Hacking Health Designing for and understanding my health Juhan Sonin March 2011
Dec 06, 2014
Cholesterol Check at MITRE in 2006
I didn’t have a pulse on my health, let alone the data.
How did I get into the Design of Health?
Cheese and salami was coursing through my blood stream (based on a meal the night before the cholesterol test…)
370 Total Cholesterol , 2006
and the Problem is…
Increasingly complex systems– Tool and Methodology gap
Decision makers are swamped with conflicDng data– Our work is increasingly mulD-‐dimensional (not a flat-‐decision space)
ArDfacts driving decisions need to be coordinated, presented
Minimal transparency into key health metrics
Started collecOng and designing the basics…
Weight,Waist circumference,Cholesterol,Exercise,Food intake…
Got a checkup.First Ome in 6 years.
But…The doctor’s back was to me while he asked me ques7ons (and then he typed the answers into the computer),
zero ques7ons about Life outside of tradi7onal health info,
no physical or emailed takeaways of next steps from the exam…
Used real data… my own data
Design with fake data = fake designReal data:•needs to be grokked by you•has min/max values, outliers•needs amplificaOon, cleanup•begets real feedback + forces people to make real decisions
Followed doctors and nurses at several Boston hospitals to SEE Healthcare in acOon.
Partner in crime, Rob McCready watching surgery.
Designing a beauOful and clinically relevant experience without beauOful data =
recipe for disaster.
projectlaika.orgOpen source so^ware has become part of the CCHIT cerOficaOon
Laika is responsible for automaOng data interoperability tesOng of Electronic Health Record systems
HITSP Specs on ConOnuity of CareIHE specs on Document Exchange
So we got into the data + standards game:
projecthdata.orghData is a method of storing and exchanging health informaOon
Goal: Influence/create Health IT standards to ease implementaOon and speed adopOon
Why? Complexity and design of current standards are a huge barrier to adopOon and effecOve usage
hData
Smartcard to standardize the healthcare “entry point” transacOon
Prototype US Healthcard data model, design, and explore HHS adopOon
US Healthcard
Jumped into personal genomics23andMe (for all my family members), Personal Genome Project ParOcipant
Medical home
Familycare
givers
Diseasemanagement
services
PersonalHealth
RecordsHealthcareproviders
DigitalHome
Cell Phone
PC
Personal Health System
PEDOMETER
BLOOD-PRESSURE
CUFF
MEDICATIONTRACKING
WEIGHTSCALE
FITNESSEQUIPMENT
IMPLANTPULSE
OX
Internet
Telemedicine
Intel Health Guide: It integrates personal communicaDon with the doctor, medicaDon reminders, educaDonal informaDon, and videoconferencing for the home.
Assisted living
I opened the door…
I’m watching TV…
I’m going to bed…
Sensors: Mo7on, Fire/Smoke/CO2, Occupancy (Bed/Chair), Use (Door, Stove, Fridge, Tub), Loca7on (Alzheimer's), Fall Alarms, Water flow…
Enable online clinic for the “pracOce of medicine”
Evolve the FOSS “Healthcare as a so^ware service” model
School nurse at first;evolve to state-‐of-‐the-‐art ambulatory screen clinic (diabetes, obesity, cardiovascular, asthma, allergies) in 2 years
Self-‐service health kioskBrief engagement to assess current healthSimple and minimally invasiveGet a health snapshot or monitor changes over Ome
Open planormCan add addiOonal measurement devicesBluetooth, Wifi, and web accessibleAccessible API for building home grown apps
MeasurementsBlood pressureWeightBody composiOonHydraOonPulseTemperatureEyesightHearingRespiraOon
How do you get a pulse on key health metrics without a single tear?
Early detecOon of chronic diseases will be as easy as carrying your cell phone in your pocket.
Engaged paOents will increasingly self-‐check and self-‐monitor using bloodless, self-‐administered medical tests.
mHealth Axioms
Bring the examinaDon room to the paDent
Bring the collecDve experDse of the pracDce, the standard of care, to the paDent’s bedside or home
Migrate from a system of episodic evaluaDon to a system of conDnuous assessment
Expect paDents and their families to be their own primary care provider (key member of the care team)
hGraphCompelling, standardized visual representa7ons of a pa7ent’s health status…on the celltop
Designed to increase awareness of the individual’s factors that can affect one’s health
Open source healthcare applica7on Created for mobile devices, star7ng with the iPhone and iPad
Your health in one pictureUsers provide, view, share, and understand a holis7c view of their health
Based on an individual’s health data, iden7fies where an individual’s health numbers are, and where they should be
Pa7ent focused, with professional clinical relevance
hScoreSingle aggregated number ranging from 1-‐100 that represents best knowledge status of an
individual’s health
Experimental measure correlated with sta7s7cal data from open sources
Used as status indicator for current plan of care
Recent updates can trigger “just in Dme” healthcare consults
AddiDonal mHealth monitors augment hGraph scope and real-‐Dme nature
Live consults with healthcare professionals
hGraph