MD
@BrennanSpiegel
Cedar Sinai
CAREN – Computer assisted rehabilitation environment system
University of South Florida
• Chronic Pain Management
• Drug (Opiod) dependence
• Anxiety
• Post traumatic stress disorder
• Rehabilitation
• Stroke
• Spinal Cord Injury
• Empathy-building
• Post partum depression
• Social interaction training
appliedvr.io/research-media
Venuturupalli, R.S, et al; Digital Medicine in Rheumatology: Challenges and Opportunites; Rheum Dis Clin N Am 45(2019) 113-126
3d Brush
Free
1250 PHP
Artificial Intelligence Bitcoin’s Blockchain
Internet of (Medical) Things
http://inspiren.com/#meetin
Techinsider.io
Futurelearn.com
13yo
Rishab
Jain
?Portable densitometry
?Portable xray
Movie: Elysium (2013)
CHALLENGES?
• Privacy / security
• Payment / profit / funds
• Applicability / Usability
• Internet Access
• Maintenance
• Ethics
Doctor
Diagnostic &
Treatment
Machine
CHALLENGES?
I’m not sure why we feel the need to create the illusion that doctors
will always be just as they’ve always been.
This is medicine’s new reality.
It’s up to doctors to decide how they will participate in medicine’s
redefinition.
The best way to predict the future is to create it.
Bryan Vartabedian, MD
@Doctor_V
33charts.com
Apologizing for Technology, Sept 2017
あ
り
が
と
う
ご
ざ
い
ま
す
THANK	YOU!

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techRHEUM (edit)

  • 1.
  • 2. techRHEUM LISA TRABOCO, MD PRA Annual Meeting Davao, March 2019
  • 3. u No financial arrangements with any of the companies of the apps, sites and hardware technology seen in this presentation
  • 4. Doc Emmett Brown HOW MANY DEGREES OF SEPARATION?
  • 7. Berci Mesko, MD, PhD @Berci The Medical Futurist Blog Brennan Spiegel, MD @BrennanSpiegel Cedar Sinai VR/AR Research Suleman Bhana, MD @DrBhana Rheum Journal Club Paul Sufka, MD @psufka Rheum Journal Club Acknowledgements Leonard Calabrese @LCalabreseDO Cleveland Clinic Marjorie Stiegler @DrMStiegler Author: The Social Prescription Dana Corriel @DrCorriel @SoMeDocs Founder Marie Ennis-O’Connor @JBBC Mayo Clinic Social Media Advisory Board #MedTwitter
  • 8. “ ” Any sufficiently advanced technology is indistinguishable from magic.” (author of 2001: Space Odyssey) ARTHUR C. CLARKE Profiles of the Future: An Inquiry into the Limits of the Possible
  • 9.
  • 10. Themedicalfuturist.com Berci Mesko, MD, PhD @Berci The Medical Futurist
  • 14.
  • 15.
  • 17. Past Present Future - Professional / Clinic Workflows - CME / Academic Medicine - The Internet Rx
  • 19. CME / Academe (Self-learning &/or Teaching): CREATE YOUR PERSONAL LEARNING NETWORK
  • 20. “Flipped Classroom” • The Flipped Learning Global Initiative". The Flipped Learning Global Initiative. Retrieved 2 August 2016. “Adaptive Learning” CME / Academe (Self-learning &/or Teaching):
  • 23. Past Present Future - Professional / Clinic Workflows - CME / Academic Medicine - The Internet Rx
  • 24. Navigating Health Websites themedicalfuturist.com WHO WHAT WHEN WHERE WHY National Center for Complementary or Integrative Health nccih.nih.gov made it is it saying was it made is the information coming from did they make the site
  • 25. ...BAKA SuspiciouS? bit.ly/impormasyon101 For more information / (Tagalog) tutorial: • BAKIT – bakit ginawa ang website? May produkto na binebenta? • KAILAN – kailan ginawa? Ito ba ay napapanahon? • ANO – ano ang sinasabi / ipinapangako? Mga pambihira o impossible ba? • SINO – sino ang nagpapatakbo ng website? Mapagkakatiwalaan? • SAAN – saan nanggagaling ang impormasyon? Sa mga (totoong) scientists/researchers?
  • 26. Internet Rx u General Medicine: u nlm.nih.gov/medlineplus u mayoclinic.com u Hopkinsrheumatology.org/rheumtv u Creakyjoints.org u Rheuminfo.com u Arthritis.org/living-with-arthritis u Selfmanagescleroderma.com/index.html DON’T Reject, REDIRECT ! themedicalfuturist.com
  • 28.
  • 29. Past Present Future - Professional / Clinic Workflows - CME / Academic Medicine - The Internet Rx
  • 30. Past Present Future - What’s App in Rheuma? - Patient Pocket Power?
  • 31. MedCalX MedConvert MDCalc Sanford Guide MIMS snp.io Calculators, Guides Evernote Dropbox File Sharing Handy Tools References (non-pdf format) Uptodate GoToWebinar CME Streaming #healthxph 1/19/19 Harrisons Kelleys UP Med Webinars Office Lens
  • 32. Add data to Excel directly from a photo— Using the Excel app, you can take a picture of a printed data table on your Android device and automatically convert the picture into a fully editable table in Excel. Koenigsbauer, et al; New to Microsoft 365 in February—advancing security and empowering a modern workplace; Retrieved March 2, 2019
  • 33. Spark Post Spark Video ClipsPixabay Content Creation Bryan Vartabedian, MD @Doctor_V 33charts.com “Doctors are the first to complain…but the last to create” • Infographics • Info-videos • Memes • Inspirational Quotes for Mental Health / Physician Burnout • Images Acronyms for Med Education
  • 35. PODCASTS RHEUMinations @AdamJBrownMD @clevelandclinic RHEUMnow Dr John Cush EBRheum Dr Mike Putnam The Curbsiders Dr Matthew Watto Dr Stuart Brigham Dr Paul Williams Dr Tony Sidari Plenary Session @VPrasadMDMPH Bedside Rounds @AdamRodman listennotes.com
  • 36. • Etymology of Gout? • If Podagra is gout of the toe/foot, what about the shoulder? The knee? • Which drug/ s was not originally designed to treat gout? • What anti-gout drug can we get from this flower?
  • 37. Past Present Future - What’s App in Rheuma? - Patient Pocket Power?
  • 38. Mobile health apps available in Apple iTunes & Google Play stores Account for half of all downloads 165,000 • IMS Institute, Patient Adoption of mHealth: Use, Evidence & Remaining Barriers to Mainsteam Adoption, 2015 • themedicalfuturist.com 36
  • 40. Devan, Hemakumar & Farmery, Devin & Peebles, Lucy & Grainger, Rebecca. (2018). Evaluation of Self-Management Support Functions in Apps for People with Persistent Pain:A Systematic Review (Preprint). 10.2196/preprints.13080. Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR Mhealth Uhealth. 2015;3(1):e27. Published 2015 Mar 11. doi:10.2196/mhealth.3422 MARS (Mobile App Rating Scale) • engagement • functionality • aesthetics • information quality • subjective quality Grainger R, Townsley H, White B, Langlotz T, Taylor WJ. Apps for People With Rheumatoid Arthritis to Monitor Their Disease Activity:A Review ofApps for Best Practice and Quality. JMIR Mhealth Uhealth.2017;5(2):e7.Published 2017 Feb 21.doi:10.2196/mhealth.6956 SuperBetter PainScale-PainDiary Curable Arthritis Power
  • 43. Tools u FLIR u Butterfly IQ u Olloclip + Gosky Frame u Wearable Tech SULEMAN BHANA, MD @DrBhana TheRheumPodcast, RheumJC, Tech Tools 2.0 BRENNAN SPIEGEL, MD @BrennanSpiegel BERTALAN MESKO, MD, PhD @Berci themedicalfuturist.com
  • 44. FLIR Chohnowksi. M; et al; Infrared thermal imaging in connective tissue disease; Reumatologia. 2017; 55(1):38-43 Lim, MJ, etc al; Digital thermography of the fingers and toes in Raynaud’s phenomenon. J Korean Med Sci 2014.Apr 29(4):502-6 $299 FLIR ONE $399 FLIR ONE Pro Venuturupalli, R.S, et al; Digital Medicine in Rheumatology: Challenges and Opportunites; Rheum Dis Clin N Am 45(2019) 113-126
  • 45. Butterfly IQ Around $ 2,000 www.butterflynetwork.com/clinical/msk
  • 46. Olloclip + Gosky phone adapter mount u Synovial Microscopy u Nailfold Capillaroscopy u Traditional image capture equipment ($$$$$) Venuturupalli, R.S, et al; Digital Medicine in Rheumatology: Challenges and Opportunites; Rheum Dis Clin N Am 45(2019) 113-126 Van Room, AM et al; Abnormal Nailfold Capillaroscopy is Common in Patients with CTD and Associated with Abnormal PFT: J Rheumatol. 2018 Dec 15 65 $ 21x MACRO Vs DermLite 495 $ 25 $ Lens is specific to a certain iphone model (lens for iphone 7 cannot be used for iphone x)
  • 47. Wearable biosensors u Can we take care of people remotely? u the doctor’s office = an artificial environment u Hawthorne effect = a form of reactivity whereby subjects alter their behavior simply in response to knowing that they are being studied Brennan Spiegel, MD @BrennanSpiegel Wearable Biosensors and the Quantified Self Movement ;April 8, 2016
  • 49. Past Present Future IOTIs the Future NOW?
  • 50. VR / AR Venuturupalli, R.S, et al; Digital Medicine in Rheumatology: Challenges and Opportunites; Rheum Dis Clin N Am 45(2019) 113-126 Torakeva, Julia; The Difference Between VR, AR, MR; Sofware Development Consultant on Quora; Feb 2, 2018 • Computer generated • Displays • Sensors • User Input
  • 51. Virtual Reality Brennan Spiegel, MD @BrennanSpiegel Cedar Sinai CAREN – Computer assisted rehabilitation environment system University of South Florida • Chronic Pain Management • Drug (Opiod) dependence • Anxiety • Post traumatic stress disorder • Rehabilitation • Stroke • Spinal Cord Injury • Empathy-building • Post partum depression • Social interaction training appliedvr.io/research-media Venuturupalli, R.S, et al; Digital Medicine in Rheumatology: Challenges and Opportunites; Rheum Dis Clin N Am 45(2019) 113-126
  • 52.
  • 55. Artificial Intelligence Bitcoin’s Blockchain Internet of (Medical) Things http://inspiren.com/#meetin Techinsider.io Futurelearn.com 13yo Rishab Jain
  • 56.
  • 57.
  • 58.
  • 60. Movie: Elysium (2013) CHALLENGES? • Privacy / security • Payment / profit / funds • Applicability / Usability • Internet Access • Maintenance • Ethics Doctor Diagnostic & Treatment Machine
  • 62. I’m not sure why we feel the need to create the illusion that doctors will always be just as they’ve always been. This is medicine’s new reality. It’s up to doctors to decide how they will participate in medicine’s redefinition. The best way to predict the future is to create it. Bryan Vartabedian, MD @Doctor_V 33charts.com Apologizing for Technology, Sept 2017