diy (health) care
TRANSCRIPT
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D I Y ( H e a l t h )
C a r e
Se l f he l p t e c hno l og i e s
Peter Cochranecochrane.org.uk
ca-global.biz
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• All countries and systems are struggling
• There are no ideal systems or solutions
• We have no common metrics to judge
• Political twiddling is not the way
• Patient expectation is on the up
• Technology is accelerating
• Rapid change the norm
Healthcare RealityThroughout the first world death is now seen as an unnatural act
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PerspectiveU S A S p e n d w e l l o v e r d o u b l e t h e U K £ £ / c a p i t a a n d t h e i r s y s t e m i s a l s o f a i l i n g - s o
a r e a l l h e a l t h s y s t e m s a c ro s s t h e d e v e l o p e d
w o r l d
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more of the same ?No matter how big the ££ investment we will only see a drawn out failure!
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Three mode strategyHealthy l iving; self monitor ing; early problem detection and action…
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Sudden Death
Terminal Illness
Organ Failure
Frailty Long Term Decline
Func
tiona
lity
Increasing Lifespan
Productive Years
Failure and Dependency
Models Work New Model(s) Required
HYPOTHESIST h e c h a n g i n g h e a l t h c a r e l a n d s c a p e
1940 1950 1960 1970 1980 1990 2000 2010 2020
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PrognosisHospitalPrime Centre of Expertise & Capability
Medical CentrePrime Point of Local Capability
Home BasedMeasurementsMonitoringMedication
Technology Push - Patient Pull
D o I t F o r M e t o D I Y - S e l f H e l p
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Most of us wi l l need some form of help at some t imethe end game
•Infirmity isn’t something we choose
•Independence is easily lost
•Ageing is not an option
•C o g n i t i o n c a n f a d e
•Offsets often possible
•Se l f he lp i s ours
•NHS the backstop
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Ever yone i s d i f ferent and un ique
One size does not fit all:
• Age• Health• Wealth• F a m i l y• F r i ends• Hous ing• Locat ion• Education
variance
Customisation is
Key
Technology can provide many more
Options
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Self sufficiency in everything possible is the
new norm powered by low cost and
increasingly capable/available IT,
Sensors, Mobility and Networks
connecting peoples, things and
information across the planet
with national, international and
local control losing their grip!
key Trend Mov i n g f rom ‘Do I t Fo r Me ’ t o D I Y
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A key TrendI t ’ s a l l a b o u t m e a n d m y l i f e
•Focussed/customised markets for everything
•The death of institutionalisation
•The rise of self determinism
•I’ll do it my way
•Designer drugs
•Designer care
•Self help first
•Deniable ageing
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H e a l t h S y s t e m s a r e n o t : - u n d e r f u n d e d - u n d e r s t a f f e d
HYPOTHESIS
H e a l t h S y s t e m s a r e :
1940/50s thinking won’t work in the 21st Century
- p o l i t i c a l f o o t b a l l s - t h e w r o n g m o d e l
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hold this thought ! Ever y th ing f ree a t the
po int of f need i s now
fundamentally impossible!
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TECHNOLOGYWhat i s on o f fe r - what i s f eas ib l e
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FUTure
5 10 1
5 20 25 30
Y e a r s
Everything in design/engineering phase visible and known
~ 50% is known & 50% a good guessGuessing and dreaming
Dreaming no dreamingThis slide set
T e c h n o l o g i e softhe
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B y i n f o r m a t i o n g r o w t hovertaken
Medical Knowledge Half <4 years
G r a d u a t e d y e s t e r d a y ~50% o f expert i se wrong !
N o c h a n c e o f c a t c h i n g u p l e t a l o n e k e e p i n g u p t o d a t e !
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outmodedB o o k s o u t o f d a t e / w r o n g I T t o o s l o w a n d c l u m s y
Abi l i ty to so lve prob lems outguns ability to remember or pure academic prowess
Every profession is suffering the same fate….
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The march of the machines…we need workable partnerships !
symbiosis
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computersH u m a n s o v e r t a ke n b y m a c h i n e s
Ches s 1997 Comp lex i t y 2000 Gene ra l Know ledge 2011 Med i ca l Know ledge 2012 Open AP I a va i l ab l e 2013 Open Pub l i c C l oud acce s s 2014
I ndu s t r i a l p roce s s con t ro lI n fo rma t ion managemen tNetwork managemen tI n fo rma t ion s to r a geI n fo rma t ion s e a rchC h e m i c a l a n a l y s i sS y s t em mode l l i n gP roce s s con t ro lComput a t i on
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medicineD i a g n o s t i c s
S u p e r i o r h u m a n d i a g n o s i s capability demonstrated in 2012
USA medical trials underway since 2013
Now gaining experience whilst gathering more information and knowledge
Greater ‘bandwidth’ and lower error rate than any human doctor
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REpair & Replace
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printed
H i g h p r e c i s i o n , g r e a t e r success rate, better quality, lower cost
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Trachea
Vertebral DiscInjection Molded
Breathing Lung
printed & programmedNew for old for everything…almost !
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...many die through secondary infections...
BURNSI n t e n s i v e c a r e d emand
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RAPID HEALS p r a y O n s t e m c e l l t r e a t m e n t s
Some patients are fully healed within a week or two with very close to normal skin !
Still being perfected and not generally available, but there is at least an ‘existence theorem’
Sav ings and outcomes ver y pos i t ive and rap id ly moves people out of ‘care’
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SENSORS
More sensitive than a dogs nose
Able to detect some cancers
Able to detect many human conditions very early
Sparking a diagnostic revolution
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GENOMIC PROFILING…in the doctors office will revolutionise medicine
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science fictionC o n t a c t l e s s , i m m e d i a t e a n d a c c u r a t e d i a g n o s i s
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REALITYComing to a store near you…
E a r l i e r d i a g n o s i s , f a s t e r treatment, impact offset, fewer people needing short and long term care
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magnificationM o v e m e n t , c o l o u r , t e m p e r a t u r e , s c a l e
I n t h e f u t u r e j u s t a p p s t o d o w n l o a d f o r y o u r m o b i l e
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DIY care?S e n s o r t e c h n o l o g i e s a v a i l a b l e t o a l l … Many low cost and affordable devices
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DIY care?Even more low cost and free apps…
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Device to PRODUCTMonitoring the in:out and effect…
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records?T h e y a r e m i n e a n d n o t y o u r s … Archaic and unworkable !
Protecting the system or helping the patient ?
Lost/in the wrong place 20 - 24% of the time
∂Cannot be searched orcorrelated in any way
∂
Electronic solutions are very simple, but not when they are managed by committees with no IT understanding !
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So simple!S o s e c u r e , a v a i l a b l e , b a c ke d u p
M e m o r y s t i c k o r
m o b i l eo r p a dD a t a s t o r e d b y p a t i e n t ,
D o c t o r, N u r s e , C a r e rH o s p i t a l … e a s y t o m a k e a v a i l a b l e ,u n d e r s t a n d ,a n d v e r yl o w c o s t
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DIY care?Connecting to the world of everything… TV
HBORadioMusicYouTubeSocial NetsCommunities
CommunicationsConferencingEmployment
EducationShopping
+++
Mechanical Armand Holster £250
Tablet£200 - £400E a s y t o
d e s i g n , b u i l d ,c o m m i s s i o n -a n o t h e r D I Yp r o j e c t !
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Signing to VoiceDevelopment advanced to be deployed very shortly
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voice to signingDevelopment advanced to be deployed very shortly
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mind controlDevelopment advanced and to be deployed v e r y s h o r t l y
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Tremors And many o t h e r i n c apa c i t i e s…
B e i n g ‘ r e p a i re d ’ b y e l e c t ro n i c i m p l a n t s a k a hea r t , b re a th i n g & o the r s t imu l a to r s
Cost o f repa i r << Cos t o f ca re
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Intel l igent prosthetics avai lable nowsymbiosis
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symbiosisExo-Skeletons are being c o m m e r c i a l i s e d f o r upper, lower and ful l body adoption
Musc le magnifiersfor the ful ly
able
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Those that can, ‘DO’,
a n d t h o s e w h o
refuse to try are left
behind !
isolation reducing Video conferencing, social nets , self help groups…
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not rocket science ! It really is child’s play and anyone can master IT and the world of apps
Feedback is vital in any effort to stay fit and healthy, not to mention long or short term recovery and rehabilitation
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getting up to speed V i t a l du r i ng a t ime o f good phy s i ca l & men ta l hea l t h
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too late ? We (can?) might
offset or at least
de lay the end
game through the
use of hi-tech and
self help early on
in the life cycle
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outsidersT h e r e a r e a l w a y s t h e d i s a d v a n t a g e d
• The obstinate
• The uneducated
• Those refusing to try
• The mentally challenged **
• The physically challenged **
• Those with an apparent ‘death wish’
** these groups can mostly be helped…
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Who Pays ? D e f i n i t e l y N OT 1 0 0 % . G o v !
Health/Care technology and Apps are extremely low price and
available for all platforms from laptop and tablet to mobile
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think anew !
Adopt a ‘younger’ mind set and be prepared to change,
to try the new, to experiment…
We have no cho ice and i t i s not at a l l easy
Sometimes we have to wait for a generation to die before change on a large scale is possible…but in this case we do not enjoy that luxury !!
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UK Private
✓✓✓
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✓✓
✓✓
✓✓
✓✓ ✓
✓ ✓✓
✓✓✓
✓
TXTwwwpage
videocalls
patientaccess
medicalpapers
socialnetseMailmobilefixed
comms channelsDirect connect to med ica l profess iona l beyond recept ion
✓ ✓
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Every industry and sector is in the same boat
We are all struggling with accelerating change
Growing complexity is confounding everyone
Big organisations are hampered by their size
There are no simple solutions or quick fixes
Technology is the pr imary dr iver/solution
Mass markets have become individualised
Growing populations are the challenge
Rising expectations now the norm
perspective
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ChangeT h e n e w s t a b l e s t a t ef o r a l l o r g a n i s a t i o n sa n d s o c i e t y …… a n d i t i s a c c e l e r a t i n g , k i l l i n g c e n t r a l i s a t i o n , e m p o w e r i n g t h e i n d i v i d u a l , m a k i n g u s a l l f a r m o r e c a p a b l e a n d p o w e r f u l …
… a n d w e h av e t o a s s u m e n e w r e s p o n s i b i l i t i e s a c ro s s t h e b o a r d … .
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W H O C a r e s ?
Se l f he l p t e c hno l og i e s
Peter Cochranecochrane.org.uk
ca-global.biz
So, Who Cares ?Most, effectively, best, longest, strongest…
We do !
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What we know for sure....In the next phase the winning companies and countries
will have taken risks, and dared to be different...
...very different...
THE FutureBe l o n g s t o t h o s e who da re t o c hange
…and the most adaptable!
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It really is up to us !!
Thank You COCHRANE a s s o c i a t e s
1995
ca-global.orgcochrane.org.uk