HXR 2016: The Health IoT: Remote Care and Mobile Solutions -Manu Varma, Philips

Editor's Notes

1. Creating a healthier future through digital innovation
2. [PHILIPS IS COLLECTING MILLIONS OF DATA POINTS] At Philips we are also collecting millions of data points across millions of devices. More than 7 million to be precise, this number is growing by the day. What we have learned is that there is a lot more to it. It’s really about making that data meaningful, actionable ….  And if you do …. we think you can make a big difference … support people living more healthy lives. Young …. old …. and all that comes in between.   At Philips this is the fundamental problem that we are trying to solve. Because we are confident, that if you CAN solve that problem (and we can), we can have a major impact on people’s lives.
3. [TRENDS] Well, let’s go through some trends and numbers together ….. that show how today, at this day and age, things are really coming together… and we have this perfect storm to make the difference…. Globally, the number of people aged 80 and over is expected to increase from 125 million to 434 million in 2050 and 944 million in 2100.
4. And there is a vast growing number of (actually also) young people living with chronic conditions such as diabetes, heart conditions and respiratory conditions due to unhealthy lifestyles. Today, we have 400M people living with diabetes. 500 million have to deal with respiratory diseases. A staggering 1.5 billion live with high blood pressure … at risk for severe heart conditions. The WHO states that childhood obesity is one of the most serious public health challenges of the 21st century. 42 million children under the age of 5 were overweight or obese in 2013. This is clearly unsustainable, so clearly something needs to be done. (Today in the United States about 75% of healthcare costs are spent on chronic diseases.) That’s simply not sustainable.
5. [TIPPING POINT] The healthcare system is at a tipping point. In the European Union 70% to 80% of healthcare costs are spent on chronic diseases. This corresponds to a €700 billion financial burden. The US has a healthcare spending of 3.2 Trillion dollar in 2015. 17% of GBP. A 4.9% increase compared to the year before. About 75% of healthcare costs are spent on chronic diseases. {Source: Health Affairs. Report National Health Expenditure Projections, 2014–24: Spending Growth Faster Than Recent Trends} If we want to do something we need to go from a system focusing on reactive care to a system that focuses on reactive care and prevention.   Where continuous monitoring helps to prevent going to the hospital.   Connected digital health services can help people living with severe chronic conditions to live as normal as possible lives with a stable condition.
6. [FROM REACTIVE TO PROACTIVE CARE] The key question is how do we leverage the connectivity of devices around us? How do we benefit it from it? How do we live healthier, happier lives as a result of our connected world? If we want to do something we need to go from a system focusing on reactive care to a system that focuses on reactive care and prevention.   Where continuous monitoring helps to prevent going to the hospital.   Connected digital health services can help people living with severe chronic conditions to live as normal as possible lives with a stable condition. The key question is how do we leverage the connectivity of devices around us? How do we benefit it from it? How do we live healthier, happier lives as a result of our connected world?
7. [CONNECTING ISLANDS OF DATA] The thing is, today still most of these devices are still islands , each separately connected to the internet. Instead of the Internet of Things, they often are the Internet of Thing. And we have all these devices creating large data pools but in the end only few of us know how can we act upon it? Look, I wear a smartwatch myself, actually two of them. On my x hand I have my Apple Watch on my right hand I have our new Philips Watch. But what’s the use of gathering truckloads of data of my heart rate or sleep? It just islands in yet a new silo. However, this data becomes relevant when this data is connected to the context of an individual person or patient and given automatically provided at the right time.  For instance if it adds to managing my cholesterol or if it would be integrated in a sleep app/program and helps me fall asleep better if I would have a sleep problem.
8. [CREATING LONGITUDINAL AND PERSONALIZED OVERVIEW OF OUR HEALTH] Today, the technology is finally emerging that we can capture the data from all of these devices in one place and start to build up a bigger, more complete picture of our health and wellbeing.  It means that information sent from those weight scales or watches or light bulbs or medical scanners will combine to uncover insights about their user that can make a big difference to their lives We can now create a longitudinal personalized overview and make that data contextual and then actionable.   But this is far from easy. You need to think how to aggregate data from all these different sources. How do you remove noise, make it accurate, cleanse it and respect privacy.  All these issues need to be solved.   Next big question is …. then what? We also need experts and behavioral change experts, nutritionists and the-for-you-relevant-care providers to review this data and turn it into meaningful coaching and insights, lifestyle recommendations.  Otherwise it’s just … a whole lot of stressful data. And you wouldn’t know what to do with.  As companies we need to connect the dots with the right clinical expertise that is how healthcare is going to be changed.
9. [CREATING LONGITUDINAL AND PERSONALIZED OVERVIEW OF OUR HEALTH] Today, the technology is finally emerging that we can capture the data from all of these devices in one place and start to build up a bigger, more complete picture of our health and wellbeing.  It means that information sent from those weight scales or watches or light bulbs or medical scanners will combine to uncover insights about their user that can make a big difference to their lives We can now create a longitudinal personalized overview and make that data contextual and then actionable.   But this is far from easy. You need to think how to aggregate data from all these different sources. How do you remove noise, make it accurate, cleanse it and respect privacy.  All these issues need to be solved.   Next big question is …. then what? We also need experts and behavioral change experts, nutritionists and the-for-you-relevant-care providers to review this data and turn it into meaningful coaching and insights, lifestyle recommendations.  Otherwise it’s just … a whole lot of stressful data. And you wouldn’t know what to do with.  As companies we need to connect the dots with the right clinical expertise that is how healthcare is going to be changed.
10. The eICU program offers centralized, remote surveillance by skilled professionals, proprietary algorithms that provide early warnings for proactive care, and continuous programmatic improvement. This clinical model can help your organization offer constant assessment and care delivery during peak census times as well as during off -hours, expand access to specialized care to remote locations, and transform the cost/care equation. Philips eICU combines population management for critical care, collaborative clinical models, clinical decision support, and reporting designed to improve clinical and financial outcomes. Patients who receive their ICU care from a hospital with an eICU program were*: 26% more likely to survive the ICU. Discharged from the ICU 20% faster. 16% more likely to survive hospitalization and be discharged. Discharged from the hospital 15% faster. Improved response times 16% Helping reduce length of stay and mortality, the Philips eICU program clinically transforms the ICU, using a proactive care model that supports improved outcomes and potentially lower costs. The eICU program utilizes bi-directional audio/video technology population management tools proprietary clinical decision support real-time and retrospective reporting tools targeted process redesign. http://www.newscenter.philips.com/main/standard/news/press/2013/20130512-largest-study-of-critical-care-telehealth.wpd#.Vi6LoBCrQUE *Lilly CM, et al. A Multi-center Study of ICU Telemedicine Reengineering of Adult Critical Care. CHEST. 2014 Mar 1; 145(3): 500-7.
11. Continuous health solutions help our clients, like Banner Health, focus on where, when, and how health happens. Healthcare isn’t just limited to a clinical setting inside the hospital. In fact, if you want to lower costs and improve outcomes, it’s important to focus on the home. That’s where health mostly happens. The Intensive Ambulatory Care program focuses on the most complex and highest cost patients – the top five percent of patients who account for 50 percent of health care spend (the most complex, highest-cost patient population). eIAC is built upon a population management software platform designed for monitoring and delivering care to the most complex patients at home. Care systems develop the organizational capability to deliver integrated, coordinated care across specialties and services at scale. The eIAC program enables all stakeholders in the clinical and social management of a patient to identify and address the root causes of the patient’s frequent admissions, creating a cohesive system of care that helps reduce hospital admissions while providing the highest level of care to patients with complex, chronic conditions.* Results*: 27% reduction in costs of care in hospitalization rates, days in the hospital, in professional service & outpatient costs - $788 per patient per month 32% reduction in in acute and long term care costs 56,000 fewer hospital days 46,000 fewer ICU days than predicted 1,890 lives estimated saved (compared to benchmark data) Banner, among others, have told us our people bring fresh ideas, clear thinking in the face of enormous complexity and a spirit of partnership that sets the bar for the industry. “Telehealth is opening up choices for patients and providers, giving them the freedom to transform how, when and where proactive care is delivered to patients,” said Derek Smith, senior vice president, Hospital to Home, Philips.” Derek Smith, Philips *Dahl, D., Khurana MD, H. (2015). Impact of an intensive ambulatory program on both financial and clinical outcomes in Banner Health. Unpublished internal study