Presentation by Robin A. Felder, PhD, Professor and Associate Director of Clinical Chemistry and Pathology, former Director of the Medical Automation Research Center and Chair, Medical Automation

1. Robin A. Felder, PhD
The University of Virginia
Department of Pathology
TRANSFORMING HEALTHCARE
THROUGH INNOVATION

2. Disclosures
 University of Virginia
 Department of
Pathology
 Medical Robotics
 Medical Automation
 Hypogen
 WellAWARE Systems
 MeyeChem
 Proteus Bio
 Global Cell Solutions
 Monte Piccolo Farm

4. Pursuit of Wellness
 State of complete
physical, mental and
social well-being
 Health results from
primarily positive
perspectives and choices
by which to live
 Technology can provide
information that facilitates
positive choices
Physical
Social
6.2
9.1
8.0
Cognitive
Wellness Balance
© Felder, 2011

5. Wellness Support
 Growing need for new sources of
data, and data interpretation
 Integration of multiple diagnostic
sources (lifestyle, self testing)
 Integrated wellness and health
record
 Ongoing information support for
maintaining healthy lifestyles

6. Wellness Technologies Monitor
 Nutrition
 Exercise
 Biometrics
 Pain reduction
 Stress reduction
 Sleep improvement
 Mood enhancement
 Health and wellness

7. Wellness Support
 Food coaching
 Rewards
 Exercise
 Nutrition
 Therapeutic compliance
 Consequence reporting
 Consequence forecasting
Overcome vicarious
goal fulfillment or,
“exhaustion of selfcontrol”

8. Home Health IT
 New revenue sources:
Medical Cloud
coaching and
Interpretations
Cloud
Interpretations

9. Proliferation
of Wellness
Tools
 Accelerometer
based
Striiv
Basis
FitBit
 Various models
for data delivery
 Basic
physiologic
measurements
Shine Misfit
BodyMedia
Nike Feulband
Scanadu
Tricorder
Zephyr
Information Week
BodyMedia

10. KNOWS
LEARNS
You and what is
around you
What you like
SENSING
Local content
& services discovery
Source: Jarrin (Qualcomm)
DISCOVERS
Things relevant
to you
FILTERS
Out the irrelevant
SEEING
INTERACTING
Augmented reality UI:
Map, 3D, in building
navigation
Connection manager
(WAN, Wi-Fi)

11. KNOWS
LEARNS
You and what is
around you
What you like
SENSING
Local content
& services discovery
Source: Jarrin (Qualcomm)
DISCOVERS
Things relevant
to you
FILTERS
Out the irrelevant
SEEING
INTERACTING
Augmented reality UI:
Map, 3D, in building
navigation
Connection manager
(WAN, Wi-Fi)

12. Lifewatch AG
new ipad mini

13. Portable Diagnostics
 iPhone based
portable ultrasound
 EKG
 Otoscope
 Dermatoscope
 Microscope

14. Cell Scope ™
 Dermatoscope – iPhone clipon
 Transmits high quality magified
pictures of skin blemishes
 “Smart Otoscope” – iPhone
ear drum microscope
 Transmits pictures of videos of
the ear canal and ear drum
 Looks at progression or
regression of disease

15. Otoscope Images
Normal Ear Drum
Ear Infection
Ruptured ear drum

16. Cloud Based Diagnosis of Parkinsons
 Non-invasive phone
based
 Low Cost
 Accurate (98%)
 Scalable to large
populations
 Remote, non-expert
 Rapid diagnosis
Max Little - Parkinson’s
Voice Initiative
TED Conference 2012

17. iPhone Body Fluid Diagnostics
 Biosense Technologies
 uCheck
 ToucHb

18. Continuous Glucose Monitoring
Dexcom

19. Embedded Wellness Sensors
 Instrument common
fixtures
 Wireless
transmission of data
 Web based
aggregation and
interpretation

20. Action Inspired Instruction
 Real time coaching
 Medically approved
content
 Tailored for individual

21. Passive Wellness Monitoring
Healthcare providers
Vital Sensor
Urine analyzer
Data management PC
Urine protein
Urine glucose
·Body temperature
·Pulse
·Blood Pressure
·Body fat percentage

22. The M.A.R.C. In-Home
Health Monitoring Project
 Create a model where the impact of chronic
disease is delayed or avoided
 Provide opportunity for medical intervention
before a crisis occurs
 Minimize impact of chronic disease on the
healthcare system

23. Passive Remote Sensing
 Wireless Sensor Array (WSA) – gathers data on daily
activities
 Data Manager (DM) –transmits data to data analysis
servers
 Capture Analysis & Reporting Engine (CARE) – captures
potential problems and alerts caregiver

24. Passive Gait Sensors
Vibration
sensors placed
in the house
detect occupant
gait

25. Passive Physiologic Sensors
Physiologic
sensors
embedded in
common
household
furniture and
fixtures

26. Sleep Monitoring
 Sleep apnea affects more
than 40 million people in the
United States alone of which
85% are currently
undiagnosed
 sleep apnea testing and
therapy market that is
expected to reach more that
$4 billion by 2012

27. Passive Vital Sign Bed Monitor
Mattress pad to measure:
• Sleep quality
• Pulse (and HRV)
• Breathing
• Movement/
restlessness
• Bed exit
• Subject position/
turning
• Body temperature
• Blood Pressure
Passive Sensing
Polysomnography

28. Sleep Quality Graphs
Restful Resident
Restless Resident

29. Remote Automated Triage
 Real time assessment of participant health
status/well being
 Ability to drill down to specifics
 Built in automated optimized dispatching
 Manual override of dispatch event or
downstream processes

30. 30

31. One Click Trending
 Health
 Socialization
 System
utilization

32. Telehome Monitoring Decreases
Costs by 74%
70000
60000
Dollars $
50000
40000
30000
20000
10000
Overall Cost of Care Comparison
$67,757.88
Unmonitored
80000
$17,407.02
Monitored
0
N=21 in each group, P<0.05;
Telemed J E Health, 2007 13(3):279-85

33. FUTURE WELLNESS
TECHNOLOGIES

34. 3D Manufacturing

36. 36

37. Wearable Cancer Detection
 First Warning Systems™ heat distribution sensing
sports bra
0.2cm
1cm
4cm

38. Underwear That Measures Blood
Pressure
 Pulse wave velocity
correlates with blood
pressure
 Tissue impedance shows
passing pulses
 Pulse timing correlated
with relative pressure
 Continuous blood
pressure monitoring

39. Automated Pharmaceuticals
 Automated Pill – iPill (Philips)
 Magnatrace™ System looks for pill
ingestion
 Networked pills (Proteus
Biomedical)
 Instrumented Pills
 Cost < $0.01
 Measure and send physiologic signals
through body electrically
 Receiver is a patch worn on the body
that also logs respiration, heart rate and
body movement, sleep patterns

40. Automated Intestinal Biopsies
 Intestinal diagnostic
imaging coupled with
miniaturized biopsies
 Pillcams with
intestinal “Velcro” to
arrest the camera at
a selective location
 Continuous
monitoring
MIT Technology Lab

41. The Eye as the Window to Health
Medical Robotics
UCSD
Preventive Science Inc.
Univ. of MD, Baltimore

42. MeyeChem, LLC
 Real time glucose
monitoring
 Alerts for low or high
glucose concentrations
 Trending analysis
 Food coaching via
telenutritionalmentoring

43. Virtual Reality
 Image enhancement,
correction, zoom
 Correction currently
limited to 0.2
logMAR, 20/32
 Full view software
modulated images
 Superimposed
augmented reality
Off axis projection with
transflective diffuser 90 field
eyewear iOptik
Gas-permeable
nanopolarizer
(iOptik contact
lens)
Diopter adjustable
mini-scleral lens
and wearable
computer (iOptik)
Zoom lens (3X)
UCSD

44. Augmented Reality
 Projection of
underlying anatomy
on living tissue
 Relies on
superimposition of
reality and
previously scanned
animated image/data

45. Not for the Faint Hearted

50. Receptivity
 Presenting health vs
wellness to a patient
 Determining what
information is TMI
 Optimizing the time
for the presentation
of wellness strategies
“Wellformation”

51. Medical Automation.org
A non-profit
educational
organization
improving
healthcare quality
and efficiency
through teaching
automation
principles and
their application in
health systems
http://medicalautomation.org

52. TagLine - Medical reality
http://medicalautomation.org

54. Robotic Reality
HRP-4C National Institute of
Advanced Industrial Science and
Technology