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Welcome to IBBME's Focal Point where each episode we highlight
research at the Institute of Biomaterials and Biomedical Engineering
here at the University of Toronto. I'm Joe Cafazzo
I am the Senior Director of Medical Engineering and Healthcare Human Factors
at the University Health Network and I happen to be
an assistant professor at the Institute of Boimaterials and Biomedical Engineering
Right so as you said you're a man of many hats but I'm specifically here to interview
about your uh.. research today
so I recently saw you give a talk uhh.. called patient heal by self
you presented the concept of patient self-care
can you please explain a little bit what that is? There's many ways to doing that
and
the way I've elected to do it as as a result of the fact that I'm
a biomedical engineer is through through technology.
it is really about people actively managing
their own chronic illness and so this is something that consumes 80 percent of
all health spendings chronic illness
yet I'm in an institution which deals only was acute care
we deal with a lot of people with chronic illness but we can only deal
with the acute aspect so that
of that illness and so that is the huge challenges to
uh..what do we do between um..
events between acute events between family doctor
visits there's an enormous amount of things that could be done in terms of a
patient that's well-managed
if only they had um.. information
and tools to help them manage their their care and unfortunately
we do very little to facilitate that as well as not giving
those inform informal caregivers the opportunity to help
um with the care of these patients and you know it's not insignificant there
were 1.7 million people in Canada
who are classified as informal caregivers and those are people who have
given up
work there maybe they've decided not
not to go back to school in order to care for a parent, a love one, excetra
and we um... don't do enough to help those people
help those patients. So
in terms of your research specifically what are some of the self
care products
uh.. you've released i know a lot of them are app based I get maybe we can just
focus
on the applications or We a number years ago we started with
one of our first attempts at at self-care was an application that
um allowed patients to monitor their blood pressure
and we develop this over
a period of time and we went into a randomized control trial where we
we tested with patients with a bluetooth-enabled
blood pressure monitor communicating with their BlackBerry which would
encourage them to take measurements more
regularly, warn them of a trend of
a high readings, and to get help if necessary.
there uh.. systolic blood pressure dropped by
on average nine points uh.. and diastolic is much four points and that translates
over
a one year period the you know the clinical effect of that is is a 20 percent
reduction
in the risk of cardiovascular mortality. Really significant and it's all
behavior change so we learned a lot from that and then we tackled another group
a adolescent um...teens 12 to 16
with uncontrolled ah..glycemic control with A1C
above eight we did a little pilot with them at SickKids
using um... our new app on
on the iPhone platform call Bant and we experimented again these are
behavioral interventions were trying to elicit positive behaviors out of these
and this is a particularly difficult group that doesn't like to do self
monitoring blood glucose their
largely a a unadherent so Bant
um.. as automatically is able to read
um.. from a a blood glucose monitors we a
we modified existing blood glucose monitors to to be able to transmit over
Bluetooth
um.. we experimented with social media aspects
um.. having them and be able to connect with other kids with type 1 diabetes
the other thing that was most significant is that we
introduce the notion of rewards and um..
the the main aspect is that they would earn points as they use this App for
for you know good self-management behaviors like taking your blood sugars
on a regular basis and so on
user set a design process. Right and one thing I noticed all the applications you have a really
gorgeous,
elegant, intuitive user interface and it seems to be really important and you
were mentioning I guess it's part of the psychology of behavioral change in
getting young diabetics to respond to your uh..
to your application so where does that fig fit into the process.
In the consumer space on the patient's space specially when its a ninety nine
cent app or its a free app
uh.. and when you're dealing with a teenager, uh... what your building
is competing with everything else on that phone
so Bant is competing with Facebook is competing with Angry Birds so
if Bant stinks uh.. there just gonna go on and and see what their Facebook
friends are doing they're gonna go on and play around if
Angry Birds. If Bant isn't any good if it if it doesn't appeal to them
they just won't use it. When they open that application up we have about thirty
seconds to impress them
and to to certain extent I believe that this is the case with with adults too
um may be somewhat less so but
if the experience is not good um there just not going to use it
so we're very cognizant of that. I've been your host
Alex A
our theme music was provided by podcastthemes.com
the full version of this interview as well as other episodes
of focal point are available at IBBME.utoronto
.ca
thanks for listening