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PATIENT ENGAGEMENT:
CAN MOBILE HEALTH APPS, SMART USES
OF DATA
AND SENSORS INCREASE COMPLIANCE,
ADHERENCE AND REDUCE MEDIC...
DISCLOSURE
• I have no commercial ties to any of the companies mentioned in this
presentation
• All external slides are us...
CONTEXT - DRUGS
• Up to $5 billion, 10+ years to reach the market
• $100-$290 billion annual cost of non-adherence
• 32 mi...
CONTEXT - MOBILE
• Apple‟s app store didn‟t exist before July 2008!
• In 2008, iphone 3G was launched, now iphone 6 is bei...
A REMINDER – WHY WE ARE HERE TODAY
• Focus on the patient
• We love to talk about technology BUT patients want health, not...
2013 – TECHNOLOGY TRENDS
• Sensors
• Big Data
• Smart pills – now being trialled in the UK
• Wearable computing – Google G...
SENSORS, QUANTIFIED SELF AND SMART
PILLS
9©2012 Proteus Confidential
Digital Medicines
Tiny, Safe Ingestible Sensor
Grain-of-sand sized sensor made from
dietary mi...
10©2012 Proteus Confidential
Circadian Pattern
Time of Day
Days
0 2 4 6 8 10 12 14 16 18 20 22 24
5
10
15
20
25
30
35
Pill...
@uMotif / www.uMotif.comCopyright uMotif 2012-2013
Engaging patient self-management software
70%
Daily use rate during
2 m...
BRIDGING THE GAP: FULL 360
@ Point of Care360TM
Clinicians Self reported real-time dataHIPAA compliant messaging
PatientsC...
SELF TRACKING – WHAT WOULD YOU
PREFER?
• Current products are crude and clumsy
• The future IS „unobstrusive‟ monitoring.
WEARABLE COMPUTING – GOOGLE GLASS
AND BEYOND?
• Google Glass costs under $200 to make – Dec 2013 expected launch
• “Imagin...
THE INTERNET OF THINGS
• In 2013, 80 things connect to
the internet per second.
Next year, how many?
• 1,000!
INFORMATION OBESITY
Will you make life simpler or harder
for patients and HCPs?
OWNERSHIP OF PATIENT DATA?
Only a minority of health apps allow the patient to own their data.
MAKING SENSE OF UNSTRUCTURED DATA
• Online communities (such as PatientsLikeMe)
• Treato Pharma platform is a unique and d...
SOCIAL IMPLICATIONS OF MOBILE
TECHNOLOGY
• Being developed by the “worried well” for the “worried well”
• Aging population...
SIDE EFFECTS OF DIGITAL HEALTH
• Regulators continue to lag behind the advances in technology
• Fragmented marketplace
• S...
THE FUTURE
• It‟s a new era in human history
• We ARE heading for the Singularity
• Brain computer interfaces. Gesture Com...
WHAT DOES THIS MEAN FOR YOU?
• A shift in your business models. Beyond the pill. Possibly beyond the mobile
phone?
• Are y...
WHAT DOES THIS MEAN FOR DOCTORS?
WHAT DOES THIS MEAN FOR PATIENTS?
WHAT DOES THIS MEAN FOR YOU?
• A shift in your business models. Beyond the pill. Possibly beyond the mobile
phone?
• Are y...
SO WHAT CAN YOU DO TODAY?
• We have evidence based medicine. Why not evidence based Digital
Health?
• Not all new technolo...
QUESTIONS?
• Email: Maneesh@mjanalytics.com
• Website: www.mjanalytics.com
• Twitter: ManeeshJuneja
• Personal Blog: manee...
REFERENCES
• Slide 3: Context – Drugs
• http://www.forbes.com/sites/matthewherper/2013/08/11/how-the-staggering-
cost-of-i...
REFERENCES
• Slide 4: Context – Mobile
• http://www.scmp.com/business/article/1167525/7-billion-humans-7-billion-
phones
•...
REFERENCES
• Slide 8: http://www.adheretech.com/
• Slides 9-10: http://www.proteusdh.com/
• Slide 11: http://signup.powhea...
REFERENCES
• Slide 14:
• http://www.mc10inc.com/digital-health/remote-monitoring/
• http://www.misfitwearables.com/#shine_...
REFERENCES
• Slide 16: http://investorplace.com/2013/08/cisco-internet-of-things/
• Slide 17:
http://www.forbes.com/sites/...
REFERENCES
• Slide 22:
• http://techcrunch.com/2013/07/13/why-behavior-change-apps-fail-to-change-
behavior/
• http://www....
Mobile Innovation Summit - Patient Engagement
Mobile Innovation Summit - Patient Engagement
Mobile Innovation Summit - Patient Engagement
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Mobile Innovation Summit - Patient Engagement

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  • Mention at the end of this slide, that I don’t need a focus group or R&D, I have my dad. Everytime I tell him about amazing new sensors that monitor your sleep or tell you your quality of your brain waves or smart pills, he normally brings my feet firmly back on the ground by saying, “How the hell is that going to help me understand if I can drink beer with my medications tonight?. It’s so confusing”
  • Ask audience to guess the answers. Get them interacting. Quote sources of statistics at end of slides. 5 Americans will die from medication error during my talk, over 500 will die by the end of this conference. We work so hard as a community to develop and launch these drugs to improve lives. Yet, it’s so SAD that our efforts don’t always translate to health for everyone. These deaths are preventable. How can we use mobile innovation to reduce those deaths to zero, and work towards 100% compliance? Quote example of my own dad.
  • Give example of my dad. In 70s, 10 medications, big user of healthcare, no iphone, no ipad, traditional outlook. Give example of patient diagnosed with HBP, they just want to know how to live life post diagnosis, so they can do things like play with grandkids, go for a hike etc. Sustainable technologies that allow a patient, young or old, black or white, rich or poor, etc. to NOT have to learn how to sync Bluetooth or understand USB charging.
  • Quote all the sources in in the final slides. Revise the quote about Big Data to make it accurate and meaningful. Give example, we struggled in GSK to analyse the US insurance claims data, and yet we are faced with an explosion of data from Digital Health. That’s pretty scary without any preparation.
  • Hope or Hype? Show all the gadgets I’m wearing, discuss the QS movement, how it’s still a very small minority of people, but what lessons are there to learn?
  • The founding vision for Proteus Digital Health was to make the medicines and medical devices we use as personalized, information rich and connected to others as any of these other products we use.We started with a provocative technology challenge problem: could we innovate a technology that would connect the daily pill to the internet? Could we actually make a new kind of digital technology that could be ingested, could be as safe as the food we eat, and as simple and tiny and inexpensive to manufacture that it could be formulated into every drug in the pharmacy?We have solved the problem and achieved the vision.Let me tell you about our first commercial product platform—what we call a Digital Health Feedback System.
  • Look at the type of data streams possible from the patch and the digital pill. Imagine how this technology will develop by 2018?
  • A UK startup, about to launch their new platform. Unique in the world. Pow Health is a novel engaging Social Healthcare Platform for everyonePow Health is inclusive. Catering for families (multiple accounts), patients or carers. It enables tracking of long-term conditions or general wellness. It is a Global, multi-language platform It empowers health and life-style-related parameters management with on-site trackers It permits data-integration from prior/concurrent personal devices and apps.It will be launching in late August 2013 with some patient-charity support alreadyPow Health aims to drive compliance and improved health outcomes. Pow Health is currently working with several pharmaceutical companies to boost the compliance issue. It uses the multiple built-in pillars within the platform. In support of that Pow Health also provides dashboards One of them is “My Health”- A powerful visual dashboard through which users can compare their health with others. Many dimensions are available such as Quality of life, symptoms, side-effects, etc.… As you know the US healthcare portability act changes the reimbursement paradigm from a service-base to an outcome-base. Pow Health will provide real-world evidence for health outcomes and what they mean to patients.
  • Another leading UK startup. Beautiful interface. Credible partners, working towards producing evidence of impact on outcomes and reduction in cost.
  • Clinician App on Ipad. Patient App on iPhone. Patient generated data shared within clinician App when patient chooses to.
  • Highlight that most of the current crop of trackers are crude and clumsy. I’m not the only one. VinodKhosla said the same at mHealth Summit in 2012. Quote the study that found that consumers were annoyed with properiery chargers, poor battery life, reliability. Show MC-10 wearable electronics on my wrist that’s as small as a postage stamp. Ask the audience, if you were a patient with 5 illnesses, taking 8 medications a day to stay healthy, which product would you wear? Quote the example of beddit sensor as one of the ‘next wave’ of sensors, beyond traditional fitbit etc.
  • Quote from VivekWadhwa – March conference, that within a few years, we will have sensors in our organs. Our apps will know more about us than our doctor does. Mention that this is not too far fetched. Mention how this has been done in cows in 2011 in the Netherlands. Ask audience if they know what the black circle around my neck is? It’s a camera, PAUSE. I could have recorded you, but I didn’t. THAT’s why we need to understand fully the risks of this new technology. When talking about google glass, if that’s got so much computing power, and smart shirts and smart fabrics coming soon, what will happen to the mobile phone as we know it? Will the smartphone integrate into our everyday clothing?
  • Quote trashcan in London that grabs data from your smartphone as you walk past A house in San Francisco has it’s own Twitter accountExpected growth – potential What will this mean for you? As patient walks past a CVS pharmacy, their phone will know that their medication is running out, and a special offer will flash on your screen from the pharmacy reminding you to get your repeat prescription?
  • Overload – quote example of my dad with 12 patient information leaflets (hold one up) Mention patients like me etc. How patients are connecting and sharing in online communities. How do you filter through all that ‘noise’ on the web and social media to understand patient experiences with your products? Move into treato. The human element. A side effect of Digital Health may be that the patient is confused about who to trust (quote the order of search results when you look at google. What if they search for your drug and get some herbal remedy website)
  • Reinforce my dad. Most of the innovations I’m coming across are not reaching him.Who is going to pay for all of this technology? Will the regulations catch up with the pace of the technology?
  • Mention that my specifics may be inaccurate, but I believe directionally I’m correct. Quote the example of the BMW in Silicon Valley, the Ford car with apps in the car that collect data. – where technology merges with our brains – will your phone tell you not to order the steak because it analysed your thought of intending to order it?
  • They may resist these new technologies (quote studies that show this)
  • Quote example of my dad again. He’s the biggest user of healthcare. Yet I’m the one that has all the mobile technology.
  • Will you be the person that took the chance on some of these new technologies, but the person sitting next to you didn’t?Quote example of GSK Digital Signature. Intranet story. You can start in the coffee break. You can go on your company intranet and find people doing this work already. Give example of at GSK, I didn’t even know what the guy down the hall was working on, let alone the other 99,999 employees around the world. Do you need a Digital Health division to be set up?
  • Transcript of "Mobile Innovation Summit - Patient Engagement"

    1. 1. PATIENT ENGAGEMENT: CAN MOBILE HEALTH APPS, SMART USES OF DATA AND SENSORS INCREASE COMPLIANCE, ADHERENCE AND REDUCE MEDICATION ERRORS? MANEESH JUNEJA MOBILE INNOVATION SUMMIT, PHILADELPHIA AUGUST 20TH 2013
    2. 2. DISCLOSURE • I have no commercial ties to any of the companies mentioned in this presentation • All external slides are used with permission of the each vendor
    3. 3. CONTEXT - DRUGS • Up to $5 billion, 10+ years to reach the market • $100-$290 billion annual cost of non-adherence • 32 million Americans take 3 or more medicines daily • 7,000 Americans die every year from medication error • 125,000 deaths annually from lack of adherence • 20-30% of prescriptions are never filled • Approx 50% of of drugs for chronic diseases are not taken as prescribed
    4. 4. CONTEXT - MOBILE • Apple‟s app store didn‟t exist before July 2008! • In 2008, iphone 3G was launched, now iphone 6 is being launched next month • 7 billion phones on the planet by 2014 • 40,000 health apps (1,000 apps added each month) • 77% of patients search for health information online
    5. 5. A REMINDER – WHY WE ARE HERE TODAY • Focus on the patient • We love to talk about technology BUT patients want health, not health outcomes. • Patients don‟t really care about the underlying technologies, even though we do • The sustainable technologies will the ones that are „unobtrusive
    6. 6. 2013 – TECHNOLOGY TRENDS • Sensors • Big Data • Smart pills – now being trialled in the UK • Wearable computing – Google Glass is just the beginning. Smart socks. Smart shirts. • The internet of Things • Lots of buzzwords and lots of HYPE! • The promise that our problems will be solved!!! • What does this mean for you? For the doctors? For the patients?
    7. 7. SENSORS, QUANTIFIED SELF AND SMART PILLS
    8. 8. 9©2012 Proteus Confidential Digital Medicines Tiny, Safe Ingestible Sensor Grain-of-sand sized sensor made from dietary minerals, manufactured into drugs Medicines Signal When Ingested Unique, pill-specific signal inside body with no battery, radio or antenna Monitor Therapy & Outcomes Wearable patch measures ingestions & full panel of physiologic response metrics Tailored Information Presentations Mobile and desktop applications drive insight and collaboration
    9. 9. 10©2012 Proteus Confidential Circadian Pattern Time of Day Days 0 2 4 6 8 10 12 14 16 18 20 22 24 5 10 15 20 25 30 35 Pill Taking Behavior Time of Day Days 0 4 8 12 16 20 24 5 10 15 20 25 30 35 0 5 Pills Taken in Day Days Taking Adherence 0 2 4 6 8 10 12 14 16 18 20 22 24 0 20 40 60 80 Time of Day Degrees Average Circadian Pattern (+-std) 0 4 8 12 16 20 24 0 2 4 6 8 Time of Day #Pills Timing Adherence Data for Unstable Elder Circadian Pattern Based on Posture Medication Taking Behavior * Dose Taken Patch not worn excluded session from % * * Supine Sitting Standing Patch not worn 90-Year Old with Mild Dementia Reveals Unstable Activity and Medication Patterns Entered Hospital Shortly After Data Collection
    10. 10. @uMotif / www.uMotif.comCopyright uMotif 2012-2013 Engaging patient self-management software 70% Daily use rate during 2 month trial Parkinson’s Disease Initial trial complete; multi-centre UK trial from Q4 2013 Partners • Marginally significant improvement in self -reported Medications rating (p<0.15) • Significant improvements in health behaviours scores
    11. 11. BRIDGING THE GAP: FULL 360 @ Point of Care360TM Clinicians Self reported real-time dataHIPAA compliant messaging PatientsClinician knowledge support Health care organizations CLINICIAN PERFORMANCE IMPROVEMENT MEASURING PATIENT OUTCOMES
    12. 12. SELF TRACKING – WHAT WOULD YOU PREFER? • Current products are crude and clumsy • The future IS „unobstrusive‟ monitoring.
    13. 13. WEARABLE COMPUTING – GOOGLE GLASS AND BEYOND? • Google Glass costs under $200 to make – Dec 2013 expected launch • “Imagine being able to put sensors in your body, that go to different organs, and they‟re just sitting there monitoring your internal health. I wouldn‟t be surprised if within 2 to 3 years, they didn‟t have an app that could diagnose my health better than my cardiologist can” – Vivek Wadhwa, Faculty, Singularity University
    14. 14. THE INTERNET OF THINGS • In 2013, 80 things connect to the internet per second. Next year, how many? • 1,000!
    15. 15. INFORMATION OBESITY Will you make life simpler or harder for patients and HCPs?
    16. 16. OWNERSHIP OF PATIENT DATA? Only a minority of health apps allow the patient to own their data.
    17. 17. MAKING SENSE OF UNSTRUCTURED DATA • Online communities (such as PatientsLikeMe) • Treato Pharma platform is a unique and differentiating patient intelligence platform that incorporates pure patient data (over 1.4 billion user-generated health related posts), social engagement, and brand analytics like never before. The NLP, patent pending algorithms, knowledge base and our proprietary patient dictionary allows us to understand patients (and caregivers) first hand experiences/attitudes/opinions with medications and diseases
    18. 18. SOCIAL IMPLICATIONS OF MOBILE TECHNOLOGY • Being developed by the “worried well” for the “worried well” • Aging population is huge problem in future • Digital Divide • Will people want their phone to know they are sick before they know they are sick? • Privacy/Security • Cost – Who will pay for it?
    19. 19. SIDE EFFECTS OF DIGITAL HEALTH • Regulators continue to lag behind the advances in technology • Fragmented marketplace • Sparse evidence that finite resources in HIT are best deployed on these projects • Smartphone usage in UK leading to increase in myopia • Kids growing up glued to phone – connected but alone • Health apps don‟t always lead to behaviour change
    20. 20. THE FUTURE • It‟s a new era in human history • We ARE heading for the Singularity • Brain computer interfaces. Gesture Computing. • A new stream of „intent‟ data • Our cars may monitor our health as we drive • Sensors in our internal organs • Fewer visits to doctors/hospitals – we can diagnose from anywhere with our phone • Real-time data directly via a patient‟s phone
    21. 21. WHAT DOES THIS MEAN FOR YOU? • A shift in your business models. Beyond the pill. Possibly beyond the mobile phone? • Are you ready to deal with startups? • What low cost innovations can you find outside of the USA? (India, Africa) • How do you pilot this technology? • Who do you need to convince? • What is the bottom line? • Will you get involved in crowdfunding/crowdsourcing?
    22. 22. WHAT DOES THIS MEAN FOR DOCTORS?
    23. 23. WHAT DOES THIS MEAN FOR PATIENTS?
    24. 24. WHAT DOES THIS MEAN FOR YOU? • A shift in your business models. Beyond the pill. Possibly beyond the mobile phone? • Are you ready to deal with startups? • What low cost innovations can you find outside of the USA? (India, Africa) • How do you pilot this technology? • Who do you need to convince? • What is the bottom line? • Will you get involved in crowdfunding/crowdsourcing?
    25. 25. SO WHAT CAN YOU DO TODAY? • We have evidence based medicine. Why not evidence based Digital Health? • Not all new technology is equal • Most of the mobile innovation will not come from traditional sources. Change where you look. • Where in your company is the expertise? • Who will own the health data that these apps generate?
    26. 26. QUESTIONS? • Email: Maneesh@mjanalytics.com • Website: www.mjanalytics.com • Twitter: ManeeshJuneja • Personal Blog: maneeshjuneja.com
    27. 27. REFERENCES • Slide 3: Context – Drugs • http://www.forbes.com/sites/matthewherper/2013/08/11/how-the-staggering- cost-of-inventing-new-drugs-is-shaping-the-future-of-medicine/ • http://online.wsj.com/article/SB100014240529702033888045766168828563187 82.html • http://www.leanblog.org/2009/08/statistics-on-healthcare-quality-and/ • http://www.senticare.com/medi2.php
    28. 28. REFERENCES • Slide 4: Context – Mobile • http://www.scmp.com/business/article/1167525/7-billion-humans-7-billion- phones • http://www.washingtonpost.com/sf/brand-connect/wp/2013/05/07/growing- appetite-for-mobile-health/ • http://www.theguardian.com/lifeandstyle/2013/jan/20/should-i-use-health-apps • http://www.pewinternet.org/~/media//Files/Reports/2013/Pew%20Internet%20He alth%20Online%20report.pdf
    29. 29. REFERENCES • Slide 8: http://www.adheretech.com/ • Slides 9-10: http://www.proteusdh.com/ • Slide 11: http://signup.powhealth.com/ • Slide 12: http://www.umotif.com • Slide 13: http://atpointofcare360.com/platform/clinical-decisions-at- the-point-of-care/
    30. 30. REFERENCES • Slide 14: • http://www.mc10inc.com/digital-health/remote-monitoring/ • http://www.misfitwearables.com/#shine_and_you • http://www.beddit.com/ • Slide 15: • http://phandroid.com/2013/05/08/what-can-you-see-and-do-with-google-glass-video/ • http://medcitynews.com/2013/05/watson-will-be-better-than-docs-other-sweeping- predictions-from-a-tech-optimist/
    31. 31. REFERENCES • Slide 16: http://investorplace.com/2013/08/cisco-internet-of-things/ • Slide 17: http://www.forbes.com/sites/johnnosta/2013/06/13/information- overload-the-big-challenge-for-digital-health/ • Slide 18: http://www.express-well.com/ • Slides 19-20: http://treato.com/apps/pharma/treato-service.htm
    32. 32. REFERENCES • Slide 22: • http://techcrunch.com/2013/07/13/why-behavior-change-apps-fail-to-change- behavior/ • http://www.dnaindia.com/health/1876205/report-smartphones-cause-rise-in- myopia-surgeon • http://www.ted.com/speakers/sherry_turkle.html

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