brigitte piniewski, md chief medical officer peacehealth laboratories, oregon vice chair mawg
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Brigitte Piniewski, MD Chief Medical Officer
PeaceHealth Laboratories, Oregon
Vice Chair MAWGContinua Health Alliance
2011 Alpbach Universities of Applied Sciences Forum
2011 PeaceHealth Laboratories 1
Using technology to Co-produce better Health outcomes: Lifestyle, Healthcare costs, Social Networks
2011 PeaceHealth Laboratories 2
Outdated Man-made constructs: Traditional Medical model, central currency, regulatory environments and so on…
Pure pursuit o
f
profit…
Social Justice
Time = 1980’s
Good
Poor Moderniza
tion
Modernizatio
n
Assumptio
ns
Assumptio
ns
Social Social justicejusticeandandHuman Human achievemeachievementntGapsGaps
2011 PeaceHealth Laboratories 3
Project at Bristol University shows [3]
Kids diet affects IQ perhaps permanently
Low expectations for American students.
America’s top math students rank 25th out of 30 countries when compared with top students elsewhere in the world. [1]
By the end of 8th grade, U.S. students are two years behind in the math being studied by peers in other countries. [2]
Seventy percent of 8th graders can’t read at their grade level, and most will never catch up.
[1] Strong American Schools analysis of data from the Organization for Economic Cooperation and Development. Based on data from Volume 2, table 6.2a (p. 227). Rank is based on students performing at Level 6 in each country on the 2006 PISA math assessment.
[2] Schmidt, W. (2003, February 4). “Presentation to Mathematics and Science Initiative.”
[3] http://www.dailymail.co.uk/health/article-1354683/Junk-food-diet-hits-childs-IQ-reveals-major-UK-study.html
4
5-6 Million Years
30-40 Years
The Economist 2003One billion adults overweight world wide
2011 PeaceHealth Laboratories
2011 PeaceHealth Laboratories 5
0 25 65 years
Illness
Pre
-Illn
ess
Welln
ess
Crowd Achievable Health
Crowd Actual Health Outcomes
DeatDeathh
60-80% Preventable
Modern Crowd health landscape… Modern Crowd health landscape… Age
2008 6
0 25 65Age
Illness
Pre
-Illn
ess
Welln
ess
DeatDeathh
“Normal” means prevalent not “Optimal”
62011 PeaceHealth Laboratories
2011 PeaceHealth Laboratories 72008 7
0 25 65Age
Illness
Pre
-Illn
ess
Welln
ess
Unpredictable Health
Predictable (Rules-based) Health
DeatDeathh
60-80% Lifestyle
Health Cost LandscapeHealth Cost Landscape
$ $ $
2011 PeaceHealth Laboratories 82008 8
0 25 65Age
Illness
Pre
-Illn
ess
Welln
ess
Unpredictable Health
Predictable (Rules-based) Health
DeatDeathh
60-80% Lifestyle
Business Model LandscapeBusiness Model Landscape
$ $ $
2011 PeaceHealth Laboratories 92008 9
0 25 65Age
Illness
Pre
-Illn
ess
Welln
ess
Unpredictable Health
Predictable (Rules-based) Health
DeatDeathh
60-80% Lifestyle
Evidence-based Evidence-based MedicineMedicine
$ $ $ $ $ $
2011 PeaceHealth Laboratories 102008 10
0 25 65Age
Illness
Pre
-Illn
ess
Welln
ess
Unpredictable Health
Predictable (Rules-based) Health
DeatDeathh
High Transparency High Transparency livingliving
2011 PeaceHealth Laboratories 11
Money is a narrow expression of wealthGaming expands our currency skill set
FrivolousGaming
Reliable unit of Health valueefficiency
Centralized Currency
Provide feedback and reward using new currency models
2011 PeaceHealth Laboratories 12
0 25 65Age
Illness
Pre
-Illn
ess
Welln
ess
DeatDeathh
60-80% Lifestyle
Modern Knowledge Modern Knowledge procurementprocurement
Legacy Knowledge Systems
Crowd-accelerated Strategic Intelligence
2011 PeaceHealth Laboratories13
High Yield health data…
• Weight change•Activity change•Response to
nutrition
2011 PeaceHealth Laboratories 14
Crowd Data Crowd Data Lowering the barriers to participateLowering the barriers to participate
Weighing Scale
Wireless Pulse Oximeter
Blood Pressure Monitor
Device Interface XHR Interface
PHR
Secure PHRWirelessUltra Low PowerUltra low cost
CommunityData Commons
Student Community data commons: Online & Mobile
•Real-time Activity Tracking•Personalized Goals•Virtual Coaching•Wellness Games & Competitions•Social Network & Nudging
Fast access to goals, guidance, support to stay motivated and connected
152011 PeaceHealth Laboratories
04/21/23 16
SPD vs. SN size
The larger your social network, the
more active you are.
SN size
SPD
04/21/23 17
04/21/23 18
04/21/23 19
2004/21/23
0 mo3 mos Reduced CVD risk
2104/21/23
Global Health Economy
2011 PeaceHealth Laboratories 22
Crowd-relevant Benchmarking
Cloud
Health IntelligenceTo leapfrog Sub-Optimal
OutcomesDisruptive Innovation
2011 PeaceHealth Laboratories 23
“You miss 100% of the shots you don’t take.”
“You miss 100% of the health intelligence you fail to monetize.” Brigitte Piniewski
2011 PeaceHealth Laboratories 24
“In a Connected world, we are no longer responsible for what is reasonably known, we become responsible for what could have been reasonably known had we collected and organized the intelligence appropriately”Brigitte Piniewski, MD Continua Boston summit 2009
Collaborators: Short listC. Codagnone, Institute for Prospective Technology Studies, EU
Commission Spain
D. Osimo, Tech4i2,Pursuasive Technologies, Brussels Belgium
Trevor Cooper, Connected Embedded Cloud Solutions, Intel US
David Kil, SKT Americas, CSO Informatics, Sunnyvale, CA USA
Dejing Dou, Associate Professor in the Department of Computer and Information Science, University of Oregon, USA
Jessica Greene, Associate Professor in the Department of Planning, Public Policy & Management , U of Oregon, USA
Xintao Wu PhD, Associate professor of Computing and Informatics at the University of N Carolina at Charlotte
Ruoming Jin PhD, Assistant professor of Computer Science at Kent State University
Prof. Iain E. Buchan Director NIBHI & NWeH Science, University of Manchester
Others…
2011 PeaceHealth Laboratories 25
2011 PeaceHealth Laboratories 26
Brigitte Piniewski, MDChief Medical OfficerPeaceHealth Laboratories1201 Lloyd Blvd, Suite 200Portland, OR 97232503 720 0655 (c)541-222-7461 (o) 541-431-9152 (f)bpiniewski@peacehealthlabs.orghttp://www.peacehealth.org/
US EU collaborative technical report, “Nudging lifestyles for better health outcomes: crowdsourced data and persuasive technologies for behavior change”
Piniewski et al. EUR 24785 EN - 2011
2011 PeaceHealth Laboratories 27
Verteilungsgerechtigkeit in der MedizinLebensführung, Gesundheitsausgaben und Social Networks
Stefan SauermannGeschäftsführender Studiengangsleiter Biomedical Engineering Sciences
19.5.2011 Fachhochschulforum Alpbach
2011 PeaceHealth Laboratories 28
Step-by-step
Learn about your community– Super users, common enemy, interaction patterns,
Initially Focus on a metabolic process that influences a modifiable health burden within any community
Establish an infrastructure including social contracts that enableindividuals to dynamically– Choose the individual participation– Collect high yield data from lightly instrumented households– See the group value that they generated, in currency units
Suite of data visualization options– Empower social interactions– Learn about metabolism and their potential to influence it– Seed other communities– Incrimentally improve and scale the system
2011 PeaceHealth Laboratories 29
Engineers first stepsProject „Healthy Interoperability“
Learn about your community– Super users, common enemy, interaction patterns,
Initially Focus on a metabolic process that influences a modifiable health burden within any community
Establish an infrastructure including social contracts that enableindividuals to dynamically– Choose the individual participation– Collect high yield data from lightly instrumented households– See the group value that they generated, in currency units
Suite of data visualization options– Empower social interactions– Learn about metabolism and their potential to influence it– Seed other communities– Incrimentally improve and scale the system
2011 PeaceHealth Laboratories 30
HIO Focus: Collect high yield data from lightly instrumented households
Image: Continua Health Alliance Overview Presentation, www.continuaalliance.org, accessed 20.8.2011
Connect many modules: Usestandardised interfaces!!!
Implement and co-develop standards
Framework developed, pilots started
NOT SUFFICIENT TO GET JOB DONE!! © 2009 FH Technikum Wien
Framework
Controller
Archive Module
IHE XDS Module
TCP/IPModule
11073 De-/Encoding
Module
IHE PDQModule
HL7 CDA Module
BluetoothModule
USBModule
ReportingModule
LogModule
2011 PeaceHealth Laboratories 31
Additional project focus:Net-working the „system“
eHealth Initiative in AT– Initiated by Ministry of Health
– Representatives fromhealthcare, industry, standards,
– national recommendations on technical standards, 2007, 2010
Started IGTelemed– Chamber of Doctors, Research
Societies, Chamber of Commerce, Standards Groups
– communication platform
– Awareness building
…
Meetings, events– Co-organise
– Attend, contribute
– Identify, link to best practices
Industry, Research– Empower, check feasibility
– Locally and international
Education– Develop „expert profiles“ within
IHE
– Students: Bachelor, Master theses, papers, projects
– Develop tutorial material
2011 PeaceHealth Laboratories 32
Concluding
The project „Healthy Interoperability“is supported by the Austrian Research Promotion Agency (FFG) within the "FHPlus in Coin" program and by the City of Vienna Municipal department 27 "EU-Strategy and economic development" following the "Fachhochschulförderrichtlinie" 2005.
Crowd sourced healthcare addresses recommendationsthat were developed at this meeting here in Alpbach
Aligns to European priorities
Evidence shows it works
It takes more than doctors and engineers.
We need to seed this further.
Lets get crowded!!
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