The document discusses emerging technologies and their potential applications in healthcare. It outlines how mobile devices and sensors could be used to remotely monitor health, enable at-home care, and simplify healthcare administration. Implantable devices and distributed medical records stored directly on individuals are presented as future possibilities that could make healthcare more convenient and personalized. The document advocates for simpler solutions over large centralized systems that are prone to limitations and failures.

1. Who Cares ? Peter Cochrane
ca-global.org
cochrane.org.uk
COCHRANE
a s s o c i a t e s

2. We are now the limiters of progress…
technology is advancing faster than we can
respond...
..but it may
not be that
way forever!

3. Big government & big companies favour big solutions...

4. When something much smaller will
suffice, or even do the job far better!

5. Not fully understanding
something doesn’t imply
we cannot exploit it!
Ballistics
Newton Einstein
Linear Non-Linear
23

6. Just how did we get here?

7. Hypothesis
Everything we know and understand is through the
good grace of our technology….

8. Hypothesis
Without computers, supercomputers, networks, the
internet, and a huge amount of software, we would
know absolutely nothing…relatively speaking

9. Internet ~ Human Brain Today!
> 109 Nodes & > 104 Links/Node

10. Advances in healthcare
1) Stop guessing @ start dissecting
2) Skeleton and muscle structure
3) Basic vascular knowledge
4) Basic organ functionality
5) Germ theory
6) Hygene
7) X-Ray
7) Antibiotics
8) Electronics - visualization - monitoring - animation
9) All electronic records
10) People supporting technologies ?

11. Advances in Healthcare

12. Advances in Healthcare
Natural methods and materials

13. Advances in Healthcare
Natural methods and materials
Synthetic - unnatural methods
and materials

14. Advances in Healthcare
Natural methods and materials
Synthetic - unnatural methods
and materials
Repair technologies

15. - Chronic disease management
- Aged care
- Well being
Life expectancy
Likelihood of
requiring care
Tech Gap
Potential carer
population

16. The rise of chronic diseases
Prolonged conditions that often do not improve and
are rarely cured completely….
- Diabetes
- Hypertension
- Congestive heart failure
- Asthma
- Depression
- Renal failure
- Liver disease
- Rheumatoid
- Osteoarthritis
- Dementia
-+++++

17. DIY test, monitoring, admin
we will have to look after ourselves more and more

18. DIY test & monitoring

19. DIY dosage admin and control
Self Complex Automated
Ventilation control dosage

20. Lab on a chip
Microelectromechanical Systems - MEMs
Nanolectromechanical Systems - NEMs

21. Lab on a chip
Microelectromechanical Systems - MEMs
Nanolectromechanical Systems - NEMs

22. MEMs
….an idea of scale NEMs
~ 500 um ~ 5 nm

23. Micro & nano sensors
Microelectromechanical Systems - MEMs
Nanolectromechanical Systems - NEMs

24. Nano bots
the dream?

25. Care at home
There will be no choice, we will be sent home!

26. Monitor everything ??
There will be no choice, we will be sent home !

27. Get networked ??
Centralized monitoring and control of everything !

28. Let’s make it really complex !

29. How about making it really simple
what is someone doing now?

30. Making it simple
and where are they ?

34. GeoFence - not a wall or a prison!

35. What else can you do with a mobile ?
1. Appointment Reminders (SMS) 11. ePrescribing
2. Patient Support (SMS) 12. Patient Paging
3. Medication Reminders (SMS) 13. Support for Alzheimer Patients
4. Appointment Booking 14. Support for Diabetes Sufferers
5. Medical Data on SIM Card 15. Clinical trials
6. Patient info for Relatives 16. Support for Dementia Sufferers
7. Peer Support for Patients 17. Support During Rehabilitation
8. Post Cardiac Surgery Support 18. Support for the Deaf
9. Accessing Patient Records 19. Support for the Chronically Ill
10.Access to Dietary Information 20. Support for Addicts

36. What else can you do with a mobile ?
21. Support for STD Sufferers 31. Smart Card Applications
22. Baby Monitoring 32. Monitoring for Asthma Sufferers
23. Suicide Watch 33. Blood Glucose Monitoring
24. Support for Children 34. Temperature Measurement
25. Food Product Dietary Information 35. Weight Measurement
26. Allergy Alert Services 36. Medication Compliance Monitor
27. Doctor at Home 37. Voice Pattern Monitoring
28. Self Diagnosis 38. Analysis of Breath
29. Patient data for oversees travellers 39. Heart Rate Monitoring
30. Data Capture from instrumentation 40. Smart Homes for the Elderly

37. What else can you do with a mobile ?
41. Patient Diaries for Clinical Trials 51. Telehealth Gateways
42. Data from Pacemakers 52. Patient Location
43. Fitness Monitoring 53. Pulse Oximetry
44. Real Time Patient Assessment 54. Personalisation Diagnosis
45. Sleep Monitoring 55. Early Detection of Syndromes
46. Collection of Data from Sensors 56. Appointment Scheduling
47. Collection of implant Data 57. Access to Patient Data
48. Diabetes Monitoring 58. Diagnosis Support
49. Detection of Septic Episodes 59. Personal Attack Alarm Services
50. Remote Antenatal Care 60. Clinician Identification

38. What else can you do with a mobile ?
61. Asset Tracking (RFID) 71. Locating Organ Donors
62. Stock Control (RFID) 72. Support for A&E Services
63. Patient Identification (RFID) 73. Tracking Surgical Instruments
64. Dispensing Support 74. Controlling Insulin Patches
65. Locating Staff 75. Billing
66. Conferencing Emergencies 76. Patient Consent
67. Accessing Training Material 77. Drug Authenticity Verification
68. Accessing Laboratory Results 78. Patient Entertainment & Comms
69. Blood Bank Support Services 79. Patient Notes Dictation Systems
70. Locating Blood Donors 80. Administration at Point of Care

39. What else can you do with a mobile ?
81. Linking Emergency Services / A&E 91. Context Sensitive Medicine
82. Access to X-ray Images 92. Disease Monitoring
83. Skin Cancer Monitoring 93. Food Contamination Alerts
84. Remote Consultation 94. Environmental Contamination Alerts
85. Data Collection from Capsules 95. MRSA Detector
86. Conventional Endoscopes 96. Telecare in Rural Areas
87. Nutrition Coaching 97. Telecare in Developing Countries
88. Monitoring Wound Healing 98. A&E Field Support
89. Support for Neurosurgeons 99. Wireless Stethoscope
90. Breast Cancer Screening 100.Support for AIDS Sufferers
101.Call Centre Health Services

40. Implants galore…

41. Sight for the blind?

42. Hearing for the deaf

43. Subcutaneous Wearables

44. The medical records saga…
Fundamental lack of understanding?
22% lost at any one time!
Security out of kilter?
Centralize or distribute?
Patient records
Hospital records

45. Subcutaneous patient records
Easy install
Effective
Reliable
Simple
Cheap

46. Subcutaneous patient records
The biggest objectors
are the religious and
superstitious!

48. Centralized to distributed ?
Outmoded
Outdated
Unavailable
Lost
Expensive
Centralized Distributed
Outdated Up to date
Unavailable Available
Off line On & off line
Unavailable Low cost
Expensive Reliable

49. ca-global.org
cochrane.org.uk
Thank You
COCHRANE
a s s o c i a t e s