Transforming Healthcare Through Innovation

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Presentation by Robin A. Felder, PhD, Professor and Associate Director of Clinical Chemistry and Pathology, former Director of the Medical Automation Research Center and Chair, Medical Automation

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Transforming Healthcare Through Innovation

  1. 1. Robin A. Felder, PhD The University of Virginia Department of Pathology TRANSFORMING HEALTHCARE THROUGH INNOVATION
  2. 2. Disclosures  University of Virginia  Department of Pathology  Medical Robotics  Medical Automation  Hypogen  WellAWARE Systems  MeyeChem  Proteus Bio  Global Cell Solutions  Monte Piccolo Farm
  3. 3. Pursuit of Wellness  State of complete physical, mental and social well-being  Health results from primarily positive perspectives and choices by which to live  Technology can provide information that facilitates positive choices Physical Social 6.2 9.1 8.0 Cognitive Wellness Balance © Felder, 2011
  4. 4. Wellness Support  Growing need for new sources of data, and data interpretation  Integration of multiple diagnostic sources (lifestyle, self testing)  Integrated wellness and health record  Ongoing information support for maintaining healthy lifestyles
  5. 5. Wellness Technologies Monitor  Nutrition  Exercise  Biometrics  Pain reduction  Stress reduction  Sleep improvement  Mood enhancement  Health and wellness
  6. 6. Wellness Support  Food coaching  Rewards  Exercise  Nutrition  Therapeutic compliance  Consequence reporting  Consequence forecasting Overcome vicarious goal fulfillment or, “exhaustion of selfcontrol”
  7. 7. Home Health IT  New revenue sources: Medical Cloud coaching and Interpretations Cloud Interpretations
  8. 8. Proliferation of Wellness Tools  Accelerometer based Striiv Basis FitBit  Various models for data delivery  Basic physiologic measurements Shine Misfit BodyMedia Nike Feulband Scanadu Tricorder Zephyr Information Week BodyMedia
  9. 9. KNOWS LEARNS You and what is around you What you like SENSING Local content & services discovery Source: Jarrin (Qualcomm) DISCOVERS Things relevant to you FILTERS Out the irrelevant SEEING INTERACTING Augmented reality UI: Map, 3D, in building navigation Connection manager (WAN, Wi-Fi)
  10. 10. KNOWS LEARNS You and what is around you What you like SENSING Local content & services discovery Source: Jarrin (Qualcomm) DISCOVERS Things relevant to you FILTERS Out the irrelevant SEEING INTERACTING Augmented reality UI: Map, 3D, in building navigation Connection manager (WAN, Wi-Fi)
  11. 11. Lifewatch AG new ipad mini
  12. 12. Portable Diagnostics  iPhone based portable ultrasound  EKG  Otoscope  Dermatoscope  Microscope
  13. 13. Cell Scope ™  Dermatoscope – iPhone clipon  Transmits high quality magified pictures of skin blemishes  “Smart Otoscope” – iPhone ear drum microscope  Transmits pictures of videos of the ear canal and ear drum  Looks at progression or regression of disease
  14. 14. Otoscope Images Normal Ear Drum Ear Infection Ruptured ear drum
  15. 15. Cloud Based Diagnosis of Parkinsons  Non-invasive phone based  Low Cost  Accurate (98%)  Scalable to large populations  Remote, non-expert  Rapid diagnosis Max Little - Parkinson’s Voice Initiative TED Conference 2012
  16. 16. iPhone Body Fluid Diagnostics  Biosense Technologies  uCheck  ToucHb
  17. 17. Continuous Glucose Monitoring Dexcom
  18. 18. Embedded Wellness Sensors  Instrument common fixtures  Wireless transmission of data  Web based aggregation and interpretation
  19. 19. Action Inspired Instruction  Real time coaching  Medically approved content  Tailored for individual
  20. 20. Passive Wellness Monitoring Healthcare providers Vital Sensor Urine analyzer Data management PC Urine protein Urine glucose ·Body temperature ·Pulse ·Blood Pressure ·Body fat percentage
  21. 21. The M.A.R.C. In-Home Health Monitoring Project  Create a model where the impact of chronic disease is delayed or avoided  Provide opportunity for medical intervention before a crisis occurs  Minimize impact of chronic disease on the healthcare system
  22. 22. Passive Remote Sensing  Wireless Sensor Array (WSA) – gathers data on daily activities  Data Manager (DM) –transmits data to data analysis servers  Capture Analysis & Reporting Engine (CARE) – captures potential problems and alerts caregiver
  23. 23. Passive Gait Sensors Vibration sensors placed in the house detect occupant gait
  24. 24. Passive Physiologic Sensors Physiologic sensors embedded in common household furniture and fixtures
  25. 25. Sleep Monitoring  Sleep apnea affects more than 40 million people in the United States alone of which 85% are currently undiagnosed  sleep apnea testing and therapy market that is expected to reach more that $4 billion by 2012
  26. 26. Passive Vital Sign Bed Monitor Mattress pad to measure: • Sleep quality • Pulse (and HRV) • Breathing • Movement/ restlessness • Bed exit • Subject position/ turning • Body temperature • Blood Pressure Passive Sensing Polysomnography
  27. 27. Sleep Quality Graphs Restful Resident Restless Resident
  28. 28. Remote Automated Triage  Real time assessment of participant health status/well being  Ability to drill down to specifics  Built in automated optimized dispatching  Manual override of dispatch event or downstream processes
  29. 29. 30
  30. 30. One Click Trending  Health  Socialization  System utilization
  31. 31. Telehome Monitoring Decreases Costs by 74% 70000 60000 Dollars $ 50000 40000 30000 20000 10000 Overall Cost of Care Comparison $67,757.88 Unmonitored 80000 $17,407.02 Monitored 0 N=21 in each group, P<0.05; Telemed J E Health, 2007 13(3):279-85
  32. 32. FUTURE WELLNESS TECHNOLOGIES
  33. 33. 3D Manufacturing
  34. 34. 36
  35. 35. Wearable Cancer Detection  First Warning Systems™ heat distribution sensing sports bra 0.2cm 1cm 4cm
  36. 36. Underwear That Measures Blood Pressure  Pulse wave velocity correlates with blood pressure  Tissue impedance shows passing pulses  Pulse timing correlated with relative pressure  Continuous blood pressure monitoring
  37. 37. Automated Pharmaceuticals  Automated Pill – iPill (Philips)  Magnatrace™ System looks for pill ingestion  Networked pills (Proteus Biomedical)  Instrumented Pills  Cost < $0.01  Measure and send physiologic signals through body electrically  Receiver is a patch worn on the body that also logs respiration, heart rate and body movement, sleep patterns
  38. 38. Automated Intestinal Biopsies  Intestinal diagnostic imaging coupled with miniaturized biopsies  Pillcams with intestinal “Velcro” to arrest the camera at a selective location  Continuous monitoring MIT Technology Lab
  39. 39. The Eye as the Window to Health Medical Robotics UCSD Preventive Science Inc. Univ. of MD, Baltimore
  40. 40. MeyeChem, LLC  Real time glucose monitoring  Alerts for low or high glucose concentrations  Trending analysis  Food coaching via telenutritionalmentoring
  41. 41. Virtual Reality  Image enhancement, correction, zoom  Correction currently limited to 0.2 logMAR, 20/32  Full view software modulated images  Superimposed augmented reality Off axis projection with transflective diffuser 90 field eyewear iOptik Gas-permeable nanopolarizer (iOptik contact lens) Diopter adjustable mini-scleral lens and wearable computer (iOptik) Zoom lens (3X) UCSD
  42. 42. Augmented Reality  Projection of underlying anatomy on living tissue  Relies on superimposition of reality and previously scanned animated image/data
  43. 43. Not for the Faint Hearted
  44. 44. Receptivity  Presenting health vs wellness to a patient  Determining what information is TMI  Optimizing the time for the presentation of wellness strategies “Wellformation”
  45. 45. Medical Automation.org A non-profit educational organization improving healthcare quality and efficiency through teaching automation principles and their application in health systems http://medicalautomation.org
  46. 46. TagLine - Medical reality http://medicalautomation.org
  47. 47. Robotic Reality HRP-4C National Institute of Advanced Industrial Science and Technology

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