Eric Horvitz, MD, PhD co-director, Microsoft Research
- from data to predictive models to decision-making
- costly challenge of re-admissions: they worked with Washington Medical Center, which had been accumulating lots of data on ER visits. Built a predictive model of readmissions: identified relevant evidence out of 25,000 indicators: if “fluid” is in the record, that’s an indicator the person will be readmitted.
- Created tool called “Readmissions Manager.
- running this program worldwide
- example of Congestive Heart Failure. $35 b. annual cost. Should you invest in an intervention program?
- another big challenge is hospital-associated infection. $20 b. a year cost. In top 10 causes of deaths in the US. Beyond looking at EMR, they introduced analysis by space and time. Another factor is the patient’s path through various parts of the hospital: could predict what % of the patient population got infections in what part of the hospital. Analyzed various factors, such as which unit of hospital they were in, who was the attending doc.
- New kinds of predictions: “surprise models” — looked at people who were re-admitteed in 72 hrs. for a condition that wasn’t on chart before.
- new set of data: patients searching web. For example, nutritional content in logs of downloaded recipes. (Maine people downloaded a lot of recipes with high carb content). This was because they found a lot of older ppl in DC area had downloaded recipes with high sodium content in holiday season.
- looked at Twitter feeds about birth of child — overlaid lots of people who’d just had babies: about 12% of women showed signs of crashing in terms of mood (post-partu m depression is underreported). Suggests you might be able to intervene in advance to help them.
more cool devices!
- telehealth platform
- for smartphone
- for a variety of conditionautomatically takes vital signs
- on-screen educational videoeasily spot trending conditions
- Vtrim: obesity treatment
- 12-20 on line classes
- high-touch program
- food & exercise journals — daily feedback from dieticians
- online meetings are text-based
- more than 3000 have taken it
- Vocera Care Experience
- CDC says 90% can’t remember the care instructions after an encounter
- they record discharge instructions
- patient can listen, watch video, have link to hospital website
- called “Good to Go”
- system to make Coumadin twice as effective
- dialogue with clinician
- patients in range 81% of time
- Omada health
- aimed at reducing pre-diabetes
- CDC rolling out a prevention program
- They wanted to do a digital solution
- digital scale, online education, then a maintenance program. Group based.
- weekly packages
- Affinity Networks
Click here to read more.. »
Great Frank Moss, former director of the Media Lab! Says health care system has always undervalued role of patient in health care. Tells stories of 4 Media Lab alums who have created great new innovations:
- Anmol Madan, Ginger.io — “big data, better health” — can determine if someone will be sick based on analysis of their communication. People trying to care for their own diabetes increase their communications by 30% — applying to mental health as well!
- Ian Eslick — thought he could do better job managing his psoriasis. “Personal Experiments.org” — ran clinical trials for a variety of conditions. Mother of a child with CF used system to better understand condition
- Vitor Pamplona — “EyeNetra” Developed $2 clipon for a smart phone that allows a person to do their own eye exam.
- John Moore, “Collaborhythm” — empowers patients to become partners in their health care. Health coach works with patients to deal with their chronic conditions.
“Given great tools and social support, ordinary people will constantly exceed our expectationnsof their ability to play an active role in their health care”
Wendy Everett,the president of NEHI:
- rhapsodized about “e-patient Dave” and his experience
- we aren’t focusing on getting doctors and nurses to engage in revolutionary way
- talked about her husband’s recent medical experience — resulting in his death..
- she saw exceptional waste throughout process — including meals when he couldn’t eat
- incredibly moving!
- she wants best in connected health to become commonplace nationwide.
Carl Dvorak, ceo of EPIC, talked about amazing range of ways they’re using apps to integrate patients into EMRs:
- lots of emphasis on mobile devices
- messaging & e-visits
- mobile check in
- patient-reported outcomes
Presentations @ Center for Connected Health Symposium:
- Michael McGarry, Ascension Health
- directs their Innovations Accelerator Team.
- how do we engage patients during 99% of time when they’re not getting care?
- Eric Rock, CEO, Vivify Health
- emphasis on connection and simplifiecation
- Dr. Dmitri Talantov
- he’s with Janssen Healthcare Innovation @ J & J
- integrated care systems,
- focus on orthopedic, cardio-vascular rehab
- need strong incentives for providers to engage under new delivery systems
- how do you engage consumers?
- barriers: need is for high-risk patient who doesn’t understand the tech
- new incentives in several states for daily reporting
- may have population that doesn’t want to engage — want to sit on couch!
- “restaurants probably have more impact on their condition than anything we can do”
- “insane opportunity in keeping people healthy!”
- how do you sell virtual care to providers?
- “pay them!”
- simplicity for them
- can’t expect them to interrupt their routines for something new.
- patients own their data
Presentation @ the Center for Connected Health Symposium:
- “patients want to engage” — willing to share data
- using body-worn sensors, to let student athletes determine when they’re in high-performance zone either in school or on field.
- working with same sensors to study military resilience, which members of your team are “in the zone”
- “Latitude Heart Coach” — trying to empower patients to engage with the data. Make it sticky. Device is a life coach.
- using YouTube celebrities to help diabetics have constant carb levels.
- work with lot of mobile solutions
- also using Instagram — attach heart rate to photos
- want to collect everyone’s heart rate in entire world!