Aging could be easier to manage with AI

hands

An amazing Quartz article talks about AI and robotic usage for elderly.

It is a must-read for people not ready to hear that we plan to use robotics instead of real people to interact with elderly in specific conditions. You will read the opinion of a doctor mentioning its use of Paro to calm the anxiety of Alzheimer’s disease patients instead of giving them sedatives.

People concerned about the harm a relationship with Paro might do to a person with dementia do not understand the gravity of the disease, Petersen says. “You come to a point in dementia where you can’t trust yourself,” she says. “It’s like being dropped in another country where you don’t speak the language, you don’t know what time of day it is. It’s terribly, terribly fear-producing. These people live in a constant state of fear because they can’t figure out what to do next. They know something’s wrong but they can’t figure out what it is. And it never ends for them. I don’t think people realize how horrific it is.”

Image source

Médecine personnalisée – Quelles libertés dans la santé de demain ?

Histoire et cite

Table ronde du 23 mars 2018 à l’Université de Genève dans le cadre du festival Histoire et Cité

Interventions de Micheline Louis-Courvoisier, Bertrand Kiefer et Christian Lovis

La diversité des intervenants permet la combinaison d’une perspective historique avec une approche de société pour analyser les problématiques d’aujourd’hui et de demain concernant la médecine personnalisée.

Quelles libertés pour le malade d’hier ? – Micheline Louis-Courvoisier

Micheline Louis-Courvoisier nous propose une approche historique de la médecine personnalisée. En tant qu’historienne et spécialiste de l’histoire de la médecine, elle nous explique comment se passaient les consultations au 18ème siècle et comment on peut relier ces expériences au contexte d’aujourd’hui.

Au cours du 18ème siècle, les consultations se faisaient sur une base épistolaire (correspondance écrite entre le soignant/médecin et son patient). Il y a plusieurs raisons à cela : la médecine basée sur les humeurs n’avait pas besoin de l’examen du corps physique ; les soignants étaient plus rares qu’aujourd’hui et souvent, même en cas de consultation occasionnelle en personne, les patients donnaient des nouvelles à leur médecin dans l’intervalle. On écrivait donc à son médecin, cependant ceci était réservé à la partie lettrée de la population.

Cette pratique permettait au médecin d’analyser l’expression de la maladie chez chaque patient en fonction de son ressenti. Le patient organisait son récit à sa manière, il n’y avait pas de lettre-type et chacun d’entre eux s’exprimait différemment. L’écriture en elle-même avait probablement également une valeur thérapeutique puisqu’il a été prouvé par plusieurs études récentes que si un patient relate ses symptômes par écrit, cela permet de le soulager partiellement.

La transmission des sens s’effectuait d’abord du somatique au sémiotique (de la maladie et des symptômes à son expression par le patient) et du sémiotique au somatique (par le médecin qui essayait d’interpréter les mots du patients). Afin de faciliter la compréhension par le médecin, le patient utilisait très souvent des comparaisons ou des images pour représenter et détailler ce qu’il ressentait.

La connexion entre les émotions et le corps a toujours été analysée et a encore été étudiée dernièrement dans une étude publiée en 2014. Les personnes participant à l’étude devaient reporter les sensations corporelles en lien avec des émotions stimulées.

topographie corporelle

Topographie corporelle des émotions de base (supérieures) et des émotions non basiques (inférieures) associées aux mots. Les cartes du corps montrent les régions dont l’activation a augmenté (couleurs chaudes) ou diminué (couleurs froides) lorsqu’on ressent chaque émotion. (P < 0,05 FDR corrigé ; t > 1,94). La barre de couleur indique la plage de statistiques t.

Source : Bodily maps of emotions; Lauri Nummenmaa, Enrico Glerean, Riitta Hari and Jari K. Hietanen; PNAS January 14, 2014. 111 (2) 646-651.

Ce type de consultation permet de constater que la relation médecin-patient reposait sur plusieurs dimensions : précision de la sensation, précision de l’expression et précision de la transmission. Au 18ème siècle, la médecine était donc très personnalisée et individualisée puisque le lien entre le médecin et le patient, basé sur une correspondance d’écrits, permettait des traitements adaptés en fonction de chaque situation.

Aujourd’hui, la situation a changé et le patient n’écrit plus à son médecin. Ce n’est pas pour autant qu’il ne bénéficie pas d’un traitement personnalisé.

Quelles libertés dans la santé de demain ? – Bertrand Kiefer

Bertrand Kiefer nous parle de la technologie et de son impact sur le système de santé mais aussi sur notre perception de la santé en elle-même.

Le pouvoir de la technologie s’accélère et dissout progressivement les liens que l’humain entretient avec la nature. Cette domination graduelle permet de dépasser la nature. Aujourd’hui est une époque centrée sur l’hybridation entre l’humain et les machines, entre l’humain et les informations grâce à l’émergence de nouvelles technologie dans le domaine des prothèses (orthopédie, cardiologie), des organes (transplantation), des cellules (immuno-oncologie) et des gènes (technologie CRISP-Cas9).

L’individu peut être vu comme un système de données. La réalité augmentée qui en est dérivée permet de voir plus que la réalité engendrant ainsi une individualisation plus poussée ainsi qu’une nouvelle dimension de la communauté.

Régis Debray, mentionné par Bertrand Kiefer, a étudié la progression des sociétés dans le contexte de l’évolution des technologies (voir tableau ci-dessous). Selon ses propos, la période actuelle est caractérisée par les réseaux, les algorithmes et l’individualisme. La technologie a donc considérablement changé l’humain et, aujourd’hui, des tendances quelque peu extrêmes émergent, comme par exemple le solutionnisme (vision philosophique qui présuppose une solution technologique à tout problème humain) ou encore le transhumanisme (mouvement prônant l’usage des sciences et des techniques afin d’améliorer la condition humaine en supprimant la souffrance, la maladie, le vieillissement ou la mort).

mediologie

Source

Ces tendances soulignent toutes que la santé personnalisée est possible aujourd’hui grâce à toutes les données qui permettent des diagnostics et des traitements plus précis.

Par contre, on a perdu le concept de normalité puisqu’il n’y a plus de « bonne santé ». En effet, un être humain se positionne toujours sur un continuum car il est toujours porteur de facteurs de risque et de prédispositions. De ce fait, on n’arrive plus à distinguer ce qui est normal de ce qui est pathologique.

L’humain garde toutefois sa liberté, qui, pour l’instant, perdure encore dans les fondements de notre société. Cette liberté permet aussi de construire la relation médecin-patient à travers les décisions partagées et les discussions liées à chaque pathologie malgré des incertitudes croissantes. Les asymétries dans la transparence contribuent à ces incertitudes car les personnes et leurs données deviennent de plus en plus accessibles, à l’inverse les entreprises et les gouvernements s’enfoncent dans l’opacité tout en surveillant étroitement les individus à travers leurs données.

Même si une partie des actes médicaux pourrait être accomplie par des robots ou des auxiliaires technologiques, la relation soignant-patient comporte tellement de niveaux (langage verbal et non-verbal, plusieurs niveaux d’interaction, transfert et contre-transfert) qu’il n’est pas possible de la remplacer. Elle est également ancrée dans une communauté de destins, sous-entendant que le soignant fait preuve d’empathie puisqu’il est lui-même faillible et mortel, tout comme son patient.

Médecine personnalisée et prédictive – Christian Lovis

Christian Lovis nous parle du déterminisme sous-jacent à la médecine personnalisée et prédictive. Le déterminisme part du principe selon lequel la succession de chaque événement est déterminée en vertu du principe de causalité. Se pose alors la question de savoir dans quelle mesure nous sommes déterminés ou libres de ce qui nous arrive ?

La biologie moléculaire s’appuie principalement sur ce déterminisme qui est encore en évolution puisque l’on n’a pas encore découvert tous les marqueurs de toutes les pathologies existantes. Le lien de causalité est parfois aussi difficile à établir. Cependant, une grande partie des thérapies ciblées contre le cancer cherchent à enrayer les processus qui se cachent derrière ces marqueurs. Ceci a contribué à améliorer l’efficacité des traitements de manière significative.

Il faut toutefois être conscient que la génétique n’explique pas tout. Selon un chercheur, seuls 10% de notre santé seraient déterminés par les gènes et la biologie. A nuancer toutefois puisque lorsque la génétique est contributive, elle l’est massivement.

determinant of health

Source: Public policy frameworks for improving population health, A.R. Tarlov, Ann N Y Acad Sci. 1999;896:281-93.

Ce qui est unique en nous est beaucoup plus important que ce que l’on a en commun avec les autres êtres humains. De plus, il a été prouvé que ce n’est pas forcément la séquence codante de notre ADN qui détermine la caractéristique génétique mais les séquences régulatrices qui entourent celle qui est codante.

Les données qui caractérisent le comportement ainsi que l’écosystème dans lequel nous vivons jouent un rôle majeur dans notre santé et sont disponibles pour être analysés. Progressivement, comme discuté précédemment, la donnée va remplacer l’humain. Nous sommes tous uniques mais le danger est de devoir ressembler à une catégorie particulière avec laquelle nous avons des points communs mais qui ne nous correspond pas complètement. Cette catégorisation induira une perte de la liberté individuelle qui pourrait potentiellement entraîner une dangereuse émergence des eugénisme et hygiénisme du passé.

Les données risquent fortement de remettre en question le système solidaire qui existe aujourd’hui. Ceci est principalement lié au fait que les données qui sont collectées sont structurées et elles perdent du contenu au cours du processus de structuration. Il y a un énorme décalage entre la perception de la société civile sur la santé et la réalité. La société civile doit lutter pour comprendre cette nouvelle médecine qui est basée sur un grand nombre de données et une technologie de plus en plus imposante.

Le développement des algorithmes et de la technologie va fort probablement déplacer le rôle du soignant vers des tâches beaucoup plus humaines et empathiques tout en laissant les algorithmes décider du meilleur traitement.

E-health Day – Internet of Me: Vision and Challenges

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I had the opportunity to attend the e-health day in Sierre (TechnoArk) on June 3rd 2016. The event was well organized around big players (Boston Scientific, Roche), showing their vision of the technology and its implementation in their own business model, and startups (L.I.F.E. Corporation, Karmagenes) unveiling their innovations in the field. Moreover, other stakeholders like the health insurance Groupe Mutuel and government-financed agency CIPRET presented their real-world experiences. The event was closed by a panel discussion on the relationships between eDoctors and ePatients.

Globally, the vision of health is: health care providers will be able to improve health outcomes by working with digital patients (the data collected by sensors will be integrated and analyze to provide personalized treatments and consequently better outcomes). Several projects are developed: prosthesis control, diabetes management, vital signs monitoring for elderly people…

Below I summarize the key takeaways from the most interesting talks (not all of them).

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BOSTON SCIENTIFIC – MEDTECH : WHICH BUSINESS MODEL FOR THE E-PATIENT ?
By Frédéric Briguet, EU Digital Health Engagement

  • The goal of the presentation was to provide clues on which business model is the most appropriate for digital health companies.
  • Medical technology companies create and develop products for patients but they really have to be aware of their ecosystem and the influences that will drive patients’ behavior.
    Body sensors brought revolutionary tools to life. They are wireless, responsive, use mobile devices and allow data analysis to be performed. However, what is the real impact on health and disease management? Many companies have sensors supported by solid hardware, cloud data collection and a dashboard for mobile phone.
  • Despite the evolution of technology, we are still lacking clinical studies and proofs. In addition, the user dropout rate is pretty high (after 6 to 8 months, users abandon the sensor(s) and the app). Needless to say that, on top of all the previous disadvantages, the amount of data generated is extremely heavy and it is difficult to extract the most relevant indicators to analyze them.
    However, the first digital health products helped open new perspectives and the potential of connections between all the stakeholders. Empowering and engaging healthcare providers is also one of the key benefits of the first digital health initiatives. Beyond those elements, what’s crucial to ensure adoption and reimbursement is to demonstrate the cost savings the technology could bring to the current health care settings. Doctors also have to support it and be convinced of the use and utility for their own patients.
  • All in all, the future of healthcare is expected to improve outcomes, reduce hospital readmission rate and control costs while maintaining care access.
  • The experience of the speaker allowed him to say which business models where the most appropriate to survive and thrive in that new field. He established 4 directions (that can be combined):
    1. The patient is not a consumer. Generally speaking, he is not really willing to know that he’s ill. His main focus is to live. Family and friends are the most concerned about the patient’s health and wellbeing. Creating and developing tools that could ease the burden for the supportive people around the patient is generally well received and adopted.
    2. Understand the business ecosystem. Knowing where to position the company is fundamental to avoid being stuck in a no man’s land. Focusing on lifestyle, coaching or care pathways is different and requirements increase massively for the care pathway segment.
    3. The population is ageing and increasing. The health care system will have to support an additional financial burden with the passing of the years because we know that the majority of the costs is generated toward the end of life. Hospitals are paid today according to their own efficiency (shorter hospital stays as well as improved outcomes will generate higher payments from heath insurances). It is the OPM principle (Other People Money) meaning that the patient (who consumes) is not the payer. It is then crucial to find new solutions to reduce the costs.
    4. Understanding the disease is more than fundamental. Compliance and adherence management and control in order to avoid hospital readmissions is one of the main issues of the whole healthcare system. Beyond that point, enhancing and improving the patient’s experience as well as the quality of care could well trigger new motivations for the patient to be compliant to his treatment.
  • Go beyond sensors-mobile-cloud-dashbord to include blockchain technology, augmented reality, internet of things… + any relevant technology or innovation that can bring value to the system. This value has to be demonstrated and proved as viable for the whole system.
  • The technology has to be integrated in the patient’s experience, nearly invisible, but not less complex.

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PATIENTS LIKE ME – THE POWER OF WE
By Chris Fidyk, Business Development Director Europe

  • Accelerating research and development of new treatment but also allowing patients to support each other and exchange life experience with a disease is the main goal of PatientsLikeMe. That network is maybe the smallest social network but the larger medical registry with more than 500’000 patients. Patientslikeme provides tools for patients to put their disease into context.
  • Today, there is a lot of momentum about patient centricity. It becomes more mainstream. Patients owe other patients their own experience (drugs, symptoms,…). Empowering people to express themselves about their journey in the disease. Then, when all the stories are aggregated, meanings and trends can be extracted.
  • It is also possible to see all people taking the same drug, its perceived effectiveness as well as some conversation analytics allowing to understand which symptoms are the most talked about, the treatment awareness, the barriers to access in addition to the reasons behind their treatment failure or cessation or continuation.
  • Data (experience and discussions) stay online and available even when the patient dies to enrich other patients’ lives. Regular video postings on Patientslikeme Youtube channel show patients sharing their own experience with the website and how it helps them cope with their disease.

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ROCHE DIABETES CARE – EHEALTH: THE FUTURE WE CREATE TODAY
By Horst Merkle, Diabetes Management Solutions Director

  • You can only do something with data when you can access to it.
  • Infrastructure is the foundation for innovation and creativity” – as quoted by a speaker at the Connected Health Conference.
  • How to meet the future? The lack of healthcare staff, the increase in chronic diseases and the rising healthcare costs are the challenges. How to manage them: accountability and empowerment for the patient and the consumer. Mastering your own health with less health and care services.
  • Today, technology-driven health is messy. The solutions have to be easy to use and secure for the patient.
  • The Personal Connected Health Alliance (PCHA) is at the forefront of health and wellness in today’s society, driving advancements in mobile and communications technologies, and the growing use of new devices, health trackers and apps by consumers and healthcare providers.
  • PCHA brings together the critical elements needed to ensure that these technologies are user-friendly, secure and can easily collect, display and relay personal health data. In PCHA’s vision for healthcare, consumers can use readily available technologies to access their personal health data, receive targeted health and wellness education, consult with healthcare providers and gain support from friends and family to improve their health.
  • PCHA focused on engaging consumers with their health via personalized health solutions designed for user-friendly connectivity (interoperability) that meet their lifestyle needs.
  • Business models are the main obstacles for interoperability to work.
  • Accu-Check Connect System from Roche provides an integrated meter, an app, and online tools for better diabetes management. The glucometer can share data in the cloud with the healthcare provider.

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WITHINGS – FROM QUANTIFIED SELF TO PREVENTIVE MEDICINE
By Alexis Normand, Health Development Director

  • The main goal of Withings is to sell connected products to the general public. Those products can be bought in supermarkets and will help the consumer monitor vital signs such as weight, blood pressure,… Without being a doctor, the consumer can create a dashboard for his health. Changes in health are driven by him and, due to the fact that he generates data, he will be at the center of the data collection and analysis.
  • Those tools could also be used to enhance corporate wellness and engage employees through gamification. Employers will offer a connected bracelet and will organize a competition. Employers are however inherently screening employees for health issues and can analyze aggregated data to discover trends. Data around workout and physical activity are enriched by environmental and lifestyle inputs but also by stress management and absenteeism information.
  • In the e-health field, we are in the prevention area and also on new territories like personal health dashboard and employer focus on employees’ health.
  • E-health could be widely applied together with EHRs (Electronic Health Records). Linking EHRs to outcomes allow hospitals to monitor their performance to get more money from payers as they will limit the expenses for the system as a whole.
  • Withings also builds an open health data platform with the implementation of national observatories aggregating data from all the users. Those platforms will support research on connected devices with scientific publication and could stimulate partnerships and collaborations with other data sources.

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GROUPE MUTUEL – IGNILIFE – DAILY HEALTH COACH
By Stéphane Andematten, Marketing Leader

  • Real world business case from concept to realization in partnership with the startup Ignilife.
  • Today more than 165’000 health apps are available with 40% dedicated to medical uses and 60% to wellness.
    Regarding Switzerland, few initiatives have been developed to date. Groupe Mutuel would like to be the forerunner and not a follower in the field.
  • Ignilife is a French startup with a subsidiary in Switzerland. It is the perfect combination of entrepreneurship, medical skills and user experience. Ignilife has a previous experience with Malakoff Médéric, the leader for private health insurance in France.
  • Ignilife is a e-coaching platform based on people. It covers physical and emotional wellbeing. A first auto-evaluation is performed by the user in order to have a broad overview. An assessment is then released by the system with risk factors and advices to manage and lower their impact. Support and follow-up is provided as a selection of programs the user can choose from. He can also connect his devices.
    Close to 300 video and audio plays are available. Each time a contest or challenge is won, it is input in the platform to show the progress and evolution.
  • It is essential to develop a rich, engaging and fun platform to keep the user motivated. The goals set are reasonable and not out of reach. There is a social media component where users can exchange experience and tips. More functionalities will be developed in the next future (health at work, back health, burnout prevention,…)
    Data protection is well managed, as all the data are stored in Switzerland on independent servers.
  • Groupe Mutuel pretends it does not use data collected by user but only on an aggregated basis. The rationale behind the implementation of such a project is the focus on prevention. It will help to keep health expenses at an acceptable level in the longer term.
  • Some stats:
    25’000 Ignilife users (out of more than 1’100’000 insured people)
    Mobile users connect much more than desktop users (2x)
    91% did their auto-evaluation
    61% engaged in a coaching program
    47% changed their habits

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MANAGE MY DATA OR BE MANAGED BY MY DATA
By Stéphane Koch, Expert in Digital Experience

  • People like to measure their own weight, the calories they burnt, their heart rate,…
    There is a real value added in using quantified self.
    However, coherence is not always part of the measures and can distort statistics extracted out of the data. Sensors sometimes lose connection with the app leaving gaps or errors in measures. Improving apps with coherence system would be a big step further or even allowing the user to correct the data himself.
  • Quantified self generally has a positive impact on the user’s wellbeing but it can also generate stress if the progress takes time to emerge or if it stops. Knowing the scope of the technology as well as his body are fundamental.
  • The website DMD (in French) allows the evaluation of digital tools and the sharing of everyone’s user experience.

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CIPRET – 7000 SWISS PEOPLE STOPPED SMOKING THANK TO A FACEBOOK PROGRAM
By Alexandre Dubuis, PhD, CIPRET Valais leader

  • CIPRET is a center for the prevention of tobacco use, recognized of public interest by authorities.
    It launched early 2016 a program to help people stop smoking via Facebook.
  • A real human adventure started and succeeded. The initiative was in 2 phases: recruitment and program on the same platform. It was completely free for the users. They just had to like the page, say they are interested and accept that all the posts written by CIPRET were the first they saw when they opened their Facebook app.
  • 3 pillars of the program:
    – Daily advices (personalized and not always linked to tobacco consumption)
    – Group support (tips and experience sharing)
    – Physical desire to smoke (will only last between 3 and 5 minutes => tips given to avoid relapse).
  • Professional support has been organized at 3 levels : the first one, community managers answer simple questions ; the second one, prevention experts take specific questions ; the third level, medical practioners take care of medical questions.
  • Some stats:
    1’500 posts created
    Support was on call during the whole week from 6am to 11pm
    13’000 messages have been answered in the first weeks
  • Key strengths: no moral scolding, always up-to-date, focus on workouts, nutrition, Sunday evening chats, real meeting groups.

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L.I.F.E – EXPRESS YOUR TRUTH THROUGH YOUR ACCURATE DATA
By Dario Ossola, PhD, Algorithm R&D Coordinator

  • L.I.F.E stands for Live – Inspire – Free – Entertain
  • The project started at the core of The Ark and focused on predictive models for tiredness, exhaustion and strain with the development of a garment.
    That garment is equipped with sensors to monitor vital signs (it is medically accurate and there is no need of a smartphone). It allows total freedom.
    It can be the third platform of communication (with the first 2 being computers and smartphones).
  • The medical accuracy is fundamental and it can be used in medical practice but also in sports. That garment has the same results as the invasive methods to analyze vital signs. It allows real life measurements and expansive communication (data omnipresence, diverse data analysis levels).
  • Two web sites: http://x10x.com/ (for women) and http://x10y.com/ (for men)

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ISYPEM2 – PERSONALIZATION OF TREATMENT DOAGE THANK TO MEDICAL DATABASES
By Séverine Petitprez, Scientific associate, Clinical pharmacology CHUV and Alevtina Dubovitskaya, Research assistant, HES-SO Valais

  • Software for personalized treatment dosage.
    Unique treatment dosage works very well for simple drugs like paracetamol. Unfortunately, for oncology or chronic diseases drugs, which are much more complex molecules, it doesn’t work as well. It can lead to toxicity, side effects or no effect at all.
  • Therapeutic follow-up normally starts with a blood sample, pharmacology experts interact and guide the doctor in order to personalize the treatment.
  • A new software (EzeCHieL) do exactly the same but in a much faster and more practical way. The software can create the patient’s drug metabolism curve based on the EHR (Electronic Health Record) and medical databases. Some genetic characteristics or co-morbidities can lead to changes in drug blood concentration.
  • Interoperability (web interface) as well as confidentiality and data security are guaranteed (pseudonymisation, anonymisation).

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KARMAGENES – BE A GAME CHANGER MEET YOURSELF
By Kyriakos Kokkoris, CEO

  • Karmagenes is a game combining gene profiling and psychological analysis. Integrating genetics with psychology for improved personal development.
  • What defines who you are: what you are (DNA) and where you live (environment & perception).
  • Genetics meet psychology.
  • Human centric approach
  • Could be a network of personalities and connect locally.
  • Personal guide for career development, personal motivation, and physical as well as emotional well-being.

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PANEL DISCUSSION – E-DOCTORS AND E-PATIENTS, AN EMERGING RELATIONSHIP
Moderated by Sébastien Mabillard, Swiss Digital Health coordinator with 5 paticipants: Dr. Jean-Gabriel Jeannot; Dr. Pietro Scalfaro; Pierre-Mikael Legris; Christine Bienvenu; David-Zacharie Issom.

  • The market is not yet mature, a lot of opportunities are waiting to be seized.
    The patient is at the center of all motivations.
  • Despite new technologies, there is a lot to do to reach the patient. Few success stories (the CIPRET is however an excellent example).
  • What about doctors’ digital education? Patients are really driving the trend today; they stimulate doctors to be up to date and they push technology adoption.
    Patients are very often looking for information online. Doctors should be prepared and help patients to use the right web sites in order to find appropriate and correct information. Doctors should also contribute and provide content on website to populate them with correct information.
  • All that information help to start interesting conversations. Information exchange should also be facilitated. The patient could be educated to provide the appropriate amount of information to avoid overload.
  • Patient should take part and be part of medical research. The patient is the least used resource in health care. With patients’ associations, precious information is stored and exchanged. That data can be analyzed.
  • The social component is extremely important for patients. Several of them like to share their experience and find support online. They also feel useful to provide information for other that have been diagnosed recently.
  • By giving access to medical and health information, communication and interactions with doctors will be easier and improved.

The potential for disruption in healthcare by Apple

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A lot has been said about the role of Apple in healthcare, the disruption it could bring and the need for it. If Steve Jobs was alive today, he would surely help the healthcare industry improve.

There is a lot of work and some progress are currently being made but they are slow to implement because evolution is not always seen as such (we all know about the learning curve…).

Apple is not the only company that could bring change and improvements, even disruption, in healthcare. All the technology companies are interested in this field and they will inevitably contribute to change the landscape.

What could Apple bring?

Analyze and integrate health data

The introduction of HealthKit in June 2014 was the start of a big wave of healthcare initiatives launched by Apple. Data collected via the HealthKit through wearables like the Apple Watch can be shared with the user’s doctor in order to improve the doctor-patient relationship. Data can then be integrated in the EHRs (Electronic Health Records) of the patient in order to enlarge the data collection.

Beyond data collection stands data analysis and it’s done with the help of the partnership with IBM Watson to support this effort.

Improve EHRs and real-time medical data to broaden prevention initiatives

Merging EHR and real-time data could enable the use of predictive analytics to anticipate health issues and diseases spread.

The implementation of EHRs could simplify and quicken the collection, use and consultation of medical data, especially in the case of emergencies. This could dramatically help to avoid medical errors due to the lack of specific retrospective information.

Partnerships

Apple has been and is still extremely smart in building strategic partnerships. 3 main partners worth keeping in mind:

  • IBM Watson: storage and analysis of raw data on IBM Watson Health Cloud for the data collected on HealthKit and ResearchKit.
  • Mayo Clinic: access to over 1 million patients in several countries around the world using dedicated proprietary EHR and communication tools for doctor-patient interactions.
  • Epic Systems: expertise in EHR covering over 100m people in USA.

HealthKit & ResearchKit

The main goal of the HealthKit is to collect data from wearables and other connected devices to better monitor individual health. HealthKit also allows the integration of 3rd party apps and devices.

ResearchKit is an add-on to the HealthKit as it helps create apps to improve clinical trials and medical studies.

Apple Watch v. 2.0 and new wearables

The new versions of the Apple Watch could potentially be developed into more sophisticated health-tracking devices with improved heart rate monitor. Moreover, thank to non-invasive technologies, new vital signs could to be captured and analyzed more accurately.

 

Related sources:

Why healthcare needs a Steve Jobs-like disruptor, STAT, February 2016.

Three More Industries Apple Could Disrupt, re/code, July 2015.

Steve Jobs didn’t disrupt, he adapted. So should healthcare, Becker’s Hospital Review, July 2014.

The Industries Apple Could Disrupt Next, Harvard Business Review, June 2014.

 

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Connecting Innovators in Life Sciences and Information Technologies – Lift Basel Conference 2015 – Day 2

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As promised, the summary of the 2nd day. I must admit, it is a bit long but all these topics were fascinating and the speakers really stood out from the “crowd” with excellent ideas. If you do not wish to read it all, just have a look at the headlines by scrolling down and skip to the topic that catches your eye.

Surgeons superpowers

Hans Florian Zeilhofer
Engineering the augmented surgeon

With the current trends in demographic development,more than 2 million people in Switzerland will be over 65 in 2050. What does it mean? More surgery as ageing is very often the synonym of diseases.

Surgery is more and more helped by technological tools, especially for complex cases like facial surgery where augmented reality could be really useful. But, technology has to be human centered and it is the moto of Mimedis, a fab lab for surgeons. Together with small interdisciplinary teams, the company focuses on design and manufacture (3D printing) of patient specific bone implants.

The speaker is not only the founder of Mimedis but also the initiator of MedTech Innovation Partners (MTIP), which helps finance innovative medical technologies. MTIP has a clear focus on innovations within health technologies. It offers business building support as well as continuity of funding and its network to accelerate growth.

More on augmented reality in surgery:

Augmented Reality for CMF-Surgery – Basel University

A Look into the Body – Augmented Reality in Computer Aided Surgery – Munich University

Philippe Cattin
Reinventing bone surgery

Nothing has changed fundamentally on how things are cut in surgery. But laser could be extremely helpful, leading to finer and more precise cuts. Plates will need to be smaller and even resorbable.

This technology also makes it be possible to perform functional cuts in order to avoid pain for the patient. It is a complete new thinking about how surgery is executed. No more straight cuts for an improved healing.

Together with enabling technologies, such as navigation and robots holding laser, surgery will be much more efficient with reduced doses of anesthesia and better recovery time.

The surgeon will not be replaced but empowered and the robot will be part of the surgery team.

AOT is dedicated to the development, manufacturing and sales of medical devices for osteotomy pursuing the vision of contact-free bone surgery using laser, robotics and navigation systems to re-invent bone surgery (osteotomy). 3 lasers are built into the system; one of them is a ruler and will measure across the cut. The main product, Carlo, is a robot, currently tested in animal experiments.

More on laser use in surgery:

Laser-cutting of bones replaces sawing – Nominated for the CTI Swiss Medtech Award 2015

Raimund Erdmann
Human-centered design

Innovation strategy coupled with human-centered design will deliver corporate value. Human-centered design is the primary goal of Erdmann Design.

HCD

For human-centered design to produce worthwile results, several and diverse stakeholders are requested to interact and think on how can you help with low tech simple solutions. Stand where problems occurred helps understand better the real context and will generate more relevant solutions.

More on human-centered design:

Usability results through human centered design and early test models – Medical Cluster Meet the Experts 2014

More on Swiss Med Tech Industry:

Swiss Medical Technology Industry 2014

Doctors and patients revisited

Haig A. Peter
Outcome-based healthcare

It is not big data anymore but it is a tsunami of data. Not only text data but pictures, videos, sensor data… and 90% of the data was created in the last 2 years.

How can we use it? What’s in there?

  • Clinical data only represents 10% of data
  • Genomics factors reprsent 30%
  • Exogenous factors represent 60%. What do we mean when we say exogenous factors? It’s the information about lifestyle (diet, sport, smoking,…), behaviors, drug adherence. It is immensely useful when combined with all the other types of information.

Machine vs. Humans?

Humans are the best machine ever because of feelings such as compassion, intuition, design, value, judgement and common sense. No robot or machine is ever capable of such skills. However, machines have huge learning capabilities, especially deep learning (+ machine learning), discovery, large-scale math and fact checking. The last competency is crucial because, as of today, we do not know exactly what’s true on the internet.

The key: Human + Machine – rethink whats possible, what would you do, how could we use it…

Examples:

Memorial Sloan Kettering teams are partnering with IBM to train Watson to interpret cancer patients’ clinical information and identify individualized, evidence-based treatment options that leverage doctors’experience and research. Big data could stimulate the building of knowledge for diseases without current treatment option – what can we do, other medications, which data do we consider,…

Watson will help reduce the time of drug discovery by identifying markers quicker and accelerate the time to market for drug projects.

Welcome to the cognitive era!

More about IBM Watson in healthcare applications:

IBM Watson Health

Watson in Healthcare

IBM pushes Watson into healthcare with new business unit – Barb Darrow – Fortune 2015

Cécile Monteil
The impact of technology on the patient-doctor relationship

Talking with patient was key before, science has now made huge progress. From “medicine is art” to “medicine is a science”. As a result, medicine today is taking the human touch away.

For a patient, talking and having explanations about the results of an exam is as important as undergoing an exam. Technology is here to increase the productivity of tasks but the relationship between the doctor and his patient has to stay and to be developed further. The human part of the process is already key in the healing process.

Technology can connect people. Today, technology allows patients to find information and to empower them. Participation in decision-making about treatment options and pathways is relevant for patients. Moreover, smartphone and connected objects can help track patient symptoms and treatment choices. It is used today for Type 1 Diabetes glucose monitoring.

With connected objects it is easier to monitor body parameters. Furthermore, doctors will be informed of those parameters and will be able to act upon.

The patient has to be at the center of care, beyond simply being part of the loop.

New types of expertise will show up, like medical data scientist, care coordinator, prevention doctor, education nurse,… and whole teams will collaborate in order to take care of the patient for better outcomes.

More about connected health:

Eppocrate

Santé connectée : quelle révolution pour la recherche médicale ? – TEDxUTCompiègne 2015

Patricia Sigam
Digital health – Time for new players
Integrated care – digitalMedLab

Yesterday, the patient-doctor relationship was compassionate, coordinated, comprehensive, continuous, accessible and family-centered. Today, the change is not only technological but also societal.

Patient-centered care is paradigm change, in which patients would like to be considered a they are and not as animals. A whole new ecosystem is emerging and developing itself.

Between a patient and his/her doctor, very often, there is a nurse. Thus, it is more a patient-nurse system or relationship.

But who is the expert?

It is crucial to visit the right expert that will be able to pose the right diagnostic. Provider empowerment (or nurse empowerment in this case) via technology will free time for the doctor while the nurse will do the consultation and collect the data to send them to the doctor. He will then be able to analyze them and act upon.

An interesting example comes from the dietitians of Canada, following obese patients and being their point of contact or new reference to talk to instead of the doctor.

Technology allows patients to stay connected with healthcare professionals following them. In addition, digital technology makes it possible for healthcare professional to be empowered.

Furthermore, caregivers and relatives can use digital technology as well. For example, Alertwatch is a tool giving relatives access to the localization of the loved one on a GPS map. Needless to say that caregivers will have more serenity, increased freedom themselves and improved information on the patient.

Remote support is complementary to human support without replacing it.

More on patient-centered care:

Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients – José A Sacristán – BMC Medical Informatics and Decision Making 2013

Time for a Thorough Evaluation of Patient-Centered Care – Paul A. Heidenreich – Circulation: Cardiovascular Quality and Outcomes 2013

Patient expectations and the paradigm shift of care in emergency medicine – Fatimah Lateef – Journal of Emergencies Trauma and Shock 2011

Global ageing

Alexandra Stolzing
Solving ageing by reprogramming cells

The human metabolism will slowly start to malfunction when we age. This will lead to damage and initiate some age-related pathologies.

The speaker shows us how she works on reprogramming cells.

ReprogrammingCells

Reprogramming is not only reversing aging. It will reboot the cell and it will restart as a fresh cell.

Reversing Ageing

Reprogramming in vivo is the next step. For example in order to repair an infarcted heart.

More on reprogramming cells:

The aging signature: a hallmark of induced pluripotent stem cells? – L. Rohani & al. – Ageing Cell 2013

Aging and reprogramming: a two-way street – S. Mahmoudi – Current Opinion in Cell Biology 2012

Manouchehr Shamsrizi
Gamification for better living

The speaker is the CEO of RetroBrain R&D and trying new approaches promoting people to live healthier. As we all know, it is difficult to incentivize now for long term benefits. The key to have a switch into the behaviors, it to change the way it is percieved: you change your behavior because it is cool and not for long term benefits.

Gamification and videogaming are fundamentally different from the actions you could perform right know. You do not even realize you are changing your own behavior.

How to motivate people? The game is challenging you again and again and when people succeed, they have a dopamine surge. These games influence will stimulate the brain and could delay dementia because of movements, social dimension and brain activity. The game can be personalized with car shapes and music appreciated by the patient.

We should have fun when we are ageing. Interview in German and RetroBrain demo.

More on gamification in health:

Gamification in healthcare isn’t just about playing games – J. Kim – Tech Target Search Health IT 2014

From Fitbit to Fitocracy: The Rise of Health Care Gamification – Knowledge @Wharton 2013

Top Ten Gamified Healthcare Games that will extend your Life – Yu-Kai Chou

Exploring the Potential of Gamification Among Frail Elderly Persons – Gamification Research 2011

Scott Smith
New emerging business models connected to the ageing society

The speaker is the founder of Changeist. For him, it is fundamental to look at the macro picture when it comes to ageing.

He took the interesting example of Paro, a companion cuddle robot. It is a seal puppet therapeutic robot. It has been tested is geriatric facilities to help patients cope with multiple diseases such as dementia.

GreyingWorld

Source

The demographic time bomb challenge is fairly widespread.

Which solutions? Which possibilities?

  • Full automation, robots helping us, freeing time for more leisure
  • Designing our future
  • Human-machine combination – the pairing has to be culturally and socially acceptable
  • Senior Quantified-Self. These technologies will probably transform the way many families care for their loved ones. Estimated market size USD 14.6 bn in 2019.
  • California Life Company – Calico. It will help bring new technologies to the market and promote their adoption for a better management of ageing.

Intervention is easy to develop but the scale up is very difficult mainly for economic reasons.

More on ageing and new business models:

The New Booming Market? Aging Baby Boomers – C. Desmarais – INC 2014

The Economic Conundrum of an Aging Population – WorldWatch Institute 2004

Developing New Business Models in the eALT Sector – Coventry Consumer Models for Assisted Living

Strategic openness in life and data science

Bastian Greshake
Human genome: why sharing is crucial?

We are limited to reading the human genome and making sense of some of the parts today. Genetic testing goes mainstream.

Growth in DTC Genetic Testing

Source

Sequencing vs genotyping? (definitions from 23andMe)

Genotyping is the process of determining which genetic variants an individual possesses. Genotyping can be performed through a variety of different methods, depending on the variants of interest and resources available. For looking at many different variants at once, especially common variants, genotyping chips or arrays are an efficient and accurate option. These do, however, require prior knowledge of the variants you want to analyze.

Sequencing is a method used to determine the exact sequence of a certain length of DNA. You can sequence a short piece, the whole genome, or parts of the genome (such as the “exome,” which are the parts of the genome that contain genes). Depending on the location, a given stretch may include some DNA that varies between individuals, like SNPs, in addition to regions that are constant. Thus, sequencing can be used to genotype someone for known variants, as well as identify variants that may be unique to that person.

With genotyping, we look at SNP. We can then make some predictions with those data. For example: to see whether I will pass some of these genetic characteristics to my children. It is also widely used for ancestry analysis and microbiome exploration.

Why should this data be open?

Snpedia is sharing genomic data and helps determine whether you have higher risk. Connecting data to others can save lives. Big data is needed in this field.

Dna digest is promoting data sharing because of limited publicly available data despite huge sequenced DNA.

Examples for open data: personal genome project, opensnp, openhumans

More on the human genome:

Website: The Human Genome – Poems on the Book of Life

Tiny Genetic Differences between Humans and Other Primates Pervade the Genome – K. Wong – Scientific American 2014

Genomic data sharing for translational research and diagnostics – P. Robinson – Genome Medicine 2014

Marion Colombani & Paul Willis
Open science to advance drug discovery in neglected diseases

Malaria takes it toll on children as 86% of deaths are noted below age 5. Despite the 47% reduction in death since 2000 thank to an UN initiative focused on trying and improving public health in developing countries, the world still needs medicines to tackle the disease.

The traditional model of drug development in silos, obsessed by profitability and shareholders value is not working for developing countries. A reassessment on how we do drug discovery in this field is necessary.

A new model with a public health focus should be developed, like product development partnership. Interesting projcts are selected and funded. Advisors work in close collaboration with partners and open source science experienced.

OpenSourceScience

Open innovation is the standard model of MMV.

How do they fund their late stage development candidate? They try to find a willing pharma partner or secure sufficient public funding.

Open Access initiative: empowering research.

20’000 drug discovery starting points have been published, MMV selected 400. They are all commercially available.

Another initiative has been launched in order to enrich the drug discovery database: the Malaria Box. Launched in 2011, it has already been supplied to 30 countries for a total of 218 boxes.

A new project: the Pathogen Box, same initiative for neglected diseases to stimulate further research.

There is an ever increasing role of open source in new drug discovery models.

More on open source drug discovery:

Open Source Drug Discovery in Practice: A Case Study – C. Ardal – PLOS Neglected Tropical Diseases 2012

The Open Source Drug Discovery Project: Need for Global Collaboration – S. Brahmachari – 2015

Gernot Abel
Going open innovation and citizen science in biotech

The speaker sees brand new opportunities for collaborative innovation.

CollaborativeInnovation

How we manage, develop and initiate innovation will shift from traditional to open approaches.

FronTraditionalToOpenInnovation

When you create into a community you not only achieve, you exceed what you achieve.

Hackers want to change something and add a new innovation to existing products. The epicenter is both in US and Europe. Novozymes started recently to collaborate with hackers in an open mode. Biologigaragen is an open space for citizen science in biology. In addition, tools are getting cheaper, easier to use and more powerful.

Examples:

  • Open trons is a USD 3000 full lab available to everyone.
  • Transcriptic is a a fully automated cell and molecular biology laboratory in the cloud.
  • Arcturus BioCloud is a way of sharing biotech experiments.
  • SYNENERGENE is a four-years mobilization and mutual learning action plan (MMLAP) supported by the European Commission under the 7th Framework Programme.

NewHorizons

Joint value capture is fully present when engaging in open innovation.

For Novozyme, open innovation brings a lot:

  • Low cost analytical technologies
  • Evaluation on given technology and opportunities
  • Insight for business development projects
  • Spot the next big theme in biotech
  • Societal impact and mutual learning cycles

Last but not least – a fantastic lesson on how to engage in open innovation.

OpenInnovationTips

Alphabet (ex-Google) is the next big thing in Life sciences

A lot is currently written about the initiatives launched by Alphabet (Google) in the life sciences field.

I had the wonderful opportunity to have a look at the report written by the internet analyst, John Blackledge, from Cowen and I must say that he’s very smart at showing the huge potential of the life sciences at the core of Alphabet (Google).

This report is amazing as it allows you to have a better understanding of what’s happening now inside Alphabet (Google). I summarized the key points/quotes from the report below and I added other articles at the end of this blog post. Moreover, I will update it frequently as the news come in. This is a fascinating topic, I really hope Alphabet (Google) would be able to replicate the same success it has built with its search engine.

Key quotes & comments from the report:

  • Expansion into health care and related segments allows Google to leverage its core competencies in Internet communications technology, data structuring and analysis, and fundamental process reinvention.

 

  • Specific areas of focus in healthcare include:
    (1) the sequencing the human genome and the rise of precision medicine: despite the monumental significance of mapping the human genome and the implications for drug discovery, this was but one step in a long journey that continues to this day. Moreover, genes are but one factor in disease, and little is known about what role environment and lifestyle play.
    (2) the digitization of health data is exploding, with a virtually endless list of sources that can offer insight into clinical data, drug studies and more. As more data is digitized, there will be a profound impact on how patient care is administered, how therapies are researched, and how drugs are tested. EHRs (Electronic Health Records) are crucial but implementation is very challenging. Harmonization and data aggregation need to find their way. Wearables are another interesting topic in the digitization of health data. Social media and discussion boards as well as patients website are essential parts of the system that must be closely monitored as more and more patients use those communication channels in order to provide feedback and comments on treatments and daily struggles with healthcare providers.
    (3) the shift to value-based care, where payments are based on the value of care, is driving a change in how services are delivered and how much consumers engage in the process. From a provider perspective, doctors are incentivized to manage patients to the best possible health outcome at the lowest cost. From a patient perspective,
    consumers are being empowered to take a more active role in their own health care.
    These health care trends are being accommodated by technology advances in areas such as social, mobile, analytics and cloud computing, all areas of Google expertise.

 

  • Alphabet invests in health in five different ways:
    (1) Google Life Sciences originated in Google[x], a research lab within Google that was funded by the company’s board of directors in January 2010 to pursue “moonshots”—audacious new projects that have a low probability of succeeding, but could be truly revolutionary if they do. The company views moonshots as critical in driving the true innovation required to affect revolutionary change and avoid the “incrementalism” or evolutionary change that tends to lead to corporate irrelevance over time. The Life Sciences team is responsible for such innovations as glucose monitoring smart contact lenses. With an expanding list of intellectual property, Life Sciences has begun to accelerate its collaborative efforts with third parties. The company is aggressively partnering with leading players in the health care space on a growing number of programs.
    (2) Calico’s mission is to harness advanced technologies to increase understanding of the biology that controls lifespan. Calico was originally conceived by Google Ventures President and General Partner, Bill Maris, who observed that most companies seek to find treatments for disease and associated symptoms, but that none address the root cause of disease and death. He wondered if studying the impact of aging on genetic material could lead to the discovery of drugs that could address many age-related diseases and significantly extend the human life span.
    (3) Google Ventures has provided seed, venture and growth stage funding to a host of companies in diverse fields, but its stated focus is machine learning and life science investing.
    (4) Google Capital was formed to invest in later-stage technology companies with a focus on emerging technology leaders and potential disruptors. Unlike the earlier stage companies in Google’s other investment vehicles, the later stage companies in Google Capital tend to be fairly common household names. Although the stated focus of Google Capital is on technology companies, the collision of technology and health care is blurring the lines of what a traditional “technology” company looks like.
    (5) Google Core: Over time, Google has invested in numerous health-related initiatives within its main corporate division. These have tended to be very closely linked to the company’s core businesses, such as Search. Earlier this year, the company announced that it will add health information that has been fact-checked by physicians directly to search results. The company is also talking to the FDA about using search query data to identify adverse drug reactions.

 

  • Google’s Health-Related Focus Areas: regardless of where they are housed within Google’s corporate structure, most of Google’s health-related endeavors share common characteristics.
    (1) Longevity
    (2) Genetics and Chronic Care
    (3) Diagnostics
    (4) Diabetes/Digital Health
    (5) Medical Devices
    (6) Telehealth/Digital Health
    (7) Wearables/Fitness

 

  • Google’s health endeavors fit with the company’s goals of “making the world’s information useful” and helping millions of people. Indeed, Google believes that many of the same principles, techniques and problem solving capabilities employed by its software developers can be applied to the massive inefficiencies that exist in health care to create transformational solutions and medical breakthroughs that help people live longer, healthier lives. Health care ambitions can be summarized as:
    (1) Analyze: Analytics to inform decision-making and provide business insight
    (2) Attract: Attract health care constituents to platforms and solutions that drive engagement
    (3) Aggregate: Aggregate data from disparate sources onto the Internet or GCP

 

Additional resources:

Alphabet to help researchers predict disease – Financial Times – April 2017

Google Life Sciences Exodus – STAT – March 2016

Verily, Google’s Health Gambit, Is Stacked With Scientists. Now It Needs to Build a Business – ReCode – December 2015

Google hires mental health expert to lead new life sciences unit – Financial Times – September 2015 (Subscription required)

Head of Mental Health Institute Leaving for Google Life Sciences – The New York Times – September 2015

Google Bets on Insurance Startup Oscar Health – WSJ – September 2015

Is Health Care Google’s Next Big Business After Search? This Investment Bank Thinks So – Re/Code – September 2015

Why Google Is Going All In On Diabetes – NPR – September 2015

Google’s health startup, AbbVie team up on drug research – Chicago-Sun Times – September 2015

Google Life Sciences Company Has New Deal, Official Nemesis in Diabetes – Re/Code – August 2015

Alphabet Breathes New Life, Resources Into Google’s Health Care Projects – iHealthBeat – August 2015

Google Health – Easy as ABC. Alphabet, Calico and the Aging of Humanity – What on Earth are they doing? – Digital Intervention – August 2015

 

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Health illiteracy – A major concern in today’s medicine

Health literacy – the ability to obtain, understand and use health information

Making sure that patients understand the information provided to them is critical for health outcomes but also to avoid side effects and disease complications.

The lack of understanding leads to several issues, not only medical like drugs confusion, over- or under-dosage, mismanagement and worsening of treatable conditions, but also financial (it is estimated, for the USA, that health illiteracy costs between USD 100 and 250 billion each year).

Moreover, it is alarming to see that, in a developed country like the USA, only 12% of the population has “proficient health literacy”.

Beyond the communication, language and cultural barriers could be very difficult to get over.

How to empower patients?

Several tools are available today to empower the patients: simplified literature & visual guides to attract attention, patient group meetings led by nurses or dedicated healthcare providers, patient associations, health-related websites, websites for patients… Apart from those interactions, mobile health together with specific apps can provide access to resources regarding one’s health.

Open communication (in both ways), patience as well as avoiding the stigmatization of weak people can really help improve health literacy and simply serve as a form of emotional support during challenging times.

It is fundamental to teach not only young doctors but also senior staff in the healthcare industry in order to tackle that issue. Without proper education and information, even the best medicine is useless.

 

Additional Resources:

Health Literacy Definition – National Network of Libraries of Medicine

Health Literacy Training and Activities – Centers for Disease Control and Prevention

Health illiteracy could be the death of us – The Guardian – 2015

Understanding the true impact of health illiteracy – ArtcraftHealth – 2015

Want to Fix Healthcare? Fix Health Literacy First – Citylimits – 2015

Racial/ethnic disparities in knowledge about one’s breast cancer characteristics – Cancer – 2015

Making health literacy a priority in EU policy – EU – 2013

Consequences of Health Illiteracy – University of Texas – 2012

Many Americans have poor health literacy – The Washington Post – 2011

The Silent Epidemic — The Health Effects of Illiteracy – NEJM – 2006 – Not only health illiteracy but illiteracy stricto sensu (unability to read)

Visual Learning Tools Overcome Health Illiteracy – Patient Safety & Quality Healthcare – 2006

Health Literacy – A prescription to end confusion – NAP – 2004 (free, just register)

Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century – Health Promotion International – 2000

 

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Google Willingness to Help Life Sciences – Wired

Google, or Alphabet, wants biomedical research and life sciences to be more than just side projects.

Several years ago, its efforts under way in that field were probably not considered seriously by the industrial stakeholders like Big Pharma and biotech companies.

Today it is different after several investments commited lately.

Discover more in the Wired article

 

Additional Resources

4 of the biggest healthcare challenges Google is tackling – HealthcareDIVE – August 2015

Here’s why Google Ventures invests so much money in life-science companies – Business Insider – May 2015

Andrew Conrad – Google Life Sciences – The 25 most influential people in biopharma in 2015 – FierceBiotech – May 2015

Google Continues To Build Upon Its Life Sciences Ecosystem – Forbes – September 2014

Meet the Google X Life Sciences Team – WSJ – July 2014

 

 

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MicroHealth Helps Patients Manage Chronic Illnesses

We know that chronic diseases account for the majority of health expenditures. Helping patients with digital tools improving the management of their condition is a great step forward!

10 thoughts from 5 great healthcare minds – Becker’s Hospital Review

5 important people gave their thoughts about our current healthcare system in this Becker’s Hospital Review article:

– Jonathan Bush, founder and CEO of athenahealth (Watertown, Mass.)

– Malcolm Gladwell, journalist and best-selling author

– Chuck Lauer, former publisher of Modern Healthcare, and author, public speaker and career coach

– Nancy Schlichting, CEO of Henry Ford Health System (Detroit)

– John Halamka, MD, CIO of Beth Israel Deaconess Medical Center (Boston)

My favorite thoughts in a nutshell:

– On healthcare’s sustainability: new infrastructure is essential. Obsolete systems are a burden and a brake when it comes to innovation and efficiency.

– On changing the practice of medicine: doctors will have to consider the patient as a whole and spend time taking care of all the aspects of his/her health.

– On high-price medicine: prices should be linked with the innovation the product brings to the patient and the other stakeholders including the health system.

– On sharing healthcare data: data sharing with the goal of improving the life of each patient by learning and analytics could be a game-changer in the next future.

All these quotes could inspire leadership styles and help us create, implement and deliver better care for the patients in need.

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Pager is an “Uber/Amazon for Healthcare” – Forbes

Several new innovative and internet-linked services are emerging every day.

Several years ago, Amazon was selling books online, then it became a one-stop shop for many other things; Google expanded its traditional search engine business into a variety of other activities; Apple as well as other mobile phone producers launched smartphones only few years ago.., we can go on forever with examples.

Healthcare is one of the last area reached by digitalization. But the trend is now more than settled.

Recently a new startup named Pager raised USD 14 million for making your medical appointments instant and for a flat fee during extended hours (from 8:00am to 10:00pm).

A Forbes article drew some parallel with Uber for taxi ordering:  “The service finds and verifies doctors for its network and bills you automatically over a linked credit card”. However the CEO, Gaspard de Dreuzy, compared the company with Amazon instead: “Pager is focused on delivering a broader range of care options on demand than exist today. It could be a tele-consult via phone or messaging, or an in-person visit in the home, or a referral to the right specialist. We like to think of ourselves as the Amazon for healthcare.”

The service is only currently available in New York, but the company will soon expand its operations with the funds raised.

Other companies like ZocDoc or Doctors on Demand are also facilitating life for patients or people looking for health services quickly.

Below an pic from WSJ (see the related article in the Additional material section):

OnDemandDoctors-WSJ2015

Additional material:

Startups Vie to Build an Uber for Health Care – WSJ – August 2015

The Best Digital Business Models Put Evolution Before Revolution – Harvard Business Review – January 2015

There’s Now A Seamless For When You’re Feeling Sick – Huffington Post – December 2014

9 Healthcare Tech Startups To Watch – InformationWeek Healthcare – December 2014

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With Big Data & Digital Health – New Collaborations are Emerging in the Pharma Industry – PWC

TeamWork

A newly published report by PWC reveals novel collaboration models for improved value of medicines

“Driven by empowered consumers and connected technology, the New Health Economy is shifting business incentives from volume to value with a focus on health outcomes beyond the clinic.”

Big data together with EHR (electronic health records) and wearables drive patient empowerment. Today, more and more, people have their say in treatment choices. Actually, health benefits and prices are crucial criteria for decision, especially as patients face today higher out-of-pocket expenses than ever before. We all well know that expensive treatments are financially disastrous for patients as mentioned in one of my previous posts.

Currently, increased focus is put on drug cost effectiveness as we switch progressively from a fee-for-service to an outcome-based world. Every treatment should be precisely calculated in order to be sure that it is optimized for all stakeholders from all points of view. In this context, already last year, PWC highlighted the beginning of a new system: the New Health Economy, where outcomes and quality are rewarded (instead of volume). It is the continuum of what has been started by Michael E. Porter several years ago.

All these changes have essential meanings. Therefore business models need to adapt to current trends: digital is unavoidable; purchaser perspective is necessary; patients need to become partners; regulatory changes have to be anticipated.

Adapting business models is fantastic but not sufficient. Novel collaborations are needed to optimize them for long-term success. All the stakeholders have to be integrated and blended by the biopharma companies: government agencies, insurers (payers as a whole), new entrants, consumers. Beyond collaborations, a consensus on the value of new medicines should be agreed on. Additionally, consumer and patient health information should be leveraged to improved personalization and precision of treatments.

In one word, several changes will flow the industry and challenges will pave the way to success. But it will become much more exciting to develop drugs in this context than ever before!

Report: PWC-21st-century-pharmaceutical-collaboration-July2015

 

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Digital Health Expected to Save US Healthcare System > $100 Billion Over Next 4 Years – Accenture

A new survey done by Accenture showed that Digital Health could have a huge impact on healthcare costs, especially in the US

A wonderful infographic has been designed to show the key points from the study (see below). There is no need to say more about it.

The link to the article.

 

Additional material:

2015 Global health care Outlook – 2015 – Deloitte

The future of healthcare—there’s an app for that – 2012 – Bain & Company

The digital dimension of healthcare – 2012 – Global Health Policy Summit Working Group

 

Accenture-Colossal-Clash-Infographic

Partnering with patients in the development and lifecycle of medicines – TIRS

Infusion

A wave of new articles on patient-centric drug development flooded the news during the last weeks

It is not a new concept. A task force was started back in 2003 by ISPOR on this topic and several thinkers proposed this vision even before.

One of the more comprehensive article on this topic is the Call for Action written by several experts in the field both in the industry and academia as well as people coming from patient associations, together for the development of a master framework for systematic patient involvement.

Several stakeholders are committed to the success of a specific medicine: researchers, developers, industrials, regulators, insurers, doctors,… but very often they all forget about the main and the most important among them: the patient. He or she is the one taking the drug, benefiting from care or even cure in some cases but also suffering from side effects.

At each stage of development, involving and engaging the patient will bring advantages (pages 8 and 9 of the article gave great figures about them):

– Early research: better prioritization, improved resource allocation, clinical trial protocols reflecting patient needs, superior recruitment rates.

– At launch and beyond: more appropriate benefit-risk assessment, focus on drugs of value to patients, improved treatment adherence.

A part from e-patients blogs, dedicated societies emerge in order to make coordination effort toward common goals like the Society for Participatory Medicine: “Participatory Medicine is a model of cooperative health care that seeks to achieve active involvement by patients, professionals, caregivers, and others across the continuum of care on all issues related to an individual’s health. Participatory medicine is an ethical approach to care that also holds promise to improve outcomes, reduce medical errors, increase patient satisfaction and improve the cost of care.”

In conclusion: “It is essential that all stakeholders participate to drive adoption and implementation of the Framework and to ensure that patients and their needs are Embedded at the heart of medicines development and lifecycle management.”

 

You probably remember the fascinating talk given by e-patient Dave in 2011 during TEDxMaastricht. Dave deBronkart said as an introduction that patients need to be much more involved in order to drive better healthcare as well as superior patient outcomes. The future is now!

 

Additional material

What’s Next for Patient-Focused Drug Development? FDA Announces Final PFDD Meetings, and BIO Recommends Broader Use of the Benefit-Risk Framework – 2015

Partnering with patients in the development and lifecycle of medicine – 2015 – Therapeutic Innovation & Regulatory Science

Integrating the patient perspective in the assessment of benefits and risks of medicines – ISPOR 2014 Workshop

Finding the patient in the drug development process – F. Lewis-Hall (Pfizer) – ISPOR 2013

Toward Patient-Centered Drug Development in Oncology – 2013 – NEJM

 

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