eHealth: Big Data, Sports Analysis & Clinical Records


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Presented by Leif Hanlen
Technology Director, NICTA

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eHealth: Big Data, Sports Analysis & Clinical Records

  1. 1. eHealth: Big data, sports analysis & clinical records Leif Hanlen Technology Director, NICTA Assoc. Prof. ICT @ Australian National University Prof. Health @ University of Canberra From imagination to impact
  2. 2. Conclusion • “Big Data” in health is using existing/available information to support better delivery of better care. • It’s not special: it’s just health. • It’s not how big it is, it’s how you use it. The convergence of biology, informatics, and engineering is turning healthcare into an information industry. Mario Castañeda, CBET, BS, MBA, National Director of the Clinical Technology Department at Kaiser Permanente “[T]he effectiveness of telehealth is currently limited by positioning telehealth outside the mainstream of healthcare” Mitchell, DCITA report, 2 1999 From imagination to impact
  3. 3. Too much data, ill-used “Current medical practice relies heavily on the unaided mind to recall a great amount of detailed knowledge – a process which, to the detriment of all stakeholders, has repeatedly been shown unreliable” Robert M. Crane and Brian Raymond The Permanente Journal Winter 2003 Volume 7 No.1 Kaiser Permanente Institute for Health Policy Emphasis added. From imagination to impact 3
  4. 4. Who is NICTA? • Australia’s ICT research center of excellence – “Use inspired research” • Making fundamental advances in ICT that can underpin the development of globally competitive products, processes and services. – 700 people (300 research staff) – 5 laboratories, 15 partner universities From imagination to impact 4
  5. 5. We’ve launched a 15 startups in the last 10 years. From imagination to impact 5
  6. 6. Transforming innovative technologies to advance the understanding of human diseases and to improve the health and well being of Australians From imagination to impact 6
  7. 7. Australia Health AU$120b per annum Where it goes 45,000 40,000 35,000 Series3 30,000 Series2 25,000 Series1 20,000 Expon. (Series1) 15,000 10,000 5,000 Src. AIHW Expon. (Series2) Expon. (Series3) 0 1 2 3 4 5 6 7 8 9 10 11 Hospital spending in $millions per year, by source 7 From imagination to impact
  8. 8. Healthcare: a systemic change is needed 40% : hospitals ($48b) 18% : medical services 5% : community health ($6b) From imagination to impact 8
  9. 9. Healthcare: a systemic change is needed Information shifts this balance 40% : hospitals ($48b) 20% : medical services 5% : community health ($6b) Scaling status quo does not help From imagination to impact 9
  10. 10. But: it’s not only “the system” at fault “Health informatics has been technology driven and IT creators have misconceptions about how clinical work is done, what characterises workers and their environment, what problems they face, and how they will use the artifact.” Redcliffe Hospital study, 2011 From imagination to impact 10
  11. 11. Meet the next ^ Chief Information Officer. From imagination to impact 11
  12. 12. This is her office: From imagination to impact 12
  13. 13. This isn’t her office. It’s a conference room for clinicians From imagination to impact 13
  14. 14. Where will the ‘health’ data come from? “Gigabit person days” Clinical notes analysis 2Mb per person per day 45% population Implants 1 Gb per person per hour 0.001% population Genomics 10 Gb per person 1% population Wearables 1 Mb per person per day 25% population From imagination to impact Proteomics 10 Tb per person 0.01% population 14
  15. 15. Where will the ‘health’ data come from? “Gigabit person days” Improvements in clinician efficiency & effectiveness Clinical notes • • • • • • About 15k~20k providers (Health Info. Systems) Limited interoperability incentive Web-interface (PCEHR) but no analytics API Privacy! Access (clinicians  developers) Adoption path: clinical champions, health systems Huge potential for community engagement Wearables • About 15m~20m providers (sensors, software, apps) • No interoperability incentive, no standards • Privacy … but many people don’t care • Access often local • Adoption path: sports : wellness : community benefit From imagination to impact 15
  16. 16. But delivery will be via mobile video Video accounts for 37% of mobile data. Ref: CISCO Systems 2011 From imagination to impact 16
  17. 17. eHealth is here. Online image viewer From imagination to impact 17
  18. 18. It's a very sobering feeling to be up in space and realize that one's safety factor was determined by the lowest bidder on a government contract. From imagination to impact 18
  19. 19. IT innovation: Old vs new • IT solutions in-house or procured • Data never leaves – Security by lock down • National (central) innovation applied locally • IT solutions by community; in-house evaluation • Data security, open design • Innovation local, grows nationally From imagination to impact 19
  20. 20. Health data (old) Design system Predict queries Hope (and wait) (and pay) From imagination to impact 20
  21. 21. Old way: Lots of data stores, no interoperability From imagination to impact 21
  22. 22. New way: Keep the data, use it better Restful services Eg. BioGrid in AU Cluster analysis for enterprise From imagination to impact 22
  23. 23. Secure data, real time, useful. From imagination to impact 23
  24. 24. Interoperability, technology adoption, community care NATIONAL E-HEALTH LIVING LABORATORY Embedding ICT in the next generation’s workflow From imagination to impact 24
  25. 25. U. Canberra AIS 1km Aged care Tertiary Hospital ANU From imagination to impact NICTA
  26. 26. Sod turning, Feb 2013, opening Feb 2014 From imagination to impact 26
  27. 27. Why? • Change the culture of care delivery: ICT part of the oxygen • Encourage bottom-up innovation – Matched to strategic (top-down) goals • Co-design, co-develop, co-deploy. – And then scale • No “death by pilot-itis” • No faith-based system changes “Scientists reproduce results; engineers build impressive and enduring artifacts; and theologians muse about what they believe but can’t see or prove.” Ted Pederson, Empiricism is not a matter of faith From imagination to impact 27
  28. 28. The Lab Philosophy • Everyone’s skin in the game – No cash for “research pilots”. – Unsustainable business models need not apply. • Open. Web based. HTML 5. – No lock-in. Open source, open access, achieve standards – Restful API’s, open data standards, privacy built in (not locked) • Mobile by defaults • Keep it real – Lab has consumers, practitioners, developers, researchers, students all co-located. No room for “not-invented-here” From imagination to impact 28
  29. 29. Health challenge: 10 bed hospital • What would a health-system look like if – 10-beds were the “norm” for hospitals? – In-home was the “norm” for care? – Tertiary hospitals were the “weapon of last resort?” From imagination to impact 29
  30. 30. Health challenge: 10 bed hospital From imagination to impact 30
  31. 31. Social media: monitoring health socially Australia/NZ has 29% of google pharmaceutical searches From imagination to impact 31
  32. 32. Clinical Information Processing Use the data that is already captured; to trigger early warnings. From imagination to impact 32
  33. 33. From imagination to impact 33
  34. 34. Technology demonstrator • Testing with partners – Use clinical notes to improve detection – Web-app visualization – Mobile data • Keep it useful for clinicians and then – Get the data we need. From imagination to impact 34
  35. 35. Clinical Information Processing Nurses, Are you tired of wasting time writing handover notes? Just talk. Let the computer sort it out. From imagination to impact 35
  36. 36. Nursing handover • Social: nurses talk, in a group, at bedside • Information passed at shift-change – And recorded on paper records 8+ hours later • Information is lost – Errors: adverse events, medication errors, omissions etc. • Workflow is inefficient – Time wasted, frustrating Nurses want to have speech recorded, but not like this. From imagination to impact 36
  37. 37. Technology demonstrator • Proof-of-concept • In 3 major teaching hospitals & 6 ward/units within • • • South West Sydney Local Health District Sydney Local Health District Web-based HTML5 app From imagination to impact 37
  38. 38. Sports analysis: gateway drug for population health “The stats of exercise are really important to me to check out my performance” Cross-country skier Colby Rook uses the device for training From imagination to impact
  39. 39. From engagement to solution • Problem “how can we track performance?” – Approached by Australian Institute of Sport to quantify training – Paper notes are impossible to search, time-consuming to fill and often missing records. AIS logbooks circa 1958 AIS logbooks circa 1998 From imagination to impact AIS logbooks circa 2010
  40. 40. Technology demonstrator • In use at Aust. Institute Sport for last 18 months • Commercialisation under way – Consumer technology with web-app integration From imagination to impact
  41. 41. Next steps? • Expertise in data mining and machine learning – Including text processing • Range of projects, interested in developing new collaboration • Also developing community for ICT development/adoption. From imagination to impact 41
  42. 42. From imagination to impact 42
  43. 43. Like this? Work with us Change this: From imagination to impact 43