Transforming Data Streams with Kafka Connect: An Introduction to Single Messa...
Healthcare informatics becomes personal informatics
1. 1
Healthcare informatics becomes
personal informatics
Ilkka Korhonen
Professor, Information Technologies for Healthcare
Tampere University of Technology, Finland
WC 2012, 28.5.2012
WC2012 Ilkka Korhonen 03.08.12
4. 21st century: the century of
behavioral change
WC 2012 Ilkka Korhonen
5. The health challenge in 21st century:
Chronic conditions
Life style diseases
Management rather than treatment
Every day rather than occasionally
6. Determinants of health
Quality/Efficacy of
10% Healthcare healthcare services
delivery
system
Behavioural patterns-
Lifestyle, exogenous
60% Nurture environmental factors, determinants
socio-economic
circumstances
Genetic predispositions, endogenous
30% Nature determinants
acquired genetic changes
SA Schroeder: We Can Do Better - Improving the Health of the American People.
N Engl J Med 2007; 357:1221-8, McGinnis et al., Health Affairs 21(2), 2002
8. Prevention opportunity via
behavioral change
• Cardiovascular disease:
73-83%
Nurses Health Study, NEJM 2000;343:16-22,
NEJM 2001;345:790-97
• Diabetes type II:
58-91%
Tuomilehto, 2001 NEJM 344(18): 1343-50
Nurses Health Study, NEJM 2000;343:16-22, NEJM
2001;345:790-97
• Cancer:
60-69%
De Lorgeril, Arch Int Med 1998;158:1181-87
HALE Project. Knoops JAMA 2004;292:1433-
1439
WC 2012 Ilkka Korhonen 8
9. Innovation and Research in Life and Health Services
These are also medicines
Education Physical Nutrition
Activity
Education is Medicine
Physical Activity is Medicine
Nutrition is Medicine
IF WE CAN DO
• Anamnesis
• Prescription
• (Self-) Administration
Needs Preferences
• Monitoring of Compliance & Outcomes
Behaviours
• Vigilance on Adverse Effects
Alberto Sanna, San Raffaele Scientific Institute: PREVE. Building the health eco-system @ Brussels, Nov. 15 th, 201 Engineering AwarenessTM
10. 03/08/12 10
A new role for citizens and patients
”People as co-producers of health and care”
Proactive Individuals as
Individuals as
co-producers of
co-producers of
Health & Care
Connected Health
Health & Care
choices
Patients as
Reactive passive objects
Health & Care Citizen-
Professionals Dependency Patient
11. Phases of ICT development
PCs PCs connected to Internet
MOBILE INTERNET
Slow or no connections Fixed broadband
Mobile took the lead with smart
Business-driven Consumer- and business-driven
phones, tablets, embedded SIMs
“History suggests the mobile Internet has potential to create /
One architecture: Client-Server Megatrend (OECD -centric)
Location-awareness and gadget
Office automation and processdestroy more wealth thanWeb computing cycles based on 10x
One architecture: prior
integration
development user multiplierbusiness models
New effect.
Mobile broadband with capacity
Regarding pace of change, more users will likely connect to the
and quality issues
Internet via mobile devices than desktop PCs within 5 years”.
Cloud
Connected
Morgan Stanley (The Mobile Internet Report, 2009)Consumer- and utility-driven
life
Size bigger than in cycle #4
Main- In fact, theInternet 2.0 Connecting Gigatrend (global)
sales of smart phones exceeded the sales of PCs in
Mini PC world to the Three or four architectures:
frame February 2011.
Internet Intenet Emb, web, app, broadcast cache
New ecosystem-centric business
Connecting
“The dominant design is the Internet and the future of mobility is the
models
people Nexec Oy)
future of Internet” (Matti Mäkelin,
Inflection 1970s- 1981- 1996- 2010
points
(c) Matti Mäkelin, Nexec Oy, Finland
12. 12
History of personal computing
“Before the introduction of the microprocessor in the early 1970s,
computers were generally large, costly world starting on 70’s.
Personal computers changed this systems owned by large
corporations, universities, government agencies, and similar-
sized institutions. End IT industry where individual users and
Development of users generally did not directly interact with
thenew innovative companiesprepare significant value with on
machine, but instead would create tasks for the computer
their personal computers
off-line equipment, such as card punches. A number of
assignments for the computer would be gathered up and
processed in same would After the in medical informatics?
What if batch mode. happen job had completed, users
-Citizens In some cases it could take
could collect the results. generating health data hours or
days betweennew era of a job to information (PHR) and
submitting health the computing center
-Citizens and new
receiving the output.” companies combining health data with
Wikipedia health information and their non-health data
new era of use of health information
-Changing role of health professionals
new era of health professionals
WC 2012 Ilkka Korhonen 03.08.12
13. 13
Personal / Consumer Health
Informatics
Consumer Health Informatics (CHI) helps bridge the
gap between patients and health resources.
Consumer Health Informatics include technologies
focused on patients as the primary users to health
information.
Giving patients tools to gather, manage, analyse
and communicate their heath information between
other patients and health professionals will change
the way health care is practised.
WC 2012 Ilkka Korhonen 03.08.12
14. Personal Health Systems =
Personal Health Systems =
Health and Wellness Technologies
Health and Wellness Technologies
Designed for the Consumer
Designed for the Consumer
Monitoring + Connectivity + Analysis + Feedback
Monitoring + Connectivity + Analysis + Feedback
15. 15
Key issues in personal health
informatics
1. Personal health monitoring
2. Personal data management (PHR)
3. Personal analysis and feedback – giving
personal meaning to data and health
information
4. Connectivity – to other patients,
services, professionals, other
application areas
”No man is an island”
WC 2012 Ilkka Korhonen 3.8.2011
16. Benefits of self-monitoring
• Daily weight monitoring helps in
weigh loss and weight maintenance
Next enable patients to:
(Kayman et al., 1990; Linde et al., 2004; Wing et al., 2006)
• •Self-monitor
Regular diet and energy
consumption monitoring supports
•Interpret the feedback
weight loss and may decrease food
•Connect data meaning to
intake (Baker & Kirschenbaum, 1993; Perri et al., 1989;
Foreyt,things that really matter
2005)
•Make real and concrete
• Stepchanges in increases exercising
monitoring their health
and behaviors – baby steps and
improved body composition
blood pressure (Bravata et al., 2007; Clemes
2009) •Share and play - master
• Self-monitoring is the most effieicnt
And clinicians to support this Wing et al., 2006
method for getting rid of bad habits
as coaches when needed
(Quinn, 2010)
WC 2012 Ilkka Korhonen
17. HRV monitoring combined with diary (=personal
context = meaning) and intelligent analysis
personally relevant discoveries!
Physiological Stress (red) and recovery (green)
Day 1 – Wed 4th of Apr, 2012
Sleep
Telcos F2f mtg Running
Delayed
recovery
Day 2 – Thu 5th of Apr, 2012
Nap Ice hockey
game on TV
(play-off)
Ilkka Korhonen – Firstbeat stressipäivä 15.5.2012
18. Adding comparison to norms 18
adding more motivation and understanding
”should I do something?”
Physiological recovery during sleep compared to population reference
Day 1 – Wed 4th of Apr, 2012
HRV based recovery measured by RMSSD is 52ms.
Population age-adjusted average is 34ms.
Your sleep time was 7h 0min. Recommended sleep duration is min 7h
Day 2 – Thu 5th of Apr, 2012
HRV based recovery measured by RMSSD is 79ms.
Population age-adjusted average is 34ms.
Your sleep time was 8h 15min. Recommended sleep duration isvaihdettava alatunnisteeseen
*Oma nimi ja esityksen aihe min 7h 03.08.12
19. Identification of areas with most 19
improvement potential – seeing the
big picture
Life style health report based on HRV
What next?
Working time
What next?
How to translate understanding into action and concrete
behaviors?
Physical activity
How to load
Physical translate understanding into action and concrete
Recovery
behaviors?
Leisure time
Health coaching
Nudging
Health coaching
Exercise Context design
Nudging
Exercise load Context design
Recovery
EE during exercise
Sleep
Total recovery
Recovery quality
Sleep time
*Oma nimi ja esityksen aihe vaihdettava alatunnisteeseen 03.08.12
20. 20
Conclusions
• The 21st century health challenge = life style related
chronic diseases
prevention and management possible only by
empowering patients to do this themselves
• Personal health informatics is informatics where patient is
the primary user of health information
• Personal health informatics enables similar revolution in
health management as happened in personal computing
• Risks are there...
• ... but so are opportunities
• Can we stop it?– or shall we rather use it?
• Health is personal – so should also health informatics be
WC2012 – Ilkka Korhonen 03.08.12
21. Thank you!
Ilkka Korhonen
Professor
Dept Biomedical Engineering
Tampere University of Technology
ilkka.korhonen@tut.fi
Notas do Editor
First and Foremost…need a system designed to meet today’s health conditions… Our nation’s health has changed, but our current delivery model has remained what is essentially an acute, episodic care business model from the 19th century, a traditional fee-for-service model based on patients visiting hospitals and physicians’ offices only when they’re sick….. In the early 20 th century, infection was the leading cause of death in the United States. Acute in nature, infections were treated as they emerged. (STATS TO SUPPORT) As the century progressed, however, infection gave way to chronic disease as the leading cause of death and primary driver of health costs in the US. The shift is BIG – BIGGER than most folks realize when they think about the system. Complex, chronic disease in less than 10% of the population account for more than 80% of the annual costs. (can we find supporting evidence point?). Think about that for a minute and you recognize there are a bunch of implications of this: Re-engineering these care processes – but they typically cross org and economic boundaries, require behavior changes and more – The data we need to manage deal with these conditions goes way beyond what is collected/managed today The user experience for managing this care may be very different than the ‘chart’ today The need to think wholistically about prevention we need to move from the value being placed SOLELY on the activities focused on acute, episodic care to value being placed on real-time health management over the long-term (acute care vs. chronic care or wellness)
Determinants of health organized as a “Systems Medicine” view.
This leads me to our other research focus Behaviour Change Support using mHealth technologies. The driving idea here is an extension of the definition of usual medicines, i.e. pharmaceuticals, surgical and therapautic interventions. We propose to include also education, physical activity and nutrition into the realm of what is considered medicines. The challenge, however, is that we need to find efficient and effective ways to administer these new medicines and to monitor their effects. This is where theories and methodologies for behaviour change support and mHealth as a means of implementation are needed.