Dec 9, 2013 • 20M

Declining Heart Rate Variability as a Predictor of the Onset of Disease: A Conversation with James Palmer (December 12th)

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Appears in this episode

David Introcaso, Ph.D.
Podcast interviews with health policy experts on timely subjects. The Healthcare Policy Podcast website features audio interviews with healthcare policy experts on timely topics. An online public forum routinely presenting expert healthcare policy analysis and comment is lacking. While other healthcare policy website programming exists, these typically present vested interest viewpoints or do not combine informed policy analysis with political insight or acumen. Since healthcare policy issues are typically complex, clear, reasoned, dispassionate discussion is required. These podcasts will attempt to fill this void. Among other topics this podcast will address: •Implementation of the Affordable Care Act •Other federal Medicare and state Medicaid health care issues •Federal health care regulatory oversight, moreover CMS and the FDA •Healthcare research •Private sector healthcare delivery reforms including access, reimbursement and quality issues •Public health issues including the social determinates of health Listeners are welcomed to share their program comments and suggest programming ideas. Comments made by the interviewees are strictly their own and do not represent those of their affiliated organization/s.
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Human physiology or biological functioning exhibits fractal or irregular patterns.  When heart rate, (or respiration rate, blood pressure, brain waves and even walking stride length) begins to lose its fractal dimension or there is a loss of heartbeat variability, this is an indication of illness.  In order to respond best to environmental circumstances, adaptative variability (not homeostasis) is what organisms strive toward.  Measuring therefore the decline in heart rate variability over time can serve as a clinically effective biomarker for the onset of disease, for example, the onset of chronic obstructive pulmonary disease (COPD), one of the leading causes of hospitalizations and re-hospitalizations.  

During this 20 minute interview Professor Palmer explains briefly the science behind what explains heart rate variability and variability more generally in biological functioning, what are the clinical or health care or clinical applications for this research, his research to avoid COPD hospitalizations and the onset of infection for leukemia patients, the larger implications of this research work and receptivity toward this different paradigm in understanding biological functioning and disease progression.

Dr. James Palmer is an Assistant Professor in Family Medicine at the University of Colorado's Anshuyltz Medical Campus in Denver.  His research concerns testing and developing the use of heart rate interval dynamics as an actionable prognostic biomarker for earlier detection and diagnosis COPD exacerbation.  Dr. Palmer also has an independent professional practice that designs applications of complexity sciences to improve clinical care processes and outcomes.  His work has helped to develop and implement healthcare improvement projects both in the US and Canada.  Dr. Palmer completed his Doctor of Management in 2007 at the Complexity and Management Centre, University of Hertfordshire, UK.  He was also educated as an economist at the University of Chicago (MA) and Texas Christian University (BA).

For a review of the theory behind and applications for monitoring variability see, for example, Andrew JE Seely, et al. "Continuous Multiorgan Variability Monitoring in Critically Ill Patients - Complexity at the Bedside," at: