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www.bd.com
© 2016 BD. All Rights Reserved.
1
C O N D U I T
C o n n e c t i n g P a t i e n t t o P r o v i d e r
C o u c h...
www.bd.com
© 2016 BD. All Rights Reserved.
2
© 2016 BD. BD, the BD Logo and all other trademarks are property of Becton, D...
www.bd.com
© 2016 BD. All Rights Reserved.
3
© 2016 BD. BD, the BD Logo and all other trademarks are property of Becton, D...
www.bd.com
© 2016 BD. All Rights Reserved.
4
David Bostick
Data Science
David Downey
Web & Server
Sean Ulrich
Mobile
Dylan...
www.bd.com
© 2016 BD. All Rights Reserved.
5
Type 2 Diabetes
Adult Onset Diabetes
With type 2 diabetes, the body either
do...
www.bd.com
© 2016 BD. All Rights Reserved.
6
Ethnographic Insights
C o n d u i t
PRIORITIESTIME DATA EDUCATION
Clinicians ...
www.bd.com
© 2016 BD. All Rights Reserved.
7
Facilitate a more meaningful
patient clinician relationship.
Vision V
I
S
I
O...
www.bd.com
© 2016 BD. All Rights Reserved.
8
Comprehensive activity metrics at
high resolution including METS,
Steps and S...
www.bd.com
© 2016 BD. All Rights Reserved.
9
DSL and rules engine for precision
user engagement
CYRANO
Data visualization ...
www.bd.com
© 2016 BD. All Rights Reserved.
10
Nearly all data in the system is stored in FHIR Resources. Extensions used a...
www.bd.com
© 2016 BD. All Rights Reserved.
11
System Architecture
Couchbase
Cluster
FHIR
Server
Clinician
Portal
Mobile
Ap...
www.bd.com
© 2016 BD. All Rights Reserved.
12
Designed for humans by humans. Messages are carefully crafted and delivered ...
www.bd.com
© 2016 BD. All Rights Reserved.
13
Mobile
App
www.bd.com
© 2016 BD. All Rights Reserved.
14
Automatically collect and display blood glucose
readings from off-the-shelf ...
www.bd.com
© 2016 BD. All Rights Reserved.
15
Sample Screens
C o n d u i t M o b i l e
www.bd.com
© 2016 BD. All Rights Reserved.
16
Clinical
Portal
www.bd.com
© 2016 BD. All Rights Reserved.
17
All out-of-range events in one place
Each Meal + Paired Test + Insulin
Serve...
www.bd.com
© 2016 BD. All Rights Reserved.
18
Clinical Portal
C o n d u i t
www.bd.com
© 2016 BD. All Rights Reserved.
19
D E M O
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BD: Couchbase Mobile and digital health: connecting patient and clinician – Couchbase Connect 2016

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Chronic disease affects millions throughout the world and costs billions in the US each year. In this session, you will learn how Couchbase Mobile has enabled our small team to build a cutting-edge Digital Health solution to lower the burden of illness and improve outcomes. We will present our system to tackle Type 2 Diabetes using connected medical devices, a patient app and clinician portal

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BD: Couchbase Mobile and digital health: connecting patient and clinician – Couchbase Connect 2016

  1. 1. www.bd.com © 2016 BD. All Rights Reserved. 1 C O N D U I T C o n n e c t i n g P a t i e n t t o P r o v i d e r C o u c h b a s e C o n n e c t 2 0 1 6
  2. 2. www.bd.com © 2016 BD. All Rights Reserved. 2 © 2016 BD. BD, the BD Logo and all other trademarks are property of Becton, Dickinson and Company. We are a Fortune 500 company that is: • Reaching the corners of the world: Locations in more than 50 countries with more than 40,000 associates worldwide worldwide • Focused on improving efficiency of healthcare delivery and patient outcomes: Understands and serves the needs of our needs of our customers, including healthcare institutions, life science researchers, clinical laboratories, pharmaceutical and biotech partners and patients • Part of the fabric of the healthcare industry since 1897: Offers legacy of medical supplies and services, devices, laboratory devices, laboratory equipment and diagnostic technologies • Continually innovating practices across the healthcare continuum: Advancing cellular research capabilities and therapies, and therapies, point-of-care diagnostics, medication management, infection prevention and patient safety Who is BD?
  3. 3. www.bd.com © 2016 BD. All Rights Reserved. 3 © 2016 BD. BD, the BD Logo and all other trademarks are property of Becton, Dickinson and Company. BD’s strategy is to apply technology and clinical knowledge to make healthcare more effective, efficient and safe. Our areas of focus are: • Enabling safer, simpler and more effective parenteral drug delivery • Improving clinical outcomes through more accurate, timely and efficient diagnostics • Providing tools and technologies to the research community that facilitate the cell, cellular diagnostics and cell therapy • Enhancing disease management in diabetes, women’s health and cancer, and infection control • Improving clinical, laboratory and research practices in emerging markets BD’s strategic focus
  4. 4. www.bd.com © 2016 BD. All Rights Reserved. 4 David Bostick Data Science David Downey Web & Server Sean Ulrich Mobile Dylan Wilson Software Lead The Team Nakul Mahajan SQA Shreesh Uniyal Mobile
  5. 5. www.bd.com © 2016 BD. All Rights Reserved. 5 Type 2 Diabetes Adult Onset Diabetes With type 2 diabetes, the body either doesn't produce enough insulin, or it resists insulin. Injectable medications Lifestyle modification Oral medications https://www.cdc.gov/diabetes/pubs/statsreport14/diabetes-infographic.pdf
  6. 6. www.bd.com © 2016 BD. All Rights Reserved. 6 Ethnographic Insights C o n d u i t PRIORITIESTIME DATA EDUCATION Clinicians don’t want to muddle through logbooks or meters and patients don’t care or don’t see any return on their effort Type 2 is a complex disease with many clinical and lifestyle concepts, all interconnected Type 2 Diabetes is serious, but isn’t always a priority; short-term choices have mostly long-term effects Patients and Clinicians both report not having enough time to adequately discuss the many facets of Diabetes
  7. 7. www.bd.com © 2016 BD. All Rights Reserved. 7 Facilitate a more meaningful patient clinician relationship. Vision V I S I O N C o n d u i t
  8. 8. www.bd.com © 2016 BD. All Rights Reserved. 8 Comprehensive activity metrics at high resolution including METS, Steps and Sleep ACTIVITY Key clinical metrics INSULIN & GLUCOSE GPS timeline from Moves app categorized / anonymized via Foursquare LOCATION LoseIt + Meal Images FOOD We outfitted 30 Type 1 and 30 Type 2 diabetics with a host of hardware and software devices to comprehensively track “free-living” diabetics. 60 Diabetics for 21 Days Data We’ve Previously Collected 2 0 1 5 O b s e r v a t i o n a l S t u d y
  9. 9. www.bd.com © 2016 BD. All Rights Reserved. 9 DSL and rules engine for precision user engagement CYRANO Data visualization and patient management CLINICIAN PORTAL Patient support and cloud connectivity CONDUIT APP Transparently and automatically connect patient data HARDWARE DEVICES Scalable database + mobile synchronization COUCHBASE + MOBILE FHIR Based REST API for CLINICIAN PORTAL WEB SERVER Solution Components C o n d u i t
  10. 10. www.bd.com © 2016 BD. All Rights Reserved. 10 Nearly all data in the system is stored in FHIR Resources. Extensions used as necessary. C O N D U I T P L A T F O R M B A C K B O N E FHIR (2) aims to simplify implementation without sacrificing information integrity. It leverages existing logical and theoretical models to provide a consistent, easy to implement, and rigorous mechanism for exchanging data between healthcare applications. F A S T H E A L T H C A R E I N T E R O P E R A B I L I T Y R E S O U R C E S Provides the API for the Clinical Web Portal. Spark (1) Server used as the base; we replaced Mongo with Couchbase R EST A PI Comprehensive set of “Resources” representing a wide variety of concepts in healthcare. Built for extensibility. JSON D ATA FOR MAT 21 Database Design: FHIR (1) https://github.com/furore-fhir/spark (2) https://www.hl7.org/fhir/overview.html
  11. 11. www.bd.com © 2016 BD. All Rights Reserved. 11 System Architecture Couchbase Cluster FHIR Server Clinician Portal Mobile App Sync Gateway BGM Conduit Smart Cap MS Bot Cyrano RX + Scheduled Twilio 3rd Party Auth
  12. 12. www.bd.com © 2016 BD. All Rights Reserved. 12 Designed for humans by humans. Messages are carefully crafted and delivered with precision. H U M A N B E H A V I O R B U I L T I N Tailored to the T2 Diabetes space. Non-programmers can write and rewrite rules. Over 40 rules with well over 100 individual messages covering a broad variety of situations will be in production. D S L F O R B U S I N E S S U S E R S Enables Scheduled Messages. Uses Couchbase Views to catch up if the RX side goes down. C R ON MOD E Uses SG Webhooks to maintain state in near-real-time. Rules are fired as events occur. R X MOD E 21 Cyrano Engagement Engine
  13. 13. www.bd.com © 2016 BD. All Rights Reserved. 13 Mobile App
  14. 14. www.bd.com © 2016 BD. All Rights Reserved. 14 Automatically collect and display blood glucose readings from off-the-shelf BG meter. Maintain BG Record Bluetooth LE Enabled Authored in C# for significant code reuse & long-term maintainability in a healthcare environment. Always available for offline use. Xamarin Native + Offline Continuously connected to the cloud for caregiver and clinician access. Cloud Connected Transparently collect insulin usage and display to user answering the age-old question: “Did I take my medication?” Maintain Insulin Record Enable user to explore the effect of food on the body. Give clinicians tangible starting point for conversations about food. Meal Vignette Connects to BG and Insulin devices
  15. 15. www.bd.com © 2016 BD. All Rights Reserved. 15 Sample Screens C o n d u i t M o b i l e
  16. 16. www.bd.com © 2016 BD. All Rights Reserved. 16 Clinical Portal
  17. 17. www.bd.com © 2016 BD. All Rights Reserved. 17 All out-of-range events in one place Each Meal + Paired Test + Insulin Serves as a conversation starter MEAL VIGNETTE BROWSER Fasting BG Insulin Adherence Per-Meal BG Trends DATA DASHBOARD ALERTS Insulin Regimen Personal Goals PATIENT REGISTRATION + SETTINGS Clinical Portal C o n d u i t
  18. 18. www.bd.com © 2016 BD. All Rights Reserved. 18 Clinical Portal C o n d u i t
  19. 19. www.bd.com © 2016 BD. All Rights Reserved. 19 D E M O

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