Healthcare

COCHRANE a s s o c i a t e s

Peter Cochrane

ca-global.orgcochrane.org.uk

Who Cares ?

We are now the limiters of progress…technology is advancing faster than we can respond...

..but it may not be that way forever!

Big government & big companies favour big solutions...

When something much smaller will suffice, or even do the job far better!

23

Not fully understandingsomething doesn’t implywe cannot exploit it!

Newton Einstein

Linear Non-Linear

Ballistics

Just how did we get here?

HypothesisEverything we know and understand is through the good grace of our technology….

Hypothesis

Without computers, supercomputers, networks, the internet, and a huge amount of software, we would know absolutely nothing…relatively speaking

Internet ~ Human Brain Today!

> 109 Nodes & > 104 Links/Node

Advances in healthcare

1) Stop guessing @ start dissecting2) Skeleton and muscle structure3) Basic vascular knowledge4) Basic organ functionality5) Germ theory6) Hygene7) X-Ray7) Antibiotics8) Electronics - visualization - monitoring - animation9) All electronic records10) People supporting technologies ?

Advances in Healthcare

Advances in HealthcareNatural methods and materials

Advances in HealthcareNatural methods and materialsSynthetic - unnatural methods

and materials

Advances in HealthcareNatural methods and materialsSynthetic - unnatural methods

and materialsRepair technologies

Life expectancyLikelihood of requiring care

- Chronic disease management- Aged care

- Well being

Potential carer population

Tech Gap

The rise of chronic diseasesProlonged conditions that often do not improve and are rarely cured completely….

- Diabetes- Hypertension- Congestive heart failure- Asthma- Depression- Renal failure- Liver disease- Rheumatoid - Osteoarthritis- Dementia-+++++

DIY test, monitoring, adminwe will have to look after ourselves more and more

DIY test & monitoring

DIY dosage admin and control

SelfVentilation

Complex control

Automated dosage

Lab on a chip

Microelectromechanical Systems - MEMsNanolectromechanical Systems - NEMs

Lab on a chip

Microelectromechanical Systems - MEMsNanolectromechanical Systems - NEMs

….an idea of scale

~ 5 nm~ 500 um

MEMs NEMs

Micro & nano sensors

Microelectromechanical Systems - MEMsNanolectromechanical Systems - NEMs

Nano botsthe dream?

Care at home

There will be no choice, we will be sent home!

Monitor everything ??

There will be no choice, we will be sent home !

Get networked ??

Centralized monitoring and control of everything !

Let’s make it really complex !

How about making it really simplewhat is someone doing now?

Making it simpleand where are they ?

GeoFence - not a wall or a prison!

1. Appointment Reminders (SMS)2. Patient Support (SMS)3. Medication Reminders (SMS)4. Appointment Booking5. Medical Data on SIM Card6. Patient info for Relatives7. Peer Support for Patients8. Post Cardiac Surgery Support9. Accessing Patient Records10.Access to Dietary Information

11. ePrescribing12. Patient Paging

13. Support for Alzheimer Patients14. Support for Diabetes Sufferers

15. Clinical trials16. Support for Dementia Sufferers

17. Support During Rehabilitation18. Support for the Deaf

19. Support for the Chronically Ill20. Support for Addicts

What else can you do with a mobile ?

31. Smart Card Applications32. Monitoring for Asthma Sufferers33. Blood Glucose Monitoring34. Temperature Measurement35. Weight Measurement36. Medication Compliance Monitor37. Voice Pattern Monitoring38. Analysis of Breath39. Heart Rate Monitoring40. Smart Homes for the Elderly

21. Support for STD Sufferers22. Baby Monitoring23. Suicide Watch24. Support for Children25. Food Product Dietary Information26. Allergy Alert Services27. Doctor at Home28. Self Diagnosis29. Patient data for oversees travellers30. Data Capture from instrumentation

What else can you do with a mobile ?

51. Telehealth Gateways52. Patient Location53. Pulse Oximetry54. Personalisation Diagnosis55. Early Detection of Syndromes56. Appointment Scheduling57. Access to Patient Data58. Diagnosis Support59. Personal Attack Alarm Services60. Clinician Identification

41. Patient Diaries for Clinical Trials42. Data from Pacemakers43. Fitness Monitoring44. Real Time Patient Assessment45. Sleep Monitoring46. Collection of Data from Sensors47. Collection of implant Data48. Diabetes Monitoring49. Detection of Septic Episodes50. Remote Antenatal Care

What else can you do with a mobile ?

71. Locating Organ Donors72. Support for A&E Services73. Tracking Surgical Instruments74. Controlling Insulin Patches75. Billing76. Patient Consent77. Drug Authenticity Verification 78. Patient Entertainment & Comms79. Patient Notes Dictation Systems80. Administration at Point of Care

61. Asset Tracking (RFID)62. Stock Control (RFID)63. Patient Identification (RFID)64. Dispensing Support65. Locating Staff66. Conferencing Emergencies67. Accessing Training Material68. Accessing Laboratory Results69. Blood Bank Support Services70. Locating Blood Donors

What else can you do with a mobile ?

91. Context Sensitive Medicine92. Disease Monitoring93. Food Contamination Alerts94. Environmental Contamination Alerts95. MRSA Detector96. Telecare in Rural Areas97. Telecare in Developing Countries98. A&E Field Support99. Wireless Stethoscope100.Support for AIDS Sufferers101.Call Centre Health Services

81. Linking Emergency Services / A&E82. Access to X-ray Images83. Skin Cancer Monitoring84. Remote Consultation85. Data Collection from Capsules86. Conventional Endoscopes87. Nutrition Coaching88. Monitoring Wound Healing89. Support for Neurosurgeons90. Breast Cancer Screening

What else can you do with a mobile ?

Implants galore…

Sight for the blind?

Hearing for the deaf

Subcutaneous Wearables

The medical records saga…

Fundamental lack of understanding?

22% lost at any one time!

Security out of kilter?

Centralize or distribute?

Patient records

Hospital records

Subcutaneous patient records

Easy installEffectiveReliableSimpleCheap

Subcutaneous patient records

The biggest objectors are the religious and superstitious!

Centralized to distributed ?OutmodedOutdatedUnavailableLostExpensive

CentralizedOutdatedUnavailableOff lineUnavailableExpensive

DistributedUp to dateAvailableOn & off lineLow costReliable

ca-global.orgcochrane.org.uk

COCHRANE a s s o c i a t e s

Thank You