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Hospital provides patient access to health information at the bedside

by System Administrator - Thursday, 20 April 2017, 6:27 PM

Hospital provee acceso a EHR al costado de la cama del paciente

Hospital provides patient access to health information at the bedside

by Kristen Lee

University of Colorado Health is securely providing patient access to health information at the bedside. Experts detail how they are able to achieve this and engage patients.

The healthcare industry has been trying to solve the problem of patient access to health information for a while now. Solutions to this problem have cropped up in the form of patient portals, mobile apps and more.

Although providing patient access to health information while patients are outside the hospital is important, equally important is providing that information while patients are in the hospital.

The University of Colorado Health (UC Health) in Denver decided to tackle this specific problem and provide hospital patients with their health information -- including lab results, test results and vital signs -- in real time, at their bedside. To accomplish this, the hospital uses Samsung tablets and Samsung's Knox Custom Configurator, said Trevor Smith, senior account manager of strategic accounts at Samsung.

"We use Knox specifically to help us in delivering content on a tablet and then … make those [tablets] secure [by] wiping them completely," said Ed Horowitz, senior multimedia developer of clinical informatics at UC Health. He explained that in addition to providing patients with their real-time health data, they can also download apps -- such as Netflix and Facebook -- onto the tablet for entertainment.

"We worked specifically with Knox to develop a … much more specific app where we can wipe any data and wipe anything in there but then have the tablet restored almost immediately to its image with the apps and the system that we want on it," Horowitz said.

Kyle Toburen, senior engineer of desktop and mobility integration at UC Health, describes the Knox system as a mobile device enrollment program rather than mobile device management, although the system falls under the umbrella of managing mobile devices.

"[Knox] applies applications and policies and profiles to a device," he said.

Balancing patient access and security

UC Health's custom Bedside app resides on top of Knox's Custom Configurator, which allows the hospital to provide patients access to health information in real time while maintaining security and HIPAA compliance in several ways:

Connection to the EHR -- Patients are able to view their health data in real time on a tablet because UC Health's custom Bedside app and Knox connect to the hospital's EHR -- Epic -- but no EHR data is stored on the tablet.

"It makes the patient much more compliant when they're active on day one with what's going on."

Ed Horowitz | senior multimedia developer of clinical informatics at University of Colorado Health

Toburen explained that the connection to Epic's server and to that specific patient's medical record is made by first scanning the patient's Epic record barcode.

"Once you've done that, you've created that connection between the tablet app and Epic and then once the patient goes into the … Bedside app [on the tablet] they can see all their information," Toburen said, adding that once the patient has been discharged, that connection from the tablet and the Bedside app to the patient's medical record in Epic is broken and that patient's record cannot be accessed from that tablet and Bedside app anymore.

"If somebody launched Bedside on the tablet it would act like it's waiting for a new patient," he said. "It's waiting for a new barcode."

Secure wipe, factory reset -- UC Health is also able to securely provide patient health data in real time because of the secure wipe and factory reset features Knox provides.

"We did need that solution that we felt completely wiped out any trace of [the patient's] stay on there and basically brought it back to … factory settings at some level and everything was wiped out," Horowitz said.

Once the secure wipe is done the tablet is restored to its default settings.

"That's where you don't have to worry about maybe [someone's] injected some sort of malicious code and it's working in the background," Toburen said. He added that if there is ever any concern of that happening, UC Health can wipe the device clean. Then, "Knox reapplies all the settings we want."

Tablets connected to external network -- Toburen explained that, as an added security measure, tablets are connected to an external network which allows patients to essentially do whatever they want -- like download entertainment apps -- on the tablet provided to them without compromising hospital security.

Knox also applies some restrictions, Toburen said. "Users don't have the ability to go in and change many of the settings. They can't choose a different network."

The importance of providing health data securely

Providing patient access to health information better engages them in their own healthcare, Horowitz said.

"It makes the patient much more compliant when they're active on day one with what's going on. It reduces the anxiety and stress level."

Horowitz added that providing patients access to their health data also helps nurses and doctors provide care more efficiently.

If a patient has all the information he needs or may want to know in front of him, Horowitz said, he won't call the nurse or doctor as often, which allows the healthcare staff to focus on other areas of the patient's care. 

Next Steps



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Hospital tones down alarms to reduce fatigue, enhance safety

by System Administrator - Monday, 16 February 2015, 1:01 AM

Hospital tones down alarms to reduce fatigue, enhance safety

Article by: JEREMY OLSON | Star Tribune 

Excessive noise can slow or prevent responses to real emergencies

After a night shift at Abbott Northwestern Hospital, Todd Ostlund would go home and switch off his phone ringer and anything else mimicking the many, many alarms a nurse hears while on duty.

And still, on many nights, he’d be roused from sleep by a “beep, beep, beep” in his dreams.

“I’m never having peace,” he said.

Medical device alarms play critical roles in a hospital — to signal trouble with a patient’s vital signs or medical equipment, and to draw caregivers to the bedside in time to help. But too often, alarms have been nuisances — set off by patient movements that cause their pulse to spike briefly, or by a momentary kink in an IV line, or patients simply scratching their noses and bumping the blood oxygen monitors on their fingers.

The resulting problem, known as “alarm fatigue,” can prevent nurses from responding to real patient emergencies, with fatal results. The Joint Commission, the nation’s hospital accrediting body, attributed 80 deaths and 13 serious injuries to alarm-related failures in a recent four-year period, and in 2013 required hospitals to commit to preventing alarm fatigue.

Now, a study from one of Abbott’s intensive care units suggests that less, indeed, can be more.

The unit switched the default settings of its pulse-rate alarms from overly conservative thresholds of high and low beats per minute, and to avoid duplication with alarms that go off for related cardiac issues.

The number of pulse rate alarms dropped 76 percent within six months — but Abbott’s nursing leaders found no resulting incidents of patient emergencies being missed. If anything, nurses responded even faster to the remaining alarms because they were less likely to be false.

The goal is to avoid any alarm “that isn’t going to prompt an urgent response,” said Dr. William Dickey, a hospitalist at Abbott who tends to patients throughout the hospital. “It’s the difference between bad and absolutely urgent.”

Ostlund noticed the change on his nights in that unit. There were far fewer alarms breaking his concentration while he tried to complete a medical chart, or pulling him from one patient to another who wasn’t in imminent need of help.

“It relieves some of the stress of being a nurse,” Ostlund said. The seven-year veteran added that he has seen colleagues leave the profession in part due to the raucous environment of a hospital.

Mayo’s results

Efforts to ratchet back alarms reflect the ebb and flow that emerges in many aspects of medicine. High-resolution CT imaging machines, for example, were broadly used until doctors discovered that their high cost and low-level radiation exposure could outweigh their diagnostic benefits in certain cases.

“Just because there’s a new gizmo on the market doesn’t mean we need to purchase it,” said Dale Pfrimmer, nurse administrator for Mayo Clinic’s thoracic and vascular division in Rochester.

Pfrimmer oversaw a similar study in two Mayo critical care units, and said a reduction in alarms over three months did not result in more emergencies such as Code Blues, when unresponsive patients needed resuscitation.

Such emergencies actually declined, though that might have been coincidental. But the alarms that went off did get the staff’s attention, he said. “You really focus when you do hear those alarms, because now they mean something.”

Missed emergencies aren’t the only danger. Nurses distracted by noise can lose concentration and make mistakes, or can fall behind in their work if they err on the safe side and check every alarm immediately. Patients in ICU care also can have their sleep disrupted.


Relatives tune out, too

The risks, and the concept of “alarm fatigue,” gained broad national attention after the 2007 death of a woman at UMass Memorial Medical Center in Boston. Nurses failed to respond to an alarm indicating that her monitor’s battery needed replacing, and, when her monitor lost power, didn’t know she was having a fatal cardiac arrest.

Alarm incidents have been reported in Minnesota, though they reportedly involved poor staffing and staff training rather than noise fatigue. A baby died in a high-profile 1997 case when poorly trained medical foster care providers turned off an oximeter that could have alerted them to her distress.

The family’s attorney in that case, Chris Messerly, has come to appreciate the issue because his father has been in intensive care.

“I was thinking these same things as I was sitting in there every day for the last week,” he said. “Sometimes [alarms] would go off and no one would come in for, like, 10 minutes.”

Frequent alarms do upset visiting families, especially if they sound severe but caregivers don’t respond immediately, said Dickey, the Abbott hospitalist. On the other hand, some relatives come to understand the issue so well that they start turning off alarms on their own, which can also create hazards, he said.

Abbott has expanded the alarms project to its neuro ICU. In addition to changing the pulse rate parameters of the EKG alarms, the hospital trained nurses in intensive care to clean the monitor lead sites on patients’ skin each day and change the leads because there is research suggesting this reduces false alarms.

Next up are reviews about the frequency of alarms for IV lines. These sometimes go off even when there are temporary kinks preventing the flow of liquid, not real blockages preventing blood, fluids or medicine from getting to patients.

Oximeters, which measure blood oxygen levels, are particularly sensitive to false alarms because they are loosely attached to a patient’s finger. Most blare alarms in four seconds, when waiting 10 or 15 seconds might differentiate between false alarms and real problems.

Then maybe Ostlund and other nurses will get some sleep at home. Ostlund was so happy about the alarms project in the ICU that he e-mailed thanks to his supervisors.

“You’ve got to imagine a constant din,” he said. “Now, it’s just not there anymore.”

Jeremy Olson • 612-673-7744


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How a mHealth outpatient solution cut new-patient visit time 33%

by System Administrator - Thursday, 18 December 2014, 6:10 PM

Webcast: How a mHealth outpatient solution cut new-patient visit time 33%

Learn how Sanger Heart and Vascular Institute, part of Carolinas HealthCare System, leveraged GetWellNetwork Ambulatory on the iPad® to provide patients with condition-specific information, help them understand their care and complete priority care interventions.

Video - Webcast


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How Boston Children's Hospital hit back at Anonymous

by System Administrator - Tuesday, 16 September 2014, 8:29 PM

How Boston Children's Hospital hit back at Anonymous

Hackers purportedly representing Anonymous hit Boston Children's Hospital with phishing and DDoS attacks this spring. The hospital fought back with vigilance, internal transparency and some old-fashioned sneakernet. That – and a little bit of luck – kept patient data safe.

By Brian Eastwood

On March 20, Dr. Daniel J. Nigrin, senior vice president for information services and CIO at Boston Children's Hospital, got word that his organization faced an imminent threat from Anonymous in response to the hospital's diagnosis and treatment of a 15-year-old girl removed from her parent's care by the Commonwealth of Massachusetts.

The hospital's incident response team quickly convened. It prepared for the worst: "Going dark" – or going completely offline for as long as the threat remained.

[ More: 'Anonymous' Targets Boston Children's Hospital ]

[10 mistakes companies make after a data breach]

Luckily, it never came to that. Attacks did occur, commencing in early April and culminating on Easter weekend – also the weekend of Patriot's Day, a Massachusetts holiday and the approximate one-year anniversary of the Boston Marathon bombings – but slowed to a trickle after, of all things, after a front-page story about the incident ran in The Boston Globe.

No patient data was compromised over the course of the attacks, Nigrin says, thanks in large part to the vigilance of Boston Children's (and, when necessary, third-party security firms). The organization did learn a few key lessons from the incident, and Nigrin shared them at the recent HIMSS Media Privacy and Security Forum.

As Anonymous Hit, Boston Children's Hit Back

As noted, the hospital incident response team – not just the IT department's – planned for the worst. Despite that fact that the information Anonymous claimed to have, such as staff phone numbers and home addresses, is the stuff of "script kiddies," Nigrin says Children's took the threat seriously.

Attacks commenced about three weeks after the initial March 20 warning. Initially, the hospital could handle the Distributed Denial of Service (DDoS) attacks on its own. Anonymous changed tactics. Children's responded. The hackers punched. The hospital counterpunched. As the weekend neared, though, DDoS traffic hit 27 Gbps – 40 times Children's typical traffic – and the hospital had to turn to a third-party for help.

The attacks hit Children's external websites and networks. (Hackers also pledged to hit anyone linked to Children's – including the energy provider NStar, which played no role in the child custody case at all but sponsors Children's annual walkathon.) In response, Nigrin took down all websites and shut down email, telling staff in person that email had been compromised. Staff communicated using a secure text messaging application the hospital had recently deployed. Internal systems were OK, he says, so Children's electronic health record (EHR) system, and therefore its capability to access patient data, wasn't impacted.

[ Research: Healthcare Security Brings Challenges, Opportunities, No Big Surprises ]

In contrast to this internal transparency, Children's, at the urging of federal investigators, didn't communicate anything externally. Nonetheless, word got to The Boston Globe, which ran its front-page story on April 23.

Nigrin, again, prepared for the worst. He didn't have to. After the article came out, the Twitter account @YourAnonNews took notice, urging hackers to stop targeting a children's hospital. Attacks continued, but at a much smaller clip.

6 Quick Tips for Beating Back Hackers

In reflecting on the Anonymous attack, Nigrin offers the following security lessons that Boston Children's learned.

  • DDoS countermeasures are crucial. "We're not above these kinds of attacks," Nigrin says.
  • Know which systems depend on external Internet access. As noted, the EHR system was spared, but the e-prescribing system wasn't.
  • Get an alternative to email. In addition to secure testing, Children's used Voice over IP communications.
  • In the heat of the moment, make no excuses when pushing security initiatives. Children's had to shut down email, e-prescribing and external-facing websites quickly. "Don't wait until it's a fire drill," Nigrin says.
  • Secure your teleconferences. Send your conference passcode securely, not in the body of your calendar invite. Otherwise, the call can be recorded and posted on the Internet before you even hang up, he says.
  • Separate signals from noise. Amid the Anonymous attack, several staff members reported strange phone calls from a number listed as 000-000-0000. At the time, it was hard to tell if this was related, and it made the whole incident that much harder to manage.

Above all, Nigrin says healthcare organizations need to pay attention to the growing number of security threats the industry faces. "There are far more than we have seen in the past," he says.

This story, "How Boston Children's Hospital hit back at Anonymous" was originally published by CIO .



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How cloud is saving lives

by System Administrator - Tuesday, 28 October 2014, 3:32 PM

How cloud is saving lives

Scientists and enterprises are turning to the cloud for HPC
The cloud is aiding projects to fight malaria and cancer, and helping banking firms simulate the financial health of clients. Archana Venkatraman reports

Please read the attached ComputerWeekly's article


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How do you describe healthcare reform to your patient?

by System Administrator - Wednesday, 23 September 2015, 7:29 PM

How do you describe healthcare reform to your patient?

By Dr. Gary Wietecha, Physician Director of Clinical Content, NextGen Healthcare

“Google it” is not the best answer to give when a patient asks you about healthcare reform.

But when you do Google “healthcare reform,” well, of course, you get lots of answers. And none of them that useful as an immediate aid to explaining health care reform to your patient.

A “one liner” health care reform definition here:  focuses on health insurance: “The Affordable Care Act (ObamaCare) increases the quality, accessibility, and affordability of health insurance.” But you’ll have to tell your patient more than that.

Before you do, pause and consider: A large percentage of our population will not be immediately affected by health care reform. Because a major portion of The Affordable Care Act is designed primarily for Americans who don’t have health insurance and seek health care only when acutely ill. You know your own patient panel the best and whether or not they are primary stakeholders for The Affordable Care Act.

What else?

Here are two other points that might help.

First, consider using “Triple Aim” as a concept and living definition for health care reform .

Created by Institute for Healthcare Improvement (IHI) President Emeritus and Senior Fellow Donald M. Berwick, MD, MPP, The Triple Aim Initiative is a three part strategy to optimize performance of the American health system. It goes like this: 1) improve the patient experience of care (including quality and satisfaction); 2) improve the health of populations; 3) reduce the per capita cost of health care. And that, on a macro scale, is really what health care reform is all about.

Second – provide patients with a time frame that might help them put their arms around the scope and scale of health care reform in America: The Patient Protection and Affordable Care Act – which drives health care reform across the nation – was signed in 2010 and will take until 2022 before all of its provisions are rolled out. A 12-year passage.

The Journey: Part of explaining health care reform

Remember the oldest ever doctor joke? “This will hurt you more than me!”

Not this time. Health care reform requires a long (multi-year, as I just pointed out) and difficult journey. And it’s a much more difficult journey for providers than patients. It’s OK to tell your patients that health care reform is making the practice of medicine much more challenging these days.

Patients will “get” what it means when you share with them that part of health care reform requires more precise clinical documentation by your staff; extra, ongoing training on new EHR and practice management software systems; and getting used to new clinical workflows that improve outcomes and reduce costs. Patients should “get” one more thing… their role in health care reform. Their journey to benefit from health care reform.

Increased patient responsibility is also part of explaining health care reform

As you dialog with patients about health care reform, you’ll do each of them a favor if you reinforce the idea of active healthcare. I like the term because it implies proactive patient behavior. Passive healthcare is reactionary; active healthcare is healthcare in motion – always seeking “better.” Active healthcare requires sustained patient participation in all matters affecting their physical and mental well-being.

Finally, tailor and scale your explanation. Keep in mind the level of sophistication each of your patients has as you explain elements of health care reform. What would you want to know about health care reform if you were the patient? And what one patient wants to know could differ greatly from what other patients may want to know, or even have the capacity to understand.

The patient encounter is health care reform

These days, patients participate in health care reform every time they see you; patients originate the mountains of structured and unstructured protected health information (PHI) now forming a mega foundation of “big data” accumulating in registries and health information exchanges (HIEs) across the country.

It’s the strategic use [sharing and analysis] of this “big data” – to provide more insightful answers and the potential to drive better clinical decision making – that represents the nirvana of health care reform in America.

And if you’ve gotten this far explaining health care reform to your patient… you’re waiting room is probably full.



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How Hiring Right (or Wrong) Has a Direct Impact on Clinical Outcomes

by System Administrator - Wednesday, 28 January 2015, 5:08 PM

How Hiring Right (or Wrong) Has a Direct Impact on Clinical Outcomes


A recent study finds that more experienced nurses deliver better patient care and shorten lengths of stay. But as more experienced nurses leave organizations for better opportunities or retirement, hospitals must hire new, less experienced nurses or temporary contract nurses. The result can lead to poor patient outcomes.

For the eBook, we spoke to nurse leaders across the country to examine the top challenges hospitals face with nurse staffing and how to overcome them.

Download to learn:

  • Hiring strategies to ensure you find the right nurse to fit your organization's culture and mission
  • Creative ways to retain and engage nurses
  • How to determine the ideal nurse-to-patient ratio for your organization
  • Success stories from hospitals that implemented policies to help educate nurses and report higher nurse satisfaction and HCAHPS (patient satisfaction) scores

Please read the attached eBook

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How Mobile Technology Can Bring Trauma Relief After Ebola

by System Administrator - Friday, 26 June 2015, 7:22 PM

How Mobile Technology Can Bring Trauma Relief After Ebola

By Nathaniel Calhoun and Elie Calhoun

Nathaniel Calhoun focuses on the intersection of last mile development work challenges, mobile education for poverty alleviation and ecological design. Follow Nathaniel on Twitter @codeinnovation.

The promise of mobile technology is that we can connect the farthest, most remote corners of the globe to the Internet—where a treasure trove of information and applications can be had nearly for free. For aid workers, this technology is proving a powerful, even revolutionary tool.

We hope our new community mental health app will demonstrate a new depth of potential impact.


When we started designing our psychosocial services app for Liberian communities recently ravaged by Ebola, we thought we’d first need to justify the very idea of focusing on mental health in a country facing so many pressing concerns.

The health system in Liberia confronts massive challenges. When hospitals are non-existent or seriously under-staffed, when malaria is endemic and young mothers die during childbirth—it can be tempting to ask people suffering from trauma to simply “toughen up.”

But as we’ve gathered our research and begun strategizing the mobile app, we’ve found prominent and trend-setting evidence that psychosocial support is no longer being neglected in the context of the world’s poor and vulnerable communities. This is a game-changing shift.

Starting this year, the World Bank and Japan are generously funding a multi-layered, multi-year program that specifically targets individuals who worked in traumatizing jobs during the Ebola outbreak. (You can read more about it here.) USAID is exploring the merits of funding similar programs and even the World Economic Forum has convened a Council on Mental Health and Well Being that seeks to put mental health on the economic development agenda.

The challenge, we’ve discovered, will be less about convincing people that low-income countries deserve mental health services —and more about how to provide such a service widely and at low cost.

What’s more, we are challenged to build support within decentralized community health systems—not as an addition to them—so that these kinds of mental health services can be provided locally and sustainably, from now on.

This is where mobile health technology can be a powerful tool.

Current programs focus on providing one-on-one mental health services—the model for psychosocial services in rich and industrialized countries. Such services are limited by the presence, cost and availability of trained mental health professionals.


Image courtesy of Second Chance Africa.

However, the findings of Second Chance Africa in Liberia indicate that one-on-one sessions are not the only way to help Liberians to escape the symptoms of complex trauma and PTSD and to rejoin their communities as fully functional and healthy members.

Rather, a well-crafted curriculum of group-based discussions, and group therapy has already helped thousands of the poorest and most-affected Liberians to experience lasting relief from their symptoms at a fraction of the price of interventions that require one-on-one approaches.

Our Community Mental Health Facilitator app project seeks to digitize and iterate Second Chance Africa’s approach into a free and open source app for community health workers to lead low-cost, easy to scale groups in their own languages and sociocultural contexts.

Quality mental health care used to be something only available for the rich, something health systems burdened by multiple and systemic challenges dismissed as impossible, with their limited resources and competing priorities. This is finally changing.

By working with community health workers connected to decentralized district health systems, psychosocial trauma support can be part of the package of basic health services available to all.

And here’s where things get really interesting.

Neither the World Bank nor USAID’s interventions leverage technologies to increase future scalability. As we see it, the approach pioneered by Second Chance Africa becomes even more cost-effective and impactful through the careful application of mobile and digital technologies.

As community health workers are increasingly equipped with mobile devices and trained to use them, trauma-focused community mental health support can spread to the farthest reaches of a country’s health system. With basic training and in-app support materials, we can build the capacity of community health workers to add PTSD-focused mental health interventions to their toolbox of community-based health services.

The potential of such an intervention for massive impact starts to become apparent when we consider the scope of the problem. In 2012, an estimated 172 million people were affected by conflict worldwide and an estimated 375 million were affected by climate disasters.

We have a humanitarian imperative to ease trauma with the best tools at the lowest cost. Using mobile technology—we can do this, and we can do it within the structure of existing health systems.

Image Credit:


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How Old Are You, Really? Biological Age Is Harder to Pin Down Than You Think

by System Administrator - Tuesday, 26 January 2016, 7:29 PM

How Old Are You, Really? Biological Age Is Harder to Pin Down Than You Think


In less than a month, I’ll be leaving my roaring 20s behind.

Like anyone crossing into a new decade of life, it feels surreal. I don’t look 30. I don’t feel 30. My health is better than it’s ever been. I tell my doctors I’m hitting the big 3-0 simply because that’s what the calendar — my only yardstick for the passage of time — is telling me.

But what if there’s a better measure for age? A number that reflects how well your body is functioning as a whole, that predicts how rapidly you’re aging, that informs physicians when to expect medical issues, that aids the search for anti-aging therapies?

That number is a person’s biological age.

Scientists are increasingly making the distinction between your chronological age — the number of years that you’ve lived — and your biological age.

It’s not just an academic curiosity. A 2015 study, which comprehensively analyzed the function of multiple body systems of nearly 1,000 young adults, found that a 38-year-old’s biological clock can read anywhere from a spritely 20 to a feeble 60.

Even more frightening is this: although none of the participants had overt health issues, some were aging three times faster than expected.

Most people think aging happens only later in life, but — not to be macabre — our life expectancy clocks are constantly ticking down, said first author Dan Belsky, a researcher at the Duke University Center for Aging.

If we want to prevent age-related disease, we’re going to have to start treatments young, he explained. The problem is: what is “young”? How do we tell a person’s true biological age?

It’s a surprisingly hard question to answer.

Belsky took the clinical route, repeatedly giving their participants the ultimate full body workup over multiple years.

His team measured the function of the liver, kidney, heart and immune system. They tracked metabolic rate, cholesterol levels, aerobic fitness and lung function. They measured memory, reasoning and creativity. They even looked at the length of telomeres — protective “caps” at the end of chromosomes that safeguard our DNA and chip away with age.

Using these data, the team was able to construct a monster algorithm that calculates a person’s biological age and predicts the pace of deterioration.

The study made waves, and for good reason: for the first time, scientists are able to quantify aging in a younger population before the first hint of diabetes, Alzheimer’s or other age-related diseases appears. Imagine if your biological age is 10 years older than what you expected, said Belsky. It’s like a tap on the shoulder, letting you know that you need to exercise, to try caloric restriction and take better care of yourself.

Yet Belsky stresses that his study is proof-of-concept only. It took years and a fortune, he laughed. For a test for biological age to go mainstream, we need “better, faster and cheaper” markers and methods.

The dream is to take a sample of your skin or blood and tell you what your biological age is, much like a saliva sample sent to 23andMe can tell you (among other things) what kind of earwax you have.

While researchers still disagree on what constitutes a good marker, recent advances have yielded a group of candidates.

All are related to molecular processes that correlate with aging.


Chromosomes are capped with repeating nucleotide sequences called telomeres that get shorter over time.

Backed by decades of research and a Nobel Prize, telomere length — a measure in Belsky’s study — is perhaps the leading candidate.

Discovered in the 1980s, telomeres are extra ATCG bits that trail off the end of chromosomes. Every time a cell divides, telomeres get chopped shorter, until they reach a critical length and prohibit the cell from dividing further. Subsequent population-wide studies found correlationsbetween telomere length, disease and mortality, further increasing its worth as a marker for biological age.

Scientists and investors alike have taken notice.

In 2010, Elizabeth Blackburn, one of the discoverers of telomeres, started a company in Menlo Park, California that provides analyses of telomere length from a person’s saliva sample. Life Length, a startup based in Madrid, claims to calculate a person’s biological age by the median length of their telomeres — if you’re willing to shell out $395 a pop.

Geron, another Silicon Valley company initially backed by Blackburn’s protégé, Carol Grieder, promised substantial clinical benefits of its telomere tests before abruptly switching gears. It now focuses on cancer therapies, and Grieder has long left her role as advisor to the company.

Geron’s switch away from telomere-based aging assays is telling. Telomere tests are fast, easy and cheap, but there’s one problem — they don’t particularly reflect age accurately when it comes to each individual person.

Honestly, the value of such tests is their “cocktail party” appeal, said Jerry Shay, a biologist at the Texas Southern Medical Center and advisor to Life Length. The variation in telomere length among people of the same age is huge, he explains. Besides, longer is not always better — recent studies have revealed a tradeoff between long telomeres and a higher risk of cancer.

Despite these caveats, telomere length still remains a highly valuable marker. “There’s going to be a huge amount of heterogeneity in any marker,” said Grieber. Telomeres are just part of the puzzle — the question is, what other markers can help complete the puzzle?

Eline Slagboom, a molecular epidemiologist at Leiden University in the Netherlands, has her money on blood.


Human red blood cells.

Blood provides oxygen vital nutrients to every tissue in our body and in turn receives their waste products. We’ve known for years that the levels of some types of waste go up with age and correlate with declining organ function, said Slagboom.

For example, a 2011 study from Tony Wyss-Coray and Saul Villeda, then at Stanford University, found that injecting a young mouse with blood collected from an aged mouse throttles its brain function. Subsequent studies also showed negative effects of old blood on the liver and heart of younger recipients.

There’s a wealth of information hidden in blood, said Slagboom. Her team is running a massive study of 3,500 people aged between 40 to 110, looking at molecules in the blood that associate with age-related diseases, including cardiovascular health, dementia, diabetes and depression.

Slagboom and others’ efforts have already led to several pro-aging candidates.

Surprisingly, many are linked to the body’s immune function, which goes into overdrive with age. One candidate, with the unwieldy name of alpha1-acid-glycoprotein, is known to increase with age and independently predicts a higher risk for mortality. Another, B2M (beta-2-microglobulin), floods the body in old age and disrupts learning and memory.

Without a doubt, the race for identifying pro-aging (and pro-youth) factors is heating up.

Earlier last year, Wyss-Coray snapped up $50 million to fund his startup Alkahest, which hopes to reverse brain deficits by inhibiting pro-aging factors that accumulate with age. Although focuses on developing blood-based therapies, it’s not hard to imagine that the slew of pro-youth and pro-aging factors it uncovers could be used to measure a person’s biological age.*

In the end, no single factor — telomere, alpha1-acid-glycoprotein, B2M or other harder to measure markers such as DNA and protein damage — can paint a complete picture of a person’s true age. It’ll take multiple factors and a lot of trial and error.

But the stakes are sky high; for startups in the game of measuring biological age, literally so.

Objective age-related markers could push the anti-aging field into a whole new era, said Luigi Fontana at Washington University. They give us a way to test promising anti-aging drugs such as rapamycin andmetformin using short-term clinical trials. Instead of decades, we could be looking at months.

I can’t stress this enough, said Fontana. Knowing someone’s biological age is “very, very important.”

* Disclosure: The author works as a postdoctoral researcher with Dr. Saul Villeda, an advisor to Alkahest, at UCSF to study pro-youth factors in young blood.

Image Credit: sergign/Shutterstock.comunderworld/Shutterstock.comAJC Commons

Shelly Fan

  • Shelly Xuelai Fan is a neuroscientist at the University of California, San Francisco, where she studies ways to make old brains young again. In addition to research, she's also an avid science writer with an insatiable obsession with biotech, AI and all things neuro. She spends her spare time kayaking, bike camping and getting lost in the woods.


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How One Hospital Turns Doctors into Leaders

by System Administrator - Wednesday, 24 December 2014, 5:26 PM

How One Hospital Turns Doctors into Leaders

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