the expanding influence of digital tools on healthy behaviours

THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS

Steven Tucker, MD, FACP, FAMS Founder & Medical Director Tucker Medical, Singapore

Background0

42% Direct Medical

58% Indirect Costs Productivity

$7,678 Average Cost per Worker

DIABETES BURDEN 2010

Png et al. BMC Public Health (2016) 16:153

1Billion SGD

HEMOGLOBIN A1C > 5.8%

44%

Bancks et al. PLoS ONE (2105) 10(3)

Perc

ent A

ge 6

5+

8

16

24

32

40

Age 65+2010 2035

20.5

11.2

DIABETES & AGEING

Wong et al. J Diabetes. (2017) 9(1):65-75.

Num

ber o

f Cas

es250000

500000

750000

1000000

Prediabetes Diabetes2010 2035 2010 2035

823,802903,596

373,104434,685

WE ARE AT WAR

THE WAR ON DIABETES

THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS

Remote Sensing1

Smart Phones2

SENSORS EVERYWHERE

SOCIAL MEDIA

E-COMMERCE

TRAVEL

EDUCATIONAL

BEHAVIOURAL

SENSORS + IOT

SOCIAL

BEHAVIOURAL

TRAVEL

EDUCATION

PERSONAL DIGITAL BEHAVIOUR

FINANCIAL

DIGITAL BEHAVIOR

Personalized Health3

DNA IS NOT A TEST

DNA IS A RESOURCE

GENOTYPING

55,685 PARTICIPANTS ACROSS 4 STUDIES

N Engl J Med 2016; 375:2349-2358.

55,685 PARTICIPANTS ACROSS 4 STUDIES

GENETIC RISK SCORE

N Engl J Med 2016; 375:2349-2358.

N Engl J Med 2016; 375:2349-2358.

RISK OF CORONARY EVENT ACCORDING TO NATURE & NURTURE

N Engl J Med 2016; 375:2349-2358.


N Engl J Med 2016; 375:2349-2358.

A Research Tool and

A Research Tool and

+genome_STEVEN_TUCKER_Full.txt

A Research Tool and

+ =genome_STEVEN_TUCKER_Full.txt

TYPE 2 DIABETES

BREAST CANCER

ALZHEIMER DISEASE

Personalized Medicine4

PHARMACO-GENOMICS

Odd

s R

atio

0

50

100

150

200

250

Malaysian Han Chinese Thai Overall

Genotyping for the HLA-B*1502 allele prior to the initiation of carbamazepine therapy in patients of Asian ancestry is the standard of care.

JAMA Dermatol. 2013;149(9):1025-1032

Cas

es

0

6

12

18

24

30

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Neurology 79(12) 1259-1267.

Genotyping is standard of care

No new cases of SJS/TEN since 2014.

CODEINE - CYP2D6

CLOPIDROGEL - CYP2C19

PROTON PUMP INHIBITORS - CYP2C19

Platforms5

DIGITAL BEHAVIOURSENSORS + IOT

COMMUNICATION

TRAVEL

EDUCATION


FINANCIAL

FAMILY

DIGITAL BIOLOGYGENOME / GRS

PHARMACOGENOME

EXPOSOME

PHENOME

CLINICAL DATA

PERSONAL DIGITAL BIOLOGY

MICROBIOME

DIGITAL HEALTHGENOME / GRS

PHARMACOGENOME

EXPOSOME

PHENOME

CLINICAL DATA

PERSONAL DIGITAL BIOLOGY

MICROBIOME

SENSORS + IOT

COMMUNICATION

TRAVEL

EDUCATION


FINANCIAL

FAMILY

NO SHORTAGE OF TOOLS

DIABETES PLATFORMS

Takeaway6

Takeaway6 How will we manage chronic disease as we age?

CONTEXTUALIZE DATA

PREVENTION > TREATMENT

PAY FOR NEW OUTCOMESMedical Health

PAY FOR NEW OUTCOMESMedical Health

Medical Treatment Health Maintenance

NEW PROVIDERS

EPISODIC TO CONTINUOUSPersonal Risk

Personal Intervention

Risk Reduction

BRANDED SUCCESSPersonal Risk

Personal Intervention

Risk Reduction

The Kodak Moment7

WHAT BUSINESS AM I IN?

N Engl J Med 2012; 367:888-889

THANK YOUFor your /me & a4en/on

the expanding influence of digital tools on healthy behaviours

Healthcare