Diabetes therapies and technology: implications for doctors and patients

What business are we in?Diabetes Therapies and Technology Conference

5th and 6th November 2016

Professor Steven C. BoyagesThe University of Sydney, Wednesday 19th October 2016

Diabetes Therapies and Technology Conference Sydney NSW AustraliaThis presentation cannot be reproduced without permission

[email protected]

• The Challenging Health Care System: Is Technology a solution

• The Promise and Pitfalls of Technology• Will the role of the health professional change and

that of the consumer/patient change in this new world

• Understanding Data and Information• Connected or Disconnected Health

Agenda

Health is a knowledge based profession

Health Services are about..

Care

Communication

Collaboration

Coordination

Clinical Care Models

Constants of HealthTO RECHON him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look up his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according the law of medicine, but to none others. (Hippocrates 460-370 BC)

Principles of Investment in Health Technology

1. Improve patient experience and outcomes

2. Improve patient safety

3. Improve provider experience

4. Create value for money

Insulin Pump Therapy and CGM

Technology TriggerPeak ofInflated Expectations

Trough of Disillusionment Slope of Enlightenment Plateau of Productivity

time

expectations

PositiveHype Negative

Hype

Source: Gartner, 2013

Insulin Pump

CGM

Telehealth Bionic pancreas

Health Apps

IBM Dr Watson

What business are we in?How do we get the balance right between negative and positive hype?

Healthcare Education Research Health Wellness Sales Coaching

The Balanced Matrix

What’s driving this changing role?

New Technology TriggersThe Nexus of IT Forces:Social, Mobile, Cloud & Big Data/Information

Source: Gartner, 2013

We need to embrace social media

InformationSomeone somewhere is capturing and storing

Nearly every transaction or interaction leaves a data signature

Data, Big Data and Information

Sheer scale has far exceeded human sense-making capabilities

At these scales patterns are often too subtle and relationships too complex or multi dimensional to observe by simply looking at the data

It helps us see the forest without getting lost in the trees

Data mining is a means of automating the process to detect interpretable patterns

Using DataBusiness Intelligence

Predictive, planning analytics

Visualization

Level of Business Impact

Business Intelligence/Analytics Shifts GearsJust as Clinical Data Emerges

Ad hoc query,OLAP, data mining

Skill Levels

Required

Reporting, dashboards

Prescriptive process

optimization

Information Patterns

Adapt and Evolve

What will happen?

Why did it happen?

What happened?

What should happen?

Retrospective Concurrent Prognostic

Source: Gartner, 2013

New methods of scientific inquiry

05/02/23 26

27

Next Generation EHR/EMR

FunctionImpact

Minimal

Full

Availability of Products2020+2012200519981993

Generation 1:The Collector

Generation 2:The Documentor

Generation 3:The Helper

Generation 4:The Colleague

Generation 5:The Mentor

Health and Clinical ICTBecomes the Challenge ofKnowledge Management

Today

Source: Gartner, 2013

Tomorrow:Awareness, Action, Agility

Pace-Layering:Structure for Innovation

Systems of Record

Systems of Differentiation

Systems of Innovation

CommonIdeas

NewIdeas

Source: Gartner, 2013

What’s Next?:Patient-Facing ICT Explodes

Source: Gartner, 2013

Care Coordination Applications

“Quantified Self” Applications

Patient Engagement/Portals

The changing role of the health professional in the digital age: The Digital Doctor

Embrace technology but don’t lose sight of the patient

Will Dr Tech ever replace the human doctor?

Understand BIT: Business (workflow), Information flow and the Technology

Understand privacy

Develop your skills

Understand security of technology, mitigate risk

Efficacy and security of technology implementation to ensure patient safety1. How do we protect our

patients in this age of technology?

2. How do clinicians understand enough of the problem to avoid risks?

3. How do we assure patient privacy?

4. A day does not go past without a major cyber attack on large enterprises. How do we avoid these in health systems?

5. Digital health identity theft?

Connected or Disconnected Health

• patient• Provider

High Touch “I tell them that their first reflex should be to look at the patient, not the computer,” Dr. Heineken said.

And he tells the team to return to each patient’s bedside at day’s end. “I say, ‘Don’t go to a computer; go back to the room, sit down and listen to them. And don’t look like you’re in a hurry.’ ”

Conclusions

1. Patients expect their endocrinologists to be up to date with the latest technology for the treatment of diabetes

2. Sometimes as the healthcare professional you need to sell the outcomes of using the technology to the patient, rather than just offering an alternative therapy

3. High touch, Great Communication and High Tech are the key