the future of digital medicine; angeles university; april 9 2016
TRANSCRIPT
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Back to the Future: Digital trends in Medicine
Ivan Olegario, MD, MDCAugust 9, 2016
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Medical scheme “product” life cycle
Time
Declining beneficiariesEscalating costs
InefficiencyWaste
Innovation
SuccessSuccess
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Technology adoption
Source: Gartner 2015
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Source: Frost & Sullivan
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Technology use matrix
GOALS USERS
Physicians Patients
Prepare and prevent E-LearningVirtual dissection
Curated online information
Data and diagnostics WearablesReal-time diagnosticsEMRs
WearablesPersonalised genomics
Therapy and follow-up Robotic interventionsTelemedicineMultidisciplinary therapies
Artificial organsAdherence controls3D-printed biomaterials
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What does the future look like?
Source: http://lifesciences.ieee.org/articles/487-a-survey-on-ambient-intelligence-in-healthcare
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Digital technologies predicted to disrupt healthcareSource: The 7 Biggest Innovations in Health Care Technology by Brian Honigman
Wearable Tech- like Google Glass
Hybrid Operating RoomsDigestible Sensors
Nanobots in Blood
Fingertip Surgery
3D Printed Biologicals
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Personal Health Devices• Personal health devices can:
– Provide information or – Sense and respond, – or both.
• They can provide intervention or everyday support.
http://www.eee.bham.ac.uk/woolleysi/projects/index.htmhttp://www.disetronic-ca.com/dstrnc_ca/rewrite/content/en_CA/3.2:20/article/DCM_general_article_53.htm
http://mlearning.edublogs.org/2006/11/20/m-learning-is-vital-for-industry-compatibility/
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Blood Pressure/Pulse Monitors
• Automatic large LED blood pressure systolic / diastolic / pulse readout with fuzzy logic.
• Automatic inflation & deflation
• 48 sets of memory to monitor your progress plus date / time / average pressure
• Requires 2 x AAA batteries.Tatung http://www.tatung.com/med/product.html
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AMON - Advanced Telemedical Monitor
• A European project from ETH, Zurich• Designed to be worn by cardiac
outpatients, the device allows remote monitoring of blood pressure, pulse, oxygen saturation, body temperature and 2-channel ECG signals.
• AMON: A Wearable Medical Computer for High Risk Patients, P. Lukowicz, U. Anliker, J. Ward, G. Tröster, E. Hirt, C. Neufelt, ISWC 2002: Proceedings of the 6th International Symposium on Wearable Computers, 7.-10. October 2002, pp 133-34
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Glucose monitoring and Wearable Insulin Pumps
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Biofeedback and “Inner-active” Games
• Biofeedback – monitoring and altering a body function such as breathing, heart rate, blood pressure through relaxation or imagery.
• ANTENSE® Biofeedback anti-tension device: $160
• emWave Personal Stress Reliever® $199
• The Journey to Wild Divine, the first in a series of “Inner-Active” computer adventures
– Biofeedback in an entertaining multimedia experience $187.50
Top left: Antense® Anti-Tension DeviceTop right: http://www.holisticonline.com/Biofeedback.htm
Bottom: http://www.myemwave.org/about_emwave_stress.html http://www.luxevivant.com/index.asp?PageAction=VIEWPROD&ProdID=166
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The “Digital Plaster”
• A device embedded in ordinary plaster• Includes sensors for monitoring health-
related metadata such as blood pressure, temperature and glucose levels.
• If the results show abnormal signs, patients and doctors would be notified.
• Can be integrated with motion sensors.[The Toumaz Digital Plaster]
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Portable TENS
• TENS machines are used for pain relief, for example, by chronic pain sufferers or for pain during child birth.
• From NHS Direct: “a pad that administers small amounts of electrical current, blocking pain signals and stimulating endorphins”
An NHS-Approved TENS machinehttp://www.maternitytens.com/index.asp?function=DISPLAYPRODUCT&productid=9.
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=914
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Personal Mobile Electrotherapy
• NovoCure is currently performing clinical trials using 100-200 kHz electric fields (tumour treating fields or TTFields), to stunt the growth of cancer cells.
• Inhibits microtubule spindle organization and resultant mitosis
• Leads to apoptosis• Animal and early human trials appear
promising.
Safety cap. A glioblastoma patient wears the NovoTTF-100A.
http://sciencenow.sciencemag.org/cgi/content/full/2007/530/3
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Live clinical record
• Readings appear as a live database• Standard queries and interfaces can be used to
manipulate the data• On-line services used to process the data• Exploits existing grid standards for reliability• Presents a range of different interfaces for
clinicians• Provides range of feedback to patients.
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Research Questions: Qualitative
• System-centred research questions– How can sensors, systems and data interact and
combine or synergise?
• User-centred research questions– How can users manage and interpret all this new
information?
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Research Questions: Quantitative
• Can we help people (doctors and patients) keep well and optimise health? (Clinical outcomes)
• Can we use new technology to make more people more well more of the time ... with less money? (Health economics)
• Can we avoid exposing people to excessive electromagnetic fields? (Risks)
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Impact to practice
• Much left to be done• Start thinking about it NOW!