November Man of the Month: Pablo Graiver

Pablo Graiver

Photo credit: Edu Ferrer

Pablo is the CEO and co-founder of TrialReach, a health tech startup focused on matching patients to clinical trials.

You’ve spent your career in the startup world, and seem to be committed to life as an entrepreneur. What does that say about you?

To want to start from the ground up and create something new, you have to be a little bit fearless. More importantly, you need to have an incredible amount of resilience. Anybody can have an idea but it takes resilience to drive that idea into something that can grow and to navigate all sorts of complications.

You started TrialReach after helping to get Kayak off the ground in Europe. Do you find a lot of similarities between travel searching and trial searching? (more…)

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A Patient at a Press Conference


The following post originally ran on Gray Connections on September 6th.

Earlier today (September 6, 2015) I gave this speech at the International Association for the Study of Lung Cancer (IASLC)  World Conference on Lung Cancer in Denver.  I’m pleased at the reception it received.

I appreciate IASLC including me in this press conference. They’ve been responsive to lung cancer patients and advocates, and have included the patient voice in several conferences. Patients and advocates participated in the planning process for this World Conference on Lung Cancer, as demonstrated by the number of patient and advocate presentation on the program. This is a first among major oncology conferences, and a step forward for engaged patients.

PRC 1As the slide says, I’m alive thanks to research, precision medicine, and other patients. My lung cancer journey is a good example of the importance of research, hope, and engaged patients and advocates. (more…)

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When In Doubt, Ask A Family Member

Val Jones, MD

The post below ran on September 9 on Better Health.

I learned a valuable lesson recently about how difficult it can be to make the correct diagnosis when you see a patient for a very short period of time. In the acute rehab setting I admit patients who are recovering from severe, life-altering brain events such as strokes, head injuries, and complex medical illnesses. It is challenging to know what these patients’ usual mental function was prior to their injuries, and so I rely on my knowledge of neuroanatomy, infectious disease, and pharmacology to guide my work up. However, I have learned that asking the patient’s family members about what they were like (in their healthier state) is extremely important as well. Personality quirks, likes and dislikes, and psychiatric history all offer clues to ongoing behavioral challenges and mental status changes.

This fact was never clearer than when I met an elderly gentleman with a new stroke. He was extremely drowsy, non-participatory, and was not oriented to anything but his name. (more…)

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When Great Healthcare Is Served With A Large Helping Of Unnecessary Mental Anguish

Val Jones, MD

Better Health first ran the post below on August 5.

I watched helplessly as a dear friend went through the emotional meat grinder of a new cancer diagnosis. Her  husband was found to have melanoma on a recent skin biopsy, and she knew that this was a dangerous disease. Because she is exceptionally intelligent and diligent, she set out to optimize his outcome with good information and the best care possible. Without much help from me, she located the finest specialists for her husband, and ultimately he received appropriate and state-of-the-art treatment. But along with his excellent care came substantial (and avoidable) emotional turmoil. The art of medicine was abandoned as the science marched on.

First came the pathology report, detailed and nuanced, but largely uninterpretable for the lay person. She received a copy of it at her request, but without any attempt at translation by her physician. In his view, she shouldn’t be looking at it at all, since it was up to him to decide next steps. She brought the report to me, wondering if I could make heads or tails out of it. Although I am not trained in pathology, I did know enough to be able to translate it, line-by-line, into normal speak. This was of great comfort to her as the ambiguity of prognosis (rather than certainty of metastasis and or mortality, etc.) was clearly outlined for the trained eye. (more…)

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Harnessing Big Data – MedTech Innovation that Segments Patients According to Need

m shepherdA recent interview with Battelle researchers David Giles and Stephanie Kute proves that big data is here to stay. An incredible amount of innovation is happening in the world of medical devices as technology improves, growing increasingly smarter and recording more information about its users. This innovation raises a few new questions: how can we utilize new technology to be most effective, and how can we ensure that private information is kept secure?

Stephanie Kute, platform lead for the Battelle analytics and health research team, spoke to MassDevice about Battelle’s strategies in the rapidly-changing world of big data. “Previously we had a clinical device development group and we had an advanced analytics group, and those were separate groups that would communicate occasionally,” Kute said. “But now, we’ve found, with the changes to big data, the availability of it and what’s being required by the market, it makes more sense to put us together. We now have a formal relationship within the structure of the organization, and medical devices and advanced analytics are coupled. The engineers need to be coupled with the data scientists, the mathematicians, and the statisticians in order to develop innovative products going forward.” (more…)

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What We Want Our Nurse to Know

chelsyI’ve worn a few different hats in the hospital world. I’ve been the scared patient, the frustrated patient in pain in the waiting room, the family member sleeping next to the patient for weeks in the ICU, the visitor who refuses to follow the visiting hours, but I’ve never been the nurse, the doctor, the receptionist, or the orderly. I’ve cried while my nurses held my hand, I’ve yelled at nurses when I’m frustrated, I’ve been given shampoo and access to a shower when I was sleeping next to a hospital bed for months without any belongings, I’ve had procedures and information explained to me when I couldn’t understand what the doctor was saying to me, I’ve been the friend watching my peers go through the rigors of nursing school, I’ve judged nurses for not being warm and comforting, and I’ve seen tears of happiness swell under their eyelids when things get better.

I have so many experiences as a patient or the guest of a patient, but I’ve never been in the shoes of my nurses. I don’t know what it’s like to see people die despite my efforts, to work on my feet for 14 hours, or to be yelled at by a crying family member and stay calm and understanding. There are so many things I wish I could go back and say to the nurses who have changed things for me and my loved ones during these experiences that I wish I had thought to say back then. As patients it’s hard to understand a perspective outside of our own, but here are some things we want you, our nurses, to know. (more…)

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Over-Reliance on Tests: Why Physicians Must Learn to Trust Themselves & Their Patients

Val Jones, MD

The post below ran yesterday on Better Health.

I met my newly admitted patient in the quiet of his private room. He was frail, elderly, and coughing up gobs of green phlegm. His nasal cannula had stepped its way across his cheek during his paroxsysms and was pointed at his right eye. Although the room was uncomfortably warm, he was shivering and asking for more blankets. I could hear his chest rattling across the room.

The young hospitalist dutifully ordered a chest X-Ray (which showed nothing of particular interest) and reported to me that the patient was fine as he was afebrile and his radiology studies were unremarkable. He would stop by and check in on him in the morning.

I shook my head in wonderment. One look at this man and you could tell he was teetering on the verge of sepsis, with a dangerous and rather nasty pneumonia on physical exam, complicated by dehydration. I started antibiotics at once, oxygen via face mask, IV fluids and drew labs to follow his white count and renal function. He perked up nicely as we averted catastrophe overnight. By the time the hospitalist arrived the next day, the patient was looking significantly better. The hospitalist left a note in the EMR about a chest cold and zipped off to see his other new consults. (more…)

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Saving AHRQ: Hope on the Horizon

Whitney Bowman-Zatzkin

You likely felt the ground shake a bit this week when the House Appropriations Committee released its FY16 funding language.

Right there in Section 266 on page 94, the language proposed the termination of the Agency for Healthcare Research and Quality (AHRQ):


With all of the attention lately about the desires in Congress to invest in research to advance the discovery of treatments for diseases – with hearings, news articles, and patients making trips to DC to be in the headlines across the country – this news came as quite a blow to many in the health research arena.

There is hope on the horizon. (more…)

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TBT: Amplifying the Voices of Patients

DLN_HeadshotThis post originally ran back on June 26, 2013 but its message is still extremely important today…patient voices should be at the forefront when it comes to improving our health care system.

Big changes are taking place in our health care system – and it’s about time.  While some innovations have been occurring in limited areas around the country, the Affordable Care Act (ACA) is making bigger, bolder transformation of the health care system more of a reality.  It is altering the way health services are delivered, changing the way we pay for care, and beginning to reward high-quality care rather than a high volume of services.

The new Center for Medicare and Medicaid Innovation is testing new care models like Patient Centered Medical Homes, Accountable Care Organizations, and the Comprehensive Primary Care Initiative to encourage better care coordination for patients and reward high quality services. That’s especially important for women, who not only use health care services themselves, but also tend to be caregivers for children and older relatives. (more…)

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A Call to Consumers to Lead the Shift in Healthcare

Sharon TerryRecently Sharon Terry a Disruptive Woman and CEO of the Genetic Alliance joined Mendelspod to kick off their new series, Personalized Medicine and the Consumerization of Healthcare. Over the last twenty years Sharon has worked tirelessly as a patient advocate, advocating for the sharing of patient data long before others were doing so.

Here what Sharon had to say on the topic here.

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Why Patient Autonomy Is Critical To Good Health Care

Val Jones, MD

The post below originally ran on Better Health on February 24th.

Many of the patients that I treat have brain injuries. Whether caused by a stroke, car accident, fall, or drug overdose, their rehab course has taught me one thing: nobody likes to be forced to do things against their will. Even the most devastated brains seem to remain dimly aware of their loss of independence and buck against it. Sadly, the hospital environment is designed for staff convenience, not patient autonomy.

In the course of one of my recent days, I witnessed a few patient-staff exchanges that sent me a clear message. First was a young man with a severe brain injury who was admitted from an outside hospital. EMS had placed him in a straight jacket to control his behavior on his trip and by the time I met him, he was in a total panic. Sweating, thrashing, at risk for self harm. He didn’t have the ability to understand fully what was happening but one thing he knew – he was being restrained against his will. The staff rushed to give him a large dose of intramuscular Ativan, but I had a feeling that he would calm down naturally if we got him into a quiet room with dim lights and a mattress with wall padding set up on the floor. (more…)

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  • January 13th, 2015 Filming in the ER: A Policymaker Perspective
    By Glenna Crooks
  • Healthcare’s Renewable Resource: Authentic Patient Experience


    Cancer is my medical degree. Navigating my way through three distinct cancer diagnoses across three unique stages of life and managing three different treatment paths is my specialty. In the course of enduring Hodgkin’s Lymphoma at age 17, melanoma at 38 and, in 2012, breast cancer at 46, I’ve amassed firsthand expertise in the critical areas of patient-provider communications, care coordination, patient safety, insurance reconciliation, disease prevention, and personalized treatment planning.

    From the time of my first cancer diagnosis over 30 years ago to today, cancer has influenced my life and risk of future disease. To put my experience in perspective, the collective time I spent in the throes of surgery, recovery and treatment of my two most significant diagnoses – Hodgkin’s lymphoma and breast cancer –totals twelve months. So, I have spent only 1/30th of my cancer experience fully immersed in the healthcare system. (more…)

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    The Day I Made Peace with an Errant Organ

    c Here’s my theory: few health crises in life are as traumatic as surviving a cardiac event. I developed this theory while I was busy having my own heart attack in the spring of 2008.

    For starters, heart attack symptoms often come out of the blue (in fact, almost two-thirds of women who die of coronary heart disease have no previous symptoms. Having a heart attack can feel so unimaginably terrifying that almost all of us try desperately to dismiss or deny cardiac symptoms. And according to a 2013 report published in Global Heart, the journal of the World Heart Federation, women are twice as likely to die within one year even if they do survive a heart attack compared to our male counterparts.

    So if – and each of these is still, sadly, a great big fat IF for too many women – we survive the actual cardiac event, and if we are near a hospital that’s able to provide an experienced team of cardiologists/cardiovascular surgeons/cardiac nurses, and if we are correctly diagnosed, and if we receive timely and appropriate treatment, and if the resulting damage to our oxygen-deprived heart muscle is not too severe, we get to finally go home, safe and sound.

    And that’s where the real trauma starts.   (more…)

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    Has Patient-Centered Health Care Run Amok?

    Trudy-Lieberman -- biggerBeginning with the Institute of Medicine’s (IOM) landmark Quality Chasm report in the late 1990s, the health policy establishment, the medical profession and the American public began to hear a new and disconcerting message: American health care was not patient-centered.

    The IOM prescribed a number of recommendations to redesign health care delivery, one calling for patients as the source of control over their care. “Patients should be given the necessary information and the opportunity to exercise the degree of control they choose over health care decisions that affect them,” the IOM recommended, noting that patients should have access to their medical (more…)

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