Podcasts about cincinnati department

Hereditary angioedema (HAE) is a rare condition often due to reduced levels C1-inhibitor, which is a protein involved in various physiological processes in plasma, most notably with the complement system. C1-inhibitor also binds and inhibits plasma kallikrein and factor XIa, thereby affecting bradykinin production. It is believed that the disruptions of these processes cause fluid to leak from the blood to connective tissue, leading to HAE attacks. Owing to its rarity, HAE is often poorly recognized, leading to misdiagnoses and significant diagnostic delays. Being aware of the early signs and symptoms of this condition can lead to faster diagnosis and the use of effective therapies.This program is supported by independent medical education grants from Takeda. To earn CME credit please visit https://checkrare.com/learning/p-consider-rare-suspecting-and-diagnosing-hereditary-angioedema/lessons/consider-rare-suspecting-and-diagnosing-hereditary-angioedema-module/  Target AudienceThis activity has been designed to meet the educational needs of physicians specializing in primary care, pediatrics, emergency care, otolaryngology, gastroenterology, and dermatology .Other members of the care team may also participate.Learning ObjectivesAfter participating in the activity, learners should be better able to:- Describe the early symptoms of HAE and its clinical relevance.- Apply best practices to diagnose HAE more efficiently to reduce diagnostic delays. Faculty Jonathan A Bernstein, MDProfessor of MedicineUniversity of Cincinnati Department of Internal MedicineDivision of Immunology, Allergy SectionPartner Advanced Allergy Services, LLCPartner Bernstein Clinical Research Center Disclosure StatementAccording to the disclosure policy of the Academy, all faculty, planning committee members, editors, managers and other individuals who are in a position to control content are required to disclose any relationships with any ineligible company(ies). The existence of these relationships is not viewed as implying bias or decreasing the value of the activity. Clinical content has been reviewed for fair balance and scientific objectivity, and all of the relevant financial relationships listed for these individuals have been mitigated.Disclosure of relevant financial relationships are as follows:Dr. Bernstein discloses the following relevant financial relationships with ineligible companies:Advisory Board Consultant: Takeda/Shire, CSL Behring, KalVista, Pharming, Biocryst, Ionis, Intellia, Pharvaris, Astria and BiomarinGrant/Research Support: Takeda/Shire, CSL Behring, KalVista, Pharming, Biocryst, Ionis, Intellia, Pharvaris, Astria and BiomariSpeaker's Bureau: PharmingPlanners for this activity have no relevant financial relationships with any ineligible companies.This activity will review off-label or investigational information.The opinions expressed in this educational activity are those of the faculty, and do not represent those of the Academy or CheckRare CE. This activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically, and draw conclusions only after careful consideration of all available scientific information.Accreditation and Credit DesignationIn support of improving patient care, this activity has been planned and implemented by American Academy of CME, Inc. and CheckRare CE. American Academy of CME, Inc. is Jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.PhysiciansAmerican Academy of CME, Inc., designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other HCPsOther members of the care team will receive a certificate of participation.There are no fees to participate in the activity. Participants must review the activity information including the learning objectives and disclosure statements, as well as the content of the activity. To receive CME credit for your participation, please complete the pre and post-program assessments. Your certificate will be emailed to you within 30 days.ContactFor any questions, please contact: CEServices@academycme.orgCopyright© 2025. This CME-certified activity is held as copyrighted © by American Academy of CME and CheckRare CE. Through this notice, the Academy and CheckRare CE grant permission of its use for educational purposes only. These materials may not be used, in whole or in part, for any commercial purposes without prior permission in writing from the copyright owner(s).

In this 283rd episode I introduce a new podcast from University of Cincinnati Department of Anesthesiology hosted by Dr. John Crowe. This episode is about Primate Anesthesia and John interviews one of his colleagues who does some anesthesia for primates at the local zoo. I think they're doing great work on this podcast and look forward to more episodes to come!Our Sponsors:* Check out Neurohacker: neurohacker.com/ACCRACAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

In this episode, hosts Drs. Peter Lu and Temara Hajjat talk to Dr. Ajay Kaul about the evaluation and management of children with esophageal achalasia and esophageal motility disorders.  We review the diagnostic tools available to evaluate esophageal motility including functional luminal impedance planimetry (FLIP), compare the treatment options available to children with esophageal achalasia, and discuss the importance of multicenter pediatric research.  Dr. Kaul is the Director of the Neurogastroenterology and Motility Disorders Center at Cincinnati Children's and Professor in the University of Cincinnati Department of Pediatrics. Register and submit abstracts for the 2nd World Congress on Pediatric Neurogastroenterology and Motility (PNM2023) here at the congress website!Article with video showing peroral endoscopic myotomy (POEM) from VideoGIE.This episode is eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!Learning Objectives:Understand the role of endoscopy, contrast imaging, high resolution esophageal manometry, and functional luminal impedance planimetry (FLIP) in the evaluation of a child with esophageal dysphagia.Recognize the specific abnormalities in esophageal motility present in the various subtypes of esophageal achalasia.Understand the treatments available for children with esophageal achalasia, including pneumatic balloon dilation, laparoscopic Heller myotomy, and peroral endoscopy myotomy (POEM).Produced by: Peter LuSupport the showAs always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes!

Ishita Basu, PhD, assistant professor at the University of Cincinnati Department of Neurosurgery, discusses her research investigating deep brain stimulation as a promising treatment for psychiatric disorders and other conditions.

This episode features two guests from the Eating Recovery Center (ERC), Dr. Elizabeth Wassenaar, MS, MD, CEDS the Denver regional medical director and Meredith Nisbet, MS, LMFT, CEDS licensed therapist and member of the ERC Clinical Response Team. We talk about what eating disorders are, how they present themselves, and how treatment at the Eating Recover Center can help. We also break down some myths regarding eating disorders and treatment, including discussions on body neutrality vs. body acceptance, body diversity, defining "health", using a Health At Every Size approach to care, and so much more! This episode is packed with helpful information whether you have experienced an eating disorder yourself or not ... learning about these conditions and how to seek proper treatment is life saving so I encourage you all to listen! For more information please use the resources mentioned in the podcast, below: eatingrecovery.com Call the clinical response team for a free conversation about services and help: 303-825-8595 If you liked this episode, you can also check out another fantastic episode on Health At Every Size with Meredith Nisbet on Mental Note Podcast, a show sponsored by Eating Recovery Center & Pathlight Mood & Anxiety Center. Formal Bio's Below: Dr. Elizabeth Wassenaar comes to Pathlight following her role as Medical Director at Eating Recovery Center (ERC), Denver. Prior to joining ERC, Dr. Wassenaar served as a staff psychiatrist and medical director at the Lindner Center of Hope with emphasis on Child and Adolescent outpatient medication management and therapy. She is Board Certified in Psychiatry and Neurology, Child and Adolescent Psychiatry and Obesity Medicine. Dr. Wassenaar has completed advanced training in: Child and Adolescent Psychotherapy Program, Cincinnati Psychoanalytic Institute Family Based Therapy (FBT) Training, University of California San Diego Eating Disorders Treatment and Research Center Motivational Interviewing for Obesity in the Primary Care Setting, DuPont/Nemours Children's Hospital System Dr. Wassenaar is a Clinical Instructor at University of Colorado Anschutz Medical Campus and served as Assistant Professor at the University of Cincinnati Department of Psychiatry and Adjunct Assistant Professor Cincinnati Children's Hospital Medical Center prior to relocating to Denver. In addition to her clinical practice she is an avid researcher and academic writer in the area of eating disorders. Meredith Nisbet, MS, LMFT, CEDS is a Licensed Marriage and Family Therapist and member of the Clinical Response Team with Eating Recovery Center and Pathlight Mood & Anxiety Center, where she enjoys engaging with patients, families, and providers seeking admission nationwide. In addition to her work for ERC and Pathlight and in her private practice, Meredith also provides education and training on weight stigma and Health At Every Size-informed care around the country. Meredith earned her bachelor's degree from the University of North Carolina at Chapel Hill and her master's degree in Marriage and Family Therapy from East Carolina University; she recently received accreditation as a Certified Eating Disorder Specialist through IAEDP. Meredith resides in Raleigh, North Carolina where she spends her free time listening to true crime podcasts, practicing hot yoga, and snuggling with her dog, Mac.

Dr. Kalyani Marathe is an Associate Professor at the University of Cincinnati Department of Pediatrics. After being inspired by her physician father, she pursued science in college where she took pre-med courses while majoring in English. Her research is focused on pediatric vulvar disease and she recently started a vulvar clinic with a pediatric and adolescent gynecologist at Cincinnati Children's Hospital. Get to know more about Dr. Marathe and how her patients have shaped her views of the diseases she treats. Listen to the very end to discover her very special hidden talent!

Dr. Kalyani Marathe is an Associate Professor at the University of Cincinnati Department of Pediatrics. After being inspired by her physician father, she pursued science in college where she took pre-med courses while majoring in English. Her research is focused on pediatric vulvar disease and she recently started a vulvar clinic with a pediatric and adolescent gynecologist at Cincinnati Children's Hospital. Get to know more about Dr. Marathe and how her patients have shaped her views of the diseases she treats. Listen to the very end to discover her very special hidden talent!

When a practice has an efficient processes in-office practice is streamlined, then you ready to embark to see patients with telemedicine. The COVID-19 pandemic is the catalyst for growth in telemedicine. Dr. Michael Greiwe, M.D. practicing orthopaedic surgeon with OrthoCincy and the founder of the OrthoLive and SpringHealthLive telemedicine platforms is my guest on this episode of Practice Management Nuggets For Your Healthcare Practice! He’s going to share with us how to increase you practice revenue, efficiency and patient satisfaction with telemedicine. Meet Dr. Michael Greiwe Michael Greiwe, M.D., is a surgeon by day and tech guru by night. He is a practicing orthopaedic surgeon with OrthoCincy, near Cincinnati, Ohio, and the founder of the OrthoLive and SpringHealthLive telemedicine platforms. The platforms allow medical practices to deliver telemedicine visits through real-time HIPAA compliant video conferencing between provider and patient - increasing practice revenue, efficiency and patient satisfaction. Dr. Greiwe is a nationally recognized expert on how telemedicine technology is changing the practice of medicine. TV news stations and podcasts across America have interviewed him about the future of telemedicine, and how to use it to improve the patient experience. He attended the University of Notre Dame, where he won the prestigious Knute Rockne Award for excellence in academics and athletics. He completed his orthopaedic surgery training at the University of Cincinnati Department of Orthopaedic Surgery and Sports Medicine. In 2010, Dr. Greiwe completed his fellowship in shoulder, elbow and sports medicine at Columbia University, training with the head team physician for the New York Yankees, Dr. Christopher Ahmad. To find more, see OrthoLive https://www.ortholive.com and SpringHealthLive https://SpringHealthLive.com.  Show Notes Publish Sept 22, 2020 00:45  Introduction Dr. Michael Greiwe 02:42  “Telemedicine is the next tool that is going to make the job easier for physicians and better for patients.” Dr. Mike Greiwe 05:14  What is Telehealth 08:53  OrthoLive Available on the App Store readily available to providers and patients 10:22 Digital Health Misconception that patients don’t want to use telehealth 11:07  “90% of Patients Prefer Telemedicine over in-office visits.” 11:54  When Is A Practice Ready To Implement Telehealth? 14:54  Processes is the way to run your practice efficiently 15:39  Future trends in telehealth 17:27  Confidence Growing with Telemedicine 18:27  Patient Access is the Beauty and the Power of Telemedicine 19:18  Lessons Learned From 500,000 Telehealth Visits – Top 3 19:45  1. Band Leader 20:10  2. Understanding Where The Low Hanging Fruit Is 20:56  3. Technology Platform Super Easy for Patient Access and Efficient for Providers 22:38  Opportunities in Canada Key word Searchie https://PracticeManagementNuggets.Live/search  

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dr. Michael Greiwe on the show to discuss telemedicine.  Dr. Michael Greiwe is a practicing orthopaedic surgeon with OrthoCincy, near Cincinnati, Ohio, and the founder of the OrthoLive and SpringHealthLive telemedicine platforms. The platforms allow medical practices to deliver telemedicine visits through real-time HIPAA compliant video conferencing between provider and patient increasing practice revenue, efficiency and patient satisfaction. In this episode, we discuss: -The benefits of telemedicine for both the patient and provider -Choosing the right telemedicine platform for your practice -How to meet patient privacy and compliance requirements -Practical tips for a seamless telehealth visit -And so much more!   Resources: Ortho Live Website Michael Greiwe LinkedIn Michael Greiwe Twitter Email: mikegreiwe@ortholive.com   A big thank you to Net Health for sponsoring this episode!  Learn more about the Redoc Patient Portal here.    For more information on Dr. Greiwe: Dr. Michael Greiwe, M.D., is a surgeon by day and tech guru by night. He is a practicing orthopaedic surgeon with OrthoCincy, near Cincinnati, Ohio, and the founder of the OrthoLive and SpringHealthLive telemedicine platforms. The platforms allow medical practices to deliver telemedicine visits through real-time HIPAA compliant video conferencing between provider and patient increasing practice revenue, efficiency and patient satisfaction. Dr. Greiwe is a nationally recognized expert on how telemedicine technology is changing the practice of medicine. TV news stations and podcasts across America have interviewed him about the future of telemedicine and how to use it to improve the patient experience. He attended the University of Notre Dame, where he won the prestigious Knute Rockne Award for excellence in academics and athletics. He completed his Founder and CEO of OrthoLive orthopaedic surgery training at the University of Cincinnati Department of and SpringHealthLive Orthopaedic Surgery and Sports Medicine. In 2010, Dr. Greiwe completed his fellowship in shoulder, elbow and sports medicine at Columbia University, training with the head team physician for the New York Yankees, Dr. Christopher Ahmad.   Read the full transcript below: Karen Litzy (00:01): Hey Dr. Greiwe, welcome to the podcast. I am so happy to have you on today to talk all about telemedicine. Michael Greiwe (00:08): Oh, thanks so much, Karen. I'm glad to be here. I really appreciate you having me on the show. Karen Litzy (00:11): Yeah. So for any of the long time listeners of this podcast, you know that back in March and April, when the covid pandemic hit, we talked a lot about tele-health. But I think it's great to sort of revisit that now that we're a couple of months in and perhaps more people are using telehealth at this time, then were back then. But what I want to know is Dr. Greiwe, did you just start using telehealth when the pandemic hit or were you more of an early adopter? Michael Greiwe (00:42): Yeah, thanks for the question. I kind of carrying out with sort of like an early adopter. You know, I started using telemedicine back when it really wasn't cool, I guess. It was like back in the 2016 time period. And I knew it was great for my patients cause they live pretty far away. I had patients that live like two or three hours away and they would drive and try to meet me. And then you know, I'd only see them for 15 minutes. I felt really bad about that. So I started using telemedicine and it's been a great thing for my practice. And then of course, you know, recent things changed everything and it's now exploded. Karen Litzy (01:16): Right. And like I said, in your bio is that you're an orthopedic surgeon. So one question that I think is probably good that you probably get asked all the time is how in the heck do you see someone for an orthopedic condition when you can't put your hands on them and kind of feel what's going on? Michael Greiwe (01:37): Yeah, that's a great question. I get it all the time. And it's one of those things where, you know, for me, and I'm sure for you as a physical therapist, you know, so much when you hear about the history of that patient. So like the history gives you probably 80 to 90% of what you need. And then the rest is sort of verifying things through, you know, a physical exam and there's certain things on video that you can kind of catch. So like if I have somebody with the rotator cuff problem, I can watch their arm move. And I just know that the rotator cuff is bothering them. And then I'll maybe order like an MRI or something along those lines sort of confirm. But ultimately for me, it's more about like, you know, I may have to see this patient in the office at a certain point in time, but I don't always have to do that. It's kind of like depends on what the history gives me. Karen Litzy (02:22): Yeah. And I agreed from a physical therapy standpoint. I get that question all the time is, well, how can you do physical therapy on someone if you can't, if you're not in the same room. And again, it comes down to listening to the patient. Like they will tell you everything you need to help treat them to help diagnose them. If you just listen in the beginning and then you can tailor your program accordingly. Now of course, like you said, there are times where you have to see the person in person, right. And sometimes that's the same with PT. So I think oftentimes when people think about tele-health, they just paint with a very broad stroke and they think, well, how can you do that? So what do you say to people who sort of have that mentality of all or nothing? Michael Greiwe (03:13): Yeah. I think if they experience it for their, you know, themselves, they can sort of see that, okay. You know, this really works and it works because, you know, if you have somebody on the other side that's engaging you and asking the right questions, you're going to eventually come to the right answer. You know, I've had patients with a frozen shoulder and I'm sure you've treated patients with frozen shoulder. It sort of have classic signs and symptoms. Sometimes the history isn't like exactly, they're just sort of out, well, you know, my shoulder has been hurting and it kind of came on over the last several months and now I can't really move my arm as well as I used to. Or maybe you might not hear that. You just hear like, well, it hurts all over all the time, but if you kind of ask some leading questions, you have the right examiner, you can find out the answer. And so I think that's really, the key is having the right person on the other side of the screen, you know, asking the right questions. I'm sure you do the same in your practice with physical therapy. Karen Litzy (04:06): Yeah, absolutely. And you know, when we're talking about our different practices and our businesses because of the COVID pandemic, a lot of places had to shut down there in person I'm in New York city. So talk about being shut down. So we were shut down quite early. Now other parts of the country are flaring up and there's a lot of uncertainty here. So when it comes to tele-health and our business, how can tele-health help our practices grow and help our businesses grow? Michael Greiwe (04:41): That's a great question. I think it's something that people are sort of finding out more and more about right now. I mean, there's so many ways to be able to utilize telemedicine in our practices to help it grow. I mean, first of all right now as an orthopedic surgeon, I see patients from around my area because of COVID in the situation we're in right now, they don't want to come into the office, you know, so they're looking online and they find, Oh, Dr. Greiwe has got an open slot to be able to be seen via telemedicine. So we're kind of advertising that at ortho Cinc, where I practice to say, Hey, anybody that might want to come in for telemedicine appointment, you can. And it just gives me access a lot better than it normally would to be able to see patients. And then I think there's other ways too. Michael Greiwe (05:25): So for instance you know, for physical therapists, you might work with employers for instance, or workplaces that need a physical therapist and you put like an iPad there to say, if you need a physical therapist, here's how I can help you, you know, call me or whatever through this device. And so there's just so many ways for us to do that inside ortho, specifically postoperative recheck appointments, they open up slots of time that, you know, you typically wouldn't have because it's a lot more efficient to see someone via telemedicine than it is in person. And you know, also there's a lot of downtime kind of between surgeries for us too, so that downtime can be utilized for telemedicine too. So there's a lot of ways we can sort of generate you know, revenue through that and kind of open up our practice a little bit more. Karen Litzy (06:13): And, what I found is I can actually help more people. Michael Greiwe (06:17): Oh yeah, absolutely. Because you could probably have group visits too. Right. You could have you know, on those group visits or are you talking about just sort of more you know, area? Yeah. Karen Litzy (06:29): Like you were saying before we went on is sometimes you have people have to drive two to three hours to see you. Right. You know, that's really, that can be really difficult. So imagine if you have, you know, this really aching shoulder pain and you have to drive two hours. Michael Greiwe (06:45): Right. Absolutely. You're absolutely right. I think what helps, what helps you is, you know, with telemedicine, you've got the reach to be able to see somebody that's five hours away or even across the country that's heard about you or, you know, maybe they know that you have certain techniques that they like. I sort of developed like a posterior shoulder replacement where it's kind of a muscle sparing approach to the shoulder. And so I have people come from like California, Texas, Montana, you know, and now I can kind of see them postoperatively and preoperatively with telemedicine. So it's a really nice, it's a nice tool from that standpoint too. Karen Litzy (07:19): Yeah. That's great. Yeah. So you could see them preoperatively, if they're across the country, they come in, you do the surgery and then you can then see them postoperative. So they don't have to stick around by you for six weeks. Michael Greiwe (07:33): Right. So I'll have him stay for the first week and then we'll have the incision to make sure everything's looking good. Take x-rays and then they'll go back home and then I'll check in with them every four or five weeks, they'll be doing physical therapy kind of in their local area. Or of course I could refer them to you to remote therapy, but yeah. So that's how they do it currently is they go back home, they work and they get their motion back. And then we'll check in again, virtual. Karen Litzy (07:57): Now how about prescribing medications? Is that something that you can do via tele? How does that work? Michael Greiwe (08:03): Yeah, it still works pretty well via telemedicine, but I don't really do any like schedule three narcotics, you know, things like that. We don't do, but you know, anti-inflammatories, you know you know, if somebody has had some nausea like Zofran or, you know, things of that nature are pretty easy to prescribe and we still prescribe and have the same prescribing practice that we do in person, it's just, I get a little bit more wary and I think it's prudent to be more wary about, you know, narcotic prescriptions and things like that, especially in the world that we live in right now. We've gotta be very careful about that. So, we're super careful with that, but I think most of the other prescriptions are totally they're okay to do. Karen Litzy (08:46): And how about this is a question that I get sometimes is what about privacy and compliance and making sure that meeting all those standards. So how can we ensure that we're doing that as a healthcare practitioner on tele-health? Michael Greiwe (09:04): That's a great question. I think, you know, it is very important, obviously. So HIPAA compliance is what it's sort of called as you know, and it's what everybody's sort of, doesn't like to have to worry about, but it's very important for our patients, right? I mean, it's, people are very much in tune with their privacy. Data privacy is becoming like a really big thing right now, but really people's healthcare privacy and their you know, their medical privacy is very, very important. So the telehealth platform that you choose, you have to make sure that that is HIPAA compliant. And that means end to end encryption. That means like the data that starts out, you know, it's carried through the internet and it's encrypted and then wherever it's housed, it's also encrypted there too, so that no one can sort of get to that information. I think that's really critical, very important for our patients and most of the platforms they will advertise whether or not they're HIPAA compliant. And you want to know kind of how many you know, what type of bit encryption they are and things like that when you look at platforms. Karen Litzy (10:06): What was that last thing you said? Michael Greiwe (10:09): Yeah, it's sort of like, as the information is traveling across the internet there's sort of, you know, bytes of information, right? And so the amount of encryption can be sort of leveled up so that, you know, basically you can have like 64 bit encryption, or you could have 264 bit encryption there's certain levels. And so it takes, it's like a string of numbers. And so that string of numbers is how much it would take to crack the code essentially. So 256 bit encryption is like, you know, a massive amount of code breaking has to happen to catch that while it's traveling through, you know, the inner web. Karen Litzy (10:50): Well, no, that's really good because I think that's something that if people are choosing a platform, it's definitely something that as a provider you want to be looking at. Michael Greiwe (11:00): Absolutely. It's very important, you know, and most providers are pretty in tune with that, but right now, like, you know, they're allowing telemedicine to occur on FaceTime and some other platforms. Karen Litzy (11:12): Now FaceTime is not HIPAA compliant. Michael Greiwe (11:17): Yeah. So we don't want to really be using that right now. And there are some providers out there that are doing it, maybe just for ease of use and because the pandemic it's happened. But ultimately what we really need to make sure is that we don't use those platforms. Those platforms are not safe, not secure. Karen Litzy (11:35): Are there any other sort of things that you want to watch out for when you're let's say, well, first we'll start with looking at different tele-health platforms. So what are the things that you want to be looking for? And if you have any advice on a do's and don'ts, while you're actually in your tele-health session, I know some of them seem like, should be common sense, but you never know. So let's go with, what should you look at first? What should you be looking at in your telehealth platform? Michael Greiwe (12:11): It's a great question. I think the first thing that's really important for patients is making sure that, you know, the HIPAA compliance there, we covered that, right? So HIPAA compliance, probably number one, number two is, does this platform allow you to, you know, keep a schedule? So one of the most frustrating things as a provider of telemedicine is, and this is what I found out many, many years ago is that there is no schedule. You know, you have to send the invitation to the patient. The patient sort of says, yes, I'd like to do this. And then, you know, they link up eventually, but what you really want us to be able to schedule the appointments, that way you can move from one person to the next, and you're not really leaving a screen and trying to come back and forth just from an efficiency standpoint. Michael Greiwe (12:53): It's not very efficient to do that. Another thing that's important, I think is being able to chat with your patient. Sometimes it's important to be able to have a conversation. And it's also important to answer questions. And so being able to have kind of a text based chat that's secure as well, that might be, you know, maybe they can send you a picture. Maybe you can send them a video. Maybe you can send them sort of a document that gives them some exercises or what have you. And that's really important too. But I think one of the other things I was gonna mention is consenting. A lot of platforms don't have consent and of course that's part of the law. You have to consent that patient for telemedicine before you have a visit in most of the States, I think 45 of the States, you have to have a consent. So very important for the consent process to happen also. And that allows you to have a legal telemedicine appointment. Karen Litzy (13:44): And that consent process. Can that be in your initial paperwork? So if you're onboarding someone and, you have, I mean, we've all been to the doctor's office, you have to fill out a million different forms, right? So same thing with PT. So can that consent to tele-health be in that onboarding or does it have to be every time you connect for a telehealth visit, do they have to consent every single time? Michael Greiwe (14:11): That's a great question. And it's really just a onetime consent, so it doesn't have to be, you know, every time. So if they just come to your office first time, you're going to maybe have him sign some paperwork that says consent to telemedicine, and that's fine. You're good to go. But in the case where you have a new patient, it's very important to make sure that you have that consent process. And so for us and what we do at ortho live and spring health live, we just have them sign off one time that they agree to telemedicine. And then we assume every time they visit the platform, they know what they're doing and they've already agreed to it. Karen Litzy (14:44): Yeah. Yeah. Cause I have woo. You just gave me a little sigh of relief cause I have it again as part of my onboarding paperwork that people are consenting to their telehealth visits, but I don't do it every single time for each visit. Michael Greiwe (15:00): Right. Then I think it's just sorta like the billing practices in your practice too. And that people sign off that they're okay with billing and that they just do it once they're not signing it every time that they come back, it applies similarly to telemedicine. Karen Litzy (15:12): Got it. Got it. Okay. So those are the things you want to look at when you're kind of shopping around for a platform. Now let's talk about some things that you want to have in mind as the healthcare practitioner during your telehealth visit with your patient on the other end. Michael Greiwe (15:30): Yeah. It's a really good question. So the first thing is if you're going to use a phone, you know, and sometimes you're using a phone because you might be on the go or maybe your platform only allows you to have a phone it's really important to make sure that you don't like hold the phone, like right underneath your nose. Because it sort of gives you like kind of the up the nose shot a little bit. So I always tell people, you know, prop your phone up in front of you, like on your keyboard, maybe that's a really good place for it. Or if you're using a laptop, obviously like your face is kind of directly in front of that camera. And it just gives you more of a conversational type of appearance to your patient rather than you're not like talking straight down to them. Michael Greiwe (16:06): I think that's important. The other thing to sort of test out is just make sure that like, you know, when you move your right arm, like your right arm is like going up in the correct location in the camera. So you're not off to the side, you know of the camera when you're trying to show them kind of what you expect, I imagine for physical therapy and you can answer this, you know, too, I imagine for physical therapy that you may have to be seen, like your full body may need to be seen at some point in time. Karen Litzy (16:33): Yeah. Yeah. You definitely need like a decent amount of space so that you can lay down on the ground. You can come up to kneeling, you're standing you're so yeah, for physical therapy, you do need a good amount of space. So it comes down to finding those spaces, whether it's in your home or your office, where you can kind of get the right angle and good lighting. Michael Greiwe (16:54): Right. That's great. I think that's really important. You know, for your listeners on the physical therapy and for us, it's also being able to screen share too. If you can screen share, then you can show x-rays MRIs, things like that. And just getting tests sent out. Like I know for my practice, you know, we had a lot of physicians go live as soon as COVID hit and nobody had practiced. And so it was disaster on the first day, it was like, you know, it was like Groundhog day. And like no one knew what they were doing. And I was running around different pods trying to help everybody. But it's important to practice just like we would never go to surgery, not practicing what we're doing, you know, you practice to on your side to make sure that everything's working properly, your camera, your audio and all of that. Karen Litzy (17:36): Yeah. Do a couple dry runs with friends and family, make sure it's working well. Yeah, that's excellent advice. And now what do let's say, physicians or therapists what do they need to do now to kind of quickly adapt to this telehealth? Because from like, I look at, it's such old hat now, but I've been doing it since March. So now you have other parts of the country who are sort of trailed behind New York city. So they're in lockdown maybe for the first time and they really need to start adapting quickly. So what advice do you give to those practitioners? Michael Greiwe (18:12): Well, you know, providers of medical services always have a hard time with change, right? I think that's like one of the tenants of being a type a personality, the personality that ends up getting into medical practices or, you know, we're very particular. So we don't like to change. That's the first thing to recognize. And, and so there's going to be bumps in the road and they're just going to be hurdles. And I think it's really important to just understand like, Hey, you got to sort of roll with the punches a little bit, understand is not usually too difficult. We just need to kind of figure out what your plan of attack is going to be. Are you going to see tele-health patients in the morning and then see your regular, you know business in the afternoon, if you're completely shut down, how are you going to adapt to that? How are you going to get the word out? Are you going to be able to market this really, really important for you to make sure you kind of figure all that out on paper before just sorta like saying, yeah, I'm going to buy this telehealth cloud from when we get rolling, you know, it's like let's plan an attack and how we're going to be seen and how we're going to be able to see patients. I think that's really, really important. Karen Litzy (19:12): Yeah. Makes sense. And now let's talk about the platforms. Let's talk about the platforms that you're involved with and how you got involved. So there's ortho live and spring health live, right? So how are you an orthopedic surgeon with all of the work that surrounds that and then sort of this tech person entrepreneur on the side. So you must have some spectacular time management skills. Michael Greiwe (19:44): Well, I've got a very forgiving wife. I know that that's number one. But you know, it is like a it's a wonderful thing for me because I really enjoy doing kind of creative things. Things that might help my patients and telemedicine was one of those things I think really was, was a great thing for my patients ultimately. But for me, telemedicine was a way for my patients to be helped in a way that we couldn't really help them through anything else. And so there wasn't a great solution. So I decided to found ortho live about three years ago, that was 2016. And it was only because I was looking around to try to find a solution for patients and for providers that was really efficient and that worked really smoothly. But what I found was that really didn't exist and it was really hard to find the right solution. Michael Greiwe (20:32): And so I decided to create it after speaking with a CEO of a telemedicine company out in the California area, he kind of runs a lot of the video for MD live and some of the other larger companies. And he said, Mike, you know, this is a great idea. You ought to kind of through on your vision to do this for orthopedics. And so I did that with ortho live and it's been really successful and I kind of knew what we needed. We just, you know, we didn't have the efficiency in a way to be able to see patients in a streamlined fashion. So we created that within orthopedics, which I knew very well. And then we kind of branched out and now we're offering services to other specialties and subspecialties as well with spring health live. Karen Litzy (21:11): And within these platforms, do you have ways to do objective measurements within these platforms? Cause I know some do some don't so how does this, how does this work let's say from an orthopedic standpoint. Michael Greiwe (21:27): Yeah. So I mean, if you want true objective measurements we have to kind of integrate with braces and things like that. So, you know, we're like a smartphone application. And so we do have API APIs that can integrate and take in information like that. It's not something that, you know, orthopedic surgeons really use on a daily basis. I would see that more for physical therapists. So we kind of have the ability to integrate with you know, applications that give you range of motion and actual discrete data. I think that's really important because it does give you some actual feedback on a day to day basis, how a patient's doing. But from an ortho standpoint, we don't really need those, like the discrete data points we just sorta need to see, okay, well, how was that patient performing? Michael Greiwe (22:09): Are they having difficulties still, you know, moving their knee, let's see you bend your knee. And if it's not really going as well as we want, we know we need to up the physical therapy, we need some more intensity there. And it's more of a good stall for us. Less on the discrete hard numbers, but with therapy, I feel like it is really important to have that feedback to say on a day to day basis that patient's not doing well, how can we help them? Do we need to intervene sooner? So maybe that's what you're getting at, but, but yeah, we have the ability to kind of feed that information back into our platform. Karen Litzy (22:39): Yeah. Yeah. That's cool. Because a lot of times it's, you know, you could say, well, if 180 degrees of shoulder elevation is considered full, it looks like maybe they're at 75% or they're at 50%. So, but it's hard to get those, like you said, very discrete numbers because we can't measure it. Right. So having the ability to kind of integrate applications to be able to do that, I think is it can be really helpful. Although I, yeah, I guess sort of postsurgical when the patient is perhaps limited to X amount of degrees of movement, I think is where that comes in really handy. Michael Greiwe (23:21): Right. Right. And we have them sort of stand kind of at the side and like watch for inflection and things like that. So I think we get, you know, to within probably five to 10 degrees, but if you're looking for exact degrees, that's where those programs, which, you know, you can strap like an iPhone to your leg now and like move your knee. And it measures range of motion through like some little track pads and things like that. And there's ways to, to really effectively get that, that motion and understand what's happening with the patient and recovery, which is nice. And so we've allowed the ability to integrate those types of applications to our platform, which is cool. Karen Litzy (23:56): Yeah. That's really cool. I was working with some developers based in Israel who have an app for gait. And so you put it in your pocket and what it does is it can tell you the excursion of your hip range of motion from flexion through extension pairing side to side, your stance time steps per minute all sorts of stuff. I think there's up to like seven or eight discrete measurements, which is super cool. So again, in times like this, this is where the technology 10 years ago didn't exist. Michael Greiwe (24:33): Yes. A hundred percent. Karen Litzy (24:36): Having that now is allowing healthcare professionals to continue to help their patients during this pandemic. Michael Greiwe (24:46): No question. I was speaking with a group that has some special socks that like will measure stride length and things like that. So they know when a person may be like, you know, unsteady with their gait when they might be a fall risk which I think is a great, it's a great thing. And so, you know, understanding when patients may need some therapy to try to help with balance is critical. I mean, falls are a multibillion dollar issue in the United States today. And if we kind of cut down on falls, it's a great, great opportunity. And so we're, I think we're leveraging little things like, you know, from a data standpoint to be able to improve population health. I think it's great. Yeah. Karen Litzy (25:26): And where do you see telemedicine moving in the future? The pandemics over is everybody just gonna wrap it up and call it quits? Or what, where do you see that moving towards in the future? Michael Greiwe (25:39): No, I think telemedicine is here to stay Karen, I think you know, so-called genies out of the bottle, you know, there's a lot of great things that have happened with telemedicine recently. I think it's here to stay. We're gonna end up seeing telemedicine continue to spike. It was on the rise. Even before the pandemic, we were seeing multi millions of patients that were being seen every year. It was doubling every year. And now it's like, I mean, I think it's gone up by 10 X. So there's going to be a lot more telemedicine, I think, in people's future. Karen Litzy (26:10): Yeah. And as we were discussing before we came on the air hopefully the providers of insurance will also agree with that and say, we are going to continue paying for these because look at the advantages it's giving look at the money we're saving because of this. Cause like you said, if you can have a telemedicine visit with someone and it prevents a fall, which is a multibillion dollar industry, would you rather pay the $2-300? Whatever it, I don't know how much it is or have that person hospitalized for hundreds of thousands. Michael Greiwe (26:48): You're absolutely right. And so if there's any, you know, any of the insurance industry listening is very, very critical that we continue with telemedicine for their patients. And it's so beneficial, not only in protecting them during this time period, you know, we definitely don't want to let them go out of the house or 70 year old patients that are potentially sick and I'll really you know, it's for their safety and it's also for the benefit of the patient. I mean, it's way more convenient for them. And so I think without a doubt, it is so important to make sure that our legislature continues to support telemedicine and telemedicine billing. Karen Litzy (27:25): Absolutely fingers crossed fingers crossed that that happened. So I'm with you on that. Alright. Now, before we start to wrap things up, is there anything that we didn't cover or anything that you want the listeners to sort of walk away with from our discussion on telemedicine? Michael Greiwe (27:43): Oh, I think the main thing is, is that, you know, there's a lot of great people out there trying to provide health care. And many of them are trying this, you know, as a new you know, thing for them in their practices. And I think supporting them in that is important. I think everybody inside their local community is really trying to do things via telemedicine now and they weren't doing that before. And so being flexible, I think with those providers, I think is important, but I also think that telemedicine is here to stay. It's one of these things where there's so much benefit on both the provider and the patient's end that it'll just continue to be here and be a part of society and medical care going forward. Karen Litzy (28:20): Yeah, absolutely. And now I have one question left and it's a question I ask everyone, and that's given where you are now in your life and in your career. What advice would you give to yourself as a fresh medical school graduate? Michael Greiwe (28:36): That's a good question. I love this question. I think for me, I was such a you know, a worrier, like I was, I was always worried about, you know, what was I going to be good enough? Was I going to be smart enough? And you know, I always knew that I believed in myself, but I didn't trust myself back in those days enough to know that I was going to be okay. And I think the thing to remember is like, you know, you went into this medical profession for a reason you want to take good care of patients. You got to believe that, you know, you're a hard worker and you're going to continue to do as best you can to take good care of people. And you're not, you know, even a few fail it's okay. I think failure is it's okay to fail. I think that's another thing that I would tell myself to, because I was so worried about failing that I wasn't willing to like branch out and take risks. But I've learned that now. And I think if I could go back, I'd tell myself, don't worry about failure. Just you're gonna be fine. Just keep working hard. Karen Litzy (29:36): Great, excellent advice. And now where can people find out more about you more about ortho and spring health live? Michael Greiwe (29:43): Great. Yeah. Well, they can actually look at our website. So our website is www.ortholive.com and then www.springhealthlive.com. So for me, I can be reached at mikegreiwe@ortholive.com. That's my email address and I'll be happy to respond. Karen Litzy (30:08): Perfect. And just so everyone knows, we'll have all of those links in the show notes under this episode at podcast.healthywealthysmart.com. So Dr. Greiwe, we thank you so much for coming on. And, and like I said, I've spoken about tele-health before, but it was way back when this started. So it's great to get more information out there for people to know that it's not just something that we're doing during the COVID pandemic, but that this is something that can be incorporated into your practice. It can help your business, help your patients. So thank you so much. Michael Greiwe (30:43): Oh, thank you, Karen. I was glad to be here. Appreciate it Karen Litzy (30:45): Anytime. And everyone. Thanks so much for tuning in, have a great couple of days and stay healthy, wealthy and smart.   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on Apple Podcasts!

Professor John Hogenesch studies circadian rhythms and the genome. He talks about The influence of cues on our circadian rhythm and how lighting and even medication timing can affect us, Studies on hospital-specific lighting and how two new hospital wings in Cincinnati are designed accordingly, and Some unusual sleep patterns, such as Delayed Sleep Phase Syndrome, and how it can affect people.  Dr. John Hogenesch is Professor of Pediatrics at Cincinnati Children's Hospital Medical Center in Human Genetics and Immunobiology at the University of Cincinnati Department of Pediatrics. He specializes in genome biology with a focus on the molecular mechanisms of circadian rhythms in mammals. He explains to listeners the basics of circadian rhythm as a daily rhythm of behavior and physiology that persists in the absence of external cues. He discusses how healthcare and specifically hospital design and schedules are often at odds with most patients' rhythms. In fact, he mentions one study in which NICU patients under a cycled light schedule went home two weeks earlier than babies under constant dimmed light conditions. He discusses his hospital's design of two new areas for NICU and PICU patients under the advisement of his lab that will integrate beds with circadian natural-light systems. He adds ways in which medication delivery and procedure timing could also be better paired with circadian rhythms and efforts to do so. Dr. Hogenesch also talks about Delayed Sleep Phase Syndrome (DSPS). Richard has such a sleep pattern and the two discuss how it manifests itself, as well as other sleep patterns, and how they affect those who experience them. He also addresses how cortisol's peak has an effect as well as how external cues interfere or work with our sleep patterns. For example, he mentions our eating timing, light exposure, and light temperature and type. He discusses how the pandemic is pushing many of us to later sleep schedules and possible hypothesizes for why. Along the way he offers some suggestions for eliminating excessive blue and green light and other similar measures.  For more, see his lab page at cincinnatichildrens.org/research/divisions/h/genetics/labs/hogenesch and the Society for Research in Biological Rhythms, which publishes helpful blog posts and articles. Available on Apple Podcasts: apple.co/2Os0myK

Dr. Beth Rymeski (Fetal Surgeon) and Dr. Rachel (Rae) Hanke (Pediatric Surgical Education Fellow) from Cincinnati Children’s Hospital bring you highlights from the 2019 International Fetal Medicine and Surgical Society (IFMSS) meeting. Part II includes interviews focusing on technical and educational innovation. Special guests include: •Stephen Emery, MD, Director of Center for Innovative Fetal Intervention at University of Pittsburgh Medical Center & Associate Professor of Obstetrics and Gynecology at Pittsburgh Magee Hospital, Pennsylvania, USA •Jose Peiro, MD, Director of Endoscopic Fetal Surgery at the Cincinnati Fetal Center and Associate Professor at the University of Cincinnati Department of Surgery, Ohio, USA •Anouk van der Schot, MSc, technical physician at Radboud University Medical Center, Netherlands •Jena Miller, MD, Assistant Professor of Gynecology and Obstetrics at Johns Hopkins Center for Fetal Therapy and Lead of Fetoscopic Spina Bifida Repair Program, Maryland USA IFMSS facilitates international collaboration, networking and exchange of ideas, with the goal of advancing the field of fetal diagnosis and therapy. Check out the Stay Current: Pediatric Surgery app at https://staycurrent.globalcastmd.com/download. Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626.

This is a live recording of the panel discussion that occurred after a screening of Difficult Love, a documentary about South African photographer Zanele Muholi and her work with the LGBT community. Associate Curator of Photography Nathaniel Stein moderated the discussion with Heal & Build co-director Alexander Shelton, and University of Cincinnati Department of Women's, Gender, and Sexuality Studies professors Ashley Currier and Thérèse Migraine-George. Hosted by Russell Ihrig. Watch ""Difficult Love"": http://www.imdb.com/videoplayer/vi3128728089 Theme song: Offrande Musicale by Bacalao Take our survey: http://bit.ly/ArtPalaceSurvey

In this episode of Hallway Conversations, Epilepsy.com Editor-In-Chief Dr. Joseph Sirven interviews Tracy Glauser, MD, PhD, Associate Director of the Cincinnati Children's Research Foundation, Director of Comprehensive Epilepsy Center, Co-Director, Genetic Pharmacology Service and Professor at the University of Cincinnati Department of Pediatrics. They will discuss new status epilepticus guidelines. This content is created through a partnership between the Epilepsy Foundation and American Epilepsy Society.

Medical Grand Rounds with Robert G. Luke, MD, Adjunct Professor of Medicine, Division of Nephrology and Hypertension, University of Cincinnati Department of Internal Medicine