While new medical discoveries and innovations are in the news every day, doctors struggle daily with using information and techniques available right now, while carefully adopting new concepts and treatments. As a practicing doctor, I deal with uncertainties and unanswered clinical questions all the time.
I encounter two key limitations in making the best possible decisions for my patients under any circumstances. First, while there are reams of information in books and online, doctors often lack the time to find and digest it all. Instead, we must work with what we carry in our heads, from personal experience and education. Another constraint, perhaps even more important, is that the information available is usually not focused on the specific individual or situation at hand.
[quote position="left" is_quote="true"]Part of the problem is that health records are traditionally kept on paper, making them hard to analyze en masse.[/quote]
For example, there are general guidelines for the ideal blood pressure a patient with a severe infection should have. However, the truly best target blood pressure levels likely differ from patient to patient, and perhaps even changes for an individual patient over the course of treatment.
The ongoing computerization of health records presents an opportunity to overcome these limitations. Analyzing electronic data from many doctors’ experiences with many patients, we can move ever closer to answering the age-old question: What is truly best for each patient? In countries with advanced health care systems, we can find optimal care by improving analysis of the data doctors already collect. In poorer and more rural countries, we must first collect that data before being able to analyze it. In both cases, medical professionals and data scientists need to work together to improve health care for everyone.
Toward individual application of mass data
This type of data-driven approach could be very useful. At the moment, a report from the National Academy of Medicine tells us that most doctors base most of their everyday decisions on guidelines from (sometimes biased) expert opinions or small clinical trials. It would be better if they were from multicenter, large, randomized controlled studies, with tightly controlled conditions ensuring the results are as reliable as possible. However, those are expensive and difficult to perform and, even then, often exclude a number of important patient groups on the basis of age, disease, and sociological factors.
Part of the problem is that health records are traditionally kept on paper, making them hard to analyze en masse. As a result, most of what medical professionals might have learned from experiences is lost—or at least is inaccessible to another doctor meeting with a similar patient.
A digital system would collect and store as much clinical data as possible from as many patients as possible. It could then use information from the past—such as blood pressure, blood sugar levels, heart rate, and other measurements of patients’ body functions—to guide future doctors to the best diagnosis and treatment of similar patients.
Industrial giants such as Google, IBM, SAP, and Hewlett-Packard have also recognized the potential for this kind of approach, and are now working on how to leverage population data for the precise medical care of individuals.
Collaborating on data and medicine
At the Laboratory for Computational Physiology at the Massachusetts Institute of Technology, we have begun to collect large amounts of detailed patient data in the Medical Information Mart in Intensive Care (MIMIC). It is a database containing information from 60,000 patient admissions to the intensive care units of the Beth Israel Deaconess Medical Center, a Boston teaching hospital affiliated with Harvard Medical School. The data in MIMIC has been meticulously scoured so individual patients cannot be recognized, and it is freely shared online with the research community.
But the database itself is not enough. We bring together front-line clinicians (such as nurses, pharmacists, and doctors) to identify questions they want to investigate, and data scientists to conduct the appropriate analyses of the MIMIC records. This gives caregivers and patients the best individualized treatment options in the absence of a randomized controlled trial.
Bringing data analysis to the world
At the same time, we are working to bring these data-enabled systems to assist with medical decisions to countries with limited health care resources, where research is considered an expensive luxury. Often these countries have few or no medical records—even on paper—to analyze. We can help them collect health data digitally, creating the potential to significantly improve medical care for their populations.
This task is the focus of Sana, a collection of technical, medical, and community experts from across the globe that is also based in our group at MIT. Sana has designed a digital health information system specifically for use by health providers and patients in rural and underserved areas.
At its core is an open-source system that uses cell phones—common even in poor and rural nations—to collect, transmit, and store all sorts of medical data. It can handle not only basic patient data such as height and weight, but also photos and X-rays, ultrasound videos, and electrical signals from a patient’s brain (EEG) and heart (ECG).
[quote position="right" is_quote="true"]Cell phones—common even in poor and rural nations—can collect, transmit, and store all sorts of medical data.[/quote]
Partnering with universities and health organizations, Sana organizes training sessions (which we call “boot camps”) and collaborative workshops (called “hackathons”) to connect nurses, doctors, and community health workers at the front lines of care with technology experts in or near their communities. In 2015, we held boot camps and hackathons in Colombia, Uganda, Greece, and Mexico. The boot camps teach students in technical fields like computer science and engineering how to design and develop health apps that can run on cell phones. Immediately following the boot camp, the medical providers join the group and the hackathon begins.
Originally the brainchild of Silicon Valley, a hackathon brings people from different fields together over a short period of time to attack a specific problem or type of problem. At Sana events, attendees focus on a specific health problem, such as how to screen rural populations for heart disease or monitor children with epilepsy using cell phones.
Teams build prototype apps to address specific problems the doctors and nurses have encountered. Some projects from the hackathon are continued as research or startup ventures.
Delivering better health care through technology
In Mexico City at the beginning of 2016, Sana held a boot camp hackathon focusing on the health needs of older people. Joining the efforts of the engineering department of the local university, Tec de Monterrey, and geriatricians at a local hospital, it produced several promising prototype applications.
One app would help to provide patients with exercises to control urinary incontinence. An “Uber-like” app would connect families with caretakers—relieving them from relying on word of mouth or worse, the phone book. A third “Tinder-like” app would help elderly people find others with similar interests, reducing their social isolation. The collaborations continue to further develop the prototypes and test a few of them in the hospital and clinics.
At the end of the day, though, the purpose is not the apps. By fostering relationships among engineers, health care providers, and even patients, the Sana and MIMIC projects are helping to move medicine into a truly functional and beneficial digital age.
Why do some folks use social media but don't engage?
Psychologist says people who never comment on social media share these 5 positive traits
For over 20 years, social media has developed into a staple in many people’s day-to-day lives. Whether it’s to keep in communication with friends and family, following the thoughts of celebrities, or watching cat videos while sipping your morning coffee, there seem to be two types of social media users: commenters and lurkers.
The term “lurker” sounds equally mysterious and insidious, with some social media users writing them off as non-participants at best or voyeurs at worst. However, mindfulness expert Lachlan Brown believes these non-commenters have some very psychologically positive and healthy traits. Let’s take a look at how each one of these traits could be beneficial and see how fruitful lurking might be even though it can drive content creators crazy.
1. Cautious about vulnerability
Consciously or not, making a post online or commenting on one puts you and your words out there. It’s a statement that everyone can see, even if it’s as simple as clicking “like.” Doing so opens yourself up to judgment, with all the good, bad, and potential misinterpretation that comes with it. Non-commenters would rather not open themselves up to that.
These silent users are connected to a concept of self-protection by simply not engaging. By just scrolling past posts or just reading/watching them without commentary, they’re preventing themselves from any downsides of sharing an opinion such as rejection, misunderstanding, or embarrassment. They also have more control on how much of themselves they’re willing to reveal to the general public, and tend to be more open face-to-face or during one-on-one/one-on-few private chats or DMs. This can be seen as a healthy boundary and prevents unnecessary exposure.
Considering many comment sections, especially involving political topics, are meant to stir negative emotional responses to increase engagement, being extra mindful about where, when, and what you comment might not be a bad idea. They might not even take the engagement bait at all. Or if they see a friend of theirs post something vulnerable, they feel more motivated to engage with them personally one-on-one rather than use social media to publicly check in on them.
2. Analytical and reflective mindset
How many times have you gone onto Reddit, YouTube, or any other site and just skimmed past comments that are just different versions of “yes, and,” “no, but,” or “yes, but”? Or the ever insightful, formerly popular comment “First!” in a thread? These silent browsers lean against adding to such noise unless they have some valid and thoughtful contribution (if they bother to comment period).
These non-posters are likely wired on reflective thinking rather than their initial intuition. Not to say that all those who comment aren’t thoughtful, but many tend to react quickly and comment based on their initial feelings rather than absorbing the information, thinking it over, researching or testing their belief, and then posting it. For "lurkers," it could by their very nature to just do all of that and not post it at all, or share their thoughts and findings privately with a friend. All in all, it’s a preference of substance over speed.
3. High sense of self-awareness
Carried over from the first two listed traits, these silent social media users incorporate their concern over their vulnerability and their reflective mindset into digital self-awareness. They know what triggers responses out of them and what causes them to engage in impulsive behavior. It could be that they have engaged with a troll in the past and felt foolish. Or that they just felt sad after a post or got into an unnecessary argument that impacted them offline. By knowing themselves and seeing what’s being discussed, they choose to weigh their words carefully or just not participate at all. It’s a form of self-preservation through restraint.
4. Prefer to observe rather than perform
Some folks treat social media as information, entertainment, or a mix of both, and commenting can feel like they’re yelling at the TV, clapping alone in a movie theater when the credits roll, or yelling “That’s not true!” to a news anchor that will never hear them. But contrary to that, social media is a place where those yells, claps, and accusations can be seen and get a response. By its design, social media is considered by experts and the media as performative, regardless of whether it is positive or negative. Taking all of the previously mentioned traits into account, one can see why they would prefer to “observe the play” rather than get up on the stage of Facebook or X.
On top of that, these non-commenters could be using social media differently than those who choose to fully engage with it. Using this type of navigation, there may be nothing for them to comment about. Some commenters are even vying for this for their mental health. There are articles about how to better curate your social media feeds and manipulate algorithms to create a better social media experience to avoid unnecessary conflict or mentally tiring debate.
If you go on a blocking spree on all of your accounts and just follow the posters that boost you, it could turn your social media into a nice part of your routine as you mainly engage with others face-to-face or privately. In terms of commenting, if your curated Instagram is just following cute dogs and all you have to offer for a comment is “cute dog,” you might just enjoy the picture and then move on with your day rather than join in the noise. These non-commenters aren’t in the show and they’re fine with it.
5. Less motivated by social validation
The last trait that Brown showcases is that social media users who browse without posting tend to be independent from external validation, at least online. Social media is built to grow through feedback loops such as awarding likes, shares, and reposts of your content along with notifications letting you know that a new person follows you or wants to connect. This can lead many people to connect their activity on social media with their sense of self worth, especially with adolescents who are still figuring out their place in the world and have still-developing brains.
Engaging in social media via likes, shares, comments, and posts rewards our brains by having them release dopamine, which makes us feel good and can easily become addictive. For whatever reason, non-commenters don’t rely on social media as a means to gauge their social capital or self worth. This doesn’t make them better than those who do. While some non-commenters could have healthier ways to boost their self worth or release dopamine into their systems, many get that validation from equally unhealthy sources offline. That said, many non-commenters’ silence could be a display of independence and self confidence.
Whether you frequently comment online or don’t, it’s good to understand why you do or don’t. Analyzing your habits can help you determine whether your online engagement is healthy, or needs to be tweaked. With that information, you can then create a healthy social media experience that works for you.