1.
User Generated Health<br />Chris Hogg<br />twitter.com/cwhogg<br />citizenmed.wordpress.com<br />

2.
6,836<br />3.4<br />127/62<br />84<br />3.2<br />

3.
We are currently in the era of disconnected health<br />

4.
We are disconnected from our health data<br />50.7% use EMR<br />$44k in stimulus per doc<br />

5.
We are disconnected from our physicians<br />

6.
We are disconnected from the healthcare system<br />

7.
We are disconnected from our own health<br />

8.
Being disconnected leads to poor health<br />

9.
Obesity Trends* Among U.S. AdultsBRFSS,1990, 1999, 2009<br />(*BMI 30, or about 30 lbs. overweight for 5’4” person)<br />1999<br />1990<br />2009<br />1/3 <br />of Americans will have diabetes by 2050<br />(CDC)<br />No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%<br />

10.
The pace of drug development is slowing<br />

11.
How did we lose control of our personal health identity?<br />

12.
Technology will disrupt healthcare…<br />(it will just take longer than other industries)<br />80% search for health<br />3rd most popular web-based pursuit<br />(Susannah Fox, Pew Internet Project)<br />

13.
Cyberchondria<br />“Unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web”<br />2 in 5 report increase in anxiety from medical search<br />(White and Horvitz, Microsoft Research)<br />

14.
The patient is the most underutilized resource in healthcare<br />

15.

16.
Measurement facilitates behavioral change<br />10.5%<br />(Seligman and Darley 1977)<br />

17.
Is mHealth adoption following a familiar pattern?<br />% of Age Group<br />Age<br />Data from:<br />Brian Dolan, MobiHealthNews<br />Susannah Fox, Pew Internet Project<br />

18.
Apple wants to connect you to your health<br />

19.

20.
New data is more powerful<br />than a new drug<br />39% reduction in <br />hospitalizations <br />over 6 months<br />

21.
50%<br />73 million have HTN<br />69% with first MI<br />

22.
Know your target audience<br />

23.
Even young people have chronic medical conditions<br />% of Patients<br />Age<br />

24.
# of chronic conditions for Medicare beneficiaries (65+)<br />5+conditions<br />But as people age, they get a lot more<br />No conditions<br />4conditions<br />1condition<br />3conditions<br />2 conditions<br />Presented at the Annual Academy Health Research Meeting, June 2007; CMS (Centers for Medicare and Medicare Services)<br />

25.
Medical / clinical is converging with health / wellness <br />

26.
What you can learn from a few data points?<br />

27.
Mood Seasonality<br />Mood by Day of Week<br />

28.

29.
Significant personal information from a single daily data point<br />

30.
30<br />Crowdsourcing personal health data<br />

31.
Xanax(Alprazolam)<br />Exercise<br />B Vitamins<br />31<br />

32.
Can crowdsourced personal health data be used to predict personalized drug responses?<br />

33.
Data is beginning to flow from the system to users<br />

34.
Access to data – <br />Blue Button<br />Practice Fusion<br />MSHV<br />

35.
Prescription data is beginning to flow<br />Surescripts data on Rx histories<br />

36.
Rx history + treatment algorithm = understanding<br />

37.
You can learn a lot about a person from a few simple data points<br />

38.
Beta Blockers<br />Diuretics<br />High Blood Pressure<br />Drug<br />ACE Inhibitors<br />Drug Class<br />Liptor<br />Zocor<br />Lovastatin<br />Pravachol<br />Crestor<br />Lescol<br />Calcium Channel Blockers<br />ARBs<br />Statins<br />70-80% of CAD patients have high blood pressure<br />High Cholesterol<br />Coronary Artery Disease<br />(CAD)<br />Myocardial Infarction<br />(Heart Attack)<br />Zetia<br />Tricor<br />Vytorin<br />Gemfibrozil<br />Niaspan<br />Medical Conditions<br />Event<br />HDL<br />and<br />Other<br />20-30% of CAD patients have Type 2 Diabetes <br />TZDs<br />Drug Class<br />Metformin<br />Type 2 Diabetes<br />DPP -4 Inhibitors<br />Drug<br />Sulphonylureas<br />Insulin<br />

39.
Hidalgo et al. PLoS Computational Biology 5(4):e1000353 (2009)<br />http://hudine.neu.edu/<br />

40.
High Cholesterol<br />High Blood Pressure<br />1<br />2<br />3<br />4<br />5<br />High Blood Pressure<br />High Cholesterol<br />High Blood Pressure<br />High Blood Pressure<br />Type 2 Diabetes<br />High Cholesterol<br />Type 2 Diabetes<br />Osteoporosis<br />

41.
Social Health App<br />Social Health App<br />Social Health Layer / Health Graph<br />Google Health<br />Microsoft HealthVault<br />Practice Fusion EMR / PHR<br />AllScripts PHR<br />Other EMR / PHR System APIs<br />Google Apps<br />MSHV Apps<br />PF Apps<br />AS Apps<br />Other PHR Apps<br />

42.
We are entering the era of Participatory Medicine<br />

43.
A medical record is a punctuated data stream<br />Gaps filled via recollection<br />Personal Health Data<br />

44.
Anamnesis<br />(patient recollection)<br />is not accurate<br />

45.
EMR data + user generated data = healthstream<br />Personal Health Data<br />

46.
Rx of Apps<br />Medications<br />METFORMIN 500MG BID<br />LISINOPRIL 20MG OD <br />Applications<br />

47.
I will own my healthstream and health data<br />

48.
The market for health data is very large<br />

49.

50.
Healthcare systems are the future<br />

51.
Data enables us all to become Citizen Scientists<br />

52.
Can butter make you smarter?<br />

53.
The MTHFR Study<br />

54.
Groups of users will come together to <br />run their own <br />clinical trials<br />

55.
Genomera: A platform for Citizen Science<br />

56.
Future study:<br />meditation and blood pressure<br />

57.
Citizen Science has the power to disrupt healthcare<br />Drug A<br />Track common measures of efficacy, potential side effects, events, etc.<br />Drug B<br />

58.

59.
For those interested in learning more, the Bay Area is a good place to be…<br />

60.
Chris Hogg<br />cwhogg@gmail.com<br />twitter.com/cwhogg<br />linkedin.com/in/cwhogg<br />citizenmed.wordpress.com<br />?<br />Thank You<br />