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Engaging Patients and Clinicians in
mHealth through the OpenmHealth
            Platform
                            Ida	
  Sim,	
  MD,	
  PhD
                      Co-­‐Founder,	
  OpenmHealth
    Director,	
  Center	
  for	
  Clinical	
  and	
  Translational	
  Informatics
                 University	
  of	
  California	
  San	
  Francisco
                             September	
  20,	
  2011
mHealth:	
  “Full	
  of	
  sound	
  and
 fury,	
  signifying	
  nothing”?




                         Hype Cycle, Gartner Group
Plateau	
  of	
  Productivity
•   “A	
  Learning	
  Healthcare	
  System	
  that	
  is
    designed	
  to	
  generate	
  and	
  apply	
  the	
  best
    evidence	
  for	
  the	
  collaborative	
  health	
  care
    choices	
  of	
  each	
  patient	
  and	
  provider;	
  to
    drive	
  the	
  process	
  of	
  discovery	
  as	
  a	
  natural
    outgrowth	
  of	
  patient	
  care”

                             U.S.	
  Institute	
  of	
  Medicine,	
  Roundtable	
  Charter
Global	
  Impact	
  of	
  Chronic	
  Disease




               WHO | Facts related to Chronic Disease
               http://www.who.int/dietphysicalactivity/publications/facts/chronic/en/
Global	
  Cost	
  of	
  Chronic	
  Disease



   $47	
  trillion
    by	
  2030               $14.7	
  trillion
                             US	
  2010	
  GDP

                           World Economic Forum, 2011
• Almost	
  1/2	
  of
  American	
  adults	
  have
  at	
  least	
  1	
  chronic
  disease
   – obesity	
  (~1/3)
   – heart	
  disease	
  and
     stroke
   – cancer
   – diabetes
   – arthritis


                               CDC Chronic Disease Overview
                               http://www.cdc.gov/chronicdisease/overview/index.htm#ref2
Stovepiped
     mHealth
• Health	
  apps	
  built
  independently
   – little	
  data	
  sharing
     and
     interoperability
• Resulting	
  user
  experience	
  is…
Siloed	
  mHealth




        Plateau of Diminished Promise
Why	
  open	
  architecture?
Stovepiped
     mHealth


• Limits	
  the	
  emergent
  power	
  and	
  potential
  of	
  mHealth
Internet	
  Hourglass	
  Model
• Standardize	
  and
  make	
  open	
  the
  “narrow	
  waist”
• Reduces	
  duplication,
  spurs	
  community
  innovation,	
  supports
  commercial	
  and	
  non-­‐
  profit	
  uses
OpenmHealth.org




        Estrin DE, Sim I. Science; 330: 759-60. 2010.
Open	
  Architecture	
  for
              User	
  Engagement
• Define,	
  build,	
  and	
  share	
  modules	
  of	
  the	
  basic
  data-­‐related	
  functions	
  common	
  to	
  engaging
  patients	
  and	
  clinicians
   –   data	
  trending	
  (e.g.,	
  is	
  weight	
  really	
  down?)
   –   signal	
  detection	
  (e.g,	
  asthma	
  exacerbation?)
   –   inferencing	
  (e.g,	
  activity	
  =	
  walk,run,bike,car…?)
   –   data	
  visualization	
  (e.g.,	
  stock	
  infographics)
• Exploring	
  user	
  interaction,	
  incentives,	
  gaming
Tipping	
  towards	
  Open
• First	
  openmHealth	
  collaborative	
  pilot
    – PTSD	
  Coach,	
  with	
  VA	
  National	
  PTSD	
  Center
• Looking	
  for	
  other	
  pilots	
  to	
  drive	
  key	
  components
  of	
  shared	
  architecture,	
  e.g.,
    – gaming
    – incentives
• Supporting	
  best	
  practices	
  and	
  generation	
  of	
  best
  evidence
• Sensitive	
  to	
  needs	
  of	
  all	
  communities
Goal	
  for	
  mHealth	
  Ecosystem
• Becomes	
  a	
  learning	
  community	
  enabled	
  by	
  an	
  open
  architecture,	
  to	
  more	
  effectively	
  innovate,	
  share,
  and	
  deploy	
  best	
  technology	
  and	
  best	
  practices	
  for
  improving	
  individual	
  and	
  population	
  health
• Ida	
  Sim	
  ida.sim@ucsf.edu
• Deborah	
  Estrin	
  destrin@cs.ucla.edu
• http://openmhealth.org/
   – a	
  project	
  of	
  the	
  Tides	
  Center	
  (www.tides.org)
• Funding
   – Robert	
  Wood	
  Johnson	
  Foundation
   – California	
  Health	
  Care	
  Foundation
• Collaborators
   – MIT,	
  Columbia,	
  CMU,	
  Northwestern,	
  Google,
     Microsoft	
  HealthVault,	
  Curious,	
  …

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Open mHealth: Engaging Patients and Clinicians in

  • 1. Engaging Patients and Clinicians in mHealth through the OpenmHealth Platform Ida  Sim,  MD,  PhD Co-­‐Founder,  OpenmHealth Director,  Center  for  Clinical  and  Translational  Informatics University  of  California  San  Francisco September  20,  2011
  • 2. mHealth:  “Full  of  sound  and fury,  signifying  nothing”? Hype Cycle, Gartner Group
  • 3. Plateau  of  Productivity • “A  Learning  Healthcare  System  that  is designed  to  generate  and  apply  the  best evidence  for  the  collaborative  health  care choices  of  each  patient  and  provider;  to drive  the  process  of  discovery  as  a  natural outgrowth  of  patient  care” U.S.  Institute  of  Medicine,  Roundtable  Charter
  • 4. Global  Impact  of  Chronic  Disease WHO | Facts related to Chronic Disease http://www.who.int/dietphysicalactivity/publications/facts/chronic/en/
  • 5. Global  Cost  of  Chronic  Disease $47  trillion by  2030 $14.7  trillion US  2010  GDP World Economic Forum, 2011
  • 6. • Almost  1/2  of American  adults  have at  least  1  chronic disease – obesity  (~1/3) – heart  disease  and stroke – cancer – diabetes – arthritis CDC Chronic Disease Overview http://www.cdc.gov/chronicdisease/overview/index.htm#ref2
  • 7. Stovepiped mHealth • Health  apps  built independently – little  data  sharing and interoperability • Resulting  user experience  is…
  • 8.
  • 9. Siloed  mHealth Plateau of Diminished Promise
  • 11. Stovepiped mHealth • Limits  the  emergent power  and  potential of  mHealth
  • 12. Internet  Hourglass  Model • Standardize  and make  open  the “narrow  waist” • Reduces  duplication, spurs  community innovation,  supports commercial  and  non-­‐ profit  uses
  • 13. OpenmHealth.org Estrin DE, Sim I. Science; 330: 759-60. 2010.
  • 14. Open  Architecture  for User  Engagement • Define,  build,  and  share  modules  of  the  basic data-­‐related  functions  common  to  engaging patients  and  clinicians – data  trending  (e.g.,  is  weight  really  down?) – signal  detection  (e.g,  asthma  exacerbation?) – inferencing  (e.g,  activity  =  walk,run,bike,car…?) – data  visualization  (e.g.,  stock  infographics) • Exploring  user  interaction,  incentives,  gaming
  • 15.
  • 16. Tipping  towards  Open • First  openmHealth  collaborative  pilot – PTSD  Coach,  with  VA  National  PTSD  Center • Looking  for  other  pilots  to  drive  key  components of  shared  architecture,  e.g., – gaming – incentives • Supporting  best  practices  and  generation  of  best evidence • Sensitive  to  needs  of  all  communities
  • 17. Goal  for  mHealth  Ecosystem • Becomes  a  learning  community  enabled  by  an  open architecture,  to  more  effectively  innovate,  share, and  deploy  best  technology  and  best  practices  for improving  individual  and  population  health
  • 18. • Ida  Sim  ida.sim@ucsf.edu • Deborah  Estrin  destrin@cs.ucla.edu • http://openmhealth.org/ – a  project  of  the  Tides  Center  (www.tides.org) • Funding – Robert  Wood  Johnson  Foundation – California  Health  Care  Foundation • Collaborators – MIT,  Columbia,  CMU,  Northwestern,  Google, Microsoft  HealthVault,  Curious,  …