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Hacking	  HealthDesigning	  for	  and	  understanding	  my	  healthJuhan	  SoninMarch	  2011
Your	  health	  data	  is	  going	  digital.
Your	  pets’	  health	  data	  is	  digital.
How	  did	  I	  get	  into	  the	  Design	  of	  Health?I	  didn’t	  have	  a	  pulse	  on	  my	  health,	  let	  alone	  ...
370	  Total	  Cholesterol	  ,	  2006                                    Cheese	  and	  salami	  was	  coursing	           ...
I	  had	  no	  clue	  what	  my	  health	  metrics	  were.I	  had	  a	  beLer	  pulse	  on	  the	  health	  of	  my	  car.
and	  the	  Problem	  is…Increasingly	  complex	  systems    – Tool	  and	  Methodology	  gapDecision	  makers	  are	  swa...
How	  do	  I	  (as	  a	  pa7ent,	  nurse,	  doctor,	  proxy)	  make	  quicker,	  more	  accurate	  decisions?
Started	  collecOng	  and	  designing	  the	  basics…Weight,Waist	  circumference,Cholesterol,Exercise,Food	  intake…
From	  sketch	  to	  digital
Early	  health	  card	  designs
Got	  a	  checkup.First	  Ome	  in	  6	  years.But…The	  doctor’s	  back	  was	  to	  me	  while	  he	  asked	  me	  ques7...
How	  do	  I	  become	  an	  informed	  and	  empowered	  paOent?
HealthCard	  was	  bornPrototyped	  with	  doctors,	  nurses,	  emergency	  responders…	  and	  oh	  yea,	  paOents.
Used	  real	  data…	  my	  own	  dataDesign	  with	  fake	  data	  =	  fake	  designReal	  data:•needs	  to	  be	  grokked...
System	  view	  of	  my	  family’s	  health
Followed	  doctors	  and	  nurses	  at	  several	  Boston	  hospitals	  to	  SEE	  Healthcare	  in	  acOon.Partner	  in	  ...
Our	  forecast
Designing	  a	  beauOful	  and	  clinically	  relevant	  experience	  without	  beauOful	  data	  =recipe	  for	  disaster...
So	  we	  got	  into	  the	  data	  +	  standards	  game:                                                                 ...
US	  HealthcardSmartcard	  to	  standardize	  the	  healthcare	  “entry	  point”	  transacOonPrototype	  US	  Healthcard	 ...
Why	  not	  a	  1040-­‐HC?
Health	  devices	  are	  gehng	  cheaper…Costs	  approaching	  zero.The	  cost	  of	  data	  is	  also	  approaching	  zero.
Body	  ProbesTorn	  bicep
Daily	  acOvity	  dashboardUsing	  2+	  years	  (0.999	  human	  “upOme”)
Wireless,	  self-­‐syncing	  devices
Part	  of	  my	  daily	  rouOneAt	  work…
MonthlyCholesterol	  and	  glucose	  self	  tesOng
Jumped	  into	  personal	  genomics23andMe	  (for	  all	  my	  family	  members),	  Personal	  Genome	  Project	  ParOcipant
23andme.com
Medical	  home                       IMPLANT               PULSE                OX     BLOOD-    PRESSURE      CUFF       ...
TelemedicineIntel	  Health	  Guide:	  It	  integrates	  personal	  communicaDon	  with	  the	  doctor,	  medicaDon	  remin...
Assisted	  living                                                                                                         ...
Sensors	  throughoutSpare	  Bedroom   Master	  Bedroom                                       Bathroom                     ...
Enable	  online	  clinic	  for	  the	  “pracOce	  of	  medicine”Evolve	  the	  FOSS	  “Healthcare	  as	  a	  so^ware	  ser...
So	  we	  prototyped	  a	  health	  staOon.
Self-­‐service	  health	  kiosk   Brief	  engagement	  to	  assess	  current	  health   Simple	  and	  minimally	  invasiv...
Evolve	  from	  nurse-­‐aLended	  toself-­‐service	  health	  experience
How	  do	  you	  get	  a	  pulse	  on	  key	  health	  metrics	  without	  a	  single	  tear?Early	  detecOon	  of	  chron...
5	  million	  doctors6.7	  billion	  pa,ents
4.7	  billion	  cell	  phones6.8	  billion	  paOents
paOentsSCALE
mHealth	  AxiomsBring	  the	  examinaDon	  room	  to	  the	  paDentBring	  the	  collecDve	  experDse	  of	  the	  pracDce...
hGraph      Compelling,	  standardized	  visual	  representa7ons	  of	  a	  pa7ent’s	  health	  status…on	  the	  celltop ...
hGraphUsed	  as	  status	  	  indicator	  for	  current	  plan	  of	  careRecent	  updates	  can	  trigger	  “just	  in	  ...
85%	  of	  adults	  have	  a	  cellphone	  today…
The	  Future:	  Stage	  zero	  detecOon           90%	  Survive                            10%	  Survive    Early	  stage	...
Special	  thanks	  to:Rob	  DingwellAndrew	  GregorowiczDirk	  KnemeyerRob	  McCreadyHarry	  SleeperBrian	  Staats
Hacking	  HealthDesigning	  for	  and	  understanding	  my	  healthJuhan	  Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
"Hacking Health" by Juhan Sonin
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"Hacking Health" by Juhan Sonin

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This is the slideshow component of a podcast in the Journal of Participatory Medicine. The author traces his development of a tool called the HealthCard, addressing the questions, "How do I become an informed and empowered patient?" and "How do I [as a patient, nurse, doctor, or proxy] make quicker, more accurate decisions?"

<a>Click here to return to the journal.</a>

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Transcript of ""Hacking Health" by Juhan Sonin"

  1. 1. Hacking  HealthDesigning  for  and  understanding  my  healthJuhan  SoninMarch  2011
  2. 2. Your  health  data  is  going  digital.
  3. 3. Your  pets’  health  data  is  digital.
  4. 4. How  did  I  get  into  the  Design  of  Health?I  didn’t  have  a  pulse  on  my  health,  let  alone  the  data.Cholesterol  Check  at  MITRE  in  2006
  5. 5. 370  Total  Cholesterol  ,  2006 Cheese  and  salami  was  coursing   through  my  blood  stream  (based  on   a  meal  the  night  before  the   cholesterol  test…)
  6. 6. I  had  no  clue  what  my  health  metrics  were.I  had  a  beLer  pulse  on  the  health  of  my  car.
  7. 7. and  the  Problem  is…Increasingly  complex  systems – Tool  and  Methodology  gapDecision  makers  are  swamped  with  conflicDng  data – Our  work  is  increasingly  mulD-­‐dimensional  (not  a  flat-­‐ decision  space)ArDfacts  driving  decisions  need  to  be  coordinated,   presentedMinimal  transparency  into  key  health  metrics
  8. 8. How  do  I  (as  a  pa7ent,  nurse,  doctor,  proxy)  make  quicker,  more  accurate  decisions?
  9. 9. Started  collecOng  and  designing  the  basics…Weight,Waist  circumference,Cholesterol,Exercise,Food  intake…
  10. 10. From  sketch  to  digital
  11. 11. Early  health  card  designs
  12. 12. Got  a  checkup.First  Ome  in  6  years.But…The  doctor’s  back  was  to  me  while  he  asked  me  ques7ons  (and  then  he  typed  the  answers  into  the  computer),  zero  ques7ons  about  Life  outside  of  tradi7onal  health  info,no  physical  or  emailed  takeaways  of  next  steps  from  the  exam…
  13. 13. How  do  I  become  an  informed  and  empowered  paOent?
  14. 14. HealthCard  was  bornPrototyped  with  doctors,  nurses,  emergency  responders…  and  oh  yea,  paOents.
  15. 15. Used  real  data…  my  own  dataDesign  with  fake  data  =  fake  designReal  data:•needs  to  be  grokked  by  you•has  min/max  values,  outliers•needs  amplificaOon,  cleanup•begets  real  feedback  +  forces  people  to  make  real  decisions
  16. 16. System  view  of  my  family’s  health
  17. 17. Followed  doctors  and  nurses  at  several  Boston  hospitals  to  SEE  Healthcare  in  acOon.Partner  in  crime,  Rob  McCready  watching  surgery.
  18. 18. Our  forecast
  19. 19. Designing  a  beauOful  and  clinically  relevant  experience  without  beauOful  data  =recipe  for  disaster.  
  20. 20. So  we  got  into  the  data  +  standards  game: hDataprojectlaika.org projecthdata.orgOpen  source  so^ware  has  become  part  of  the  CCHIT   hData  is  a  method  of  storing  and  exchanging  health  cerOficaOon informaOonLaika  is  responsible  for  automaOng  data   Goal:  Influence/create  Health  IT  standards  to  ease  interoperability  tesOng  of  Electronic  Health  Record   implementaOon  and  speed  adopOonsystems Why?  Complexity  and  design  of  current  standards  are  HITSP  Specs  on  ConOnuity  of  Care a  huge  barrier  to  adopOon  and  effecOve  usageIHE  specs  on  Document  Exchange
  21. 21. US  HealthcardSmartcard  to  standardize  the  healthcare  “entry  point”  transacOonPrototype  US  Healthcard  data  model,  design,  and  explore  HHS  adopOon
  22. 22. Why  not  a  1040-­‐HC?
  23. 23. Health  devices  are  gehng  cheaper…Costs  approaching  zero.The  cost  of  data  is  also  approaching  zero.
  24. 24. Body  ProbesTorn  bicep
  25. 25. Daily  acOvity  dashboardUsing  2+  years  (0.999  human  “upOme”)
  26. 26. Wireless,  self-­‐syncing  devices
  27. 27. Part  of  my  daily  rouOneAt  work…
  28. 28. MonthlyCholesterol  and  glucose  self  tesOng
  29. 29. Jumped  into  personal  genomics23andMe  (for  all  my  family  members),  Personal  Genome  Project  ParOcipant
  30. 30. 23andme.com
  31. 31. Medical  home IMPLANT PULSE OX BLOOD- PRESSURE CUFF Cell PhonePEDOMETER Digital Home WEIGHT SCALE PC Internet Family Disease Healthcare Personal FITNESS care management Health EQUIPMENT providers givers services Records MEDICATION Personal Health System TRACKING
  32. 32. TelemedicineIntel  Health  Guide:  It  integrates  personal  communicaDon  with  the  doctor,  medicaDon  reminders,  educaDonal  informaDon,  and  videoconferencing  for  the  home.
  33. 33. Assisted  living I  opened  the  door… I’m  watching  TV… I’m  going  to  bed…Sensors:  Mo7on,  Fire/Smoke/CO2,  Occupancy  (Bed/Chair),  Use  (Door,  Stove,  Fridge,  Tub),  Loca7on  (Alzheimers),  Fall  Alarms,  Water  flow…  
  34. 34. Sensors  throughoutSpare  Bedroom Master  Bedroom Bathroom Living  Room Kitchen
  35. 35. Enable  online  clinic  for  the  “pracOce  of  medicine”Evolve  the  FOSS  “Healthcare  as  a  so^ware  service”  modelSchool  nurse  at  first;evolve  to  state-­‐of-­‐the-­‐art  ambulatory  screen  clinic  (diabetes,  obesity,  cardiovascular,  asthma,  allergies)  in  2  years
  36. 36. So  we  prototyped  a  health  staOon.
  37. 37. Self-­‐service  health  kiosk Brief  engagement  to  assess  current  health Simple  and  minimally  invasive Get  a  health  snapshot  or  monitor  changes  over  OmeOpen  planorm Can  add  addiOonal  measurement  devices Bluetooth,  Wifi,  and  web  accessible Accessible  API  for  building  home  grown  appsMeasurements Blood  pressure Weight Body  composiOon HydraOon Pulse Temperature Eyesight Hearing RespiraOon
  38. 38. Evolve  from  nurse-­‐aLended  toself-­‐service  health  experience
  39. 39. How  do  you  get  a  pulse  on  key  health  metrics  without  a  single  tear?Early  detecOon  of  chronic  diseases  will  be  as  easy  as  carrying  your  cell  phone  in  your  pocket.Engaged  paOents  will  increasingly  self-­‐check  and  self-­‐monitor  using  bloodless,  self-­‐administered  medical  tests.
  40. 40. 5  million  doctors6.7  billion  pa,ents
  41. 41. 4.7  billion  cell  phones6.8  billion  paOents
  42. 42. paOentsSCALE
  43. 43. mHealth  AxiomsBring  the  examinaDon  room  to  the  paDentBring  the  collecDve  experDse  of  the  pracDce,  the  standard  of  care,  to  the  paDent’s  bedside  or  homeMigrate  from  a  system  of  episodic  evaluaDon  to  a  system  of  conDnuous  assessmentExpect  paDents  and  their  families  to  be  their  own  primary  care  provider  (key  member  of  the  care  team)
  44. 44. hGraph Compelling,  standardized  visual  representa7ons  of  a  pa7ent’s  health  status…on  the  celltop Designed  to  increase  awareness  of  the  individual’s  factors  that  can  affect  one’s  health Open  source  healthcare  applica7on   Created  for  mobile  devices,  star7ng  with  the  iPhone  and  iPadYour  health  in  one  picture Users  provide,  view,  share,  and  understand  a  holis7c  view  of  their  health     Based  on  an  individual’s  health  data,  iden7fies  where  an  individual’s  health  numbers  are,   and  where  they  should  be Pa7ent  focused,  with  professional  clinical  relevance  hScore Single  aggregated  number  ranging  from  1-­‐100  that  represents  best  knowledge  status  of  an   individual’s  health Experimental  measure  correlated  with  sta7s7cal  data  from  open  sources
  45. 45. hGraphUsed  as  status    indicator  for  current  plan  of  careRecent  updates  can  trigger  “just  in  Dme”  healthcare  consultsAddiDonal  mHealth  monitors  augment  hGraph  scope  and  real-­‐Dme  natureLive  consults  with  healthcare  professionals
  46. 46. 85%  of  adults  have  a  cellphone  today…
  47. 47. The  Future:  Stage  zero  detecOon 90%  Survive 10%  Survive Early  stage  detecDon Late  stage  detecDon
  48. 48. Special  thanks  to:Rob  DingwellAndrew  GregorowiczDirk  KnemeyerRob  McCreadyHarry  SleeperBrian  Staats
  49. 49. Hacking  HealthDesigning  for  and  understanding  my  healthJuhan  Sonin
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