emerging information technologies in health care€¦ · emerging information technologies in...

Emerging Information Technologies

in Health Care Yan Chow, MD, MBA / Director, Innovation and Advanced Technologies

Kaiser Permanente Information Technology

Oakland, California, USA

yan.chow@kp.org

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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.

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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

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Weight, body fat, BMI © Withings

Galvanic skin response (GSR)

Q Sensor © Affectiva

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Skin glucometer

© Dexcom

Wireless pulse oximeter

© iHealth Labs

Products not endorsed by KP

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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

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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

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Seat pressure ID - Adv. Inst. of

Industrial Tech (Japan)

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3

Interactive glass mirror display © Corning

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Under-mattress activity and VS sensing © EarlySense

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imPulse EKG monitor © Plessey (UK)

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Products not endorsed by KP

SleepClock © Renew

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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

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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

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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

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Proteus Raisin microchip pill

Pill dispenser

© MedReady

© Xhale

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© Proteus

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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

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2

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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

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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

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6 5

Google Glass © Google

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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

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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