Limit patient calls on doctors without jeopardizing care

A challenging idea; how to limit the [physical] visits to doctors ? How to limit  [telephone] calls to doctors? Email/chat ? Without sacrificing quality of care ?

When doctors have better insigths - multiple instantaneous data streams -  

both patients and doctors will benefit!

In our vision we see people (patients) with wearables and smart appliances delivering data to a decision support systems which connects patients and General Practioners (doctors). Although the connection is always 'on' (24x7) GPs will only be notified in case of unusual and unexpected trends, whether good or bad. Imagine a patient suffering from a heart condition who gains weight or  a patient with a 'walker' (rollator in Dutch) who falls. In today's world we would call the doctor when we think something is wrong and inform the GP about our personal condition. Smarter healthcare - avoids, may be even replaces, this traditional question/answer, with a solution that monitors, detects, connects, and facilitates better human decisions. In case of an anomaly the connection will be made with the decision support system - which will analyze and share the relevant data, and suggest the decisions, with the GP. Doctors don't have to stare at dashboards 24x7 as they'll only be notified on suspicion of an unexpected trend; it provides them with the option to change, or add-to, the suggested precautionary measures.   

Easy to implement ?

As with any complex issue - let's address this step-by-step - assessing the state-of-the-industry and addressing pre-requisites.  Smart devices contribute to the wellbeing of people - whether these are wellness or medical appliances; and there a plentitude of devices addressing many needs already on the market. Our connectivity [mobile] infrastructure is very good - guaranteeing high levels of availability. Two prerequistes are therefore in place to make this work; but there's more to this ...

Smart Appliances - convenience at a price

Smart devices would be more useful to patients & doctors if these [devices] are easier to connect with other devices and systems as we need data from a mulitude of sensors to provide a broad view of a patient's condition. To achieve this each device should provide a standard option to share its data - and not necessarily save this data to its own database. Because most appliances are smart standalone products,with their own communication protocol, in a closed loop fashion, interoperability becomes a complex IT issue, requiring skilled technicians to make data available on a 'other platforms'. In the image below we shows smart devices, from 2 different vendors, each comes with its own IT solution for analysis & saving data. For patients to share this with their doctor a number of issues arise: (1) the already described issue of not being able to access both data streams and apply this into one dashboard view and (2) there's no possibility to use both data streams to real-time monitor and/or decide in real-time when an incident occurs / is about to happen.

This is counterproductive and goes against modern principles. It doesn't match the 'general' movement of the 'Quantified Self" of providing choices to owners. We feel it's time to  take action !

 

Our Mission: Adoption of Patient Central Appliances [APCA]

We put effort into creating an 'open data' world; in which data ownership and sharing is decided by users, aka people, aka customers, aka patients; not vendors. Today's technologies offer great ways to achieve this at a low cost; so there's no reason why non-IT people can't take control. Our APCA efforts are directed at creating an open data file / dossier, collecting data from a range of appliances such as weight scales, blood pressure monitors, thermometers etc, etc. Patient data must be under the control of the patient - and the ability  must be provided to share that data in multiple formats; raw data, formatted (with UI), full case data, email data, may be even in spreadsheets - basically applying formats that are common with modern IT standards.  This rules out the sole option of only saving data in the vendor's EcoSystem.  Patient/user control means that when there's consent between the patient and his/her doctor - data can be shared, even exported, in order to improve the doctor's consultation. 

Vendor 'lock-in'; an open EcoSystem is needed

It make sense that vendors add features to their devices as this keeps their customer within their brand borders and inside their ecosystem. For the consumer this doesn't make sense as the result as it saves data, their data, on that device (or within the vendor's eco-system) and can only be accessed by vendor's own [mobile] apps or through use of an API. We have to convice vendors a a new requirement; ensure that their devices can operate in a 'recording', 'monitoring',  mode only with the ability to push data to an external system or database - such to be deisnated by the customer. This can be easily implemented by means of a 'configuration setting'. Such a [new]  requirement can be implemented alongside their own implementation of saving personal data in their proprietary solution.

Apple, Withings, iHealth they all have their own closed EcoSystem

Apart from the above mentioned vendors, providing an open EcoSystem is in the commercial interest of vendors as it appeals to the customer needs for open data requirements. Granted, there's not one customer type, in this case it are many, largely unorganized, group of patients, doctors and many other stakeholders that we see as 'customers'.  Vendors should be more sensitive to the fact that a bigger, better picture (a 360 view of the patient) requires a multitude of sensors/devices/appliances - well beyond their own offerings. For this view to be accurate personal & historical data need to be included - again this is well beyond to what they can / should support. Not a single device can, or should, address all these requirements; instead new ways of cooperation - even with competitive vendors - should be considered. 

The doctor's perspective: a 360 view is key to better diagnostics

Doctors keep stressing the need for more, accurate and timely information. This will put them in a better position to actually determine/diagnose what the patient's problem can be. Such information, when delivered real-time, can also be used for preventive actions - consider patients suffering from heart failure - in which case a multitude of data streams (data delivered by a variety of sensors) will notify the doctor who can then decide for preventive check-ups - or he can refer the decision to a cardiologist ; sharing the information with 'one-lick-of-the-mouse'.  An 'open' data world facilitates this; it makes it easier to monitor patients and share data in case diagnosis action is required !

Our steps towards creating an "open [data] world" 

Our goal is to have the 1st implementation of open data operable by July [2016] in Amsterdam. We work with vendors and doctors to make this possible on a small scale, starting with a weight scale implementation. We work some exceptional medical specialists - each with their particular interest and specialism- driven by 'doing' and all with the same mission: creating the best possible patient care ! We will start with the weightscale device in the list below

 

smart devices for monitoring/measuring  (left to right):

blood glucose, oxygen saturation, [body] temperature, blood pressure, weight

 

The pace and visibility of our progress depends on many aspects, which likely will take time as these need to be properly addressed by stakeholders; it therefore makes it hard to define 'ready' dates. Note that we spend less effort on pre-announcing or writing exetensive plans - our energy is on the actual works - doing by delivering !

Stay abreast & connect 

Via this blog we'll provide regular updates. Updates will primarily be communicated via LinkedIn and Twitter . Our monthly eMailing newsletter will focus on high-level progress. 

 

Posted in IoT, Wearables on Apr 18, 2016