Personalized Healthcare Approaches

My billion-dollar question in regenerative medicine: Why are we still drilling into people's bones for stem cells? 🤔 The biggest bottleneck in advancing MSC-based therapies is the limited, invasive, and inconsistent sources from which we currently obtain mesenchymal stem/stromal cells (MSCs). 1/ Current MSC sources are invasive and scarce. Bone marrow extraction is painful and yields low cell counts. Adipose tissue requires surgery and shows huge variability between donors. This limits how many donors participate and drives up cost and complexity. 2/ Donor variability disrupts consistency. MSC quality varies with donor age and health. Older donors’ cells have lower regenerative potential, making it hard to get large batches of uniform, effective cells for therapies. 3/ Isolation and expansion are slow and costly. Extracting MSCs takes hours of lab work, and growing enough cells for clinical use takes weeks, during which cells can lose their potency. Plus, strict contamination controls and GMP regulations add complexity and expense. Menstrual blood-derived MSCs (MenSCs) can bridge the gap Menstrual blood offers a game-changing alternative: a non-invasive, easily accessible, and repeatable source of MSCs with high yield potential. Collecting MenSCs regularly from healthy donors means: • No painful procedures boost donor willingness • More consistent, renewable stem cell supply • Faster, scalable sourcing to meet clinical demands At Muse Bio, we’re pioneering this innovative approach to unlock a more efficient, scalable, and patient-friendly path for regenerative therapies, overcoming the bottlenecks that have held the field back for too long. Let's give these cells a second chance to create future regenerative therapies.

I just published a strategy I think has the potential to revolutionize drug costs in the US: using uplift modeling to make precision medicine actionable at scale. --- Yesterday Milliman published a white paper (in the comments) written by myself and Tanner Boyle about utilizing uplift modeling as a novel method for #PrecisionMedicine Uplift modeling is a predictive modeling technique that could be used to identify specific patients that are more likely to get the benefits of a drug (or more likely to get the side effects). For example, statins require a certain number of patients to take them for years before they prevent a heart attack/stroke. Uplift modeling allows us to identify those patients more likely to be that one patient that prevented the heart attack/stroke vs the dozens that just get muscle pain and pay for the drug over those years. --- While statins are the most prescribed drugs in the world, I see uplift modeling being much more impactful for drugs with high #DrugPrices Let's look at GLP-1s as an example: Doctors say roughly 10% to 15% of patients who try #GLP1s are "non-responders" Uplift modeling lets us identify those 10-15% of patients that won't respond or are less likely to be adherent. Check out the attached image for a mock example of what this modeling can produce. The image is showing that Drug X is very effective for weight loss for about 20% of the population, but minimally effective for the other 80%. --- Something I strongly highlight in the paper is the importance of ethical use of this information. There is a potential for techniques such as these to exacerbate existing disparities in healthcare because of the data available for training these models, and the potential for using them to deny needed care. Extra precaution should be taken to anticipate and address these challenges, ensuring that the benefits of precision medicine are accessible and equitable. --- If you're interested in better allocating your #PharmacyBenefits resources, take a look at this paper and see if uplift modeling could help better manage high-cost drugs or #SpecialtyPharmacy

It's 1983. A psychologist in New Mexico noticed something  about his treatment of patients with alcohol use disorder. The more he argued with patients to change,  the more they resisted. So William Miller tried the opposite. He stopped telling patients what to do.  He started asking what they wanted. The results shocked the addiction field. This became Motivational Interviewing. And it's the most underused approach in healthcare today. Here's why every clinic needs someone trained in MI: 1/ It flips the script on patient care • Traditional medicine: "Here's what you need to do" • MI approach: "What matters most to you?" • Patients become the experts on their own lives • Clinicians draw out motivation instead of imposing it 2/ The evidence is overwhelming • Works for addiction, diabetes, heart disease, weight • Improves medication adherence across conditions • Reduces treatment dropout rates significantly • Even brief MI interventions create lasting change 3/ It solves the adherence problem • We don't have a knowledge problem in healthcare • Patients know smoking is bad, exercise is good • They're stuck between wanting change and fearing it • MI helps them resolve that ambivalence Here's the core insight: The more you push someone to change,  the more they push back. But when you help them voice their own reasons  for change, resistance melts. Four simple skills make it work: • Open questions that explore, not interrogate • Affirmations that build confidence • Reflections that deepen understanding • Summaries that connect the dots If you're integrating behavioral health into primary care,  MI isn't optional. It's the bridge between medical advice and  actual behavior change. We keep blaming patients for "non-compliance." Maybe we should look at how we're talking to them. ---------- 👉 Your clinic isn't using motivational interviewing. ⁉️ Why not?!

Sometimes research confirms the zeitgeist and sometimes it’s way ahead of the zeitgeist. An example of the latter is this amazingly prescient 2018 paper published in the journal JAMA Cardiology by Kevin Volpp, Harlan Krumholz, and David Asch. Kevin Volpp, the director of the Penn Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, and David Asch, both Professors of Medicine and Health Care Management at the School of Medicine and Wharton School at the University of Pennsylvania, are members of Thrive Global’s scientific advisory board.    The paper, entitled “Mass Customization for Population Health,” notes that the U.S., which lags in life expectancy compared to other industrialized countries, spends huge amounts of money developing new medical technologies and yet doesn’t deploy existing ones very well. In cases in which effective treatment options exist, adherence is only about 40% to 45%.   And here was the prescient part: to increase adherence, and thus better health outcomes, “risk reduction strategies might be matched to individual preferences, observed behavioral phenotypes, and estimated risk.”   That’s exactly what AI, through hyper-personalization, will allow us to do — and it’s also what we’re currently integrating into our behavior change model at Thrive. Imagine a customized, hyper-personalized AI health coach trained not only on the best peer-reviewed science, but also on our biometric, lab and other medical data, and, as the paper states, our individual preferences — what conditions allow us to get quality sleep, which foods we love and don’t love, how and when we’re most likely to walk, move and stretch, and the most effective ways we can reduce stress.    The combination of behavioral science engagement tools combined with synchronized and automated medication refills could be thought of, the authors write, as a “behavioral polypill.” As they conclude, “behaviors ultimately determine much of the effectiveness we derive from the treatment strategies we already have.”   With AI, the behavioral polypill can become a powerful reality and significantly move the needle on health outcomes. https://lnkd.in/djvmuTxh #Health #AI #Personalization #ArtificialIntelligence #Behavior #Outcomes

I created a model of understanding Chronic Pain, specially when it overlaps with Anxiety, Depression, and Insomnia. I call it the SEC model of chronic pain, and it offers a comprehensive framework that addresses the multifaceted nature of chronic pain by integrating three core dimensions: Sensory, Emotional, and Cognitive. This model emphasizes that effective pain management requires a holistic approach, considering not just the physical sensations but also the emotional and cognitive experiences associated with pain. ⸻ 🔍 Overview of the SEC Model 1. Sensory: This dimension pertains to the physical sensations of pain, including intensity, location, and quality. It encompasses the neurological and physiological aspects that contribute to the perception of pain. 2. Emotional: Chronic pain often leads to emotional responses such as depression, anxiety, and frustration. These emotional states can, in turn, exacerbate the perception of pain, creating a cyclical relationship between pain and mood disorders. 3. Cognitive: This aspect involves the thoughts, beliefs, and attitudes individuals hold about their pain. Negative thought patterns, such as catastrophizing or feelings of helplessness, can intensify the experience of pain and hinder effective coping strategies. ⸻ 🧠 Clinical Implications The SEC model underscores the importance of a multidisciplinary approach to chronic pain management. By addressing all three dimensions, healthcare providers can develop more effective treatment plans. Interventions may include:    •   Cognitive Behavioral Therapy (CBT): Targets maladaptive thought patterns and promotes healthier coping mechanisms.    •   Mindfulness and Meditation: Helps in managing emotional responses and reducing stress-related exacerbation of pain.    •   Physical Exercise: Improves physical function and can have positive effects on mood and cognitive function.    •   Pharmacological Treatments: Medications may be used to address both the sensory aspects of pain and associated mood disorders. I advocate for integrating these interventions to address the complex interplay between the sensory, emotional, and cognitive components of chronic pain . ⸻ 📚 Further Reading For a more in-depth understanding, consider exploring the book 100 Questions and Answers About Chronic Pain, co-authored by Dr. Rakesh Jain, which delves into various aspects of chronic pain management . https://a.co/d/4Me1Iuz ⸻ By adopting the SEC model, healthcare professionals can better understand the multifaceted nature of chronic pain and implement comprehensive treatment strategies that address the full spectrum of patients’ experiences.

CAR-T therapy, which engineers a patient’s own immune cells, is showing promising potential to recalibrate dysregulated immunity in autoimmune disease. Early studies report reduced pathogenic B-cell activity and sustained remission in systemic lupus erythematosus and rheumatoid arthritis. By selectively targeting autoreactive pathways rather than broadly suppressing the immune system, CAR-T introduces a more precise, disease-modifying strategy that may ultimately transform current approaches to autoimmune treatment.

Virtual environments for mental health therapy open doors to more adaptable and engaging treatment methods, offering a promising supplement to traditional approaches through immersive technology. Therapeutic applications in the metaverse enable more accessible care, overcoming physical and geographical limitations, which is particularly beneficial for those with mobility restrictions. The flexibility of these virtual environments allows therapy to be customized to individual needs, providing patients with controlled settings that feel safe. The interactive nature of these spaces enhances patient engagement, making therapeutic processes more relatable. Real-time monitoring allows therapists to adjust treatment instantly, which can improve responsiveness to patient progress. This approach is versatile and suitable for conditions such as anxiety, PTSD, and phobias, making it a valuable tool in modern mental health care. #metaverse #healthcare #DigitalTransformation

Mental Health Tech: Meeting people where they are, when they are Mental health isn’t a straight line; good days and tough ones often mix together. This is where technology makes a real difference, turning the waiting period between sessions into an active part of the healing journey; AI powered chatbots offering 24/7 support, personalized mental training apps, AI based tools analyzing text or video interactions, and Facial Emotion Recognition, flagging early warning signs for therapists. These innovations don’t replace traditional care but complement it, making mental health support more responsive and proactive. It’s not a magic wand, but it’s a big step toward meeting patients where they are, when they are. #MentalHealthInnovation #MentalHealthTech #TechTransformingMentalhealth #DigitalTherapy

Please see this new paper I have had the pleasure of co-authoring with Dr Joanna Fox and Professor Shula Ramon entitled ‘The process of deinstitutionalisation from within an institution: evaluating innovations in a closed ward for women with (borderline) personality disorder’ (2025). This paper hits home some hard truths but it took me a long time as someone with lived experience to come to terms with accepting that facts do not care about feelings. Can inpatient services be better? Absolutely, in my decade working within in-patient I have never thought or heard ‘we are there’ or ‘we are done’ with respect to improvement. We strive to improve everyday. The idea that in-patient services do not make a difference, should be abolished and are only about containment is simply not true as demonstrated by this and many other papers. It is a disservice to staff who have dedicated their lives to supporting people and the service users to suggest otherwise, as some of the most marginalised and often discriminated in society who require a wide and dynamic range of support systems from inpatient to community. If you look at CAMHS and PD services dwindle over the years to be replaced with not even non evidence based models, just no model at all. It’s not as if we have taken away beds and made community provision better, community services have been dessimated even more with unrealistic caseloads and unprecedented levels of risk. In this paper we explore how we can deinstitutionalise from within and it’s worth having a read. 1. Purpose: • To evaluate new intervention methods alongside Dialectical Behaviour Therapy (DBT). • To explore how “deinstitutionalisation from within” can happen inside a closed ward. 2. Methods: •Photovoice (patients take photos to reflect on their experiences, then discuss them in interviews). •Staff reports every three months. •Mixed methods: qualitative (interviews, photos from service users) and quantitative (incident tracking). 3. Innovations: • Integration of Experts by Experience (people with lived experience in paid roles highly regarded by service users and staff). • Emphasis on shared decision-making and co-production. (Organisation practiced authentic Co-production at every level) • Use of peer support, “peer leave,” and activities to promote independence. • Vocational, therapeutic, and creative activities (e.g., cooking academy, mindfulness, occupational therapy clinics). 4. Findings (Interim): • Reduced incidents of self-harm and crises between evaluation periods. • Service users reported stronger self-esteem, self-worth, and empowerment. • Personalised activities and ward culture fostered trust, responsibility, and hope. • Relationships with staff described as supportive and non-judgemental, contrasting with more negative past experiences. • Transition planning (discharge books, goals, education/work ambitions) improved likelihood of successful reintegration into the community.

🧠 The Science Behind Lasting Health Changes: 5 Behavior Change Models Every Healthcare Professional Should Know Why do some patients successfully adopt healthier lifestyles while others struggle? The answer lies in understanding proven behavior change theories that guide effective intervention design. 🛒 Transtheoretical Model (TTM) Recognizes 5 stages: Precontemplation, Contemplation, Preparation, Action, Maintenance. The key insight? Tailor your intervention to where your patient is right now, not where you want them to be. 🐦 Social Cognitive Theory (SCT) Three powerful forces drive change: self-efficacy (belief in ability), observational learning (modeling), and reciprocal determinism (person-behavior-environment interaction). Success tip: Show patients others like them succeeding. 💚 Health Belief Model (HBM) Behavior change happens when patients perceive threat (susceptibility + severity), see benefits outweighing barriers, feel confident in their ability, and receive cues to action. It’s about shifting perception, not just providing information. ✏️ Theory of Planned Behavior (TPB) Three factors predict behavior: attitudes toward the behavior, subjective norms (social pressure), and perceived behavioral control. Address all three for maximum impact. 🔵 Self-Determination Theory (SDT) Lasting change requires fulfilling three psychological needs: Autonomy (choice), Competence (mastery), and Relatedness (connection). Support these, and motivation becomes intrinsic. 💡 Clinical Application: Instead of saying “you need to exercise more,” try: “What type of movement brings you joy?” (SDT) or “What’s worked for you before?” (TTM) or “Who in your life is active?” (SCT). Which behavior change theory resonates most with your clinical practice? How do you help patients move from knowing what to do to actually doing it? #LifestyleMedicine #BehaviorChange #PatientCare #HealthPsychology #ClinicalPractice #HealthCoaching #PreventiveMedicine #HealthcareEducation