Open mHealth: Engaging Patients and Clinicians in

Engaging Patients and Clinicians inmHealth through the OpenmHealth

PlatformIda  Sim,  MD,  PhD

Co-­‐Founder,  OpenmHealthDirector,  Center  for  Clinical  and  Translational  Informatics

University  of  California  San  FranciscoSeptember  20,  2011

mHealth:  “Full  of  sound  andfury,  signifying  nothing”?

Hype Cycle, Gartner Group

Plateau  of  Productivity

• “A  Learning  Healthcare  System  that  isdesigned  to  generate  and  apply  the  bestevidence  for  the  collaborative  health  carechoices  of  each  patient  and  provider;  todrive  the  process  of  discovery  as  a  naturaloutgrowth  of  patient  care”

U.S.  Institute  of  Medicine,  Roundtable  Charter

Global  Impact  of  Chronic  Disease

WHO | Facts related to Chronic Diseasehttp://www.who.int/dietphysicalactivity/publications/facts/chronic/en/

Global  Cost  of  Chronic  Disease

$47  trillionby  2030 $14.7  trillion

US  2010  GDP

World Economic Forum, 2011

CDC Chronic Disease Overviewhttp://www.cdc.gov/chronicdisease/overview/index.htm#ref2

• Almost  1/2  ofAmerican  adults  haveat  least  1  chronicdisease– obesity  (~1/3)– heart  disease  and

stroke– cancer– diabetes– arthritis

StovepipedmHealth

• Health  apps  builtindependently– little  data  sharingandinteroperability

• Resulting  userexperience  is…

Plateau of Diminished Promise

Siloed  mHealth

Why  open  architecture?

StovepipedmHealth

• Limits  the  emergentpower  and  potentialof  mHealth

Internet  Hourglass  Model

• Standardize  andmake  open  the“narrow  waist”

• Reduces  duplication,spurs  communityinnovation,  supportscommercial  and  non-­‐profit  uses

OpenmHealth.org

Estrin DE, Sim I. Science; 330: 759-60. 2010.

Open  Architecture  forUser  Engagement

• Define,  build,  and  share  modules  of  the  basicdata-­‐related  functions  common  to  engagingpatients  and  clinicians– data  trending  (e.g.,  is  weight  really  down?)– signal  detection  (e.g,  asthma  exacerbation?)– inferencing  (e.g,  activity  =  walk,run,bike,car…?)– data  visualization  (e.g.,  stock  infographics)

• Exploring  user  interaction,  incentives,  gaming

Tipping  towards  Open

• First  openmHealth  collaborative  pilot– PTSD  Coach,  with  VA  National  PTSD  Center

• Looking  for  other  pilots  to  drive  key  componentsof  shared  architecture,  e.g.,– gaming– incentives

• Supporting  best  practices  and  generation  of  bestevidence

• Sensitive  to  needs  of  all  communities

Goal  for  mHealth  Ecosystem• Becomes  a  learning  community  enabled  by  an  open

architecture,  to  more  effectively  innovate,  share,and  deploy  best  technology  and  best  practices  forimproving  individual  and  population  health

• Ida  Sim  [email protected]• Deborah  Estrin  [email protected]• http://openmhealth.org/

– a  project  of  the  Tides  Center  (www.tides.org)

• Funding– Robert  Wood  Johnson  Foundation– California  Health  Care  Foundation

• Collaborators– MIT,  Columbia,  CMU,  Northwestern,  Google,

Microsoft  HealthVault,  Curious,  …