Brought to you by the Mobile Collective, with the support of the ICT KTN, the CI KTN, and the Mobile Applications Centre at Imperial College. Featuring: Patients Know Best, Wellnote, Epicollect, & MoDiSe

1. MC ThinkCamp – mHealth
June 3rd, 2011
( #tcmh )

2. Where do ideas for mHealth innovation
come from?

3. Saying ‘I Wish’

4. Seeing New Patterns

5. Doing a bit of Mix’n’Mash

6. Doing a bit of Drag’n’Drop

7. Playing Leapfrog

8. Disruption:
new authority figures

9. Disruption:
overshot customers

10. First Speaker:
Dr Mohammed Al-Ubaydli
In 2008, Mohammed founded Patients Know Best, a
website that gives patients online access to their
medical data. Mohammad has over 15 years of
experience in medical software. He trained as a
physician at the University of Cambridge; worked as a
staff scientist at the National Institutes of Health; and
was a management consultant to US hospitals at The
Advisory Board Company. Patients Know Best was
featured in Wired magazine’s March 2011 issue.

11. Patient-controlled records
Dr Mohammad Al-Ubaydli

12. Women’s suffrage over time
Source:
h*p://en.wikipedia.org/wiki/Timeline_of_women's_suffrage

13. Women’s suffrage over time
Professionals objecting to patient control
are like Swiss men objecting to women
voting in 1971: wealthy, civilized,
eloquent… and on the wrong side of
history

14. A bit about me…
Trained as physician at the
University of Cambridge.
Trained as programmer and
worked as NIH Staff Scientist.
Honourary Senior Research
Associate, UCL Medical
School.
Continuing research on PHRs
from 2,700 US hospitals, new
book in 2010:
book.patientsknowbest.com

15. Our customers
Use our platform to save money from
shared workflow
1. Thalidomide Trust / Imperial College
hospital wanted us for online
consultations
2. Great Ormond Street hospital
wanted us for home health care
electronic prescribing
3. More clinicians joining every day as
patients invite them to
We can do what Microsoft, Google and
the NHS cannot do

16. PKB is the only option for patient-
controlled medical records
We will put patients in charge of making decisions about their
care, including control of their health records
The Coalition:our programme for government, Cabinet Office,
2010.
http://programmeforgovernment.hmg.gov.uk/nhs

23. GP surgeries and private
clinics conduct online
consultations

24. Great Ormond Street Hospital and home health
care providers

25. Detailed explanations
for patient save
clinician’s time

26. Roadmap
1. Basics: definitions, and why do this
at all?
2. Today: letting go of assumptions
3. Tomorrow: embracing possibilities

27. Some definitions
Clinicians Patient
Personal health
Electronic patient records Patient portals Personal records
records

28. Some definitions
Clinicians Patient
Personal health
Electronic patient records Patient portals Personal records
records
Data by clinicians
for clinicians

29. Some definitions
Clinicians Patient
Personal health
Electronic patient records Patient portals Personal records
records
Easing the patient’s burden
Scheduling appointments
Ordering medication refills
Secure messaging
Access to the EPR
See: Pyer et. al 2004, Ralston et. al 2007.

30. Some definitions
Clinicians Patient
Personal health
Electronic patient records Patient portals Personal records
records
Data by patient for patient
Powerful but unstructured
NHSmail users have mailbox shrunk
06 Feb 2008
NHS staff who use the health service’s email service NHSmail have been informed
that after a recent move to Microsoft Exchange their mailbox size has been capped.
Some 80% of NHS accounts have been capped at just 200Mb, which
appears miserly compared with the hefty 6Gb offered by Gmail for free, or
the 5Gb offered for free on Windows Live Hotmail.

31. Some definitions
Clinicians Patient
Personal health
Electronic patient records Patient portals Personal records
records
Markle Foundation’s ideal
PHR:
Access controlled by patient
Lifelong records
Information from all
Universal access
Private and secure
Transparent
Easy exchange
See: Connecting for Health, 2004

32. Roadmap
1. Basics: definitions, and why do this at all?
2. Today: letting go of assumptions
3. Tomorrow: embracing possibilities

33. Patient-held records already here
Some parts of some health systems have already
had them
In continental Europe and much of developing world, this is the norm
UK private health care, and US fragmented care, patients end up doing this
anyway
NHS maternal notes and child personal health record use the patient to
cross silos
Distribution is arbitrary, but users assume
otherwise

34. Conflict is gone
Discomfort clinicians feel is due to limitations of
paper
Piece of paper cannot be in two places at the same time
Transporting paper takes time and money
Clinicians do not feel safe unless they hold the only copy of the paper
Digital records eliminate the conflict

35. Patient-controlled records awesome
This is the only way to bridge the silos
Within “integrated” systems like NHS and Kaiser Permanente, clinicians do
not talk to each other across community and hospitals
Within single institution e.g. hospital, clinicians do not talk to each other
across departments
Within same department, clinicians do not talk to each other across
specialities
The patient is the only person who turns up to all
the appointments, so give them the records

36. Patients should manage their clinicians
Unique patients require truly patient-centred care
In a rare chronic disease, the patient knows more than most of the clinicians
they meet
There are 30 million people with rare diseases in Western Europe and the
USA
But even patients with common diseases have unique combinations of
diseases and circumstances
Every patient is unique

37. Roadmap
1. Basics: definitions, and why do this at all?
2. Today: letting go of assumptions
3. Tomorrow: embracing possibilities

38. Patients with HIV publishing all notes

39. Patients use (much) better tools than you

40. Pa>ents
use
(much)
be*er
tools
than
you

41. Patients have better genetics tools than
99% of clinicians do (or ever will)

42. Patients will collect data you never knew

43. Patients will collect data you never knew
Useful web sites
Patients Like Me for HIV: patientslikeme.com
23andMe for genetic sequencing:
23andme.com
RelifeInSite for pain documentation:
reliefinsite.com
Lifepsychol for monitor quality of life:
lifepsychol.com
Personal health records: A guide for clinicians
Al-Ubaydli, 2011, John Wiley & Sons
http://book.patientsknowbest.com

44. Patient-reported outcomes /
observations / information
Patient-controlled records as a research tool
Patient-reported outcomes on each consultation
Patient-reported observations on data that had never previously been collected in medical
records
Patient-reported information through sentiment analysis of diaries

45. Mohammad Al-Ubaydli
Patients Know Best
team@patientsknowbest.co
m
www.patientsknowbest.com
Thank you for listening

46. First Demo:
Dr Henry Lee
Henry Lee is training as a Surgeon in
London and studied medicine at the
University of Wales College of Medicine.
He holds an academic post at Imperial
College London and is researching the way
that measure of wellbeing can be used for
policy purposes.

55. Second Demo:
Dr David Aanensen
David Aanensen is a bioinformatician in the School of
Public Health, Imperial College London. His research
focus is on the use and development of web
applications for infectious disease microbiology.

56. EpiCollect
Dr
David
Aanensen
Dept.
Infec>ous
Disease
Epidemiology
Imperial
College
London

57. Tracking
Animal
disease
Batrachochytrium
dendroba1dis
(Bd)

58. Bd-­‐Maps
• Bd
is
a
fungal
pathogen
causing
wide-­‐spread
amphibian
mortality.
• Demands
colla>on
of
cases
of
disease.
• Communi>es
of
scien>sts
submit
data.
h*p://www.bd-­‐maps.net

64. EpiCollect
-­‐
Smartphones
for
data
collec>on
• GPS
–
loca>on
aware
• Cameras
for
s>lls
or
videos
• Keyboards
for
text
entry
• Data
transfer
to
/
from
central
databases.
Aanensen
et
al
(2009)
PLoS
ONE
4(9):
e6968

65. h*p://www.epicollect.net
• Generic
issue
–
mobile
data
collec>on
• Any
projects
where
centralising
textual
data
along
with
GPS
and
/
or
photos/media
from
many
different
people,
from
many
different
places,
would
be
useful.

66. h*p://www.epicollect.net
Mobile
phone
app
(Android
and
iPhone)
and
web
applica>on
for
data
colla>on.
Free
and
open
source

67. h*p://www.epicollect.net
Create
a
Project
Design
a
form
for
Load
Project
into
the
View
data
collected
website
at
data
collec>on
EpiCollect
mobile
app
at
your
project
EpiCollect.net
and
collect
data,
website
or
on
your
including
GPS
posi>on
phone
(download,
and
photo
view
on
maps/
charts,
filter.)

87. Ci>zen
data
collec>on
• Yellowstone
na>onal
Park
• 3,472
sq
m
visited
by
thousands
of
people
each
year.
• Currently
undertaking
projects
to
allow
members
of
the
public
to
aid
researchers
in
iden>fica>on
and
mapping
of
invasive
plant
species.

88. Archaeological
dig
sites
Dig
sites
across
Europe
Pre
–
major
building
works
Replacing
paper
forms
for
linking
and
mapping
areas
of
dig
sites.

89. Street
art*
• Categorised
by
type
–
eg
posters,
s>ckers,
stencils
etc.
*Disclaimer:
probably
not
to
be
encouraged…

90. Animal
Health
surveillance
in
Kenya
/
Tanzania
Maasai
vets
Carry
out
Disease
Surveillance
of
86,000
animals
with
Google
Mobile
phones
Ongoing
monitoring
of:
East
Coast
Fever;
anthrax
and
rabies;
FMD
Gabriel
Turasha
(Vetaid
Tanzania)
Nick
Short
(RVC)
and
Niall
Winters(IOE)

91. • No
reliance
on
data
networks
for
collec>on.
• Data
can
be
sent
to
any
server.
• Two-­‐way
data
transfer
• Simple
XML
descrip>on
of
project
forms
and
for
defini>on
of
server
loca>ons.

92. Acknowledgements
• Dr
Derek
Huntley,
Jon
Evans,
Chris
Powell,
Prof.
Brian
Spra*
d.aanensen@imperial.ac.uk
Funded
by:

93. Second Speaker:
Dr Adesina Iluyemi
Adesina is an executive board member and a co-chair of the
Global Health Commission of the NEPAD Council, a non-profit
organization. His expertise lies in mHealth and Telemedicine
innovation and policy development. He has in the past
collaborated with influential international multilateral,
organizations such as the WHO, UN, ITU, and the
Commonwealth Secretariat. He is a Fellow and Council
member Telemed & eHealth Section of the RSM England, and
a co-founder and executive director of MODISE; an initiative
working to bring low-cost connected mobile diagnostics to
developing countries.

94. mHealth Developing Countries: Past, Present
& Future
Introducing MoDiSe
Dr
Adesina
Iluyemi
DDPH
RCS
(Eng)
Vice
President
&Co-­‐
Founder
MoDiSe
adesina@modise.org
www.modise.org
Sustainable Serendipitous Situated

95. An Overview
USERS CASES
CITIZENS (Consumers, Patients) Call Centre models
TeleDoc, Pakistan
COMMUNITY (Population) SMS Casting Model
Masiluleke, South Africa
CLINICIANS (Health Workers) Mobile Telemedicine, Botswana
CENTRES ( Facilities) Mobile Microscopy e.g LUCAS
Source:
Author
• Need
to
move
Beyond
SMS!
• Clinicians
&
Centres
offer
be*er
Commercial
Opportuni>es
Sustainable Serendipitous Situated

96. Voice & SMS, few Data Apps
Cell-­‐Life
Sustainable Serendipitous Situated Page
96

97. Health Workers using PDAs
Sustainable Serendipitous Situated Page
97

98. PDA to Smartphone
Simputer
GSMA
Sustainable Serendipitous Situated

99. Mobile + Medical Renaissance
• Teleradiology
• Remote
Imaging
• Laboratory
Detec>on
• Clinical
Diagnosis
• Rural
Healthcare
• Emergency
Medicine
• Pandemics
• Epidemics
• Point
of
Care
Diagnos>cs
OPPORTUNITY
FOR
LOW-­‐COST
INOVATIONS
IN
DEVELOPING
COUNTRIES
Sustainable Serendipitous Situated

100. Medical Innovations 1
•
Medical
Devices/
Mobile
Microscopy
e.g
LUCAS,
CellScope
• Assis>ve
Technology?
e.g
NETRA
for
remote
eye
examina>on
• Mobile
EHR
e.g
mGEOs
with
geotagging
and
web-­‐interface
UCLA
2009
Sustainable Serendipitous Situated

101. Medical
Innova>on
2
• Mobile
Telemedicine
e.g
Click
Diagnos>cs
for
skin
&
oral
lesions
and
cervical
screening
in
Botswana
•
Real
Pa>ent
Monitoring
e.g
A
pilot
with
a
Private
Hospital
in
Nigeria
• Medical
Apps
e.g
Moodle4iPhone
pilots
using
Android
&
iPhonein
Peru
Sustainable Serendipitous Situated

102. Introducing
MoDiSe
MISSION: Collaborate with
private sector innovators /
biotechnology
researchers and local
entrepreneurs to facilitate the
development of Point of Care tools
to prevent, diagnose and treat
neglected tropical and
non-communicable
diseases in the developing
world-
www.modise.org
Non-for-Profit Organization
in Canada
Sustainable Serendipitous Situated

103. MoDiSe: Our Strategy
Mobile
Diagnos>cs
for
Global
Health
h*p://www.modise.org
Sustainable Serendipitous Situated
6/7/11
MoDiSe

104. MoDiSe: Our Concept
MoDiSe
Sustainable Serendipitous Situated
6/7/11

105. Acknowledgements
1. Mobile Healthcare Industry Summit
2. CHMI, University of Portsmouth
3. NEPAD Council
Sustainable Serendipitous Situated

106. ThinkCamp was brought to you by:
We are an ‘idea-to-launch’ community platform for the collaborative
development of mobile applications, products & services across many
industries. (More than just apps – think personal mobility services, mHealth
applications, SIM-card embedded devices, sensory data meets cloud
computing, and SMS-based solutions in the developing world).
We bring the mobile developer & designer community together with members
of professional communities, such as healthcare; facilitate the sharing of
experiences, insights and skills; and provide a structure for developing and
acting on the innovative ideas that emerge. We do this by running a series of
ThinkCamp events which take a collaborative approach to generating and
developing good ideas. Adhoc teams which form around the ideas are
supported & nurtured by a wide range of participating technologists, field
experts and market channel partners to implement a solution or turn turn the
developed proposition into a commercially viable product or service. Our first
area of focus is mHealth.
Over time we will also build an online collaboration community for idea
development that provides a supportive process all the way to
implementation. The business model for all who get involved is joint venture /
revenue share
@mobilecollectiv

107. ThinkCamp was made possible with the support of our partners:
With thanks also to: