Dr. Justin interviewed Dave 
Korsunsky, the founder of “Heads Up Health” which has developed an innovative and yet very user-friendly software to help centralize all of your health, fitness and medical data in one place.
Most people have their medical records scattered across different doctors’ offices and medical facilities. Using new advancements in electronic health record technology, Heads Up Health can help you gather scattered records into one location so you have a complete view of your medical history right at your fingertips.
Find out how you can be empowered with this tool to manage your health.
In this episode we cover:
01:24 The need to manage one’s health data
04:45 Standard lab and functional lab ranges
06:33 Color coding system for lab works
07:06 Lifestyle and clinical data integration
09:56 Automated and manual entry of data support
19:15 Collaborate information with healthcare team
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Justin Marchegiani: Hey there, this is Dr. Justin Marchegiani and welcome to another awesome episode of Beyond Wellness Radio. We now have full podcast transcriptions over at justinhealth.com. Head over to justinhealth.com, click on the podcast button and you will be able to access all shows forward and past. And while you are there, feel free to sign up for the Thyroid and Hormone Video Series. Some great information there for everyone and while you are there you can also sign up for the podcast newsletter where you will get access to these podcasts right in your inbox before anyone else. While you are there, you can also schedule a consult with myself if you want to dive into any other functional medicine or health issues. Again stay tuned for the show. And if you are enjoying it, please feel free and share. Sharing is caring. Think of one person that could benefit from the show and share it. And also, feel free and head over to beyondwellnessradio.com/ITunes and send us a review. We really appreciate it. Thanks and enjoy the show.
Justin Marchegiani: Hi there! This is Dr. Justin Marchegiani with Beyond Wellness Radio. Today we have a super awesome guest talking about an awesome new service and product that I think everyone listening to the show should be interested in. I am interested in it. And I am going to be using it with my patients to help provide better service and to help organize all the lab data that I am bringing up my patients. But I would like to welcome David Korsunsky to the show.
Dave Korsunsky: Thank you, Justin. Happy to be here.
Justin Marchegiani: Awesome, Dave. Well, why don’t you tell the listeners a little bit more about yourself and how your life kind of like wound up here.
Dave Korsunsky: Sure. Well, I was working in Silicon Valley, for a huge software company and found myself struggling with stress and fitness and just overall health and wellness and personal performance. And so, that just set me down a path of starting to look at other ways to optimize my health and I guess it first started when I discovered Biohacking. Started reading some of the material on Bulletproof Executive and started devouring that type of information and started working and consulting with experts like yourself. And it really just took me in an entirely new direction in terms of how I thought about my health and how I thought about managing my health. And over the years, as I have become more informed, what I realized was there was a real lack of tools out there for individuals who do want to take more control of their health and do want to become empowered. We just need more effective tools for doing things like managing all the different files, all of the different lab results, all of the different data we are collecting ourselves. And so, largely born out of my own frustrations, I decided to put this product together. And with the support from a lot of great people including yourself, we are at a great point and we are close to releasing it now.
Justin Marchegiani: Yes, I am really excited about this software because it is going to really take everyone’s health data and organize it and literally put it at their fingertips. So they give people the ability to kind of see the difference between their labs from this year to last year. Be it that color coding technology that some lab companies have brought out to make things more visual. I mean, I could think of my first consultation with you, Dave and you came in with these stacks of lab works. You know, excel sheets upon excel sheets and we were trying to look through things and look at trends and kind of roll up our sleeves and dig in to the data. And it was tough. And I think you know this thing that you have created, you are kind of bringing about here is going to make it easy for the Biohacker because all these Biohackers, they are just as serious as you collecting their data, testing, quantifying. But not only the Biohacker, it is going to make it easy for the physician that is trying to come up with the action plan of how we are going to move forward to achieve this goal.
Dave Korsunsky: Yes, that is right. And just thinking back to some of those days when we were working off of a spreadsheet. I think like many people I have lived in more than one city over the years, more than one state. In fact, in my case, more than one country. My records where everywhere. And so one of the first things I did when I wanted to start improving my health was I just went out to try to collect them all. And some of the records were coming in on paper and some physicians were just mailing me a CD with the PDF file on it. And even within the San Francisco Bay area, I have seen a few different doctors. I have got labs at Stanford. I have got labs at UCSF. And I have got labs with my GP at Saint Mary’s. None of those medical facilities were able to allow me to centralize my records even though they are all using the same software program on the bad end, most of them anyhow. And just to make matters worse, I just went on to The Affordable Care Act, switched to a different physician because my old physician did not take my new insurance and had to go to another doctor. And so, now I have labs in a fourth medical facility.
Justin Marchegiani: Oh, man.
Dave Korsunsky: And then, working with yourself, you would just give me the lab reports and I would go to the Quest and get a PDF file. So I had all of those documents. So the first thing we did was how do we get all of the medical records in one place and basically get away from the spreadsheets. What we are doing that is very unique is first of all we can automatically connect already to over 500 medical facilities.
Justin Marchegiani: Wow!
Dave Korsunsky: All we need is your log in credentials. We automatically download all of the data or if you have historical data, it is very simple to just log in, enter your historical records. And soon we will also be able to offer service where we will be able to help people with this. So, we hope that it is going to make things a lot easier for people to just centralize their records and then actually just consult with whoever they want because they have everything available to them at their fingertips.
Justin Marchegiani: That is great. So there are going to be ways to look at also the standard lab range that is there to help pick up pathology or disease. But from what I understand, there are also going to be ways that people can look at functional lab ranges and maybe look at things from a functional standpoint too. How does that work?
Dave Korsunsky: Yes. We realize that there are different reference ranges out there. Depending on what type of specialist you are consulting with. And so we are working on features where we will have standard lab ranges in there which can be used broadly. Or you will also have the ability to enter functional ranges in there. For example, just talking with some of our Beta testers, they are working off of a lot of the thyroid markers that are much different from traditional MD ranges. And so you will be able to enter your own ranges and will automatically adjust the color coding and the ranges based on whatever you deem is appropriate based on how you are working with your physicians. So, that is something that a lot of people are asking for and we are very close to having that feature working.
Justin Marchegiani: That is great. Because there are a lot of people, especially being someone that specializes in thyroid issue, we look at a lot of thyroid issues but in the conventional setting, they are typically using labs like TSH. And they are using a very high lab range where we can have patients come in that will get the TSH thumb. But when we use a more sensitive lab range then we will be able to pull in data like T4, T3, rT3 and a thyroid antibody, etc. Is that correct?
Dave Korsunsky: Yes, and that is one of the things that you help me with personally. And so, I am equally passionate about making that same thing available to everybody. So, yes all of the thyroid markers will be there. The reference ranges can be customized. And so, yes all of that stuff will be working.
Justin Marchegiani: Well, I am so excited because this will make my job easier as a doctor to help patients. And then also, really drive home that complete picture. I love some of the color coding stuff that you showed me as well. Kind of like the green, the red stuff so you can see when things are starting to get out of range. I think it is important to have that color coding featured to add that visual element.
Dave Korsunsky: I agree. And I think one of the other really important things as I am sure you can attest to is, okay great we have all of the clinical data in one place. But what happens on the day to day situation as well.
Justin Marchegiani: Yes.
Dave Korsunsky: So, for example, I am collecting a lot of data on my own. Within the healthcare industry there has been a lot of talk right now about patient-generated data.
Justin Marchegiani: Yes.
Dave Korsunsky: That is what happens between doctor visits. Those months that go by and people are starting to collect incredibly valuable data on themselves through a lot of emerging technology. So, whether I am tracking my basal temperature everyday, for thyroid or weight, or glucose or blood pressure: all of that vital stats data even nutritional data from things like MyFitnessPal and other software apps and wearables; sleep data for example. So we also made it possible to incorporate all of the lifestyle data and all of the clinical data in one place.
Justin Marchegiani: Got it.
Dave Korsunsky: People typically keep those things discreet but they are actually one and the same. So it was really important to integrate all of that information as well. You have been helping me develop a lot of these features. So we are equally excited about that part.
Justin Marchegiani: That is great. You see right now I have my Fitbit in front of me, I have my blood sugar meter, my ketone meter. I have a Pedia for I have MyFitnessPal that keeps track of maybe calories or macronutrient ratios. And from what I understand, we are going to be able to combine everything together and put all the data in one place.
Dave Korsunsky: Yes. That is absolutely right. So for example, you will be able to plot trends to say, “Is the information on nutrition coming in from the mobile app MyFitnessPal? How does that correlate to data about my glucose?”
Justin Marchegiani: Wow!
Dave Korsunsky: Which is coming from my glucometer. So this has typically been completely disconnected data sets. So there has never been a good way to look at it like that. And so by having all of the information in one place, we can start to provide some very powerful analytics that people can use to study their health. And then also as an education tool and then to consult with their healthcare team as well to view all of these stuff together. So exciting features.
Justin Marchegiani: Well, that is great! So I have a blood pressure cuff that is bluetooth that will also hook up to?
Dave Korsunsky: Yes. We set it up so that you can use a lot of the bluetooth devices. So if you have a bluetooth cuff or a bluetooth glucometer or a wireless scale, all of that stuff works and it will automate the process of importing the data so you do not have to enter anything. But we also realize a lot of people do not have the time or the money or even the desire to work with all of the fancy stuff. Like me for example, I have a bluetooth cuff but actually in my old school, Omron One which is not even wireless is actually way more consistent. So you can use a manual glucometer or a manual scale or cuff. All of these stuff can be entered manually or using some of the wireless technology. So we support both use cases.
Justin Marchegiani: That is great! So how does it work? If I have like a five page blood test and I do not feel like spending the time punching each value in. How does that work? How do I get that done?
Dave Korsunsky: Yes. That is a great question. So, we are very close to launching our concierge service. So that will be for individuals who do not have the time, or the desire or the expertise to sit down and enter it all in which can be tedious, especially for users that have 10, 15 sets of labs historically, like some of our Beta testers do. We will have a service that can help with all the data entry. So we take whatever source. Whether it’s PDFs or however you have been recording your history and concierge service will just help you get it all into one system and then you just end up with something that has everything in front of you. All of the information will be there. Graphs will be there. It is all very user-friendly. It is all engineered around the end-user, using interfaces that you are very familiar with as the consumer and as a user of technology. Unlike a lot of healthcare systems which are still using a lot of legacy software, we have engineered this to be very user-friendly, very engaging for the user and you just get everything right in front of you.
Justin Marchegiani: That is great! And I see there is a video here on Vimeo on the Heads Up Health. It is kind of a nice little info video on how everything kind of flows. We will put that on the show notes too.
Dave Korsunsky: Yes. Just a really quick explainer video of how it works. It is also on the website. So it is just under 2 minutes. You can get a sense of what it is we are trying to do. This software has been something that was transformational for me, in my own health. I am incredibly passionate about making this available for everybody.
Justin Marchegiani: Yes, I am really passionate about getting it out there for my patients but I am also really passionate about getting it out there for doctors because it will make the doctors lives so much easier. Kind of plotting out goals and data and really helping to create an action plan that really encompasses all the data.
Dave Korsunsky: Yes, I agree. My sister is actually a naturopathic doctor in Canada, who is an expert like yourself. Who is in the functional medicine realm. I think one of the challenges, and correct me if I am wrong here, is you do not have access to the patient’s electronic health record because that only exist with the MD or health system that has that data set. So we believe that the individual should have their information. So you can envision patients who show up to you on Day 1 and you have their entire history available. And so we hope that it will be very valuable to experts like yourself.
Justin Marchegiani: Yes. And it is nice to be able to chart that stuff down. The patient can kind of see it too so they kind of know what is going on. So they are kind of in the loop with what is happening in the process.
Dave Korsunsky: Yes, I agree.
Justin Marchegiani: And then what is the full website again, Dave?
Dave Korsunsky: Its headsuphealth.com and right now we are in a small limited beta so we are adding users very slowly. People can sign up at the website and we will let them in as soon as we have room. We are growing very slowly. We want to make sure our performance stays really strong. We want to make sure all of the features are stable. So, we are growing slowly and all of the information is available online.
Justin Marchegiani: That is great. So can we do a screen share for everyone at home just so they can take a look at the podcast via the YouTube and they can kind of see how this looks and feels?
Dave Korsunsky: Yes, that sounds great. So, I will go ahead and share my screen here with you so that you can see this and I will just step through some of my own data and show you how it works for me as the individual. So let me know when you see my screen come up, Justin.
Justin Marchegiani: All right. Got it here.
Dave Korsunsky: Cool. So this is what I see every day when I log in. And this is the information that is most important to me. And everyone can configure this dashboard differently. But think of this as your vital signs. And so the first thing you set up is, “What are the most important metrics for me?” In my case, it is the data around body compositions. So each of these tiles on the screen here is coming from a different data source. Some of it might be coming from my doctor’s office where my electronic health record is. Some of it might be coming from a wearable device or an app. Some of it I might be tracking manually. So you can see the first two tiles are coming from my withing scale. My BMI automatically gets updated based on my weight and height. And on the middle row, actually one of the most important metrics for me is my sleep. I notice a huge difference in my work performance on the nights where I get eight hours versus six or seven.
Justin Marchegiani: So true.
Dave Korsunsky: So I am using the Misfit Shine, it’s a device on the wrist similar to the Fitbit but just slightly different in terms of battery life and the way it collects the sleep data. But this one is probably the most important for me performance wise. So here is just the seven-day trailing history of my sleep. I am at about 7.4 hours. And I sit at a desk all day like many people so this one here is just making sure I get up and go for a walk or a run everyday and staying physically active.
Justin Marchegiani: That is good.
Dave Korsunsky: And so, here is an example of something I am tracking manually. My meditation time. It is not coming from an online source anywhere. I just enter that data in so I can just give you a quick shot of how that would work. So if I want to enter my meditation or my glucose or any metric manually, I can just enter that in here. 25 minutes was mindfulness, add some notes, XYZ and that data will show up as well. So this is just my vital signs. And if I was tracking basal temperature, you can see I can just add basal temperature to my dashboard which I was. So that is the vital signs. I think in this day and age, Justin a lot of people would think of vital signs as what you might think about a medical office. But I think the vital signs is, “Am I sleeping enough? Am I moving enough?” And so vital signs in the digital health era I think are more around metrics like those ones as much as they are around heart rate and blood pressure, for example.
Justin Marchegiani: Absolutely. And there are some things like maybe your doctor may have you run a functional glucose tolerance test for you. You eat your breakfast and then chart your blood sugars for the next three hours after that where you could maybe add that element in, too. Like a one hour, two hour or three hour after your…
Dave Korsunsky: Yes. And that is something that I do regularly, just testing different meals and their effects on my blood sugar. So, for example, one thing that I have been doing is entering glucose after different meals for example.
Justin Marchegiani: Nice.
Dave Korsunsky: So you can see I can enter a reading as fasting 1 hour, 2 hour or 3 hour or put the medication tags on it. And what that allows us to do is, I will just show you how the graphing engine works, where I can actually just look at my glucose for example and you can see here I can actually toggle between the 1 hour and the 2 hour and the 3 hour and even graph it against other sources like exercise. But you can see from my 1 hour readings, and actually if I moved the mouse over to each data point, it shows exactly what I ate so I know which one spiked it more than others. So, that is how we are doing a lot of the graphing work in addition to just the raw data collection.
Justin Marchegiani: Yes, this is very Apple-apps, super easy, user-friendly. Can you show people how the food diary part works? I know, you just got an integration with MyFitnessPal, I think?
Dave Korsunsky: Yes, that we just actually finished the integration and we are just building in the features to bring in that data. So that is not something I can show you today, but that will be working within the next week or two. The MyFitnessPal data will integrate here. It will actually just show within the analyzer, here. I will go back for a moment. So it will show up as another data source. It will show up under nutrition. And then you will have total calories, macronutrients. And those can be plotted as well for example.
Justin Marchegiani: That is great.
Dave Korsunsky: So this is the labs and this is my own data. This is all of my records for the last 10 years. Some of these are coming in automatically through connections to UCSF. Some of them are coming from the labs that you had me run which were entered manually. But the main thing is I have all of my history here even though these information were probably scattered across four different doctors’ offices and 10 different PDF files. And so I get everything in one place. Here is my total cholesterol. You can see that difference just going on and off. Paleo for example, how some of the diet affects cholesterol. These are the things I can trend and track myself. So, when you have everything in one place you get a lot more insight into yourself. I probably got six more years of history in here than any one physician. That is the power behind integrating this all into one specific system.
Justin Marchegiani: That is great. Is there a certain section here for notes, at all?
Dave Korsunsky: Not for individual biomarkers, per se. That is something also that we are thinking about adding. So if I wanted to flag a particular reading with just some of my own personal notes that is something we just got a feature request for, very easy to do. And so we are looking at adding that. But that does not exist today; it is something we can easily add as we go.
Justin Marchegiani: How about just a section for notes for maybe a person just trying to rate about how they are feeling on a certain day or a doctor coming in there that wants to make some notes on maybe some stress factors or something else that they want to add in?
Dave Korsunsky: Yes, it’s a simple journal feature and will just be in here. There will be a place to add journal entries and so that will be a place just for adding notes.
Justin Marchegiani: And so if your file here and let us say, you bring another nutritionist or an acupuncturist on board and you would not let them have access to your file, how does that work?
Dave Korsunsky: Sure. So, it will simply be a situation where you will be able to invite them into your profile. You will be able to control which permissions they are able to see and then authorize or de-authorize that individual at any time. But in my case, for example as I have mentioned my sister is a health professional. I want her looking at my data. I want yourself to have access to my data. I would also like potentially an MD or other people on my care team to have access. That is a very difficult thing to do and we are doing it all in ways that are fully HIPAA compliant. It is challenging but we will have that available. And so the goal is that you will be able to have your whole care team collaborate with you around your information. So that is the vision.
Justin Marchegiani: Yes, my wife had a family member that got injured this last winter. And while she was in the hospital care taking, she noticed the physicians that were coming in and out of the room. Literally, there was virtually no communication between them. And there was not a streamline system to keep information you know at people’s fingertips. So it seems like maybe certain hospitals, they have a software like this for that hospital.
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