The document discusses the state of personal connected health, including the roles of wearables, sensors, apps, devices, and interoperability with electronic health records. It describes how consumer-generated health data from these tools is being integrated into clinical workflows to improve care, though incentives and barriers still exist. Evidence is emerging that connected health can help with conditions like diabetes, and the field continues to see strong venture funding and innovation.

1. Personal Connected Health:
From Wearables to EHRs to Workflow
John Sharp, MSSA
Senior Manager, PCHA/HIMSS
9/12/2016 Personal Connected Health Alliance

2. Personal Connected Health Alliance
• Division of HIMSS
• Originally focused on events
– mHealth Summit
• Now expanding to thought leadership,
convening stakeholders, publishing technical
guidelines, promoting innovation and
developing an evidence base on an
international level
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3. Defining Personal Connected Health
• Personal: unique to a specific person –
different for every individual, customized
• Connected: individual’s information flows
seamlessly, with their consent, to and from a
clinician, caregiver or community
• Health: the state of a person’s physical, social
and mental well-being including but not
limited to the absence or control of a disease
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4. State of Personal Connected Health
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Consumer
Apps &
Devices
Mobile
phone
Cloud Interop

5. CONSUMERISM
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6. Consumerism and Health
• From Philips Future Health Index
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7. 7
Future of treatment
Connected health devices
(apps, wearables, biosensor
devices) for patients will form
part of treatment plans in the
future
33%38%
27%37%
33%42%
USA UK
Physicians
Consumers
Diabetics

8. Consumer and Provider
• Seeing the same data –
displayed in ways that
are usable/actionable
for each
• Participatory healthcare
• Partnership in care
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9. Consumerism
• Dana Lewis
• Type 1
• Do It Yourself
Artificial
Pancreas
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10. WEARABLES AND SENSORS
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11. Wearable Market
• Fitness bands
• Smart watches
• Shoe devices and smart shoes
• Smart clothing
• Ear devices
• Headsets
• Glasses
• Tatoos
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12. Sensors
• Accelerometer
• Gyroscope
• Multi-touch
display
• GPS
• Microphone
Can enable monitoring
of multiple actions:
• Gait and balance
• Fitness
• Timed walk
• Reaction time
• Hand dexterity
• Tone audiometry
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13. Future Applications of Sensors
• Smartphones can be
used to identify atrial
fibrillation with existing
hardware
• uses the phone's own
accelerometer and
gyroscope to check for
atrial fibrillation
• http://www.news-
medical.net/
• Wristband detects and
alerts for seizures
• http://news.mit.edu
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14. New Devices
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Smart Inhalers Medical smart tatoos
Robotics and
exoskeletons
medicalfuturist.com

15. APPS AND DEVICES
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16. App and Device Market
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• 78.5 million
consumers using
home health
technologies by 2020

17. Personal Health Dashboard
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18. Cloud enabled
• Data moves from the
personal health device or
app
• Through secure transmission
• To cloud storage
• For analysis and visualization
• Delivered to consumer and provider
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19. HEALTHCARE INTERNET OF THINGS
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20. Healthcare Internet of Things
Categories
• Clinical efficiency
• Clinical grade biometric
sensors
• Consumer/home
monitoring
• Infant monitoring
• Fitness wearables
• Advanced sports apps
• Brain sensors/
neurotechnology
• Sleep monitoring
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21. Internet of Things (IoT)
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22. 9/12/2016 Personal Connected Health Alliance

23. INTEROPERABILITY
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24. Interoperability and the EHRs
Perhaps the most important shortcoming of
the EHR is the absence of social and
behavioral factors fundamental to a patient’s
treatment response and health outcomes.
In this world of patient portals and electronic
tablets, it should be possible to collect from
individuals key information about their
environment and unique stressors—at home
or in the workplace—in the medical record.
• JAMA - August 15, 2016
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25. Patient Generated Health Data
• From these sensors, apps and devices, we
have data – what do we do with it?
– ONC PGHD Fact Sheet
https://www.healthit.gov/sites/default/files/patie
nt_generated_data_factsheet.pdf
– ONC Patient Engagement Playbook
https://www.healthit.gov/playbook/pe/chapter-4/
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26. Interoperability
Personal
Health
Devices
• Personal
Health
Devices
Interface
Personal
Health
Gateway
• Services
interface
Health &
fitness
Service
• HIS
Interface
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EHR
Design Guidelines

27. Integrating into Workflow
Data from devices,
questionnaires
Transmission Integration engine
Store in EMR
Algorithm
generates alert or
inbox to team
member
Take action
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28. Integrating
Patient Generated Health Data
• Workflow options
– Alert about significant change in status
– Unusual reading which may indicate device
malfunction
– Combination of data indicating risk for
readmission
– Overall trends sent to inbox as a message
• To whom should each situation be routed?
– Medical home team member
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29. INCENTIVES AND BARRIERS
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30. Provider Incentives
• Readmission penalties
• Diabetes Prevention Programs
• Accountable Care Organizations
– pay for value
• Chronic Care Management
• Comprehensive Primary Care Plus
• Care bundles – joint replacement, cardiac
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31. Barriers to Connected Health
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32. Behavior Change and Coaching
• Devices and apps alone cannot create real
change
• Need strategy and coaching to enable health
behavior change
• Example – Diabetes Prevention Programs
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33. EVIDENCE AND INNOVATION
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34. Evidence
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propellerhealth.com

35. Evidence
• Text 2 Move: Diabetes Care
– Partners Healthcare
– Personalized text messages encouraged physical
activity
– Significant lowering of HbA1c levels
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36. Evidence
• NODE Health – Network of Digital Evidence
– From the Sinai App Lab
• Newsletter includes
– Initiatives
– Publications
– Resources
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37. Innovation – Venture Funding
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2015 – 4.5 Billion

38. Innovation – Venture Funding
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39. State of Personal Connected Health
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Consumer
Apps &
Devices
Mobile
phone
Cloud Interop

40. Personal Connected Health Alliance
• December 11-14, 2016
• Gaylord National | Washington, DC Area
• PCHAconference.org
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41. Contact Me
• jsharp@pchalliance.org
• @JohnSharp
• Linkedin.com/in/johnsharp
• Recent blogs:
http://www.pchaconference.org/blogs
9/12/2016 Personal Connected Health Alliance