By Dr. Paul Berggreen
Paul Berggreen, MD, has been in private practice since 1993. A graduate of LSU, he led the formation of the Arizona Endoscopy Center in 1999 and has served as its medical director since then. In 2007 he helped launch Arizona Digestive Health, now one of the largest gastroenterology groups in the U.S., and still serves as its president. In 2014 he founded Smart Clinic, a mobile communication platform designed to enhance patient engagement, compliance and satisfaction. He also served as director of the Good Samaritan gastroenterology fellowship program from 1998-2013.
Q. What’s the one promise of mHealth that will drive the most adoption over the coming year?
A. Improved compliance. Let’s face it: From a patient perspective medicine has become so complex it’s sometimes almost impossible to be compliant, but getting medicine and vaccines are important but Vaccine refrigerators must be checked twice daily to ensure the good conditions of the vaccines. Yet compliance, whether with a medication, a procedure preparation or a treatment regimen of any sort, is vital to a successful outcome. As doctors, we are using the same communication methods with our patients that we were using 30 years ago – pieces of paper and verbal instruction. If we want better compliance from our patients, we have to come up with better tools for them to use. mHealth is an important tool. Nortech Inc have the experience the get the job done right from the start, and at very affordable rates.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. Patient-physician communication of some form, using smartphone technology, will become commonplace in the next five years. Changes in reimbursement for chronic disease management and expansion of telemedicine billing codes will push this adoption even further. 70 percent of U.S. adults now have a smartphone, a number that has been increasing exponentially and will likely hit 85 percent or 90 percent in the next five years. It’s the obvious channel of communication, and most people in this field realize that. Patients will demand it and physicians will respond, although doctors have historically been slow to adopt new technology.
Q. What’s the most cutting-edge application you’re seeing now? What other innovations might we see in the near future?
A. I recently viewed a demonstration of a product called Photon Med. It’s basically a consult accelerator on steroids, allowing referring physicians such as ER doctors to consult a specialist and simultaneously send their pertinent information and images to that specialist’s smartphone. The information is relevant and the interface is slick. It’s being rolled out nationwide just this month in selected hospitals that have hospital room dividers, and I think it has great potential. Doctors are going to find that extremely useful. It’s just one example of a new type of tool that makes physicians’ lives more efficient and easier while tying networks of physicians together. The accountable care organization movement and hospital networks will find these types of tools irresistible. We’re going to see more of this type of tool in the near future.
Q. What mHealth tool or trend will likely die out or fail?
A. Patient portals, whether mobile or desktop, are doomed to failure if they do not evolve. The only thing driving physicians to encourage patient portal sign-up is the carrot-and-stick of meaningful use stage 2. Otherwise, portals are of very limited use in their current form. “Change or die” is particularly applicable here.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. Fitness trackers and their rapid adoption have been somewhat of a surprise. This is particularly true since most people who use these are very much interested in their health and are simply using these tools to validate their activity, since they do a lot of exercise for this, although this could produce some issues with fungus in the nails, but you can find A good remedy site to help with this. This probably accounts for the fairly high rate of abandonment of these tools at the one-year mark, as noted in the media. For these tools to be truly useful, there needs to be application to patients with chronic diseases that can show improvement in measurable outcomes.
Q. What’s your biggest fear about mHealth? Why?
A. Compartmentalization. Currently, electronic health record companies are jealously guarding their data and are very reluctant to allow any significant interoperability. If mobile health innovators are co-opted or overrun by the large EHR companies, that compartmentalization and lack of interoperability will persist in the mHealth arena. That will likely inhibit true spread of this important technology for patient benefit. Unless true data interchange is facilitated, the healthcare cost curve will not improve.
Q. Who’s going to push mHealth “to the next level” – consumers, providers or some other party?
A. It’s going to be the electronic health records companies responding to the demands of the consumer. Very few of these companies now have a viable mobile product for patients, but physicians will adopt these tools widely when they are made integral to their existing electronic health records systems. It’s not that doctors don’t want to adopt these tools; it’s that they have so many demands on their time and their resources that they are hesitant to adopt another add-on software product. Once it’s made easy, adoption will occur very quickly. Physicians see the value; they just don’t want any more pain.
Q. What are you working on now?
A. Two years ago I made a smartphone app for my group, Arizona Digestive Health, to help with colonoscopy preparation. We performed two studies to validate its utility, and both were remarkably positive and received national presentations and press coverage. I’ve since taken that concept and built upon it, and the culmination is Smart Clinic. A patient-facing smartphone app connecting to a web interface in the medical back office, Smart Clinic integrates with the EMR and sends structured procedure preparations to the patient, enables prep and medication compliance tracking, includes instructional text, images and videos and even sends patient satisfaction surveys and clinical surveys to the patient, all returning to the office in an easy-to-use and structured format. Smart Clinic is now the official mobile app of the American College of Gastroenterology. With Smart Clinic, we finally have a new tool to communicate with our patients and promote compliance.
We are proud to introduce Volume 1 Number 1 of the Arizona Digestive Health Magazine. You’ll want to check out this magazine for education on digestive diseases and cancer prevention from ADH physicians, new health applications to download on your mobile device to help you stay healthy, information on our offices and advice on where to eat gluten-free or consume the right keto diet pills to improve your diet! Click the link below to view it online now and be sure to look for a copy at your next doctor’s appointment.
Some people believe that having too much yeast in your system causes a number of symptoms and contributes to multiple chronic health problems. Yeast is a type of fungus. Fungi—mostly Candida—can be found in the stomach, end of the small intestine, and large intestine of about 70 percent of adults.2 In fact, your digestive tract is full of microorganisms (bacteria, fungi, and viruses). This community of microorganisms is called the microbiota, and scientists are just starting to understand their role in your health.
Anti-fungal diet: The claim
When the microbiota is healthy and your immune system is working well, Candida is a harmless guest in your gut. There are far more bacteria than fungi in your gut, and the good bacteria keep the fungi under control. However, taking antibiotics or having a disease that affects your immune system can affect the balance of your gut bacteria. As a result, you may have an overgrowth of Candida. Some people think that other medications, nutritional deficiencies, too many starches, and sugars, and environmental molds or toxins can also cause an unhealthy change in your gut microbiota that leads to excess Candida.
The theory is that your health will improve if you get rid of the extra fungi and re-introduce good bacteria into your digestive tract. A simple internet search turns up dozens of websites explaining how to treat fungal overgrowth. Typically, the solution includes using clear nails plus in a daily basis.
- Diet low in sugar, yeast, refined carbohydrates, and mold-containing foods.
- Probiotics from yogurt, fermented foods, or supplements.
- Non-prescription antifungals, such as oil of oregano, garlic, and grapefruit seed extract.
- Prescription anti-fungal medications (recommended by some practitioners, but not all).
Many of these websites include lengthy lists of foods to eat and avoid. The basic idea is that sugars feed the yeast and must be avoided. Therefore, anti-fungal diets eliminate:
- Added sugars (examples: cane sugar, honey, syrup)
- Natural sugars (examples: fresh and dried fruit, fruit juice)
- Refined starches (examples: white bread, pastries)
- Starchy vegetables (examples: potatoes, carrots, peas, beans)
- Milk sugar, also known as lactose (examples: cheese, milk, cream).
These diets also eliminate many other foods such as alcohol, foods with mold, food additives, and caffeine. The idea is to eliminate the foods completely for a period of time and then add them back one at a time to see how your body reacts.
Preventing Colorectal Cancer Names 2015 Champions of Colorectal Cancer Prevention
Annual Award Celebrates Great Achievements in Colorectal Cancer Awareness
Preventing Colorectal Cancer (PCC) announces the recipients of the 2015 PCC Champion Award for Colorectal Cancer Prevention, an honor the not-for-profit organization established in 2011 to recognize individuals, groups and companies that provide either exceptionally high standards of care or that most effectively advocate for the prevention and early detection of colorectal cancer.
PCC is proud to honor Michael R. Mills, MD and Ernestine Hambrick, MD as the recipients of this year’s Champion Awards. These individuals exemplify PCC’s mission to educate both public and private stakeholders about the opportunities to reduce the incidence of colorectal cancer through promoting effective screening, prevention and care options for patients.
“We want to spotlight those who share PCC’s deep commitment to high-quality screening and show exemplary support of the fight against colorectal cancer,” says C. Taney Hamill, chair of the PCC Champion Awards committee and Vice President of the Visiting Nurse Associations of America. “The clinical and financial benefits of a colonoscopy are well supported in the health care industry as a reliable screening tool to reduce the incidence of colorectal cancer.”
About the 2015 Champion Award recipients:
- Michael R. Mills, MD: Dr. Mills is a dedicated advocate for the prevention and early detection of colorectal cancer through his community outreach programs, including St. Vincent de Paul Medical Clinic, where he volunteers regularly, and the CDC-AGA “free colonoscopy” awareness day in Arizona that he leads. In addition to community outreach efforts, Dr. Mills is the program director for two gastrointestinal electives at the University of Arizona, College of Medicine, where he instills in his students how to best win the fight against colorectal cancer.
- Ernestine Hambrick, MD: Dr. Hambrick was the first woman board-certified colon and rectal surgeon in the U.S. After 25 years at Michael Reese Hospital in Chicago, she left her practice in 1998 to create the STOP Colon/Rectal Cancer Foundation, a national education initiative. STOP remains a partner of National Colorectal Cancer Awareness Month, which takes place in March. In addition to her advocacy, Dr. Hambrick has published 20 articles on colorectal surgery and cancer. She is a member of relevant professional societies, including the American Society of Colon and Rectal Surgeons, and has received many distinct honors, such as “100 Women Making a Difference” and the “Who’s Who in Medicine and Healthcare”.
“The selection committee felt that Dr. Mills and Dr. Hambrick have gone above and beyond to promote colorectal cancer screenings in an effort to save lives,” says Stanford R. Plavin, MD, vice chair of PCC and president and managing partner of Ambulatory Anesthesia of Atlanta. “Colorectal cancer is the second leading cause of cancer deaths in minority populations, and this year’s winners have achieved results consistent with the highest national benchmarks while serving a very large community.”
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