How Workplaces Are Improving Employee Health — And What Millennials Can Do To Help

How Workplaces Are Improving Employee Health — And What Millennials Can Do To Help

How Workplaces Are Improving Employee Health — And What Millennials Can Do To Help

Employee health has always had a big impact on overall company performance, but we’re only now starting to take more proactive action. Poor employee health can cost businesses upwards of $225.8 billion each year, or $1,685 per employee, which includes lost productivity, time off work due to illness, and additional healthcare costs.

Employee health has always had a big impact on overall company performance, but we’re only now starting to take more proactive action. Poor employee health can cost businesses upwards of $225.8 billion each year, or $1,685 per employee, which includes lost productivity, time off work due to illness, and additional healthcare costs.

This figure doesn’t include the costs of lower morale and less energy and interest in work, which could further decrease productivity and increase employee turnover. What’s more, companies with better employee health benefits also benefit from being more attractive to potential candidates, which makes them better performers.

Fortunately, modern workplaces are starting to realize these detrimental effects and are instituting new policies and features to improve employee health. So what measures are being adopted, and how can millennials entering the workforce contribute to better health-focused office cultures?

How Workplaces Are Improving Employee Health

These are just some of the important—and sometimes subtle—features of modern workplaces attempting to improve employee health:

  1. Better air filtration. Indoor air is full of potentially harmful particles, including spores, pollen, dust, dirt, bacteria, allergens, and chemicals from cleaning products. In an office environment, with dozens of people, the air quality is even worse, and can influence the onset of asthma, allergies, and general feelings of discomfort. Thankfully, the solution is pretty simple–installing a high-quality air filter, choosing the right filters, and changing the filters regularly can dramatically improve the quality of the air — not to mention the productivity of employees sensitive to allergens.
  2. Ergonomic seating. Ergonomic seating may seem like a luxury, but it’s an important installation if you care about your employees’ health. Ergonomic seating relieves pressure from the back and neck, and encourages a healthier posture throughout the workday. Over the course of years, ergonomic seating can prevent a multitude of problems, including back pain, hip pain, and even complications like carpal tunnel syndrome.
  3. Walkable offices. You can also have a substantial impact on your employee health by making your office more walkable. This could mean providing more walking opportunities within the office itself, or by choosing an office location central to a downtown area, to encourage more people to walk to work.
  4. Healthy snacks. Some companies are encouraging employees to lead healthier lifestyles by providing healthy snack options in the breakroom. Employees who forget lunch or need a midday pick-me-up can choose from vegetables, nuts, and fruits, rather than candy bars and junk food in the vending machines. This simple change can introduce one extra healthy meal, per day, in the lives of employees.
  5. Leisure and relaxation areas. Don’t forget, there’s a mental and emotional component to health as well. If employees are constantly stressed, with no available outlet, they’re going to be at risk for high blood pressure, heart disease, and countless other complications. To combat this, businesses are doing more to create and maintain leisure and relaxation areas in their main offices, so employees have a chance to sit back, relax, decompress, or even nap to get through an especially tough workday.

How Millennials Can Help

If you’re the CEO or founder of your own company, you have the power to do just about whatever you want to improve your employees’ health; even if it costs several thousand dollars a year, the benefits you institute will likely end up saving you money by improving morale and productivity in the long run.

But if you aren’t in charge, there are still some things you can do to push for proactive, positive changes in your work environments:

  • Introduce healthier food choices. Instead of buying donuts for the office, buy a basket of fresh fruit. If enough of you make healthy food choices regularly enough, it will encourage the entire office to follow suit.
  • Start a ride to work program. Motivate yourself (and others) to ride to work by starting a ride-to-work program. Simply biking to work can provide you with the day’s cardiovascular exercise and keep you in healthy shape.
  • Encourage incidental exercise. You can inspire yourself and your coworkers to get more incidental exercising by going on walks during lunch, taking the stairs instead of the elevator, or even stretching at your desk.
  • Talk to your bosses. Don’t be afraid to speak up about the benefits of better employee health; talk to your bosses about what you can do as an organization to improve it.

Every small change you make to your office environment can have an impact on you and the people around you. Your investments will return to you many times over—especially if you institute these changes early on in your career.

As more businesses invest more in their employees’ health, public pressure will mount for national, cultural changes, and soon, health-centric workplaces will become the new normal.

Original article: FORBES

By: Larry Alton

Is Texting Physician Orders 2G2BT?

Is Texting Physician Orders 2G2BT?

Is Texting Physician Orders 2G2BT?

First it was banned, then it was given the green light. Now, it’s been banned again. What’s the future look like for text messaging PHI in a health care environment?

Text messaging has become so ingrained in our daily lives that it’s hardly a surprise the communication tool has made its way into the medical industry. While text messaging holds promise to improve care processes, it also is a major privacy concern with skeptics concerned about the consequences of physicians and nurses text messaging physician orders and other protected health information (PHI) on a regular basis.

First it was banned, then it was given the green light. Now, it’s been banned again. What’s the future look like for text messaging PHI in a health care environment?

Text messaging has become so ingrained in our daily lives that it’s hardly a surprise the communication tool has made its way into the medical industry. While text messaging holds promise to improve care processes, it also is a major privacy concern with skeptics concerned about the consequences of physicians and nurses text messaging physician orders and other protected health information (PHI) on a regular basis.

While the practice was initially banned in 2011, it was permitted again in May 2016, with the thought that technology had advanced enough to allow for completely secure text messaging. Then, in December 2016, the practice was once again banned, with federal officials saying more time is needed for secure implementation.

Is banning the practice of text messaging PHI the best idea, or are there merely a few hurdles that need to be cleared before it can be implemented?

Why Was Secure Text Messaging Banned?
The use of secure text messaging was banned in 2011 due to a lack of usable security protocols. The text messaging applications were unable to verify the sender or store information as a record.

Additionally, any information from a text message had to be manually entered into the patient’s EHR. Information and care orders being sent by text message are difficult to verify, and there’s the potential for patient information to be compromised or lost, or care orders to be incorrectly received or carried out based on a text message. It also was too difficult to verify that the person sending the orders was indeed the attending physician.

The ban was lifted briefly in 2016 but then reinstated a few months later. The Joint Commission determined that more information was needed before a secure text-messaging program could be successfully implemented.

Secure Text Messaging Challenges
Before regaining the trust of The Joint Commission, the secure text messaging of PHI presents health care organizations with several issues, including the following:

• Identity verification: For the concept to be viable, a mechanism must be in place to verify the identity of both the sender and the recipient to ensure the information is going to the correct person.

• Message encryption: Messages sent on the system must be secured through the highest level of encryption.

• Message archiving: Messages should be archived on the device when possible and in the patient’s EHR.

• Secure facility-specific contact lists: Users should not be able to add or delete contacts.

• Accuracy: Transferring the information from text messages to a patient’s EHR leaves the information open to potential transcription errors. With some industry sources estimating an average of 80% of all medical bills contain errors, accurate information transfer or transcription is essential.

It can also be argued that requiring nurses to manually transfer or transcribe information from a text message adds to their already significant workload, making their busy days and nights that much more difficult. Also, skeptics have raised concerns about potential treatment delays in cases where nurses or other health care professionals must text the physician to clarify an issue.

Matthew Werder, chief technology officer at Hennepin County Medical Center in Minnesota, says the challenges are nothing out of the ordinary. “Because the market is still maturing and new players enter the market regularly, challenges are inevitable, but they are being overcome as the technology features are fine-tuned,” he says. “The good news is that there are numerous options, so while it may take some time to make a good choice, it is actually rather exciting to have so many good options to consider.”

Finding Answers
Once the challenges have been identified, how can they be overcome? Is it possible to create a secure text messaging system that protects patient data while still being functional? According to The Joint Commission, the following is a rundown of problems and their possible solutions:

• Identity verification is one of the easiest questions to answer. Most new commercial smartphones are equipped with fingerprint scanners. Pairing a fingerprint scan with a unique alphanumeric password can both secure the device and be used to verify the sender and/or recipient’s identity. These passwords should be changed on a random but regular basis.

• Message encryption should be included on both the sender’s and recipient’s devices, and wireless transmissions must have the highest level of encryption possible. While encryption can be applied individually, employing a security or encryption specialist may achieve better results.

• A message archive should be kept for a specific amount of time as determined by an administrator. The archive must be kept on record in the patient’s EHR and deleted only after either a specific amount of time or at the administrator’s discretion.

• The contact list should be facility specific and incapable of being edited or altered.

• Patient data transferred from a secure text message to an EHR must be accurate. Some form of quality assurance must be performed before the PHI is submitted to the patient’s EHR. If the facility opts not to use transcriptionists or other HIM professionals, it’s possible to implement technology that can transfer PHI directly from a phone to a patient’s file.

“Any new solution such as secure text messaging requires the application of a comprehensive communications strategy,” Werder says. “I personally underestimated the strength of the richness of the pager culture, which has stood the test of time and remains a highly reliable and cost-effective communication solution. Secure texting—like earlier advances—merits a broad view of the benefits it offers to improve enterprise collaboration. Otherwise, it will face some resistance, as previous advances did, because some will view it as unneeded change. In my experience, the technologies on the market today are very intuitive and require little training. Depending on the institution, various policies may need to be modified to establish the guardrails for effective communication through text messages.”

Privacy Concerns
Text messaging in a health care environment raises security questions, mostly due to the nature of the messages, the majority of which are anonymous and impersonal, and can be sent by anyone with a phone. Even after health care organizations have taken steps to secure the transmission of text messages, security lapses can occur. For example, text messages may be directed to the incorrect party.

“It is important for the health care industry—particularly organizations like The Joint Commission—to recognize that secure, ephemeral, and compliant messaging platforms mitigate modern cyber threats, which are increasing in frequency and complexity,” says Galina Datskovsky, PhD, CRM, FAI, CEO of Vaporstream. “An example of one of these threats is mobile ransomware, a recent trend gaining popularity that targets vulnerable SMS communications, which 95% of health care workers use when they don’t have a secure solution available.

“To address the threats head-on, organizations should not only embrace but also require the implementation of secure messaging platforms to collaborate between care giving teams, physicians, specialists, pharmacists, payers, and the patient, since they are specifically designed to utilize text in a HIPAA-compliant manner. These platforms leverage the convenience of mobile text messaging while ensuring the protection of PHI, personally identifiable information, and internet protocol, and seamlessly integrate with EHR systems to streamline workflows and compliance. Once that hurdle is removed, it is important to simplify rollout and integrate into all existing systems to accelerate adoption and increase participation.”

Secure text messaging would seem to have a place in the near future of health care. For example, in a fast-paced environment, such as an emergency department, a quick text message can be an ideal platform to keep physicians and nurses in touch with each other.

“Secure text messages that are immediately and automatically routed to the correct care team member for the particular clinical situation at hand allow care team members to easily communicate and collaborate without the needless disruption that ‘blind’ phone calls/pages create—forcing physicians and nurses to answer calls even if the correspondence is not urgent in nature,” explains Michelle McCleerey, PhD, MA, MEd, MBA, RN, vice president of product management at PerfectServe.

As more vendors target solutions, the push to allow PHI in text messaging will likely grow much stronger, she says. “Given that there are cloud-based secure messaging vendors that have assumed and overcome the challenges of archiving and documenting PHI from text messages, the benefits of text messaging far outweigh any obstacle it would pose to a health care organization,” McCleerey says. “These types of intelligent messages alleviate the need for care team members to search and struggle for the right individual to contact, prevent the wrong individual from being contacted, and eliminate the patient care time wasted waiting for a return call—all of which significantly delay patient care and degrade the patient experience.”

Moving away from and supplementing traditional communication methods has improved workflow at Hennepin County Medical Center, where staff have found text messaging to be effective for mass alert notifications, patient throughput problem solving, quick questions, and patient status updates. “Secure text messaging brings the opportunity for improved collaboration among caregivers and the extended care team,” Werder says. “Traditionally, communication among nurses, physicians, support staff, and others utilized and still use a plethora of technologies, from pagers to overhead announcements. At Hennepin County, we are fully embracing secure messaging for our health care system to improve collaboration and communication pathways among our care teams.”

Work to Be Done
Throughout the business world, text messaging has become a common, convenient communications tool used to keep colleagues connected throughout the day. While text messaging can be just as useful in a medical setting, steps must be taken to ensure patient information is protected before, during, and after transit.

The Joint Commission is in the process of researching and determining the best way to implement secure text messaging in a health care environment. Once a secure system can be ensured, experts believe it may have a significant impact on patient care. However, until issues concerning data security can be resolved, the prospect of health care professionals exchanging patient data via text remains just out reach.

— Kayla Matthews is a writer contributing to conversations about health, technology, and new developments in science. You can follow her on or on Twitter @KaylaEMatthews.

A Matter of Location

A Matter of Location

A Matter of Location

Is it better to have an EMR grounded in-house or one residing skyward?

When it comes to implementing an EMR, perhaps no decision will be as vital as whether to go with a server-based choice or one that resides in the cloud.

Health care organizations of all sizes have the option of accessing their EMRs through in-house computer networks or via cloud-based technology, where records are stored remotely and accessed when needed. Which option an organization chooses often depends on a number of different factors.

The Best Fit
Both local and cloud technologies are held to the rigorous standards of the Centers for Medicare & Medicaid Services (CMS). In the publication “Risk Management Handbook, Volume III,” CMS states that facilities have the responsibility to protect sensitive information whether the data are housed at the facility or in the cloud.

By CMS standards, cloud services are a general support system and must be approved for operation by the CMS office of the chief information security officer and the CIO of CMS. As the publication states, “All systems deployed in a cloud environment must be evaluated for an authorization to operate using the same security standards and requirements as those deployed in traditional environments, and must be maintained only within those authorized environments.”

Given that both local and cloud-based technology must meet the CMS standards, both will provide equivalent levels of security. However, there are other factors that differentiate the technologies.

Ron Sterling, an HIT consultant with Sterling Solutions, says, “The whole issue with cloud-based vs local systems is a compliance and strategic issue. If you buy your own system, you have to purchase the resources that you expect to need over the next 12 to 36 months. However, the cloud is virtual and can add resources on demand. Therefore, with the cloud, organizations can expand as necessary.”

Such flexibility is especially beneficial for small practices, which may lack the resources for full-time IT staffs. It also enables small organizations to ensure HIPAA compliance and keep pace with advancing technology. If such practices were to select a cloud-based vendor, Sterling says they could adjust resources as necessary with the vendor’s assistance. “This allows practices to rely on the cloud vendor for a number of HIPAA compliance issues such as system recovery and backup,” he says. “In a small practice it is very difficult to meet HIPAA security requirements with a local network. The practice may not have a secure place for the server or backups. With cloud-based technology, many HIPAA security issues can be solved at a reasonable price.”

“Cloud-hosted EMRs are a good fit for lean IT departments that are sensitive to staffing concerns, as they generally minimize both the need for on-premise IT skills and the risk of sustaining local staffing for such expertise,” says Tim Ruff, vice president of solutions management at M*Modal. “The technical requirements for an EMR typically involve back-end infrastructure such as web servers, databases, monitoring tools, and/or virtualization stacks. From a support perspective, cloud-based EMRs are good insurance against staffing concerns and in many ways represent an outsourcing of both technology and people.”

Brina Hollis, PhD, CST, MHHS, CBRS, a health informatics faculty member at Kaplan University, says the cloud can be enjoyed by both large and small health care organizations. “Smaller organizations don’t have the upfront costs for technology and personnel, and facilities will ask what the vendor can do for them, given their needs. Larger organizations are also looking toward the cloud and testing the waters in different areas. For example, some larger hospitals have cloud-based e-mail systems, or some other aspects of the organization may be in the cloud. In such instances, the facilities are using multibased systems, a combination of local and cloud access,” she says.

Provider Preference
According to Sterling, cloud vendors are reshaping the economics of software acquisition. “We see this in the Microsoft world,” he says. “They’d rather have revenue from an organization every month than have a company buy software once every few years. And more and more vendors are making it hard or impossible to buy their systems outside of a cloud offering. Some vendors make it attractive to use the cloud by swapping a big upfront software fee with a lower monthly service fee. However, when we look at the numbers per month against the cost of the license, support, and hardware hosting, we find that if a health care provider bought the license and installed it on the cloud, at the two- to four-year mark, the license fee would have been paid even though many cloud vendors do not decrease their service fee at any point. To address this issue, some vendors reduce the price at the three-year mark. Many vendors do not.”

Hollis believes the combination of convenience and lower upfront costs has led more small providers to opt for the cloud. However, large systems have not been as eager to take the leap for fear of losing control of their data. “It comes down to the needs of the organization,” she says. “Larger hospital systems have IT departments regardless of where their EMRs are housed. And there are a lot of other variables. We have to have the proper bandwidth to access EMRs in the cloud, for example. Larger organizations are afraid of the unknown, which is why so many of them are only testing the technology with pieces of their businesses in the cloud and others held locally.”

Tim McMullen, senior vice president of health care and life sciences with NTT DATA Services, says EMR preferences are in a state of flux. “The industry trend is absolutely moving from server-based EMRs to a greater comfort level among providers with cloud-based EMRs,” he says. “Health care is still behind other industries in this movement, but there is momentum now.”

Pros and Cons
Providers that adopt a cloud-based system need not be concerned with upgrades, backups, and the physical protection of the EMR network at a specific location, Sterling says. “As an example, many cloud servers have backup so that they can move to a different place in the event of catastrophic failure,” he explains.

Hollis says cloud-based technology offers fewer upfront costs, with the price tag spread among a vendor’s clients. “A typical local system can cost about $40,000 to set up; cloud-based could be half that,” she says. “In the latter case, there is no hardware or software that needs to be purchased and maintained. All the health care organization needs is an internet connection and a vendor.”

Hollis notes that many organizations believe cloud vendors deliver better support, including continuous information backup and data protection, and the ability to meet the requirements of incentive programs. “A lot of the host companies have more sophisticated security measures. They are very strict in meeting all of the mandates. It’s the responsibility of the vendor to meet the requirements for meaningful use. Those organizations that use cloud-based vendors can rely on them for that purpose. And a health care provider who travels needs only an internet connection to access records. Even if that individual is on an unsecured internet system, he or she still has the security provided by the vendor,” she says.

Cloud-based EMRs have their drawbacks. “A big con is that communications costs increase,” Sterling says. “An organization has to be sure it has the communication capacity to go to a server that is potentially hundreds of miles away. Bandwidth and other calculations can be done to be sure information can be sent back and forth. This is a particular challenge in health care because we do have a lot of images. Scanned lab reports or HIPAA consent forms are both image heavy.

“When we move into a diagnostic arena, that is a whole different animal—scans, field tests, and high-quality radiology studies are all examples of documents that require high-definition accurate images. That can take a lot of time to send to the vendor and then get it back. Although not as big an issue in primary care practices that typically do not transfer large quantities of high-definition images, exchange of information is one of the biggest challenges to using cloud-based technology.”

Hollis says the quality of the internet service is a major factor in determining whether a cloud-based system makes the grade. “If you don’t have a lot of bandwidth, you can have some lag, particularly with larger images and, if the internet goes out, there is no way to access the cloud. That can leave practices in the dark if they don’t have local backup,” she says.

Hollis believes the possibility of slow or intermittent internet service in remote areas should sway rural practices from adopting the technology.

Vendor reliability is another issue that must be addressed, she says. “Vendors may go out of business without communicating with hospitals and/or organizations to help set up a new system with another vendor,” Hollis says. “With our cell phones, we can back up to the cloud, for instance, but we can’t do that if the vendor is having difficulty.”

According to Ruff, by choosing to place its EMR in the cloud, an organization risks a loss of flexibility and control within its IT department. This occurs when vendors, in order to serve many different customers on a large scale, must standardize EMRs to some extent with regard to deployment and workflow.

In-house systems have their own set of challenges. For example, organizations must have hardware, personnel, and a strategy in place in the event of growth. Also, data security becomes more complicated. “You are responsible for more HIPAA issues because you have to protect the in-house equipment. With the cloud, you are capitalizing on the fact a lot of people are sharing equipment and resources in the cloud. In the cloud, someone else is monitoring that system,” Sterling says.

Adds McMullen, “It is rare to find a hospital without multiple vendors, particularly around the periphery of the EMR space. A common challenge is that some vendors want to host only their own applications. The added cost of managing applications outside their own core competencies is generally not something they want to take on. Being able to bundle applications from their own proprietary suite of offerings is an advantage for the vendor.”

Disaster Recovery
In the event of a disaster, cloud-based systems are protected from a number of environmental issues. For example, most cloud-based vendors are protected from power spikes and boast redundant communications systems, which are features only a few stand-alone practices can afford.

“From a disaster recovery perspective, in general, cloud-based systems are better protected and have better fail-safes,” Sterling says. “Say you’re working out of a data center in Atlanta; a cloud-based system may have a backup in Dallas. A regular health care practice would more than likely not have such capability. In fact, a lot of stand-alone practices do not update back-up and HIPAA compliance procedures in a timely fashion. They may not be actually backing up, or they may be keeping the back-up devices in the same place as they keep the server itself. Cloud-based vendors have backups in other locations. And, in a number of cloud-based solutions, they can switch quickly and lose only a short amount of time.”

Hollis notes the importance of having a safety net. “When we think about any EMR system, we have to have backups. Otherwise, there is no way to ensure access to information in case of catastrophe or even a smaller issue,” she says.

Hollis cites the case of a Los Angeles health care facility whose system was hacked and its data held for ransom. In that instance, the facility was forced to move to paper records to keep the hospital up and running. It ultimately paid the perpetrators to regain control over its own computer system.

“If the hospital had been on a cloud-based system, not only would such a breach have been less likely to occur but also back-up records would have been available to keep the hospital running smoothly,” Hollis says. “Just as cell phone providers remind consumers to back up to the cloud, cloud-based systems will come with those reminders for health care facilities. Cloud-based systems can be automatic, but local systems often are not, so if proper backups are not done on the latter systems, that could lead to larger problems.”

In general, cloud-based vendors are stricter with their security protocols than facilities with in-house systems. Also, cloud vendors are available to assist with recovery efforts. With an in-house server-based system, the IT department must be vigilant in completing backups and well schooled in retrieving information in the event of a failure.

“In the case of the Los Angeles hospital, someone could have simply gotten lax in their security, backup, and disaster recovery protocols,” Hollis says. “If an organization is small, such an incident could put them out of business. There could also be fines and possible jail time, although jail is not a common consequence in an EMR breach.

“In terms of security and disaster recovery, we can look at the banking industry, where we can bank online with ease of mind,” Hollis continues. “We need to have oversight that is looking 24 hours a day to be sure that there are no weak spots that would allow hackers access to protected health information.”

Overall Costs
It can be difficult to ascertain the financial impact of each system, particularly when organizations must factor in communication expenses. “If you look at cloud-based answers, you are looking at $300 to $700 per month for cloud-based offerings, not including the communication costs,” Sterling says. “Depending on the area of practice, how big the communication pipe has to be can have an impact, so it’s difficult to nail down the exact costs.”

Because cloud-based systems eliminate the need for the work to be completed in-house, Hollis believes their overall cost is minimal compared with a server-based system. However, Ruff notes that the wide range of available EMR choices makes it difficult to make financial comparisons. “An EMR can be delivered to a provider in many ways, and, as an example, a virtualized application typically has a higher infrastructure cost than an application that is web browser based,” he says.

The Right Solution
In the end, Ruff maintains that providers don’t need to have a preference between hosted cloud-based solutions and on-premise applications. As long as the product works, there’s not much to separate the two. “A cloud-based solution, by virtue of its being hosted somewhere else, typically has anywhere, anytime accessibility as a core part of its offering. But if set up correctly, an on-premise solution can be equally accessible. The onus is on the local IT department to make the latter happen,” he says.

“Generally, planning for the different solutions—on-premise vs the cloud—typically would generate different concerns to mitigate,” Ruff continues. “When doing a thorough evaluation, it might be helpful to keep in mind that while hosted solutions are sensitive to external factors such as internet connectivity, on-premise solutions might drive costs up with duplication of resources. Decision makers then need to weigh those factors against what is best for their organization’s needs.”

— Susan Chapman is a Los Angeles-based freelance writer.

A Matter of Location
By Susan Chapman
For The Record
Vol. 29 No. 8 P. 10

What happens to the brain as we age?

What happens to the brain as we age?

What happens to the brain as we age?

Brain aging is inevitable to some extent, but not uniform; it affects everyone, or every brain, differently. Slowing down brain aging or stopping it altogether would be the ultimate elixir to achieve eternal youth. Is brain aging a slippery slope that we need to accept? Or are there steps we can take to reduce the rate of decline?

Throughout our lifetime our brain changes more than any other part of our body. From the moment the brain begins to develop in the third week of gestation to old age, its complex structures and functions are changing, networks and pathways connecting and severing.

During the first few years of life, a child’s brain forms more than 1 million new neural connections every second. The size of the brain increases fourfold in the preschool period and by age 6 reaches around 90 percent of adult volume.

The frontal lobes – the area of the brain responsible for executive functions, such as planning, working memory, and impulse control – are among the last areas of the brain to mature, and they may not be fully developed until 35 years of age.

Normal Brain Aging

As we age, all our body systems gradually decline – including the brain. “Slips of the mind” are associated with getting older. People often experienced those same slight memory lapses in their 20s and yet did not give it a second thought.

Older individuals often become anxious about memory slips due to the link between impaired memory and Alzheimer’s disease. However, Alzheimer’s and other dementias are not a part of the normal aging process.

Common memory changes that are associated with normal aging include:

  • Difficulty learning something new:Committing new information to memory can take longer.
  • Multitasking: Slowed processing can make processing and planning parallel tasks more difficult.
  • Recalling names and numbers: Strategic memory that helps memory of names and numbers begins to decline at age 20.
  • Remembering appointments: Without cues to recall the information, appointments can be put safely in storage and then not accessed unless the memory is jogged.

While some studies show that one third of older people struggle with declarative memory (memories of facts or events that have been stored and can be retrieved), other studies indicate that one fifth of 70-year-olds perform cognitive tests just as well as their 20-year-old counterparts.

Scientists are currently piecing together sections of the giant puzzle of brain research to determine how the brain subtly alters over time to cause these changes.

General changes that are thought to occur during brain aging include:

  • Brain mass: Shrinkage in the frontal lobe and hippocampus – areas involved in higher cognitive function and encoding new memories – starting around the age of 60 or 70 years.
  • Cortical density: Thinning of the outer-ridged surface of the brain due to declining synaptic connections. Fewer connections may contribute to slower cognitive processing.
  • White matter: White matter consists of myelinated nerve fibers that are bundled into tracts and carry nerve signals between brains cells. Myelin is thought to shrink with age, and as a result, slow processing and reduce cognitive function.
  • Neurotransmitter systems: Researchers suggest that the brain generates less chemical messengers with aging, and it is this decrease in dopamine, acetylcholine, serotonin, and norepinephrine activity that may play a role in declining cognition and memory and increased depression.

In understanding the neural basis of cognitive decline, researchers can uncover which therapies or strategies may help slow or prevent brain deterioration.

Recent discoveries in brain aging

Several brain studies are ongoing to solve the brain-aging conundrum, and discoveries are being frequently made.

Stem cells

Recently, researchers from Albert Einstein College of Medicine in New York revealed in a mouse study that stem cells in the brain’s hypothalamus likely control how fast aging occurs in the body.

“Our research shows that the number of hypothalamic neural stem cells naturally declines over the life of the animal, and this decline accelerates aging,” says Dr. Dongsheng Cai, Ph.D., professor of molecular pharmacology at Einstein. “But we also found that the effects of this loss are not irreversible. By replenishing these stem cells or the molecules they produce, it’s possible to slow and even reverse various aspects of aging throughout the body.”

Injecting hypothalamic stem cells into the brains of normal old mice and middle-aged mice, whose stem cells had been destroyed, slowed or reversed measures of aging. The researchers say this is a first step toward slowing the aging process and potentially treated age-related diseases.


“SuperAgers” are a rare group of individuals over the age of 80 years who have memories as sharp as healthy people decades younger.
SuperAgers’ brains shrink at a slower rate than people of the same age.

Research by Northwestern University Feinberg School of Medicine in Chicago, IL, compared SuperAgers with a control group of same-age individuals. They found that the brains of SuperAgers shrink at a slower rate than their age-matched peers, which results in a greater resistance to the typical memory loss observed with age, thus revealing that age-related cognitive decline is not inevitable.

“We found that SuperAgers are resistant to the normal rate of decline that we see in average elderly, and they’re managing to strike a balance between life span and health span, really living well and enjoying their later years of life,” says Emily Rogalski, associate professor at the Cognitive Neurology and Alzheimer’s Disease Center (CNADC) at Northwestern University Feinberg School of Medicine.

By studying how SuperAgers are unique, the researchers hope to unearth biological factors that might contribute to maintaining memory ability in advanced age.

Therapies to help slow brain aging

Factors have been discovered that speed up brain aging. For example, obesity in midlife may accelerate brain aging by around 10 years, and both sugar and diet varieties of soda are correlated with fast-tracking brain age, having smaller overall brain volume, poorer episodic memory, and a shrunken hippocampus.

A growing body of evidence suggests that people who experience the least declines in cognition and memory all share certain characteristics:

  • partaking in regular physical activity
  • pursuing intellectually stimulating activities
  • staying socially active
  • managing stress
  • eating healthily
  • sleeping well

Recent research highlights a plethora of ways that we can actively take charge of our health and perhaps decrease the rate at which our brains age.


One intervention that crops up time and time again to stave off age-related mental decline is exercise.

A combination of aerobic and resistance exercise of moderate intensity for at least 45 minutes each session and on as many days of the week as possible has been reported to boost brain power in people aged 50 and over significantly.

Likewise, other research by the University of Miami found that individuals over the age of 50 who engaged in little to no exercise experienced a decline in memory and thinking skills comparable to 10 years of aging in 5 years, compared with those who took part in moderate- or high-intensity exercise. Essentially, physical activity slowed brain aging by 10 years.

Dancing has also shown to have an anti-aging effect on the brain of seniors. A study conducted by the German Center for Neurodegenerative Diseases, Magdeburg, Germany found that while regular exercise can reverse the signs of brain aging, the most profound effect was seen in people who danced.

Playing an instrument

Baycrest Health Sciences in Toronto, Canada, revealed why playing a musical instrument may help older adults ward off age-related cognitive declines and retain their listening skills.

Researchers found that learning to play a sound on a musical instrument changes brain waves in such a way that improves an individual’s listening and hearing skills. The alteration in brain activity indicates that the brain rewires itself to compensate for disease or injuries that might prevent a person’s ability to perform tasks.

“It has been hypothesized that the act of playing music requires many brain systems to work together, such as the hearing, motor and perception systems,” said Dr. Bernhard Ross, senior scientist at Baycrest’s Rotman Research Institute. “This study was the first time we saw direct changes in the brain after one session, demonstrating that the action of creating music leads to a strong change in brain activity.”


A key component of brain health is diet. Recent research has linked omega-3 and omega-6 fatty acids in the blood with healthy brain aging. Another study has also determined that consuming foods included in the Mediterranean or the MIND diet is associated with a lower risk of memory difficulties in older adults.

Research by the University of Illinois, Champaign, IL, discovered that middle-aged people who have higher levels of lutein – a nutrient that is found in green leafy vegetables, such as kale and spinach, and eggs and avocados – had similar neural responses to younger individuals than of people the same age.

“As people get older, they experience typical decline. However, research has shown that this process can start earlier than expected. You can even start to see some differences in the 30s,” informs Anne Walk, a postdoctoral scholar and the first author of the study. “We want to understand how diet impacts cognition throughout the lifespan. If lutein can protect against decline, we should encourage people to consume lutein-rich foods at a point in their lives when it has maximum benefit.”

The number of American adults over the age of 65 is set to more than double in 40 years, rising from 40.2 million in 2010 to 88.7 million by the year 2050. Due to this aging population, it will become increasingly important to understand the cognitive changes that go hand in hand with aging.

While many questions remain regarding the aging brain, research is making progress in illuminating what happens to our cognitive functions and memory throughout our lifetime, and it is emphasizing ways we can preserve our mental abilities to improve our quality of life as we advance into older adulthood.

3 Ways Virtual Reality Is Transforming Medical Care

3 Ways Virtual Reality Is Transforming Medical Care

3 Ways Virtual Reality Is Transforming Medical Care

Think virtual reality is just about gaming and the world of make-believe? Get real. From product design to real estate, many industries have adopted VR and related technologies— and nowhere are the benefits of VR greater than in healthcare.

“We are seeing more and more of this incorporated faster than ever before,” said Dr. Ajit Sachdeva, Director of Education with the American College of Surgeons. “VR has reached a tipping point in medicine.”

Think virtual reality is just about gaming and the world of make-believe? Get real. From product design to real estate, many industries have adopted VR and related technologies— and nowhere are the benefits of VR greater than in healthcare.

“We are seeing more and more of this incorporated faster than ever before,” said Dr. Ajit Sachdeva, Director of Education with the American College of Surgeons. “VR has reached a tipping point in medicine.”

As NBC News MACH reported previously, psychologists have found VR to be good for treating post-traumatic stress disorder. And stroke doctors, pain specialists, surgeons, and other medical practitioners have found their own uses for VR. In some cases, medical VR involves the familiar headsets; in others, 3D glasses and special video screens give a VR-like experience.

Scientists Find New Way To ‘Print’ Living Tissue
The use of VR and 3D visualization technology in medicine isn’t brand-new. Medical researchers have been exploring ways to create 3D models of patients’ internal organs using VR since the 1990s. But advances in computing power have made simulated images much more realistic — and much faster to create.

X-rays, CT scans, and MRI scans can now be turned into high-resolution 3D images in under a minute, said Sergio Agirre, chief technology officer of EchoPixel, a Mountain View, California firm whose visualization software is being used in hospitals across the U.S. “Twenty years ago, it would probably take them a week to be able to do that.”


These days, common surgical procedures like appendectomies or cesarean sections are often pretty routine — one case is similar to the next. But some especially complicated procedures — including the separation of conjoined twins — present unique challenges that can be met only with meticulous planning. For these, 3D visualization is proving to be a game-changer.

Recently, VR played a vital role in the successful separation of conjoined twins at Masonic Children’s Hospital in Minneapolis. The three-month-old twins were joined far more extensively than some other conjoined twins, with intricate connections between their hearts and livers. That meant the surgery to separate the twins would be unusually complicated — and potentially very dangerous for the twins.

Before surgery, the surgical team took CT, ultrasound, and MRI scans and created a super-detailed virtual model of the twins’ bodies — and then ventured “inside” their organs to identify potential pitfalls and plan how these would be avoided during surgery.

“You look through the 3D glasses, and you can basically walk through the structure, peeling apart parts so you can look at exactly what you want to,” said Dr. Anthony Azakie, one of the surgeons who separated the twins. He said the high-resolution visualization “helped minimize the number of surprises that we were potentially dealing with.”

VR technology is also being used by vascular specialists like Dr. In Sup Choi, director of interventional neuroradiology at Lahey Hospital & Medical Center in Burlington, Massachusetts. When he uses interactive 3D visualizations to prepare for procedures to fix aneurysms and blocked arteries, he said, he gets “a better idea of what types of devices we have to use and what approach might work best.”


If doctors are donning VR gear, so are their patients. They’re using the headsets to immerse themselves in a peaceful virtual world that takes their focus off discomfort associated with medical problems and treatments.

This New Device Turns Your Smartphone Into A Medical Lab
Because anesthesia and sedation can be risky for some patients, including those who are frail or very elderly, some hospitals are offering these patients VR headsets as a way to help control pain during minimally invasive procedures. It’s still experimental at this point, but the results so far have been successful.

Similarly, VR has been shown to reduce anxiety in cancer patients undergoing chemotherapy infusions. VR is even making injections and other painful or potentially frightening procedures less distressing to children.

But burn patients may be some of the biggest beneficiaries of VR technology. From daily cleaning and bandaging of burns to skin grafts, severe burn patients experience “some of the most painful procedures in medicine,” said Dr. Hunter Hoffman, a University of Washington scientist with expertise in the use of VR for pain relief. “Pain medications help, but they’re often not strong enough.”

SnowWorld is used to distract a burn patient from pain. Hunter Hoffman
For these patients, Hoffman helped create the VR game ”SnowWorld,” which features imagery designed specifically to distract burn patients from pain. Patients who play the game during treatment report up to 50 percent less pain than similar patients not playing the game, according to preliminary research. Other research suggests that patients playing the game actually show changes in the brain that indicate they’re feeling less pain.

SnowWorld is now being evaluated in clinical trials at four sites in the U.S. and at two international sites.

VR shouldn’t be considered a replacement for pain-killing medication, Hoffman said, adding that combining drugs and VR could be especially effective.

A pediatric burn patient uses virtual reality to distract from pain during physical therapy exercises at Shriners Children Hospital in Galveston, Texas.

VR is also helping patients overcome balance and mobility problems resulting from stroke or head injury.

“Using VR, I can control what’s going on around the patient and measure what kind of impact it’s having on that patient’s ability to change,” said Emily Keshner, a professor of physical therapy at Temple University in Philadelphia. “We expose them to this repeatedly and we give them feedback about how they can respond to prevent themselves from falling.”

Research has shown that VR-mediated rehabilitation can speed the pace at which these patients regain physical abilities. There’s a long way to go in conducting all the research needed to validate these results and make these techniques part of routine practice, Keshner said — but it’s on the way.

One study of stroke patients showed that VR rehab led to more improvements in arm and hand movement compared to conventional rehab after four weeks of therapy. The VR-assisted patients had better mobility when the doctors checked in two months later. Other research has shown similarly successful outcomes for patients with cerebral palsy undergoing rehab for balance problems.

“The power of VR [for therapy] is that you’re really changing the way people perceive the world,” Keshner said. “They learn how to respond. And after practicing in that virtual world, they are much more confident and capable.”

– 3 Ways Virtual Reality Is Transforming Medical Care – Aug.22.2017 via NBC News

Written by: 
Sarah DiGiulio

Australia’s inside-out digital health strategy

Australia’s inside-out digital health strategy

Australia’s inside-out digital health strategy

The thing to remember about strategy documents is that they’re merely aspirational. They set out a proposed pathway to achieving a set of defined goals, but they’re no guarantee that those goals will even be achieved.

Australia’s digital health strategy, released on Monday, is no exception.

The thing to remember about strategy documents is that they’re merely aspirational. They set out a proposed pathway to achieving a set of defined goals, but they’re no guarantee that those goals will even be achieved.

Australia’s digital health strategy, released on Monday, is no exception.

As the old BBC TV series Yes Minister taught us, when it comes to writing government reports, “the tricky bit should be disposed of in the title”. This strategy [PDF] does exactly that: Safe, seamless, and secure.

That dealt with, let’s look at some of the details that worry me.

“An economic analysis, undertaken as part of the development of this strategy, has estimated that the gross economic benefit of secure messaging could be around AU$2 billion over four years and more than AU$9 billion over 10 years,” says the strategy.

That’s the gross benefit, but what about the net economic benefit? Setting up the digital health record system during its trial phase had its budget topped up by a few hundred million a couple of times, putting it well into the billion-dollar project category.

As a submission from health insurer HCF put it: “Health does not lack innovation, the issue always is in scalability, and execution in a fragmented system.”

This integrated national system will have to link up statewide systems, and as the strategy notes, there’s “no overarching standard in place to govern the sharing of data”. The potential for massive cost blowouts is obvious.

“There have been widespread calls from peak professional bodies and health services for immediate action to create a standardized, universally accepted, secure messaging capability,” the strategy says.

So why implement secure messaging as part of a massive, complex data interoperability project, where delays in other parts of the project could well delay this “immediate action”?

You could just set up encrypted email as a separate project. Or use WhatsApp?

The strategy does list some “critical success factors”, but there’s no discussion of risk mitigation strategies, except to note that the risks exist.

The top critical success factor is “trust and security assurance”, of course. And here we hit what I think is the big problem.

If patients are to be “put at the centre of their healthcare”, and their biggest worry is that their confidential health data might be breached, then surely this whole strategy is inside out.

Surely you don’t mitigate the data breach risks by pouring all that data into a massive, complex system that can be accessed by tens of thousands of people.

If patients are meant to be at the centre of their healthcare, then maybe they should be carrying the data. After all, medical practitioners only need that data if the patient is right there in front of them.

Give every Australian resident a USB stick to carry around their neck on a string, like soldiers wear dog tags recording their blood type. Or maybe a wristband with some Bluetooth cleverness.

I’m guessing that won’t happen, because that way we can’t include all that delicious data in a big data champagne cocktail to hand to Big Pharma or whomever.

Ah yes, here we are, in goal seven: “A thriving digital health industry delivering world-class innovation”. That doesn’t sound very patient-at-the-centre to me.

There are so many ways for this or any other digital health strategy to fail. But don’t worry. The strategy recognises that another critical success factor will be “effective governance and leadership”.

“Strong national leadership will be critical to the success of this strategy. No single organisation can achieve the desired outcomes from digital health alone. A coordinated approach will support governments and industry to deliver on the objectives,” it says.

With the Australian government’s well-known track record with this sort of big IT project, we can obviously rest assured that everything will run smoothly as expected.

 By for The Full Tilt