Friday Fireside Chat: Dr. Booker, founder, OnPulse

Today, I’m talking to Dr. Corenthian “Corey” Booker.

Corey Booker, not to be confused with the mayor of Newark, is a physician. He received his undergraduate degree in Neurobiology and Physiology at the University of Maryland College, and his medical degree from Creighton University.

Thanks for talking to MedCrunch. What is OnPulse?

OnPulse is a new healthcare product designed to get you, the patient, on the same page as anyone involved in your healthcare. It’s an online environment allowing providers to communicate to one another and their patients. Not only physicians, but staff members –anyone who owns a piece of patient care. With instant online access through the product’s patient profile, connected health teams can view and share relevant information, no matter what EMR they use, or whether they’re at the office, at home or on the road.

Who should use OnPulse?

Any healthcare provider who is currently communicating by email or any specialist trying to manage a large team with email should love OnPulse. Also, any patient who emails their provider should use OnPulse.

How do patients access OnPulse?

It’s web based now (mobile app will be available this summer), so they would log on at http://www.onpulse.com and enter a username and login. Right now, it is by Invitation Only. You can request an invitation at our website. We will release it to more people next month. It can be accessed on iPads and will eventually be available on mobile phones.

What makes OnPulse different from anything else out there?

What makes OnPulse different is we allow the individuals who have an account to own their information. The difference is whenever you stop receiving care somewhere and close an account, you no longer have access to that information. With OnPulse, if you end a relationship with a doctor or provider, you own your information and you can share it with another provider anywhere or anytime you want or the next time you need to access care you can share it with that provider. As a system, multiple providers from different organizations can communicate. It’s based on 4 things: 1. Simplicity. 2. Access. 3. Peace of Mind. 4. On-line teams communicating in one place.

What regulations exist concerning ownership of patient health information?

Multiple state statutes, regulations, and cases govern the ownership of health information and the information contained in medical records. The classic statement of the rule concerning ownership of medical records is that the provider owns the medical records maintained by the provider, subject to the patient’s rights in the information contained in the record.

 
But,under the federal Health Insurance Portability and Accountability Act (HIPAA), every person “has a right of access to inspect and obtain a copy of protected health information.” The Meaningful Use regulations require that outpatient providers give patients clinical summaries within three business days for at least half of all office visits, if requested. Hospitals have to provide an electronic copy of discharge instructions upon request.

 
The stage two meaningful use places a much greater emphasis on patient engagement and set high standards for making data electronically available to patients. Physicians should think about these requirements as they work to implement a new EHR system. The new rules state that a professional must make electronic records available to 50 percent of their patients. Furthermore, 10 percent of a physician’s patients must actually view and download these records.

Should people be concerned about privacy?


As a patient no one knows you have an OnPulse account unless you tell them. Under HIPPA they allow providers to do what they currently do and allow them to invite other providers to the health team. Everyone on the team knows who has access to information. The system is only transparent to those using it.

When did you develop the idea for OnPulse?
I was exposed to communication in our healthcare system during my first summer of medical school. Writing HEDIS measures for the National Committee for Quality Assurance (NCQA), as a Washington Health Policy Fellow intern, taught me that our system was fragmented.

My understanding of communication in healthcare matured in residency when I became responsible for confused patients, busy consultants and returning phone calls to referring doctors for unreceived faxes, but I didn’t do anything about it until my fellowship. As a resident, you learn to communicate with everyone involved, you manage the communication with among your resident colleagues, consultants, patients and the people who are training you. As a resident, you learn to communicate with everyone involved, you manage the communication with among your resident colleagues, consultants, patients and the people who are training you. As a resident I saw, how our means of communication can fail the provider team and the patient. I didn’t know what to do about it at the time.

Within the first six months of my fellowship, I had a patient who looked at me with tears because she had suffered financially, physically and emotionally –she said, ‘I thought you guys were all communicating.’ That was it. I realized that all the faxes, phone calls and emails had failed her and so did our team, despite our best intentions.

Mostly, I learned even more about communicating in healthcare when I became a patient after I ruptured both of my patellar tendons, which connects your knee cap to your lower legs. I realized how difficult it is to navigate healthcare and to have a choice. I also learned how difficult it was for all of the providers to communicate as they are trying to help you reach a certain outcome, especially when they are not in the same organization. For instance I had an orthopedic surgeon and two physical therapist all in different places. This experience really informed how important the asset a patient was to the health team and really improved the system.

How does a patient get started using it?

The patient can either be invited by their provider or they can open their own account. Adding providers is simple. We recommend they that they invite providers that they have an established relationship with, especially an electronic one. If they have multiple providers helping them on a single issue they can suggest to their primary provider to form a health team in OnPulse. Then, you’re able to exchange messages, create a task and share files. Whenever information is requested by you –you receive a text or email alert that something is available to you.

OnPulse spans the communication needs for across sickness, wellness and fitness . For example, some patients even use it to communicate with their fitness trainer, keeping track of a daily routine, and keeping all their health information in one place.

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Are there any costs involved for the patient or the provider?

It is free to an individual patients and individual providers. No fee for individual users either patients or doctors. There are subscription payments as a practice to include your business for independent practices or hospitals.

What are the benefits of using OnPulse?

Medical practices can share vital information with other providers and their mutual patients in an easily accessible, unified place. It gives providers and patients secure access to the entire team of healthcare providers. It gives both peace of mind that what they send is actually received by the right person. It helps streamline communication. And it provides personalized communication with everyone. And it’s free to an individual patient and individual provider to use.

Where do you envision OnPulse in 5 years?

My vision for it is to become the healthcare communication environment of choice for all providers and patients. OnPulse, the new on-line healthcare communication environment for patients and providers.

How did medicine and entrepreneurship meet?

My background is medicine with a consistent thread of entrepreneurship. During my fellowship I completed the masters program in clinical informatics at the Duke University’s Fuqua School of Business to better understand how to apply my ideas to clinical medicine. Prior to this time I dabbled in buying and selling houses, creating an online stationary company for my creative wife Kathy and forming a mobile application development company, but by far (besides my kids) OnPulse is the thing that wakes me up and takes me to bed.

“I believe in better communication in healthcare. That’s why I developed OnPulse, where everyone can easily contribute to the personalized best care for the patient and the patient will own 100 percent of their records, and be able to share them accordingly with their health team of choice.” ~ Corey Booker, MD/founder, OnPulse

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For More Information visit http://www.onpulse.com

 

If you have any questions for Dr. Booker, feel free to ask them below.

Cool Allergy Relief Tip

Nearly 20% of Americans will suffer from Spring allergies.

Dr. David Lang, an allergist at Cleveland Clinic brings us a “cool” tip.  He says one of the easiest things you can do this time of year to ease allergies is turn up the AC.

“Air conditioning is a major measure that can be effective.  With the air conditioner on and windows closed, you cut down your indoor pollen count by 90 percent or more.  So air conditioning in buildings and cars is key for reducing level of symptoms, medication reliance.”

Dr. Lang recommends seeing an allergist if symptoms don’t respond to natural or over the counter remedies, and interfere with daily functioning.  Right now, tree and grass pollen are at their peak.  Children and pets can be affected too.

Symptoms of Grass Allergies:

Irritated Nose, Throat and Eyes

  • People who suffer from grass allergies may suffer from watering eyes, sneezing and congestion, post-nasal drip, sore throats and dry, constant coughing. A grass allergy can cause a full range of breathing problems, from wheezing to triggering a full-blown asthma attack. Allergic conjunctivitis can also occur, which is an inflammation of the membrane that lines the inside of the eyelids. This causes red-rimmed, swollen eyes and sometimes even a crusting of the eyelids. Allergic shiners–which are dark circles under the eyes that are caused by increased blood flow in irritated sinuses–may also occur with a grass allergy.

Skin Irritation

  • Irritated skin, including redness, itching, rashes, bumps and hives can all occur due to a grass allergy. These reactions can occur anywhere on the body, but often show up on the hands and fingers. Some doctors call this reaction “hayfever of the skin.” Treatment with antihistamines is usually the best way to handle this symptom. Reactions can be severe (even anaphylactic) if the allergen comes into direct contact with open skin, such as when a soccer player falls and scrapes her leg on the grassy field.

General Unwellness

  • As with other seasonal allergies, many people who suffer from grass allergies also complain of extreme fatigue, and feeling mentally dull or “out of it.” These people complain of feeling spacey, unable to concentrate and foggy much of the time. Headaches, mood swings and even nausea can result from a grass allergy.

Natural Relief and Prevention

  • There are many ways to prevent reactions and naturally provide relief once symptoms occur. Daily nasal cleansing with either a neti pot or nasal squirt bottle can be an effective way to irrigate the sinuses and flush allergens from the nasal passages. Another preventative measure is to always wear a mask when you mow the grass, and keep grass cut short. Use air conditioners indoors and in cars whenever possible. Instead of drying clothes on the line, where they can pick up allergens, dry clothes in a dryer during grass pollen season. Shower each night before bed to wash off pollen. For a sore throat due to post nasal drip or coughing, try gargling with warm salt water.

Medication

  • There are many different kinds of over-the-counter and prescription medications available for sufferers of grass allergies. Eye drops, nasal sprays, decongestants and antihistamines are the most popular. There are also various prescription medications available that work with the body in different ways to hinder the release of histamines. According to Medicine Online, immunotherapy allergy shots help many patients.

Read more: Symptoms of a Grass Allergy | eHow.com http://www.ehow.com/about_5057895_symptoms-grass-allergy.html#ixzz1sqHCqlyx

15 Things Your Walk Reveals About Your Health

 

Paula Spencer Scott, Caring.com senior editor discovered there really is something to the way he or she moves.  Cue Aerosmith.
 

 
 
The following are 15 walking styles which reveal a whole lot about your health.  If you find one that describes you or someone you know, click on the link below to find out more information about it.
 

1. Walking at a snail’s pace may reveal: Shorter life expectancy

The average speed was 3 feet per second (about two miles an hour). Those who walked slower than 2 feet per second (1.36 miles per hour) had an increased risk of dying.   Walking speed is a reliable marker for longevity, according to a University of Pittsburgh analysis of nine large studies, reported in a January 2011 issue of The Journal of the American Medical Association.

2.  Walking with not too much arm swing may  reveal: Lower back trouble

If someone is walking without much swing to the arm, it’s a red flag that the spine isn’t being supported as well as it could be, because of some kind of limitation in the back’s mobility. Back pain or a vulnerability to damage can follow.

3.  One foot slaps the ground may reveal: Ruptured disk in back, possible stroke

Sometimes experts don’t have to see you walk — they can hear you coming down the hall. A condition called “foot slap” or “drop foot” is when your foot literally slaps the ground as you walk.   A ruptured disk in the back is a common cause, since it can compress a nerve that travels down the leg.

4.  A confident stride in a woman may reveal: Sexual satisfaction

Your stride and gait don’t always indicate bad things.  Women who have a fluid, energetic stride seem to be more likely to easily and often have vaginal orgasms, researchers said.

5.  A short stride may reveal: Knee or hip degeneration

When the heel hits the ground at the beginning of a stride, the knee should be straight. If it’s not, that can indicate a range-of-motion problem in which something is impairing the ability of the knee joint to move appropriately within the kneecap.

6.  Dropping the pelvis or shoulder to one side may reveal: A back problem

Muscles called the abductors on the outside of the hips work to keep the pelvis level with each step we take. So while we’re lifting one leg and swinging it forward, and standing on the other, the abductors keep the body even — unless those muscles aren’t working properly.

7.  Bow legged stride may reveal: Osteoarthritis

Bowlegs (also called genu varum) happen because the body can’t be supported adequately; the knees literally bow out.

8.  Knock-kneed appearance may reveal: Rheumatoid arthritis

In knock-knee (genu valgum, or valgus knee), the lower legs aren’t straight but bend outward.  Sometimes osteoarthritis can also result in knock-knees, depending which joints are affected.

9.  A shortened stride on turns and when maneuvering around things may reveal: Poor physical condition

Balance is a function of coordination between three systems: vision, the inner ear, and what’s called “proprioception,” which is the joints’ ability to tell you their position. The joints can do this because of receptors in the connective tissue around them. But the quality of the receptors is related to how much motion the joint experiences.

10.  A flat step without much lift may reveal: Flat feet, bunions, neuromas

Flat feet are obvious at a glance: There’s almost no visible arch (hence one of the condition’s names, “fallen arches”). But other conditions can also cause a flat walk.

 

11.  Shuffling feet may reveal: Parkinson’s disease

Shuffling — bending forward and having difficulty lifting feet off the ground — isn’t an inevitable aspect of aging. It’s a distinct gait that may indicate that someone has Parkinson’s disease.  The person’s steps may also be short and hesitant

12.  Walking on tiptoes, both feet may reveal: Cerebral palsy or spinal cord trauma

It’s related to overactive muscle tone, caused by stretch receptors that fire incorrectly in the brain. When the toe-walking happens on both sides, it’s almost always because of damage high in the spinal column or brain, such as cerebral palsy or spinal cord trauma.

13.  Walking on tiptoes, one foot may reveal: Stroke

Doctors assessing toe-walking look for symmetry: Is it happening on both sides or only one? When a person toe-walks only on one side, it’s an indicator of stroke, which usually damages one side of the body.

14. A bouncing gait may reveal: Unusually tight calf muscles

Specialists can see the heel-off, the first part of a normal step, happen a bit too quickly, because of tight calf muscles.

15.  One higher arch and/or a pelvis that dips slightly may reveal: One leg is shorter than the other

Limb (or leg) length discrepancy simply means that one leg is shorter than the other. You can be born with limb discrepancy or get it as the result of knee or hip replacements, if limbs don’t line up perfectly after healing.  Shoe inserts usually can make up for a quarter-inch discrepancy; surgery is sometimes recommended for larger differences.

Read the entire article here: http://www.caring.com/articles/things-walk-reveals-about-health

 

This content was originally published by Caring.com: “15 Things Your Walk Reveals About Your Health” and this excerpt reprinted here with permission.

First Non-Invasive Imaging to Detect Brain Tumors

Diagnostic Brain Tumor Test Could Revolutionize Care of Patients with Low-Grade Gliomas

Researchers at UT Southwestern Medical Center have developed what they believe to be the first clinical application of a new imaging technique to diagnose brain tumors. The unique test could preclude the need for surgery in patients whose tumors are located in areas of the brain too dangerous to biopsy.

This new magnetic resonance spectroscopy (MRS) technique provides a definitive diagnosis of cancer based on imaging of a protein associated with a mutated gene found in 80 percent of low- and intermediate-grade gliomas. Presence of the mutation also means a better prognosis.

“To our knowledge, this is the only direct metabolic consequence of a genetic mutation in a cancer cell that can be identified through noninvasive imaging,” said Dr. Elizabeth Maher, associate professor of internal medicine and neurology at UT Southwestern and senior author of the study, available online in Nature Medicine. “This is a major breakthrough for brain tumor patients.”

UT Southwestern researchers developed the test by modifying the settings of a magnetic resonance imaging (MRI) scanner to track the protein’s levels. The data acquisition and analysis procedure was developed by study lead author Dr. Changho Choi, associate professor of the Advanced Imaging Research Center (AIRC) and radiology. Previous research linked high levels of this protein to the mutation, and UT Southwestern researchers already had been working on MRS of gliomas to find tumor biomarkers.

“Our next step is to make this testing procedure widely available as part of routine MRIs for brain tumors. It doesn’t require any injections or special equipment,” said Dr. Maher, medical director of UT Southwestern’s neuro-oncology program.

To substantiate the test as a diagnostic tool, biopsy samples from 30 glioma patients enrolled in the UT Southwestern clinical trial were analyzed; half had the mutation and expected high levels of the protein. MRS imaging of these patients had been done before surgery and predicted, with 100 percent accuracy, which patients had the mutation.

For Thomas Smith of Grand Prairie, the test helped determine the best time to begin chemotherapy. When an MRS scan showed a sharp rise in the 25-year-old’s protein levels, this indicated to his health care team that his tumor was moving from dormancy to rapid growth.

“We treated him with chemotherapy and his protein levels came down,” Dr. Maher said.

Before participating in the study, Mr. Smith had tumor removal surgery in 2007. Because part of the tumor could not be safely removed, however, he continued to suffer seizures and had other neurological problems. Since chemotherapy, his symptoms have diminished.

“I did six rounds of chemo, every six weeks,” Mr. Smith said. “My seizures stopped and all my symptoms improved. I am only on anti-seizure medication now.”

Notes about this brain cancer research article

Other UT Southwestern researchers involved in the study included Sandeep Ganji, a doctorate student in radiological sciences; Dr. Ralph DeBerardinis, assistant professor of pediatrics and with the Eugene McDermott Center for Human Growth and Development; Dr. Kimmo Hatanpaa, associate professor of pathology; Dr. Dinesh Rakheja, assistant professor of pathology; Dr. Zoltan Kovacs, assistant professor in the AIRC; Drs. Xiao-Li Yang and Tomoyuki Mashimo, both senior research scientists in internal medicine; Dr. Jack Raisanen, professor of pathology; Dr. Isaac Marin-Valencia, resident in pediatrics; Dr. Juan Pascual, assistant professor of neurology and neurotherapeutics, pediatrics, and physiology; Dr. Christopher Madden, associate professor of neurological surgery; Dr. Bruce Mickey, professor of neurological surgery and otolaryngology-head and neck surgery, and radiation oncology; Dr. Craig Malloy, professor in the AIRC and of internal medicine and radiology; and Dr. Robert Bachoo, assistant professor in neurology and neurotherapeutics, and internal medicine.

Funding: The research was supported by grants from the National Institutes of Health, the Cancer Prevention and Research Institute of Texas and financial support from the Annette G. Strauss Center for Neuro-oncology at UT Southwestern.

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Contact: Debbie Bolles – The University of Texas Southwestern Medical Center
Source: The University of Texas Southwestern Medical Center press release
Original Research: Abstract for “2-hydroxyglutarate detection by magnetic resonance spectroscopy in IDH-mutated patients with gliomas” by Changho Choi, Sandeep K Ganji, Ralph J DeBerardinis, Kimmo J Hatanpaa, Dinesh Rakheja, Zoltan Kovacs, Xiao-Li Yang, Tomoyuki Mashimo, Jack M Raisanen, Isaac Marin-Valencia, Juan M Pascual, Christopher J Madden, Bruce E Mickey, Craig M Malloy, Robert M Bachoo and Elizabeth A Maher from Nature Medicine

 Also See Link Below: Novel Drug Makes Brain Tumors Glow Hot Pink

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