Navigating Healthcare – Patient Safety and Personal Healthcare Management

World Malaria Day 2017

Posted in Africa, DigitalHealth, Healthcare Technology, Innovation by drnic on April 25, 2017

Malaria

 

World Malaria day is today – Tuesday, April 25, 2017. Recognizing global efforts to control and perhaps one day eradicate this major killer that disproportionately affects my home country of Africa.

The WHO African Region continues to shoulder the heaviest malaria burden, accounting for an estimated 90% of malaria cases and 92% of malaria deaths in 2015. The WHO South-East Asia Region accounted for 7% of global malaria cases and 6% of malaria deaths. Three quarters of these cases and deaths are estimated to have occurred in fewer than 15 countries, with Nigeria and Democratic Republic of the Congo accounting for more than a third

 

Status of Malaria Today

Based on the WHO 2016 Malaria report there were 212 Million cases globally of Malaria. While we have seen some great progress with a decrease in Malaria infection rate between 2010 and 2015 of 21% and a decrease in the mortality rate of 29% we have a long way to go. Almost Half the population of the world is at risk from Malaria, and in 2015 an estimated 429,000 people died from Malaria. That’s the whole population of Miami dining every year.

Source: Marc Averette

More than 2/3 of the deaths that occur in children under the age of 5 and pregnant women are really susceptible – that’s a double hit on vulnerable populations.

The lifecycle encompasses the mosquito as carriers and transmission to humans. This is a great graphic summarizing the

 

 

Prevention and Treatment

The basis of prevention and treatment is tied to 3 basic methods

  • Insecticides and Mosquito Nets
  • Indoor spraying of insecticides
  • Preventative Therapies for pregnant women, children and infants in Africa

 

The good news is that advances in Digital Health and mobile technologies that are bringing testing capabilities to many remote and underserved areas. Testing rates of suspected malaria cases have increased from 40% in 2010 to 76% in 2015 much of it due to rapid testing capabilities that economical and are increasingly available.

Sadly despite the progress, some of the mainstays of prevention and treatment are being impacted by the emergence of insecticide and drug resistance that has seen 60 countries reporting resistance to at least one of the 4 classes of insecticides and even more troubling 5 countries have reported drug resistance to the core compound used in antimalarials artemisinin

 

 

The report card by country is a mixed bag with some progress and success but increases in incidence in other areas

Many organizations have been working hard in this area and that includes the work by the Bill and Melinda Gates foundation has been focusing for many years on a World free of Malaria. They have invested over $2 Billion in grants spread across multiple areas prevention, mitigation and treatment.

Current Problems

Its a tricky virus that uses all sorts of clever subterfuge to fooling our bodies and the other carriers into ignoring the infection. There is even a clever “bending” of the red cell wall to allow the virus to enter more easily as demonstrated at Imperial College – Malaria parasites soften our cells’ defenses in order to invade:

However, now researchers led by a team at Imperial College London have found that the parasites also change the properties of red cells in a way that helps them achieve cell entry. The results are published in Proceedings of the National Academy of Sciences.

There are many fronts open and Papua New Guinea are one of the countries that dare to hope with encouraging progress that may bring about the end to the disease

In PNG, control measures – in particular the rollout of long-lasting, insecticide-treated bed nets – have resulted in the prevalence of malaria declining by more than 80% across the country since 2009. Cases reported at four sentinel sites have dropped from 205 to 48 per 1,000, surpassing all expectations.

 

New Strategies in Treatment of Malaria

There has been a lot of work on Vaccines for Malaria and it would appear some successful studies including this one from Germany

University of Tübingen researchers in collaboration with the biotech company Sanaria Inc. have demonstrated in a clinical trial that a new vaccine for malaria called Sanaria® PfSPZ-CVac has been up to 100 percent effective when assessed at 10 weeks after the last dose of vaccine.

So perhaps like Dengue – it may be “The Beginning of the End”. Let’s not let up – this is a major killer. Even with prevention and mitigation therapy as expatriates living overseas in Malaria ridden areas my mother still contracted the disease. We have had a global eradication program in action since the 1950’s – with advancement in science and understanding perhaps we are finally on the cusp of eradication?

You can find out more here and download the Infographic: Malaria Can Be Defeated

 

World Malaria Day 2017 was originally published on Dr Nick – The Incrementalist

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Digital Health Summit

This is Australia’s premier health innovation convention on the technologies that are revolutionizing healthcare and the implementation of ehealth initiatives and I was honored to be asked to give a keynote presentation at the Digital Health Summit taking place in Melbourne 29-30 March 2017. The bonus was listening to so many great presentations throughout the day from some great speakers.

The Perfect Storm for Healthcare

The opening session that set the tone for the future came from Alfred Poor, Editor for Health Tech Insider who eloquently described the perfect storm of The Internet, wireless communications and the pervasive smartphones that last year shipped 1.5 Billion – enough to provide one for every 5 people on the planet. Innovation that can take off the shelf technology and create accessible telehealth programs that reduce readmissions from 20% to 6%.

Everything from wearables devices to non-invasive sensors and monitoring to allow the capture of data on patients, improve care and treatment options and allow the elderly to safely stay in their home. Innovations that address the major challenges around the world in the society that needs to adapt and focus on wellness:

2009 Continua Health Alliance Brigitte Piniewski, MD

 

Stuart Smith took us through the potential for Gamification: exploring the magic of video games in health and rehabilitation providing repeated examples where implementing Gamification to engage with patients was seen as some kind of Voodoo by his colleagues who were amazed at the incredible success and high utilization by patients

He showed examples of rehabilitation patients using Sony Play Station with Microsoft Kinect that made the rehab program a positive experience and even had the audience dancing along with Dance Dance Revolution explaining how they had adapted this to elderly patients and using Glenn Miller and Big band music

With the explosion of data comes increasing risks to the security and privacy of data and Nathan Steiner Veeam Software detailed the expanding risk and the staggering incidence of data breaches that extend well beyond healthcare which remains the top target for hackers. No surprise and notably the FBI highlighted the hacking community that is targeting vulnerable FTP servers.

Julian Bright and Adrian Medhurst from Amelie AI took the audience on an interactive journey with an Artificial Agent focused on mental health issues and braved the Live Demo gremlins as captured on this Periscope:

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Personalized Medicine

 

Dr Robert McLeay, Founder, DoseMe highlighted the changing nature of medicine that improves on the old style model of guess work on drug choice and dosage and builds individual models to reduce the side effects and maximize the selection of the right drug for patients first time round – practical personalized medicine available for your patients today

Professor Phil Robinson, Head, Cell Signalling Unit, Children’s Medical Research Institute (CMRI), co-lead of The Australian Cancer Research Foundation International Centre for the Proteome of Cancer (ProCan) shared the exciting international progress being made in fighting cancer with industrial scale proteomic system that they have set up in the Children’s Medical Research Unit that was Announced by Vice-President Joe Biden on 17 July 2016 in Melbourne as part of the Cancer Moon shot that has rapidly grown to include 10 Nations, 18 Institutions. They are now producing huge amounts of proteomic data and creating Digital Proteme Maps that has been committed to the public domain indefinitely to facilitate ou sharing and learning and will be providing new options for targeting cancer. You can see more about their project here.

Digital Health Innovations from the Front Line

 

We heard from 2 clinicians from the US Aenor J Sawyer, MD, MS Director, UCSF Skeletal Health Health Innovation &Tech in Ortho University California, San Francisco and Dr Megan Ranney, Associate Professor of Emergency Medicine; Director, Emergency Digital Health Innovation program, Brown University. They shared the experiences from UCSF and Brown University of applying digital technology in the clinical setting offering insights into the use of sensors, Virtual reality and how to evaluate the technology in the context of a busy hospital and Emergency room.

 

After lunch, the panel session on the future of aging was hosted by The Hon Bronwyn Pike, former Victorian Minister for Housing, Aged Care, Community Services, Health, Education, Skills and Workforce Participation focusing on the innovations in place and how the sector can benefit from the data and analytics increasingly available from the digital transformation taking place. and then a detailed review of the great Victorian Stroke Telemedicine Program that has been rolled out with great success by Prof. Christopher Bladin, Program Lead – Victorian Stroke Telemedicine Project, The Florey Institute of Neuroscience & Mental Health with a proven protocol that is statewide and heading nationwide

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Social Media in Healthcare

 

Professor Enrico Coiera, Director, Centre for Health Informatics, Australian Institute of Health Innovation offered some tantalizing insights into the way that social media is changing the way we think about health. Not only does Social Media offer a means of reaching and engaging with patients it is also a potential avenue for treatment. The social propagation of obesity as detailed in this New England Journal of Medicine article: Network Medicine — From Obesity to the “Diseasome” and these complex networks are of direct relevance

He left us wondering of social media can treat social disease (his BMJ article Social networks, social media, and social diseases talked about this concept)

Modeling of Data

 

James McCaw, Associate Professor in Mathematical Biology, The University of Melbourne shared insights into the modeling for influenza forecasting and pointed out that despite how much progress we have made in medicine the influenza pandemic of 1918/9 (Spanish Flu) would have a similar effect on the population today

The models for prediction have improved but he likened them to weather forecasting capabilities from the 1970’s

 

It was a great day filled with insights from a wide selection of experts covering a huge range of areas. All the talks were engaging with practical tips and wisdom that the attendees could take back and use.

Digital Health Summit was originally published on Dr Nick – The Incrementalist

The Best Exotic Marigold Hotel

Posted in DigitalHealth, Healthcare Technology, Innovation, Inspiration, Technology by drnic on February 9, 2017

HIMSS is rapidly approaching and I am excited to be presenting:

The Best Exotic Marigold Hospital: Learning digital lessons from the hospitality industry to personalize the healthcare experience on Monday February 20, 2017 — 01:30 PM EST – 02:30 PM EST in the Chapin Theatre (W320) – Session ID:
43

The Friction of Travel

As part of my role I travel a lot and I have watched the travel experience change over the last several years. Remember the time when you actually visited the check-in desk before proceeding to the gate to get your boarding pass?

 

I remember that in the early days I still wanted to go to the check in desk but quickly discovered that the ability to check in at home the night before made my life easier and reduced the friction of travel. The same is happening in the hospitality industry and I am excited to be presenting with Nathalie Corredor, SVP Startegy for Hilton Worldwide

 

The Hilton group have invested a huge amount of effort in refining their Digital Experience you can do everything from make a reservation, choose her room, get your digital key access once again decreasing the friction of travel. This increases the customer satisfaction and improves the hotel staff productivity so instead of spending time checking in guests and creating key cards, the staff can spend their time making sure guests feel welcome and taking care of their individual requests and needs. By removing people from the administrative process, the hotel was able to make the guest experience more welcoming and friendly.

Healthcare environments can learn some important lessons from the hospitality industry, as well as retail and travel websites. By taking service staff out of tasks that are more efficiently done by computers, these industries are able to personalize the customer experience, improve accuracy of data entry and cut their costs.

For companies in the hospitality, retail and travel industries, efficiency, accuracy and cost control is directly related to their ability to compete successfully for customers. But just as important is the customer experience. These industries have learned that a customer irritated by the friction in the buying/checking in process is a customer who will seek out other options in the future. While some customers will put up with a poor experience to cut costs if they must, as soon as those customers find an affordable option that is less irritating, they are gone. And, importantly, companies are no longer being compared just to the competition in their own market — now their competition is any optimal experience from any industry. If our online interaction with Amazon is friction-free, then we want and expect the same experience from everyone else.

You can read more here on the Beckers Health IT and CIO Site (Beckers – The Best Exotic Marigold Hospital – Nick van Terheyden)

 

 

The Best Exotic Marigold Hotel was originally published on DrNic1

Healthcare in the Year 2030

The Year 2030

by Dr Nick van Terheyden (@DrNic1)

How will the world of medicine change in the next 15 years? Well 15 years ago AOL had just bought Time Warner, the human genome had just been deciphered and published and the first inhabitants of the International Space Station had arrived.

The Year 2030 – my bed has been tracking my vital signs throughout the night and notices I was restless and managed fewer REM cycles during sleep than usual. Prometheus (my personalized artificial automated agent) checks my calendar and traffic and elects to wake me an hour later. Appointments for the morning are rescheduled and my drone pick up is postponed. Prometheus sends an update to “Hestia” (my kitchen AI) with instructions to increase the energy component of my meals for the day to adapt for the lack of sleep and deliver a boost of energy with almond snacks through the day. Prometheus sends my updated sleep and vitals data to my personal health record. While I rest peacefully the rest of the household is awakened and sets about their day.

 

Time to Get Up

When it’s time to awaken, the bed starts warming to ease the process, the lights slowly turn on and the GPR (Galactic Public Radio) custom news cycle is playing gently in the background. My calendar has been reorganized, and there’s an additional appointment with Asclepius (My health AI) before I leave in the morning. My food is ready and waiting and contains a boost in energy, helping me wake up and acclimate after the poor night’s sleep. I hear the inbound calling for Asclepius and take the call. We review the reasons for my poor night’s sleep and agree I should track this more closely for the next few days to ward off any potential problems. In this instance Asclepius suggests no further investigation is warranted, but if I am worried a drone will be dispatched with some auto investigator tools to apply and track additional parameters if necessary.

Personal Drone
Personal Drone

As we finish my personal drone arrives and I step outside, catching my foot on a fallen replicator brick discarded by one of the children. As I fall my head strikes the corner of a table and carves into my cheek. Prometheus is immediately on top of the situation checking on my vitals, and while no major damage to my body, the cut will need review and probably some stitches. Checking with local urgent care facilities, the optimal treatment for me today is a quick trip to the urgent care clinic and my drone is reprogrammed to take me there immediately.

Urgent Care in the Future

As I arrive my MedicAlert Digital Bracelet transmits my allergy to lignocaine and identifies me based on the bracelet

and my retinal scan taken as I walk through the door, which authenticates my presence and consent initiates transfer of my medical data and records to the clinic.

Robot Nurse
Robot Nurse

 

 

I’m guided to a room where a robot nurse cleans my wound and positions me on the bed and brings in the Panacea (the medical repair robot). My medical record shows I have had a recent Tetanus shot, and a comparison of my previous vitals shows there are no serious changes that would warrant additional investigation. Repair completed, my records are updated with the new details and a drone appears to take me to work.

 

 

 

Medical Offices and Care in the Future

As I step into my office my team are all walking in (virtually) and the central console and screens around the room light up with data on our first patient. We process through the details provided by the various Artificial Intelligence agents and data gathering tools. “Jane” (name changed to preserve her privacy) has been having some frequent dizzy spells and falls – her mother had Meniere’s disease and a degenerative disease linked to the A2ML1-AS1 / ADAM20P1 / MTor Complex 2 / WDFY3-AS2 – we think there may be a link. Even though Jane does not have these gene expressions there may be a new epigenetic influencer she received that is affecting her stable sequence. We need to get to the bottom of this. Jane is here too (virtually) – with her mother and father – and they are looking at the same data, shown with basic annotations to help them understand the details.

South Korean Researchers unveil first CRISPR nanobot editor
South Korean Researchers unveil first CRISPR nanobot editor

We think we have an answer, but want to share the details and show Jane and her family the model of the CRISPR editor nanobot and its effects before we decide on the next course of action. Do we create a more realistic model of her body functions with the cell printer and test on that? Or is the confidence in our simulation high enough to warrant immediate therapy? Whatever we decide we will get real time approval from the GMAA (Galactic Medical Agent Agency that replaced the FDA in 2021). Jane and her family have seen a new therapy advertised and they want to understand how that might work for them. We pull up the details and all the data on patients and do an immediate comparison. The data’s questionable but, more importantly, it’s contraindicated in anyone with GRAMS domain, Heat Shock 70kDa protein expression and several others that disqualify Jane.

We elect a wait and see approach – so much easier these days with the real time monitoring and detailed data we have on patients that allows us the scope to wait and watch while reassuring patients. Directives are sent to their family “agents” and a drone dispatched to their location with some additional monitors for Jane to wear to give more detailed data on her for the next few days.

Amazon Prime Air Drone Delivery
Amazon Prime Air Drone Delivery

 

As we complete the consultation a drone arrives with my almond snacks and some water – perfect timing.

 

 

 

 

 

 

This post appeared in abbreviated form on SHIFT communication site – and is included in their downloadable ebook

 

Healthcare in the Year 2030 was originally published on DrNic1

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Joining the MedicAlert Board

MedicAlert

I am excited to be elected to the MedicAlert Board joining Jessica Federer, head of digital development at Bayer. As Barton Tretheway, CAE, chair of the MedicAlert Foundation Board pointed out

Their collective experience aligns with our priorities and will be immeasurable to us as we look to leverage the power of new technology to expand the mission of MedicAlert Foundation, which is designed to help save lives

Which succinctly captures my feelings around this additional role. I personally experienced the value of the MedicAlert solution, brand and promise when I practiced as an Emergency Room physician in the United Kingdom. It was part of the standard procedure for any patient who arrived unconscious or confused to look for the signature bracelet

Traditional Medical Alert Bracelet

 

With its iconic Caduceus (similar but different to the Rod of Asclepius) which was the traditional sign of the God Hermes and became established as the symbol of medicine in the United States in the late  19th Century.

History of MedicAlert

The Original MedicalAlert User – Linda Collins

The history of MedicAlert dates back to the Early 1950’s developed by parents of Linda Collins who had an who had an anaphylactic reaction to tetanus anti toxin (which in her instance she only received a small scratch test as was the practice in 1953) and had a severe reaction. She survive but her parents Dr Marion Collins and his wife Chrissie realized that she was at risk and made a paper bracelet and note that was attached to her coat detailing her severe allergy.

 

 

 

 

 

In fact the original MedicAlert Bracelet is now in the permanent collection of the Smithsonian Institution in Washington, D.C. Today

The Original Bracelet stored in the Smithsonian in Washington DC
The Original Bracelet stored in the Smithsonian in Washington DC

From these modest beginnings things have developed with early recognition by “Peace Officers”. The California Peace Officers magazine even ran an article back in January 1957 highlighting the MedicAlert bracelet to their members. In the era before mobile phones and always on communication it was a reliable way of identifying individuals and providing immediate access to a 24- hour phone line linked to critical and life saving information for that individual. This function continues today with a live 24/7 Emergency Response Service

I worked on one of these switchboards as a Medical Student many years ago

 

 

with full health and personal information including your personal health record and emergency contacts information and available in other countries including Australia, the UK, Canada and South Africa to mention a few through affiliates and partnered with many groups including AAFP, Alzheimer’s Association, ACEP, Autism Association, Philips LifeLine, National Alliance of Mental Illness, Food Allergy Initiative – to mention but a few

The age of computing brought new innovations and the ability to more readily store and retrieve more information for members and track and follow membership and presidential recognition dating back as far as April 9-16, 1978 when then President Jimmy Carter commemorated the occasion of MedicAlert and their contribution to Medic Alert week in April. Even Hollywood got in on the act with appearances of the MedicAlert in everything from the Today Show and Good Morning America to CHiPs

and Columbo

Peter Falk in Columbo

 

Moving into the Digital Age

The organization is moving into the digital age with solutions around stored medical records, moving to digital mobile formats and storage solutions and even exploring the potential for RFID enabled solutions and in partnership with the American Medical Association has a joint venture on advanced directives.

Back in 1956 Dr Marion Collins commented that

“I think I can save more lives with MedicAlert that I’ll ever save with my scalpel”

Which is much like my own perception of medicine and the opportunity of Digital Health that I saw 30 years ago and continues to be the case. It’s this combination of a storied brand and concept from MedicAlert as a foundation and the opportunity to update for the new Digital world we live in that presents such an exciting opportunity. We are facing a Silver Tsunami of people who struggle to age in their homes and technology and solutions that help them do so, safely and with the support of their relatives and the health system will be in high demand.

I’m looking forward to working with my fellow board members and the MedicAlert team to continue the tradition and build on the brand with a Digital update and twist

 

 

 

 

 

 

Joining the MedicAlert Board was originally published on Dr Nick van Terheyden, MD

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The Dell World DoMoreHIT Panel

Posted in #DoMoreHIT, Dell, Healthcare Technology, HealthIT, HIT, Innovation, social media, Technology by drnic on April 1, 2016

On Tuesday March 15th, 2016 a the Dell Lounge at South by Southwest (SXSW) we hosted the #DoMoreHIT Thinktank event.

This was Dell’s 5th’s annual healthcare Think Tank. Together with my good friend and colleague Mandi Bishop – Healthcare Analytics Innovations & Consulting Practice Lead, Dell, #HIT100 influencer, @MandiBPro we were joined by a veritable who’s who of thought leaders from healthcare and related industries for an outstanding set of panelists:

  • Claudia Williams, Sr. Advisor, Health Innovation and Technology at White House Office of Science and Technology Policy

2016DoMoreHITPanelists

 

 

We divided the session up into three segments –  Data explosion in Healthcare, Embracing New Technology and How to be Future Ready

 

The Data Explosion in Healthcare

  • Physicians, patients and health systems are over whelmed with data – is there too much noise to discern the signal of relevance?
  • Is there any focus area for gathering or managing data that healthcare should target over others (wearables vs genomics vs population health vs clinical data vs lab values vs imaging for example)? And are there data sources outside those traditionally considered “health” that you’d consider particularly relevant?
  • What can patients – and clinicians – do to get ready for the deluge of data and information that they will be receiving and become increasingly responsible for managing?
  • How can we, as an industry, and our individual organizations help make the vast quantities of diverse data into meaningful information that can be readily understood?
  • How much do you trust the quality of the data sources your organization is using for BI and analytics? And how do you address it if/when you don’t trust the data quality?
  • If your organization is collecting data about your patients/consumers, do you offer that data – and any health insights derived from it – back to those patients/consumers? If so, how? And if not, why not?

 

 

Embracing New Technology

  • How do we embrace technology while keeping the focus on patient and compassion?
  • Is there any new technology that stands out as delivering value that patients, clinicians and health systems can jump on, now?
  • Do you think there’s a fear amongst healthcare providers that digital health technology, in conjunction with advanced analytics, will change – perhaps reduce – the role of the clinician in healthcare delivery?
  • What do you see as ripe opportunities for emerging technology to disrupt healthcare? What’s already been done that’s working, and what do you think is on the horizon that’s about to break?
  • How do we make wearable technology and remote monitoring accessible to the underserved populations who may best benefit?
  • What do you think are the biggest obstacles to tech adoption (for consumers and for providers/industry)?

 

 

Future Ready Healthcare

  • What does being “future-ready” mean to you and your organization? How can you be future ready in the age of constant and increasingly rapid change?
  • What one thing do you think will change the future of healthcare this year, in 3 years and in 10 years?
  • Increasingly people want personalized health and wellness care – how do we deliver that with the current system that does not readily enable personalization (both from a technology perspective and from an incentives perspective)?
  • Do you believe precision medicine principles – genomics informing personalized clinical pathways – are sustainable across vast numbers of people? Or are they perhaps best narrowly applied to complex disease states with limited number of affected persons? And how will incentives have to change to align?
  • When was the last time your doctor asked you how you’d like to be engaged? And if they’ve asked you, have they done what you suggested?
  • Do you have a formal patient/member advisory board/council? If so, how does it work? And if not, why not?

 

The event was a great success and despite the global LiveStream issues at the time we managed to trend #2 on Twitter just behind #IndianaJones

TwitterTrend

 

As of writing there have been over 20M #DoMoreHIT impressions and the material continues to provide additional utility and is in use in other forums. The venue itself was packed and there have to date been 2,500+ Livestream views and ongoing On-Demand promotion and use. In house attendees and online described it as the “best panel yet!”

The 3 sessions from LiveStream can be viewed here

http://livestream.com/Dell/2016DoMoreHIT

The Highlight Reel from the Dell Lounge Week Long Activities

Dell lounge Photos here

The Dell World DoMoreHIT Panel was originally published on Dr Nick van Terheyden, MD

What 2016 will Bring for Healthcare Technology

Posted in Africa, Disruptive, Innovation, Patient Engagement, Technology by drnic on March 25, 2016

2015 was an incredible year in technology and healthcare; from new consumer technology and personalized devices coming to market to the introduction of new supercomputers that reduce the time and cost of healthcare data analysis. It’s been great to see how innovation continues to penetrate the medical profession, improving patient services and care. As we look to 2016, there are some areas that we can expect technology to further impact.

Dance like no one watching Encrypt - Security

Growing patient concern over security

Security is a major concern for consumers and the healthcare industry, and the threat of it is only rising. While technology and data provides patients with the precise, personalized medicine that they want, individuals have not forgotten the security breaches that occurred this past year, which had heightened their concern, particularly with the type of personal information in medical records. Implementing stronger, more reliable and transparent security practices will be a critical objective for medical practitioners, but equally important will be reestablishing trust with their patients and consumers.

The consumerization of healthcare

Consumers have grown to expect personal and custom experiences from technology.  The consumerization of healthcare will gather greater momentum and the healthcare industry will see the first effects of this trend on individual behavior in 2016. By treating patients and individuals seeking healthier lifestyles as consumers, the healthcare and related technology developed becomes more and more applicable to serving their needs and meeting them where they are. This is a great thing. As an example, imagine telehealth kiosks now allow patients to engage in a face-to-face video consult with their doctor, or have their vitals taken and receive a diagnosis – without setting foot in their doctor office.  Pilot programs for these “pods” are being tested in Rite Aid and the Cleveland Clinic.

The latest innovations will further fuel the moment around treating patients as consumers and developing relevant technology that make it easier for them to monitor their health and seek treatment, driving more adoption and healthier populations.

IoT - We have to go out for Dinner - Fridge not Talking to Stove

Embracing the Internet of Things toward patient engagement

The Internet of Things (IoT) connects billions of objects around the world, and in 2016, the healthcare industry will take the first steps in tapping IoT’s full potential through passive monitoring. Leveraging wearables and connected devices, healthcare organizations, with the consent of patients will be able to passively monitor the wellness of patients and personalize their experience. For example, for those with chronic diseases, such as diabetes or heart disease, these devices can monitor all aspects of the patient’s  daily life to provide insight to the patient and the healthcare providers, into how different activities, such as eating, sleeping or watching TV, affects his or her body. Connected devices equipped with real-time feedback can provide subtle alerts that prompt, caution or encourage patients to stick with or avoid certain behaviors.  These devices can also help them to comply with a treatment or regimen. In 2016, we’ll see the industry understand that subtle patient engagement through passive monitoring can have positive, long-term effects on behavioral change.

 

The potential of ICD-10

While the rollout of ICD-10 was reluctantly undertaken by some in 2015, the healthcare industry will begin to realize its actual potential in 2016. As a result of ICD-10, healthcare organizations will receive a higher level of granularity in the clinical data that has been collected including patient information and clinical data.  Utilizing this data will enable new insights and deeper analysis.  This will be the first step in turning descriptive healthcare analytics to predictive and prescriptive insights enabling results like reducing readmission and improving population health management. However, as we see potential benefits being realized, discussions will center on the interoperability of systems that is limiting analysis and holding back potential insights.

Africa-Kids-iPad

More democratized, globalized healthcare

While diseases such as AIDS and malaria are now considered chronic or curable with the proper treatment, there are still geographical, technological and societal barriers that pose great challenges when trying to treat the demographics that are most commonly affected. In the third world and emerging countries, healthcare organizations are leveraging technology, including simple mobile devices, to provide patients with faster, more effective care. In 2016, we will see more companies create technology that democratizes healthcare with innovations that help to lower the cost of healthcare, enhance patient engagement and improve overall worldwide population health.

Not only is it exciting to imagine how we’ll see technology continue to evolve and change everyday life, but also fascinating to see the impact and opportunities for enabling healthcare providers. These trends will manifest in some exciting and innovative changes in 2016 that will have a tremendous impact and further improvements in patient care.

 

This post originally appeared in HealthIT Outcomes

 

Original

 

 

What 2016 will Bring for Healthcare Technology was originally published on Dr Nick van Terheyden, MD

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Digital Health for the Undeserved

A recent report published by Jane Sarsohn-Kahn for the California Health Foundation: Digitizing the Safety Net Health Tech Opportunities for the Undeserved offers some deep insights into reaching the population most in need of help but often left out in the discussions of the latest and greatest technology to break into the news cycle.

As pointed out low-income households have access to mobile technology with 8 out of 10 sending and receiving text messages – in fact mobile phone usage and ownership mirrors the experience in Africa where many of the communities have little choice given the paucity of existing infrastructure and have bypassed the traditional communications systems in favor of mobile networks
Adults who own a cell phone, Africa

and gave rise to a whole innovation of mobile banking that originated that pre-dated, is more flexible and is more widely used than anything developed in the west (The M-Pesa system) – servicing the unbanked people of Africa without requirements to have a smart phone nor to use an app. I’ve written about the opportunity we have of learning from our African friends in the past)
In the case of the undeserved here in the US many of these people mirror these experiences and providing easy access using simple tools is effective not just from a cost standpoint (as Healthcrowd showed $1 for mobile messaging vs $34 for paper mailing) – and that’s even before you consider the engagement/response rate we find with mobile applications and interactions…think about it, when you want to reach your children do you send them an email or text them

Textpectation

 

Take the time to read about the multiple projects that are reaping big benefits and doing so cost effectively. These are real working projects with a range of technology that has demonstrable impacts and could be applied to many more groups and environments. The extensive piece takes you on a journey from everything as simple as text messaging from Healthcrowd to the medication adherence and tracking concepts of Proteus Digital Health of digestible sensors that track your pill from manufacture to ingestion.

There are a few guiding principles to help steer you to success

  • Meet people where they are – widely varied and none are typical
  • Build Trust – under promise, over deliver; everything is fragile for this community and failure can be far more catastrophic for them than “average” users
  • Address social determinants of health – just providing a ride to get to the clinic could mean the difference between success and failure and an Uber Ride is a lot more cost effective than an ambulance required for the crisis that could have been averted
  • Consider the cost of data service – data is expensive on many plans treat it like memory used to be in the days of 640K
  • Recognize the many layers of health literacy – not just comprehension but basic literacy and even language
  • Speak in the Vernacular – and make it culturally sensitive too

As Aman Bhandari said

“The new sexy is scaling what can work”

Proven solutions that have been effective provide great opportunities for those looking to make that impact on their own area.

 

 

 

Digital Health for the Undeserved was originally published on Dr Nick van Terheyden, MD

The Patient Electronic Show – CES

https://digitalhealthsummit.com
CES Digital Health Summit

Once again I am headed to CES this year. Last year the DigitalHealth pavilion was overflowing with people, innovation, and wearables designed to influence us to a healthier life.

The show still features the big sections of technology for cars, televisions and 3-D printers but much of the show is being turned over to healthcare and the Digital Health pavilion. Like my friend and colleague Jane Sarasohn-Kahn I see the big move towards high-deductible consumer driven health plans (HDHP) beinge a key part of the major uptake in digital health devices and wearables. We already got a sneak peek into this post the holiday period with FitBit rising to the top of the Apple App store charts and coming in in the top 3 of Amazon’s list of holiday gifts.

So this years hot trends

Wearables and the Internet of Medical Things

With personal financial responsibility comes a much bigger focus on the costs of healthcare services and how to avoid them. To avoid expensive costs later in life requires focus on behavior now on as captured in this excellent graphic from Bridgitte Piniewski, MD:

Lifestyle is the biggest factor in improving health
Lifestyle is the biggest factor in improving health

Expect CES 2016 to feature much more Digital Health and especially focused on the Internet of (Medical) Things – the key to engagement is making the workflow frictionless. Its no use creating yet another app or solution that requires consumers to download, install, learn or use yet another option. The success in this space will be around integrated solutions.

Wearables will expand and include even more data and the recent announcement of Samsung of the expanded capability in their new health-focused chip

that will add body fat, skeletal muscle mass, heart rate and rhythm, skin temperature, and stress level to the biometric tracking capabilities.

Expect many more additional features to the wearables mobile platform with add on modules, some already on show like the Philips Ultrasound, others work in progress

3-D Printing

Reaching new levels of innovation. Simple ideas like creating 3-D models base don actual patient anatomy prior to taking on complex surgery, printing prosthetics that are customized to the individual but now increasingly merged with wearables and printing biosensing strips that can be used for in home diagnostic testing. Researchers at Florida Atlantic University printed strip with bio material including antibodies and nanoparticles that can detect bacteria and viruses

 

Thin, lightweight and flexible materials developed by researchers at Florida Atlantic University, Stanford University and Harvard University, integrate cellulose paper and flexible polyester films as new diagnostic tools to detect bioagents in whole blood, serum and peritoneal fluid. Credit: Florida Atlantic University

Artificial Intelligence

Take a look at Lunit that helps physicians make accurate diagnosis with machine learning that offers object detection (application of existing technology to the healthcare domain)

http://lunit.io/static/img/illust_proj1.png

There are others including IBM’s Watson for Healthcare and in our Dell’s portfolio announced at RSNA ZebraMed

 

Repurposing Existing Technology

In my review from CES 2015 there were plenty of drones (with some medical applications) and technology to aid flying and use. Many were showing image stabilization as captured in my video here:

and I captured this on a custom video gimball
https://vine.co/v/ehj1nZH175x/embed/simplehttps://platform.vine.co/static/scripts/embed.js

We have so much opportunity to innovate in healthcare by repurposing existing technology for DigitalHealth. This image stabilization technology has been applied to the task of eating which for most of us is easy but for some eating is a challenge of hand stabilization due to tremors:

You can buy these from Giftware (which was acquired by Google).

Parkinson is one of the leading causes of these tremors (about 1 Million americans are living with Parkinson’s and an estimated 7-10 Million worldwide). Its a simple idea (not to diminish the brilliant application and innovation by the founders) and a testament to the bright minds that fill our world and will continue to find solutions to problems we face in healthcare.

Join me at CES16

We’ve come a long way from CES in 1967

So I invite you to follow along for #CES16 my twitter handle (@DrNic1), my Instagram (DrNic1) account for pictures and Vine (DrNick) for insights, posts, pictures and short video segments of innovation throughout the course of the show

 

If you are here come join me and my fellow panel participants:
Shai Gozani, M.D., Ph.D., CEO and President, NeuroMetrix, Inc.
Beth Bierman, Partner, Morgan Lewis & Bockius
Bakul Patel, Associate Director for Digital Health, FDA, Center for Devices

Roadmap to FDA Approval: What You Need to Know
3:30-4:30 PM Tuesday, January 5
Las Vegas Convention Center, North Hall, N259

The discussion will be moderated by Alfred Poor, Editor, Health Tech Insider

and on Thursday the DigitalHealth Summit that will be in the Venetian, Level 4, Lando 4304

 

The Patient Electronic Show – CES was originally published on DrNic1

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Memorable Healthcare from 2015

Posted in Innovation by drnic on December 31, 2015

The New York Times pulled together a list of memorable stories from 2015 (Medical and Health News that Stuck with us here)
– The discovery that Ebola is not cured nor over
– The ongoing war against epidemics and debilitating and now potential treatable diseases
– Anxiety and stress increasing (or is it increasingly diagnosed) and little progress in treatment
– The ongoing Drug Nuclear arms race of blockbuster (and unaffordable) prices for new drugs
– valuing time with the clinician for discussion of end of life care
– the sorry state of mental health in this country pales into insignificance with the chain therapy in Africa
– Despite real progress in treating Type 1 Diabetes unnecessary limitations are still being placed on children

Its been an interesting year and we have made much (rapid) progress. These stories are just the tip of iceberg and next year expect many more and heres hoping for some real change to a broken healthcare system

Memorable Healthcare from 2015 was originally published on Dr Nick van Terheyden, MD

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