Health Newsfeed – Johns Hopkins Medicine Podcasts

Apps to monitor things like physical activity, food intake and other aspects of health abound, with a new study in the BMJ showing that on Google’s platform, the majority of those apps get as good as they give, since they’re harvesting a wealth of data about you. Seth Martin, a cardiologist at Johns Hopkins and one developer of a health app called Corrie, explains.

Martin: That was in impressive large scale analysis of the Google Play, of the Android app store looking at mobile health apps. They looked at over 20,000 apps and then they ended up focusing on about 15,000 that were free to download. They really had sophisticated ways that they looked at apps and I don’t think it’s surprising that the apps are collecting a lot of data, sharing a lot of data, and that the privacy policies were not as transparent or accurate as they needed to be.  :29

Martin says for now, you need to be very vigilant about your apps and privacy settings. At Johns Hopkins, I’m Elizabeth Tracey.

Corrie is the name of an app that integrates all aspects of post-heart attack care so people can avoid having a second one. Corrie was developed at Johns Hopkins by a team, including cardiologist Seth Martin, who says the app development came about because of patient need.

Martin: A big feature of Corrie is high quality patient education. In the form of written articles but also in the form of animated videos, and so it’s about education, it’s about tracking your key heart indicators, your heart rate, your physical activity. It has a connected blood pressure monitor. It’s about understanding your medicines and tracking those medicines on a daily basis, it’s about what appointments are critical for you during follow up, getting calendar reminders to go to those appointments. A lot of it is fundamental pieces of one’s care that often falls through the cracks.  :32

Martin expects Corrie to be available much more widely soon. At Johns Hopkins, I’m Elizabeth Tracey.

Health apps purport to serve lots of functions, with a new one called Corrie simplifying things for those who’ve had a heart attack and would like to make changes to avoid another. Seth Martin, a cardiologist at Johns Hopkins and one of the app’s developers, says simply deluging people with information after a heart attack just wasn’t working for many.

Martin: There has to be a better way, and the better way is a digital forward strategy where we go directly to the smart phone, what’s in all our patient’s hands, the smart watches on their wrists, there’s that intimate personal power that you have there, it’s something that’s with you all time, and our thought was to build something really effective, really easy to use, that can basically extend what we can offer as a healthcare system to really put the power in the patients.  :26

Corrie has a wide range of features that enable people to keep all their information in one place and understand how its integrated in a holistic approach to heart health. The app should be widely available soon, Martin says. At Johns Hopkins, I’m Elizabeth Tracey.

Corrie is the name of an app designed to help integrate the many things people need to do to minimize their risk of a second heart attack. Seth Martin, a cardiologist at Johns Hopkins and one of the app’s designers, says the team started with asking patients about their experience.

Martin: What’s come up again and again is I’m feeling alone, I don’t understand what the medical team is saying, I don’t feel confident that I know what I need to do when I leave the hospital. So Corrie was built directly to address those needs. Corrie’s built on Apple’s research kit, care kit, and health kit. The spirit here is to empower patients to take a more active role in their health care. Ultimately when it comes to patient education a lot of the times it’s confusing to the patients.  :28

Corrie has been tested in several sites and is poised to roll out more widely, Martin says. Reviews from patients have been very positive, he says. At Johns Hopkins, I’m Elizabeth Tracey.

Patients are at the center of a new app to help people improve their cardiovascular health called Corrie. Corrie was developed at Johns Hopkins by Seth Martin, a cardiologist, and colleagues to help those who’ve had a heart attack implement the vast amount of existing medical knowledge to help them prevent a second one.

Martin: We have so much evidence in preventive cardiology about what works, healthy diet and exercise, evidence based medicines that make a real impact in our patient’s outcomes. One of the things that has just been published again and again and again about is, we have all this but we don’t use it well. We really need to start with the patients, interview patients, do human centered design. Understand the needs, work backwards from the needs to the technology to then develop a solution that truly meets those needs.  :29

Martin says in designing the app his team conducted interviews with patients who’d had a heart attack to hear directly from them what was lacking in their follow-up care and hopes the app will be widely available soon. At Johns Hopkins, I’m Elizabeth Tracey.

If you’ve had a heart attack a new app that’s been developed at Johns Hopkins could help you avoid a second one by engaging you in your own care. Seth Martin, a cardiologist at Hopkins and one developer of this app, called ‘Corrie,’ explains.

Martin: Corrie is Cor is Latin for heart. And Corrie is a mobile health app that helps guide patients in a holistic way through their cardiovascular disease prevention. We built an interdisciplinary team here at Hopkins. Clinicians, patients, engineers, coming together to build Corrie. We partnered with Apple. Apple’s a key industry partner for us early on. They helped us make Corrie intuitive and easy for patients to use.  :27

Martin says early validation studies on Corrie have shown that patients begin using it even while they’re in the hospital recovering from a heart attack, and it helps them interact with the medical team taking care of them. He hopes Corrie will be available more widely soon. At Johns Hopkins, I’m Elizabeth Tracey.

Deprescribing is an effort underway among primary care physicians to completely assess all medicines a person is taking, including vitamins, supplements and over the counter medicines, and reduce that number to the fewest possible while still achieving therapeutic goals. Caleb Alexander, an internal medicine expert at Johns Hopkins, explains.

Alexander: It does take time, but it’s time that’s well spent for many patients and it is a process, it’s not an event. You know the thousand mile journey begins with one step. So when it comes to deprescibing, it’s not as if everything has to be achieved in a single office visit. And in fact it’s often only by looking and discussing these matters over time that one gets a very firm sense of the likely value or lack thereof of a given product.  :28

Alexander says patient participation in the process is critical as only you will know whether some medicines are beneficial or not. At Johns Hopkins, I’m Elizabeth Tracey.

If you’re taking a number of medicines your physician may bring up the idea of 

‘deprescribing’ to you. That’s the idea that many of these medicines may no longer be needed, may not be providing enough benefit versus their potential for harm, or may be substituted with a simpler regimen. Caleb Alexander, an internal medicine expert at Johns Hopkins, describes deprescribing.

Alexander: This is a concept that has been long in the making and that is long overdue. We spend billions of dollars trying to figure out when to start medicines and next to nothing trying to figure out when to stop them. It’s just all too easy to stack one medicine on top of another on top of another. There’s a very real phenomenon that happens when many patients come in, especially the elderly, with these long medications lists which is that we need to clean things up.  :28

Alexander says any deprescribing effort must also include any vitamins, supplements and over the counter medicines you may be taking as well. At Johns Hopkins, I’m Elizabeth Tracey.

Implantable recorders, which are placed under the skin and monitor someone’s heart for a prolonged period of time, may help identify a heart condition known as atrial fibrillation in those who’ve had a stroke, two recent studies find. Michele Johansen, a stroke expert at Johns Hopkins, describes the findings.

Johansen: I think that the good question that it does answer is in patients that you really have concern for atrial fibrillation, an implantable loop recorder you shouldn’t give up. An implantable loop recorder is a wonderful mechanism that we now have to monitor patients over time. And that the majority of patients do really well. So I think that thinking about implantable loop recorders, the yield you get from an implantable loop recorder, that is a very viable way by which you can work up patients is a real takeaway from this article. We don’t need to wonder about that anymore.  :28

Johansen notes that correctly identifying the cause of a first stroke is paramount in preventing a second one, and implantable recorders can help. At Johns Hopkins, I’m Elizabeth Tracey.

For people who’ve had a stroke, finding out why will dictate their management going forward, with a pair of new studies showing that an implantable monitor to look for atrial fibrillation, where part of the heart doesn’t beat in synchrony, may help for some patients. Michele Johansen, a stroke expert at Johns Hopkins, explains.

Johansen: Secondary prevention of stroke is where finding the cause of the stroke really matters. And so when you talk about atrial fibrillation, that is the most common cause of what’s called a cardioembolic stroke. So cardioembolic stroke just meaning that the clot came from the heart, broke off and went to the brain. The reason that finding atrial fibrillation is patients that have had strokes, is that the way that you treat patients who have atrial fibrillation is different than the way that you treat other patients who have strokes.  :28

Johansen notes that for those with atrial fibrillation, or a-fib, as it is often abbreviated, certain medicines are indicated that are not used in those with other causes of stroke. At Johns Hopkins, I’m Elizabeth Tracey.