D I Y ( H e a l t h )

C a r e

Se l f he l p t e c hno l og i e s

Peter Cochranecochrane.org.uk

ca-global.biz

• All countries and systems are struggling

• There are no ideal systems or solutions

• We have no common metrics to judge

• Political twiddling is not the way

• Patient expectation is on the up

• Technology is accelerating

• Rapid change the norm

Healthcare RealityThroughout the first world death is now seen as an unnatural act

PerspectiveU S A S p e n d w e l l o v e r d o u b l e t h e U K £ £ / c a p i t a a n d t h e i r s y s t e m i s a l s o f a i l i n g - s o

a r e a l l h e a l t h s y s t e m s a c ro s s t h e d e v e l o p e d

w o r l d

more of the same ?No matter how big the ££ investment we will only see a drawn out failure!

Three mode strategyHealthy l iving; self monitor ing; early problem detection and action…

Sudden Death

Terminal Illness

Organ Failure

Frailty Long Term Decline

Func

tiona

lity

Increasing Lifespan

Productive Years

Failure and Dependency

Models Work New Model(s) Required

HYPOTHESIST h e c h a n g i n g h e a l t h c a r e l a n d s c a p e

1940 1950 1960 1970 1980 1990 2000 2010 2020

PrognosisHospitalPrime Centre of Expertise & Capability

Medical CentrePrime Point of Local Capability

Home BasedMeasurementsMonitoringMedication

Technology Push - Patient Pull

D o I t F o r M e t o D I Y - S e l f H e l p

Most of us wi l l need some form of help at some t imethe end game

•Infirmity isn’t something we choose

•Independence is easily lost

•Ageing is not an option

•C o g n i t i o n c a n f a d e

•Offsets often possible

•Se l f he lp i s ours

•NHS the backstop

Ever yone i s d i f ferent and un ique

One size does not fit all:

• Age• Health• Wealth• F a m i l y• F r i ends• Hous ing• Locat ion• Education

variance

Customisation is

Key

Technology can provide many more

Options

Self sufficiency in everything possible is the

new norm powered by low cost and

increasingly capable/available IT,

Sensors, Mobility and Networks

connecting peoples, things and

information across the planet

with national, international and

local control losing their grip!

key Trend Mov i n g f rom ‘Do I t Fo r Me ’ t o D I Y

A key TrendI t ’ s a l l a b o u t m e a n d m y l i f e

•Focussed/customised markets for everything

•The death of institutionalisation

•The rise of self determinism

•I’ll do it my way

•Designer drugs

•Designer care

•Self help first

•Deniable ageing

H e a l t h S y s t e m s a r e n o t : - u n d e r f u n d e d - u n d e r s t a f f e d

HYPOTHESIS

H e a l t h S y s t e m s a r e :

1940/50s thinking won’t work in the 21st Century

- p o l i t i c a l f o o t b a l l s - t h e w r o n g m o d e l

hold this thought ! Ever y th ing f ree a t the

po int of f need i s now

fundamentally impossible!

TECHNOLOGYWhat i s on o f fe r - what i s f eas ib l e

FUTure

5 10 1

5 20 25 30

Y e a r s

Everything in design/engineering phase visible and known

~ 50% is known & 50% a good guessGuessing and dreaming

Dreaming no dreamingThis slide set

T e c h n o l o g i e softhe

B y i n f o r m a t i o n g r o w t hovertaken

Medical Knowledge Half <4 years

G r a d u a t e d y e s t e r d a y ~50% o f expert i se wrong !

N o c h a n c e o f c a t c h i n g u p l e t a l o n e k e e p i n g u p t o d a t e !

outmodedB o o k s o u t o f d a t e / w r o n g I T t o o s l o w a n d c l u m s y

Abi l i ty to so lve prob lems outguns ability to remember or pure academic prowess

Every profession is suffering the same fate….

The march of the machines…we need workable partnerships !

symbiosis

computersH u m a n s o v e r t a ke n b y m a c h i n e s

Ches s 1997 Comp lex i t y 2000 Gene ra l Know ledge 2011 Med i ca l Know ledge 2012 Open AP I a va i l ab l e 2013 Open Pub l i c C l oud acce s s 2014

I ndu s t r i a l p roce s s con t ro lI n fo rma t ion managemen tNetwork managemen tI n fo rma t ion s to r a geI n fo rma t ion s e a rchC h e m i c a l a n a l y s i sS y s t em mode l l i n gP roce s s con t ro lComput a t i on

medicineD i a g n o s t i c s

S u p e r i o r h u m a n d i a g n o s i s capability demonstrated in 2012

USA medical trials underway since 2013

Now gaining experience whilst gathering more information and knowledge

Greater ‘bandwidth’ and lower error rate than any human doctor

REpair & Replace

printed

H i g h p r e c i s i o n , g r e a t e r success rate, better quality, lower cost

Trachea

Vertebral DiscInjection Molded

Breathing Lung

printed & programmedNew for old for everything…almost !

...many die through secondary infections...

BURNSI n t e n s i v e c a r e d emand

RAPID HEALS p r a y O n s t e m c e l l t r e a t m e n t s

Some patients are fully healed within a week or two with very close to normal skin !

Still being perfected and not generally available, but there is at least an ‘existence theorem’

Sav ings and outcomes ver y pos i t ive and rap id ly moves people out of ‘care’

SENSORS

More sensitive than a dogs nose

Able to detect some cancers

Able to detect many human conditions very early

Sparking a diagnostic revolution

GENOMIC PROFILING…in the doctors office will revolutionise medicine

science fictionC o n t a c t l e s s , i m m e d i a t e a n d a c c u r a t e d i a g n o s i s

REALITYComing to a store near you…

E a r l i e r d i a g n o s i s , f a s t e r treatment, impact offset, fewer people needing short and long term care

magnificationM o v e m e n t , c o l o u r , t e m p e r a t u r e , s c a l e

I n t h e f u t u r e j u s t a p p s t o d o w n l o a d f o r y o u r m o b i l e

DIY care?S e n s o r t e c h n o l o g i e s a v a i l a b l e t o a l l … Many low cost and affordable devices

DIY care?Even more low cost and free apps…

Device to PRODUCTMonitoring the in:out and effect…

records?T h e y a r e m i n e a n d n o t y o u r s … Archaic and unworkable !

Protecting the system or helping the patient ?

Lost/in the wrong place 20 - 24% of the time

∂Cannot be searched orcorrelated in any way

∂

Electronic solutions are very simple, but not when they are managed by committees with no IT understanding !

So simple!S o s e c u r e , a v a i l a b l e , b a c ke d u p

M e m o r y s t i c k o r

m o b i l eo r p a dD a t a s t o r e d b y p a t i e n t ,

D o c t o r, N u r s e , C a r e rH o s p i t a l … e a s y t o m a k e a v a i l a b l e ,u n d e r s t a n d ,a n d v e r yl o w c o s t

DIY care?Connecting to the world of everything… TV

HBORadioMusicYouTubeSocial NetsCommunities

CommunicationsConferencingEmployment

EducationShopping

+++

Mechanical Armand Holster £250

Tablet£200 - £400E a s y t o

d e s i g n , b u i l d ,c o m m i s s i o n -a n o t h e r D I Yp r o j e c t !

Signing to VoiceDevelopment advanced to be deployed very shortly

voice to signingDevelopment advanced to be deployed very shortly

mind controlDevelopment advanced and to be deployed v e r y s h o r t l y

Tremors And many o t h e r i n c apa c i t i e s…

B e i n g ‘ r e p a i re d ’ b y e l e c t ro n i c i m p l a n t s a k a hea r t , b re a th i n g & o the r s t imu l a to r s

Cost o f repa i r << Cos t o f ca re

Intel l igent prosthetics avai lable nowsymbiosis

symbiosisExo-Skeletons are being c o m m e r c i a l i s e d f o r upper, lower and ful l body adoption

Musc le magnifiersfor the ful ly

able

Those that can, ‘DO’,

a n d t h o s e w h o

refuse to try are left

behind !

isolation reducing Video conferencing, social nets , self help groups…

not rocket science ! It really is child’s play and anyone can master IT and the world of apps

Feedback is vital in any effort to stay fit and healthy, not to mention long or short term recovery and rehabilitation

getting up to speed V i t a l du r i ng a t ime o f good phy s i ca l & men ta l hea l t h

too late ? We (can?) might

offset or at least

de lay the end

game through the

use of hi-tech and

self help early on

in the life cycle

outsidersT h e r e a r e a l w a y s t h e d i s a d v a n t a g e d

• The obstinate

• The uneducated

• Those refusing to try

• The mentally challenged **

• The physically challenged **

• Those with an apparent ‘death wish’

** these groups can mostly be helped…

Who Pays ? D e f i n i t e l y N OT 1 0 0 % . G o v !

Health/Care technology and Apps are extremely low price and

available for all platforms from laptop and tablet to mobile

think anew !

Adopt a ‘younger’ mind set and be prepared to change,

to try the new, to experiment…

We have no cho ice and i t i s not at a l l easy

Sometimes we have to wait for a generation to die before change on a large scale is possible…but in this case we do not enjoy that luxury !!

UK Private

✓✓✓

✓✓

✓✓

✓✓

✓✓

✓✓ ✓

✓ ✓✓

✓✓✓

✓

TXTwwwpage

videocalls

patientaccess

medicalpapers

socialnetseMailmobilefixed

comms channelsDirect connect to med ica l profess iona l beyond recept ion

✓ ✓

Every industry and sector is in the same boat

We are all struggling with accelerating change

Growing complexity is confounding everyone

Big organisations are hampered by their size

There are no simple solutions or quick fixes

Technology is the pr imary dr iver/solution

Mass markets have become individualised

Growing populations are the challenge

Rising expectations now the norm

perspective

ChangeT h e n e w s t a b l e s t a t ef o r a l l o r g a n i s a t i o n sa n d s o c i e t y …… a n d i t i s a c c e l e r a t i n g , k i l l i n g c e n t r a l i s a t i o n , e m p o w e r i n g t h e i n d i v i d u a l , m a k i n g u s a l l f a r m o r e c a p a b l e a n d p o w e r f u l …

… a n d w e h av e t o a s s u m e n e w r e s p o n s i b i l i t i e s a c ro s s t h e b o a r d … .

W H O C a r e s ?

Se l f he l p t e c hno l og i e s

Peter Cochranecochrane.org.uk

ca-global.biz

So, Who Cares ?Most, effectively, best, longest, strongest…

We do !

What we know for sure....In the next phase the winning companies and countries

will have taken risks, and dared to be different...

...very different...

THE FutureBe l o n g s t o t h o s e who da re t o c hange

…and the most adaptable!

It really is up to us !!

Thank You COCHRANE a s s o c i a t e s

1995

ca-global.orgcochrane.org.uk