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Augmented Personalized Healthcare
How Smart Data with IoTs and AI is about to change
Healthcare
Invited Talk @ Big Data Integration and IoT for Smart Health Care,
3rd Intl Forum on Research and Technologies for Society and Industry
Modena Italy, 13 September 2017
Prof. Amit Sheth
LexisNexis Ohio Eminent Scholar; Executive Director, Kno.e.sis
Wright State University
Background: http://bit.ly/k-APH, http://bit.ly/kAsthma, http://j.mp/PARCtalk,
2
• Traditional Healthcare
• Healthcare: Then and Now
• Augmented Personalized Health for health care
of the future, and associated technical
challenges
• kHealth: Three ongoing applications
Outline
3
Traditional Healthcare
How are you feeling
today?I am not feeling well
since yesterday
afternoon.
4
Healthcare: Then and Now
Episodic Continuous
5
Healthcare: Then and Now
Disease focussed Beyond medical intervention:
Lifestyle change/holistic,
Wellness, Quality of Life
6
Healthcare: Then and Now
Clinic centric Patient centric
(Anywhere the patient is)
7
Healthcare: Then and Now
Clinician control Patient empowered
8
Healthcare: Then and Now
Limited data 360 degree multimodal
● Personal-Public-Population
● Physical-Cyber-Social big data
driven
The Patient of the
Future
MIT Technology Review,
2012
http://www.technologyreview.com/featuredstory/426968/the-patient-of-the-future/9
Patients are increasingly taking control of own health
Patient Generated Health Data (PGHD) are “health-related data created, recorded, or gathered by or from
patients (or family members or other caregivers) to help address a health concern. PGHD include, but are not
limited to health history, treatment history, biometric data, symptoms, and lifestyle choices.”
Office of the National Coordinator for Health Information Technology (ONC).
Google:Verily Life Sciences
https://blog.verily.com/2017/04/introducing-verily-study-watch.html
AIM: Doctor in a self-driving Car
[Image: courtesy Artefac, https://flipboard.com/@flipboard/-who-needs-a-hospital-when-this-self-dri/f-4204314e11%2Ffastcodesign.com t]
12
Converting big data into smart data through contextual and
personalized processing such that patient and clinician can
make better decisions and take timely actions for Augmented
Personalized Health
Future Health Care
13
Augmented Personalized Healthcare (APH) is expected
to enhance healthcare by personalizing the use of all
relevant
Physical, Cyber, and Social data obtained from wearables,
sensors and Internet of Things, mobile applications,
electronic medical records, web-based information,
and social media for better health for an individual.
Data include traditional clinical data, PGHD and public health data, as well as
environmental and social data that could impact an individual’s health.
Augmented Personalized Healthcare
14https://cdn1.tnwcdn.com/wp-content/blogs.dir/1/files/2013/12/augmented-reality-doctors-lab.jpg
Augmented Personalized Healthcare
15
Providing actionable information in a
timely manner is crucial to avoid
information overload or fatigue
Sleep data
Community
dataPersonal
Schedule Activity data
Personal
health
records
Data Overload for Patients/health aficionados
16
Challenges in deriving actionable insights from Sensor Data
According to Forbes, the wearables market exceeded $2 billion in
2015, 3 billion in 2016 and will be over 4 billion in 2017.
Leading to vast volume of healthcare data: some key issues
● Sensor reliability and Quality
● Sensor data Heterogeneity
● Contextual Interpretation and Abstraction
● Personalized Health and Health Objective
https://www.linkedin.com/pulse/digital-health-why-doctors-should-care-doug-hart
17
Sensor Data Reliability and Quality
1.https://wq.io/media/images/quality-large.png, 2https://readwrite.com/2017/05/26/study-wearables-counting-calories-dl4/,
3.https://www.wsj.com/articles/smartphones-open-a-new-world-for-medical-researchers-1498442821
● Consumer graded devices can be terrible and inaccurate [2]
● Is data generated from them useful for health application?
● Research shows they can be effective for health applications [3]
18
Is sensor data useful for Health Decision making?
19
Sensor Data Heterogeneity
Questionnaire Data
Electronic Medical
Records
Gene
Lab Test Wearables and Sensors
To enable the proper interpretation of data and for determining remediation measures,
it is essential to convert the data into abstractions ignoring inessential differences and
providing an integrated view for the clinician to take action
Hyperthyroidism
Elevated
Blood
Pressure
Systolic blood pressure of 150
mmHg
“150”
..
.
..
.
Too much data does not help make timely decisions =>
Contextual Interpretation and Sensor Data Abstraction
Personalized Health and Objectives: one size does not fit all
Millions of people - > one treatment
Wearable and Sensor data
2222
ACTIONS
situation awareness useful
for decision making
Converting data to actions
Hyperthyroidism
Elevated
Blood
Pressure
Systolic blood pressure of 150
mmHg
“15
0”
..
.
..
.
ABSTRACTIONS
make sense to humans
KNOWLEDGE
for interpretation of
observations
Contextualization
Personalization
DATA
Observations from
machine and social
sensors
Kno.e.sis’ kHealth initiative follows this
approach -- currently for asthma in children,
bariatric surgery, ...
23
• Asthma Management in Children
• Bariatrics Surgery for Obese Adults
• Pain Management
kHealth Personalized Digital Health Initiative
kHealth Asthma Management
25
kHealth: Health Signal Processing Architecture
Personal
level Signals
Public level
Signals
Population
level Signals
Domain
Knowledge
Risk Model
Events from Social
streams
Take Medication before
going to work
Avoid going out in the
evening due to high pollen
levels
Contact doctor
Analysis
Personalized
Actionable
Information
Data Acquisition
& aggregation
26
26Asthma Domain Knowledge
Domain
Knowledge
ICS= inhaled corticosteroid, LABA = inhaled long-acting beta2-agonist, SABA= inhaled short-acting beta2-
agonist ;
*consider referral to specialist
Asthma Control and Actionable Information
Asthma Control
Daily Medication
choices for
stating therapy Not Well Controlled
Poor Controlled
Severity Level of
Asthma
Intermittent Asthma
Mild Persistent Asthma
Moderate Persistent Asthma
Severe Persistent Asthma
Recommended Action Recommended Action Recommended Action
SABA prn
Low dose ICS
Medium ICS alone or
with LABA/Montelukast
High dose
LABA/Montelukast
Medium ICS
Medium ICS +
LABA/ Montelukast or
High Dose ICS
Need specialist care
Medium ICS
Medium ICS +
LABA/ Montelukast or
High Dose ICS
Need specialist care
27
Sensordrone – for monitoring
environmental air quality
Wheezometer – for
monitoring
wheezing sounds
Can I reduce my asthma
attacks at night?
What are the triggers?
What is the wheezing level?
What is the propensity
toward asthma?
What is the exposure level
over a day?
Commute to work
Decision Support for Doctors and Patients: A Scenario
Luminosity
CO
level
CO in gush
during day
time Actionable
Information
Personal level
Signals
Public level
Signals
Population
level Signals
What is the air quality indoors?
Close the window at home
during day to avoid CO2
inflow, to avoid asthma
attacks at night
28
k-Health Dashboard: A Platform to Visually Analyse to find
Correlations (e.g., Patient Symptoms and Personalized Data)
Multimodal Data Streams & Anonymised Patient Data Visualized for Correlation Analysis
interpreted in with the help of knowledge graph (relevant medical knowledge)
29
Activity limitation observed with high pollen activity
30
Low exhaled nitric oxide observed with absence of coughing
31
Medication use possibly leading to decreasing exhaled nitric oxide
32
Activity Limitation is likely related to high exhaled nitric oxide
33
Computing Predictors
Medications
Activity
Temperature
Humidity
Pollen
Air Quality
Spirometry
Outdoor, Indoor & Medical
(Predictors)
Logistic
Regression
Model
[Ax1+Bx2+Cx3…..]
Weights
Computed
Cough
Cough
Symptoms
Outcome Prediction
34
34
Risk
assessment
model
Semantic
Perception
Personal level
Signals
Public level
Signals
Domain
Knowledge
Population
level Signals
GREEN -- Well Controlled
YELLOW – Not well controlled
Red -- poor controlled
How controlled is my asthma?
Patient Health Score (Diagnostic)
35
35
Risk
assessment
model
Semantic
Perception
Personal level
Signals
Public level
Signals
Domain
Knowledge
Population
level Signals
How vulnerable* is my control level today?
Patient Health Score (Prognostic)
kHealth Bariatrics
The purpose of our research is to determine if monitoring Bariatric patient’s pre- and postoperative
compliance with active and passive sensors can bolster bariatric patient’s progress and lessen
weight recidivism
● 500 million people all over the world are obesity
● 36% of the adults in the United States suffer from obesity
● 65% of the world’s population lives in countries where the occurrence of death
due to overweight and obesity is higher than being underweight
Obesity
● Chances of regaining weight as stomach can still expand after surgery
● Continuous monitoring of the patients by the surgeon is very essential
Bariatric Surgery
Challenges Post-Bariatric Surgery
● Patient acceptance and active participation involving continuous
monitoring of the patient
● Cost and reimbursement models
● Challenging research in understanding of variety of data over long period
A system that can
● monitor the patient continuously and remotely
● identify non-compliance before and after surgery
● nudge/assist for better compliance for improved outcomes and reduce
recidivism
Post-Bariatric Surgery Solution
kHealth Post-Bariatric Surgery Proposed Method
Aggregate the data collected from the sensors, questionnaires and use artificial
intelligence techniques to:
● analyse and predict the deviations that could cause the post surgical
complications and,
● serve as an assistant leading to better patient-compliance and outcomes
kHealth Bariatrics: Kit
43
43
How do we solve problems with real world complexity, gather vast
amount of data, diverse knowledge……. and come up with
intelligent decisions that works for an individual at a given time?
next: a pedagogical take
Semantic Perceptual Cognitive computing
Interplay between Semantic, Cognitive and Perceptual Computing (SC, CC and PC) with examples
Related videos, papers, slides via: http://knoesis.org/vision
Semantic Perceptual Cognitive computing in two use cases:
Asthma and Traffic Management
46
Thank you
Thank you, and please visit us at
http://knoesis.org
For more information on kHealth, please visit us at
http://knoesis.org/projects/khealth
Cognitive
Computing
Semantic
Computing
Perceptual
Computing
Contributors and collaborators for this talk:
Pramod
Anantharam
Cory
Henson
Dr. T.K.
Prasad
Sanjaya
Wijeratne
Utkarshani
Jaimini
Ohio Center of Excellence in Knowledge-enabled Computing
Wright State University

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Augmented Personalized Healthcare with IoT and AI

  • 1. Augmented Personalized Healthcare How Smart Data with IoTs and AI is about to change Healthcare Invited Talk @ Big Data Integration and IoT for Smart Health Care, 3rd Intl Forum on Research and Technologies for Society and Industry Modena Italy, 13 September 2017 Prof. Amit Sheth LexisNexis Ohio Eminent Scholar; Executive Director, Kno.e.sis Wright State University Background: http://bit.ly/k-APH, http://bit.ly/kAsthma, http://j.mp/PARCtalk,
  • 2. 2 • Traditional Healthcare • Healthcare: Then and Now • Augmented Personalized Health for health care of the future, and associated technical challenges • kHealth: Three ongoing applications Outline
  • 3. 3 Traditional Healthcare How are you feeling today?I am not feeling well since yesterday afternoon.
  • 4. 4 Healthcare: Then and Now Episodic Continuous
  • 5. 5 Healthcare: Then and Now Disease focussed Beyond medical intervention: Lifestyle change/holistic, Wellness, Quality of Life
  • 6. 6 Healthcare: Then and Now Clinic centric Patient centric (Anywhere the patient is)
  • 7. 7 Healthcare: Then and Now Clinician control Patient empowered
  • 8. 8 Healthcare: Then and Now Limited data 360 degree multimodal ● Personal-Public-Population ● Physical-Cyber-Social big data driven
  • 9. The Patient of the Future MIT Technology Review, 2012 http://www.technologyreview.com/featuredstory/426968/the-patient-of-the-future/9 Patients are increasingly taking control of own health Patient Generated Health Data (PGHD) are “health-related data created, recorded, or gathered by or from patients (or family members or other caregivers) to help address a health concern. PGHD include, but are not limited to health history, treatment history, biometric data, symptoms, and lifestyle choices.” Office of the National Coordinator for Health Information Technology (ONC).
  • 11. AIM: Doctor in a self-driving Car [Image: courtesy Artefac, https://flipboard.com/@flipboard/-who-needs-a-hospital-when-this-self-dri/f-4204314e11%2Ffastcodesign.com t]
  • 12. 12 Converting big data into smart data through contextual and personalized processing such that patient and clinician can make better decisions and take timely actions for Augmented Personalized Health Future Health Care
  • 13. 13 Augmented Personalized Healthcare (APH) is expected to enhance healthcare by personalizing the use of all relevant Physical, Cyber, and Social data obtained from wearables, sensors and Internet of Things, mobile applications, electronic medical records, web-based information, and social media for better health for an individual. Data include traditional clinical data, PGHD and public health data, as well as environmental and social data that could impact an individual’s health. Augmented Personalized Healthcare
  • 15. 15 Providing actionable information in a timely manner is crucial to avoid information overload or fatigue Sleep data Community dataPersonal Schedule Activity data Personal health records Data Overload for Patients/health aficionados
  • 16. 16 Challenges in deriving actionable insights from Sensor Data According to Forbes, the wearables market exceeded $2 billion in 2015, 3 billion in 2016 and will be over 4 billion in 2017. Leading to vast volume of healthcare data: some key issues ● Sensor reliability and Quality ● Sensor data Heterogeneity ● Contextual Interpretation and Abstraction ● Personalized Health and Health Objective https://www.linkedin.com/pulse/digital-health-why-doctors-should-care-doug-hart
  • 17. 17 Sensor Data Reliability and Quality 1.https://wq.io/media/images/quality-large.png, 2https://readwrite.com/2017/05/26/study-wearables-counting-calories-dl4/, 3.https://www.wsj.com/articles/smartphones-open-a-new-world-for-medical-researchers-1498442821 ● Consumer graded devices can be terrible and inaccurate [2] ● Is data generated from them useful for health application? ● Research shows they can be effective for health applications [3]
  • 18. 18 Is sensor data useful for Health Decision making?
  • 19. 19 Sensor Data Heterogeneity Questionnaire Data Electronic Medical Records Gene Lab Test Wearables and Sensors To enable the proper interpretation of data and for determining remediation measures, it is essential to convert the data into abstractions ignoring inessential differences and providing an integrated view for the clinician to take action
  • 20. Hyperthyroidism Elevated Blood Pressure Systolic blood pressure of 150 mmHg “150” .. . .. . Too much data does not help make timely decisions => Contextual Interpretation and Sensor Data Abstraction
  • 21. Personalized Health and Objectives: one size does not fit all Millions of people - > one treatment Wearable and Sensor data
  • 22. 2222 ACTIONS situation awareness useful for decision making Converting data to actions Hyperthyroidism Elevated Blood Pressure Systolic blood pressure of 150 mmHg “15 0” .. . .. . ABSTRACTIONS make sense to humans KNOWLEDGE for interpretation of observations Contextualization Personalization DATA Observations from machine and social sensors Kno.e.sis’ kHealth initiative follows this approach -- currently for asthma in children, bariatric surgery, ...
  • 23. 23 • Asthma Management in Children • Bariatrics Surgery for Obese Adults • Pain Management kHealth Personalized Digital Health Initiative
  • 25. 25 kHealth: Health Signal Processing Architecture Personal level Signals Public level Signals Population level Signals Domain Knowledge Risk Model Events from Social streams Take Medication before going to work Avoid going out in the evening due to high pollen levels Contact doctor Analysis Personalized Actionable Information Data Acquisition & aggregation
  • 26. 26 26Asthma Domain Knowledge Domain Knowledge ICS= inhaled corticosteroid, LABA = inhaled long-acting beta2-agonist, SABA= inhaled short-acting beta2- agonist ; *consider referral to specialist Asthma Control and Actionable Information Asthma Control Daily Medication choices for stating therapy Not Well Controlled Poor Controlled Severity Level of Asthma Intermittent Asthma Mild Persistent Asthma Moderate Persistent Asthma Severe Persistent Asthma Recommended Action Recommended Action Recommended Action SABA prn Low dose ICS Medium ICS alone or with LABA/Montelukast High dose LABA/Montelukast Medium ICS Medium ICS + LABA/ Montelukast or High Dose ICS Need specialist care Medium ICS Medium ICS + LABA/ Montelukast or High Dose ICS Need specialist care
  • 27. 27 Sensordrone – for monitoring environmental air quality Wheezometer – for monitoring wheezing sounds Can I reduce my asthma attacks at night? What are the triggers? What is the wheezing level? What is the propensity toward asthma? What is the exposure level over a day? Commute to work Decision Support for Doctors and Patients: A Scenario Luminosity CO level CO in gush during day time Actionable Information Personal level Signals Public level Signals Population level Signals What is the air quality indoors? Close the window at home during day to avoid CO2 inflow, to avoid asthma attacks at night
  • 28. 28 k-Health Dashboard: A Platform to Visually Analyse to find Correlations (e.g., Patient Symptoms and Personalized Data) Multimodal Data Streams & Anonymised Patient Data Visualized for Correlation Analysis interpreted in with the help of knowledge graph (relevant medical knowledge)
  • 29. 29 Activity limitation observed with high pollen activity
  • 30. 30 Low exhaled nitric oxide observed with absence of coughing
  • 31. 31 Medication use possibly leading to decreasing exhaled nitric oxide
  • 32. 32 Activity Limitation is likely related to high exhaled nitric oxide
  • 33. 33 Computing Predictors Medications Activity Temperature Humidity Pollen Air Quality Spirometry Outdoor, Indoor & Medical (Predictors) Logistic Regression Model [Ax1+Bx2+Cx3…..] Weights Computed Cough Cough Symptoms Outcome Prediction
  • 34. 34 34 Risk assessment model Semantic Perception Personal level Signals Public level Signals Domain Knowledge Population level Signals GREEN -- Well Controlled YELLOW – Not well controlled Red -- poor controlled How controlled is my asthma? Patient Health Score (Diagnostic)
  • 35. 35 35 Risk assessment model Semantic Perception Personal level Signals Public level Signals Domain Knowledge Population level Signals How vulnerable* is my control level today? Patient Health Score (Prognostic)
  • 36. kHealth Bariatrics The purpose of our research is to determine if monitoring Bariatric patient’s pre- and postoperative compliance with active and passive sensors can bolster bariatric patient’s progress and lessen weight recidivism
  • 37. ● 500 million people all over the world are obesity ● 36% of the adults in the United States suffer from obesity ● 65% of the world’s population lives in countries where the occurrence of death due to overweight and obesity is higher than being underweight Obesity
  • 38. ● Chances of regaining weight as stomach can still expand after surgery ● Continuous monitoring of the patients by the surgeon is very essential Bariatric Surgery
  • 39. Challenges Post-Bariatric Surgery ● Patient acceptance and active participation involving continuous monitoring of the patient ● Cost and reimbursement models ● Challenging research in understanding of variety of data over long period
  • 40. A system that can ● monitor the patient continuously and remotely ● identify non-compliance before and after surgery ● nudge/assist for better compliance for improved outcomes and reduce recidivism Post-Bariatric Surgery Solution
  • 41. kHealth Post-Bariatric Surgery Proposed Method Aggregate the data collected from the sensors, questionnaires and use artificial intelligence techniques to: ● analyse and predict the deviations that could cause the post surgical complications and, ● serve as an assistant leading to better patient-compliance and outcomes
  • 43. 43 43 How do we solve problems with real world complexity, gather vast amount of data, diverse knowledge……. and come up with intelligent decisions that works for an individual at a given time? next: a pedagogical take
  • 45. Interplay between Semantic, Cognitive and Perceptual Computing (SC, CC and PC) with examples Related videos, papers, slides via: http://knoesis.org/vision Semantic Perceptual Cognitive computing in two use cases: Asthma and Traffic Management
  • 46. 46 Thank you Thank you, and please visit us at http://knoesis.org For more information on kHealth, please visit us at http://knoesis.org/projects/khealth Cognitive Computing Semantic Computing Perceptual Computing Contributors and collaborators for this talk: Pramod Anantharam Cory Henson Dr. T.K. Prasad Sanjaya Wijeratne Utkarshani Jaimini
  • 47. Ohio Center of Excellence in Knowledge-enabled Computing Wright State University