All posts by blackfriar

data saving lives, entrepreneurship, healthcare, rapid learning health systems, research methodology, technology

Jointly Health – analytics for remote monitoring

Jointly Health is the first Big Data Analytics and Closed-Loop Decision Support Platform for Remote Patient Monitoring

From their website:

Company Overview

Jointly Health is a venture-backed company headquartered in Orange County, CA. In collaboration with Qualcomm Life, Jointly Health provides a very disruptive, end-to-end Remote Patient Monitoring and Analytics Platform that can detect changes in health states much earlier and with greater specificity. Jointly Health also makes this information actionable by healthcare professionals inside their existing workflow.

First Application

The first application of Jointly Health is to reduce preventable hospital admissions in patients with complex chronic disease. In the U.S. there are 4 million preventable hospitalizations resulting in $88 billion in preventable costs and unquantifiable amounts of human   suffering. Remote patient monitoring has the potential to reduce these hospitalizations but is plagued by missed intervention opportunities, false alarms and inefficiencies. Jointly Health solves these problems.

Uniqueness

Jointly’s proprietary platform utilizes a number of advanced technologies including Predictive Analytics, Complex-Event Processing, Real-Time Analytics, Signal Processing and Machine Learning and has four distinct advantages.

1. Can collect a wide variety of remote health data at high velocity and volume. This includes multiple types of physiological data, human observational, environmental, contextual, and other meta data.

2. Has an adaptable ecosystem that enables our customers to build complex disease models which we can then execute.

3. Can remotely detect changes in health states much earlier and with greater specificity.

4. Provides healthcare professionals with a closed-loop decision support system for intervention optimization.

————-

From: http://www.medgadget.com/2013/11/futuremed-day-4-the-end-of-the-beginning.html

Kreindler elaborated on the value of high speed data for applications including remote patient monitoring and analytics to proactively detect deteriorating health states before they being to detract from quality of life. The energetic talk concluded by touching on how Jointly Health, in collaboration with Qualcomm Life, harnesses big data and analytics to make “information actionable.”

 

cool, data saving lives, entrepreneurship, healthcare, rapid learning health systems, research methodology

His Brother’s Keeper – The PatientsLikeMe story

Heyworth is the founder and former CEO of the ALS Therapy Development Institute (ALS TDI), a non-profit biotechnology organization driven to developing treatments for amyotrophic lateral sclerosis (ALS). The first half of Heyworth’s talk focused on his emotional motivation for ALS TDI, which began when his younger brother Stephen was diagnosed with ALS. Heyworth’s investigation into the options available for managing his brother’s disease revealed a disturbing fact: as much as 80% of ALS research outcomes could not be replicated, making much of the support for ALS clinical trials statistically unsubstantiated.

Heyworth raised the question of how we can move forward when there are faults in the data at the heart of our assumptions. The fact that ALS, considered one of the best-researched medical conditions, might have no real supportable data drove Heyworth to establish ALS TDI in 1999 with the aim to champion a new model of disease research based outside of academia and for-profit organizations. Heyworth’s story was captured by author Jonathan Weiner in His Brother’s Keeper and by the PBS documentary So Much So Fast.  Heywood’s discussion also touched on his work as co-founder of PatientsLikeMe, an online resource for disease-specific medical information. The tool allows patients to track their diseases and share this information with others dealing with the same conditions. PatientsLikeMe disrupts the current system of clinical trials with patient-driven databases that provide insight into the efficacy of specific treatments.

Taken from: http://www.medgadget.com/2013/11/futuremed-day-4-the-end-of-the-beginning.html

healthy habits, nutrition, policy

AdShame saying stop, or we’ll say stop again?

A commendable element of a multi-prong approach… every bit helps.

adShame showcases the ways the alcohol and food industry regularly flout the rules when it comes to responsible advertising.

Our aim is to show that self-regulation is not working, and changes are needed to ensure that regulation protects children and young people from the harmful effects of alcohol and unhealthy food advertising. 

http://www.adshame.org.au/

entrepreneurship, healthcare, musings, quotes & aphorisms

Advertising… the original Cognitive Behavioural Therapy.

The more I look at and think about cognitive behavioural therapy, the more I become persuaded that it is way less complicated than it sounds, but at the same time, quite a powerful way to change someone’s mind and/or behaviour.

In an odd way, it’s like academics and researchers are catching up to business, discovering that it’s possible to influence thinking in others using methods such as speaking with people, or sms’ing them, then applying the term cognitive behavioural therapy, when in actual fact, it’s just advertising (or promotion, or whatever well-worn and proven marketing modality best applies).

data saving lives, healthcare, musings, policy, politics

Urologists… WTF?

If the urologists behaved any more egregiously, they’d be drifting into crimes against humanity. It’s good to see the Cancer Council calling this out for what it is: “A disservice to men”. It’s also time for these ghouls to cease veiling their self-interest as their patients’.

http://www.medicalobserver.com.au/news/cancer-council-urges-men-to-think-carefully-before-prostate-testing

Cancer Council urges men to think carefully before prostate testing

Catherine Hanrahan   all articles by this author

A DRAMATIC increase in prostate cancer cases has prompted Cancer Council NSW to call for men to think carefully before being tested, but urologists refute the suggestion men are being treated unnecessarily.

A new study shows the number of prostate cancer diagnoses in Australia jumped 276% over the 20 years from 1987 to 2007.

This is a result of increased testing, lead author Associate Professor Freddy Sitas of Cancer Council NSW, said.

He said that even if a positive result is correct, unless they operate, doctors have no foolproof way of knowing if the cancer is aggressive or relatively harmless.

“Saving lives is our priority, but we urgently need a better test,” Professor Sitas said.

“The tests have saved men with aggressive forms of the disease, but at a high cost.”

A 27% drop in the death rate was observed over the study period, he said.

However, the increase in new cases is much greater than this.

“This indicates that many men were diagnosed with cancers that would not have harmed them.”

However, the Urological Society of Australia and New Zealand has strongly refuted claims by the Cancer Council NSW that men have been done a “great disservice” by the growth in prostate cancer diagnoses, and have been subjected to unnecessary treatment.

“Twenty years ago we didn’t have a test to diagnose prostate cancer, which meant most men presented with advanced, incurable disease,” Professor Mark Frydenberg, the Urological Society’s Vice-President, said.

Many low risk cancers were more typically observed, not treated, he said, with active surveillance, now considered a mainstream pathway.

The University of NSW’s Professor Mark Harris says: “Until we have a better method of screening, men need to be fully informed about the pros and cons of testing.”

Cancer Epidemiol 2013; online 1 November

complex adaptive systems, data saving lives, entrepreneurship, healthcare, healthy habits, meaning, musings, nutrition, policy, quotes & aphorisms, rapid learning health systems, research methodology

The behaviour change arms race…

Behavior change is difficult, but to date it has dominated by industries, such as the processed food industry, who have mastered the art of mass market behaviour change through a withering combination of product research, development and engineering, marketing, advertising and promotion, all founded on an unstoppable and lucrative business model. At this moment in history, industry is the unopposed, global behaviour change super power. Serious capital investment with serious returns but with the unfortunate side-effect of producing a global epidemic of non-communicable disease.

The institutions charged with protecting the public’s health have been caught flat footed. Rather than trying to neutralise industry’s behaviour change efforts, medically-dominated health systems have instead chosen to layer their own lucrative pharmaceutical and surgical business model on top.

Doctors quite legitimately pay lip service to the “diet and exercise” mantra because they know it doesn’t work. And why doesn’t it work? Because anyone can say eat healthier food and exercise, thus making it difficult to justify their years of training and high fees. It’s much better for doctors to note “diet and exercise”, but then pump the drug and surgery options.

So what needs to happen?

A countervailing super power must be established. Not one founded around a powerful business model, but rather a movement of interested citizens, concerned by the grotesque monentization of the population’s health. In effect, a competing super power in the behaviour change arms race.

Key characteristics:

  • protect the children
  • use evidence, but don’t wait for conclusive results
  • empower with data
  • apply political dark arts

Funding sources:

  • social impact bonds
  • crowd sourcing
  • private health insurers
  • government (not a good time for this)

Inspirations

  • Purpose.com
  • GetUp.org.au

 

healthcare, healthy habits, policy, rapid learning health systems, research methodology, technology

Cth Fund on health management apps

  • 40,000 to 60,000 health and wellness apps
  • health app market estimated to be work $700M in 2012, doubling by end of 2013
  • 52% of smartphone owners have used their device to gather health information
  • 19% have at least one health app on their phone
  • safety-net populations have better-than-expected access to mobile devices and are more likely to use their phones to access health information
  • chronic disease (diabetes and asthma) management apps are often extensions of proven interventions that yield clinical benefits and/or financial savings
  • User’s (particularly older users) most popular features: diagnoses, monitoring BP, BSLs
  • User’s least popular features: medication and exercise reminders
  • Providing feedback on progress supports sustained use
  • 30 – 60% of melanomas screened via a teledermatology app were diagnosed as benign!!!!
  • Asthmapolis is an asthma app that is fully integrated with the rescue inhaler to indicate where and when the inhaler is used, correlate that with weather etc.
  • FDA differentiates between lifestyle apps and apps which send data to clinicians – the latter are considered medical devices and will be regulated.

 

PDF: 1713_SilowCarroll_clinical_mgmt_apps_ib

Source: http://www.commonwealthfund.org/Publications/Issue-Briefs/2013/Nov/Clinical-Management-Apps.aspx?omnicid=20

data saving lives, healthcare, policy, rapid learning health systems

McKinsey on Big Data in Health Care

 

Key drivers for big data:

  • Fiscal concerns
  • Moves to value-based reimbursement
  • Aggregated, live data sets provide best evidence for decision making

Key barriers to adoption:

  • patient privacy
  • reluctance to take a holistic, patient-centred approach to value

Pathway to a new value framework:

  • right living (prevention)
  • right care – correct Dx, Rx, Mx + coordination/sharing
  • right provider – workforce innovation
  • right value – outcomes-based reimbursement
  • right innovation – R&D to reduce costs, not increase it

Exemplars of Big Data in Health

  • Kaiser Permanente has fully implemented a new computer system, HealthConnect, to ensure data exchange across all medical facilities and promote the use of electronic health records. The integrated system has improved outcomes in cardiovascular disease and achieved an estimated $1 billion in savings from reduced office visits and lab tests.
  • Blue Shield of California, in partnership with NantHealth, is improving health-care delivery and patient outcomes by developing an integrated technology system that will allow doctors, hospitals, and health plans to deliver evidence-based care that is more coordinated and personalized. This will help improve performance in a number of areas, including prevention and care coordination.
  • AstraZeneca established a four-year partnership with WellPoint’s data and analytics subsidiary, HealthCore, to conduct real-world studies to determine the most effective and economical treatments for some chronic illnesses and common diseases. AstraZeneca will use HealthCore data, together with its own clinical-trial data, to guide R&D investment decisions. The company is also in talks with payors about providing coverage for drugs already on the market, again using HealthCore data as evidence.

McKinsey_BigData_Offerings

Ginger.io

Another company, Ginger.io, offers a mobile application in which patients with select conditions agree, in conjunction with their providers, to be tracked through their mobile phones and assisted with behavioral-health therapies. The app records data about calls, texts, geographic location, and even physical movements. Patients also respond to surveys delivered over their smartphones. The Ginger.io application integrates patient data with public research on behavioral health from the National Institutes of Health and other sources. The insights obtained can be revealing—for instance, a lack of movement or other activity could signal that a patient feels physically unwell, and irregular sleep patterns (revealed through late-night calls or texts) may signal that an anxiety attack is imminent.

Key Assumptions

  • Value-based payment reform must continue
  • There will be a willingness to progress, innovate and learn from other sectors
  • Privacy issues prevail

 

Notes from interview with Nicolaus Henke (video)

  • data availability
  • easier and cheaper to link data sets and then compute them
  • understanding population health better – predict who’s going to get sick, especially with regard to chronic disease – better clinical and economic outcomes

Current opportunities for providers:

  • understanding, predicting and preventing diseases in individuals and populations
  • linking up the health system around the patient
  • understanding value (holy grail) – where are funds being directed, how can they be moved around to optimise outcomes and made more efficient

Future opportunities – change the practice of medicine altogether:

  • Medicine is currently an art that involves the application of heuristic judgement by highly trained professionals distributed around the world
  • Imagine a future where half of all diseases are well characterised, and can be automatically detected sensors embedded in our environment

Building capabilities

  • We currently mainly capture clinical and payment transactional data
  • How do we capture and exploit new, less structured data – behavioural, genomic, environmental – allows prediction
  • Managing very large data sets – totally new skill set
  • Analytics
  • Understanding the consumer better (a la other industries)
  • Health economics and value analysis – where can we invest on the margins to save money
  • Clinical leadership is critical – they need to be inspired and engaged in order to create new models of care and improve their own outcomes and systems

 

PDF: The_big_data_revolution_in_healthcare
Source: http://www.mckinsey.com/insights/health_systems_and_services/the_big-data_revolution_in_us_health_care