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MC ThinkCamp mHealth june 3 2011


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Brought to you by the Mobile Collective, with the support of the ICT KTN, the CI KTN, and the Mobile Applications Centre at Imperial College.

Featuring: Patients Know Best, Wellnote, Epicollect, & MoDiSe

Published in: Health & Medicine, Business
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MC ThinkCamp mHealth june 3 2011

  1. 1. MC ThinkCamp – mHealth June 3rd, 2011 ( #tcmh )
  2. 2. Where do ideas for mHealth innovation come from?
  3. 3. Saying ‘I Wish’
  4. 4. Seeing New Patterns
  5. 5. Doing a bit of Mix’n’Mash
  6. 6. Doing a bit of Drag’n’Drop
  7. 7. Playing Leapfrog
  8. 8. Disruption:new authority figures
  9. 9. Disruption:overshot customers
  10. 10. First Speaker:Dr Mohammed Al-Ubaydli In 2008, Mohammed founded Patients Know Best, a website that gives patients online access to their medical data. Mohammad has over 15 years of experience in medical software. He trained as a physician at the University of Cambridge; worked as a staff scientist at the National Institutes of Health; and was a management consultant to US hospitals at The Advisory Board Company. Patients Know Best was featured in Wired magazine’s March 2011 issue.
  11. 11. Patient-controlled records Dr Mohammad Al-Ubaydli
  12. 12. Women’s suffrage over time Source:  h*p://  
  13. 13. Women’s suffrage over time Professionals objecting to patient control are like Swiss men objecting to women voting in 1971: wealthy, civilized, eloquent… and on the wrong side of history
  14. 14. A bit about me… Trained as physician at the University of Cambridge. Trained as programmer and worked as NIH Staff Scientist. Honourary Senior Research Associate, UCL Medical School. Continuing research on PHRs from 2,700 US hospitals, new book in 2010:
  15. 15. Our customersUse our platform to save money fromshared workflow1. Thalidomide Trust / Imperial Collegehospital wanted us for onlineconsultations2. Great Ormond Street hospitalwanted us for home health careelectronic prescribing3. More clinicians joining every day aspatients invite them toWe can do what Microsoft, Google and the NHS cannot do
  16. 16. PKB is the only option for patient-controlled medical recordsWe will put patients in charge of making decisions about theircare, including control of their health recordsThe Coalition:our programme for government, Cabinet Office,2010.
  17. 17. GP surgeries and privateclinics conduct onlineconsultations
  18. 18. Great Ormond Street Hospital and home healthcare providers
  19. 19. Detailed explanationsfor patient saveclinician’s time
  20. 20. Roadmap1. Basics: definitions, and why do thisat all?2. Today: letting go of assumptions3. Tomorrow: embracing possibilities
  21. 21. Some definitions Clinicians Patient Personal health Electronic patient records Patient portals Personal records records
  22. 22. Some definitions Clinicians Patient Personal health Electronic patient records Patient portals Personal records records Data by clinicians for clinicians
  23. 23. Some definitions Clinicians Patient Personal health Electronic patient records Patient portals Personal records records Easing the patient’s burden Scheduling appointments Ordering medication refills Secure messaging Access to the EPR See: Pyer et. al 2004, Ralston et. al 2007.
  24. 24. Some definitions Clinicians Patient Personal health Electronic patient records Patient portals Personal records records Data by patient for patient Powerful but unstructured NHSmail users have mailbox shrunk 06 Feb 2008 NHS staff who use the health service’s email service NHSmail have been informed that after a recent move to Microsoft Exchange their mailbox size has been capped. Some 80% of NHS accounts have been capped at just 200Mb, which appears miserly compared with the hefty 6Gb offered by Gmail for free, or the 5Gb offered for free on Windows Live Hotmail.
  25. 25. Some definitions Clinicians Patient Personal health Electronic patient records Patient portals Personal records records Markle Foundation’s ideal PHR: Access controlled by patient Lifelong records Information from all Universal access Private and secure Transparent Easy exchange See: Connecting for Health, 2004
  26. 26. Roadmap1. Basics: definitions, and why do this at all?2. Today: letting go of assumptions3. Tomorrow: embracing possibilities
  27. 27. Patient-held records already here Some parts of some health systems have already had them In continental Europe and much of developing world, this is the norm UK private health care, and US fragmented care, patients end up doing this anyway NHS maternal notes and child personal health record use the patient to cross silos Distribution is arbitrary, but users assume otherwise
  28. 28. Conflict is gone Discomfort clinicians feel is due to limitations of paper Piece of paper cannot be in two places at the same time Transporting paper takes time and money Clinicians do not feel safe unless they hold the only copy of the paper Digital records eliminate the conflict
  29. 29. Patient-controlled records awesomeThis is the only way to bridge the silosWithin “integrated” systems like NHS and Kaiser Permanente, clinicians donot talk to each other across community and hospitalsWithin single institution e.g. hospital, clinicians do not talk to each otheracross departmentsWithin same department, clinicians do not talk to each other acrossspecialitiesThe patient is the only person who turns up to allthe appointments, so give them the records
  30. 30. Patients should manage their clinicians Unique patients require truly patient-centred care In a rare chronic disease, the patient knows more than most of the clinicians they meet There are 30 million people with rare diseases in Western Europe and the USA But even patients with common diseases have unique combinations of diseases and circumstances Every patient is unique
  31. 31. Roadmap1. Basics: definitions, and why do this at all?2. Today: letting go of assumptions3. Tomorrow: embracing possibilities
  32. 32. Patients with HIV publishing all notes
  33. 33. Patients use (much) better tools than you
  34. 34. Pa>ents  use  (much)  be*er  tools  than  you  
  35. 35. Patients have better genetics tools than 99% of clinicians do (or ever will)
  36. 36. Patients will collect data you never knew
  37. 37. Patients will collect data you never knew Useful web sites Patients Like Me for HIV: 23andMe for genetic sequencing: RelifeInSite for pain documentation: Lifepsychol for monitor quality of life: Personal health records: A guide for clinicians Al-Ubaydli, 2011, John Wiley & Sons
  38. 38. Patient-reported outcomes / observations / informationPatient-controlled records as a research toolPatient-reported outcomes on each consultationPatient-reported observations on data that had never previously been collected in medicalrecordsPatient-reported information through sentiment analysis of diaries
  39. 39. Mohammad Al-Ubaydli Patients Know Best m www.patientsknowbest.comThank you for listening
  40. 40. First Demo:Dr Henry Lee Henry Lee is training as a Surgeon in London and studied medicine at the University of Wales College of Medicine. He holds an academic post at Imperial College London and is researching the way that measure of wellbeing can be used for policy purposes.
  41. 41. Second Demo:Dr David Aanensen David Aanensen is a bioinformatician in the School of Public Health, Imperial College London. His research focus is on the use and development of web applications for infectious disease microbiology.
  42. 42. EpiCollect     Dr  David  Aanensen  Dept.  Infec>ous  Disease  Epidemiology   Imperial  College  London  
  43. 43. Tracking  Animal  disease  Batrachochytrium  dendroba1dis  (Bd)  
  44. 44. Bd-­‐Maps  •  Bd  is  a  fungal  pathogen  causing  wide-­‐spread   amphibian  mortality.  •  Demands  colla>on  of  cases  of  disease.    •  Communi>es  of  scien>sts  submit  data.   h*p://­‐  
  45. 45. EpiCollect  -­‐  Smartphones  for  data  collec>on  •  GPS  –   loca>on  aware  •  Cameras  for  s>lls  or  videos  •  Keyboards  for  text  entry  •  Data  transfer  to  /  from            central  databases.   Aanensen  et  al  (2009)  PLoS  ONE  4(9):  e6968  
  46. 46. h*p://  •  Generic  issue  –  mobile  data  collec>on  •  Any  projects  where  centralising  textual  data  along   with  GPS  and  /  or  photos/media  from  many   different  people,  from  many  different  places,   would  be  useful.    
  47. 47. h*p://  Mobile  phone  app  (Android  and  iPhone)  and  web  applica>on  for  data  colla>on.  Free  and  open  source  
  48. 48. h*p://  Create  a  Project   Design  a  form  for   Load  Project  into  the   View  data  collected  website  at   data  collec>on   EpiCollect  mobile  app   at  your  project   and  collect  data,   website  or  on  your   including  GPS  posi>on   phone  (download,   and  photo   view  on  maps/ charts,  filter.)  
  49. 49. Ci>zen  data  collec>on   •  Yellowstone  na>onal  Park   •  3,472  sq  m  visited  by   thousands  of  people  each  year.   •  Currently  undertaking  projects   to  allow  members  of  the  public   to  aid  researchers  in   iden>fica>on  and  mapping  of   invasive  plant  species.  
  50. 50. Archaeological  dig  sites   Dig  sites  across  Europe   Pre  –  major  building  works    Replacing  paper  forms  for  linking  and  mapping   areas  of  dig  sites.  
  51. 51. Street  art*   •  Categorised  by  type  –  eg   posters,  s>ckers,  stencils  etc.  *Disclaimer:  probably  not  to  be  encouraged…    
  52. 52. Animal  Health  surveillance  in  Kenya  /  Tanzania   Maasai  vets  Carry  out  Disease  Surveillance  of  86,000  animals  with   Google  Mobile  phones   Ongoing  monitoring  of:          East  Coast  Fever;  anthrax  and  rabies;    FMD                    Gabriel  Turasha  (Vetaid  Tanzania)  Nick  Short  (RVC)  and  Niall  Winters(IOE)    
  53. 53. •  No  reliance  on  data  networks  for  collec>on.  •  Data  can  be  sent  to  any  server.  •  Two-­‐way  data  transfer  •  Simple  XML  descrip>on  of    project  forms  and   for  defini>on  of  server  loca>ons.  
  54. 54. Acknowledgements  •  Dr  Derek  Huntley,  Jon  Evans,  Chris  Powell,  Prof.  Brian  Spra*   Funded  by:  
  55. 55. Second Speaker:Dr Adesina Iluyemi Adesina is an executive board member and a co-chair of the Global Health Commission of the NEPAD Council, a non-profit organization. His expertise lies in mHealth and Telemedicine innovation and policy development. He has in the past collaborated with influential international multilateral, organizations such as the WHO, UN, ITU, and the Commonwealth Secretariat. He is a Fellow and Council member Telemed & eHealth Section of the RSM England, and a co-founder and executive director of MODISE; an initiative working to bring low-cost connected mobile diagnostics to developing countries.
  56. 56. mHealth Developing Countries: Past, Present & Future Introducing MoDiSe Dr  Adesina  Iluyemi  DDPH  RCS  (Eng)   Vice  President  &Co-­‐  Founder   MoDiSe   Sustainable Serendipitous Situated
  57. 57. An OverviewUSERS CASESCITIZENS (Consumers, Patients) Call Centre models TeleDoc, PakistanCOMMUNITY (Population) SMS Casting Model Masiluleke, South AfricaCLINICIANS (Health Workers) Mobile Telemedicine, BotswanaCENTRES ( Facilities) Mobile Microscopy e.g LUCAS Source:  Author  • Need  to  move  Beyond  SMS!  • Clinicians  &  Centres  offer  be*er  Commercial  Opportuni>es   Sustainable Serendipitous Situated
  58. 58. Voice & SMS, few Data Apps Cell-­‐Life   Sustainable Serendipitous Situated Page  96  
  59. 59. Health Workers using PDAs Sustainable Serendipitous Situated Page  97  
  60. 60. PDA to SmartphoneSimputer   GSMA     Sustainable Serendipitous Situated
  61. 61. Mobile + Medical Renaissance • Teleradiology   • Remote  Imaging   • Laboratory  Detec>on   • Clinical  Diagnosis   • Rural  Healthcare   • Emergency  Medicine   • Pandemics   • Epidemics   • Point  of  Care  Diagnos>cs  OPPORTUNITY  FOR  LOW-­‐COST  INOVATIONS  IN  DEVELOPING  COUNTRIES   Sustainable Serendipitous Situated
  62. 62. Medical Innovations 1•   Medical  Devices/Mobile  Microscopy  e.g  LUCAS,  CellScope  • Assis>ve  Technology?  e.g  NETRA  for  remote  eye  examina>on  • Mobile  EHR  e.g  mGEOs  with  geotagging  and  web-­‐interface   UCLA  2009   Sustainable Serendipitous Situated
  63. 63. Medical  Innova>on  2  • Mobile  Telemedicine  e.g  Click  Diagnos>cs  for  skin  &  oral  lesions  and  cervical  screening  in  Botswana  •   Real  Pa>ent  Monitoring  e.g  A  pilot  with  a  Private  Hospital  in  Nigeria  • Medical  Apps  e.g  Moodle4iPhone  pilots  using  Android  &  iPhonein  Peru     Sustainable Serendipitous Situated
  64. 64. IntroducingMoDiSeMISSION: Collaborate withprivate sector innovators /biotechnologyresearchers and localentrepreneurs to facilitate thedevelopment of Point of Care toolsto prevent, diagnose and treatneglected tropical andnon-communicablediseases in the developingworld-www.modise.orgNon-for-Profit Organizationin Canada Sustainable Serendipitous Situated
  65. 65. MoDiSe: Our Strategy Mobile  Diagnos>cs  for  Global  Health   h*p://   Sustainable Serendipitous Situated6/7/11   MoDiSe    
  66. 66. MoDiSe: Our Concept MoDiSe     Sustainable Serendipitous Situated6/7/11  
  67. 67. Acknowledgements1. Mobile Healthcare Industry Summit 2. CHMI, University of Portsmouth 3. NEPAD Council Sustainable Serendipitous Situated
  68. 68. ThinkCamp was brought to you by: We are an ‘idea-to-launch’ community platform for the collaborative development of mobile applications, products & services across many industries. (More than just apps – think personal mobility services, mHealth applications, SIM-card embedded devices, sensory data meets cloud computing, and SMS-based solutions in the developing world). We bring the mobile developer & designer community together with members of professional communities, such as healthcare; facilitate the sharing of experiences, insights and skills; and provide a structure for developing and acting on the innovative ideas that emerge. We do this by running a series of ThinkCamp events which take a collaborative approach to generating and developing good ideas. Adhoc teams which form around the ideas are supported & nurtured by a wide range of participating technologists, field experts and market channel partners to implement a solution or turn turn the developed proposition into a commercially viable product or service. Our first area of focus is mHealth. Over time we will also build an online collaboration community for idea development that provides a supportive process all the way to implementation. The business model for all who get involved is joint venture / revenue share @mobilecollectiv
  69. 69. ThinkCamp was made possible with the support of our partners: With thanks also to: