juno…the blizzard that wasn’t [nyc edition]

I’m pretty sure the entire country is well aware of the “blizzard” that was supposed to hit the Northeast last night and today.  I put the word “blizzard” in quotations to refer to the storm that actually hit NYC, as it was anything but a blizzard.  The more north and east portions of the Northeast certainly got hit harder, but NYC certainly went into panic mode.  For the first time in the history of the subway system, the entire system shut down on Monday night.  A ban was placed on road travel.  SNOW DAYS FOR EVERYONE.

Ah, snow days.  You would be so nice if I didn’t have a job that never shuts down.  (In other news, I have the best job security ever.  You keep being ridiculously unhealthy, America.)  Although I never really worried about getting to work (I’ve got two feet and I know how to use them!), I was worried about work being a disaster from people calling out due to not being able to get into work.  Luckily, a few nurses ended up sleeping at the hospital overnight, so we actually were quite well staffed.  Hooray.

But getting to work certainly made me nervous, and I woke up a few times last night to check and see how much snow we actually had.  Each time, I was never impressed.  I should have prefaced this entire post by saying that I grew up outside Chicago.  In order to get a snow day, it had to start snowing somewhere around 4am – and it better be snowing had.  Any earlier, and there was enough time to get the snowplows and salt trucks out, clearing the roads in time to school.  Any later, and it was too late to call off school.  I remember going to elementary school with snow over my head after a few good snowstorms.

I would like to take this time to note that had the snowstorm been as bad as they said it was going to be, I strongly considered wearing my New York City Marathon parka to walk to and from work.  It breaks the wind.  It’s impossible to miss.  I’d be warm and wouldn’t be hit by any cars.  I consider this a win-win situation.  (And yes, I still have my parka without any legitimate reason to use it so far…)

So.  Much.  Orange.

The walk to work wasn’t so bad.  My doorman reminded me that no buses or subways were running, and I reminded him that my boots were made for walking.  I heard that the parks were closed, but I figured no one would be patrolling them.  WRONG.  I got yelled at by a park guy with a snow blower when I tried to enter, even after saying I was a nurse trying to get to work.  Needing to reroute, I found one of the cross roads and walked down the street without another person in sight.

If I had to imagine what a zombie apocalypse would look like in NYC, it would be pretty close to what Tuesday morning was.  A few photographers were out with their tripods and fancy cameras, capturing pictures of an empty city.  Plenty of doormen were out with shovels and pails of salt.  Otherwise, people were walking.  In the street.  It was so quiet.  Sometimes a police car would go by, but New York City is certainly odd without the constant buzz of traffic.

nyc snow Lexington Ave.  With the assistance from plenty of filters.

Work went along as usual since the hospital doesn’t necessarily change its flow just because the weather is being weird.  Walking home was much less eventful than the morning commute – the park was open and many people were still out sledding.  One guy in Central Park asked me for a lighter (actually, his friend yelled, “Ask that white girl for a lighter!”), to which I wanted to say that 1) you’re not allowed to smoke in Central Park and 2) I’m a burn nurse, so no, I don’t have a lighter.

I’m looking forward to an easier commute tomorrow…may even one that involves a bus ride?

Did you get a snow day?  Are you snowed in up in Boston?  Did you run?  Are you sledding?  Did all the snow melt?  Or maybe you worked as well…?

And please tell me other people still have their marathon parkas stored away for a day like today…

HITLAB Summit

After spending the entire long Thanksgiving weekend at work (Wednesday-Sunday, aka five day shifts in a row, aka the most day shifts I’ve ever worked in a row), I was looking forward to having Monday off.  Well, until I got an email from my hospital saying that they had tickets to HITLAB Summit and that we could get tickets for free!  I’ve heard of HITLAB before – they do a lot of work in healthcare innovation and supporting people who have new ideas in healthcare technology.  My unit at work is currently involved in a special project assisted by the technology and innovation departments within the hospital, where we are trying out new technology without necessarily having to go through all the normal steps needed for rules and regulations.

If you’ve ever set foot in a hospital, you most likely realized that the hospital is behind the times in many ways.  Medicine itself is very slow to change, and the institutions where medicine is performed are therefore also very slow to change.  “Evidence based” is a key phrase used to describe what we do in the hospital and is one of the main reasons why it is so difficult to make any changes…you basically have to prove that the new way is better than the old way and that it won’t cause harm.  You can’t just try out new things on people, so the research process is very slow.  As for technology…resident still carry pagers, if that gives you an idea of how behind we are!

It should come as no surprise that people are working on technology not only to improve the hospital experience, but also to improve health of people in general.  I think that this second part is so key – you know how much health care costs, and it’s astounding.  Our health care system isn’t built on keeping people healthy, it’s built on treating people when they’re already sick.  This is why we need to shift our entire mentality and invest in what will keep people healthy.  (Although, if it’s all about money, there’s not much money in keeping people healthy!)  As for within the hospital system (because people are always going to get sick no matter how hard you try), we certainly have room for improvement.

Not everyone in the hospital is open to change, whether some people fear the technology itself or just believe in what always works, and I believe that we could change for the better.  Therefore, I thought that this conference would be interesting, as well as provide an opportunity to see what technology and innovation is out there.

The agenda sounded great: 

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And I looked forward to many of the talks.  Most of them were fairly short (ten minutes max), but they ranged from how to get started with innovation to challenges that healthcare innovation faces to women in technology.  Some of the talks weren’t quite what I was expected, but it was interesting to hear from a variety of perspectives.

My favorite takeaways from the speeches included:

  • Focus on one problem to solve.  Simple is better.  You can grow later.
  • Make sure you have a problem for your solution.  We have many solutions for problems that don’t exist.  (Don’t create new problems just to fit your solution!)  We’ve recently implemented some technology in the hospital that is supposed to make our work safer/better/easier, but if there wasn’t a problem to begin with, why are we adding in more steps?
  • Anyone can build something.  The first speaker spoke about this, and the main point of his talk was that you don’t have to be a techie to have ideas.  You may need someone to help you build them, but innovation isn’t reserved for the coders of the world.
  • Are we reaching health and happiness?  Dr. Witek spoke about drug development and how they’re created to cure/manage a disease or issue, but sometimes they have terrible side effects or are difficult to take every day.  Therefore, research shouldn’t stop at just finding a drug that works, we need to work to make it so people are not only healthy, but they’re also happy.
  • Women are needed in technology and innovation.  Not surprisingly, women are underrepresented in healthcare technology.  The summit had a panel of women who spoke about women in this area and how important it is to have a diverse group of people working on a project since it provides greater insight, especially into the needs of women.  No one really says anything specific about why women are needed other than for diversity, other than maybe to provide thoughts about what women what in healthcare innovation.  Also, I always wonder what it would be like to have a man on a panel about women in technology.

 

the world cup

In addition to many talks (which I thought could have been a little longer, they only skimmed the surface), the HITLAB Summit also had the “World Cup” of innovation.  Developers submitted their innovations for an opportunity to win.  Last year’s winner was AdhereTech, which is a pill bottle that transfers patient’s adherence to medications to their physicians or research group.  If a patient misses a dose, they get a text or call to remind them, and when their supply is running low, a pharmacy is notified to mail a refill.  Adherence to medication cannot only be medically devastating for people with complex diseases, but it is also costly when people have complications from not taking their meds.  I think it’s a really cool idea.

The people who presented at the World Cup this year were:

  1. NVS Technologies.  This is a molecular diagnostics company that is creating a way to test bacteria at the bedside.  If you work in an ICU, it seems to work like EPOC or iStat where you can get results within minutes.  Imagine getting results from your BAL within an hour instead of days!  Get those antibiotics narrowed down in the first day…  (This won the World Cup!)
  2. CareTicker.  This application helps caregivers track the care (bathing, medications, going to appointments, etc) they provide.  Although this is aimed at caregivers for the elderly, it reminds me off apps I’ve seen for babies where you can put in diapers and feedings.  The idea is that is provide incentives and community for caregivers.
  3. Owned Outcomes.  This is a company that assists in placing people in facilities that fit their needs once discharged from the hospital.  Patients/families can list the most important qualities they would like in a rehab facility/nursing home/etc, and the program matches them based on what is available to them and what previous clients have commented.  Part of the idea is to keep people healthy and decrease readmissions to hospitals.
  4. Psious.  This is (what I consider to be) virtual reality based cognitive behavioral therapy.  They use virtual reality to help treat various forms of anxiety, such as fear of flying or spiders.  Patients wear the virtual reality and can be guided by the therapist.  I like the idea for something so concrete as flying, but they made claims about PTSD which I think would be interesting to explore further.
  5. Touch Surgery.  I thought this was so fascinating.  One of the issues in surgical training (well, I can’t comment on surgical training because I’m not a surgeon, but I can imagine) is that you don’t really get to experience an operation until you’re operating on someone.  So surgeons/surgeons in training created an app that is like real life “Operation.”  You can go step-by-step through a wide variety of operations, and it can test you on how to perform a surgery.  This could be great for medical education (doctors out there, please comment!), but also great for patients who are interested in seeing what their upcoming surgery really involves.  (And it’s free!  Download it and give it a try!)

 

And that was that!  Overall, it was an interesting day that was very different from my normal work at the bedside.  Although I really like the work at the bedside, taking care of people while they’re acutely ill, I do like the idea of keeping people healthy and what technology we can use to do that.  Plus, technology is a great way to help reach populations that may seem out of reach – especially those in lower income areas and countries.  This definitely got my wheels turning, and I’m thinking about what’s next and how to improve health in the world.

How has technology or innovation helped you stay healthy or in managing disease?  What would you like to see change in the future?

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