The document discusses the disconnection in healthcare, highlighting that individuals are often separated from their health data, physicians, and the healthcare system itself, leading to poor health outcomes. It emphasizes the role of technology in disrupting healthcare, suggesting that patient-generated health data could enhance personal health management and facilitate behavioral change. The transition towards participatory medicine is envisioned, where individuals take ownership of their health data and actively contribute to their healthcare journey.

1. User Generated HealthChris Hoggtwitter.com/cwhoggcitizenmed.wordpress.com

2. 6,8363.4127/62843.2

3. We are currently in the era of disconnected health

4. We are disconnected from our health data50.7% use EMR$44k in stimulus per doc

5. We are disconnected from our physicians

6. We are disconnected from the healthcare system

7. We are disconnected from our own health

8. Being disconnected leads to poor health

9. Obesity Trends* Among U.S. AdultsBRFSS,1990, 1999, 2009(*BMI 30, or about 30 lbs. overweight for 5’4” person)1999199020091/3 of Americans will have diabetes by 2050(CDC)No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

10. The pace of drug development is slowing

11. How did we lose control of our personal health identity?

12. Technology will disrupt healthcare…(it will just take longer than other industries)80% search for health3rd most popular web-based pursuit(Susannah Fox, Pew Internet Project)

13. Cyberchondria“Unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web”2 in 5 report increase in anxiety from medical search(White and Horvitz, Microsoft Research)

14. The patient is the most underutilized resource in healthcare

16. Measurement facilitates behavioral change10.5%(Seligman and Darley 1977)

17. Is mHealth adoption following a familiar pattern?% of Age GroupAgeData from:Brian Dolan, MobiHealthNewsSusannah Fox, Pew Internet Project

18. Apple wants to connect you to your health

20. New data is more powerfulthan a new drug39% reduction in hospitalizations over 6 months

21. 50%73 million have HTN69% with first MI

22. Know your target audience

23. Even young people have chronic medical conditions% of PatientsAge

24. # of chronic conditions for Medicare beneficiaries (65+)5+conditionsBut as people age, they get a lot moreNo conditions4conditions1condition3conditions2 conditionsPresented at the Annual Academy Health Research Meeting, June 2007; CMS (Centers for Medicare and Medicare Services)

25. Medical / clinical is converging with health / wellness

26. What you can learn from a few data points?

27. Mood SeasonalityMood by Day of Week

29. Significant personal information from a single daily data point

30. 30Crowdsourcing personal health data

31. Xanax(Alprazolam)ExerciseB Vitamins31

32. Can crowdsourced personal health data be used to predict personalized drug responses?

33. Data is beginning to flow from the system to users

34. Access to data – Blue ButtonPractice FusionMSHV

35. Prescription data is beginning to flowSurescripts data on Rx histories

36. Rx history + treatment algorithm = understanding

37. You can learn a lot about a person from a few simple data points

38. Beta BlockersDiureticsHigh Blood PressureDrugACE InhibitorsDrug ClassLiptorZocorLovastatinPravacholCrestorLescolCalcium Channel BlockersARBsStatins70-80% of CAD patients have high blood pressureHigh CholesterolCoronary Artery Disease(CAD)Myocardial Infarction(Heart Attack)ZetiaTricorVytorinGemfibrozilNiaspanMedical ConditionsEventHDLandOther20-30% of CAD patients have Type 2 Diabetes TZDsDrug ClassMetforminType 2 DiabetesDPP -4 InhibitorsDrugSulphonylureasInsulin

39. Hidalgo et al. PLoS Computational Biology 5(4):e1000353 (2009)http://hudine.neu.edu/

40. High CholesterolHigh Blood Pressure12345High Blood PressureHigh CholesterolHigh Blood PressureHigh Blood PressureType 2 DiabetesHigh CholesterolType 2 DiabetesOsteoporosis

41. Social Health AppSocial Health AppSocial Health Layer / Health GraphGoogle HealthMicrosoft HealthVaultPractice Fusion EMR / PHRAllScripts PHROther EMR / PHR System APIsGoogle AppsMSHV AppsPF AppsAS AppsOther PHR Apps

42. We are entering the era of Participatory Medicine

43. A medical record is a punctuated data streamGaps filled via recollectionPersonal Health Data

44. Anamnesis(patient recollection)is not accurate

45. EMR data + user generated data = healthstreamPersonal Health Data

46. Rx of AppsMedicationsMETFORMIN 500MG BIDLISINOPRIL 20MG OD Applications

47. I will own my healthstream and health data

48. The market for health data is very large

50. Healthcare systems are the future

51. Data enables us all to become Citizen Scientists

52. Can butter make you smarter?

53. The MTHFR Study

54. Groups of users will come together to run their own clinical trials

55. Genomera: A platform for Citizen Science

56. Future study:meditation and blood pressure

57. Citizen Science has the power to disrupt healthcareDrug ATrack common measures of efficacy, potential side effects, events, etc.Drug B

59. For those interested in learning more, the Bay Area is a good place to be…

60. Chris Hoggcwhogg@gmail.comtwitter.com/cwhogglinkedin.com/in/cwhoggcitizenmed.wordpress.com?Thank You