The Future of mHealth - Jay Srini - March 2011


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Jay Srini's presentation of her take on the Future of mHealth, presented at the 3rd mHealth Networking Conference, March 30, 2011. Aside from being one of the preeminent thought leader in the area of innovation and mhealth, she holds a number of positions including Assistant Professor at the University of Pittsburgh and CIO for LifeWIRE Corp.

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  • McKinsey research points to the huge impact of chronic conditions, which now claim at least three-quarters of all health care spending in most developed countries. One government-run health insurer in Germany, for example, has costs totaling more than €6 billion, including €4.9 billion for chronic conditions such as cardiovascular disease (€760 million) and diabetes (€500 million).
  • Read more: Precision medicine could be the key to better, cheaper care - FierceHealthcare first, intuitive medicine, involves highly trained specialists (think Dr. Gregory House) handling difficult diagnoses and treatment. The second, empirical medicine, deals with the expensive world of chronic care and trial-and-error treatment, Forbes reports. Lastly, precision medicine is where the diagnosis and therapy are known. Treatment can be made routine and moved out of the hospital. "Disruption will involve pushing more of medicine into the precision category, then automating that care to make it better and cheaper," Forbes reports.
  • Wikipedia's definition currently says:"Mobile eHealth or mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless healthcare delivery systems. The field broadly encompasses the use of mobile telecommunication and multimedia technologies in healthcare delivery." Mobile technologies by nature lend themselves to more decentralized health service delivery. Although Ministries of Health in low and middle income countries and policy makers are eager to explore the use of mobile phones and other ICT to promote health, the lack of a comprehensive model, knowledge base, and published data on the health benefits poses significant barriers. Read more: Define m-health, but then let's move on to the issues that actually affect care - FierceMobileHealthcare
  • Consider a hypothetical group of 100,000 people born in 1901. If they experienced the mortality rates in all age groups present at the turn of the 20th century, then only 31 would be expected to reach age 100. On the other hand, in a group of 100,000 people born in 2006 and experiencing our era's mortality rates, 1,737 would live to 100. The Delineation of Home Healthcare: The Natural Evolution of a Healthy IndustryHowever, giving "old age" greater legitimacy in the lexicon of 21st-century medicine has risks, especially beyond the industrialized world. A 2005 study found that "death registration" is complete in only 64 of 115 countries reporting data to WHO. Only one-third of the 57 million deaths that will occur this year around the world will be assigned a cause and reported to a government bureau of vital statistics.
  • The cost of monitoring a VA patient at home is $1,900 per year, compared with $77,000 for nursing home care, according to the government agency.Last summer, General Electric and Intel launched a joint venture focused on home health care, including a device that enables video conferencing between doctors and patients and a motion sensor system that tracks senior's movements and sends an alert if they fall. Verizon announced last April it would partner with telemedicine developer BL Healthcare on a wireless health care platform. In October, AT&T said it would begin offering WellDoc's mobile health applications, including diabetes management, to its employees.
  • Read more:
  • sensor application and research areas in healthcare: diagnostics and therapeutics, in terms of primary, secondary and tertiary prevention methods for sensor data analysis, with a special focus on the analysis of multimodal data integration of sensor data resp. extracted information with health information systems and decision support systems to achieve individualization of diagnostics acceptance of wearable sensor technologies for healthcare, both by potential users/ relatives  and healthcare professionals.
  • Developed by researchers at the Holst Center in the Netherlands, the Smart Bandage uses a film that combines light sources and photo sensors (pixels) to measure the amount of oxygen circulating in the blood around the damaged tissue.Ellie Zolfagharifard writes that he team hopes the Smart Bandage will help in the commercialization of the next generation of extremely small and very low-cost printed electronic sensor technology.
  • PiiX, is a wireless, water-resistant sensor that sticks to a patient's chest like a large Band-Aid and monitors heart rate, respiratory rate, bodily fluids, and overall activity. It transmits the data to a central server for analysis and review by doctor and patient.The basic technology platform has already received FDA approval, but Corventis envisions the PiiX as much more than a simple monitoring system. The company is working to generate algorithms that can predict, for instance, when a patient is on the verge of heart failure by comparing trends in his or her vital signs to other cases. "When you apply it in the real world, the algorithm begins to learn," says CEO Ed Manicka. "Not from 5 or 10 patients, but from hundreds of thousands of patients, as the system is applied across the planet."
  • , there is no denying the immense influences he and his creation have over the world… yes, not a single nation but Planet Earth. 550 million “friends” can not be wrong…there is no denying the immense influences he and his creation have over the world… yes, not a single nation but Planet Earth. His creation is Facebook and his name is Mark Zuckerberg, TIME Magazine Person Of The Year 2010. 550 million “friends” can not be wrong…
  • Social media is here  to stay… and its position and power in health care is ever expanding as well.Get on board… the train is being loaded
  • Yes, mobile apps have been hailed as one of the next big things in healthcare. But, are we there yet?
  • Currently there are 17,000 mHealth applications in major app stores, 74% of them adhering to the paid business model. With more and more traditional healthcare providers joining the mobile applications market, the business models will broaden to include healthcare services, sensor, advertising and drug sales revenues.“With the growing sophistication level of mHealth applications, only 14% of the total market revenue in the next 5 years will come from application download revenue” explains Egle Mikalajunaite senior research analyst. “76% of total mHealth application market revenue will come from related services and products such as sensorsOf the current health apps on the market, 43% are designed for health care professionals, indicating the future of mHealth has far-reaching personal and institutional potential.
  • Imagine a computer scientist that was itself a super-intelligent computer. It would work incredibly quickly. It could draw on huge amounts of data effortlessly. It wouldn't even take breaks to play Farmville. Read more:,8599,2048138,00.html#ixzz1GVkGkPE4
  • Researchers at Massachusetts General Hospital have built a $200 portable device that can hook up to a smartphone and analyze a tiny amount of tissue to determine in an hour whether a patient’s cancer is malignant and likely to spread.The device can display its findings using the monitors on mobile phones.The researchers found they could obtain 96 percent accurate predictions of whether a cancer was malignant in the first group of 50 people — better than the 84 percent accuracy of current methods. To validate the work, they used the test in a second group of 20 people, and found it was 100 percent accurate
  • MRI and nuclear magnetic resonance (NMR) scanners typically use large, powerful magnets, but that is unnecessary when the samples being scanned are very small — say, just one-millionth of a liter of fluid, which is all that is needed for an accurate detection of cancer cells. Researchers now have developed a device "that, even including the magnet, can fit in the palm of your hand," researcher Jered Haun, a medical engineer at Harvard Medical School in Boston, told TechNewsDaily.
  • Welcome to Freedom.For those that face diabetes every day as individuals, as doctors and nurses or as parents, we recognize the arduous task of managing this disease. We have developed a symphony of connected devices that aim to reduce burden while providing more insight to people with diabetes, their healthcare team and their family.
  • T2, a component center of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), is based at Joint Base Lewis-McChord, Wash. T2 has set up laboratory-based usability tests as part of a study to examine the iPhone 4’s FaceTime application, and other platforms in the future. T2 is exploring how the application can be used and how well it can connect.
  • On the domestic front, Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, said, “We need to be moving towards open sourced, independent infrastructure where you have components of different manufacturers that can plug and play. FDA is looking to the development of those different types of standards to get the biggest bang for our buck.”
  • Measure Test Treat Analyze Learn cycle
  • Along the way, the PHA supports users by measuring progress, providing ongoing feedback, and continually awarding micro-payment incentives.
  • As Mr Gates pointed out this week, “Middle-income countries are where most innovation in health care is going to come from.”Mobile phones' impact on health care could be even greater in the developing world, where mobiles far outnumber PCs. “For most of the world”, says Mr Jones, “this is the only computer they are ever going to own. It's on the internet. And they carry it everywhere.” Get ready for the doctor in your pocket.
  • The tricky part is finding a way to pay for telemedicine which doesn't fit into the traditional U.S. health care model centered around visits to the hospital and the doctor's office.
  • The Future of mHealth - Jay Srini - March 2011

    1. 1. Jay Srini <br /><br /><br />412 760 9593<br />Chief Strategist SCS Venutures<br />
    2. 2. What we know today?<br />What are we doing today?<br /> Where is the future headed to <br />Challenges and opportunities<br />Agenda<br />
    3. 3. McKinsey quarterly- Impact of Chronic Conditions-75% of healthcare Spend<br />
    4. 4. Dramatic Increase in Diabetes Disease Burden<br />
    5. 5. Hospitalization is expensive yet rehospitalization is not under control<br />The rates include all patients in fee-for-service Medicare programs who were discharged between October 1, 2003, and September 30, 2004. The rate for Washington, DC, which does not appear on the map, was 23.2%.<br />
    6. 6. The P’s of HealthCare<br />Predictive <br />Proactive<br />Participatory<br />Personalized<br />Preventative<br />Precision Medicine<br />
    7. 7. The C’s (criteria)of Health Care Delivery<br />Content<br />Context<br />Collaboration<br />Communication<br />Convenience<br />Customization<br />Community<br />
    8. 8. The Right Principles<br />Right Care ( Right to access and right to waive)<br />Right Time <br />Right Place<br />Right Delivery Mode/Channel<br />Right Price<br />Right Personnel<br />Right Partnerships<br />
    9. 9. What do we know today?<br />What are we doing today?<br />Where is the future headed to? <br />What are Challenges and opportunities<br />Agenda<br />
    10. 10. Let us start with Definitions<br />Mobile eHealth or mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless health care delivery systems and is part of a movement towards citizen-centered health service delivery. <br />The most widely cited and definitive definition is by Istepanian et al. as ‘emerging mobile communications and network technologies for healthcare.’ <br />Other later citations include Bardram et al. as m-health is focused on embedded wireless devices that track health-related parameters:<br />
    11. 11. Washington Post<br />The tsunami looms: By 2050, nearly 90 million Americans will have passed age 65, and every corner of society will feel the impact. With our inadequate health-care workforce, outmoded retirement ideas and rigid housing policies, how can our country prepare? Beyond rethinking ways to ensure retirement savings (mandatory government savings plans?) and redefining retirement (phased retirements? working longer?), researchers and professionals are trying out, and in some cases reviving, some ideas.<br />
    12. 12. VA Saves with Health Buddy--- Moral Keep the Patient at Home <br />
    13. 13. Text Messaging in HealthCare<br />
    14. 14. Lifestyle management<br />
    15. 15. Text messaging-Simple yet Effective<br />University of Oregon study published in the journal Health Psychology found that a series of eight anti-smoking text messages per day over a three week period was highly effective in stimulating the parts of the brain that fight cravings. <br /> The researchers wrote, "Text messaging may be an ideal delivery mechanism for tailored interventions because it is low-cost, most people already possess the existing hardware and the messages can be delivered near-instantaneously"<br />
    16. 16. Episodic Care to Continuous Care<br />
    17. 17. Wearable wireless <br />
    18. 18. Wound healing status<br />Shape of things to come Smart: bandage tells doctors about state of wound healing<br />Published 8 April 2009<br />Dutch researchers develop a smart bandage which updates doctors about the wound healing process; bandage made of printed electronic sensors; the researchers' next goal: add an antenna to transmit information about the patient's health remotely to the attending physician<br />Here is good news for soldiers and first responders who are injured in the line of duty, patients in hospitals, and the medical staff that takes care of them: a bandage that makes use of printed electronics could soon alert doctors to changes in the wound-healing process without the need to undergo extensive check-up appointments. <br />By using techniques currently employed in glucose monitoring, the Smart Bandage is claimed to employ advanced scalable printing to enhance patient monitoring by regulating how often a bandage needs to be changed<br />
    19. 19. Corventis- Proactive Preventative and Individualized<br />What Corventis is trying to do is fundamentally create a new type of machine intelligence that serves to manage the patient's overall health,“ CEO Ed Manicka<br />
    20. 20. Electronic Knee since 2004<br />The new study funded by NIH ( 600,000) is being conducted in collaboration with researchers at the University of Florida, Stanford University and University of Western Australia.<br />
    21. 21. Monitor over the age rangesFetal monitoring to Fall monitoring From Home to Hospitals<br />
    22. 22. Every breath you take every move you make( awake or asleep) I will be watching you!!<br />
    23. 23. Phone Booths and Stethoscopes- relics of the past <br />
    24. 24. Cell phone + Imaging device<br />Using a filter the scope can now spot microscopic critters tagged with dye that glows under fluorescent light -- things like Mycobacterium tuberculosis A software app is able to then count the number of cells within a given sample<br />
    25. 25. Communities in health<br /><ul><li>Some interesting facts from the article- 550 million members thus far.
    26. 26. If Facebook was a country, it will be the third largest in population after India and China- 1 of 12 people on Earth has a Facebook account- Nearly half of Americans have a Facebook account- 70% of Facebook members live outside of the United States- Facebook members speak 75 different languages- About 700,000 people join Facebook each day</li></li></ul><li>From Patients like me to Facebook communities for Cancer /Diabetes<br />from <br />from<br />
    27. 27. Tsunami Damage- Health Wealth and Happiness at Stake <br />
    28. 28. Clinical world is easier to handle with mobility <br />
    29. 29. Clinical reference libraries on the go<br />
    30. 30. There is an app for that!!<br />March 22, 2011 | Terry Sharrer<br />                                                                                <br />Eldercare Mobility <br />App for iPad<br />
    31. 31. The Stark Current Reality <br />There are now more than 250,000 apps available for the iPhone, more than 30,000 such apps for smart phones running Android, and several thousand for those who have Blackberry devices. <br /> According to a pretty recent survey by the Pew Internet and American Life Project, 17% of cell phone users have used their phone to look up health or medical information but only 9% have software applications or “apps” on their phones that help them track or manage their health<br />
    32. 32. What we know today?<br />What are we doing today?<br /> Where is the future headed to <br />Challenges and opportunities<br />Agenda<br />
    33. 33. Mhealth Market 2015<br />revenue from digital health technology and services would exceed $5.7 billion in 2015, compared with $1.7 billion in 2010, fueled by devices that monitor chronic conditions like hypertension and diabetes and by wellness and fitness applications and programs- Park Associates<br />
    34. 34. Cell Phone Penetration in US<br />
    35. 35. Frenetic Adoption of Mobile DevicesChilimark Research<br />
    36. 36. Year Man Becomes ImmortalWhen Humans Transcend Biology<br />
    37. 37. The future to come<br />Organic Intelligence and Artificial Intelligence Blur cannot be Unblurred<br />Imagine a computer scientist that was itself a super-intelligent computer. It would work incredibly quickly. It could draw on huge amounts of data effortlessly. It wouldn't even take breaks to play Farmville,8599,2048138,00.html#ixzz1GVo4h2aC<br />
    38. 38. Cough into your phone<br />
    39. 39. Cancer Diagnostics<br />96% accuracy for establishing a cancer diagnosis, surpassing conventional clinical analyses by immunohistochemistry<br />Cost 200 dollars<br />
    40. 40. Accurate Information at the right time <br />Smart phones equipped with what are essentially hand-held MRI scanners can accurately diagnose life-threatening tumors, researchers say.<br />
    41. 41. CellNOVO: ITUNES for Diabetes<br /><br />
    42. 42. Vitality Glow Caps- Coordinated CareIt is not just about the Technology!!<br />
    43. 43. Wearable Wireless to Smart Bandages<br />Wireless Body Area Network (WBAN) connects independent nodes (e.g. sensors and actuators) that are situated in the clothes, on the body or under the skin of a person. The network typically expands over the whole human body and the nodes are connected through a wireless communication channel. According to the implementation, these nodes are placed in a star or multihop topology<br />
    44. 44. Blown to bits<br />evaluate respiratory status on Mt Everest. <br />The doctor studied the ultrasound image of the patient’s lungs. Sure enough, the telltale signs of altitude sickness were apparent. That was not a surprise. The patient was a climber at base camp on Mount Everest, 6,400 meters above sea level. Doctor was in Detroit<br />
    45. 45. Can we then impact brain performance<br />Wireless EEG enables continuous remote monitoring-Mar 11, 2011 11:28 AM <br />Imec, Leuven, Belgium, a nano-electronics research company, and R&D provider Holst Centre, Eindhoven, The Netherlands, demonstrated a prototype headset that records high-quality EEG signals and wirelessly transmits real-time data to a receiver located 10 m from the system<br />
    46. 46. What else is your phone meant for?<br />
    47. 47. T2 – DCoEIphone 4’s Face Time Application<br />Researchers with the National Center for Telemedicine and Telehealth are exploring how smart phones and cargo containers equipped with two-way video technology can link soldiers to care across long distances. Tests are underway for smart phones, and the first converted cargo container is already in use<br />
    48. 48. The Internet of Things Ambient Assisted Living<br />
    49. 49. Health, Wealth and Incentives<br />
    50. 50. Power of CollaborationWisdom of the Crowds<br />James Yang Illustration<br />
    51. 51. UCLA Wireless Health Community <br />
    52. 52. West Wireless Institute<br />
    53. 53. WLSA<br />
    54. 54. Holst Center<br />
    55. 55. The Eye to the FutureFrom Health Monitoring to Bionic Sight<br />basic image processing and Internet access, a contact-lens display could unlock whole new worlds of visual information, unfettered by the constraints of a physical displayRead more: Solar Powered Augmented Contact Lenses Cover Your Eye with 100s of LEDs Augmented Reality Contact Lens – Inhabitat - Green Design Will Save the World<br />
    56. 56. What we know today?<br />What are we doing today?<br /> Where is the future headed to <br />Challenges and opportunities<br />Agenda<br />
    57. 57. Technology causes Technical Issues<br />Mickey McManus- Maya<br />
    58. 58. Privacy Wars– Who knows about YouWho wants to know about You<br />EXelate<br /><br />Rapleaf<br />BlueKai<br /> Intellidyn<br />,8599,2058114-2,00.html<br />
    59. 59. Holst –Imagine a Future <br />
    60. 60. Lifestyle Continuous Sensors<br />
    61. 61. Challenges<br />Dr. Eric Topol, vice chairman and chief innovation officer of the West Wireless Healthcare Institute and director of the Scripps Translational Science Institute at Scripps Health.<br />"In addition to that overarching challenge, we will need to work together as an industry to overcome regulatory, reimbursement and legislative barriers. Enlightened policies are desperately needed to change outdated, inefficient models of healthcare deliveryRead more: Leaders in San Diego m-health community discuss wireless innovation, roadblocks - FierceMobileHealthcare<br />
    62. 62. Mobile Etiquette<br />
    63. 63. Wrapping Up<br />
    64. 64. Nov 2010 Conference on m-health<br />Bill Gates keynoted the conference and was clear about the future or mobile health. "Diagnosis of malaria and TB will likely be the first ones you can assign a number to and say without this mobile phone app these people would have died," Gates said. "In the diagnostics areas we're seeing some very good stuff come through." <br />And Aneesh Chopra, U.S. Chief Technology Officer, told attendees at the summit that cloud computing and improved connectivity are likely to speed up the process by which mobile health innovations go from ideas to implementation. <br /><br />
    65. 65. The Perfect Storm<br />Continuous cycle of learning analyzing measure treating and testing- <br />Measure ->Test_> EBD/CDSS-> Treat-> Learn not a linear path<br />
    66. 66. The GoalLive Like your Life depends on it<br />What you do not measure you cannot manage- <br />Birth of Personal Health Management Systems-- Behavioral and Life Style Modification through Education, Engagement and Incentives <br />
    67. 67. A must readUnwired to wired to wireless <br /><br /><br /><br />
    68. 68. A must watch<br /><br />
    69. 69.
    70. 70. Mobile phones- A piece of the puzzleTowards Integrated Healthcare Access<br />
    71. 71. Tele or E or MTime to drop the Prefix<br />It is time for integration – Provide a multi modal delivery of care which is personalized and pertinent to the patient and is cost effective<br />It is time for Prevention to take Center stage<br />It is time for Coordinated Care integrating physicians, nurse practitioners, Diabetes educators, dieticians and smoking cessation specialist etc.<br />Health Literacy and Individual Engagement is Critical<br />It is time to provide the RIGHT care for all<br />
    72. 72. WSJ segment – Innovations in Healthcare<br /><br />