TRANSFORMING HEALTHCARE THROUGH INNOVATION
Robin A. Felder, PhDThe University of VirginiaDepartment of Pathology
Disclosures
University of Virginia Department of
Pathology
Medical Robotics Medical Automation Hypogen WellAWARE Systems MeyeChem Proteus Bio Global Cell Solutions Monte Piccolo Farm
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
© Felder, 2011
Social Physical
Cognitive
8.0
6.2 9.1
Wellness Balance
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
Wellness Technologies Monitor
Nutrition Exercise Biometrics Pain reduction Stress reduction Sleep improvement Mood enhancement Health and wellness
Wellness Support
Food coaching Rewards
Exercise Nutrition Therapeutic compliance
Consequence reporting Consequence forecasting
Overcome vicarious goal fulfillment or, “exhaustion of self-control”
Home Health IT
New revenue sources: Medical Cloud coaching and Interpretations
Cloud Interpretations
Proliferation of Wellness Tools
Accelerometer based
Various models for data delivery
Basic physiologic measurements
Information Week BodyMedia
FitBit
Nike Feulband
Zephyr
Basis
Striiv
BodyMedia
Scanadu Tricorder
Shine Misfit
SENSINGLocal content
& services discovery
SEEINGAugmented reality UI:Map, 3D, in building
navigation
INTERACTINGConnection manager
(WAN, Wi-Fi)
KNOWSYou and what is
around you
LEARNSWhat you like
DISCOVERSThings relevant
to you
FILTERSOut the irrelevant
Source: Jarrin (Qualcomm)
SENSINGLocal content
& services discovery
SEEINGAugmented reality UI:Map, 3D, in building
navigation
INTERACTINGConnection manager
(WAN, Wi-Fi)
KNOWSYou and what is
around you
LEARNSWhat you like
DISCOVERSThings relevant
to you
FILTERSOut the irrelevant
Source: Jarrin (Qualcomm)
Cell Scope ™
Dermatoscope – iPhone clip-on 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
Cloud Based Diagnosis of Parkinsons Non-invasive phone
based Accurate (98%) Remote, non-expert
Low Cost Rapid diagnosis Scalable to large
populations
Max Little - Parkinson’s Voice InitiativeTED Conference 2012
Embedded Wellness Sensors Instrument common
fixtures Wireless
transmission of data Web based
aggregation and interpretation
尿糖
尿蛋
白
· Body temperature· Pulse· Blood Pressure· Body fat
percentage
Vital Sensor
Data management PC Urine protein Urine glucose
Urine analyzer
Home network
Healthcare providers
Passive Wellness Monitoring
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
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
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
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
Polysomnography
Passive Sensing
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
Telehome Monitoring Decreases Costs by 74%
N=21 in each group, P<0.05;Telemed J E Health, 2007 13(3):279-85
Overall Cost of Care Comparison
$67,757.88
$17,407.02
0
10000
20000
30000
40000
50000
60000
70000
80000
Do
llars
$
Unm
onito
red
Monitored
Underwear That Measures Blood Pressure Pulse wave velocity
correlates with blood pressure
Pulse wave velocity correlates with blood pressure
Tissue impedance shows passing pulses
Pulse timing correlated with relative pressure
Continuous blood pressure monitoring
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
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
The Eye as the Window to Health
Univ. of MD, Baltimore
UCSD
Medical Robotics
Preventive Science Inc.
MeyeChem, LLC
Real time glucose monitoring
Alerts for low or high glucose concentrations
Trending analysis Food coaching via
telenutritionalmentoring
Virtual Reality Image enhancement,
correction, zoom Correction currently
limited to 0.2 logMAR, 20/32
Full view software modulated images
Superimposed augmented reality
Gas-permeable nanopolarizer (iOptik contact lens)
Off axis projection with transflective diffuser 90° field eyewear iOptik
Zoom lens (3X) UCSD
Diopter adjustable mini-scleral lens and wearable computer (iOptik)
Augmented Reality
Projection of underlying anatomy on living tissue
Relies on superimposition of reality and previously scanned animated image/data
Receptivity
Presenting health vs wellness to a patient
Determining what information is TMI
Optimizing the time for the presentation of wellness strategies “Wellformation”
A non-profit educational organization improving healthcare quality and efficiency through teaching automation principles and their application in health systems
Medical Automation.org
http://medicalautomation.org