Is it self-tracking? We are only beginning to understand the power of self-tracking be it due to the quantified self movement or because of the increasing number of connected medical devices. A real opportunity is in understanding how mobile devices will play a key role in the future of our personal health. Medical Devices, sensors, big data, cloud computing are and will continue to enable continuous monitoring of people and patients.
16. Driving Down Costs
•
•
•
•
•
•
Measure and track
Predict
Prevent
Manage
Incent and Influence Behavior
Direct financial incentives to share and participate
27. Over 50 million
Americans suffer
from Asthma &
Chronic
Respiratory
Disease (CPOD).
The time and
frequency of a rescue
inhaler’s use is one of
the most important
signals of a sufferer’s
level of asthma
control and COPD
status.
28. Over 60% of patients
with asthma are not
under control and over
50% of patients with
COPD take at least one
daily medication, but
adherence rate
estimates range
between 32-50%.
Pathfinder A group of designers, developers, strategists, quality and regulatory folks based here in ChicagoWe help medical firms develop innovative software products
Pathfinder A group of designers, developers, strategists, quality and regulatory folks based here in ChicagoWe help medical firms develop innovative software products
Pathfinder A group of designers, developers, strategists, quality and regulatory folks based here in ChicagoWe help medical firms develop innovative software products
growth of fitness trackers (graphic)number of wearable sensors growing (graphic)(fitbit, misfit, jawbone, basis)
growth of fitness trackers (graphic)number of wearable sensors growing (graphic)(fitbit, misfit, jawbone, basis)
Even Apple is working on multiple wearables, with lots of cool materials, technologies, and integration with iphone, ipad, etc.Expect at least one, maybe more this yearIncludes biosensors, sleep detection, etc.Expect a wearable (watch with sensors) this year
Why is Apple working on this? And more importantly – why are they meeting with the FDA? Regulate Medical Devices.Because there’s lots of money there.
Health cost as percent of our GDP – has grown. From 5% to over 16%. If it keeps going …
There’s an epidemic of diabetes and obesity – we haven’t even started to see the costs of this yet…(the costs for chronic diseases looks to be growing dramatically, both because of aging and habits.)
We spend a lot on healthcare for the elderly.
And those Baby Boomers are just starting to hit that age.
So who cares about these trends? The people who pay.Employers – their costs have been going up, and they’re looking for ways of reducing those costsInsurers – are doing more things for risk sharing, working for the employersHospitals – are bearing more of the costs – don’t get paid for readmissions, and are starting to have more shared risk/shared value – things like ACOsThe Government – almost half the expenditures on Healthcare are from the government – for medicare and medicaidBut also you – see that? 28% is paid by consumers
But also you. You pay for it indirectly – through higher taxes, through less income (I’m an employer – I look at the total cost of an employee – that includes their health care costs.) from your job, etc.But also directly: Your premiums are growing, and your out of pocket costs are growing.
(Need graphic here … )The way you drive down costs and improving outcome:Is by preventing illnessesManaging them so they don’t progressPrevent bad outcomes- So you measure and trackHelps you analyzeCatch things earlyHelps you predict – and prevent. As we’ll see later – heart attacksManage – adherence to drugs, diet and exercise – change behavior(By the way, your employers and others will likely start giving you bigger and bigger incentives around a lot of this stuff.)Direct financial incentives to share and participate
(Pathfinder Infographic – Wearable Sensors) - this should be edited down… Proliferation of Sensors (cost drop, different types, onboard phone, wearable, ambient)Mobile and wireless transmissionThese can fit directly into this – measure, alert, predict, prevent, etc.
Then this is where we come in, on the software side…The device is connected via bluetooth to a smartphone (android for now, soon iphone)Which sends that data via private data network to the cloudReal time analytics, (based on algorithms for wing failure prediction from aerospace) to predict heart attacks. Presented to clinicians and patients. In trials at the Veterans Administration, so far they’re able to predict heart attacks up to 7 days in advance.
Our friends at Propeller Health (used to be Asthmapolis) have an interesting solution for Asthma and COPDAsthma and COPD are chronic respiratory diseases that cause your airways to swell and narrow making it difficult to breathe. Over 50 million people are affected in the United States alone.In order to relieve symptoms such as shortness of breath and chest tightness, people use a rescue or relief inhaler. People vary in the types of triggers and irritants which cause their symptoms; however asthma and COPD are unique in that people carry their inhaler with them, and use it at the time and place when they are experiencing symptoms.The time and frequency of your rescue inhaler use is one of the most important signals of your level of asthma control and COPD status. People with uncontrolled respiratory disease are at greater risk of suffering an attack, or worse, ending up in the hospital.The Propeller sensor is a small device that attaches to the top of your existing inhaler and stays out of your way when you need to use it. The Propeller sensor keeps track of your medication use for you, with a record of the time and place you have used your inhaler. It can be used with both rescue and controller medications for tracking symptoms and adherence respectively.
The Propeller sensor wirelessly syncs with your smart phone using your phone’s built in Bluetooth technology. Pairing the sensor with your phone is an easy, one-time step. Once your sensor is paired, your phone will automatically capture the data from your sensor whenever it is nearby.The Propeller mobile app for iOS (such as iPhone and iPod Touch) and Android devices allows you to view the data your sensor captures and give you personalized feedback and education on ways to improve your asthma control or COPD status. Plus Propeller automatically keeps a record of your trends including time, date and location of when you use your inhaled medications.Over 60% of patients with asthma are not under control and over 50% of patients with COPD take at least one daily medication, but adherence rate estimates range between 32-50%. Self-reported adherence estimates for COPD are generally higher than those based on pharmacy claims data. Patients with asthma tend to under report their symptoms and COPD patients may delay notifying their physician until they have worsened to the point of needing immediate care.While the majority of exacerbations can be prevented through proper management, over 60% of individuals with asthma do not have their disease under control and less than half of COPD patients adhere to their respiratory medications. Using inhalers to collect data on when and where people are having symptoms, Propeller provides personalized feedback and education on how to improve asthma control and COPD management.Early outcomes have been promising. In 2013, more than 2/3 of Propeller users with asthma were well-controlled or transitioned to well-controlled; by comparison only 30-40% of the general population with asthma have their disease under control. In recent programs, up to 80% of patients with asthma remain engaged with Propeller 3-6 months after enrollment. As a result, the Propeller platform has yielded an 80% improvement in medication adherence.In clinical studies of Propeller, after only three months of using the system we found that:– Uncontrolled asthma declined by 50 percent– More than 70 percent improved their level of controPatients in our programs reduce their healthcare utilization for both emergency and inpatient care, resulting in an average savings of more than $600 per patient.Very interesting things about what's happening where, and what environmental factors are
One of the things that is going to start happening is that this data will start to be correlated with other data.Not just data from your sensors, but also your medical records – and anything else that might affect your health (you saw that before)In this case: Your credit score and your zip code. In fact these two numbers have very big correlation to health outcomes…
Connecting and Controlling Multiple Sensors and Devices (If-Then)So you can measure your brainwaves, stress, heart rate, blood glucoseIntake, etc. Your location… You can control your house’s temperature, the lighting, the music, the coffee maker, your pool or spa (we both work on that, by the way)Swimming pool heats when theres’ a barbecue on the calendar, etc. So folks like IFTTT – if this then that, or Zapier, or Hugin