Stanford cs247 lecture 2 21-11 final v ss

User Generated Health
Chris Hogg
twitter.com/cwhogg
citizenmed.wordpress.com

6,836
3.4
127/62
84
3.2

We are currently in the era of disconnected health

We are disconnected from our health data
50.7% use EMR
$44k in stimulus per doc

We are disconnected from our physicians

We are disconnected from the healthcare system

We are disconnected from our own health

Being disconnected leads to poor health

Obesity Trends* Among U.S. AdultsBRFSS,1990, 1999, 2009
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
1999
1990
2009
1/3
of Americans will have diabetes by 2050
(CDC)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

The pace of drug development is slowing

How did we lose control of our personal health identity?

Technology will disrupt healthcare…
(it will just take longer than other industries)
80% search for health
3rd most popular web-based pursuit
(Susannah Fox, Pew Internet Project)

Cyberchondria
“Unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web”
2 in 5 report increase in anxiety from medical search
(White and Horvitz, Microsoft Research)

The patient is the most underutilized resource in healthcare

Measurement facilitates behavioral change
10.5%
(Seligman and Darley 1977)

Is mHealth adoption following a familiar pattern?
% of Age Group
Age
Data from:
Brian Dolan, MobiHealthNews
Susannah Fox, Pew Internet Project

Apple wants to connect you to your health

New data is more powerful
than a new drug
39% reduction in
hospitalizations
over 6 months

50%
73 million have HTN
69% with first MI

Know your target audience

Even young people have chronic medical conditions
% of Patients
Age

# of chronic conditions for Medicare beneficiaries (65+)
5+conditions
But as people age, they get a lot more
No conditions
4conditions
1condition
3conditions
2 conditions
Presented at the Annual Academy Health Research Meeting, June 2007; CMS (Centers for Medicare and Medicare Services)

Medical / clinical is converging with health / wellness

What you can learn from a few data points?

Mood Seasonality
Mood by Day of Week

Significant personal information from a single daily data point

30
Crowdsourcing personal health data

Xanax(Alprazolam)
Exercise
B Vitamins
31

Can crowdsourced personal health data be used to predict personalized drug responses?

Data is beginning to flow from the system to users

Access to data –
Blue Button
Practice Fusion
MSHV

Prescription data is beginning to flow
Surescripts data on Rx histories

Rx history + treatment algorithm = understanding

You can learn a lot about a person from a few simple data points

Beta Blockers
Diuretics
High Blood Pressure
Drug
ACE Inhibitors
Drug Class
Liptor
Zocor
Lovastatin
Pravachol
Crestor
Lescol
Calcium Channel Blockers
ARBs
Statins
70-80% of CAD patients have high blood pressure
High Cholesterol
Coronary Artery Disease
(CAD)
Myocardial Infarction
(Heart Attack)
Zetia
Tricor
Vytorin
Gemfibrozil
Niaspan
Medical Conditions
Event
HDL
and
Other
20-30% of CAD patients have Type 2 Diabetes
TZDs
Drug Class
Metformin
Type 2 Diabetes
DPP -4 Inhibitors
Drug
Sulphonylureas
Insulin

Hidalgo et al. PLoS Computational Biology 5(4):e1000353 (2009)
http://hudine.neu.edu/

High Cholesterol
High Blood Pressure
1
2
3
4
5
High Blood Pressure
High Cholesterol
High Blood Pressure
High Blood Pressure
Type 2 Diabetes
High Cholesterol
Type 2 Diabetes
Osteoporosis

Social Health App
Social Health App
Social Health Layer / Health Graph
Google Health
Microsoft HealthVault
Practice Fusion EMR / PHR
AllScripts PHR
Other EMR / PHR System APIs
Google Apps
MSHV Apps
PF Apps
AS Apps
Other PHR Apps

We are entering the era of Participatory Medicine

A medical record is a punctuated data stream
Gaps filled via recollection
Personal Health Data

Anamnesis
(patient recollection)
is not accurate

EMR data + user generated data = healthstream
Personal Health Data

Rx of Apps
Medications
METFORMIN 500MG BID
LISINOPRIL 20MG OD
Applications

I will own my healthstream and health data

The market for health data is very large

Healthcare systems are the future

Data enables us all to become Citizen Scientists

Can butter make you smarter?

The MTHFR Study

Groups of users will come together to
run their own
clinical trials

Genomera: A platform for Citizen Science

Future study:
meditation and blood pressure

Citizen Science has the power to disrupt healthcare
Drug A
Track common measures of efficacy, potential side effects, events, etc.
Drug B

For those interested in learning more, the Bay Area is a good place to be…

Chris Hogg
cwhogg@gmail.com
twitter.com/cwhogg
linkedin.com/in/cwhogg
citizenmed.wordpress.com
?
Thank You

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Stanford cs247 lecture 2 21-11 final v ss

by Chris Hogg on Feb 22, 2011

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Stanford cs247 lecture 2 21-11 final v ss — Presentation Transcript