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Digital Data-Driven Healthcare and Wellbeing

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en route to
Digital Data-Driven
Healthcare and Wellbeing
Kimmo Kaski

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Healthcare Expenditure Challenge
Longer lives but bigger spending
MIT Technology Review: Business Report on “A Cure for He...

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Digitalisation & ICT make technology Data-driven
transforming Society and its Services
Digitalisation
Data-driven Services...

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Digital Data-Driven Healthcare and Wellbeing

  1. 1. en route to Digital Data-Driven Healthcare and Wellbeing Kimmo Kaski
  2. 2. Healthcare Expenditure Challenge Longer lives but bigger spending MIT Technology Review: Business Report on “A Cure for Healthcare Costs“ (2014) 74 75 76 77 78 79 80 81 82 83 years 73 $1,500 $2,500 $3,500 $4,500 $5,500 TUR HUN SVK MEX POL CZE KOR ISR GRC NXL ITA JPN GBR BEL AUS IRL CHE FRA DEL CAN NLD SWE Life expectancy vs. per person health spending, OECD nations Healthcare spending linked to longer lives FIN USAUSA 20% 1960 1970 1980 1990 2000 2010 Expenditures on healthcare as a percentage of GDP 4% 8% 12% 16% 0% USA Other high-income countries 2020 2030 2040 Big spending in Healthcare 40% 24% 28% 32% 36% Need multidisciplinary Research & Technology & Innovations to further improve Healthcare and save Costs? FIN
  3. 3. Digitalisation & ICT make technology Data-driven transforming Society and its Services Digitalisation Data-driven Services Cyber Security Media & Entertainment & Games ICT Cloud Computing Data Analytics Internet of Things Built Environment & Smart Cities Service Economy & Trade & Commerce Arts & Humanities & Public Institutions Energy & Traffic & Transportation Healthcare & Wellbeing Societal & Social Services Process & Manufacturing Industry Public SectorPrivate Sector ICT in Aalto: > 80 profs & groups CS: 45 profs & 400 staff produce ⅓ Finland’s MSc Cover ICT areas Aalto Digi Platform Fostering digitalisation cooperation in Aalto and with industrial and academic partners CS Spearheads • Data science • Internet of Things (IOT) • Data repository & HPC • Digital Health • Security & privacy • Software
  4. 4. Finland – Test-bed for Data-driven Services Countries with biobanks Universal healthcare Unique national identification number Genetically isolated population Recalling made easy (biobank act + national identification number)
  5. 5. Finland – Test-bed for Data-driven Services Countries with biobanks Universal healthcare Unique national identification number Genetically isolated population Recalling made easy (biobank act + national identification number)
  6. 6. Finland – Test-bed for Data-driven Services Countries with biobanks Universal healthcare Unique national identification number Genetically isolated population Recalling made easy (biobank act + national identification number)
  7. 7. Finland – Test-bed for Data-driven Services Countries with biobanks Universal healthcare Unique national identification number Genetically isolated population Recalling made easy (biobank act + national identification number)
  8. 8. Finland – Test-bed for Data-driven Services Countries with biobanks Universal healthcare Unique national identification number Genetically isolated population Recalling made easy (biobank act + national identification number)
  9. 9. Helsinki area – offers a unique environment for Health & Wellbeing Technology and Innovation Ecosystem Harvard MGH MIT Greater Boston area High-Tech industry UH HUS AALTO Greater Helsinki area Health Technology (FIHTA) Need to join expertise to tackle the healthcare challenge
  10. 10. Helsinki Health Capital cluster & Data-driven Healthcare - initiative Consortium: Aalto University: Kimmo Kaski, Juho Rousu, Risto Ilmoniemi, Markus Mäkelä; University of Helsinki: Tomi Mäkelä, Risto Renkonen; Hospital District of Helsinki and Uusimaa (HUS): Ari Lindqvist, Mikko Rotonen; Finnish Health Technology Association (FIHTA): Tom Ståhlberg; Helsinki Metropolia University of Applied Science: Tero Nurminen; Health Capital Helsinki: Tuula Palmen Funding: Technology Industries of Finland Centennial Foundation, 6/2015 – 12/2016
  11. 11. Health Capital cluster & Data-driven Healthcare initiative Health Capital Cluster Data-driven Healthcare Data-collection and management technologies Research and Development Focus Areas Platform for health & wellbeing research, technology and innovation at Meilahti Medical Campus Development of data- analytics environment for personalised medicine and engaging healthcare Development of wireless sensor-based health & wellbeing data-collection and management methodologies
  12. 12. Data-Driven Healthcare Ecosystem build-up in greater Helsinki area* Consortium for Data-Driven Healthcare Ecosystem build-up is enlarging: Nokia/Digital Health labs; BC Platforms; Medixine; BCB Medical; Noona Healthcare; FMI - Ilmatieteenlaitos; CSC – Tieteen Tietotekniikan keskus; Väestöliitto, … Data Collection Infrastructure Data Repository Helsinki Metropolia University of Applied Sciences Aalto University Data Analytics Predictive Modelling Digital Health Technologies Tech-firms & The Finnish Health Technology Association (FIHTA) Life Science University of Helsinki The Hospital District of Helsinki and Uusimaa Medical expertise Data-Driven Healthcare Technologies *Technology Industry’s Centennial Foundation: ”Health Capital & Data-Driven Healthcare Consortium”
  13. 13. Health & Wellbeing Data Analytics Environment for Predictive Medicine & Personal Engaging Healthcare See also: MIT Technology Review: Business Report on “Data-Driven Healthcare“ (2014)
  14. 14. Health & Wellbeing Data Analytics Environment Health & Wellbeing Analytics Environment Wellbeing knowledge and data (Family Federation of Finland) Clinical expertise and Data (HUS) Biomedical knowledge & Biobanks (UH & HUS) Environmental & Air Quality expertise and Data (FMI) Big Data Analytics (Aalto) High- performance and Cloud computing (CSC) Sensors & Internet of Things (Aalto) Researchers Individuals Medical Decision Support
  15. 15. Data-Driven Decision Support for Digital Health (D4Health) • Funding by AoF ICT2023 progamme (1.1.2016-31.12.2017) • Volume: 1.3Meur, ca. 12 person years. • Consortium of 5 units ‒ Aalto/CS (J. Rousu, coordinator) ‒ Aalto/HIIT (S. Kaski) ‒ Aalto/EEA (S. Särkkä) ‒ UH/HIIT (G. Jacucci) ‒ FIMM (T. Aittokallio) • Collaboration: HUS, BC Platforms, Duodecim
  16. 16. Data-Driven Decision Support for Digital for Digital Health (D4Health) • Analytics methods development • User Interfaces for Analytics and Exploratory Search • Integration of multiple data sources • Network pharmacology modelling • Patient monitoring • Case studies (with HUS): • Chronic Obstructive Pulmonary Disease (COPD) • Acute Myeloid Leukemia • Neonatal intensive care
  17. 17. Biodesign Finland - Innovating Medical Technologies in Interdisciplinary Teams Identify Clinical immersion Invent Concept creation, prototyping Implement Development strategy Team Formation Med Tech Innovations, Startups & Industry Leaders Biodesign is a systematic process to invent new technologies to improve medical practice. AALTO: Risto Ilmoniemi, Paavo Kinnunen ja Jaakko Nieminen HU: Risto Renkonen HUS: Visa Honkanen AALTO VENTURE PROGRAM: Olli Vuola
  18. 18. Health Technology growth in Finland growth rate high, startups & trading balance boom! 2014 • Exports: 1.8 billion € • Growth from 2013: 8.3% • Surplus: 829 million € • Growth from 2013: 10.7% + Wellbeing technology Companies: 400 Revenue: 4 billion € Personnel: 10 000 + Startup boom By courtesy of FIHTA 200 400 600 800 1200 1400 1600 0 1996 1000 Finnish Health & Wellbeing technology trade, 1996-2014 1800 EUR million -98 2000 -02 -04 -06 -08 -10 -12 -14 Export Trading balance Import

Editor's Notes

  • Countries with Biobank:
    Europe: Austria, Belgium, Bulgaria, Czech Republic, Cyprus, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Ireland, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Spain, Sweden, Switzerland, UK
    Asia: China, India, Japan, Korea, Malesia, Singapore, Taiwan, Thailand
    Afrikka: Gambia, Uganda, South-Africa,
    Middle east: Iran, Israel, Jordan, Kuwait, Qatar, UAE
    Others: Australia, Canada, USA, New Zealand, Russia
    Latin America: LACTumorbank Network (governmental cancer institutions): Argentina, Brasil, Chile, Columbia, Cuba, Equador, Mexico, Panama, Peru, Uruguay, Venezuela

    Biopankki on lääketieteellinen kokoelma, joka sisältää DNA:ta, verta tai muita näytteitä ihmisen elimistöstä sekä lisäksi tietoja kunkin näytteenantajan terveydestä ja elintavoista. (Tiede 3/2006: Biopankin kynnyksellä (s.17)
    Biobanks can be established within academic medical or research institutions, pharmaceutical/biotechnology companies or as stand-alone organizations.
    Types of Biobanks: Population based biobanks for genetic research and clinical/disease-orientated biobanks that collect biological samples from patients, aiming at discovery and validation of genetic and
    non-genetic risk factors of diseases.


    Sources:
    http://specimencentral.com/biobank-directory/
    http://bbmri-eric.eu/memberstates
    http://www.nature.com/gim/journal/v9/n3/full/gim200726a.html
    http://www.esbb.org/biobanks.html
    http://ftp.jrc.es/EURdoc/JRC57831.pdf
    About Biobanks: https://www.google.fi/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0ahUKEwiTt_3OnLjJAhUK2SwKHffLDsAQFggfMAA&url=http%3A%2F%2Fwww.springer.com%2Fcda%2Fcontent%2Fdocument%2Fcda_downloaddocument%2F9789401795722-c2.pdf%3FSGWID%3D0-0-45-1493350-p177035425&usg=AFQjCNE0teYnvHY6qgVa4WpreuUbHXtzfA



    LATINALAINEN AMERIKKA:
    LACTumorBank Network: governmental cancer institutions: Kolumbia, Kuuba, Mexiko, Peru, Equador, Argentiina, Uruguay, Chile, Panama, Venezuela, Brasilia
    http://bvsms.saude.gov.br/bvs/publicacoes/inca/Claudio_Gustavo_Stenaff_Latin_America_and_Caribbean.pdf

    MALTA
    http://www.um.edu.mt/biobank

    UUSI-SEELANTI
    http://ir.canterbury.ac.nz/handle/10092/2594
    https://www.fmhs.auckland.ac.nz/en/faculty/cbr/our-centre/biobank.html

    AFRIKKA: Uganda, Cape Town
    http://www.b3africa.org
  • Countries with Biobank + Universal Healthcare
    Europe: Austria, Belgium, Czech Republic, Cyprus, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Ireland, Luxembourg, Netherlands, Norway, Portugal, Romania, Slovakia, Spain, Sweden, Switzerland, UK
    Asia: Japan, South Korea, Singapore, Taiwan, Thailand
    Middle east: Israel, Kuwait, UAE
    Others: Australia, Canada, New Zealand
    Latin America: LACTumorbank Network (governmental cancer institutions): Argentina, Chile, Cuba, Panama, Venezuela


    Source: 58 countries with universal health care in 2009, according to Stuckler, et al.[1]
    Stuckler, David; Feigl, Andrea B.; Basu, Sanjay; McKee, Martin (November 2010). "The political economy of universal health coverage. Background paper for the First Global Symposium on Health Systems Research, 16–19 November 2010, Montreaux, Switzerland" (PDF). Pacific Health Summit. Seattle: National Bureau of Asian Research. p. 16. “Figure 2. Global Prevalence of Universal Health Care in 2009; 58 countries: Andorra, Antigua, Argentina, Armenia, Australia, Austria, Azerbaijan, Bahrain, Belarus, Belgium, Bosnia and Herzegovina, Botswana, Brunei Darussalam, Bulgaria, Canada, Chile, Costa Rica, Croatia, Cuba, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Kuwait, Luxembourg, Moldova, Mongolia, Netherlands, New Zealand, Norway, Oman, Panama, Portugal, Romania, Singapore, Slovakia, Slovenia, South Korea, Spain, Sweden, Switzerland, Taiwan, Thailand, Tunisia, UAE, Ukraine, United Kingdom, Venezuela.”

    Lähde: http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/

    https://en.wikipedia.org/wiki/Universal_health_care
    https://en.wikipedia.org/wiki/Universal_health_care#/media/File:Universal_health_care.svg


  • Countries with Biobank + Universal healthcare + National Identification Number
    Europe: Austria, Belgium, Denmark, Estonia, Finland, France, Iceland, Netherlands, Norway, Sweden, Switzerland, UK
    Latin America: LACTumorbank Network (governmental cancer institutions): Chile

    Unique national identification number: selitetään auki missä maissa on vastaavanlaiset henkilötunnukset käytössä, kuin Suomessa + miksi unique: koodaus.
    Suomalaisen henkilötunnuksen algoritmin kehitti Erkki Pale, joka toimi toisessa maailmansodassa salakieliasiantuntijana.
    Henkilötunnus mahdollistaa ihmisten seuraamisen, rekisteritietojen yhdistämisen  laajojen tietoaineistojen muodostuminen (mm. Potilastiedot voidaan linkata näytteeseen  digitaalinen fenotyyppaus

    Eroavaisuus maiden kesken: henkilötunnuksen perusrakenne.
    vastaava tunnus kuin Suomessa otettiin käyttöön muissakin Pohjoismaissa, vieläpä samoihin aikoihin.
    Henkilötunnuksen perusrakenne on kaikissa Pohjoismaissa samanlainen, vaikkakin yksityiskohdissa on poikkeavuuksia.
    Ihmisten numerointi tällä tavoin oli siis suosittu ajatus.


    Source: https://fi.wikipedia.org/wiki/Henkilötunnus
    Muualla vastaavanlaista henkilötunnusta käytetään muun muassa Ruotsissa (personnummer), Norjassa (fødselsnummer), Tanskassa (personnummer tai CPR-nummer), Islannissa (kennitala), Virossa (isikukood), Alankomaissa (burgerservicenummer), Belgiassa (rijksregisternummer), Ranskassa (code INSEE), Itävallassa (Sozialversicherungsnummer), Sveitsissä (AHV-Nummer), Liettuassa (asmens kodas) ja Chilessä (Rol Único Nacional tai RUN).

    Yhdysvalloissa on samankaltainen järjestelmä (social security number, SSN), vaikka sitä ei alun perin luotukaan samanlaiseen tarkoitukseen. SSN:ia ei anneta ihmiselle jo syntymästä, joten on mahdollista elää Yhdysvalloissa ilman sellaista, joskin sen puute vaikeuttaa käytännön asioiden hoitamista.

    Suomalaisen henkilötunnuksen koodauksen avaus:
    http://www.tuomas.salste.net/doc/hetu/tunnus.html


    Taustaa suomalaisesta henkilötunnuksesta:
    Henkilötunnus on nykyisin kaikilla suomalaisilla. Suomalainen henkilötunnus on 11-merkkinen merkkijono. Se sisältää henkilön syntymäpäivän, yksilönumeron ja tarkistusmerkin. Lisäksi tunnuksesta käy ilmi sukupuoli. Tunnus on tarkoitettu henkilöiden erotteluun tietojärjestelmissä siten, että oikeat tiedot kohdistuvat oikeaan henkilöön.

    pp = syntymäpäivä (01..31)
    kk = syntymäkuukausi (01..12)
    vv = syntymävuosi (00..99)
    välimerkki ilmoittaa syntymävuosisadan: + = 1800, - = 1900, A = 2000-luku
    nnn = yksilönumero, naisilla parillinen, miehillä pariton (002..899)
    t = tarkistusmerkki

    Henkilötunnus alkaa syntymäpäivällä. Se ilmoitetaan 6-numeroisella luvulla.
    Syntymäpäivän ja henkilötunnuksen loppuosan välissä on välimerkki. Siitä näkee syntymävuosisadan. Välimerkki on 1800-luvulla syntyneillä plusmerkki (+), 1900-luvulla syntyneillä yhdysmerkki (-) ja 2000-luvulla syntyneillä A-kirjain.
    Henkilötunnuksen loppuosan kolme ensimmäistä merkkiä ovat yksilönumero. Sen avulla erotellaan toisistaan ihmiset, joilla on sama syntymäpäivä.
    Yksilönumeron viimeinen numero kertoo sukupuolen. Miehillä numero on pariton, naisilla parillinen. Miehillä henkilötunnuksen loppuosa on siis jokin seuraavista: xx1x, xx3x, xx5x, xx7x tai xx9x. Naisilla loppuosa on vastaavasti xx0x, xx2x, xx4x, xx6x tai xx8x.
    4) Henkilötunnuksen viimeinen merkki on tarkistusmerkki. Merkillä varmistetaan, että tunnuksessa olevat numerot ovat oikeat.Tarkistusmerkkin laskukaava: Henkilötunnuksesta otetaan välimerkki pois. Tunnuksen 9 ensimmäistä merkkiä tulkitaan 9-numeroiseksi luvuksi, joka jaetaan luvulla 31. Jakojäännös muutetaan tarkistusmerkiksi henkilötunnuksen tarkistusmerkkitaulukon avulla.



  • Countries with Biobank + Universal healthcare + national identification number + genetically isolated population
    Eurooppa: Finland, Iceland

    Source: http://hmg.oxfordjournals.org/content/11/20/2507.full


    The struggle to identify susceptibility genes for complex disorders has stimulated geneticists to develop new approaches. One approach that has gained considerable interest is to focus on genetically isolated populations rather than on the general population.

    In general, the statistical power to detect a real association or linkage is limited by the background noise in the population under study. This noise consists of all possible combinations of environmental and genetic factors present in the population. Therefore, in heterogeneous populations, large sample sizes would be needed to obtain sufficient statistical power to detect genetic risk factors. More homogeneous populations such as genetically isolated populations have been proposed as a possible alternative for these large sample sizes, because environmental variation might be lower and the genetic make-up of these populations is expected to be less complex owing to founder effects, thus improving the signal-to-noise ratio. The use of genetically isolated populations is not new; for example, in Finland, there are numerous examples of Mendelian disorders with increased prevalence (29). This has been especially valuable for mapping rare recessive disorders. but many researchers believe this could be a solution for more complex disorders as well because of the relatively uniform genetic background of the population. Some culturally and genetically isolated populations have a more similar way of living, eating habits and natural environment that reduces environmental variation. Often these populations have been founded by a small number of individuals, followed by a period of genetic isolation, during which genetic drift might have been seen and population expansion mainly occurred by population growth and not by immigration. In addition, if genealogical records are available, the kinship coefficient of patients can be determined, which is often higher than in heterogeneous populations. In countries from Scandinavia, for example, state healthcare registries have been maintained over centuries


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