Saving the Healthcare System

Transcription

1 Majid Sarrafzadeh Professor of Computer Science (Electrical Engineering, courtesy) Co-Director Wireless Health Institute (WHI) Saving the Healthcare System

2 NORTH AMERICA Airline Million Flights Fatal Event Last Fatal Air Canada (1983) Delta Airlines JetBlue Southwest Airlines United Airlines None 0 None Effective modeling/monitoring/diagnostics for the simplest machines

3 Today we lack continuous monitoring and diagnostics for far more complex (100 mil X) human body. On average, nearly 20% of the 1 million heart failure patients admitted to US hospitals each year are readmitted within a month The total lifetime treatment cost of Brain Disease is estimated at about $3.3 trillion

4 Outline Problems & Trends Monitoring & Diagnostics in Next Steps

5 Problems & Trends

6 Statistics on Global Chronic Disease (Geyman and Thorpe Reports & World Economic Forum 2011) Chronic Disease Management is 80+% of all Healthcare Costs 1 in 3 Adults < 65 have at least 1 Chronic Disease 8 in 10 Seniors >65 have at least 1 Chronic Disease U.K. spends 8.4% of current GDP on Healthcare U.S. spends 17% of current GDP on Healthcare Experts project that Healthcare costs will be 75% of Global GDP by 2030 if not curbed by new ways to care for the chronically ill

7 Top 6 Chronic Diseases & Comorbidities Heart Disease Diabetes Cardiovascular Disease COPD Cancer Stroke Other Comorbidities Obesity Hypertension Kidney Disease Cerebrovascular Disease Arthritis Osteoporosis Liver Disease Oral Diseases

8 On average, nearly 20% of the 1 million heart failure patients admitted to U.S. hospitals each year are readmitted within a month. Heart failure is the leading cause of those readmissions, with overall Medicare cost of $17 billion every year -- 20% of all Medicare payments. Approximately 14 million people in Europe currently suffer from heart failure: forecast to increase to 30 million by the year 2020 Direct costs of patients with advanced heart failure in France in 2007 were 1.6 billion Wir

9 8.3% of the US population has diabetes, resulting in $174 billion spent per year. In 5 European Union Member States, the total direct cost of diabetes was 90 billion in Diabetes Costs China $26 Billion a Year. China has 92.4 million people with diabetes Wir

10 2012: Monitoring & Diagnostics

11 OUTCOMES COST The Vision Ubiquitous Body Monitoring Health Care PREDICTIVE ANALYTICS Transforming Chronic Care for both Patients & the HC Industry Deliver proactive real-time virtual health & illness management Significantly improve patient outcomes Avoid & reduce costly acute care interventions

12 CHF Patient Monitoring (III) Collaborator Prof. Michael Ong, The School of Medicine, UCLA and Doctors and Nurses in UC Area Hospitals Patients & Measurements Target recruitment: 1500 patients Measurement: Weight, BP, Questionnaires Identified 3-day & 7-day BP fluctuation as better predictors than DWC Improved prediction accuracy by 20% & sensitivity by 45% over thresholding algorithm based on DWC

13 Diabetes Telehealth Study Collaborators Drs. Sheila Ahmadi & Tannaz Moin, The Ronald Regan UCLA Medical Center Patients & Measurements # of patients enrolled: 51 Target recruitment: 100 patients Measurement: blood glucose, general health status and medication compliance -Mean HbA1c at enrollment 9.8 -Mean HbA1c at 3 month follow-up 7.3 Wir

14 Medical Event Prediction System DATA STORAGE & MANAGEMENT PRE-PROCESSING Raw Data Meta Data Data Cleaning Data Transformation Prediction Data Training Data Prediction Model Generation Gateway ECG & Motion DATA COLLECTION PREDICTION

15 Prediction Engine Clustering Activity Monitoring Task optimization Regression Step-by-step health Clustering Feature Regression Feature Classification Dimensionality Extraction Selection Reduction Continuous data Preprocessing Preprocessing Classification Clustering Feature Regression Feature Classification Dimensionality Extraction Selection Reduction Time-varying Clustering Feature Regression Feature Classification Dimensionality Extraction Selection Reduction Context-aware Clustering Feature Regression Feature Classification Dimensionality Extraction Selection Preprocessing Reduction Prediction Clustering Feature Regression Feature Classification Dimensionality Extraction Selection Reduction Preprocessing Clustering Feature Regression Feature Classification Dimensionality Extraction Selection Reduction Preprocessing Feature Extraction Feature Selection Dimensionality Reduction Preprocessing Preprocessing

16 2012++: Monitoring & Diagnostics

17 SmartCane SEM frehab SmartShoe

18 Facts about Child Obesity Children aging 8-18 spend more time (44.5 hr/week) in front of computer game screens than any other activity except sleeping 30.3% of children (age 6-11) are overweight and 15.3% are obese Another country that I just visited: Altogether, around 200 million people are thought to be overweight, and 60 million (7.1%) obese. No Pain No Game

19 Context-Aware Prediction / social networking Examples For children with asthma, traffic-related air pollution within 5 km radius of home causes repeated hospitalization (Delfino, 2009). 5 to 7 % of weight loss and 20 minutes exercise each day can reduce the risk of diabetes (DPP Research Group, 2002). Sport participants are more motivated to engage as a means for social enjoyment than to achieve positive health benefits (Kilpatrick, 2005). The seasonal variation in blood pressure was greater in older subjects and was highly related to max/min daily air temperature (Brennan, 1982). Delfino, R J. (2009). Repeated hospital encounters for asthma in children and exposure to traffic-related air pollution near the home. Annals of allergy, asthma, & immunology, 102(2), The Diabetes Prevention Program (DPP) Research Group. (2002) The Diabetes Prevention Program (DPP) : Description of lifestyle intervention, 25 (12), Kilpatrick, M. (2005). College students' motivation for physical activity: Differentiating men's and women's motives for sport participation and exercise. Journal of American College Health, 54(2), Brennan, P. (1982). Seasonal variation in arterial blood pressure. British Medical Journal, 285(6346),

20 Step-by-Step toward Health What is the most effective way to reduce the likelihood of mortality? How to reduce chance of heart attack in overweight individuals? How to lose 20 lbs in 10 years? What are important factors for a safe weight loss? When to start to lose weight? How much to lose each year/month?

21 2022: Monitoring & Diagnostics

22 Full disposal and/or implantable body sensors for continuous monitoring Power Sources: harness the body s bioelectrical and biochemical energy to serve as a source of power.

23 Body area networks that can be worn or implanted to continually capture biological data Integration of diagnostic sensors and data with therapeutic devices capable of releasing payloads, and/or initiating a therapeutic response Biodegradable polymers with drug eluting capabilities which can be externally or internally excited

24 Tablets, smartphones will be so The yet to be popularized "ihologram" application will be the default interactive device to be used by patients, caregivers and clinical care team. The patient or his/her care team will materialize in a i- hologram space as a virtual visit.

25 End-to-End Sensing and Monitoring Diagnostics Activity Monitoring Task optimization Clusteri Regressi Classification ng on Clusteri Step-by-step Feature Regressi Feature health Classification Dimensionali ng Extracti on Selectio ty Reduction Clusteri Feature Regressi Feature n Continuous data Classification Dimensionali ng Extracti on Selectio Preprocessing ty Reduction Clusteri Feature on Feature n Time-varying Regressi Dimensionali Extracti Preprocessing Selectio Classification ng on ty Reduction Clusteri Feature on Feature n Context-aware Regressi Classification Dimensionali ng Extracti on Preprocessing Selectio ty Reduction Clusteri Feature Regressi on Feature n Prediction Dimensionali Extracti Preprocessing Selectio Classification ng on ty Reduction Clusteri Feature Regressi on Feature n Dimensionali Extracti Preprocessing Selectio Classification ng on ty Reduction Feature on Feature n Dimensionali Extracti Preprocessing Selectio ty Reduction on n Preprocessing

26 Next Steps

27 We are facing a global crisis that will cripple the strongest economies A solution is foreseeable: need a concerted effort to cope with the complexity We are getting there: slowly but surely A HealthIT revolution to achieve the goals before it is too late Contact majid@cs.ucla.edu