mc thinkcamp mhealth june 3 2011
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Brought to you by the Mobile Collective, with the support of the ICT KTN, the CI KTN, and the Mobile Applications Centre at Imperial College.Featuring: Patients Know Best, Wellnote, Epicollect, & MoDiSeTRANSCRIPT
MC ThinkCamp – mHealth June 3rd, 2011
( #tcmh )
Where do ideas for mHealth innovation come from?
Saying ‘I Wish’
Seeing New Patterns
Doing a bit of Mix’n’Mash
Doing a bit of Drag’n’Drop
Playing Leapfrog
Disruption: new authority figures
Disruption: overshot customers
First Speaker: Dr Mohammed Al-Ubaydli
In 2008, Mohammed founded Patients Know Best, a website that gives patients online access to their medical data. Mohammad has over 15 years of experience in medical software. He trained as a physician at the University of Cambridge; worked as a staff scientist at the National Institutes of Health; and was a management consultant to US hospitals at The Advisory Board Company. Patients Know Best was featured in Wired magazine’s March 2011 issue.
Patient-controlled records Dr Mohammad Al-Ubaydli
Women’s suffrage over time
Source: h*p://en.wikipedia.org/wiki/Timeline_of_women's_suffrage
Women’s suffrage over time
Professionals objecting to patient control are like Swiss men objecting to women voting in 1971: wealthy, civilized, eloquent… and on the wrong side of history
Trained as physician at the University of Cambridge.
Trained as programmer and worked as NIH Staff Scientist.
Honourary Senior Research Associate, UCL Medical School.
Continuing research on PHRs from 2,700 US hospitals, new book in 2010: book.patientsknowbest.com
A bit about me…
Our customers
Use our platform to save money from shared workflow
1. Thalidomide Trust / Imperial College hospital wanted us for online consultations
2. Great Ormond Street hospital wanted us for home health care electronic prescribing
3. More clinicians joining every day as patients invite them to
We can do what Microsoft, Google and the NHS cannot do
We will put patients in charge of making decisions about their care, including control of their health records
The Coalition:our programme for government, Cabinet Office, 2010. http://programmeforgovernment.hmg.gov.uk/nhs
PKB is the only option for patient-controlled medical records
GP surgeries and private clinics conduct online consultations
Great Ormond Street Hospital and home health care providers
Detailed explanations for patient save clinician’s time
1. Basics: definitions, and why do this at all? 2. Today: letting go of assumptions
3. Tomorrow: embracing possibilities
Roadmap
Some definitions
Patient portals
Clinicians
Electronic patient records Personal health
records Personal records
Patient
Patient portals
Clinicians
Electronic patient records Personal health
records Personal records
Patient
Data by clinicians for clinicians
Some definitions
Patient portals
Clinicians
Electronic patient records Personal health
records Personal records
Patient
Easing the patient’s burden
Scheduling appointments
Ordering medication refills
Secure messaging
Access to the EPR
See: Pyer et. al 2004, Ralston et. al 2007.
Some definitions
Patient portals
Clinicians
Electronic patient records Personal health
records Personal records
Patient
NHSmail users have mailbox shrunk 06 Feb 2008
NHS staff who use the health service’s email service NHSmail have been informed that after a recent move to Microsoft Exchange their mailbox size has been capped.
Some 80% of NHS accounts have been capped at just 200Mb, which appears miserly compared with the hefty 6Gb offered by Gmail for free, or the 5Gb offered for free on Windows Live Hotmail.
Data by patient for patient Powerful but unstructured
Some definitions
Patient portals
Clinicians
Electronic patient records Personal health
records Personal records
Patient
Markle Foundation’s ideal PHR:
Access controlled by patient
Lifelong records
Information from all
Universal access
Private and secure
Transparent
Easy exchange
See: Connecting for Health, 2004
Some definitions
Roadmap
1. Basics: definitions, and why do this at all?
2. Today: letting go of assumptions 3. Tomorrow: embracing possibilities
Patient-held records already here
Some parts of some health systems have already had them
In continental Europe and much of developing world, this is the norm
UK private health care, and US fragmented care, patients end up doing this anyway
NHS maternal notes and child personal health record use the patient to cross silos
Distribution is arbitrary, but users assume otherwise
Conflict is gone
Discomfort clinicians feel is due to limitations of paper
Piece of paper cannot be in two places at the same time
Transporting paper takes time and money
Clinicians do not feel safe unless they hold the only copy of the paper
Digital records eliminate the conflict
Patient-controlled records awesome
This is the only way to bridge the silos
Within “integrated” systems like NHS and Kaiser Permanente, clinicians do not talk to each other across community and hospitals
Within single institution e.g. hospital, clinicians do not talk to each other across departments
Within same department, clinicians do not talk to each other across specialities
The patient is the only person who turns up to all the appointments, so give them the records
Patients should manage their clinicians
Unique patients require truly patient-centred care
In a rare chronic disease, the patient knows more than most of the clinicians they meet
There are 30 million people with rare diseases in Western Europe and the USA
But even patients with common diseases have unique combinations of diseases and circumstances
Every patient is unique
Roadmap
1. Basics: definitions, and why do this at all?
2. Today: letting go of assumptions
3. Tomorrow: embracing possibilities
Patients with HIV publishing all notes
Patients use (much) better tools than you
Pa>ents use (much) be*er tools than you
Patients have better genetics tools than 99% of clinicians do (or ever will)
Patients will collect data you never knew
Useful web sites
Patients Like Me for HIV: patientslikeme.com
23andMe for genetic sequencing: 23andme.com
RelifeInSite for pain documentation: reliefinsite.com
Lifepsychol for monitor quality of life: lifepsychol.com
Personal health records: A guide for clinicians Al-Ubaydli, 2011, John Wiley & Sons
http://book.patientsknowbest.com
Patients will collect data you never knew
Patient-reported outcomes / observations / information
Patient-controlled records as a research tool
Patient-reported outcomes on each consultation
Patient-reported observations on data that had never previously been collected in medical records
Patient-reported information through sentiment analysis of diaries
Thank you for listening
Mohammad Al-Ubaydli Patients Know Best [email protected] www.patientsknowbest.com
First Demo: Dr Henry Lee
Henry Lee is training as a Surgeon in London and studied medicine at the University of Wales College of Medicine. He holds an academic post at Imperial College London and is researching the way that measure of wellbeing can be used for policy purposes.
Second Demo: Dr David Aanensen
David Aanensen is a bioinformatician in the School of Public Health, Imperial College London. His research focus is on the use and development of web applications for infectious disease microbiology.
EpiCollect
Dr David Aanensen Dept. Infec>ous Disease Epidemiology
Imperial College London
Batrachochytrium dendroba1dis (Bd)
Tracking Animal disease
Bd-‐Maps
• Bd is a fungal pathogen causing wide-‐spread amphibian mortality.
• Demands colla>on of cases of disease.
• Communi>es of scien>sts submit data.
h*p://www.bd-‐maps.net
• GPS – ‘loca>on aware’ • Cameras for s>lls or videos
• Keyboards for text entry • Data transfer to / from
central databases.
EpiCollect -‐ Smartphones for data collec>on
Aanensen et al (2009) PLoS ONE 4(9): e6968
• Generic issue – mobile data collec>on
• Any projects where centralising textual data along with GPS and / or photos/media from many different people, from many different places, would be useful.
h*p://www.epicollect.net
Mobile phone app (Android and iPhone) and web applica>on for data colla>on.
Free and open source
h*p://www.epicollect.net
Create a Project website at EpiCollect.net
Design a form for data collec>on
Load Project into the EpiCollect mobile app and collect data, including GPS posi>on and photo
View data collected at your project website or on your phone (download, view on maps/charts, filter.)
h*p://www.epicollect.net
Ci>zen data collec>on
• Yellowstone na>onal Park • 3,472 sq m visited by thousands of people each year.
• Currently undertaking projects to allow members of the public to aid researchers in iden>fica>on and mapping of invasive plant species.
Archaeological dig sites
Replacing paper forms for linking and mapping areas of dig sites.
Dig sites across Europe
Pre – major building works
Street art*
• Categorised by type – eg posters, s>ckers, stencils etc.
*Disclaimer: probably not to be encouraged…
Animal Health surveillance in Kenya / Tanzania
Ongoing monitoring of: East Coast Fever; anthrax and rabies; FMD Gabriel Turasha (Vetaid Tanzania) Nick Short (RVC) and Niall Winters(IOE)
Maasai vets Carry out Disease Surveillance of 86,000 animals with Google Mobile phones
• No reliance on data networks for collec>on.
• Data can be sent to any server.
• Two-‐way data transfer
• Simple XML descrip>on of project forms and for defini>on of server loca>ons.
Acknowledgements
• Dr Derek Huntley, Jon Evans, Chris Powell, Prof. Brian Spra*
Funded by:
Second Speaker: Dr Adesina Iluyemi
Adesina is an executive board member and a co-chair of the Global Health Commission of the NEPAD Council, a non-profit organization. His expertise lies in mHealth and Telemedicine innovation and policy development. He has in the past collaborated with influential international multilateral, organizations such as the WHO, UN, ITU, and the Commonwealth Secretariat. He is a Fellow and Council member Telemed & eHealth Section of the RSM England, and a co-founder and executive director of MODISE; an initiative working to bring low-cost connected mobile diagnostics to developing countries.
mHealth Developing Countries: Past, Present & Future
Introducing MoDiSe
Dr Adesina Iluyemi DDPH RCS (Eng) Vice President &Co-‐ Founder
MoDiSe [email protected] www.modise.org
Sustainable Serendipitous Situated
An Overview
USERS CASES CITIZENS (Consumers, Patients) Call Centre models
TeleDoc, Pakistan COMMUNITY (Population) SMS Casting Model
Masiluleke, South Africa CLINICIANS (Health Workers) Mobile Telemedicine, Botswana
CENTRES ( Facilities) Mobile Microscopy e.g LUCAS
Source: Author
• Need to move Beyond SMS!
• Clinicians & Centres offer be*er Commercial Opportuni>es
Sustainable Serendipitous Situated
Voice & SMS, few Data Apps
Page 96
Cell-‐Life
Sustainable Serendipitous Situated
Health Workers using PDAs
Page 97 Sustainable Serendipitous Situated
PDA to Smartphone
GSMA
Simputer
Sustainable Serendipitous Situated
Mobile + Medical Renaissance
• Teleradiology • Remote Imaging • Laboratory Detec>on • Clinical Diagnosis • Rural Healthcare • Emergency Medicine • Pandemics
• Epidemics • Point of Care Diagnos>cs
OPPORTUNITY FOR LOW-‐COST INOVATIONS IN DEVELOPING COUNTRIES Sustainable Serendipitous Situated
Medical Innovations 1
• Medical Devices/Mobile Microscopy e.g LUCAS, CellScope
• Assis>ve Technology? e.g NETRA for remote eye examina>on
• Mobile EHR e.g mGEOs with geotagging and web-‐interface
UCLA 2009
Sustainable Serendipitous Situated
Medical Innova>on 2
• Mobile Telemedicine e.g Click Diagnos>cs for skin & oral lesions and cervical screening in Botswana
• Real Pa>ent Monitoring e.g A pilot with a Private Hospital in Nigeria
• Medical Apps e.g Moodle4iPhone pilots using Android & iPhonein Peru
Sustainable Serendipitous Situated
Introducing MoDiSe MISSION: Collaborate with private sector innovators / biotechnology researchers and local entrepreneurs to facilitate the development of Point of Care tools to prevent, diagnose and treat neglected tropical and non-communicable diseases in the developing world-
www.modise.org Non-for-Profit Organization in Canada
Sustainable Serendipitous Situated
MoDiSe: Our Strategy
6/7/11 MoDiSe
Mobile Diagnos>cs for Global Health
h*p://www.modise.org
Sustainable Serendipitous Situated
MoDiSe: Our Concept
6/7/11
MoDiSe Sustainable Serendipitous Situated
Acknowledgements 1. Mobile Healthcare Industry Summit
2. CHMI, University of Portsmouth 3. NEPAD Council
Sustainable Serendipitous Situated
ThinkCamp was brought to you by: We are an ‘idea-to-launch’ community platform for the collaborative development of mobile applications, products & services across many industries. (More than just apps – think personal mobility services, mHealth applications, SIM-card embedded devices, sensory data meets cloud computing, and SMS-based solutions in the developing world).
We bring the mobile developer & designer community together with members of professional communities, such as healthcare; facilitate the sharing of experiences, insights and skills; and provide a structure for developing and acting on the innovative ideas that emerge. We do this by running a series of ThinkCamp events which take a collaborative approach to generating and developing good ideas. Adhoc teams which form around the ideas are supported & nurtured by a wide range of participating technologists, field experts and market channel partners to implement a solution or turn turn the developed proposition into a commercially viable product or service. Our first area of focus is mHealth.
Over time we will also build an online collaboration community for idea development that provides a supportive process all the way to implementation. The business model for all who get involved is joint venture / revenue share
@mobilecollectiv
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