Burden Of Care For Patients Research Articles

Determinants of caregiver burden in male patients with epilepsy following penetrating traumatic brain injury

PurposeWe determined burden of caring for patients with post-traumatic epilepsy (PTE) following penetrating traumatic brain injury (TBI) and identified factors predicting higher burden. MethodWe assessed 331 caregiver-veteran dyads in Phase 2 (136 PTE, 136 non-PTE, and 59 HC dyads), 133 in Phase 4 (47 PTE, 56 non-PTE, and 30 HC dyads) – 30 years later, and 46 dyads in the follow-up study (18 PTE, 19 non-PTE, and 9 HC). Caregiver’s burden was measured by Zarit Burden Index and a questionnaire. Veterans completed demographic, mental and physical well-being, quality-of-life, and medical-related information. Caregivers provided information about burden and their assessments of cognitive decline and neuropsychiatric status of the veterans. ResultsPTE caregivers perceived significantly more burden than comparison groups at all phases. Bivariate analyses revealed that caregiver distress due to the veteran’s neuropsychiatric state including cognitive decline, apathy, and disinhibition and the veteran’s characteristics including older age at epilepsy onset and role limitation due to physical problems were associated with higher burden. Finally, we revealed disinhibition distress, and role imitation due to physical problems as the predictors in a model of caregiver burden. ConclusionElevated PTE caregiver burden is persistent across the life span suggesting that caregivers could benefit from counseling and targeted psychosocial interventions to reduce their burden.

A case of effective usage of a weighted blanket for a person with severe dementia

Sleep disorders are common among persons with dementia: 50.8% of them have insomnia. 1 The behavioural and psychological symptoms of dementia (BPSD), including day‐night reversal and wandering during the night, increase the care burden of patients' family members and care staff. In general, pharmacological therapy is prescribed to treat sleep disorders; however, as its effectiveness is limited, non‐pharmacological therapy (NPT) has also been proposed. 2 Weighted blankets (WBs) have been used as an NPT in the USA and the Nordic countries, and their effectiveness has started to attract the attention of Japanese medical professionals. Phototherapy is the most common and effective form of NPT, and other forms of this intervention such as lifestyle therapy, electrical stimulation, and cognitive behavioural therapy are also widely employed. 3 To facilitate better sleep quality in persons with dementia afflicted with symptoms of day‐night reversal, the Alzheimer's Association of America recommends various types of lifestyle changes: reducing naps, increasing daytime activity, and regulating sleep rhythms with adequate exposure to sunlight. 4 WBs have demonstrated positive psychological effects in adults with depression and in children with developmental disabilities. They have also been used for persons with dementia in Nordic countries. Field et al. reported that pressure stimulation of the body releases oxytocin, a happy hormone, which has a calming effect and activates the secretion of serotonin. 5 This study was the first clinical trial of WBs for persons with dementia in Japan. CASE PRESENTATION Our case study demonstrates the effectiveness of a WB for a person with severe dementia. The participant was a woman in her 80s living in a nursing home who agreed to participate in the study. At the time of the case study, she was 138 cm tall and weighed 42 kg. She was diagnosed with Alzheimer's disease in 1991. Her symptoms progressed over time, and she began to exhibit symptoms such as wandering, collecting things, and odd eating behaviours. There were complaints from the neighbours about these symptoms, and she was moved to a nursing home in June 2016. At that time, her Clinical Dementia Rating was 3 (severe dementia) and ranked at care level 5 (extreme need of care) on the Long‐term Care Insurance system. She had a sleep disorder, with BPSD including day‐night reversal, wandering during the night, and hallucinations. Because she had difficulty answering questions, using the Mini‐Mental State Examination was not feasible. She had never received pharmacological therapy for her sleep disorder, and her only daily medication was a laxative. She needed mild care support with daily activities. For example, when she fell asleep while sitting up and eating, the care staff would help her eat. She frequently left her room and wandered around the floor throughout the night. The care staff would catch her wandering and lead her back to bed to lie down. The care staff attempted lifestyle therapies from the time of her admission, such as promoting participation in activities during the day and sleep induction at night. The results of the lifestyle therapies showed a slight increase in sleep time, but her nocturnal auditory hallucinations, hallucinations, and wandering did not decrease; thus, the burden on the care staff increased.

Developing services for long COVID: lessons from a study of wounded healers

Persistent symptoms lasting longer than 3 weeks are thought to affect 10-20% of patients following SARS-CoV-2 infection. No formal guidelines exist in the UK for treating patients with long COVID and services are sporadic and variable, although additional funding is promised for their development.In this study, narrative interviews and focus groups are used to explore the lived experience of 43 healthcare professionals with long COVID. These individuals see the healthcare system from both professional and patient perspectives, thus represent an important wealth of expertise to inform service design.We present a set of co-designed quality standards, highlighting equity and ease of access, minimal patient care burden, clinical responsibility, a multidisciplinary and evidence-based approach, and patient involvement; and we apply these to propose a potential care pathway model that could be adapted and translated to improve care of patients long COVID.

Beyond AREDS Formulations, What Is Next for Intermediate Age-Related Macular Degeneration (iAMD) Treatment? Potential Benefits of Antioxidant and Anti-inflammatory Apocarotenoids as Neuroprotectors.

Age-related macular degeneration (AMD) is the commonest cause of severe visual loss and blindness in developed countries among individuals aged 60 and older. AMD slowly progresses from early AMD to intermediate AMD (iAMD) and ultimately late-stage AMD. Late AMD encompasses either neovascular AMD (nAMD) or geographic atrophy (GA). nAMD is defined by choroidal neovascularization (CNV) and hemorrhage in the subretinal space at the level of the macula. This induces a rapid visual impairment caused by the death of photoreceptor cells. Intravitreal injection of anti-vascular endothelial growth factor (VEGF) antibodies is the standard treatment of nAMD but adds to the burden of patient care. GA is characterized by slowly expanding photoreceptor, and retinal pigment epithelium (RPE) degeneration patches progressively leading to blindness. There is currently no therapy to cure GA. Late AMD continues to be an unmet medical need representing a major health problem with millions of patients worldwide. Oxidative stress and inflammation are recognized as some of the main risk factors to developing late AMD. The antioxidant formulation AREDS (Age-Related Eye Disease Studies), contains β-carotene, which has been replaced by lutein and zeaxanthin in AREDS2, are given to patients with iAMD but have a limited effect on the incidence of nAMD and GA. Thus, to avoid or slowdown the development of late stages of AMD (nAMD or GA), new therapies targeting iAMD are needed such as crocetin obtained through hydrolysis of crocin, an important component of saffron (Crocus sativus L.), and norbixin derived from bixin extracted from Bixa orellana seeds. We have shown that these apocarotenoids preserved more effectively RPE cells against apoptosis following blue light exposure in the presence of A2E than lutein and zeaxanthin. In this review, we will discuss the potential use of apocarotenoids to slowdown the progression of iAMD, to reduce the incidence of both forms of late AMD.

Practical Management of Pilonidal Disease.

Summary:Pilonidal disease is a common problem across the globe, with a wide variety of options for management, ranging from healing by secondary intention to flap closure. As new techniques have been introduced, the ideal method to reduce complications and limit recurrence has become unclear. In this review, we highlight the most common methods used to treat pilonidal disease, as well as the senior author’s preferred technique for management. Ideally, surgeons are able to choose the optimal procedure for each patient and maximize outcomes with minimal patient care burden and morbidity.

INNV-22. PROSPECTIVE ANALYSIS OF UTILIZATION OF TELEMEDICINE IN NEURO-ONCOLOGY

Abstract OBJECTIVE to offer neuro-oncology care to patients in rural/suburban settings that may not otherwise have access to urban amenities, specialists, and clinical trials. To test the feasibility of telemedicine in Neuro-Oncology by measuring cost savings, travel time savings, and burden of care. To screen patients for clinical trials. BACKGROUND Neuro-Oncology services are primarily available only at tertiary care hospitals. This increases the burden of care for patients who live in suburban and rural areas, as they have to travel long distances for their care. Hence, some families and patients do not seek care as travel time increases the stress on patients and their caretakers who are already dealing with the devastating diagnosis of a brain tumor. Similarly, these patient groups do not have access to clinical trials. METHODS To help ease above hardships on patients, we built a telemedicine Neuro-Oncology program that is studying the quality of care compared with daily routine visits in the cancer center. We are enrolling 30 patients in each cohort of the study, cohort A, telemedicine visits and cohort B, regular clinic visits for a total of 60 patients after obtaining written consent. We are providing them survey identifying quality measures of care (24 questions). The survey is provided to the patients and their caregivers at the end of their visit. RESULTS Survey answers are inputted into Survey Monkey. After the completion of 60 total patient visits, surveys will be evaluated and the results will be analyzed. CONCLUSION We are looking for the long-term feasibility of utilizing telemedicine care in rural/suburban settings for Neuro-Oncology patients. We anticipate that there will be cost savings, travel time savings and reduction in burden of care without compromising patient satisfaction or quality of care provided. We are also studying the feasibility of screening patients for clinical trials.

Orofacial clefts: treatment based on a multidisciplinary approach

Orofacial clefts: treatment based on a multidisciplinary approach

Survey on perceived work stress and its influencing factors among hospital staff during the COVID-19 pandemic in Taiwan.

This study aimed to investigate the perceived work stress and its influencing factors among hospital staff during the novel coronavirus (COVID‐19) pandemic in Taiwan. A web‐based survey was conducted at one medical center and two regional hospitals in southern Taiwan, targeting physicians, nurses, medical examiners, and administrators. The questionnaire included items on the demographic characteristics of hospital staff and a scale to assess stress among healthcare workers caring for patients with a highly infectious disease. A total of 752 valid questionnaires were collected. The hospital staff reported a moderate level of stress and nurses had a highest level of stress compared to staff in the other three occupational categories. The five highest stress scores were observed for the items “rough and cracked hands due to frequent hand washing and disinfectant use,” “inconvenience in using the toilet at work,” “restrictions on eating and drinking at work,” “fear of transmitting the disease to relatives and friends,” and “fear of being infected with COVID‐19.” Discomfort caused by protective equipment was the major stressor for the participants, followed by burden of caring for patients. Among participants who experienced severe stress (n = 129), work stress was higher among those with rather than without minor children. The present findings may serve as a reference for future monitoring of hospital staff's workload, and may aid the provision of support and interventions.

Burden in primary family caregivers caring for uremic patients on maintenance peritoneal dialysis.

Managing the burden of care for patients with chronic debilitating diseases is an important issue. Herein, we assessed the burden in primary family members caring for uremic patients on maintenance peritoneal dialysis. One hundred seventy caregivers and 170 patients were recruited. Self-perceived scoring along the Zarit Caregiver Burden Scale (ZCBS), World Health Organization Five-item Well-Being Index (WHO-5), and Warwick-Edinburgh Mental Well-being Scale (WEMWBS) were determined for caregivers. There was an inverse relationship between ZCBS and WHO-5 or WEMWBS scores in caregivers, suggesting that the higher the burden, the lesser the self-perceived well-being. One hundred two of 170 caregivers (60%) reported mild to moderate burden, indicating a common presence of mild to moderate caring-related mental and physical stress. Moreover, 31 caregivers (18.2%) reported moderate to severe burden. Several patient disease factors, including diabetes and frailty, increased caregiver burden, while insurance coverage and out-of-pocket medical costs were also positively correlated. Caregivers who lived with patients and spent longer hours in caring-related activities had higher burden scores, while regular exercise seemed to partially alleviate the burden. Our study clearly showed that caring for patients with maintenance peritoneal dialysis caused physical, mental, and social burden in family caregivers, with the extent of the stress being influenced by patients' disease severity and other demographic factors in both patients and caregivers.

The effect of the burden of patient care with cancer on family caregivers

Cancer is a major problem that affects today's society. Besides patients suffering from this disease, cancer has also a huge impact on the quality of life of the family. This study aimed to investigate the latest bibliography on the effect of the burden of patient care with cancer on family caregivers. Family caregivers face physical health problems such as physical pain, fatigue, sleep disturbances. Moreover, several psychological effects are shown, in which various disorders such as depression are included. Psychological disorders, also, include adjustment disorder, panic disorder, anxiety, and emotional reactions such as anger, frustration, and fear. In the financial sector, caregivers face several problems due to the coverage of medical needs which are reinforced by reducing or stopping their work because of the care burden. At the same time, they are confronted with social impacts in which loneliness and isolation are attributable to the limitation of their social activities. As far as the age group of the patient is concerned, the effects of caring for young patients are more psychological than physical in opposite to the older people. The burden experienced by the family of the cancer patient exhausts family and it becomes necessary to identify problems and assess their needs. Health professionals should strength caregivers with actions such as psychological support, training, and participation in social and supportive programs in order to improve their personal health and quality of life.

The Effectiveness of Self-Management Program Based on 5A Model on patient care burden for stroke patients

The Effectiveness of Self-Management Program Based on 5A Model on patient care burden for stroke patients

The Relationship between Family Attitude and Family Caregiver Burden of Patients with Schizophrenia in Tangerang

Introduction: Schizophrenia is a mental disorder that occurs in the long term and affects the thought process which demanding for the required care. Negative attitudes can be one of the factors that influence the family burden that is getting heavier. This study aimed to determine the relationship of family attitudes to the family burden of caring for schizophrenic patients at the psychiatric hospital in Kota Tangerang. Methods: The study was a descriptive correlation with Cross-Sectional design. The population of this study was the family caregivers of patients with schizophrenia who visited the psychiatric clinic at Kota Tangerang Hospital. This study used the accidental sampling method, recruited as many as 64 people. The instrument of this study was the Burden Assessment Schedule (BAS) questionnaire and the Family Attitude Scale (FAS) had been examined the validity and reliability test. The Chi-square test was used for the statistical analysis to identify the relationship between family attitude and caregiver burden. Results: The results of this study were 23 respondents who had a positive attitude with a light burden of 52.2% while those with a negative attitude had 41 respondents with a heavy burden of 80.5. The p-value was 0.007 showed that there was a significant relationship between family attitudes and the burden of the family caring for patients with schizophrenia in psychiatric hospitals in Kota Tangerang Hospital. Conclusion: It suggests that health care providers need to consider the burden perceived by the caregivers so they are more likely to show a positive attitude in providing care for the beloved-one.Keywords: Caregiver Burden, Family Attitudes, Family Caregivers, Patients with Schizophrenia

Outcomes of sepsis in patients with multiple myeloma.

e20513 Background: Patients with Multiple Myeloma (MM) are at risk for developing sepsis due to defective humoral immunity, underlying disease factors like renal failure, iron overload, and treatment with immunosuppressive agents. Sepsis is a significant cause of morbidity and mortality in patients with MM. In this study, we aimed to study trends of inpatient outcomes and health care burden of patients with sepsis in MM. Methods: Adult patients with MM admitted to the hospital from 2012 to 2017 were identified from the Nationwide Inpatient Sample database and were stratified into two groups based on the diagnosis of sepsis. Multivariate regression analysis was used to adjust for confounders when calculating for mortality. Statistical tests for trends of mortality, length of stay and hospital charges were performed. Results: A total of 513,615 patients with MM met the inclusion criteria. Sepsis was found to be the most common cause of admission amongst these patients (12.2%) and of the patients with MM who died in the hospital, 38.1% carried the primary diagnosis of sepsis. Mean age of the patients was 70.1 years and they were predominantly Caucasian (62.1%) with male preponderance (57.7%). MM patients admitted with sepsis were found to have higher mortality (15.7 and 3.5% P < 0.0001),higher hospital costs (22,082$ vs 15,206; P < 0.0001) and longer hospital stays (8.1 days vs 6.0 P < 0.0001) when compared to those admitted for other reasons. Temporal trends have been noted to improve over the years, with mortality decreasing from 18% to 13.1%, (p trend < 0.001). Length of stay (in days) decreased from 8.3 to 7.7 days (p trend = 0.009) and hospital charges (in dollars) decreased from 22,407 to 21,209 (p trend < 0.001). Conclusions: Although the improving trends are promising, sepsis still continues to be significantly contributing to morality and morbidity in patients with MM. Measures to identify the changing spectrum of infectious diseases, their predisposing risk factors along with strategies to recognize and prevent early stages of sepsis could have a significant impact on lowering mortality and health care burden. [Table: see text]

Costo anual de la atención médica de pacientes con dermatitis atópica moderada a grave en México. Estudio multicéntrico

In Mexico, the economic burden of medical care for patients with atopic dermatitis is unknown. To determine the annual direct medical costs of the treatment for patients with moderate to severe atopic dermatitis who receive medical attention at "Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado" (Institute for Social Security and Social Services for State Workers, better known as ISSSTE), as well as the main variables associated with it. A multicenter, retrospective cohort study. Clinical records of patients with moderate to severe atopic dermatitis were reviewed and a multivariate analysis was designed by using a generalized linear model. 65 patients were included; 41 of them (63.07 %) had moderate atopic dermatitis, and 24 (36.92 %) had severe AD; 39 (60 %) of them were female patients. In groups with severe atopic dermatitis, statistically significant differences were observed in matters of the duration of the evolution of the disease, comorbidities, intense pruritus, and depression. The average annual cost of medical care for patients with moderate atopic dermatitis was 1527 ± 623 USD, and for patients with severe atopic dermatitis the cost was 9487 ± 8990 USD. Significant differences were observed in dermatology consultations, referrals, laboratory and diagnostic studies, and the number of drugs prescribed by physicians. With the multivariate analysis, it was identified that the highest cost was presented by severe patients (p = 0.0001) who were younger and had comorbidities, along with diagnosis of depression. The severity of atopic dermatitis, the age average, the presence of comorbidities, and the diagnosis of depression are the variables with the highest association and impact on the direct cost of medical care.

Orthodontic-care burden of patients with unilateral and bilateral cleft lip and palate

Objective: The aim of the study was the evaluation of the orthodontic care burden of patients treated in Division of Facial Abnormalities Department of Orthodontics, Wroclaw Medical University. Methods: The patient’s medical data with complete uni - and bilateral cleft lip and palate (ULCP and BLCP), who finished the orthodontic treatment between 2012 and 2019 were evaluated. The duration of orthodontic treatment, number of removable appliances, kilometers traveled, number of visits and surgical procedures performed were recorded. The sample was divided into 2 groups according to ICD-10 diagnosis code identification. All data was subjected to statistical analysis. Results: For the UCLP patients (n = 54) the mean time of orthodontic treatment was 9,24 years, the mean time of orthodontic appointments was 62,91, the mean number of removable appliances was 4,12, the mean number for surgical procedures was 3.35, and the mean distance traveled to attend the center for orthodontic appointments was 5466,95km. For the BCLP patients (n = 19) the mean time of orthodontic treatment was 10,16, the mean time of orthodontic appointments was 66,26, the mean number of removable appliances was 4,12, the mean number for surgical procedures was 4.05, and the mean distance traveled to attend the center for orthodontic appointments was 3758,23km. Conclusion: Orthodontic treatment of patients with uni- and bilateral cleft lip and palate is very burdensome for the patients. However, the care burden at the Division of Facial Abnormalities Department of Orthodontics, Wroclaw Medical University is not less than in other European countries.

Responsiveness of the Activity Participation Outcome Measure in adult patients with Traumatic Brain Injury in an acute private neurological rehabilitation setting in South Africa

INTRODUCTION: Acute neurological rehabilitation aims to reduce the burden of care of patients with traumatic brain injury (TBI) and increase their activity participation. Tracking change throughout the rehabilitation is essential for funders of the service as well as the patient. Valid, reliable and responsive outcome measures are thus needed for accurate measurement of change This study compared the responsiveness to change of the Functional Independence Measure™+ Functional Assessment Measure (FIM™+FAM) with the Activity Participation Outcomes Measure (APOM). This was administered TBI patients in the acute neurological rehabilitation phase in a private health care facility in South Africa. METHOD: A quantitative, prospective, longitudinal cohort design was used. A sample of 24 in-patients over 12 months was scored weekly on both outcome measures. The responsiveness between the APOM and FIM™+FAM was tested using the dependent t-test for paired samples and the effect size from admission to discharge was calculated with the standardised response mean. : Both measures were responsive to change and tracked improvement in activity participation (APOM) and reduction of burden of care (FIM™+FAM). No significant statistical difference was found between the responsiveness of the two measures however positive changes were reported in each individual patient CONCLUSION: Although both measures are responsive to track change in TBI patients, the APOM includes more specific items that occupational therapists address in rehabilitation. The lack of a measure of physical components in the APOM makes it a difficult to be the only one to use in an environment where there is a high physical burden of care in patients. However, the APOM could be used in conjunction with other impairment-based scales that target physical components. It is recommended that more occupational therapists use the APOM with TBI populations Key words: Activity participation outcome measure, Traumatic Brain Injuries, Acute neurological rehabilitation, responsiveness

Prediction of functional outcome and discharge destination in patients with traumatic brain injury after post-acute rehabilitation.

As the survival rate of traumatic brain injury increases, the burden of care for patients with traumatic brain injury is emerging as a socioeconomic issue and the discharge destination is one of the important outcome measures in the post-acute rehabilitation unit. To investigate the predictors of functional outcome and discharge destination in patients with traumatic brain injury after post-acute rehabilitation. A retrospective review was performed on 86 patients who were admitted to the rehabilitation unit between January 2010 and June 2017. Multiple regression analysis was used as a statistical method to identify the factors affecting Modified Barthel Index and discharge destination. The number of days from traumatic brain injury onset to rehabilitation unit admission (odds ratio = 0.959, P = 0.049), brain surgery for traumatic brain injury management (odds ratio = 0.160, P = 0.021), initial Glasgow Coma Scale score (odds ratio = 1.269, P = 0.022) and Mini-Mental State Examination score at admission (odds ratio = 1.245, P < 0.001) were the predictive factors for higher Modified Barthel Index after rehabilitation. Underlying vascular risk factors (odds ratio = 0.138, P = 0.015), Modified Barthel Index score after rehabilitation (odds ratio = 1.085, P < 0.001) and deductible-free insurance (odds ratio = 0.211, P = 0.032) were the predictive factors of home discharge. The functional outcome of patients with traumatic brain injury after rehabilitation was related to the severity of initial injury, cognitive function at admission and rehabilitation timing. The discharge destination after rehabilitation was related to functional outcome, insurance issues and underlying vascular risk factors.

Inter-professional collaboration reduces the burden of caring for patients with mental illnesses in primary healthcare. A realist evaluation study

Background: The implementation of primary care for mental health is often insufficient, which leaves its mark on staff. A team-based approach of mental healthcare prevents poor staff morale. A community health centre (CHC), therefore, set up a project promoting interprofessional collaboration with a mental health team (MHT).Objectives: This study aimed to understand how an MHT would influence staff morale in a primary care setting, aiming to formulate some recommendations for future projects.Methods: In 2017, interviews and a focus group discussion were conducted among the staff of a CHC. Using a qualitative approach, we aimed to unravel contextual factors and mechanisms that determine the effect of an MHT on staff morale.Results: The project relieved the burden of the patient encounters and staff members felt more valuable to patients. Underlying mechanisms were recognition, altered attitudes towards patients and role clarity. Facilitating factors were intercultural care mediators and a positive team atmosphere, whereas inhibiting factors were inefficient time management and communicative issues.Conclusion: Our study elucidated mechanisms and the contextual factors by which an MHT in general practice improves staff morale.KEY MESSAGESAn MHT improves staff morale in a CHC, through nurturing recognition, through altering staff members' attitudes and through ensuring role clarity.Pitfalls are inefficient time management and poor communication.Policymakers should stimulate interprofessional collaboration in primary mental health.

An Implementation of the Nursing Education APP with Intelligent Question Setting Schemes

The number of clinical nurse is insufficient which causes the nursing manpower in the hospital is short staffed in recent years. However, the burden of patient care did not decrease but increase on the contrary. Therefore, the way to build a small and strong medical team under the existing manpower is to start with the enhancement of basic skills and the strength of nursing education and training. With the increasing application of mobile APP, applying of them to education and training in various professional fields has become more and more popular. In this study, an intelligent learning APP for nursing students is established according to the actual needs of the nursing students and clinical staffs. In addition to the basic nursing education functions, in particular, it provides an intelligent learning situation analysis and exam questions selection model in order to allow users to obtain a more targeted and personalized training environment during the learning process. The experimental results show that the mobile nursing education and learning system established with the APP can promote students’ learning efficiency and outcomes by about 34%, and it also gets a good responses in terms of satisfaction.

Clinician App Tackles Stress of Patient Task Management.

Coordination of patient care is a complex process that requires the collaboration of a diverse team as well as management of critical, often disparate, tasks. Managing these processes puts clinicians and their teams under a lot of stress, often leading to feelings of fatigue and burnout. Designed to assist with the administrative burden of patient care and practice management, Dock Health is a secure collaboration and task management platform. Dock Health was the result of a collaboration between Michael Docktor, MD, a pediatric gastroenterologist and clinical director of innovation at Boston Children's Hospital (BCH), and Keather Roemhildt, a veteran user experience (UX) designer now at Twitter. Ahmed Morsy, Editor-in-Chief of IEEE Pulse, spoke with Michael Docktor (Figure 1) about the potential this platform has to assist with patient management tasks and ease the stress of clinician and administrative burnout.