Practitioner Portal Walkthrough - Tiny Health

My name is Emily Serda and I'm a microbiome specialist here with Tiny Health. I'd like to give you an orientation to the practitioner portal. When you enter your results, the first thing you will see is the patient view of the results as well. This is important because the first notable thing on the screen is the microbiome summary score here at the top. That score is compiled from an algorithm that takes the metrics below all of the findings in the report into account. This is configured based on the patient's age and we do have different ranges for infants, toddlers, children and adults. The other things to note here on the main results page is over to the right. You will see that there is an action plan so the patients do receive actions based on these results. We will talk about how to really streamline that for your patients so that we can reduce overwhelm. I'm going to go down into the See all metrics button here. Click into that and this is where you can get all of the insights with stool chemistry that will appear at the top right in line with all of the shotgun metrics as well. In these insights you'll notice that we separate the results into great normal needs improving and needs support. For any of the insights you can click in to the metric and you will be able to see what the reference range is for that individual's age. You'll also be able to scroll down within the microbial metrics. If they resample over time, you will be able to your beneficial microbes collapse that category and then move on to look at pathogens, collapse that category and so on. It's also worth noting in our test you will see different indices, you will see bacteria or microbes that we are looking for and you will see metrics that say capacity. And because with whole genome sequencing we are looking at that whole genome, we are looking for both the microbes present in the gut and then also the genes present to perform certain functions in the microbiome. This methane production marker is a great example of this where we are looking for the specific microbe Methanobrevibacter smithi. Methane production capacity is where we're looking to see if the microbes in the microbiome are carrying the genes to produce methane and so this capacity becomes a functional marker of the microbiome's ability to perform different functions. You will also see indices mucus degradation index, for example. In indices we are taking into consideration both the taxa present to the microbes present in the gut, for example, and mucus degradation Index if you scroll down you will be able to see the mucus degraders into this individual samples. We are also taking into consideration the genes present for the function of mucus degradation. We within an index. So the indices are a combination of the taxa and the genes. As we move down you'll be able to see the different categories. So you'll see beneficial microbes, the disruptive microbes or pathogens. Gut inflammation. These are the indices. Microbially driven inflammation, short chain fatty acid production, butyrate capacity. So these short chain fatty acid capacity means that are the genes present for this function in the gut. Digestion and absorption markers are similar. With the word capacity. We are looking at those functional metrics or the genes present to help with the digestion of these different food types. In the balance and robustness section. This is really kind of a zoomed out view, a thousand foot view of what this gut environment looks like. Where we can see richness and diversity or like an alpha and beta diversity for this population you will be able to see overabundant species. These species are different from pathogens in that they are supposed to be there. At low levels you will see there is a grape, there's a normal range here. And then at high levels they start to be associated with different conditions and detrimental actions to the gut. Further down you'll see our gut resilience scores. Oral microbes, all the major phyla, common microbiome members, which are those ones that can be opportunistic. We need them at low levels but not at high levels. Then the microbial enzymes and metabolites section where we do call out all of these metrics, including a number of functional metrics looking at GABA production and bile acid production capacity within any of these metrics when they are out of range. Secondary bile acids for example, when you click into the metric on the right hand side you will see the action items that are linked to this metric. So eating more fiber like Konjac glucomannan could help to bring down this this metric back into range. For any of these, when you click into them you will see the actions. We'll have a little about section, some recommendations about duration and how to use or how to implement this action. We list food things supplements as well, especially for adults. This action plan, like I said it is linked to the metric itself. And on the left hand side you can also navigate to the entire action plan underneath the results tab. Supplements as well, especially for adults. This action plan, like I said it is linked to the metric itself. And on the left hand side you can also navigate to the entire action plan underneath the results tab. If I click on that action plan, this does bring up everything in the order of importance that we feel is best for this gut result. So increasing butyrate production capacity would be the number one action that we would like to take for this individual. And if I click on that action plan, this does bring up everything in the order of importance that we feel is best for this gut result. So increasing butyrate production capacity would be the number one action that we would like to take for this individual. And any of these actions down below will help to bring that up for that individual. So these you will see here, there are six actions linked to this and it is up to you and your patient presentation of course to figure out which one may work best for them and their lifestyle. Any of these actions down below will help to bring that up for that individual. So these you will see here, there are six actions linked to this and it is up to you and your patient presentation of course to figure out which one may work best for them and their lifestyle to reduce overwhelm. Like I said, sometimes you will have a kind of a a lot of red marks in a report and as you scroll down you'll see a lot of actions here and then even more in the yellow needs improvement section and patients can feel overwhelmed by that. So one thing that you can do is to click in to any of these metrics. I will click into fermented foods for example and scroll down and you will see that we have little bookmarks on the side. So perhaps for this individual to reduce overwhelm. Like I said, sometimes you will have a kind of a lot of red marks in a report and as you scroll down you'll see a lot of actions here and then even more in the yellow needs improvement section and patients can feel overwhelmed by that. So you would like them to read about diversity for resiliency and getting get some ideas for this. This is a PDF that you can share with your patients. And then further down perhaps this individual cannot have cow's milk, has a cow's milk allergy. So you would know One thing that you can do is to click in to any of these metrics. I will click into fermented foods for example and scroll down and you will see that we have really like them to consider. Maybe some sauerkraut pickles and maybe some miso would be great for them. What happens when you click these bookmarks, little bookmarks on the side so Perhaps for this individual is that it compiles your recommendations and and pulls it over into the bookmark section. So if I click on bookmarks only, the things bookmarked will pop up. And often with patients who have complex reports that are going to need a bunch of tiers of intervention, you can bookmark the first three things, then send them a message and say don't worry about the overwhelm. Click into the bookmarks and that's where we'll start until we can meet again in the action. You would like them to read about diversity for resiliency and get some ideas for this. This is a PDF that you can share with your patients. And then further down perhaps this individual cannot have cow's milk, has a cow's milk allergy. So you would reach and plan. We also have so we have this. The needs support and needs improvement are based on those red and yellow markers within the test results down below. We do have a section called resources based on your survey. There's nothing here in this report but if a patient has eczema or constipation, I'd really like them to consider maybe some sauerkraut pickles and maybe some miso and reports that on their health surveys when they activate would be great for them. What happens when you click these bookmarks is that it compiles your recommendations and and pulls it over into the bookmark section. So if I click on bookmarks only the things bookmarked will pop up and often their test. There will be recommendations that populate here. These recommendations for eczema and constipation, for example, are not meant to shift the microbiome necessarily, but they can be a jumping off point to help with symptoms and different lifestyle recommendations to help with the condition. We also have an additional resources section that's available on and with patients who have complex reports that are going to need a bunch of every test here. We do have different ways to probiotics, for example to recover from antibiotic treatment and years of intervention. You can bookmark the first three things then send them a message and say don't worry about the overwhelm. Click into the bookmarks and that's where we'll start until we can meet again in the action. Be able to see everything else down here. The other resources are pulled in based on the patient's age and what they have put in their survey. The probiotics for recovery for antibiotics, for example. If I click into that again, it's going to give some guidance about action plan. We also have so we have this. The needs support and needs improvement are based on those red and yellow markers within the test results, how to use these and for you it will give you the ability to have a jumping off point for recommendations that you may. Down below we do have a section called resources based on your survey. There's nothing here in this report, but if a patient has eczema or constipation and reports that on their health surveys when they activate their test, there will be recommendations that populate here. These recommendations for eczema and constipation, for example, are not meant to shift the microbiome necessarily, but they can be a jumping off point to help with symptoms and different lifestyle recommendations to help with the condition. We also have an additional resources section that's available on every test here we do have different ways to probiotics, for example to recover from antibiotic treatment. And you'll be able to see everything else down here. The other resources are pulled in based on the patient's age and what they have put in their survey. The probiotics for recovery for antibiotics, for example. If I click into that again, it's going to give some guidance about how to use these. And for you it will give you the ability to have a jumping off point for recommendations that you may want to make for your patient. Okay, so I'm going to go back to the results page here. On the main results page we also have a very powerful section called the want to make for your patient. Okay, so I'm going to go back to the results page here. On the microbiome breakdown and gut type section over on this side, when you click into that, you will see the gut type for the individual. This does this is based on the dominant bacteria types that are found in the individual's microbiome. And based on those bacteria types, we know what this gut should be good at. This one, for example, is great at digesting fiber and turning it into butyrate. Down below the gut type section, the microbiome breakdown is here. And so we have all of the metrics that we report in the main section of the test. But this is where you'll be able to see all of the species in the patient sample. Here you can look to see the very topmost species or the most abundant species all the way down. If I were to scroll down to the point.005% range, which is, which is our sensitivity level here, you'll also be able to see a line that really breaks down the microbiome into the amount of unfriendly beneficial variable, which are those opportunistic ones that we need at low levels, but not individually at high levels. And then unknown species that science just doesn't know about. They are in databases, but we don't quite know their function yet. So you'll be able to see that in a line, which can be very helpful. You can also sort. So just like the metrics in the main page, if I unclick everything except unfriendly, you will be able to see only the unfriendly species in this individual's gut. So it is a powerful view here. You can also look by genus, family or phylum if you find that helpful. And then at the species level, if you were looking for a specific bacteria, let's say Streptococcus, for example, you can type into the search and it will find all of the Streptococcus strains in the sample. Okay, back out to the main page. Also on this main results page, we can scroll down and if I go underneath the main findings, this does match up with those main actions that we saw. And then further down you will see that we have a condition section. In the condition section, this is looking at condition associations. So based on our internal data, when somebody reports constipation, for example, on their survey, we have had a number of tests where we can see what the gut looks like when there is reported constipation. So over time, we're able to start to pick up on patterns and see what may need to shift in order to ease some of these conditions. If we click into any of these, let's click into hypertension, for example. Here we can see that having a lower butyrate and a, an overgrown Ruminococcus nabis species and then a higher TMA or trimethylamine. Also, these all may be related to hypertension. And so this can be a nice jumping off point if you have a lot of metrics to work on, but they're coming in with a main complaint. You can kind of see what metrics that you may want to tackle first. Down below, you'll be able to read about the condition, the condition associations, and it is worth noting that for these condition associations, they are different based on the age of the individual. So, for example, we are not reporting on hypertension in toddlers. So adults definitely have some different condition associations compared to some of the children. Okay. The last place that I would like to show you as a practitioner, I think it's important to go to know that you can go to the home section of this page and here you'll be able to see the patient's tests if they've done more than one it will list those here. And even more importantly you will see health responses for each test that they've submitted. So sometimes I meet with practitioners and they have yet to meet with their patient but the patient has run the test and so you don't have that full health history. By clicking into Health Responses you're going to get the survey answers that they gave to us when they activated the kit. So you'll see the main complaint. You'll be able to see if they're on medications or supplements, what the sample type was like, whether it was a loose stool, whether there's constipation. All of that here when you click Health Responses so it can be a nice way to have that information going into the test interpretation. Okay I hope this was helpful for looking at the Practitioner portal. You are always welcome to schedule a call for further support or for results review.