Paul Abramson MD spoke at the Medicine X Conference 2012 at Stanford, on the topic of integrating self tracking approaches into his medical practice and implications for the larger health care system. The concept of a Quant Coach is introduced as an integral member of a medical team.

1. THE QUANTIFIED DOCTOR
Self Tracking and Medical Care
Paul Abramson MD
My Doctor Medical Group
UCSF Clinical Faculty
@paulabramsonMD

2. “Many of the people who come to my
office .. have come because modern medicine
has failed them in some way, or they have
used up its power to help them and they
know not what else to do”
-- Rachel Naomi Remen, MD

3. BS, MS Electrical Engineering

4. “the last bubble”
MD

5. Rural - Urban - International
Small Practice - Big Practice -
District Hospital - University -
Rural Clinic - Inpatient -
Outpatient

6. WHAT’S WRONG WITH MY OWN
HEALTH?

7. WHAT’S WRONG WITH
HEALTH CARE?
(partial list)
•Conflicts of interest*
•Ineffective for many things
•Lack of interactivity and empowerment
•Poor customer service

8. WHO MIGHT BENEFIT FROM
A SELF-TRACKING PARADIGM?

9. Diagnosed medical
problem not adequately
treated by conventional
paradigm

10. Symptoms or syndromes not
adequately diagnosed by
conventional paradigm

11. Desire to identify environmental,
food, contextual or social
contributors to symptoms

12. Desire for behavior or lifestyle change

13. Or just a desire to be involved
in the process

14. A FEW HIGH-YIELD DIAGNOSES
•Irritable •Psoriasis
Bowel
Syndrome •Addiction
•Chronic Fatigue •Diabetes Mellitus
•Noncardiac Chest Pain •Anxiety
•Depression •Headaches

15. 2007-present
Founded My Doctor Medical Group
in San Francisco

16. THE PROMISE:
GATHER DATA AND BENEFIT FROM FEEDBACK!

17. BUT MOST PEOPLE
CAN’T PULL IT OFF BY THEMSELVES
(AND/OR HAVE A COMPLICATED MEDICAL ISSUE)

18. Doctor Quant Coach
Self-Tracker
Other Team
Members
Patient

19. THE QUANT COACH
•A distinct member of the health care team
•Different skill set from a doctor
•Not burdened by the doctor-patient power
differential

20. SELF TRACKING CULTURE
•Personal narrative
•Iterative process
•Specific problems and terminology

21. SELF TRACKING CULTURE
•Choose appropriate tools
•Reflection on specific incidents
( Reflect - adjust - track )
insights and progress

22. DAVID
50 years old
Engineer
Stoic

23. DAVID
3 month gradual onset
Exertional but intermittent:
Shortness of breath
Chest discomfort
“Palpitations”

24. DAVID
Labs
EKG
Echocardiogram
Hospital admission
Stress echo

25. DAVID
“Everything is normal”
So now what?

26. DAVID
Dietary Sensitivity?
Reflux? Work Stressor?
Arrhythmia?
Environmental trigger?
Poor sleep?
Panic Disorder?

27. Mymee App
Dyspnea Chest Pain Cold
Indoor Air Quality Meter
Palpitations Dyspnea People Food
Sleep EEG

28. Dyspnea

29. But it’s not really about the data

30. But it’s not really about the data
It’s about the process

31. WHERE ARE WE NOW:
BETA TESTING
•Quant coaching in NYC - nonmedical
•Quant coaching in Pittsburgh, PA - nonmedical
•Quant coaching in SF - medically supervised
(My Doctor Medical Group)

32. HOW TO FIX HEALTH CARE?
Top down -- Electronic health exchange, “big data”
analytics, performance measures, Accountable Care
Organizations, Patient Centered Medical Homes, apps for
providers and systems.
Meh.

33. HOW TO FIX HEALTH CARE?
Bottom up -- Self tracking, own your own data,
quant coaching, personal experiments, doctor as
collaborator and consultant. Artful and appropriate
use of technology.

34. CONTACT ME
Paul Abramson MD
My Doctor Medical Group
San Francisco
Tel 415-963-4431
Twitter @paulabramsonmd
ADN @paulabramsonmd
mydoctorsf.com
quantdoctor.com