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Hacking HealthDesigning for and understanding my healthJuhan SoninMarch 2011

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Your health data is going digital.

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Your pets’ health data is digital.

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How did I get into the Design of Health?I didn’t have a pulse on my health, let alone the data.Cholesterol Check at MITRE in 2006

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370 Total Cholesterol , 2006 Cheese and salami was coursing through my blood stream (based on a meal the night before the cholesterol test…)

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I had no clue what my health metrics were.I had a beLer pulse on the health of my car.

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and the Problem is…Increasingly complex systems – Tool and Methodology gapDecision makers are swamped with conflicDng data – Our work is increasingly mulD-­‐dimensional (not a flat-­‐ decision space)ArDfacts driving decisions need to be coordinated, presentedMinimal transparency into key health metrics

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How do I (as a pa7ent, nurse, doctor, proxy) make quicker, more accurate decisions?

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Started collecOng and designing the basics…Weight,Waist circumference,Cholesterol,Exercise,Food intake…

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From sketch to digital

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Early health card designs

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Got a checkup.First Ome in 6 years.But…The doctor’s back was to me while he asked me ques7ons (and then he typed the answers into the computer), zero ques7ons about Life outside of tradi7onal health info,no physical or emailed takeaways of next steps from the exam…

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How do I become an informed and empowered paOent?

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HealthCard was bornPrototyped with doctors, nurses, emergency responders… and oh yea, paOents.

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Used real data… my own dataDesign with fake data = fake designReal data:•needs to be grokked by you•has min/max values, outliers•needs amplificaOon, cleanup•begets real feedback + forces people to make real decisions

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System view of my family’s health

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Followed doctors and nurses at several Boston hospitals to SEE Healthcare in acOon.Partner in crime, Rob McCready watching surgery.

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Our forecast

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Designing a beauOful and clinically relevant experience without beauOful data =recipe for disaster.

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So we got into the data + standards game: hDataprojectlaika.org projecthdata.orgOpen source so^ware has become part of the CCHIT hData is a method of storing and exchanging health cerOficaOon informaOonLaika is responsible for automaOng data Goal: Influence/create Health IT standards to ease interoperability tesOng of Electronic Health Record implementaOon and speed adopOonsystems Why? Complexity and design of current standards are HITSP Specs on ConOnuity of Care a huge barrier to adopOon and effecOve usageIHE specs on Document Exchange

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US HealthcardSmartcard to standardize the healthcare “entry point” transacOonPrototype US Healthcard data model, design, and explore HHS adopOon

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Why not a 1040-­‐HC?

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Health devices are gehng cheaper…Costs approaching zero.The cost of data is also approaching zero.

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Body ProbesTorn bicep

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Daily acOvity dashboardUsing 2+ years (0.999 human “upOme”)

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Wireless, self-­‐syncing devices

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Part of my daily rouOneAt work…

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MonthlyCholesterol and glucose self tesOng

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Jumped into personal genomics23andMe (for all my family members), Personal Genome Project ParOcipant

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23andme.com

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Medical home IMPLANT PULSE OX BLOOD- PRESSURE CUFF Cell PhonePEDOMETER Digital Home WEIGHT SCALE PC Internet Family Disease Healthcare Personal FITNESS care management Health EQUIPMENT providers givers services Records MEDICATION Personal Health System TRACKING

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TelemedicineIntel Health Guide: It integrates personal communicaDon with the doctor, medicaDon reminders, educaDonal informaDon, and videoconferencing for the home.

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Assisted living I opened the door… I’m watching TV… I’m going to bed…Sensors: Mo7on, Fire/Smoke/CO2, Occupancy (Bed/Chair), Use (Door, Stove, Fridge, Tub), Loca7on (Alzheimers), Fall Alarms, Water flow…

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Sensors throughoutSpare Bedroom Master Bedroom Bathroom Living Room Kitchen

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Enable online clinic for the “pracOce of medicine”Evolve the FOSS “Healthcare as a so^ware service” modelSchool nurse at first;evolve to state-­‐of-­‐the-­‐art ambulatory screen clinic (diabetes, obesity, cardiovascular, asthma, allergies) in 2 years

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So we prototyped a health staOon.

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Self-­‐service health kiosk Brief engagement to assess current health Simple and minimally invasive Get a health snapshot or monitor changes over OmeOpen planorm Can add addiOonal measurement devices Bluetooth, Wifi, and web accessible Accessible API for building home grown appsMeasurements Blood pressure Weight Body composiOon HydraOon Pulse Temperature Eyesight Hearing RespiraOon

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Evolve from nurse-­‐aLended toself-­‐service health experience

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How do you get a pulse on key health metrics without a single tear?Early detecOon of chronic diseases will be as easy as carrying your cell phone in your pocket.Engaged paOents will increasingly self-­‐check and self-­‐monitor using bloodless, self-­‐administered medical tests.

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5 million doctors6.7 billion pa,ents

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4.7 billion cell phones6.8 billion paOents

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paOentsSCALE

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mHealth AxiomsBring the examinaDon room to the paDentBring the collecDve experDse of the pracDce, the standard of care, to the paDent’s bedside or homeMigrate from a system of episodic evaluaDon to a system of conDnuous assessmentExpect paDents and their families to be their own primary care provider (key member of the care team)

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hGraph Compelling, standardized visual representa7ons of a pa7ent’s health status…on the celltop Designed to increase awareness of the individual’s factors that can affect one’s health Open source healthcare applica7on Created for mobile devices, star7ng with the iPhone and iPadYour health in one picture Users provide, view, share, and understand a holis7c view of their health Based on an individual’s health data, iden7fies where an individual’s health numbers are, and where they should be Pa7ent focused, with professional clinical relevance hScore Single aggregated number ranging from 1-­‐100 that represents best knowledge status of an individual’s health Experimental measure correlated with sta7s7cal data from open sources

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hGraphUsed as status indicator for current plan of careRecent updates can trigger “just in Dme” healthcare consultsAddiDonal mHealth monitors augment hGraph scope and real-­‐Dme natureLive consults with healthcare professionals

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85% of adults have a cellphone today…

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The Future: Stage zero detecOon 90% Survive 10% Survive Early stage detecDon Late stage detecDon

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Special thanks to:Rob DingwellAndrew GregorowiczDirk KnemeyerRob McCreadyHarry SleeperBrian Staats

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Hacking HealthDesigning for and understanding my healthJuhan Sonin