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The C3N Project held a live webcast on August 21, 2012 - the third in a quarterly series scheduled for 2012. Drs. Peter Margolis and Michael Seid – C3N Principal Investigators – presented an overview of the project and answered questions throughout the hour. We were also joined by Ginger.io, who collaborates with the C3N on one of our innovations: Passive PRO. The mobile app, also called Ginger.io, passively tracks data and has the potential to predict flares for patients in the IBD community. To test the app, visit ginger.io/join/c3n today! And watch the live webcast by visiting Vimeo: https://vimeo.com/48010954
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LIVE WEBCAST | Featuring August 21, 2012
C3N Supported by NIH NIDDK R01DK085719
AHRQ R01HS020024 AHRQ U18HS016957
Welcome!• We will pause for questions after
the C3N Project overview, and at the conclusion of our feature presentation we will host more time for Q&A; but you can also direct questions and comments anytime using the chat function
• After the presentation, a short survey will appear – thanks for your feedback + participation!
• First, a few technology pointers…
Peter Margolis, MD, PhD
Michael Seid, PhD
Raising Your Hand
4
Raise your hand Lower your hand
Writing Comments & Asking Questions
CLICK HERE TO OPEN BOX.
TYPE YOUR QUESTION HERE!
6
take the conversation to twitter
#C3N@C3NProject@Ginger_io
An Introduction of the C3N Projectwith Dr. Peter Margolis
What if….?
• …we could create a vastly better chronic care system by harnessing inherent motivation and collective intelligence of patients and clinicians?
• … this system allowed patients and physicians to share information, collaborate to solve problems, use their collective creativity and expertise to act in ways that improve health?
What is the C3N?
• Self-reinforcing network
• “Lab” and “proving ground”
• A social, technical and scientific platform to support a learning health system
Learning Health Systems
• Patients and providers work together to choose care based on best evidence
• Drive discovery as natural outgrowth of patient care
• Ensure innovation, quality, safety and value
• All in real-time
Institute of Medicine
Design
Observation
Synthesis
Screen
Test Adapt, Implement & Spread
Prototype testing
Pilottesting
Concept design
Generate new ideas Test new ideas Spread new ideas
C3N Design Process
Creating Conditions for a C3N
1. Align motivation around common vision
2. Make it easy to contribute – design, system engineering and
technology
3. Enable better communication4. Reduce “transactional” costs
Percent of Patients in RemissionJ
ul-
20
07
N=
33
8A
ug
-20
07
N=
39
6S
ep
-20
07
N=
42
8O
ct-
20
07
N=
47
9N
ov
-20
07
N=
50
8D
ec
-20
07
N=
53
1J
an
-20
08
N=
57
0F
eb
-20
08
N=
60
7
Ma
r-2
00
8 N
=6
43
Ap
r-2
00
8 N
=6
54
Ma
y-2
00
8 N
=6
67
Ju
n-2
00
8 N
=6
71
Ju
l-2
00
8 N
=6
86
Au
g-2
00
8 N
=7
31
Se
p-2
00
8 N
=7
54
Oc
t-2
00
8 N
=8
01
No
v-2
00
8 N
=8
32
De
c-2
00
8 N
=9
01
Ja
n-2
00
9 N
=9
73
Fe
b-2
00
9 N
=9
95
Ma
r-2
00
9 N
=1
02
1A
pr-
20
09
N=
10
70
Ma
y-2
00
9 N
=1
11
2J
un
-20
09
N=
11
94
Ju
l-2
00
9 N
=1
24
0A
ug
-20
09
N=
12
77
Se
p-2
00
9 N
=1
31
4O
ct-
20
09
N=
13
44
No
v-2
00
9 N
=1
36
6D
ec
-20
09
N=
14
00
Ja
n-2
01
0 N
=1
42
1F
eb
-20
10
N=
14
10
Ma
r-2
01
0 N
=1
44
0A
pr-
20
10
N=
14
55
Ma
y-2
01
0 N
=1
46
1J
un
-20
10
N=
14
71
Ju
l-2
01
0 N
=1
48
9
Au
g-2
01
0 N
=1
51
8S
ep
-20
10
N=
15
47
Oc
t-2
01
0 N
=1
57
6N
ov
-20
10
N=
19
85
De
c-2
01
0 N
=2
03
2J
an
-20
11
N=
20
43
Fe
b-2
01
1 N
=2
06
5M
ar-
20
11
N=
21
24
Ap
r-2
01
1 N
=2
19
1M
ay
-20
11
N=
22
06
Ju
n-2
01
1 N
=2
27
2J
ul-
20
11
N=
23
01
Au
g-2
01
1 N
=2
33
5
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Percent of IBD Patients in Remission (PGA)
Month
Perc
ent o
f Pati
ents
Why Crohn’s as a Prototype?
• Number of patients small
• Few incentives for industry to invest in research
• No center has enough patients
• Teenagers especially likely to use Internet communications
Reducing Transactional Costs Example: Data Collection
“Enhanced” Registry
• Research using distributed registry of 10,000 patients
• Automated Pre-visit Prompts• Automated Physician Pre-Visit Planning
Infliximab and Thiopurine Treatment by Site
0%
10%
20%
30%
40%
50%
60%
70%
1 2 3 4 5 6 7 8 9 1 0 1 1 1 2 1 3 1 4
Sites
Per
cen
tag
e o
f C
D P
atie
nts
Inf liximab Thiopurine
“Enhanced” Registry - Research
