Ooo. Yes, I have a high blood. Stage two.
Each Humanwide participant was outfitted with four digital health devices that we
ended up tracking through their electronic health record.The pedometer
can be very helpful for the healthcare team to be able to support a particular
patient's exercise related goals.The digital scale gives immediate feedback
to patients and the healthcare team on lifestyle changes and it also attracts
improvement in the body mass index. Having a home blood pressure cuff can
provide a more accurate representation of blood pressure control, giving
opportunity for early detection and intervention, whether it's lifestyle
changes or medication. When we know our own body's response to different types
of food we're able to make healthier choices in our diet and the healthcare
team can engage with us to manage our diabetes risk. These devices are
important because clinicians now can tailor the care according to a
patient's individual physiology in a way that they haven't been able to do before.
This is the photograph of my dad's family side.This is my grandmother, she
died at the age of 90, however her husband, he died at the age of 60 with
heart attack. My Auntie Baby she died at the age of 80 with heart attack. My Uncle
Nonoy he died at the age of somewhere in the 60s range as well of heart attack.
My uncle Toto, he also died of basically complications of diabetes.
Uncle Boi, he died of lung cancer. And then my dad, I don't think my dad reached
age 60. I think he died probably at the age of late 50s. He died of basically
complications of diabetes. The youngest one, my Auntie Nanette, she
also has diabetes and heart condition problems, so that's how they died. My
brother, my sister, right, they all have high triglycerides just like me.
My brother's higher, like six hundreds. I'm like in the 400s. I think my sister's,
like in the 300s. My cousins on my father side also have high
triglycerides like most of my cousins do. Humanwide is a pilot that we are
conducting in a primary care clinic in Santa Clara. We at that clinic have also
implemented a team-based care model which we think is going to help us
transform what we're doing in primary care. The focus of Humanwide is to
consider how can we leverage the best of the art and science of medicine that we
have at Stanford and across the country in the world -- technology, genomics,
diagnostics -- how do we leverage that so that we are focusing on prevention and
proactive care to prevent disease before it strikes.
How are you? Very good, thank you. Great. I just ask that we recheck your blood
pressure before you go, okay? All right.
Okay, let's compare. See I'm normal. So you haven't had problems at home
previously? No, what I realized is all my readings are like high, every one at home
Most of my readings at home is high. Okay. Yeah. Wow.
Just a matter of minutes. The conclusion is that both numbers are giving us a
little bit high values and so it's just something for us to just pay attention
to regardless. I'm not sure how high it is but it's on the higher side. As I
mentioned before, I used to eat more salt in my diet, junk foods etc and now I eat
less junk foods. But, I don't know maybe it's just my body right?
I never had blood pressure problems before. Yet the blood pressure has gone
up. So, even at the office visit here, using our cuff, so it's
not just your blood pressure cuff. There is a risk of cardiovascular disease with
high triglycerides unfortunately. Right. But as you understand we're not really
clear on how to treat it beyond lifestyle. We're starting to eat healthier right.
There's Filipino foods that are not healthy but there's also a
lot of Filipino dishes that are healthy. My family you know we have like bad
genes right? Most of my family have heart stroke. Ours on the young age already
have like triglycerides, high blood cholesterol, so that's why it motivates
me to eat healthy you know. While my auntie's here my mom is also recovering
from surgery so we try to eat healthy food. At least starting to.
My goodness you look amazing! Really? Yes, you lost 10 pounds since April. Where are we, we’re in the middle of --
end of May? I don't even know what the date is. Maybe it's because of working too much.
Are you working. Yeah. Are you exercising more and everything? Eating healthier. I know.
Exercising, probably the same as last time.
I got 132 over 92. But at least not that high, right? It's borderline. My feeling is
if you continue to lose weight watch your salt and get some
exercise, then we're going to see the trend go down. If not and you're still
kind of hovering at this borderline, then I'm tempted to put you on a medication. That's where I am, that's what
I'm thinking. Right? So let's monitor your blood pressure if you can do it for me.
Is it crazy to do that like twice a week? That's doable. Met with him. Still high. Pressure's
132 over 92 but had lost 10 pounds since April which is great. But he had
changed his diet. Under a lot of stress, not sleeping. I told him to
come back in a month prior to him leaving. I’ll probably put him on some hydrochlorothiazide.
He's still running hot. Because this is a new diagnosis for him, yeah.
And he’s prediabetic, we’ve got the family history so I’m like we need to…it's time.
Welcome everyone to the clinical advisory meeting. I'll just
present a case that hopefully will tee up the second section of our
discussion on digital health. So this is a 43 year-old Filipino man with multiple
cardiovascular risk factors including high triglycerides and multiple male
family members who have severe coronary artery disease. And in the Humanwide
ambulatory blood pressure cuff, the one that he just got through the pilot,
detected intermittent high blood pressures that were 145 to 160 over 90 or over 100.
However in clinic he always had normal blood pressures, it was interesting we
weren't able to find one single elevated blood pressure in
his in office measurements but later this was verified with a more formal
24-hour ambulatory blood pressure assessment
and and then that helped us diagnose masked hypertension which then obviously
address his concern which was primarily around his own risk for cardiovascular
disease given his family history. So that gives you a sense of maybe some of
the benefits of the digital health component.
This study opens a lot of new thinking right in terms of approach as to how you
detect problems. I like the fact that they're doing it systematically, not just
guessing. What motivates me about this program is I see the results real time.
That keeps me motivated in terms of improving my health and my lifestyle.
I want to be able to see my granddaughters. And them
also see a granddad.