What if an app could guide you to better health, similar to how GPS navigation directs you to your desired destination? What if the app could use real-time information to redirect you around a disease, just as you’re rerouted to avoid traffic? What if the app could provide step-by-step directions to get you to your optimal health state, whether you’re a professional athlete or retired school teacher? We discuss how this navigational approach to healthcare could become a reality by combining emerging technology with well-established cybernetic principles.

1. Ramesh Jain
Institute for Future Health
University of California, Irvine
Jain@ics.uci.edu

2. We believe that…
• A holistic focus on lifestyle, environment, social, and medical aspects
is now feasible and essential for human health.
• The translation of research should start right from the beginning.
• Working with companies and communities to make this a new model
for health research is essential.

3. The fundamental drivers of health are
intertwined.
• Quality of Life
• Cost
• Productive Lifespan
Health
Productive Lifespan
Cost
Quality of Life

4. Healthcare was supposed to be about people.
Employers
Health
Providers
Insurance
Companies

5. But healthcare became a financial enterprise.
Employers
Health
Providers
Insurance
Companies

6. Important Turning Point in Health
In the mid-20th century, the primary causes of death worldwide shifted from infections to
chronic conditions.

7. Evolution Continues
The Economist Dec. 13, 2003

8. Changing Times.
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://
www.cdc.gov/diabetes/statistics
Obesity (BMI ≥30 kg/m2)
1994 2000
No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9% >26.0%
2008
Diabetes
No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0%
1994 2000
2008

9. INFECTIOUS DISEASES
ILLNESS OCCURS
TEST & DIAGNOSIS
CARE
$3.15
Trillion
• High fixed costs (hospitals, equipment)
• Hotel model of occupancy for revenue
• Relies on intuitive medicine for
diagnosis – REACTIVE
MEET
• Outpatient model is better suited
• Extremely expensive to care for a
patient in an infectious disease care
model – THAT IS WHAT WE DO TODAY
CHRONIC DISEASES
Heart Disease Cancer Type 2 Diabetes
Brain Diseases Lung Diseases Bone Diseases
Treating Chronic Disease in an Infectious Disease Model

10. Medicine-Genetics-Environment-Lifestyle

11. The problem: What is right Vs. What is Easy.

12. Data, information, and knowledge Continue to
Transform Industries.
Artificial Intelligence: Converting Available Data
to Useful Information.

13. Popular Episodic Approach was OK in 20th Century!
v You go to a doctor because you feel sick.
v The doctor asks you questions about your health status and
history while observing your reactions.
v The doctor examines your body and may order some tests
(such as x-rays or blood work).
v Based on your exam and test results, the doctor estimates your
health state (disease and its severity).
v A prescription and regimen are stipulated and explained.
v You try to follow those instructions.
v The doctor sees you periodically as needed (possibly
recommending continued visits, hospital admission, or surgery
followed by a stay in ICU).

14. Episodic Health Cycle: MEGI
Estimate
(Disease)
Guidance
Influence and
Compliance
Measure
Collect all
Relevant data
Health: Collect Data; Derive Actionable Information; Provide
Guidance at Right Time, in Right Situation, in a right way.

15. 2017: New Cars(17.85M) and New Humans(3.98M)
q Most cars send more than 25 gigabytes of
data/hour (130TB per year) to the cloud.
q The data is used for longitudinal studies as
well as for population and social studies.
q Most people collect almost zero data.
q The data collected is not usable.
Who do we value more: cars or humans?

16. A New Perspective for Health
Health
Personal Models
and
Cybernetics.
Focus on:

17. How did you get to your destination?

18. Turn-by-turn directions felt so advanced!
Maps
Points of Interest
Starting Point
Destination
Mapping
System
Just 10 years ago!

19. Cybernetics: Feedback revolutionizes system design
Modern control theory and AI came from Cybernetics.

20. Basic Systems Theory
Where x, u, and y are state, input, and output vectors;
A, B, C, and D are appropriate matrices for transformation.
Observability: Determine state using measurements.
Controllability: Get to desirable state.

21. Magic Happened: Can you drive without a navigation
system?
Maps
Points of Interest
Current State : GPS
Current Traffic:
Waze
Destination
Cybernetic
loop
Navigation
system

22. Health Navigator
• What if an app could guide you to better health, similar to
how GPS navigation directs you to your desired
destination?
• What if the app could use real-time information to redirect
you around a disease, just as you’re rerouted to avoid
traffic?
• What if the app could provide step-by-step directions to get
you to your optimal health state, whether you’re a
professional athlete or retired school teacher?

23. Measure
Collect all data
Perpetual Health Guidance
Guidance
Estimate
(Health State)
Influence and
Compliance
How do we close
the loop?
Inspiration:
Navigation Systems.

24. Key Components
• Data Source Selection and Ingestion
• Building Personal Models:
• Short term (Maybe for specific health situation)
• Long term
• Health State estimation
• Recommendations
• Influence and Adherence

25. Key Technology Components
• Measure
• Multimodal semantics, Synchronization
• Semantic compression
• Event Recognition in multimodal signals
• Event mining: learning and causality, Associative rule mining
• Estimate
• Learning for diagnostics
• Causality from event characteristics
• Guide
• Recommendations in context
• Situational knowledge in recommendation engines
• Optimization of health and quality of life
• Influence
• Gamification
• Communicating right information at right time in a right way

26. Personal Health Navigator
MEASURE:
COLLECT DATA
STREAMS
EVENTSHOP
ENVIRONMENT
KNOWLEDGE
ESTIMATION
(HEALTH STATE)
MICRO-REPORTS
LOCAL
MEDICAL
DEMOGRAPHICS
ENVIRONMENT
REGULATIONS
DATA
STREAM
PROCESSING
EVENT
DETECTION
EVENT MINING
PERSONICLE
‘OMICS’
INFLUENCE AND
ADHERENCE
PERSONAL
MODEL
GUIDANCE
HEALTH CARE
PROVIDER
supervisory
system

27. –Daniel Kahneman, Awarded 2002 Nobel
Memorial Prize in Economic Sciences
“Quantifying information about time usage
and its frequency, as well as stress level,
pleasure, and other affective states of each
individual, is potentially useful for health
research”
Our system automatically
builds Personicle on Android.
Recording Daily Activities: Personicle

28. Automatic Creation of Personicle

29. Unobtrusive collection of Personicle

30. Pulling data from ALL sources in Personicle

31. Food is an important MISSING LINK
No good technique for logging food diary
Food Recognition
Nutrition in Food
People’s preferences: what when, where,
weather, company, …
Grand Challenge: Create a Detailed Personal Food Log.

32. Personal Model Builder
‘Omics’
Personal
Model
Environment
Knowledge
Personicle
AI + Learning
• Propensity to
diseases
• Rule Based Health
Behavior
EventShop for Situation Recognition
and geo-spatial event analysis.
Could be for
Whole Life
Recent Past
After a particular health Condition
(such as heart attack)

33. Pattern
Mining
High-level
Pattern
Formulation
Pattern Query
…
Data Streams Event Streams Semi-interval Event Sequences
Data-Driven Analysis
Hypothesis-Driven Analysis
While air pressure is high, pollution
starts increasing gradually, within T
time units asthma outbreak happens.
((pollution_inc_steadily ;ωT asthma_outbreak ) ||
airpressure_stayshigh)
Example:
Interactive Visualization
Interactive Event Mining
Bottom Up
Top Down

34. Event Stream Mining for Rule-Based Actionable Insights
Spicy food and 2 glasses of wine result in sleepless nights.
Personicle
Food Stream
t1 t2 t3 t4 t5
Warn him when he is at an Indian restaurant.
Sleep

35. Personal Health Navigator: Diabetes
MEASURE:
COLLECT DATA
STREAMS
EVENTSHOP
ENVIRONMENT
KNOWLEDGE
ESTIMATION
(HEALTH STATE)
MICRO-REPORTS
LOCAL
MEDICAL
DEMOGRAPHICS
ENVIRONMENT
REGULATIONS
DATA
STREAM
PROCESSING
EVENT
DETECTION
EVENT MINING
PERSONICLE
‘OMICS’
INFLUENCE AND
ADHERENCE
PERSONAL
MODEL
GUIDANCE
HEALTH CARE
PROVIDER
supervisory
system
Activity
Food
Medication
Glucose Level
Activity
Food
Medication
Glucose
Level in last
3 hours
Sensitivity to
different foods.
Sensitivity to
medication.
Activity Checks.
Glucose Level
Checks.

36. PHN and
• Guide to better health, better quality of life.
• Uses real-time information to redirect you around a disease, as if a
doctor is with you 24/7.
• Provides step-by-step directions to get you to your optimal health
state.

37. PHN and Employers
• Employee satisfaction and wellbeing.
• Potential reduction in cost of healthcare.
• Productive and predictive relations with employees.

38. PHN and Insurance
Companies
• Personalized Protection and Incentives
• Data and Insights for Value-based reimbursements
• Preventive, Predictive, Personalized
• Use of SDOH in Insurance

39. PHN and Health Providers
• Patient Engagement for Reducing Readmissions
• Patient Relationship Management
• Precise information about patient conditions
• Perpetual care rather than episodic subjective information

40. Health
Navigator
Your food and
activity scores
for the last 3
days are on low
side.
Health Navigator in Action
My
recommendations
for you are.

41. Our Goal
• A Personal Health Navigator as an early embodiment of a
novel approach for Future Health.
• Build a community around Future Health that will bring
medical science and all relevant technologies to advance
Future Health.
• Identifying realistic approaches to work with like-minded
groups and individuals to realize Future Health.

42. Thanks.
jain@ics.uci.edu