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Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Closing the loop:#WeAreNotWaiting to change the future of healthcare
@DanaMLewis | #OpenAPS | #WeAreNotWaiting |
www.OpenAPS.org
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Getting diagnosed with a chronic disease is like being struck by
lightning.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Food, hormones, sickness, stress
Insulin, exercise, sickness, stress
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Cruise control makes it easier to drive your target speed.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
An artificial pancreas is the closest thing to “cruise control” for diabetes.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
…But an artificial pancreas is not yet commercially available.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
The current tools are not perfect….
Insulin Pump
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Insulin is the “gas” pedal.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
….and there are other tools but they are not interoperable.
Continuous Glucose Monitor (CGM) Insulin Pump
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
This all leaves people frustrated and at risk, every day and every night.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Data access is also a struggle.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
If we can’t change existing devices…
what if we could add *new* tools?
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Tackling the problem of less-audible alarms:
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Tackling the problem of less-audible alarms:
1. Get data from device with open source code2. Display data & generate louder alarms3. Share data with loved ones4. Add “snooze” buttons5. Enter specific actions/more buttons6. Create forecast (algorithm) with data sources7. Add additional “smart” alarms with action
recommendations
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
From reactive to predictive: an “open loop”
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
What happens if we “close the loop”?
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
We already have in our pockets the tools
needed for an “artificial pancreas”.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Components of an open source artificial pancreas
(Illustration by Clint Ford for Popular Science)
1. Continuous glucose monitor
2. Insulin pump
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Components of an open source artificial pancreas
(Illustration by Clint Ford for Popular Science)
1. Continuous glucose monitor 2. Raspberry Pi (“controller”)3. Battery4. CareLink USB stick (“translator”)5. Insulin pump
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Life with a DIY Closed Loop
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
(It’s not “rocket science”)
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
What about regulations?
• Most users “test” their traditional medical devices, too.
• Individual experiments with “off label” use of medical devices are not a regulated activity in the U.S. – and so while we can’t (per the U.S. FDA) “distribute” devices, people can self-experiment with their own.
• The self-QA approach is even stronger when utilizing open source tools made with/by/for the community.
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Taking the DIY, artificial pancreas from (n=1) to (n=1)*many by:
• Focusing on safety
• Limiting dosing ability in hardware and software
• Using same dosing calculations a person would use
• Responding (or not) to unexpected data
• Tolerating communication failures
• Failing back safely to standard device operation
#OpenAPS:
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Documentation
Code
Reference Design
OpenAPS.org Github.com/openaps
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
#OpenAPS is now (n=1)*112+
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
The challenges of traditional regulation:
• Individuals are inadvertently being pressured to not share their innovations (!) for fear of retribution and regulations.
• There need to be more opportunities for individuals, academic research, and commercial innovation efforts to intersect.
• Companies should not be held liable by 3rd
parties (including patients themselves!) innovating or adapting technology – and need to be explicitly encouraged to allow access to data. @DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Traditional innovation
User-driven innovation
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
Traditional innovation
User-driven innovation
@DanaMLewis
Vermont Health Information Exchange SummitNavigating the Health IT Landscape
#WeAreNotWaitingto change the future of healthcare.
Are you?
#OpenAPS | @DanaMLewis | OpenAPS.org
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