When it comes to treating patients with behavioral health issues, including Post Traumatic Stress Disorder, Dr. Laura Bajor is always on the lookout for new tools that could help.
She sees the potential of emerging technology.
But Bajor, who is medical director for the CORE program at North Tampa Behavioral Health, 29910 State Road 56 in Wesley Chapel, isn’t into technology for technology’s sake.
Organizations that engage in that approach, she said, “tend to create a ‘flavor of the month’ atmosphere.’”
(B.C. Manion/Staff Photo)
Ultimately, that’s counterproductive, Bajor said, because “that actually ends up alienating folks from trying new things, because they’ve lost faith in the actual benefit of new technology.”
Instead, Bajor believes that “technology and research are most useful when they improve a patient’s investment in their own health, and their quality of life.”
She’s constantly on the lookout for new tools, or collaborations, to help her find the best ways to help the patients she’s treating.
“In my opinion, one of the absolute worst conversations to have with a patient is to have to sit across a desk from them and say ‘We’ve run out of treatment options for you, and we’re not working on anything new. Good luck.’
“The real aim of health care is not that they remain our patients, it’s that they function well on their own without us. So, we can move them toward that,” Bajor said.
Along those lines, “we’re using technology to assess sleep, activity level, change in heart rate throughout the course of the day, and a few other parameters,” she said.
This permits a more focused approach to prescribing medication and planning treatment, she said.
The idea is to be able to show patients evidence regarding their progress or lack of it, which helps save time and reduces frustration, she said.
Technology also is used to help patients learn how to control their own stress and anxiety levels, which helps them regain a sense of control and self-confidence, she said.
Bajor said she began using emerging technology about four years ago, with a series of small innovation grants in a clinic at the VA in Boston.
She was able to pilot the use of different kinds of fitness, sleep, and stress trackers with her staff and patients. That eventually spread into a partnership with the Basis division of Intel, who worked to equip patients from about 15 different clinics and programs with their gear.
She believes part of the reason she was recruited to become the medical director of the CORE program at North Tampa Behavioral was because of those experiences and skills.
Sleep plays a significant role in a patient’s health, Bajor said.
“The first paper I ever published was about tracking sleep first rather than hitting people with very high-caliber meds,” Bajor said.
When someone comes into the clinic and sleep is part of their problem, they are put on a tracking system for a couple of days before any medication is prescribed, she said.
“Is the problem that they’re not going to bed until 3 in the morning? Is the problem that they can’t fall asleep? Or, is it that they’re waking up 10 times?
“We would actually use different treatment approaches, depending on which or all of those problems they have,” she said.
“A person, once they’ve been sleeping, you can probably use much less medicine,” she said. That helps to avoid prescribing medication that can affect their functioning during the day, and reduces potential for side effects.
“All of these things have side effects,” she added.
While in Boston, Bajor said she worked with top-notch researchers and clinicians from the Harvard and Boston University systems, she said.
“I worked mainly in Ann Rasmusson’s lab at the National Center for PTSD, where there is a major focus on using exercise, cognitive therapy, and other novel approaches to calm down the neuroendocrine system, get folks’ frontal lobes back on line, and in doing all that, help PTSD patients get back in control of their anxiety,” she said.
“Ann and her crew have continued to be generous in providing advice about how to translate these ideas into our CORE program,” she said, where exercise, yoga, diet and other approaches are being used to treat veterans.
“There’s an emerging parameter called heart rate variability,” Bajor said. “It’s kind of the newest thing in physiologic tracking. It’s the rate at which a heart rate changes.
“We’re watching that with guys who are doing PTSD therapy,” she said.
“We can tell: Should we back off a little, or should we try harder?
“There’s actually NFL coaches and Olympic coaches that are using the same HRV (heart rate variability). They’ll say, ‘Well this guy should take a day off from weightlifting.’ Or, ‘We should push this guy harder, he’s not going hard enough.’’’
“We can kind of do the same thing,” she said.
Bajor also noted she’s received help from a number of other experts in the areas of research methods, dissemination of innovation and day-to-day management of new ideas in a clinical setting.
“The trajectory of my medical career has been a little unorthodox,” Bajor said.
She went from being a student at the Naval Academy, to becoming a search and rescue pilot, to being a Department of Defense engineer. She left that job to attend medical school.
In addition to her current work, she also belongs to “Tampa Hackerspace,” a group she describes as an eclectic group of brilliant folks who have pooled their resources into a space where members have access to things like 3-D printers, laser cutters, full metal and wood shops, and the expertise of leaders in their various fields.
She just joined the group in the summer and already has ideas that will be used in her clinic, she said.
“Making those connections and sharing knowledge. There’s no way to measure that. It’s just invaluable,” said Bajor.
She welcomes opportunities for collaborations that will lead to better care for patients.
Published August 24, 2016