Connected Health Conference Day 2

       The second and final day of the Connected Health Conference was another great and engaging way to spend a day indulging in digital health technology.  Several themes continued to emerge as the conference wound down.
Personalization
       Many Digital Health companies are trying to provide personalized experiences for their customers.  Using video, text and even digital personal assistants like Alexa, these companies are looking to make something unique for each patient.  Patients may change behaviors and make more lasting changes with personalized experiences and regular communications.  A lot of the options included regular coaching and taking a more holistic look at a disease process.  I found it quite fascinating that results one company was able to obtain with weight loss when they incorporated virtual mental health care.
AI
       Whether its called Artificial Intelligence, Augmented Intelligence or Assisted PilloIntelligence, it is clear that AI is going to become a large part of the healthcare landscape very soon.  As above, some of the personalization of digital health technology can be algorithmic to guide diagnosis and treatment options.  AI can predict a diagnosis based on symptoms as well and physicians in many cases and are even better at identifying skin cancers.  Fairly soon, a patient may be able to use AI to help understand the symptoms they have, maybe even diagnose themselves and then guide a patient through the next step in the healthcare system.  The picture to the right is of Pillo, a new AI driven droid like robot that will dispense your medications on time, discuss your health, call you family and even activate emergency services if needed.
       For physicians, we will have to start to adapt to having AI as part of our work flow.  Initially it might just be technology with natural language processing allowing physicians an easier way to interact with EMRs.  But as AI proves to be more any more effective at synthesizing and analyzing data, physicians may find that they no longer need to spend much time on the process of diagnosis.  As above, if a patient can check a worrisome more at home with an app on their phone, the physician may just be needed to confirm and remove the lesion.  Physicians may find that they are spending much more time creating treatment plans and executing a treatment plan than looking for a specific disease.
Convenience
       A fascinating statistic was discussed at the Connected Health Conference that has been churning around my brain.  The average American has 4 physician visits a year and spends about 15 minutes of face time with a physician each time.  That adds up to just one hour of face to face time with a physician every year for the average American.  When you think about it from a patient point of view, there is so much that is inconvenient about medical care.  Most outpatient care follows business hours, so an appointment requires taking time away from work.
       It is almost a cliche to talk about wait times but once a patient takes time off from work, spends time driving to their physician’s office, they will need to wait for 15-60 minutes in the waiting room.  Then once they are actually taken to an exam room they usually wait there, allowing the physician to determine the beginning and end of every appointment, simply by walking in and out of the exam room.  There are insurance hassles and paperwork hassles and call-back issues.  Trying to see a physician is inconvenient for a lot of people.  Digital health is trying to change that, providing technology that can bring the healthcare system to the patient on their terms.  I heard many times at the conference that a patient’s home is going to become the center of their healthcare delivery.  Withe remote patient monitoring, home diagnostics, AI driven personal healthcoaches and virtual visits, digital health can provide convenient care that a patient is more likely to use and use in an effective manner.
       Overall, I felt the Connected Health Conference was a huge success and I had a profound impact on me.  By empowering patients to be at the lead of their own care Digital Health will revolutionize where and how we provide and receive medical care – and sooner than we think.

Scenes from the Connected Health Conference

HoloLens 3D

Using the HoloLens 3D from SphereGen.  Used it to review cardiac anatomy and to review radiologic images of a foot and ankle.

 

Me and Pillo

Here I am with my new friend Pillo.  Pillo is a home health AI healthcare companion.  Can dispense your medication, record your blood pressure, call your family and tell you a joke.

Pillo

Pillo reminds of a droid from Star Wars.

 

Reflections on Day 1 of the Connected Health Conference

       The Connected health Conference in Boston has been a great experience for me so far.  It has been so fun to be immersed in everything digital health.  Discussed Artificial Intelligence and machine learning as well as telehealth and wearable technology.  There have been a few themes that resonated with me that I would like to share.
       As clinicians and as any provider of healthcare, in the very near future it will be expected that we meet the patient where they are, not where we would like them to be.  Remote patient monitoring was a constant motif throughout the day today. There are so many telehealth and virtual visit opportunities for patients.  Anyone who thinks that medical care should happen exclusively within the walls of a medical office or hospital will be the least successful healthcare providers moving forward.  Digital health is many things, but is it clear to me today that it is really about providing convenience to patients.
       More than any other group, those involved in Digital and Connected Health are acutely aware of the exponential growth in healthcare needs in America over the next decade.  One stat that absolutely drove this home was the idea the in 2020, less than two and half years from now, there will be more people over 65 years old than there will be children under 5.  The needs of those older adults will preclude most one on one care and the virtual care provided these patients will be able to fill in the gaps of care.
       It is 100% clear to me that Fee-For-Service payment models holds back new models of care.  Physicians, health care teams and administrators can not focus on experimenting and creating brand new models when you have to work so hard to on Fee-For-Service.  I heard Clayton Christensen speak today and he mentioned that in a lot of health systems, they make money when a patient is sick.  Better models would allow a healthcare system to make money to keep the patient well or to get well faster.  That is not where many of us are but where we all wish we could be.
       Many of the companies I met today are looking to go directly to the patient or caregiver to sell their product.  That has two consequences for physicians and those that provide medical care.  Traditional healthcare providers may find themselves marginalized in the decision making process for their patients.  We will find that our patients obtain devices and apps without any physician guidance.  The second issue that we, as physicians, will be expected to review and evaluate said data.  This will be expected of us, regardless of how beneficial we think the information is.
       Finally, one of the Keynote Speakers this morning was Futurist Chunka Mui.  He said something that will stick with me for a very long time.  He said that the “fast learner wins.”  That is applicable to everything in today’s medical and business environment.  When you think about it, it applies to everything.  Those who learn the fastest can adapt to changes faster.  It’s that adaptation in a rapidly changing world that leads to success.  I can’t wait to learn more tomorrow.  And learn it quickly.

Physicians Leading Patients to Quality Medical Information Online

To create and foster high patient engagement, every patient must be able acquire thebook-1659717_1920 necessary knowledge to be informed. For the longest time, the main source of medical information for patients was their actual physician. Physicians were the gateway into understanding one’s own body and disease process. This has rapidly changed because of the internet.  No longer is medical information trapped in old books or a physician’s mind.  Now there are thousands of ways to find medical information, much of it completely useless, inaccurate, not widely applicable or simply plain wrong.

Many physicians will complain that their patients find medical information online and want to discuss it or use it to drive diagnosis and treatment. They are worried that the information their patient found is not accurate, that it will distract a patient from the real medical issue.  To some degree, all physicians worry about losing their position as an arbiter or gatekeeper of what medical information their patient receives, losing that feeling that their patients see them as the expert.

The next natural step for physicians is to become a guide and help patients navigate health information themselves. It should be a physician’s responsibility to to lead their patients to high quality medical resources. As physicians we need to steer our patients towards good information, which will limit opportunities for them landing on less accurate or just plain quack medicine sites. Below is a good place to start when trying to find good quality medical information

General Medical Information
To find high quality medical information on a wide variety of medical conditions I would start with WebMD, Mayo Clinic, FamilyDoctor.org, KidsHealth and the Center for Disease Control.
www.webmd.com
www.mayoclinic.org/patient-care-and-health-information
www.familydoctor.org
www.kidshealth.org
www.cdc.gov

Condition Specific Medical Sites
To research a little more deeply on specific conditions I would recommend the following sites. Both Cancer.org and Cancer.net are excellent resources for information on cancer. Heart.org and Diabetes.org are great for researching cardiovascular disease and diabetes. The National Alliance of Mental Illness has great resources on mental illness.
www.cancer.org
www.cancer.net
www.heart.org
www.diabetes.org
www.nami.org

If you are looking for an objective reference for alternative medicines and treatments, the best place to start is the National Center for Complementary and Integrative Health. The website for this division of the the National Institute of Health is full of useful information to make better decisions on alternative therapies and can be found at nccih.nih.gov.

Lastly, I would recommend looking at two two parts of the Healthfinder website. Using the guides provided there, it can give every patient a template for how to prepare and get the most out of their time with their own physician. The section called Take Charge of Your HealthCare provides a step by step guide to maximizing your use of the the healthcare system and you can find that here. My favorite part is the section on Talking With the Doctor. This has many common medical conditions and provides a series of questions that you should be sure to ask about each condition. These prompts can make a visit with your physician much more efficient and may propel you to better decision making with your physician. You can find that site here.

Record Breaking

Very happy to announce that this October, Digital Medicine and You has surpassed all of last years visitor metrics.  This website has had more visitors and more page views so far in 2018 than we had all of last year.  Very excited about this and thought I would share.  As always, love to hear any feedback or have conversations about Digital Health.

October 2017 Heads Up Concussion and Helmet Safety App

October 2017 Heads Up Concussion and Helmet Safety App

Heads Up Front PageWhat it is: A mobile app that provides information on preventing, identifying and responding to head injuries and concussions.
What devices: iPhones, iPads, Android devices
Cost: Free 
Who should use it: Parents, coaches, healthcare providers, anyone involved in youth sports
Why use it:   The risk of head injuries during sports has become a regular topic of conversation.  Potential damage to a player’s brain, especially the those younger participants in contact sports is on the mind of many athletes, parents and coaches.  The Heads Up app from the Centers for Disease Control provides well-researched and actionable information regarding head injuries and concussion as well as plans for prevention.
       The most important aspect of prevention of head injuries and concussions is appropriate safety equipment. The Heads Up app offers the Helmet Fit 360.  This interactive component of the app allows users to see all facets of appropriate safe fitting of a sports helmet.  The options cover everything from baseball and softball helmets to helmets for skateboarding and equestrian sports.  It will show you how to measure a child’s head to find the right fit for each helmet, visualize how it might it should fit snugly on a head and clearly show how a child’s eyes should be in relation to the helmet for adequate vision.  Every figure for each helmet can turn 360 degrees by swiping across the touchscreen on your device.Heads Up Eye fit
Heads Up Snug

 

       The other component of the Head Up app is a very in depth look at the information all parents, coaches and even healthcare providers need to know about head injuries and concussions.  There is information on basic signs to look out for, both from an adult and Heads up What is a concussionchild participants point of view.  There are danger signs to review to see if emergency personnel need to be activated.  There are great guidelines to follow to help those children who have had a concussion to help them return to school, succeed in school and eventually return to the plain sports.  There are options to be linked directly to the CDC’s website for further information.

       Overall this app is a must have for everyone involved in youth sports to be aware of the risks of head injuries, work on prevention and if needed, helped an injured athlete recover successfully.

September 2017 Simple Contacts

Title: Simple ContactsFront page

What it is: Mobile eye exam and contact purchasing app

What devices: iPhone and any internet connected computer

Cost: Free to download app, (contacts can be purchased through the app)

Who should use it: Anyone at least 18 years old who wears contacts, no recent changes in vision and no significant eye disorders

Why use it: For everyone out there that has tried to wear their contacts longer than recommended to stretch out their remaining supply of contacts, this app is for you. Simple Contacts is a mobile app that puts you in control of obtaining an eye exam and purchasing contacts on your schedule.

eye exam

Simple Contacts turns your iPhone or computer into a personalized eye exam. Through the app, videos of your eyes are captured while looking up, down and to the side. Then the app directs you to set your phone 10 feet away from you, even giving you guidance on how far away you are. Using voice commands, the Simple Contacts app directs you to cover one eye and read letters on your phone, just like at a regular in person eye exam

The feedback on my exam was much faster than I expected. Honestly, I cheated the exam a little, not completely covering my eyes. Within a couple minutes of completing the exam I received a text from Simple Contacts stating that I needed to redo my eye exam. Specifically, the Simple Contacts system had identified my exam because “it didn’t detect that your eyes were covered properly.” I couldn’t fool the app and re-took the eye exam, this time completely covering my eyes as instructed.

peaking text

Simple Contacts caught me cheating on the eye exam and asked me to repeat the test.

Once your exam is complete, the videos are then sent securely to an Ophthalmologist for review. The next morning I received an email from the physician who reviewed my exam. She had recommended that with my significant myopia, that I really need a true retinal evaluation every year.

I was able to choose the exact style of daily contacts I already use and in 4 days, 6 months of contacts arrived in my mailbox. I never stepped foot in a healthcare institution.

check out

To use Simple Contacts, you really need to have a set of contacts you feel are comfortable to just reorder. I would not recommend trying a different brand through this app.

This app does not replace a complete eye exam performed in person. For many people with certain medical conditions, they should always seek routine eye care. If you have glaucoma, diabetes, cataracts or any type of medical condition with ocular manifestations Simple Contacts is not something I would advise.

Overall, Simple contacts is easy to use and the convenience of the app is spectacular. You will never run out of contacts again.