Back to the Future: Digital trends in Medicine

Ivan Olegario, MD, MDCAugust 9, 2016

Medical scheme “product” life cycle

Time

Declining beneficiariesEscalating costs

InefficiencyWaste

Innovation

SuccessSuccess

Technology adoption

Source: Gartner 2015

Source: Frost & Sullivan

Technology use matrix

GOALS USERS

Physicians Patients

Prepare and prevent E-LearningVirtual dissection

Curated online information

Data and diagnostics WearablesReal-time diagnosticsEMRs

WearablesPersonalised genomics

Therapy and follow-up Robotic interventionsTelemedicineMultidisciplinary therapies

Artificial organsAdherence controls3D-printed biomaterials

What does the future look like?

Source: http://lifesciences.ieee.org/articles/487-a-survey-on-ambient-intelligence-in-healthcare

Digital technologies predicted to disrupt healthcareSource: The 7 Biggest Innovations in Health Care Technology by Brian Honigman

Wearable Tech- like Google Glass

Hybrid Operating RoomsDigestible Sensors

Nanobots in Blood

Fingertip Surgery

3D Printed Biologicals

Personal Health Devices• Personal health devices can:

– Provide information or – Sense and respond, – or both.

• They can provide intervention or everyday support.

http://www.eee.bham.ac.uk/woolleysi/projects/index.htmhttp://www.disetronic-ca.com/dstrnc_ca/rewrite/content/en_CA/3.2:20/article/DCM_general_article_53.htm

http://mlearning.edublogs.org/2006/11/20/m-learning-is-vital-for-industry-compatibility/

Blood Pressure/Pulse Monitors

• Automatic large LED blood pressure systolic / diastolic / pulse readout with fuzzy logic.

• Automatic inflation & deflation

• 48 sets of memory to monitor your progress plus date / time / average pressure

• Requires 2 x AAA batteries.Tatung http://www.tatung.com/med/product.html

AMON - Advanced Telemedical Monitor

• A European project from ETH, Zurich• Designed to be worn by cardiac

outpatients, the device allows remote monitoring of blood pressure, pulse, oxygen saturation, body temperature and 2-channel ECG signals.

• AMON: A Wearable Medical Computer for High Risk Patients, P. Lukowicz, U. Anliker, J. Ward, G. Tröster, E. Hirt, C. Neufelt, ISWC 2002: Proceedings of the 6th International Symposium on Wearable Computers, 7.-10. October 2002, pp 133-34   

Glucose monitoring and Wearable Insulin Pumps

Biofeedback and “Inner-active” Games

• Biofeedback – monitoring and altering a body function such as breathing, heart rate, blood pressure through relaxation or imagery.

• ANTENSE® Biofeedback anti-tension device: $160

• emWave Personal Stress Reliever® $199

• The Journey to Wild Divine, the first in a series of “Inner-Active” computer adventures

– Biofeedback in an entertaining multimedia experience $187.50

Top left: Antense® Anti-Tension DeviceTop right: http://www.holisticonline.com/Biofeedback.htm

Bottom: http://www.myemwave.org/about_emwave_stress.html http://www.luxevivant.com/index.asp?PageAction=VIEWPROD&ProdID=166

The “Digital Plaster”

• A device embedded in ordinary plaster• Includes sensors for monitoring health-

related metadata such as blood pressure, temperature and glucose levels.

• If the results show abnormal signs, patients and doctors would be notified.

• Can be integrated with motion sensors.[The Toumaz Digital Plaster]

Portable TENS

• TENS machines are used for pain relief, for example, by chronic pain sufferers or for pain during child birth.

• From NHS Direct: “a pad that administers small amounts of electrical current, blocking pain signals and stimulating endorphins”

An NHS-Approved TENS machinehttp://www.maternitytens.com/index.asp?function=DISPLAYPRODUCT&productid=9.

http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=914

Personal Mobile Electrotherapy

• NovoCure is currently performing clinical trials using 100-200 kHz electric fields (tumour treating fields or TTFields), to stunt the growth of cancer cells.

• Inhibits microtubule spindle organization and resultant mitosis

• Leads to apoptosis• Animal and early human trials appear

promising.

Safety cap. A glioblastoma patient wears the NovoTTF-100A.

http://sciencenow.sciencemag.org/cgi/content/full/2007/530/3

Live clinical record

• Readings appear as a live database• Standard queries and interfaces can be used to

manipulate the data• On-line services used to process the data• Exploits existing grid standards for reliability• Presents a range of different interfaces for

clinicians• Provides range of feedback to patients.

Research Questions: Qualitative

• System-centred research questions– How can sensors, systems and data interact and

combine or synergise?

• User-centred research questions– How can users manage and interpret all this new

information?

Research Questions: Quantitative

• Can we help people (doctors and patients) keep well and optimise health? (Clinical outcomes)

• Can we use new technology to make more people more well more of the time ... with less money? (Health economics)

• Can we avoid exposing people to excessive electromagnetic fields? (Risks)

Impact to practice

• Much left to be done• Start thinking about it NOW!