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Cardiologists, it is time to say goodbye to linear thinking and embrace exponential
Advances in artificial intelligence, robotics, infinite computing, ubiquitous broadband networks, digital manufacturing, nanomaterials, synthetic biology, and many other exponentially growing technologies will enable us to make greater gains in the next two decades than we have in the previous two hundred years.
In order to understand why I say this, one needs to understand the basis of Moore’s law and exponential thinking. What does this mean? It means that the technology created in the past has helped develop the technology of tomorrow in an exponential pace and will continue to do so. Say what? Lets say you were asked the following question “From your current location, where would you be if you took 30 steps?” You would probably be able to say with accuracy your location. Now, if we address this in an exponential concept. Taking 30 steps exponentially (1-2-4-8-16-32-64-128 etc) you would end up 1 billion steps away. Would you have been able to predict this? Likely not since most of us are linear thinkers. This is the foundation of exponential technology. Most people in healthcare are not used to thinking about how technologies that grow at this rate will impact our future and doing so is a key component in making this a better world. If you want more information regarding this, don’t miss the article from Nature “Moore’s law is not just for computers”
Ok… What does any of this have to do with cardiology or the ACC? ACC ’13 marks the third year that The Cardiovascular Education Innovation Forum has been a part of the annual meeting. Despite it’s recent inception, this Forum has been growing linearly (I am trying to change that but there are many obstacles!). This year’s Forum was a little different than prior years. Three fellows, including myself, joined the program committee and helped determine the topics and speakers. Our goal is to mold the Forum into what we know it can become. I have been fortunate enough to be a Singularity University Futuremed alumni in 2011 and 2013. The mission of Singularity University is “How to impact the lives of 1 billion people in 10 years”. (For those not familiar with it, please check it out at http://futuremed2020.com/). Will this happen by placing better drug-eluting or bioabsorbable stents? How about renal artery denervation or TAVR. Change of this magnitude in healthcare will require new strategies and technology along with a different way of thinking. Not just a new design of an existing product. And by the way, I am starting interventional cardiology in June 2013, but then pursuing a biodesign fellowship. I am certain that tech-savy healthcare providers who have embraced technology will lead the revolution in healthcare change.
That is the goal of the cardiovascular innovation forum. To show and motivate every cardiologist to try and impact the life of hundreds at a time. This year the CVIEF invited The Society of Physician entrepreneurs to help and orient cardiologists on the path to materializing our ideas. Venture Capitalists and Angel investors that talked about what type of ideas they are likely to fund, how to approach them, a gameplan to follow. 
I invited the “Disruptive” Dr. David Albert , creator of the alivecor. Everyone should know what it is, but for those that don’t, it is an iphone case that has 2 finger sensors in the back, and when placed, it detects an ekg tracing (Lead I, but some hacks can be done to obtain more) which you then see in your screen and can transmit it to the cloud. Joe smith from west wireless, Mathew Patterson from airstrip technology and last but not least Daniel Kraft from the FutureMed program of Singularity University. His talk was “Exploring the frontiers of exponential technologies in Cardiology”
Dr. Kraft started talking in the last hour of the expo, from 1 to 2. This very challenging time was due to his busy schedule. Another challenge was he was talking for an hour. Some were hesitant about allotting 1 hour to a speaker but I was 100% sure the audience would respond. After sending a couple of tweets to the ACC13 hashtag, the audience grew and was captivated in a matter of minutes. Cardiologists were just amazed on what technology had to offer to us, and how a cocktail of medicine, technology and innovation could be the savior of healthcare. If you want details on topics he spoke about, please check The FutureMed Magazine at http://futuremed2020.com/magazine.
60 minutes later no one had moved. Cardiologists, who are stereotyped to have short attention span were glued to their seats for the next hour. Quotes from the audience after his talk “This is the talk that everyone at ACC should have heard”, “I had no clue those things were possible”, “Why is the Cardiovascular Innovation forum in this corner?”, “That was mind blowing” and from a lot of people “Thank you for assembling this” It was a pleasure being a part of the Cardiovascular Innovations Educational Forum at ACC ’13. II hope to see it grow exponentially for ACC ‘14
Many will agree with me, many will not. If you do not, I will invite you for a cup of java in 2 years and see what you think by then. Feel free to contact me twitter @christianassad
e-mail: christian.assad at singularityu.org
Best
Christian
The 15 Smartphone Apps your Doctor Should be Prescribing
Check the Virtual Magazine at: http://goo.gl/mjfmD
Every time you go to the doctor you will hear the same thing. Lifestyle modifications. Doctors are supposed to encourage you to become healthier, eat better, sleep better and exercise more. Stop smoking etc.
This words or sentences are extremely easy for your doctor to say them, but, difficult to follow, extremely difficult in some cases.
Even doctors, colleagues of mine do not follow them. Yet, they HAVE THE AUDACITY to tell the patient to follow them? BAAAHH Simply ridiculous in my opinion.
Who am I to talk? Well I exercise as much as I can during the week. If time is an issue I will at least take 15 minutes of my day to do an ab workout routine and always, I MEAN ALWAYS eat healthy. I would rather skip a meal than eat junk food. It is no longer a routine but a lifestyle, a lifestyle I chose to adopt many years ago. I want to be in the best shape possible not only for me but for my family. With this apps I will try to help you adopt such a lifestyle. If you have questions, doubts or concerns feel free to shoot me a tweet at @christianassad. I will be more than happy to try and help you succeed!
With this issue I have made a list of 15 apps that either I have used or friends have used to get healthier. The apps are in 3 categories. Healthy Eating , Exercise and Sleep Routine and they are as follows;
Some are free, and some cost 3-4 USD. In any case they are all great and this issue will save you time since there are thousands of applications in this field. This recommendations are based from my personal experience or friends of mine. Hope you enjoy them.
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Healthy Eating
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1) Fooducate
2) Calorie Counter – Myfitnesspal
3) Restaurant Nutrition
4) LoseIt
5) Smoothieselector
6) Whole Food Recipe Maker
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Exercise Better
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1) Runkeeper
2) JEFIT
3) Nike Training Club
4) Nexercise
5) Endomondo
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Sleep Routine
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1) Sleep Bug
2) Sleep Cyle
3) PZIZZ
4) Deep sleep
Electronic Cigarettes, Is it time to Swap the Smoke for Vapor?
Electronic Cigarettes: Swapping the Smoke for Vapor
Often in my cardiology clinic I encounter patients that have tried to quit smoking in multiple occasions always to end up in the same alley.
As doctors, we are supposed to encourage patients to quit smoking every time they come to our clinics and “guide” them to the right pathway. Easier said than done. As a Cardiologist I am amazed and amused to a certain extent when I see my colleagues recommending patients to lose weight, eat healthier, and stop smoking. Yet many of them do contrary to this recommendations. You have to practice what you preach…
Recently a very pleasant man came to my clinic. He had history of heart attack, and sudden cardiac death. Resuscitation was performed and he was lucky enough to come back to the world to his family. After 10 years he continues to smoke. Why? His answer is “I enjoy smoking too much doc, but believe it or not I do not inhale”… Ok.. Thats when I noticed. Winning the Lotto is more feasible than making him quit smoking…
Medical Societies do not recommend the use of E-Cigarettes as a cessation method for smoking. due to its possible harmful effects. FURTHER TRIALS ARE NEEDED. (Dont you just love how we practice medicine). I have spoken with patients who have made the jump by their own will to vaping instead of smoking and have not met one that is dissapointed. They all say the feel better, healthier, with more energy. Biased may be, but I can tell you from a subjective standpoint… They also look healthier.
In summary. I can not tell patients to use or prescribe e-cigarettes, but I can say that they appear to be a far better option than inhaling 4,000 chemicals from smoke…
In the following pages I will go over some information regarding smoking and vaping and different types of electronic cigarettes just to educate people on what is out there. I am by no means an expert on the subject, but hopefully this info can help others as much as it helped me.
Hope You like it ———> Electronic Cigarettes: Swapping the Smoke for Vapor
Impact of Emerging Exponential Technologies in the way we practice Medicine
I was asked to give a talk in my University which is The University of Texas Medical Branch, regarding exponential technologies in Medicine. For those who do not know me, I am a cardiologist who is passionate about incorporating technology into medicine. I have no doubt that major changes will be happening in the incoming years in the way we practice as well as how we engage with our patients. Click here for the link to see or download or copy paste http://goo.gl/IwCdB
Before giving the talk I overheard people saying “it is a joke, this is a cardiology meeting, what is he talking about” I also heard others with more positive comments. As one of my slides states “The problem with close minded people is that their mouths are always open”.
Soon after initiating my talk I could see how the audience became captivated with what I had to say. My goal was to open some eyes to the potential of exponential technologies. I wanted to show them technologies that are and will be game changers in our every day practice, and hopefully ignite some light bulbs to stop conventional routine thinking and dream a little…
Hope you like the slides
Update: 3 hours after the upload it became top presentation of the day, 6 hours later top presentation talked about in facebook, and 36 hours later 30,000 views
Contact:
Twitter: @christianassad
E-Mail: christian.assad-kottner at singularityu.org
Using Social Media to Engage and Improve Learning in any Medical Conference.
TIME TO ENGAGE YOUR MEDICAL AUDIENCE
Over the last couple of years I have become increasingly bored and tired on how medical conferences are presented in Academic Institutions. It does not matter if it is; Morbidity and Mortality, Journal Club, Morning Report, State of the Art conference. It is always the same format. The content of the material may be great but digesting it is difficult.
It is like trying to give someone a boiled chicken thigh with no salt or spices. If you are vegetarian it would equal an uncooked piece of Tempeh. They are both good for you but good luck swallowing more than 3 pieces.
Same thing goes for these conferences. With all the tools out there, it is a true shame that we continue presenting our medical knowledge to students, residents and fellows in the same, insipid didactic forms.
OK… So what do you recommend?
I previously wrote an article about yammer and how I am using it in the Cardiology department to stimulate learning between cardiology fellows and faculty. Well now I have opened the doors to internal medicine residents and they are learning with us. In a future I would not be surprised if the whole institution is part of such network. Each subspecialty having its own groups. Each group sharing knowledge, asking questions, solving problems that any given team is just stuck upon. I will make another post in a near future on how this is working on. (I can only expect it to get better after being purchased by Microsoft for 1.2billion dollars… but in any case)
I recently had talk on a Journal Club about a particular article. One little problem… I wanted to incorporate social media in my talk to make it more interesting, more interactive. I wanted to make it “fun”. This is how I did it.
I wanted to incorporate Twitter into my Powerpoint presentation. I did some websearch aka (googled it) and I stumbled upon SAP WEB 2.0, blog created by Timo Elliott. Here he presents some templates he created in which you can incorporate Twitter into you presentation. There is no wrong or right answer on how to use it, just use your imagination, ask yourself “What could make my presentation more interesting”. This is what my powerpoint presentation looks like
1) THIS IS THE FIRST SLIDE. THE 2 ICONS YOU SEE IN THE UPPER RIGHT CORNER WILL BE PRESENT THROUGHOUT THE PRESENTATION AND TAKE ME TO THE CORRESPONDING SLIDE SHOWN BELOW (2,3). IN ADDITION I ALSO HAVE A LIVE STREAM IN ALL OF MY SLIDES THAT CAN BE TURNED ON AND OFF DURING MY PRESENTATION. AUDIENCE MEMBERS CAN SHARE THEIR THOUGHTS AT THE SAME TIME I AM TALKING. SOME MIGHT FIND IT DISTRACTING, I FIND IT AMAZING AND ENGAGING.
2) AT ANY GIVEN TIME I CAN CLICK THE TWITTER ICON ON THE UPPER RIGHT CORNER OF MY PRESENTATION AND WILL TAKE ME TO THE SLIDE THAT SHOWS THE TWEETS OF THE HASHTAG IM USING DURING MY CONFERENCE. IN MY CASE, I AM A CARDIOLOGIST AND GIVING A CARDIOLOGY JOURNAL CLUB, I NAMED IT CARDIOTWEETS
3) IN THIS SLIDE I CAN TYPE A QUESTION LIVE IN THE PRESENTATION WITH THE OBJECT BOX I CREATED. IN ADDITION I CAN ALSO CREATE ANSWERS. THE AUDIENCE LATER TWEETS THEIR VOTE AND GET THEM IN A BAR GRAPH OR PIE CHART
HOPE YOU LIKE IT AND FIND IT USEFUL SPECIAL THANKS TO TIMO ELLIOT FOR CREATING SUCH A MASTERPIECE AND SHARING IT.
HAVE A QUESTION? EMAIL ME AT: CHASSADK AT GMAIL.COM
How to Jump in the Social Media Healthcare bandwagon easily and smoothly
More and more we are hearing about social media and the potential it has on healthcare. A trend has been picking up and many doctors already feel comfortable using these different tools PROPERLY. However, many MDs, Residents and Fellows in training are dubious and hesitant about using social media. I have been an advocate about its potential for several years now and tried to get others involved but with ambiguous success. Examples could be Twitter, Facebook, Google +, Foursquare, and even medical directed social apps like Doximity.
A recent article talks about this, published in the Houston Business Journal, ”Houston hospitals, doctors infected by social media” talks about the importance of Social Media in healthcare and why more doctors should be adopting it. Well, for those of you that want to start slowly, for those that are scared about embarking in this area and are hesitant about using facebook or twitter there is a simple answer for you to test drive it. The answer is Yammer.
Yammer is a social platform that allows you create a private social network specifically for your institution, business, clinic etc. All you need is the same domain in the email and off you go. In case this is not possible an external social network is possible. By the way thanks to Nate Osit for recommending it!
An example of a way that I implemented Yammer is as a learning tool. I created a group inside yammer called “Cardiology Lounge” (being a Cardiology Fellow). In this group, residents, fellows, and faculty post questions of interesting cases, ,discussions, pictures, etc. It is creating a learning environment which is fun secondary to the interaction with each other. If you are walking in the hallway you can login to Yammer, check the group and in a few minutes see whats cooking. No useless status updates like we are sometimes exposed in facebook.
In my opinion, if you are new to social media, and want to try it slowly try out yammer. Feel Free to contact me
Twitter @christianassad
E-Mail: chassadk at gmail.com
Evidence of anti-cardiac antibody deposition in end-stage failing myocardium: A potential contributor to disease progression
I recently presented a research project I have been working on for the last 5 years approximately at The Annual Meeting of International Interventional Cardiology (CADECI 2012). The Research was “Evidence of anti-cardiac antibody deposition in end-stage failing myocardium: A potential contributor to disease progression”
It was awarded the Best International Research Project of 2012 at the meeting. In the findings we show that an overwhelming amount of patients with heart failure, be it ischemic or non ischemic have anti-cardiac antibody deposition in the myocardium (70/100) while normal hearts were completely negative (0/40) .
These findings suggest that the immune system play a significant role in the development and disease progression of heart failure and could be a window for future therapeutic modalities. If this grabbed your attention I recommend you download the PPT and watch it with the animations in order to understand the concept better. Feel free to contact me with any questions.
QUANTIFY WHAAAAT? STOP XQ-SES! Start MOVING!
Warning: If you do not believe in hard work stop reading…
I always have been a health exercise oriented person and so has my family. I thank them for raising me up like these. Problem I see is most families are not raised like these and for this reason obesity has become an epidemic.
Few things about myself
1) I am a tech geek, love technology and see enormous potential in the areas of healthcare, fitness etc
2) I am getting extremely annoyed by all this quantification gadgets costing hundreds of dollars aiming at consumers to get fit. THIS IS RIDICULOUS
As I mentioned before. You already have a quantification device at home and its cheap. An Amazing Weight Scale. Use it…
Reasoning is that quantifying will help you measure yourself in order to get fit. Agree it can help in some cases but in your average “Joe” is not needed. The most important denominator in successful weight loss and health is MOTIVATION.
General Rules:
1) BURNING CALORIES + EATING RIGHT + EXERCISE = LOSING WEIGHT
2) LOSING WEIGHT = MOTIVATION = INCENTIVE TO KEEP EXERCISING
3) ALL OF THESE = IN GENERAL:
IMPROVE CHOLESTEROL LEVELS, BLOOD PRESSURE, MOOD, ENERGY LEVELS, METABOLISM
You do not need any quantification device, you don’t need to spend more. You want to give something cool for X-Mas? For a birthday? Sheez don’t give another GADGET… Give them a Can of Motivation if you know what I mean. Easier to be said than done. Agree but to prove my point that no quantifications devices are needed…
I will start an exercise regimen today. I invite you to do so also! In 3 months I’ll show why I do not believe in spending in gadgets to quantify myself. Save your money… Today I got 5 more people start an exercise routine with me.. want to join? Be it P90, P90X, INSANITY, Cross Training, Swimming, WHATEVER YOU ENJOY.,YOU NAME IT. JUST START MOVING
Need Motivation: Check http://www.beachbody.com/category/success_stories/p90x-success-stories.do
(I am in no way affiliated to beachbody. Just like the results section and believe in can help anyone)
The best gift you can give yourself for X-Mas and New Year is straightforward. Like everything in life involves hard work but the end result will be a lifechanger! Become a better you…
GOOD LUCK! Everyone can do it you just need to be pushed in the right direction!
Want to hear more?
Send me a Tweet I will help in any way I can
Workouts R DEAD. Time for FUNouts and VANouts
In a recent post I mentioned on how healthcare professionals recommend their patients working out 3-5 times per week. The reasons behind it are; improve glucose control, hypertension, cholesterol levels, and weight just to mention a few. All extremely important points, so… Why is it so hard to get patients to exercise?
I have the answer now. It is not difficult to convince patients to exercise. It is difficult to convince anyone to do so. Yes, it depends on the place you live in, but in general, it is difficult to get people to start doing something if they do not have this habit.
I recently started a health/fitness campaign in my institution called “MoveYourGlute”. Guess the name is self explanatory. I have been trying to get people to exercise and with all honesty it is more challenging than I thought. What I came to realize is that even convincing my colleagues to workout is a difficult task. It would be logical to assume that it would be easy to get my friends and colleagues to workout right? Well, think again. I have been trying to do this for 3 weeks now and even though I got 114 people enrolled in the group. Out of those I can say 15 are working out appx 3 times a week when they did not do it before. But, one important point needs to be highlighted. I did not get them to workout I got them to do FUN activities (Keypoint #1) Today for the first time nurses and students started asking me “What is the deal with this” and their final answer was “This is Great” so word is spreading around, slowly but surely.
Key points from my experience so far: Before we proceed let me define two concepts that I came up with
– FUNout= An exercise that is fun and enjoyable to do
– VANout= An exercise that you do because you want to look good. You want to be attractive and while doing so you are also becoming healthier.
1) Activity needs to be fun, if not it becomes a chore. It becomes more work in an already busy day and therefore doomed to fail. I like to run but many do not enjoy it, they do not see it as FUN experience, and due to this reason I only got 3 people to run with me so far. I will keep trying and keep you posted.
2) So what now? Make it FUN! I incorporated Beach Soccer, Ultimate Frisbee, Volleyball, Flag football, Basketball and still asking for opinions and the response increased. Word is getting out now. People are asking me about the program and want to add more people to join.
3) Someone needs to be the SOUL, the LEADER of the group at least in the initial phase. If you do not have someone pushing others at first this will not happen. I consider myself a fun intense person and this has helped me create a group. I may be annoying to some but my final goal is HEALTH so forgive me if I don’t care about their opinion.
4) Last but not least… Do not underestimate the power of VANITY. Vanity is one of the most powerful incentives for someone to workout that I have witnessed over 
the years… I know few people that workout to improve cholesterol, glucose, htn, etc but know 100s that workout to be in shape. As superficial as it may sound, everyone or at least almost everyone wants to look good. Looking good makes you feel good and feeling good makes you want to workout more leading you to a VANcycle. Maybe the goal that we set for someone should not be a number in their labs but how they will look in 3,6,12 months??? How much time can they endure an Activity that is fun for them? As Ray William Johnson would say “ Hey, I’m just saying…”
In Summary, it is difficult to incorporate workouts to the lifestyle of people who don’t have this habit. Few people want to work more after work and that is basically what a workout is, more work to be in shape. Not very appetizing or attractive is it? Therefore FUNouts or VANouts are likely to be better options. Healthcare providers have tried for years to improve health for everyone, not only patients. From my experience we as doctors have failed miserably in getting patients to workout and implement a healthier lifestyle when they never have done this before. Maybe its time to change our approach. As you can see I am currently working on this and hoping to figure out a better way to get my colleagues to workout. In a future, the idea is to incorporate patients into the equation and have healthcare providers and patients push each other to be in better shape and therefore healthier.
I Could be Naive and know many could think I am crazy. If that is the case this would not be the first time I get that, and it will not be the last time I prove them wrong.
It is simple… Not one person wants to WORK all their life but almost everyone wants to have FUN and look GOOD all their life. Therefore stop with the workouts and start with the Funouts or Vanouts!
So… What do you want to look like in 3 ,6, 12 months?
Some Sites that kind of share my opinion:
http://skinnymom.com/do-you-exercise-for-vanity-or-health/
http://drdalearcher.com/imjustsayin/Health-or-Vanity
http://www.thatsfit.ca/2010/09/17/vanity-as-fitness-motivation/
http://www.marksdailyapple.com/health-vanity/
Patients should Exercise 5 times per week. How about you, Doctor?
As usual, many of my post Ideas occur when I am rounding in the hospital. Today was no different.
Went in Mr. (X)’s room and we started talking about his blood pressure control. He told me he was taking all of his medications. Half way through our conversation he told me “I have to be honest Doc, I did not follow my PCP’s recommendation 100%”. I asked what did he mean with this and he replied “ I have not been working out 5 times per week”. I answered laughing “ More than 50% of the doctors I know don’t work out at all”.
As a Doctor, I know this is challenging and even more so with our hectic schedule, but there is something I strongly believe and that is -> PRACTICE WHAT YOU PREACH. How can a doctor tell a patient to lose weight, do exercise, and follow a diet when he does not do so himself?
This got me starting another SoMe Experiment; I called it the MOVEYOURGLUTE Experiment. So today I started. The first thing I tried was to get my colleagues to run with me, get them to exercise, lose weight, eat better, etc.
So while walking in the hospital and saw someone, I explained briefly and tried to make them exercise today with me and start a routine.
I share with you the initial Responses I got:
- 5/40 approximately said -> Count me in. 12% will run with me today
The Rest
- “Naa I exercise already” (I wanted to respond “ I do not see how” but well who am I to judge) I insisted a little more did not work
- “My back hurts”
- “My feet hurt after I run”
- “I have little free time and I would rather relax and watch TV”
- “I want to sleep more than I want to exercise”
All valid points, but we have to remember this is exactly how our patients feel. So how do WE change? How do WE modify these feelings? How can WE get a patient to follow an exercise routine, a diet, when most of us have difficulty doing so?
We as physicians have to understand the implication of telling them what working out 5 days per week means. Want to cut it short? How about 3 days?
Today I start the #Moveyourglute Experiment. Speaking with nurses, medical students, residents, fellows, faculty and trying to make them exercise. Today some could understand the implication and discipline it takes to work 3 days a week, or 5 days a week and hopefully pass the knowledge to their patients.
Thanks for Reading and do not forget to MOVEYOURGLUTE 
Update: Went running with 3/5 out of the 40 that I asked. Total of 4 miles and excellent experience. The rest of my colleagues, well guess they were NON-COMPLIANT with my recommendation . Tomorrow will be another day
