Zoobiquitous Medicine: Q&A with Barbara Natterson-Horowitz

Barbara Natterson-Horowitz, Professor of Medicine in the Division of Cardiology at UCLA Medical School, offered an unusual perspective on how human patients, including those suffering from mental illnesses, can be helped by applying insights from animal health. We caught up with Barbara to learn more about how her Zoobiquity idea improves understanding of ourselves and the natural world.

Zoobiquitous Medicine. Barbara Natterson-Horowitz at TEDMED2014. Photo: Sandy Huffaker for TEDMED.
“When I see a human patient, I always ask, ‘What do the animal doctors know about this problem that I don’t know?'” Barbara Natterson-Horowitz at TEDMED2014. [Photo: Sandy Huffaker for TEDMED.]

What motivated you to speak at TEDMED?

After 20 years of practicing cardiology taking care of patients with heart attacks and high cholesterol, I was thrust into the world of veterinary medicine. Seeing my human patients as human-animal patients completely changed how I practice medicine and understand health and disease. Insights from this species-spanning approach to medicine can benefit human and animal practitioners and patients alike. It’s thrilling to introduce this approach to physicians, psychologists, dentists, nurses, etc. and watch their viewpoints transform; the exposure at TEDMED led to a collaboration between a celebrated human breast cancer physician studying a mutation that causes breast cancer in women with a veterinary oncologist working on the same mutation that causes breast cancer in jaguars and other animals!

Why does this talk matter now?

Animals and humans get basically the same diseases. From heart failure, diabetes and brain tumors to anxiety disorders and compulsions, the challenges we face aren’t uniquely human. Discovering why, where, and how non-human animals get sick reveals crucial but hidden clues to human health and illness. For instance:

Breast cancer: When beluga whales began dying of breast and colon cancer in the St. Lawrence estuary, a parallel epidemic of breast cancers in women was discovered in the same region. This species-spanning breast cancer outbreak was ultimately linked to toxins from local aluminum smelting plants.

Obesity: Medical insights into obesity — which challenges physicians and veterinarians alike as animal and human patients are becoming more fat — are generated by a zoobiquitous approach.  Awareness of worsening obesity in domestic and wild animal populations challenges us to consider environmental factors including endocrine disrupting chemicals,  antibiotics, and even climate change as contributors to the “plurality of obesity epidemics.”

Infectious disease: The majority of infections that could create human pandemics come from animal communities. From Ebola to West Nile Virus, SARS to H1N1, some of most worrisome threats to human health and survival are encountered first by veterinarians and animal experts. If we fail to pay attention to these experts and miss out on the opportunity to collaborate, we lose crucial information and increase unnecessary risk for human populations.

How do you see your work fitting into species-survival, wildlife preservation and conservation?

Zoobiquity emphasizes the interconnectedness of animal and human lives and ecosystems. Animals can be sentinels of disease in humans. When horses in Venezuela start to die, it can mean equine encephalitis may threaten local human populations. When cormorants and crows get sick with West Nile virus in Queens and the Bronx, elderly and immunocompromised patients may also be at risk for the virus. On the other hand, humans can be sentinels of disease in animals. Human outbreaks of Brucellosis often lead to identification of sick and suffering animals. The detection of lead poisoning in a child often leads to exposure and disease in local wildlife. Bringing practitioners of animal and human health together encourages the transfer of information from the world of human medicine that is vitally relevant and important to wild animal populations.

What do you hope for the legacy of Zoobiquity? 

Zoobiquity Conferences have now been held across the US and internationally. At these events human health practitioners including physicians, nurses, dentists, psychologists and others come together with animal health practitioners including veterinarians, behaviorists, nutritionists and others to discuss the shared diseases of their different species. I’ve heard some veterinarians joke, “real doctors take care of many species.” Bringing the comparative approach to the human medical community has the power to transform how physicians, nurses, psychotherapists and others understand disease, their patients and the environmental and evolutionary factors that link us all together.  I hope Zoobiquity is successful in bridging the worlds of animal and human health, ecology and evolutionary biology.

Check out our archived Facebook chat with Barbara about species-spanning medicine. 

It’s smart to design simple: Q&A with Josh Stein

On the TEDMED stage, serial entrepreneur and CEO & Co-founder of AdhereTech Josh Stein shared what he’s learned about designing ‘smart’ devices and the internet of things as they relate to positively influencing patient behavior. We caught up with Josh to learn more.

The Internet of Medical Things
Connected Medical Devices Will Revolutionize Healthcare… If Patients Actually Use Them. Josh Stein at TEDMED2014. (Photo: Sandy Huffaker for TEDMED)

Why does the talk matter now? What impact do you hope the talk will have?

The Internet of Medical Things is going through a period of incredible growth, which is absolutely fantastic for patients! However, there’s an enormous design hurdle in regard to user adoption, and this hurdle is largely ignored. In short, there is too great a focus on what these devices can do, and not enough focus on how these devices will actually do it.

The Internet of Things, (IoT), or ‘smart’ devices, can be separated into two distinct categories: devices that users purchase and devices they don’t purchase.

Most IoT devices fall into the former category. Users will pay a lot of their own money for a gorgeous new smart phone, TV, or fitness tracker because these gadgets provide an immediate benefit to the user (they are awesome and fun to use). In these instances, consumers are willing to go through a reasonable set up and learning process for these devices.

In contrast, a large percentage of smart IoT medical devices actually fall into the latter category: users don’t buy these devices, and they are provided to users by a third party. This occurs because: 1) other parties subsidize these tools in order to improve patient outcomes and thereby decreasing overall costs or increasing revenue, 2) consumers typically don’t like to pay for medical devices, and 3) consumers typically don’t see a tangible immediate benefit from these devices.

The reason why this distinction is so important is that most smart medical devices are designed as if they fall into the former category, at least from a user-experience perspective, when they actually fall into the latter category. Thus, these smart med devices are designed as if patients will go through a long and complicated set up process to use said devices, when in reality the patient will not perform such tasks. Patients are simply expected to do way too much in order to use most smart med devices.

I shared this thought at TEDMED 2014 with the hope that this notion will resonate with other smart medical device creators. This could potentially lead to improved devices and better patient health.

What kind of meaningful or surprising connections did you make at TEDMED?

I met Jim Madara, the CEO of AMA; he and his team spoke about the innovative ways in which they are revolutionizing how medicine is taught. I met Marc Koska; his syringe is one of the most ingenious medical devices that I have ever seen. It solves a huge problem through simplicity and understanding its user. I built a relationship with an individual who is innovating clinical trials at one of the most innovative companies in healthcare. I don’t want to mention this person’s name because, though this introduction, my company is now planning an engagement with his incredible organization. Stay tuned for updates on this collaboration – we’ll keep TEDMED in the loop!

I also met one of my favorite stand-up comedians, Tig Notaro. Her TEDMED talk was awe-inspiring, and it was amazing to see a whole other side to her. I can’t say enough great things about her and her work!

I had the pleasure of speaking with Jay Walker. His wisdom and advice has directly impacted product and vision of my company. I genuinely attribute a great deal of our success to the conversations I’ve had with him.

What is the legacy you want to leave?

I want to be known as someone who has a net positive benefit on the world. Professionally, I believe I’m on the right track with the innovative work that my team and I are doing –  our product has been improving the adherence and outcomes of patients since 2013. We work long hours, but seeing improved patient health and traction continues to motivate us.