Happy World Health Day from TEDMED

As an important part of our TEDMED community, we know that you are passionate about creating a healthier world. In the spirit of World Health Day, TEDMED is committed to sharing and convening a global conversation about what is new and important in health and medicine. From September 10-12, 2014, we invite you to bring TEDMED to your home, school or office via TEDMED Live Streaming.

The full stage program will be experienced remotely worldwide via TEDMED Live Streaming in over 100 countries. And remember, TEDMED Live is available free to thousands of medical organizations, academic institutions and government facilities worldwide.

We hope you’ll join us for TEDMED 2014 as we unlock the power of imagination in service of a healthier, more vibrant planet.

SIGN UP HERE TODAY!

Jay Walker joins National Academies Board on Science, Technology and Economic Policy

We at TEDMED are excited to announce that Jay Walker, TEDMED’s curator, has joined the Board on Science, Technology and Economic Policy (STEP) of the United States National Academy of Sciences.

STEP’s mission is to advise federal, state and local governments on how best to create and apply new scientific and technical knowledge, both to enhance productivity and boost American prosperity.

“Innovation is critical to our economic vitality.  We’ve already seen how advances from varied disciplines and groups of all sizes are absolutely revolutionizing healthcare and medicine and propelling us into the future.  We have the will and we have the imagination.

“I’m honored to be invited and glad that I can help the National Academies and STEP reinforce our readiness to be in the forefront of science and technology,” Jay Walker said.

Along with his work curating TEDMED, Jay is well known as a digital innovation leader.  He is 11th on the list of the world’s most patented living inventors, is named on more than 450 issued and pending U.S. and international patents, and was founder of Priceline.com.

We at TEDMED are excited to announce that Jay Walker, TEDMED’s curator, has joined the Board on Science, Technology and Economic Policy (STEP) of the United States National Academy of Sciences.

STEP’s mission is to advise federal, state and local governments on how best to create and apply new scientific and technical knowledge, both to enhance productivity and boost American prosperity.

“Innovation is critical to our economic vitality.  We’ve already seen how advances from varied disciplines and groups of all sizes are absolutely revolutionizing healthcare and medicine and propelling us into the future.  We have the will and we have the imagination.

“I’m honored to be invited and glad that I can help the National Academies and STEP reinforce our readiness to be in the forefront of science and technology,” Jay Walker said.

Along with his work curating TEDMED, Jay is well known as a digital innovation leader.  He is 11th on the list of the world’s most patented living inventors, is named on more than 450 issued and pending U.S. and international patents, and was founder of Priceline.com.

The STEP board includes industrial managers, investors and former public officials in a wide range of policy areas. They are:  Chair, Paul Joskow (Alfred P. Sloan Foundation); Ernst Berndt (MIT); Jeff Bingaman (Former U.S. Senator); Ellen Dulberger (Ellen Dulberger Enterprises LLC); Alan Garber (Harvard University); Kathryn Shaw (Stanford University); Laura Tyson (UC-Berkeley); and Hal Varian (Google Inc.).

Congratulations, Jay, and thank you for your leadership.

TEDMED moves annual gathering to September; University of California, San Francisco will partner for unified event in two cities

It has long been TEDMED’s mission to encourage broad-scale, multi-disciplinary, collaborative thinking; to reach across borders to find fresh inspiration; and to bring leaders face-to-face so they can gain insight from other passionate thinkers and doers.

That’s why TEDMED is transforming its annual event, starting this year.

Instead of gathering in April, we will produce our first live, digitally linked, dual-stage event on September 10-12, 2014. In addition to our home at the John F. Kennedy Center for the Performing Arts in Washington, DC, TEDMED’s annual event will also take place simultaneously in San Francisco. One event, one program, two stages – with speakers and Hive entrepreneurs at each venue, and an opportunity for Delegates from each host city to personally share the experience.

shutterstock_95855803We’re thrilled to announce that the University of California, San Francisco (UCSF) will be our ongoing institutional partner in the San Francisco Bay Area. UCSF is one of the world’s top medical research institutions and supports the work of many of the most innovative and transformative minds in the health sciences today. Their participation is an exciting part of this year’s event and a boon to our long-term, year-round goals.

Because research and innovation in health and medicine are global enterprises, in 2015 TEDMED will convene the only simultaneous, worldwide, multi-disciplinary gathering focused on the future of health and medicine. TEDMED will partner with leading medical research institutions and financial supporters in other host cities in China, Japan, the Middle East and Western Europe, which will be announced at a future date.

Live from the Nation’s Capital and Innovation Central

“We are seeing a revolution in health from the ground up, as technology pushes patient engagement and encourages a new culture of active wellness,” says TEDMED’s Jay Walker. “A growing wave of health information will transform health delivery at every level.”

Sharing TEDMED’s mission to advance health worldwide, UCSF is a natural first institutional partner. The university is both a leader in biomedical research – it’s first among public institutions in research support from the National Institutes of Health – and in translating science to serve the public through its professional schools and medical center.

Outgoing UCSF Chancellor Susan Desmond-Hellmann, who spoke at TEDMED 2013, played a key role in bringing our new partnership to life. During her tenure, Desmond-Hellmann has worked to establish UCSF as a force for transformation and innovation, including hosting the first OME Precision Medicine Summit in May of 2013. She has recently been named CEO of the Bill & Melinda Gates Foundation.

Our expanded event will still be uniquely TEDMED.  We’ll have an equal number of brilliant speakers in both venues, delivering insights that challenge the status quo, inspire progress in health and medicine, tap into our imaginations and help drive new discovery.  (The Hive, our innovation showcase, will be equally prominent in both cities, too.)

“We will digitally share live content between Washington and San Francisco, creating a single unified program in two co-equal host cities. Creativity, imagination and innovation are languages spoken on both coasts,” says Shirley Bergin, TEDMED’s COO/CMO.

“This transformation is about exploring new ways to convene a global community that addresses issues critical to all humanity.  Today’s complex challenges in health and medicine demand our best thinkers from every discipline. Our health at all levels – personal, family, community, organization, nation, and planet – continues to move to center stage as we recognize the vital connection between health and everything we care about. We invite those passionate about creating a healthier future to join us in this mission,” she adds.

Click here to register for TEDMED 2014. We’ll be releasing further details, including information about our program and speakers, in the coming weeks.

 

The exit interview: Farzad Mostashari on imagination, building healthcare bridges and his biggest “aha” moments

Farzad Mostashari, MD, stepped down from his post as the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services (HHS), during the first week of October, which was also the first week of the Federal partial shutdown. During his tenure, Dr. Mostashari, who spoke at TEDMED 2011 with Aneesh Chopra, led the creation and definition of meaningful use incentives and tenaciously challenged health care leaders and patients to leverage data in ways to encourage partnerships with patients within the clinical health care team.

Whitney Zatzkin and Stacy Lu had the opportunity to speak with Dr. Mostashari during his last week in office.

WZ: Sometimes, a person will experience an “aha!” moment – a snapshot or event that reveals a new opportunity and challenges him/her to pursue something nontraditional. Was there a critical turning point when you figured out, ‘I’m the guy who should be doing this?’

Yeah, I’ve been fortunate to have a couple of those ‘aha’ moments in my life. One of them was when I was an epidemic intelligence service officer back in 1998, working for the CDC in New York City. I’ve always been interested in edge issues, border issues; things that are on the boundaries between different fields. I was there in public health, but I was interested in what was happening in the rest of the world around electronic transactions and using data in a more agile way.

In disease surveillance we often look back — the way we do claims data now – years later or months later you get the reports and you look for the outbreak, and often times the outbreak’s already come and gone by the time you pick it up. But I started thinking and imagining: What if the second something happens, you can start monitoring it? In New York City the fire department was monitoring ambulance calls. I said, ‘Wow, if we could just categorize those by the type of call, maybe we’ll see some sort of signal in the noise there.’

When I was first able to visualize the trends in the proportion of ambulance dispatches in NYC that were due to respiratory distress, what I saw was flu.  What jumped out at me was the sinusoidal curve. Wham! At different times of year, it could be a stutter process – it would go up and you would see this huge increase, followed two weeks later by an increase in deaths. It was like the sky opening up. The evidence was there all along, but I am the first human being on earth to see this. That was validation, for me, of the idea that electronic data opens up worlds. To bring that data to life, to be able to extract meaning from those zeros and ones — that’s life and death. That was my first ‘aha’ moment.

The second aha was after I joined New York City Department of Health, and I started a data shop to build our policy around smoking and tracking chronic diseases. What we realized was that healthcare was leaving lives on the table. There were a lot of lives we could save by doing basic stuff a third-year medical student should do, but we’re not doing it.  Related to that – Tom Frieden had a great TEDMED talk about everybody counts.

I said, ‘I want to take six months off and do a sabbatical, and see if there’s anything to using electronic health records to provide those insights, not to save lives by city level, but on the 10 to the 3 level – the 1,000 patient practice. That started the whole journey.  None of the vendors at the time had the vision we had, but we finally got someone to work with us and rolled this system out.  We called some doctors some 23 times, and did all the work to get to the starting line.  Finally, I took Tom on a field visit to see one of the first docs to get the program.

It was a very normal storefront in Harlem, and a nice physician, very caring, very typical.  I asked her what she thought of the program. She said, ‘It’s ok. I’m still getting used to it.’  I said, ‘Did you ever look at the registry tab on the right, where you can make a list of your patients? She said no.  I said, ok – how many of your elderly patients did you vaccinate for flu this year? She said, ‘I don’t know, about 80 to 85 percent.  I’m pretty good at that.’  I said, ‘o.k., let’s run a query.’  And it was actually something like 22 percent. And she said – this was the aha moment – ‘That’s not right.’

That’s generally the feeling the docs have when they get a quality measure report from the health plan. But that’s population health management — the ability to see for the first time ever that everybody counts. And being able to then think about decision support and care protocols to reduce your defect rate. That was the validation that we’re on to something. Without the tools to do this, all the payment changes in the world can’t make healthcare accountable for cost and quality if you can’t see it.

WZ: Everyone has that moment in life when they’re considering all of their career options. As you were considering medical school, what else was on the table?

I actually didn’t think I was going to go to medical school. I was at the Harvard School of Public Health. I was interested in making an impact in public health. I grew up in Iran, and thought I would do international public health work. And then my dad got sick; he had a cardiac issue. The contrast between the immediacy of the laying on of hands of healthcare, and the somewhat abstractness of international public health — the distance, the remove — tipped me into saying,  ‘You know, maybe I should go to medical school.’  I’ve been on that edge between healthcare and public health ever since, and always trying to drag the two closer to each other.

SL: Fast forward 20 years.  You’re giving another talk at TEDMED.  What’s the topic?

TEDMED and Jay Walker’s vision is more powerful in the futurescope, rather than in the retroscope. It’s more powerful to be where we are today and imagine a different future rather than look back and say, ‘Oh, yeah, we’ve done this.’  So what’s the future I would love to imagine?

The most exciting thing – as Jay Walker once mentioned in a talk comparing “medspeed” to “techspeed” – is to fully imagine what will happen if techspeed is brought to healthcare. Right now, there’s all this unrealized value that’s being given away for free that doesn’t show up on any GDP lists – what Tim O’Reilly called “the clothesline paradox.”  That kind of possibility brought to medicine, but where software costs $100,000 as opposed to free, and it evolves daily and is more powerful and quicker every day, and it’s beautiful and usable and intuitive, and that’s what people compete on.

And all of that is toward the goal of empowering people.  Someone said, maybe it was Jay at TEDMED, that a 14-year-old kid in Africa with a smart phone has more access to information than Bill Clinton did as President. Information is power, and it has changed everything but healthcare. For me the vision is breaking down that wall, so that patients can be empowered and can bind themselves to the mast to use what we’ve learned about how behavior changes.

It’s not as simple as you give people information and they change their behavior.  It’s information tools that build on that data and build on communities and a much more sophisticated understanding about how behavior changes. What TEDMED is also great at, is understanding the power of marketing. People think of marketing of being about advertising, but marketing is the best knowledge we have about how to change behavior and all those intangibles, those predictably irrational insights, of how and why we do what we do.

It’s harnessing those, instead of having them lead to worse health – like present value discounting that leads to people wanting to procrastinate and eat that doughnut now instead of going to the gym. Or the power of anchoring, where we fixate on the first thing we see and won’t think objectively about the true risks of things. Or the herd effect, our friend is overweight and so we are more likely to be overweight.

All those nudges that are possible can be delivered to us ubiquitously and continuously, and we can choose to have them. It’s not some big brother dystopic vision. It’s me saying, ‘I want to be healthier, so I will do something now that will help me overcome and use my irrationality to help me stay healthy.  To me, that’s the neat new edge between mobile cloud computing, personal healthcare, behavioral economics, healthcare IT, data science and visualization, design, and marketing. It’s that sphere that has so many possibilities to get us to better health.

The thing about the health is, we have a Persian saying: Health is a crown on the head of the healthy that only the sick can see. When you have it, you don’t appreciate it, but when you’re sick and someone you love is sick, there’s nothing better.  You would do anything to get that. We need to bring that vision of the crown to everyone and help each of us grab it when we can.

WZ: I noticed you closing your eyes while preparing to answer a question. How do you pursue being able to exercise your imagination, in particular while you’re sitting in a building that’s been marked for being the least imaginative?

Because the world, as it is, is too immediate and real and limiting, sometimes you have to close your eyes to see a different world.

What has been amazing has been to see that, contrary to what people expect, this building is filled with people with untapped, unbound, unfettered imaginations who are slogging through. They’re just trapped. You give them the opening, the smallest bit of daylight to exercise that, and they’re off and running.

I give a lot of credit to Todd Park as our “innovation fellow zero,” He saw the possibility that there are more than two kinds of people in the world, innovators and everybody else. For him, it was about going to create a space where outside innovators can be the catalyst or spark that elevates and permissions the innovation of the career civil servant at CMS in Baltimore. That’s been cool.

SL: What’s your bowtie going to do after you leave HHS?  Will we see it lounging on the beach in Boca?

I like the bowtie.  I think I’m going to keep it.  Perhaps the @FarzadsBowtie Twitter handle is going to go into hibernation, I don’t know.  I don’t control it. One of the things the bowtie does for me is help me remember not to get too comfortable.

I once said at the Consumer Health IT Summit – ‘You’re a bunch of misfits – glorious misfits. And I feel like I’m very well suited to be your leader. You know, I always felt American in Iran, and felt Iranian in America when I came here. I felt like a jock among my geeky friends, and like a geek among jocks. For crying out loud, I wear a bowtie!  I don’t have to tell you I’m a misfit.’

It’s that sense of not fitting into the world as it is. The world doesn’t fit me.  So instead of saying,  ‘I need to change,’ this group of people said, ‘The world needs to change.’ That’s the difference between a misfit and a glorious misfit.

The person who doesn’t fit into our healthcare system is the patient. The patient’s preferences don’t fit into the need to maximize revenue and do more procedures. The patient’s family doesn’t fit into the, ‘I want to do an eight-minute visit and get you out the door’ agenda. The patient asking questions doesn’t fit.  That’s the change we need to make. It’s not that we need to change. Healthcare needs to change to fit the patient.

Shortly following this interview, Dr. Mostashari left HHS and is now the a visiting fellow of the Engelberg Center for Health Care Reform at the Brookings Institution, where he aims to help clinicians improve care and patient health through health IT, focusing on small practices.

This interview was edited for length and readability.

The Hive @TEDMED 2014: Now accepting applications and nominations

Hive

Are you an entrepreneur leading a start-up with the potential to transform medicine or healthcare? If so, we encourage you to apply to The Hive @TEDMED 2014.

TEDMED, in partnership with the StartUp Health Network, officially welcomes applications starting today – and will do so until January 22, 2014. We also invite you to nominate other start-ups and entrepreneurs whom you believe should be part of The Hive this April 9-11in Washington, DC.

Exciting innovations are challenging the status quo across health and medicine in areas like biotech, health IT, mHealth, life sciences, health tech, and more. TEDMED celebrates the ideas behind this progress in The Hive – an immersive and informal social environment dedicated to exploring and showcasing transformative startups and the inspiring entrepreneurs that power them.

At TEDMED 2014, innovators from incubators and accelerators, government-run challenges, academically led programs, independent start-ups and labs will fuse their imagination with the experience of our community to help propel new start-ups along their paths to reshaping the future.

Find out more about TEDMED 2014 and The Hive 2014, or get started with the application/nomination process.

Online live event on genomics and medicine: Where promise meets clinical practice

It was big news this week: A major change shift in cardiac care recommendations.

The American Heart Association and the American College of Cardiology released new guidelines that adjusted expectations for lowering low-density lipoprotein (LDL) levels to a specific number, and adding other risk factors into the equation of who should take statins, a class of drugs designed to treat high cholesterol.

shutterstock_118323973Experts developed the guidelines based on population studies that averaged the benefits of cholesterol-lowering drugs across millions of people. But for some people, the medications do not work as well and in some cases, cause adverse affects, such as painful leg cramping.  What would it take to customize cholesterol lowering with the best drug at the right dose?

Enter the emerging field of personalized medicine, or National Human Genome Research Institute (NHGRI) calls it, genomic medicine. Doctors have known for decades that some people are at higher risk of a common disorder such as diabetes, or react poorly to medications. Since the completion of the Human Genome Project in 2003, NHGRI has led numerous studies to understand the genetic differences in people at increased risk for disease and to understand how best to use genetic testing to customize an individual’s medical treatment.

The field of cancer care is likely one of the first beneficiaries. Cancer is a genetic disease.  Genomic research is increasingly helping to inform and shape diagnosis and treatment recommendations.

One example: Earlier this month, researchers at the University of Michigan identified a type of mutation that develops after breast cancer patients take anti-estrogen therapies. The mutation may cause some patients to become resistant to this therapy, but blood test monitoring may mean clinicians can spot the advancing mutation and tinker with treatment before resistance becomes full-blown.

Glioblastoma multiforme (GBM) is a common and deadly type of brain cancer that will kill some 14,000 people this year. Most patients die within 14 months of their diagnosis. In 2008, GBM became the first cancer that researchers from The Cancer Genome Atlas Research Network began to systemically study.

Researchers discovered GBM fell into four different molecular subtypes, discovering in the process that chemotherapy and radiation did not work as well for some of the genotypes. Patients with that molecular profile, then, may be able to avoid toxic treatment and its ravaging side effects. The work also uncovered new details on mutations in genes that promote cancer, called oncogenes, and others that protect against cancer, known as tumor suppressor genes.

“The Cancer Genome Atlas project, a collaboration between the National Cancer Institute and NHGRI as been analyzing 500 cancer samples of one common cancer and comparing them to 500 normal genomes from the same patient to see what has changed and causes them to grow out of control,” says Larry J. Thompson, NHGRI spokesperson. “TCGA has studied more than a dozen common cancers and work continues at a rapid pace to understand genetic changes that cause most tumors.

“Genomics is also changing the way some cancers are categorized. For example, we know now that on a cellular level a lung cancer can be closely related to a form of colon cancer, which may speed repurposing of some cancer drugs,” he says.

The race is on.  In September, The National Institutes of Health (NIH) issued three grants totaling more than $25 million for three research groups to develop a database of the millions of genomic variants potentially relevant to human disease, and to decipher which may be useful for clinical practice.

“We’re in the early stages of these applications. We’re learning so much, so fast, it’s hard to know what’s going to break first, and what will turn out to be clinically relevant and meaningful,” Thompson says.

What’s possible on the horizon?  We’ll ask that of NHGRI’s Director, Dr. Eric Green, who will be joining TEDMED and other guests this Thursday for a live Google+ Hangout event at 2pm ET.  Among the topics we’ll discuss:

  • What is technically possible now, and what is the medical rationale for wanting to push this area of scientific research?
  • What are the barriers to progress?
  • Where will the field be in five years?
  • How is genomic research changing clinical practices?
  • How will we address regulations, reimbursement issues and other practical considerations?

Click here to register.  We’ll take questions from our Twitter, Google+ and Facebook audiences and will answer as many as possible.

Once upon a time at TEDMED: The story behind a groundbreaking cancer research collaboration

When we heard that two former TEDMED speakers, Drs. David Agus and Anthony Atala, had been awarded an NIH grant to develop the first-ever integrated bioengineered/computational model of metastatic colon cancer, TEDMED investigated the backstory of their unique collaboration.

It turns out the two met at TEDMED, which makes us proud; our mission is to be a petrie dish in which minds from many realms can mingle and imagine entirely new phenomena. The Agus/Atala collaboration is one example of many — a book arose from a chance meeting in the mens’ room at one TEDMED – and has the potential to make a huge impact on human health.

We asked David Agus to explain how it all came about.

Can you describe how you and Dr. Atala got the idea for this project?

I heard his talk, and he heard mine, and we met at a speaker reception – TEDMED is also very much about what happens between the talks.  When you speak at TEDMED, you’re presenting so the general audience can understand.  But when the two of us got together, we were talking about not just where the technology is today, but where could it go in the future.

shutterstock_75799198We’re both from different domains — I’m an oncologist; Anthony is a surgeon. My group has developed methods of computational cancer modeling; he has a system upon which you can put in a cancer cell and model its growth. Some of the biggest advances in science happen when you cross domains. The NIH had put out a call for submissions to help answer provocative questions in cancer.  So we said, ‘Can we put our two technologies together and make this happen?’

TEDMED has always been viewed as an organization for presenting big ideas about science and medicine.  But it’s also an organization for progress. You get people in the room, you give them a substrate — normally a glass of wine — and let them go, and things happen.

What drew you together to work on this?

Listen, we’re both nerds, we’re both into science, but we’re also both clinicians who take care of patients, and that combination is unusual.  We’re also both driven by seeing people dying from disease. It took a couple of years for this project to come to fruition, but both of us are very fortunate to have remarkable teams to help us do that. Many organizations don’t have the resources to do the pilot experiments and to take the risk.

What does it take to get researchers from various fields to come together on something like this?  Are other critical areas making strides?

For good or for bad, cancer doctors are willing to take a lot more risk than those in other areas.  The cancer field is on the forefront of change; the patients want to take more risk, and regulatory agencies have given us the leeway to do so. We don’t have a choice. There have been over a million published papers on cancer; billions of dollars spent on research. Yet, our understanding of disease metastases has made very little progress. We’re obligated to do things differently. For a more chronic disease like Alzheimer’s, risk taking has a different scenario.

Will current students of science and medicine have an easier time of crossing bridges for collaborative discovery once they begin their careers? 

The notion of cross domain thinking, and getting a physician and mathematician and stem cell scientist together is novel and new. Science rewards only the first author and last author on publications, and we’re talking about a team here of six scientists. Who’s going to get credit?  We have to push change.

What have been some of your favorite TEDMED talks?

One experience that truly changed me was hearing Jay Walker talk about the history of the flu. I was shocked; I thought it would be the goofiest presentation in the world. Yet it changed the ways I’ve thought about things and impacted many things that I think and what I write about.

I’ve started going back to primary sources and the historical side of medicine, whether with Hippocrates and epidemiology, or the plague in London. Doctors take care of patients and create observations that may be even more valuable today.  Back then, we had hours to observe, and we’ve lost that power. Anecdotes and stories are all we have to go on in medicine, and these are stories we need to pay serious attention to.

Have you started other collaborations at TEDMED? 

For me, it’s about the relationships I’ve developed, a broad network of individuals whom I now talk to on a regular basis who have ideas that inspire me. For example, Danny Hillis and I met separately at TEDMED, and it’s led to a lot of collaborative work.

When I go to a cancer meeting, it’s only cancer doctors there. The beauty of TEDMED is that we really get people from many different domains coming together. It may not be a direct influence – you do this part of a problem, and I’ll do that — but hearing how others from different disciplines solved problems changes how you approach your own.

TEDMED speakers Agus and Atala collaborate to study how cancer tumors grow

Using three-­‐dimensional organ creation, three-time TEDMED speaker David Agus of the Keck Medicine of University of Southern California (USC) will lead a team that aims to discover clues to metastatic cancer growth by developing a first-ever integrated bioengineered/computational model of metastatic colon cancer.

Agus is the principal investigator of a $2.3 million, four-­year “Provocative Questions” grant awarded recently by the National Cancer Institute (NCI), a division of the National Institutes of Health (NIH). The project title is “An Integrative Computational and Bioengineered Tissue Model of Metastasis.”  Agus is a pioneer in computational cancer modelling, particularly in the area of proteomics.

Co-authoring the study is TEDMED 2010 speaker Anthony Atala, MD, professor and director of the Wake Forest Institute for Regenerative Medicine (WFIRM) and chair of the department of urology at Wake Forest University. His team engineered the first lab-grown organ to be implanted into a human — a bladder — and is developing experimental fabrication technology that can “print” human tissue on demand.

The first phase of the project will be to calibrate a model with data from bioengineered liver tissue. Phase two will subject the growing tumors to physical changes likely to affect them in the human body, including alterations to oxygenation and drug treatment. In the third phase, the team will compare simulations of tumor growth in actual patients with outcome data from these patients.

USC co-­authors include Heinz-­Josef Lenz, M.D., professor of medicine and preventive medicine and associate director for clinical research and co-­‐leader of the Gastrointestinal Cancers program at the Keck School, as well as Paul Macklin, Ph.D., assistant professor of research, and Dan Ruderman, Ph.D., assistant professor of research medicine, at the Center for Applied Molecular Medicine. Also co-authoring from WFIRM is Shay Soker, Ph.D., professor.

Below, David Agus speaks at TEDMED 2010 on “A new strategy in the war against cancer.”

David Agus: A new strategy in the war against cancer

The NCI Provocative Questions project was launched in 2012 and is based on 20 important questions from the research community, intended to stimulate researchers to seek out especially effective and imaginative ways to study cancer. According to the NCI, the questions are categorized into five themes: Cancer prevention and risk; mechanisms of tumor development or recurrence; tumor detection, diagnosis and prognosis; cancer therapy and outcomes; clinical effectiveness.

Anthony Atala talks at TEDMED 2010 about growing organs in the lab.

Anthony Atala: Growing new organs

TEDMED speaker Lisa Nilsson to show new bodies of art

TEDMED 2012 speaker Lisa Nilsson, who wowed the audience with her fantastic paper sculptures of human anatomy, will show her latest work,  a series called “Connective Tissue” in New York City from October 10 through November 9th at the Pavel Zoubok Gallery.

Nilsson constructs the pieces with tightly curled, 1/4-inch-thick strips of Japanese mulberry paper and the gilded edges of old books, using a centuries-old process called quilling, or paper filigree. This painstaking technique — larger pieces take Nilsson about two months to complete — was popular with nuns and the aristocracy from the 13th through 18th centuries.

Angelico (detail) 2012,  mulberry paper and the gilded edges of old books. Photo: John Polak

Angelico (detail) 2012, mulberry paper and the gilded edges of old books. Photo: John Polak

As she explained in her TEDMED talk,  the “fleshy” quality of the coiled paper drew her mind towards picturing anatomy, and hand-colored illustrations in an ancient French medical book inspired her first piece, a transverse view of female torso.

Nilsson uses a variety of sources for her work, including aged hand-painted French and German anatomy texts, as well as images from the U.S. National Library of Medicine’s Visible Human Project. The male cadaver for that project is that of a 38-year-old Texas murderer who was executed by lethal injection.

“I do notice, especially with that male figure, that his body is very thick and imposing. He’s not a delicate individual, and I wonder if that has something to do with the life he led,” she says.

The resulting pieces are lush yet, upon closer inspection, intricate, delicate and fragile, like the human body.  Nilsson says her work is popular with surgeons – for obvious reasons – but that non-medical folk also appreciate it’s unique and visceral vantage point.

Screen Shot 2013-09-06 at 12.04.39 PM

In an interview with Installation magazine, Nilsson said:

Attention to detail and careful observation are, for me, a means of practicing devotion, a practice common to the scientists and makers of religious art that I admire.  I am inspired, aesthetically, by scientific imagery and objects.  My approach to my work is “play-scientific.”  I use tweezers and scalpels and pretend I’m a surgeon from time to time, but without any of the intense responsibility of the real thing, for which I would be decidedly ill-suited.

For more, visit www.lisanilssonart.com and watch TEDMED Curator Jay Walker’s Q&A with Nilsson.

Rebecca Onie: At last, healthcare considering patients’ social needs

By Rebecca Onie

In April of 2012, I had the opportunity to pose a simple question to the TEDMED community:  What if our healthcare system actually kept us healthy?

This is a simple and universally shared aspiration –the idea that our healthcare system could prevent patients from getting sick in the first place, rather than only treating patients after they have fallen ill. But as is so often the case in healthcare, this can feel intractable. Addressing the root causes of poor health –for example, prescribing antibiotics to a pediatric patient only to find out she has no food at home or is living in a car—can feel overly expansive, complicated, and expensive.

Rebecca Onie at TEDMED 2012

At TEDMED 2012, we sought to present a solution that is instead simple, effective, and cost-effective: in the clinics where Health Leads operates, physicians can prescribe healthy food, heat in the winter, and other basic resources patients need to be healthy, alongside prescriptions for medication. Patients then take those prescriptions to our desk in the clinic waiting room, where our corps of well-trained college student Advocates “fill” those prescriptions by working side-by-side with patients to connect them to the existing landscape of community resources.

The response at TEDMED, as well as the continued demand that Health Leads has experienced since then, has been swift and unequivocal: over the past nine months, we have received expansion requests from more than 700 healthcare institutions that are urgently seeking solutions that will address their patients’ true health needs.

This demand is symbolic of a much larger shift taking place within the healthcare market. The next 12 months, as we all know, will be an unprecedented moment of fluidity and possibility in healthcare. More than twenty million previously uninsured people will introduce complex social needs into the Medicaid system – in the face of a 21,000 physician shortage. Healthcare providers, accountable for delivering health outcomes in this challenging landscape, are compelled to pursue new care delivery models that account for the realities of patients’ lives.

A Health Leads advocate at Hasbro Children's Hospital in Providence, Rhode Island meeting with a patient. Credit: Courtesy of Health Leads

A Health Leads advocate at Johns Hopkins Hospital Children’s Center in Baltimore, Maryland meeting with a patient. Credit: Courtesy of Health Leads

 

These providers – like Health Leads partner Nassau University Medical Center (NUMC)– are leading the way in demonstrating that it is indeed possible to address patients’ basic resource needs in a clinical setting. NUMC has fully integrated Health Leads into its pediatric outpatient operations – empowering doctors, nurses, and social workers there to ask their patients: Are you running out of food at the end of month? Are you worried about paying the electrical bill?

If the answer is yes, those same providers can refer any patients in those clinics to Health Leads, just like any subspecialty referral – and our Advocates can provide real-time updates to the rest of the clinic team about whether or not a patient got the needed resource, yielding better informed clinical decisions.

Furthermore, NUMC is just one of many institutions that are acknowledging the economic value of addressing patients’ social needs – two-thirds of Health Leads’ clinical partners cover all or some of the cost of our services.

Shifting market trends in healthcare are providing increasing financial incentives for healthcare institutions to pay for models like Health Leads: for example, to achieve Patient-Centered Medical Home certification, institutions must show that they 1) maintain a current resource list on five topics of key community service areas of importance to the patient population and 2) track referrals to patients/families.

Health Leads fulfills both of these basic requirements and also gives clinicians a fully built-out patient flow that is aligned with the design principles of a medical home: we are physically based in the clinic, available to patients with a referral from their primary care provider, and are incorporated as part of the greater care coordination team.

The healthcare system is moving.  Clinicians are demanding the ability to address all of the factors that prevent their patients from staying healthy. Patients expect to be able to speak with their doctor about the things that are making them sick in the first place –running out of food at the end of the month, or lack of electricity needed to keep their medicine refrigerated. And hospitals are allocating scarce budget dollars to address these needs.

At long last, the healthcare system is grappling with the realities of patients’ lives. If we together act now to adopt  practical, simple solutions that work, we can move at last from imagination to implementation. And we can create a new kind of healthcare – for patients, for doctors, and for all of us.

Rebecca Onie is Co-Founder and CEO of Health Leads. Join a representative from Health Leads and other organizations for TEDMED’s online discussion about the social determinants of health this Thursday at 2 pm ET. Ask questions via Twitter #greatchallenges – we’ll answer as many as we can on air.