Future of Wearables in Telemedicine & eHealth

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Gamifying wearables for serious medical applications: A case study on back health Dr. Robert MacKenzie https:// ch.linkedin.com/in/robertneilmackenzie Royal Society of Medicine: Telemedicine & eHealth HOW CAN WEARABLES IMPROVE HEALTH AND CARE?

Transcript of Future of Wearables in Telemedicine & eHealth

Gamifying wearables for

serious medical

applications: A case

study on back health

Dr. Robert MacKenzie

https://ch.linkedin.com/in/robertneilmackenzie

Royal Society of Medicine: Telemedicine & eHealth

HOW CAN WEARABLES IMPROVE HEALTH AND CARE?

The Lokomat

Hocoma - Leader in Robot-Assisted Functional Movement Therapy

Cochrane Review 2013 - Mehrholz, J., Elsner, B., Werner, C., Kugler, J., Pohl, M. (2013). «Electromechanical-assisted training for walking after

stroke.» Cochrane Database Syst Rev 7: CD006185.

• Wear a band, watch, belt, clip etc.

• Sensors collect a set of parameters (i.e. data)

• Algorithms (app) provide analysis and

recommendations on how to improve your well being

• Regular folks empower themselves

with appropriate sensors & data

• Increase (awareness of) physical activity

• Improve fitness (“health”)

• Benchmark performance in the context of a larger group

• Leveraged social network support (i.e. accountability)

• High-tech nagging to urge you to do the right thing

• Many become immune to product use and benefit

Telemedicine and eHealth require better

results with new wearable paradigms!

!

Solutions looking for problems

Where is the direct causality between problems

(i.e. pathologies) and solutions (i.e. treatments)

for wearables in medical health?

https://rockhealth.com/reports/the-future-of-biosensing-wearables/

• Benchmark performance in the context of a larger group

• Leveraged social network support (i.e. accountability) and link to

targeted intervention, control and medical support

• Learn new behaviour(s) for self-guided prevention and treatment

• Enable early diagnosis, treatment and study enablement with

meaningful, contextual data, instead of “just” big data

• Wear a band, watch, belt clip etc.

• Sensors collect a set of parameters (i.e. data)

• Algorithms (app) provide feedback for medically

meaningful, timely (e.g. real-time) learning experience

• Regular folks empower themselves

with specific sensor & app solution

• Increase (awareness of) physical activity

and quantifiable state of health

• Improve health and treat pathology

• Data owned by user for targeting sharing with

medical professionals

Alternative Paradigm

Purpose-driven, evidence-based wearables

focused on self-treatment, experience &

learning with specific links to medical system

How?

Serious Medical Gamification!

• Blunt, Richard (2009) Does Game-Based Learning Work? Results from Three Recent Studies

• Van Eck, Richard (2006) Digital Game-Based Learning, EduCause Vol 41. No 2.

• Kapp, Karl (2012) The Gamification of Learning: What Research Says About Simulations and Serious Games

Serious Games- designed for a primary purpose (i.e. learning) other than pure entertainment

How can wearables be trusted for use outside of the medical system?

Consumer WearablesUsable and purchasable by anyone

Consumer Medical WearablesPurchasable and usable by anyone

Clinical Medical WearablesMedical expert use or prescription

ECG Signal Continuous Glucose

Motion, Heart Rate

Blood Pressure Continuous Glucose+Posture

ECG & Respiration

Functional Back Therapy

Functional Back Assessment

Fitness Activity

Med

ical

Reg

ula

tio

n

Emerging wearable category for telemedicine & eHealth

… …

• 80-90% of lower back pain is

musculoskeletal related

• Classified as non-specific back pain,

because no direct caused can be

diagnosed

• Most people resort to some form of

self-therapy (e.g. yoga, medication,

ignoring the problem)

How do wearables and back pain fit together?

Institute for Health Metrics and Evaluation

What Is the Optimal Therapy for Back Pain?

MultimodularApproach

Psychotherapy & Stress Reduction

Exercise TherapyMedication &

Surgery

Other (e.g.

Massages, TCM, Hot/Cold, Supports,

Magnetic Pulse)

• Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J, 15, Airaksinen, Brox, Cedraschi,

Hildebrandt, Klaber-Moffett, Kovacs, Mannion, Reis, Staal, Ursin, Zanoli, et al., 2006

• High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults, Bigos SJ, Holland J,

Holland C, Webster JS, Battie M, Malmgren JA., 2009 http://www.ncbi.nlm.nih.gov/pubmed/19185272

Conventional Back Therapy (e.g. Between Sessions)

Common Patient Problems

• No access to a therapist!

• Interest, time, money, available

appointments, etc.

• Motivation to exercise?

• Movements are boring

• Guidance, real-time feedback &

(expert) source of information?

• What should I do?

• How much should I do it?

• Am I doing it right? Wrong?

• Quantifying performance & my

specific activity?

• To whom accountable?

100

%

Simple Back Therapy Timeline

Therapy

Continues

Therapy Session Therapy SessionBetween Sessions30

%

Patient “movement”

Pharmacy

Therapist

Chiropractor

Doctor

Prevention

Self-Therapy

No Action

Patient

1) Has low back pain

2) Seeks advice diagnosis and

treatment INSIDE medical system

3) performs self-therapy OUTSIDE of

and with a weak link to the medical

system

70

%

100

%

Alternative Back Therapy Timeline

Therapy Session Therapy Session

Therapy

Continues

Wearable Therapy

Patient

1) Has low back pain

2) Seeks advice diagnosis and

treatment INSIDE medical system

3) Certain population performs self-

therapy OUTSIDE of and with a

weak link to the medical system

4) Consumer medical wearables to

empower self-therapy & link to

medical system

30

%

Empower

Self-Therapy

Pharmacy

Therapist

Chiropractor

Doctor

New patient interaction

Prevention

Self-Therapy

No Action

70

%

How

How can a consumer medical wearable help treat chronic low back pain?

Functional Movement Therapy

+ Technology

= Redevelopment of Core &

Deep Muscles

= Restoration of Motion to

Vertebral Joints

= Motivation, Learning &

Real-Time Feedback

Exercise

Therapy

Gamification &

Mobile Technology

Gamification

Wearable• 2 Sensors

Medical• CE, FDA Class 1

Consumer• End User

• Patient

Mobile

Problem

Non-specific low back pain

Solution

Exercise Therapy +

Reinventing the Back Exercising Experience

• Focus on the therapy goal, not just fitness

• Movement Awareness

• Mobilization

• Stabilization

• Stretching

• Balancing

• 17+ movements from classic therapy

• 45+ therapeutic exercises developed with

therapists & movement experts

Compensation Feedback

• Mild – Red colour

• Medium – Smoke,

enlarged Movement Tutor,

pre-warning of severity

• Severe – Complete

“Severe Action” window

and game pause to study

ideal movement from the

Movement Tutor

Serious Game Elements

• Continuous correction

small, fine movements

• Back movement mirroring

• Movement guidance

• Movement awareness

• Performance (score,

movement indices)

• Augmented Performance Feedback demonstration of Valedo: www.valedotherapy.com

Understandable quantitative & qualitative performance information

Trusted consumer medical wearables changes patient-doctor/therapist interaction

Users own their data and controls it’s integration

Wearable paradigm shift from monitoring & data to

real-time feedback, experiential learning & self-therapy

Thank you!

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