Jeffrey Olgin, MD
What is the Health eheart Study? An electronic (decentralized) cohort that leverages internet and mobile technology to collect realtime, real-life dense measures and outcomes on 1M adults via surveys, apps, sensors, electronic health information and biospecimens. ELIGIBLE PARTICIPANTS: Any adult 18 years of age Collecting big data to predict, prevent and treat heart disease.
What do we hope to accomplish? New paradigm for conducting clinical research Larger & more efficient trials Nimble and rapid deployment Blending healthcare, research & dissemination Develop more robust prediction algorithms Collection of dense data Personalized pattern-based prediction Leverage & develop technology New sensors & mhealth technologies Validation & translation into improved health Develop new paradigms for healthcare delivery Testing ground for disease management strategies
Health eheart Study Team PRINCIPAL INVESTIGATORS Jeffrey Olgin, MD (Chief of Cardiology, UCSF; researcher, clinical trials) Gregory Marcus, MD, MAS (Cardiologist, UCSF; CV epidemiology) Mark Pletcher, MD, MPH (Internist, UCSF; CV epidemiology, clinical trials) CO-INVESTIGATORS James Fowler, PHD (Social Scientist, UCSD) Michael Blum, MD (Cardiologist & CMIO, UCSF) Ida Sim, MD, PhD (Internist, UCSF; Open mhealth) CARDIOLOGY Department of Epidemiology & Biostatistics Cardiovascular Research Ins tute
Health eheart Study Team Web developers Integration developers Engagement experts Web design team Social Media team Research coordinators Data coordination Data scientists Biospecimen core lab CARDIOLOGY Department of Epidemiology & Biostatistics Cardiovascular Research Ins tute
Existing Partnerships CARDIOLOGY Self Funded
Existing Partnerships
Existing Partnerships Technology & Sensors Validation & Development azumio
Existing Partnerships
Thousands Impact of Heart Disease 600 500 400 300 200 100 - Annual Mortality (US) Hrt Dis Trauma Cancer Mental Hlth Arthritis COPD/Asthma Hypertension Diabetes Hyperlipidemia Back Pain Childbirth GI Dis Skin Dis CNS Kidney Dis Stroke Lupus Other Dis Other CV Infectious AHA: Heart disease and stroke statistics. Circulation. 2013 US Annual Health Care Expenditures 57 53.7 47.4 45.9 38.6 35 34.6 27.2 24.2 20.4 19.9 18.8 18.8 18.4 17.6 16.2 74.3 72.2 72.1 95.6 0 20 40 60 80 100 Billions of Dollars
Decreasing Federal Funding Science 341; 701 August 16, 2013
Cost Per Pa ent (millions) Increasing Expense of Clinical Research Cost of Clinical Research $50,000 $45,000 2008 $40,000 2011 $35,000 $30,000 $25,000 $20,000 $15,000 $10,000 $5,000 $- Phase I Phase II Phase III Phase IV IOM Transforming Clinical Research 2012 350 300 250 200 150 U.S. Technology Use U.S. Technology Use Smartphone users Tablet users Total US Population Total online population Consumer computers Regular mobile Internet use 100 50 0 2010 2011 2012 2013 2014 2015 2016 Source: Forrester Research
Can Technology be Leveraged? 91% of smartphone owners keep their smartphones within 3 feet, 24 hours a day. Morgan Stanley
Strategy Non-traditional sources of recruitment Data collection evisits Sensor integration Mobile apps BlueButton+ and EMR integration Facebook integration Novel outcomes ascertainment methodology Rapid deployment of sub-study & randomized trials
Accomplishments 3000 4000 30% HeH Age Distribution 2000 Enrollment 20% 1000 IRB Approval V1.0 V1.1 V2.0 (sensor Integra on) Mobile App AHA Partnership 10% Oct 12 Nov 12 Seed Funding Hired Team Apr 13 Design & Development ENROLLMENT BEGAN Aug 13 Design & Development Sep 13 Engagement Admin Interface Analy cs BlueBu on + Intgn 0%
AHA 2020 Impact Goal By 2020, to improve the cardiovascular health of all Americans by 20%, while reducing deaths from cardiovascular disease and stroke by 20%. 20% 2020
Life s Simple 7 mylifecheck.heart.org HEALTH BEHAVIORS Smoking Diet Physical Activity Body Weight HEALTH FACTORS Glucose Cholesterol Blood Pressure
Definition of Cardiovascular Health LIFE S SIMPLE 7 POOR INTERMEDIATE IDEAL Smoking Status Adults >20 years of age Children (12 19) Physical Activity Adults > 20 years of age Children 12-19 years of age Current Smoker Tried prior 30 days None None Former 12 mos 1-149 min/wk mod or 1-74 min/wk vig or 1-149 min/wk mod + vig >0 and <60 min of mod or vig every day Never /quit 12 mos 150+ min/wk mod or 75+ min/wk vig or 150+ min/wk mod + vig 60+ min of mod or vig every day Healthy Diet Adults >20 years of age Children 5-19 years of age 0-1 components 0-1 components 2-3 components 2-3 components 4-5 components 4-5 components Healthy Weight Adults > 20 years of age Children 2-19 years of age 30 kg/m 2 >95 th percentile 25-29.9 kg/m2 85th-95th percentile <25 kg/m 2 <85 th percentile Blood Glucose Adults >20 years of age Children 12-19 years of age 126 mg/dl or more 126 mg/dl or more 100-125 mg/dl or treated to goal 100-125 mg/dl Less than 100 mg/dl Less than 100 mg/dl Cholesterol Adults >20 years of age Children 6-19 years of age 240 mg/dl 200 mg/dl 200-239 mg/dl or treated to goal 170-199 mg/dl <170 mg/dl Blood Pressure SBP 140 or DBP 90 mm Hg SBP120-139 or DBP 80-89 mm Hg or treated to goal <120/<80 mm Hg
Mobile Health Heart 360
Needs FUNDING Additional funding needed to sustain full vision Moving at a pace faster than federal funding sources PARTICIPANTS Spread the word Strategic partnerships (eg. Advocacy, insurers, health plans, corporate wellness, others) TECHNOLOGY PARTNERS