Emerging Technologies in Healthcare

Virendra Prasad, GM-Engineering, Edifecs

July 26, 2012

Tele communication in India ( July 2012)• Late nineties, India invested in Cellular instead of wired phone

lines• India's mobile phone subscribers' base touches 929 million

• Wireline: 33 million• Wireless: 929 million (~ 28 time of wire line)

• Overall teledensity in India reached 79.28 per cent

Benefit of Emerging Technology Adoption

Global

Connected Healthcare

World

More information, more connected, leads to better care and better research.

Creating a connected healthcare world

Network of networks

Network of networksEssential components for a connected healthcare world

Source: CSC

Emerging Technologies

1. Smartphone

Information wherever you are

2. Virtual Reality/3D gaming

Simulation of real world scenario

3. Wearable Devices

Unobtrusive continuous health monitoring

4. Ontology

Knowledge as a set of concepts within a domain, and the relationships among those concepts.

5. Machine Learning

Data to Information

6. Big Data

Unlimited storage and compute

7. Cloud Computing

Deliver Infrastructure, Platform and/or Application as Service

8. Crowd Sourcing

Leverage the crowd

SmartphoneInformation wherever you are

SmartphoneInformation wherever you are

Smartphone are becoming rich in personalized information center due their following abilities: Portable personal device with phone, camera, music,

internet and apps PIM: Personal Information Management Profiles tracker – likes and dislike profiling Location information: GPS Information Guide: Search, directions, deals etc. Sensors

Three-axis gyro Accelerometer Proximity sensor Ambient light sensor

Notifications Apps for almost everything

About 5,800 health care smartphone applications

Perfect device for collecting personal information through direct data entry or indirect through sensors and preferences that can be useful for personal healthcare and wellness management.

SmartphoneApplications in healthcare

Medical Content and First Aid

Boost Health and Fitness

Health Monitoring and Treatment

Training on the Go

System Monitoring

Collaboration

Medical Content and First Aid

iTriageCreated by two ER docs, iTriage helps you answer the questions: “What medical condition could I have?” and “Where should I go for treatment?”

Medical Content and First Aid

WebMD

WebMD helps you with your decision-making and health improvement efforts by providing mobile access 24/7 to mobile-optimized health information and decision-support tools including WebMD’s Symptom Checker, Drugs & Treatments, First Aid Information and Local Health Listings.

Boost Health and Fitness

GPS enabled fitness Apps

Health Monitoring and Treatment

iHealth

iHealth's Blood Pressure Dock lets you take more control of your personal healthcare using iPhone 4, iPad and iPod touch (4th Gen.).

Training on the Go

RNotes: Nurse’s Clinician Pocket Guide

RNotes® helps nurses provide premium patient care by putting the latest quick-reference, clinically-focused nursing information at their fingertips.

Payers related use cases

Provider Support

Apps for Members, e.g. health4me from Unitedhealthcare.

Visibility on the Go Tracking information Dashboards

Business Process Exception Management Monitoring Notifications

Virtual Reality (VR) / 3D

gaming

Simulation of real world scenarios

Virtual Reality(VR)

Surgery Surgical navigation, IGS, CAS, AR surgery, and

robot-assisted surgery

Medical Data Visualization Multi-modality image fusion, advanced

2D/3D/4D image reconstruction, and pre-operative planning and other advanced analytical software tools

Education and Training Virtual surgical simulators and other simulators

for medical patient procedures

Rehabilitation and Therapy Immersive VR systems for pain management,

behavioral therapy, psychological therapy, physical rehabilitation, and motor skills training

3D Gaming

Pulse !!: Virtual Clinical Learning Lab for Health Care Training

Pulse!! is the first ever, immersive virtual learning space for training health care professionals in clinical skills. Cutting-edge graphics recreate a lifelike, interactive, virtual environment in which civilian and military heath care professionals practice clinical skills in order to better respond to injuries sustained during catastrophic incidents, such as combat or bioterrorism.

It is developed in partnership with Texas A & M University - Corpus Christi and is funded from a federal grant from the Department of the Navy's Office of Naval Research.

Wearable Devices

Unobtrusive continuous health monitoring

Wearable Devices

Wearable devices equipped with sensors, Web connections, or both, help consumers and healthcare providers track health and fitness.

ABI Research last year estimated that the market for wearable health-related devices, ranging from heart monitors to biosensors that read body temperature and motion, will reach more than 100 million device sales annually by 2016.

NIKE + FUELBANDNike has put forth a hi-tech wristband that keeps a tab on how active you are throughout the day. The Nike+ Fuel Band measures activities through a new metric called NikeFuel. You earn NikeFuel depending upon how active you are.

Basic B1

The consumer-oriented Basis B1 wrist band incorporates five sensors to provide a precise view of a person's health immediately and over extended periods of time.

an optical blood flow sensor that detects heart rate, through pulse or blood flow;

a 3D accelerometer, a highly sensitive sensor that detects the smallest movements, regardless of whether users are alert and active or sleeping;

a body temperature sensor to measure exertion during activity;

an ambient temperature sensor to detect the outside temperature and compare it to body temperature to boost the accuracy of caloric burn calculations;

and a galvanic skin response sensor to measure the intensity of sweat output.

Health Monitoring and Treatment

Raisin: A raisin that can save your life

The FDA recently approved the marketing of a new medical device, Raisin Personal Monitor, worn like a band-aid that receives data from a sensor you swallow in a pill and then sends out a wireless health report.

The device manufacturer, Proteus Biomedical, developed ingestible sensors made out of food products that serve as markers in the body. Then it transmits an ultra-low-power signal to the Raisin, recording everything from date/time, type of drug, dose, place of manufacture and physical reactions.

It was designed primarily for heart failure patients, but the applications may extend to other conditions.

Image by Proteus Biomedical

OntologyKnowledge as a set of concepts within a domain,

and the relationships among those concepts.

Ontology

Ontology models knowledge as a set of concepts within a domain, and the relationships among those concepts.

An ontology renders shared vocabulary and taxonomy which models a domain with the definition of objects and/or concepts and their properties and relations.

Ontology helps in taking a data and converts into information using common set of concepts or terminology so that the information can be: Categorized Uniform meaning so that it can be compared with other set of

data

Used in Artificial Intelligence, the Semantic Web, biomedical informatics, library science, enterprise bookmarking, Knowledge Management.

Healthcare Usages: EHR HIE Translation: ICD10 ICD9 Unstructured data processing Analytics

Machine Learning

Data to Information

Machine Learning

Machine Learning is the study of computer algorithms that improve automatically through experience.

Main Algorithm Types Supervised Learning

Classification Regression

Unsupervised Learning Clustering Density Estimation

Applications Natural Language Process, useful for EHR Fraud Detection Predictive Analytics Forecasting

Big DataUnlimited storage and compute

Big Data

Data Characteristics

Volume

Variety

Velocity

Variability

Complexity

Desired Properties of a Big Data System

Robust and fault-tolerant

Low latency reads and updates

Scalable

General System

Extensible

Allows ad hoc queries

Minimal maintenance

Debuggable

Big Data is data sets that exceeds the boundaries and size of the normal processing capabilities forcing you to take non traditional approach.

Big data is a popular overloaded term used to describe the exponential growth, availability and use of information, both structured and unstructured.

Latest Buzz Word: “BIG DATA”

Big Data Technical Approach

NoSQL Storage

Distributed Storage

Parallel Processing

MapReduce

Lambda Architecture

The Lambda Architecture solves the problem of computing arbitrary functions on arbitrary data in realtime by decomposing the problem into three layers

1. Speed Layer

Compensate the high latency of update to serving layer

Fast incremental algorithm

Batch layer eventually override speed layer

2. Serving layer

Random access to batch view

Updated by batch layer

3. Batch Layer

Store master dataset

Compute arbitrary view

Hadoop

Hadoop is a platform that provides both distributed storage and computational capabilities.

Hadoop was first conceived to fix a scalability issue that existed in Nutch, an open source crawler and search engine.

It is based on Google papers on Google File System (GFS), and MapReduce, a computational frameworks for parallel processing.

Hadoop: MapReduce

Hadoop: Related Technology

Big Data

Use cases Batch Transaction Processing Analytics Test Data selection based on

rules/scenarios Search EHR & HIE

Cloud ComputingDeliver as service

Cloud Computing

Cloud computing is the delivery of computing and storage capacity as a service.

The name comes from the use of a cloud-shaped symbol as an abstraction for the complex infrastructure it contains in system diagrams.

Cloud computing entrusts services with a user's data, software and computation over a network.

There are three types of cloud computing: Infrastructure as a Service (IaaS) Platform as a Service (PaaS) Software as a Service (SaaS)

eMixElectronic Medical Information Exchange

A cloud-based virtualized radiological image and information report service, provides secure access for physicians, hospitals and patients to view images and information.

In the past, this was done by setting up a special network connection to transmit the file, express-mailing a CD, or printing and mailing the image (film).

http://www.emix.com/

Crowd SourcingLeverage the crowd

Crowd Sourcing Crowd sourcing is a process that involves outsourcing tasks to a

distributed group of people. This process can occur both online and offline.

The difference between crowdsourcing and ordinary outsourcing is that a task or problem is outsourced to an undefined public rather than a specific body, such as paid employees.

Crowd sourcing delivers the elasticity of cloud by leveraging peer-to-peer technologies.

It also mitigates concerns about loss of privacy, since a single cloud provider does not have a global view of anyone’s data.

Also, it presents a more economical solution compared to cloud computing: instead of paying a cloud provider for services, the contribution is made in-kind by becoming part of the computing system that offers computing power, storage capacity, data or knowledge. As a consequence, the concept of “cloud owner” is removed from the equation.

Human brain guided computation is able to perform task that computers can not do. Example, quality or accuracy of a content on Wikipedia.

Crowd Sourcing: Challenges

Will we be able to crowd-source CPU hours in the future?

Will the crowd carry sensors on their mobile devices to make the network more aware of environmental situations?

Do new security questions arise?

How should we deal with performance issues?

How can we extract high-quality answers from data created by the crowd, which implies many small contributions from well-intentioned providers that may not be correct?

Crowd Sourcing: Examples

SETI@home

Search for Extraterrestrial Intelligence (SETI)

(http://setiathome.berkeley.edu/)

An early example of crowd computing was the discovery of a gold deposit location at the Moribund Red Lake Mine in Northern Ontario. Using all available data, the company, Goldcorp, Inc. had been unable to identify the location of new deposits on their land. In desperation, the CEO put all relevant geological data on the web and created a contest, open to anyone in the world. An obscure firm in Australia used their software and algorithms to crack the puzzle. As a result, the company found an additional 8 million ounces of gold at the mine. The only cost was the nominal prize money awarded.

Real Time Traffic information including jams, speed, construction etc.

Crowd Sourcing: Use Cases

Enterprise Use Cases

Managing business processes for their customers

Moderating images and user-generated content

Analyzing sentiment for brands in Social Media

Improving search relevance

Processing data (business listings, points-of-interest, contacts, etc…)

Structuring and normalizing digital content

MeditationLet the brain do the healing …

Thank you!