Personal Connected Health AllianceEmpowering individuals to better manage their health

Dr George Margelis

Is Personal Connected Health the Answer to Interoperability?

The world is moving to a focus on linking individuals with interoperable, personalized health solutions that meet their lifestyle needs.

Empowering Individuals to Better Manage Their Health

Advantages of Personal Connected Health

Consumers are not just linking health data to the Providers any longer

• Potential to transform human health and healthcare delivery, and to reduce global disparities in healthcare access

• Adds motivation and inspiration to health self-management by taking advantage of support networks in social media and other online forums

• Capable of reducing the impact of chronic disease, which is responsible for the greatest portion of healthcare expenditures

• Ability to shift from treatment focus to preventive care by making health self-management a part of everyday life

• Allows us to enjoy life longer outside of traditional healthcare

Engaging Consumers at Every Stage of Life

Health and Relief Pharma

…and Providing Links to Family, Friends, Social Networks & Providers

• Consumers become engaged in health self-management• Links to social networks become a source of positive

reinforcement• A secure line of communication is established between

providers and caregivers outside the exam room

• Consumer-collected data can enrich healthcare for

individual patients and patient populations

PCH Creates an Information- and Inspiration-Rich Environment for Health Improvement

Better use of resources, reduced cost, improved clinical outcomes…and health management incorporated into everyday life

7

The Goal: Improve Lifestyle Choices, Health

= Non Modifiable Contributors to Disease

= Modifiable Contributors to Disease

Hu et al. Diet, lifestyle and the risk of type 2 Diabetes in women. NEJM 2001 Sep 13;345(11):790-7.Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000; 343: 16–22

• Wearable trackers to monitor calories burned through activity

• Apps for diet/nutrition advice and caloric intake, on smart phone and/or computer

• Social networking for inspiration and competition (i.e., Jenny Craig, Biggest Loser), using online forums such as Facebook

Envisioning A Better Way: Weight Loss

• Wearable trackers to monitor specific activity• New sensors to enable 3d tracking and

movements• Already in use for Rehabilitation and

Diagnostic purposes• Can be utilized to stimulate inactive or

cognitive impaired individuals• Interoperability allows for this data to be

collected by healthcare team

Envisioning A Better Way: Gaming

• Disease-based forums (web, social media) for peer advice on treatment options and experience

• Connectivity to providers via provider portal, for expert advice during diagnosis, treatment and follow-up Apps to find a clinical trial

• PCH-enabled studies that use sensors, trackers and/or remote monitoring for data accuracy and patient convenience

Envisioning A Better Way: Management of Rare & Serious Diseases

• Individual and online gaming for children/teens with chronic diseases

• Apps to support connection to people with communication disorders, such as autism

• Wearable sensors and wireless monitoring for elderly living independently

• Remote monitoring by healthcare providers to augment parental care of a sick child or aging parent

• Social networking for caregivers, i.e., Facebook book, online chat with the ability to share sensor data

Envisioning A Better Way: Care of Special Populations

Envisioning A Better Way: Clinical Trials

• Direct involvement of the individual in the trial

• Evaluate patient populations

• Accelerate patient recruitment

• More efficient and effective management of clinical trails, data collection and reporting

• Better quality, more reliable data

• Get new drugs to market faster

Compliance with global industry standards is proven to decrease time to market and reduce development costs:

• Lower Design Costs: saves US$ 40,000-$80,000 in development costs per device

• Faster to Market: decreases integration time from three months to just three weeks

• Increased Efficiency: quicker, less expensive integration to EMR or HIE platforms

• Forward/backward compatibility: longevity of devices

• Easy to expand or add new programs/products with plug-and-play

Envisioning A Better Way: Interoperability

Envisioning A Better Way: Adoption

UK (NHSWorcestershire)

Japan WG

Denmark

Singapore

SE Asia WG

Australia WG

India WG

Brazil WG

Middle East

= Adopting Continua

= Local Work Group

US Veterans Administration

& US Department of

Defense

US WG

Japan

EU WG

PCH: Why Now?

• Consumer market is exploding– more than 97,000 mobile health apps are currently available;

– each day the top 10 apps generate up to 4 million free and 300,000 paid downloads

• New regulations and incentives transforming healthcare delivery, putting consumers at the center of their care – the Affordable Care Act features comprehensive health insurance reform to improve the

quality and patient access to care in the US

– Meaningful Use Stage 3 to address population health

• Governments around the world demonstrating significant interest in adopting personal connected health (ex: Denmark, UK, Abu Dhabi, Singapore)– the UK’s 3million lives initiative changing care delivery using connected health tools for

citizens with chronic conditions

• Globally, healthcare in crisis and world population aging

PCHA: An Historic CollaborationContinua Health Alliance, mHealth Summit & HIMSS

• Global plug-and-play interoperability Design Guidelines and Product Certification program

• Unmatched industry education, thought leadership and networking

• International leadership in hospital-based health technologies

• Worldwide presence to promote local, regional and national public policy, advocacy and market development

Generating greater awareness, availability and access to plug-and-play, consumer-friendly personal health technologies to

empower individuals to better manage their health and wellness, anywhere at any time.

PCHA Mission

• Promoting education and awareness through events and outreach to all stakeholders

• Facilitating adoption of global industry standards for user-friendly interoperability between devices; privacy and security

– publishing annual Continua Design Guidelines for end-to-end, plug-and-play interoperability; certifying products

– Ratified by ITU as global standard for PCH technologies

• Defining the path to market by advocating for appropriate regulation and promoting investment

• Supporting governments and health ministries seeking connected health solutions

• Operating in nations around the globe to promote market development

PCHA Strategic Initiatives

The Time is Now

PCHA will coordinate stakeholders in PCH and maintain a ‘consumer first’ position

• It’s about the individual• The technology is available• Consumers are demanding it• Nations are implementing it• We can’t afford to miss this opportunity

The Market will not grow until we reach interoperable solutions

HealthRecord

Network(HRN)

Interface

Personal Device

Weight Scale

Pulse Oximeter

Independent

Living Activity

Cardio / Strength

Medication

Adherence

Glucose Meter

Pulse /

Blood Pressure

Thermometer

Physical Activity

Peak Flow

Electrocardiogram

Insulin Pump

AggregationManager

PersonalArea

Network(PAN)

Interface

WideArea

Network(WAN)

Interface

TelehealthServiceCenter

HealthRecords/Networks

EHR

PHR

NHIN

HIE

WiFi, 2G, 3G & 4G

Architecture to Enable PCH

Get Involved with PCHA!

Web: www.pchalliance.org

Email: ask@pchalliance.org

Case Examples

Denmark’s National Action Plan for Telemedicine

Scope

• Secure collection, transmission, storage of personal health data from

patients’ homes to healthcare providers across the country

• Sharing of medical documents & images

• Management of health records, medical appointments, etc.

Objectives

• Ensure end-to-end, plug-and-play connectivity of personal health

devices; establish interoperability standards

• Ensure personal health devices & services easy to deploy, secure &

convenient for patients & providers

• Reduce acute care stays

• Enable elderly to live home independently

• Develop chronic disease management programs

• Expand use of telemedicine

Denmark: Centralized Approach to Standards Adoption

• Mandated national compliance with interoperability

standards (Continua)

• Pros:

– National healthcare IT conformity supports large-scale

population health and creation of cost, operational

efficiencies

– Limited systems integration issues during rollout and

subsequent changes in technology

• Cons: limited regional, local influence over standards

development; currently fewer choices in devices

UK Dept of Health: 3millionlives (3ML) Campaign

• Based on evidence from the Whole System Demonstrator

Programme (6,000+ person telehealth/telecare study)

Goals

• Improve lives of 3ML people with long term conditions, social

care needs

• Develop market, remove barriers to delivery (5 yrs)

• Create environment to support uptake

• Public/private cooperation to simplify procurement and

commissioning processes for telehealth, telecare at scale

• Put NHS and UK industry at the forefront of telehealth, telecare

globally

• Promote benefits of telehealth and telecare services to patients

3ML: Regional Approach to Standards Adoption

• All personal health device providers must comply with CEN ISO/IEEE 11073

• Contracting occurs on a local basis

• NHS Worcestershire County and East Shires Purchasing Organization have voluntarily adopted Continua

• Pros: localities maintain maximal control (device selection, cost)

• Cons: healthcare IT infrastructure likely to require significant integration to achieve end-to-end interoperability at a national scale

Catalonia, Spain: Regional Approach

• Catalonia, Spain

– Population covered by universal healthcare with a mix

of public/private providers

– Health Ministry funded ICT organization (TicSalut)

coordinates standards, integrates health and social

welfare systems

– 100% of hospitals use EHRS; 70% have mobile tools

– Device integration primarily based on Hl7 standards

Opportunities & Challenges for Big Data

Opportunities• Adopt common standards for PHRs to enable data

aggregation, tracking from multiple consumer devices– A starting point for big data, especially in decentralized

markets• Agree upon type, definition and format of personal health data

relayed from consumer devices to a medical records system– Ex: Health Records Network

Challenges• Retail and home devices need common standards to enable

consumer plug and play• Clinical workflow impact complicates standards adoption• End-to-end standards adoption