mc thinkcamp mhealth june 3 2011

MC ThinkCamp – mHealth June 3rd, 2011

( #tcmh )

Where do ideas for mHealth innovation come from?

Saying ‘I Wish’

Seeing New Patterns

Doing a bit of Mix’n’Mash

Doing a bit of Drag’n’Drop

Playing Leapfrog

Disruption: new authority figures

Disruption: overshot customers

First Speaker: Dr Mohammed Al-Ubaydli

In 2008, Mohammed founded Patients Know Best, a website that gives patients online access to their medical data. Mohammad has over 15 years of experience in medical software. He trained as a physician at the University of Cambridge; worked as a staff scientist at the National Institutes of Health; and was a management consultant to US hospitals at The Advisory Board Company. Patients Know Best was featured in Wired magazine’s March 2011 issue.

Patient-controlled records Dr Mohammad Al-Ubaydli

Women’s suffrage over time

Source: h*p://en.wikipedia.org/wiki/Timeline_of_women's_suffrage

Women’s suffrage over time

Professionals objecting to patient control are like Swiss men objecting to women voting in 1971: wealthy, civilized, eloquent… and on the wrong side of history

Trained as physician at the University of Cambridge.

Trained as programmer and worked as NIH Staff Scientist.

Honourary Senior Research Associate, UCL Medical School.

Continuing research on PHRs from 2,700 US hospitals, new book in 2010: book.patientsknowbest.com

A bit about me…

Our customers

Use our platform to save money from shared workflow

1. Thalidomide Trust / Imperial College hospital wanted us for online consultations

2. Great Ormond Street hospital wanted us for home health care electronic prescribing

3. More clinicians joining every day as patients invite them to

We can do what Microsoft, Google and the NHS cannot do

We will put patients in charge of making decisions about their care, including control of their health records

The Coalition:our programme for government, Cabinet Office, 2010. http://programmeforgovernment.hmg.gov.uk/nhs

PKB is the only option for patient-controlled medical records

GP surgeries and private clinics conduct online consultations

Great Ormond Street Hospital and home health care providers

Detailed explanations for patient save clinician’s time

1. Basics: definitions, and why do this at all? 2. Today: letting go of assumptions

3. Tomorrow: embracing possibilities

Roadmap

Some definitions

Patient portals

Clinicians

Electronic patient records Personal health

records Personal records

Patient

Patient portals

Clinicians



Patient

Data by clinicians for clinicians

Some definitions

Patient portals

Clinicians



Patient

Easing the patient’s burden

Scheduling appointments

Ordering medication refills

Secure messaging

Access to the EPR

See: Pyer et. al 2004, Ralston et. al 2007.

Some definitions

Patient portals

Clinicians



Patient

NHSmail users have mailbox shrunk 06 Feb 2008

NHS staff who use the health service’s email service NHSmail have been informed that after a recent move to Microsoft Exchange their mailbox size has been capped.

Some 80% of NHS accounts have been capped at just 200Mb, which appears miserly compared with the hefty 6Gb offered by Gmail for free, or the 5Gb offered for free on Windows Live Hotmail.

Data by patient for patient Powerful but unstructured

Some definitions

Patient portals

Clinicians



Patient

Markle Foundation’s ideal PHR:

Access controlled by patient

Lifelong records

Information from all

Universal access

Private and secure

Transparent

Easy exchange

See: Connecting for Health, 2004

Some definitions

Roadmap

1. Basics: definitions, and why do this at all?

2. Today: letting go of assumptions 3. Tomorrow: embracing possibilities

Patient-held records already here

Some parts of some health systems have already had them

In continental Europe and much of developing world, this is the norm

UK private health care, and US fragmented care, patients end up doing this anyway

NHS maternal notes and child personal health record use the patient to cross silos

Distribution is arbitrary, but users assume otherwise

Conflict is gone

Discomfort clinicians feel is due to limitations of paper

Piece of paper cannot be in two places at the same time

Transporting paper takes time and money

Clinicians do not feel safe unless they hold the only copy of the paper

Digital records eliminate the conflict

Patient-controlled records awesome

This is the only way to bridge the silos

Within “integrated” systems like NHS and Kaiser Permanente, clinicians do not talk to each other across community and hospitals

Within single institution e.g. hospital, clinicians do not talk to each other across departments

Within same department, clinicians do not talk to each other across specialities

The patient is the only person who turns up to all the appointments, so give them the records

Patients should manage their clinicians

Unique patients require truly patient-centred care

In a rare chronic disease, the patient knows more than most of the clinicians they meet

There are 30 million people with rare diseases in Western Europe and the USA

But even patients with common diseases have unique combinations of diseases and circumstances

Every patient is unique

Roadmap

1. Basics: definitions, and why do this at all?

2. Today: letting go of assumptions

3. Tomorrow: embracing possibilities

Patients with HIV publishing all notes

Patients use (much) better tools than you

Pa>ents use (much) be*er tools than you

Patients have better genetics tools than 99% of clinicians do (or ever will)

Patients will collect data you never knew

Useful web sites

Patients Like Me for HIV: patientslikeme.com

23andMe for genetic sequencing: 23andme.com

RelifeInSite for pain documentation: reliefinsite.com

Lifepsychol for monitor quality of life: lifepsychol.com

Personal health records: A guide for clinicians Al-Ubaydli, 2011, John Wiley & Sons

http://book.patientsknowbest.com

Patients will collect data you never knew

Patient-reported outcomes / observations / information

Patient-controlled records as a research tool

Patient-reported outcomes on each consultation

Patient-reported observations on data that had never previously been collected in medical records

Patient-reported information through sentiment analysis of diaries

Thank you for listening

Mohammad Al-Ubaydli Patients Know Best [email protected] www.patientsknowbest.com

First Demo: Dr Henry Lee

Henry Lee is training as a Surgeon in London and studied medicine at the University of Wales College of Medicine. He holds an academic post at Imperial College London and is researching the way that measure of wellbeing can be used for policy purposes.

Second Demo: Dr David Aanensen

David Aanensen is a bioinformatician in the School of Public Health, Imperial College London. His research focus is on the use and development of web applications for infectious disease microbiology.

EpiCollect

Dr David Aanensen Dept. Infec>ous Disease Epidemiology

Imperial College London

Batrachochytrium dendroba1dis (Bd)

Tracking Animal disease

Bd-‐Maps

•  Bd is a fungal pathogen causing wide-‐spread amphibian mortality.

•  Demands colla>on of cases of disease.

•  Communi>es of scien>sts submit data.

h*p://www.bd-‐maps.net

•  GPS – ‘loca>on aware’ •  Cameras for s>lls or videos

•  Keyboards for text entry •  Data transfer to / from

central databases.

EpiCollect -‐ Smartphones for data collec>on

Aanensen et al (2009) PLoS ONE 4(9): e6968

•  Generic issue – mobile data collec>on

•  Any projects where centralising textual data along with GPS and / or photos/media from many different people, from many different places, would be useful.

h*p://www.epicollect.net

Mobile phone app (Android and iPhone) and web applica>on for data colla>on.

Free and open source


Create a Project website at EpiCollect.net

Design a form for data collec>on

Load Project into the EpiCollect mobile app and collect data, including GPS posi>on and photo

View data collected at your project website or on your phone (download, view on maps/charts, filter.)


Ci>zen data collec>on

•  Yellowstone na>onal Park •  3,472 sq m visited by thousands of people each year.

•  Currently undertaking projects to allow members of the public to aid researchers in iden>fica>on and mapping of invasive plant species.

Archaeological dig sites

Replacing paper forms for linking and mapping areas of dig sites.

Dig sites across Europe

Pre – major building works

Street art*

•  Categorised by type – eg posters, s>ckers, stencils etc.

*Disclaimer: probably not to be encouraged…

Animal Health surveillance in Kenya / Tanzania

Ongoing monitoring of: East Coast Fever; anthrax and rabies; FMD Gabriel Turasha (Vetaid Tanzania) Nick Short (RVC) and Niall Winters(IOE)

Maasai vets Carry out Disease Surveillance of 86,000 animals with Google Mobile phones

•  No reliance on data networks for collec>on.

•  Data can be sent to any server.

•  Two-‐way data transfer

•  Simple XML descrip>on of project forms and for defini>on of server loca>ons.

Acknowledgements

•  Dr Derek Huntley, Jon Evans, Chris Powell, Prof. Brian Spra*

[email protected]

Funded by:

Second Speaker: Dr Adesina Iluyemi

Adesina is an executive board member and a co-chair of the Global Health Commission of the NEPAD Council, a non-profit organization. His expertise lies in mHealth and Telemedicine innovation and policy development. He has in the past collaborated with influential international multilateral, organizations such as the WHO, UN, ITU, and the Commonwealth Secretariat. He is a Fellow and Council member Telemed & eHealth Section of the RSM England, and a co-founder and executive director of MODISE; an initiative working to bring low-cost connected mobile diagnostics to developing countries.

mHealth Developing Countries: Past, Present & Future

Introducing MoDiSe

Dr Adesina Iluyemi DDPH RCS (Eng) Vice President &Co-‐ Founder

MoDiSe [email protected] www.modise.org

Sustainable Serendipitous Situated

An Overview

USERS CASES CITIZENS (Consumers, Patients) Call Centre models

TeleDoc, Pakistan COMMUNITY (Population) SMS Casting Model

Masiluleke, South Africa CLINICIANS (Health Workers) Mobile Telemedicine, Botswana

CENTRES ( Facilities) Mobile Microscopy e.g LUCAS

Source: Author

• Need to move Beyond SMS!

• Clinicians & Centres offer be*er Commercial Opportuni>es


Voice & SMS, few Data Apps

Cell-‐Life


Health Workers using PDAs


PDA to Smartphone

GSMA

Simputer


Mobile + Medical Renaissance

• Teleradiology • Remote Imaging • Laboratory Detec>on • Clinical Diagnosis • Rural Healthcare • Emergency Medicine • Pandemics

• Epidemics • Point of Care Diagnos>cs

OPPORTUNITY FOR LOW-‐COST INOVATIONS IN DEVELOPING COUNTRIES Sustainable Serendipitous Situated

Medical Innovations 1

•  Medical Devices/Mobile Microscopy e.g LUCAS, CellScope

• Assis>ve Technology? e.g NETRA for remote eye examina>on

• Mobile EHR e.g mGEOs with geotagging and web-‐interface

UCLA 2009


Medical Innova>on 2

• Mobile Telemedicine e.g Click Diagnos>cs for skin & oral lesions and cervical screening in Botswana

•  Real Pa>ent Monitoring e.g A pilot with a Private Hospital in Nigeria

• Medical Apps e.g Moodle4iPhone pilots using Android & iPhonein Peru


Introducing MoDiSe MISSION: Collaborate with private sector innovators / biotechnology researchers and local entrepreneurs to facilitate the development of Point of Care tools to prevent, diagnose and treat neglected tropical and non-communicable diseases in the developing world-

www.modise.org Non-for-Profit Organization in Canada


MoDiSe: Our Strategy

6/7/11 MoDiSe

Mobile Diagnos>cs for Global Health

h*p://www.modise.org


MoDiSe: Our Concept

6/7/11

MoDiSe Sustainable Serendipitous Situated

Acknowledgements 1. Mobile Healthcare Industry Summit

2. CHMI, University of Portsmouth 3. NEPAD Council


ThinkCamp was brought to you by: We are an ‘idea-to-launch’ community platform for the collaborative development of mobile applications, products & services across many industries. (More than just apps – think personal mobility services, mHealth applications, SIM-card embedded devices, sensory data meets cloud computing, and SMS-based solutions in the developing world).

We bring the mobile developer & designer community together with members of professional communities, such as healthcare; facilitate the sharing of experiences, insights and skills; and provide a structure for developing and acting on the innovative ideas that emerge. We do this by running a series of ThinkCamp events which take a collaborative approach to generating and developing good ideas. Adhoc teams which form around the ideas are supported & nurtured by a wide range of participating technologists, field experts and market channel partners to implement a solution or turn turn the developed proposition into a commercially viable product or service. Our first area of focus is mHealth.

Over time we will also build an online collaboration community for idea development that provides a supportive process all the way to implementation. The business model for all who get involved is joint venture / revenue share

@mobilecollectiv

ThinkCamp was made possible with the support of our partners:

With thanks also to:

mc thinkcamp mhealth june 3 2011

Health & Medicine

patient control

acrossspecialitiesthe

patientcentred care

clinicians unique patients

health systems

money clinicians

paper digital records

clinicians donot