The Power of the ePatient: Implications of Emerging Technologies in Cancer Care
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Emerging Information Technologies
in Health Care Yan Chow, MD, MBA / Director, Innovation and Advanced Technologies
Kaiser Permanente Information Technology
Oakland, California, USA
2
9M members
17K physicians
173K employees
37 hospitals
611 clinics
37M office visits a year
3K clinical research studies
$50B revenues
EHR: Largest, most advanced implementation in the nation
PHR: nearly 6M members signed up
Kaiser Permanente Largest private integrated health care system in the U.S.
3
Garfield Innovation Center
• Opened 2006 near OAK
• 37,000 sq ft warehouse
• Space design, workflow
simulation, technology
testing
• Full-scale med-surg ward,
L&D, OR, ED, NICU
• Home environment
• Pt Room of the Future
• Open prototyping space
• 48,000+ visitors from over
42 countries
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Operating Room of the Future
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Home Environment
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Health Care in Crisis
• Demand increasing
• Costs increasing
• Reimbursements decreasing
• Health care worker shortages
• Incentive misalignment
© Getty Images
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Current Approaches
• Automate best practices
• Integrate health care across care
delivery ecosystem
• Use data-driven analytics
• Move care to less expensive venues
• Move care to lower-tier workers
• Engage and empower the consumer
• Create new incentives
• Develop technology-enabled care
delivery models
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Virtual Health Care
Telemedicine and Telehealth
© Kaiser Permanente
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Four Virtual Care Models
Remote Monitoring Monitoring of data
Generates alerts for early intervention
Saves travel time and more efficient
Patient convenience
Requires engagement
© Getty Images
Store & Forward Asynchronous, send photo or video
Saves travel time and more efficient
Improves access
Patient convenience
Impersonal
© Sony
Live Video Consultation Synchronous
Saves travel time
Improves access
Patient convenience
Everyone must show up at the same time
© Regenstrieff
Guided Self Service Personalized guidance
Health education
Preventive care
Social networks
Self management
Requires engagement
© Kaiser Permanente
Products not endorsed by KP
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What’s Required?
Hospitals
Suppliers Labs
Clinics Ancillary Services
Pharmacies
Payers Doctors
Nurses Regulators
Care Coordination
Common Best Practices
EHRs & Health Info Exchange
Reporting Mechanisms
Accountability Framework
Reimbursement Structure
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HR, motion, skin temp, sweat
© Basis
Clip-on pediatric otoscope
© CellScope
Telemonitoring Hubs and Sensors
Care Innovations Guide
© Care Innovations
Home hub © Health Buddy
Home hub © Honeywell
Cell hub
© Tunstall
Mobile ultrasound © Mobisante
iPhone
glucometer
© IBGStar
4
Weight, body fat, BMI © Withings
Galvanic skin response (GSR)
Q Sensor © Affectiva
1 2
Skin glucometer
© Dexcom
Wireless pulse oximeter
© iHealth Labs
Products not endorsed by KP
5
3
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Mobile Search
Mobile Browsing
Mobile Voice Calls
Mobile Messaging
Mobile Video Conferencing
Mobile Location-Based Services
Mobile Context-Aware Services
Mobile Office
Mobile Music & Book Library
Mobile Banking
Mobile Commerce
Mobile Payment
Mobile Health Mobile Social Networking
Mobile Gaming
Mobile Image Recognition
© Huawei
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20,000+ Consumer Medical Apps OneHealth MyDiabetes Pillboxie
RunKeeper JEFIT
Depression Connect
Med Helper Pro
HealthPrize
EyeChart
MyNetDiary
1 5 4
6
3 2
7 9 8 10
Products not endorsed by KP
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Professional Apps Visible Body
DrawMD
AirStrip Cardiology
Epocrates VisualDx
Isabel
SwiftPayMD
WellDoc Diabetes Manager Mobisante
MedCalc
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5 4
6
3 2
7 9 8 10
Products not endorsed by KP
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KP Apps
• Mobile EHR
– See your lab results
– Send a message to your doctor
– Refill your prescriptions
– Book an appointment
• Portfolio of mobile apps
• Mobile app development
group
© Kaiser Permanente
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Big Data
and Analytics
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Data Sources
Organizations
© Getty Images
Internet
© Getty Images
Biomedical Research
© Getty Images
New Biodata
© Getty Images
Devices & Sensors
© Getty Images
EHR & IT
Systems
© Getty Images
Health Plan
Members
© Kaiser Permanente
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• 20% Structured – Traditional business intelligence analytics
• 80%+ Unstructured
– Clinical notes, monitoring data, imaging, surveys,
email, phone calls, photos, videos, location, context
• Highly complex
– Multiple regulated silos, lexicons, differences in
accuracy, integrity, availability, reliability, usability
Nature of Health Care Data
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Use Cases
Care Delivery Decision support
Real-time monitoring in
hospital and home
Personalized medicine
Comparative
effectiveness research
Workflow optimization
Cost and quality
analytics
Operations Business analytics
Marketing and supply
chain analytics
Fraud and breach
detection
Payment and pricing
models
Health economics
research
Public Health National and regional
patient registries
Biosurveillance
Preventive health
analytics
Data mining for new
multimodal approaches
to major public health
issues
Research Biomedical research
literature
Clinical trial analytics
Predictive modeling for
drugs and devices
Genomics, biodata
Analysis of disease
patterns to plan future
R&D investments
© SAIC © ELQ © Marin © Super Scholar
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Scanning
the Future
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Environmental Computing
VS sensing at a distance © Kai Medical Car drowsiness sensor © Nissan
1
Seat pressure ID - Adv. Inst. of
Industrial Tech (Japan)
4
3
Interactive glass mirror display © Corning
7
Under-mattress activity and VS sensing © EarlySense
5
imPulse EKG monitor © Plessey (UK)
6
Products not endorsed by KP
SleepClock © Renew
2
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Activity sensor
© Fitbit
Wearable Sensors
Sensor patches
© Proteus / Avery Dennison
BodyMedia FIT activity sensors © KP
1 3
Nike+ shoe with embedded sensors © Nike
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Pendant personal emergency response system
© Philips Healthcare
5
Wireless activity sensor stickers © Green Goose
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2
Fabric sensors detect movement, HR, T, moisture
© Exmovere
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Earbud sensor for VS
© Valencell
4
Products not endorsed by KP
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Medication Adherence
Med reminder watch
© Cadex
GlowCap pill bottle cap
© Vitality Med adherence app
© Pill Phone
MagneTrace necklace
© MagneTrace
Xhale SMART tracer system
1
Proteus Raisin microchip pill
Pill dispenser
© MedReady
© Xhale
3
© Proteus
2
Pill dispenser © SentiCare
Products not endorsed by KP
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Robots
Hector the robot © CompanionAble
mPower 100
© Myomo
eLEGS by Berkeley Bionics © Zimbio
© VGo
Legally blind driver in self-driving car © Google
© iRobot
Paro baby seal
Telepresence
robots
Smartpet robot dog
© Bandai
Products not endorsed by KP
1 3
5
7
2
6
4
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Natural Interfaces
© CSM
Electrical signal speech recognition © NASA
© PrimeSense
Gaze tracking © Tommy Strandvall
Tobii eye gaze tracking system © engadget
Kinect MIDI interface © Microsoft
Nintendo Wii © Nintendo
Products not endorsed by KP
1 3
5
2
6 4
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Golden-I
AR glasses
© Motorola
Augmented and Virtual Reality
Real-time sign translation © Word Lens
Burn surgery under VR anesthesia © Univ. Washington
VR multi-user simulation training © Forterra
Molecular
drug
modeling
© Roche
Vuzix AR Smart Glasses prototype
© engadget
Products not endorsed by KP
1 4 2
6 5
Google Glass © Google
7
3
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Next-Gen Technology
Wristband interface
© NEC
Tongue drive © Georgia Tech
MIT bio-
electronic
ocular
implant ©
engadget
Brain-car interface, Emotiv EEG © Free University of Berlin EEG interface © Neurosky
Stretchable skin sensor © MC10
Skinput © Microsoft
Products not endorsed by KP
1 3
5
2
6
4
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Lessons Learned
• New technologies rarely stand alone
• Innovation is often driven by strategic
considerations rather than a traditional
business case
• Organizations may be limited in how
rapidly and in what sequence they can
absorb a series of new technologies
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Q & A