25 november 2015 high tech campus, eindhoven · 25 november 2015 high tech campus, eindhoven . 2...
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Text Text Eindhoven Innovation Day
25 November 2015
High Tech Campus, Eindhoven
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Self-management of health and disease - Vision on the future Reinder Haakma Philips Research
November 25, 2015
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• Aging population with more chronic and lifestyle related diseases puts a focus on healthcare cost containment
• Fast population growth requires improved access to care
• Digital technology offers new opportunities for more outcome based health management
• In the age of the quantified self, consumers are more actively engaged in their health and health is an engine for today’s economy
A new world dynamic… requires a new approach
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We target healthcare customer and consumer needs along the health continuum
Enable more effective
therapies, faster recovery and
better outcomes
Ensure first time right diagnosis
with personalized and adaptive care
pathways
Support recovery and chronic care
at home
Enable people to manage their own health
Help people to live a healthy life
in a healthy home
environment
Improve population health outcomes and efficiency through integrated care, real-time analytics and value-added services
Monitoring, informatics and connected care
Prevention Healthy living Diagnosis Treatment Home care
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We build off strong leadership positions
1 Global leader: #1 or #2 position in the global market. Source: GfK, Nielsen, Euromonitor, Frost and Sullivan, Home Healthcare TBS, PCMS market insight.
Global top 3
Diagnostic
imaging
Global leader
Sleep & Respiratory Care
Global leader
Image-guided
interventions
Global leader
Ultrasound #1 in China
Air
Global leader1
Male electric
shaving
Global leader
Power
toothbrush
#1 in North America
Home
Monitoring
Global leader
Mother &
Childcare
#1 in North America
Cardiology Informatics
Global leader
Patient Monitoring
Monitoring, informatics and connected care
Prevention Healthy living Diagnosis Treatment Home care
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Self-management of health and disease • Main challenge in healthcare
Improve the quality and cost-effectiveness of healthcare systems
• Trends in healthcare
Self-management of health and disease • patient-centered health care • patient empowerment • taking charge of your own health • shift from care giver to patient
• increase the patient’s role and the responsibility
Boundaries between primary care and secondary care diminish • through technological advances and political intervention
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Re-thinking medical diagnosis and treatment - From patient perspective
diagnosis treatment
clinical decisions
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Technology trends
• Quantified self Acquiring self-knowledge by self-monitoring
on aspects of daily life such as • behavior and performance
(food intake, physical activity) • biometrics, physical as well as mental
(heart rate, mood, alertness) • environment
(air quality, light exposure).
• Wearable electronics
wearable sensors (EEG, ECG, video, etc.) and wearable computing as enablers of self-monitoring and self-sensing allowing people to quantify biometrics in daily life settings in a cheap and convenient way.
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Unobtrusive heart rate monitoring - Philips WeST business
Alpha 2
Forerunner 225
Cardio Runner miCoach
Smart Watch
Alpha Fit Smart
Link
Fuse
Velo
Health Watch
Jan2013 Jan2016
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Photoplethysmography
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WeST measurements
• Heart Rate beats per minute (bpm)
• VO2Max
ml/min
• Energy Expenditure
kcal/h
• Motion Cadence
cycles/min
• Respiration Rate
breaths/minute (brpm)
• Sleep Stage
• Wake, REM, Light, Deep sleep
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Self-management across the health continuum
• Self-management Enabling people/patients to manage their health on a day-to-day basis.
• Across the health continuum for cardio-vascular conditions
Overweight → Hypertension → Atrial Fibrillation → Heart Failure
Prevention Healthy living Diagnosis Treatment Home care
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Healthy living
Healthy living
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Healthy living - An ounce of prevention is worth a pound of cure
• Four healthy lifestyle factors
never smoking maintaining a healthy weight exercising regularly following a healthy diet
• together are associated with
as much as an 80 risk percent reduction of developing the most common and deadly chronic diseases.
• The risk factors of the leading health conditions are highly behavior-related.
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Activelink - A Philips – Weightwatchers collaboration
Measure
Monitor
Motivate
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Prevention
Prevention
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Hypertension and blood pressure
• Blood pressure
the pressure exerted by circulating blood upon the blood vessel walls one of the principal vital signs
• Hypertension
chronic medical condition in which the blood pressure is elevated rarely accompanied by any symptoms • identified usually through screening,
or when seeking healthcare for unrelated problems
prevalent in 30-45% of the EU population • steep increase with age
major risk factor for cardiovascular diseases • stroke, myocardial infarction, heart failure,
aneurysms, peripheral arterial disease • a cause of chronic kidney disease
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Hypertension
• World Health Organization (WHO) – Prevalence
Globally, the overall prevalence of raised blood pressure in adults aged 25 and over was around 40% in 2008.
– Impact Hypertension is the most important preventable risk factor for premature death
worldwide. Raised blood pressure is estimated to cause 7.5 million deaths, about 12.8% of the total
of all deaths. Raised blood pressure is a major risk factor for coronary heart disease and ischemic as
well as hemorrhagic stroke.
• Of those with high blood pressure
82% are aware they have it 75% are under current treatment 53% have it controlled 47% do not have it controlled
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• Office or clinic BP Sphygmomanometer • Two measurements • By clinician
• Ambulatory BP
BP at regular intervals • Every 15 to 30 minutes • Automatically operated
• Home BP
Two measurements each time Operated by user/patient
• New solutions
More easy and less obtrusive More frequent measurements
Monitoring blood pressure
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Unobtrusive, continuous BP monitoring
• Measurements Continuously PPG
• wrist & ankle Cuff measurements for calibration
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Treatment strategies - lifestyle changes
• Guidelines
Salt restriction Moderation of alcohol consumption Increased consumption of vegetables,
fruits, and low-fat dairy products Reduction of weight Regular exercise Quit smoking
• Effective lifestyle modification may lower
blood pressure as much an individual antihypertensive drug.
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Treatment strategies - pharmacological therapy
• Agreement on the major mechanism of the benefits of antihypertensive therapy is lowering of BP per se the effects on cause specific outcomes of the various agents are similar or differ by only a minor
degree the type of outcome in a given patient is unpredictable all classes of antihypertensive agents have their advantages but also contra-indications
• Classes of antihypertensive agents
diuretics (including thiazides, chlorthalidone and indapamide) beta-blockers calcium antagonists angiotensin-converting enzyme (ACE) inhibitors angiotensin receptor blockers
• Physicians should pay attention to adverse drug effects — even those purely
subjective — as they are powerful deterrents to treatment adherence.
• If necessary, doses or drugs should be changed in order to combine effectiveness with tolerability.
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Diagnosis
Diagnosis
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Atrial Fibrillation
Screening Management
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Treatment
Treatment
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Early stratification of cardio-vascular health risks
Combining available data to develop new stratification techniques on patient health and prognosis (context-dependent, personalized decision support)
Central use case: cardiac resynchronization therapy (CRT):
Heart Failure
Data sources: • electronic patient records/cardio-database:
lab results medication cardiac records measurements
• wearable personal health devices (PPG)
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Home care
Home care
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Medication management
Philips ResearchLifestyle Program
Getting New
Medication Obtaining
The Medication
Finding Out
How to Use
The Medication
Organizing
The Medication Taking
The Medication
Dealing With
Mistakes Dealing With
Side Effects
Keeping Up
With The Medication
Getting
The Medication
Reviewed
Taking
Medication
Away from Home
1 2 3 4 5
6 7 8 9 10
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Medication monitoring - for personalized titration
• Balancing act Outcome = Efficacy x Adherence QOL = outcome – side effects
• Beta blockers
Used in cardiac arrhythmia management protecting the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention).
Beta blockers have a reductive effect on heart rate Adverse drug reactions include hypotension,
fatigue, dizziness and insomnia.
• Personalized titration for
optimize dose-response minimize side effects early detection of deterioration identify drug interactions and comorbidities
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Re-thinking medical diagnosis and treatment - From patient perspective
diagnosis treatment
clinical decisions
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Wearables invade the market
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The future after 2020 …
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Text Text Eindhoven Innovation Day
25 November 2015
High Tech Campus, Eindhoven