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- 1. PREDICTIVE HEALTH APPLICATIONS APPLE INC. Team 1 – Marina Cohort Yara Ibrahim Asrhdeep Kaur Tanya Mushohwe Yi Zhang Ugur Duezguen Idris Kavak Juan David Argüello
- 2. Agenda 2 1) Industry Overview 2) Current Situation 3) Opportunity 4) Data Strategy 5) Business Opportunity 6) Risk Management
- 4. The Healthcare Industry in the US Industry Key Metrics 4 Hospitals 43% Ambulatory Services 40% Nursing & Care Facilities 10% Social Assistance 7% % of Revenue $2.7 Tr Revenue 2.7 % Annual Growth 2013-2018 $254 Bn Profit $2.3% PROJECTED Annual Growth Product/Service Segmentation
- 5. The Potential of Health Tech Health Tech focuses not only on developing intelligent hardware, but also unlocking the power of massive data within the health industry. 5 Health Tech disruption by tech companies Innovative Delivery Models that reach more people by bringing healthcare to them Data-driven Technology present across all the value chain (diagnose, treat, deliver) Value vs. Volume Predictive insights through powerful data collection
- 7. Apple in Healthcare: What Data does it have? Apple’s native Health App 7 • Activity: measures daily movement patterns • Mindfulness: breathing and lifestyle behavior • Nutrition: food and calorie intake tracking • Sleep: sleep and rest analysis
- 8. Apple in Healthcare: What Data does it have? Third-party apps integrated through the App Store 8 provide on-demand fitness classes and coaching allow users to track and store fitness and workout activity. provide calorie tracking, meal planning and wellness coaching.
- 9. Apple in Healthcare: What Data does it have? Custom Development Apps for Medical Providers and Research Research Kit Tools conduct medical studies though iOS devices Care Kit Continue patient recovery at home and track progress • Medical Records • Health Portal • Log-in authentication • Lab results 9
- 10. Apple in Healthcare: Hardware capabilities? Through the iPhone and Apple Watch, Apple can collect more data Gyroscope and Accelerometer record basic movement and activity information Acts more as a mobile data storage device with limited body- related collection capabilities Broader health data collection: • Direct body contact • Heart rate monitoring 10
- 11. OPPORTUNITY3
- 12. 9% 10% 10% 11% 11% 11% 12% 10% 17% 0% 5% 10% 15% 20% Australia Austria Belgium Canada France Germany Switzerland United Kingdom United States What’s is the Healthcare Industry Missing? Healthcare Investment as a Percentage of GDP Investment is used primarily for • Medical Equipment • Program and administrative expenses 12
- 13. What is Apple Missing? • The health information is scattered in different sources. • Currently the Health app is not using predictive models for the public • Apple still lacks additional health metrics that can complement analysis 13
- 14. Predictive Health Services And Analytics We believe that Apple can transform its Health App into a more predictive and intelligent digital tool. 14
- 15. STRATEGY4
- 16. Data Strategy Enhance the Apple Health App Capabilities CENTRALIZE Concentrate all health data in the Health App EXPAND Gather additional health information: • Genetics • Public/Private databasesPREDICT Use machine learning integration Intelligent Health App 1 3 2 16
- 17. Data Strategy 1 – Centralize Health Information Convert the Health App into the unique centralized health database. Intelligent Health App 1 3 2 Certain 3rd party apps don’t store information in the Health App. Redirect as much information as possible to the same database. Current Proposed 17
- 18. Intelligent Health App 1 3 2 Data Strategy 2 – Expand Existing Information Incorporate new information that hasn’t been collected so far. Complementary information such as genetics haven't been added a) Add optional DNA testing b) Access other databases Current Proposed 18
- 19. Intelligent Health App 1 3 2 Data Strategy 2 – Expand Existing Information A) Incorporate individual DNA sequencing information to the Health App though partnerships or M&A. • Determine medical traits • Discover disease predisposition • Determine best treatments Competitors In 2007, Google acquired: DNA Analysis Benefits 19
- 20. Intelligent Health App 1 3 2 Data Strategy 2 – Expand Existing Information B) Access and utilize other public and private databases in order to complement health and disease information • Government public health information • Hospitals and medical provider data • Academic research databases • Private big data companies/startups 20
- 21. Intelligent Health App 1 3 2 Data Strategy 3 – Predict Transform the Health App from historic to predictive Health app is purely historic and lacks smart functionalities a) Predictive data analytics b) Smart UI through Siri Current Proposed 21
- 22. Intelligent Health App 1 3 2 Data Strategy 3 – Predict A) Analyze all centralized data in the Health App to create predictive health models for individual and collective purposes Machine Learning Big Data Analytics Individual Level • Health and activity reports • Disease predictions • Tailored treatments/plans Collective Level • Determine health trends • Uncover new diseases • Discover population insights 22
- 23. Intelligent Health App 1 3 2 Data Strategy 3 – Predict B) Integrate Health App with Siri to enhance user experience and enable smart features “Hey Siri” Smart Health • Interact with Siri • Ask health questions • Explore and understand your data • React in case of emergency 23
- 25. Business Opportunity Product – Enhanced Apple Health App • Centralized database • Comprehensive data - Individual - Collective • Predictive capabilities • Interactive user Interface 25
- 26. Business Opportunity Product – Enhanced Apple Health App Old Health App Enhanced Health App 26 Interactive user Interface with Siri
- 27. Business Opportunity Product – Enhanced Apple Health App 27 Personal predictive insights
- 28. Business Opportunity Revenue streams 28 Personal Analytics as a Service (HAaas) 030201 #1 New health software and applications New medical-specific wearables and hardware Competitive Advantage
- 29. RISK MANAGEMENT6
- 30. Risk Management Data Privacy and Security 30 1 2 The currentt security infrastructure is not ready to store that amount of sensitive data Growing concern with the access and utilization of health information from the user's perspective • Increase authentication in Health App • Separate personal info from medical data • Use UX/UI to improve data management Mitigation Actions
- 31. Risk Management Government Regulations 31 1 2 Public legislation (such as HIPAA) doesn’t address healthcare data stored on a mobile device. Hardware with increased health capacities such as wearables require further FDA approval • Multi-stakeholder efforts towards polishing data and hardware regulation Mitigation Actions
- 32. THANK YOU
Notes de l'éditeur
- Source: IBIS World Market Research IBISWorld Sector Report 62 Healthcare and Social Assistance in the US http://clients1.ibisworld.com.hult.idm.oclc.org/reports/us/industry/default.aspx?entid=1550 Accessed through Hult Library.
- Health Tech focuses not only on developing intelligent hardware, but also unlocking the power of massive data within the health industry. Innovative and cost-effective delivery models that are able to reach more people by bringing healthcare to them instead of pushing towards an care facility. The use of data-driven technology is more present across all the value chain of healthcare (diagnose, treat and care delivery), with a focus on patient data centralization. Shift from volume to value: Thorough powerful data collection and analytics, develop predictive and personalized health services that harness mobile connectivity. Health Tech Potential
- Apple Health App https://www.wareable.com/apple/how-to-use-apple-health-iphone-fitness-app-960 It consolidates health data from the Iphone, Apple Watch, and third-party apps & categorizes them into 10. (4 main) Activity-> Encourages to move. Measures daily movement, steps/distance travelled. Apple Watch(only) records simply but meaningful movement e.g. how much you stand, how much you exercise, all-day calorie burn. Recommended 3rd-party apps: Freeletics: Fitness Coach, Nike+ Run Club Sleep-> Encourages to sleep consistently. Runs Sleep Analysis. Time you spend in bed, movement during sleep, sleeping habits. Recommended 3rd-party apps: Sleep Cycle, Beddit Sleep Monitor Mindfulness-> Encourages to relax and meditate. Apple Watch(only) – Breathe app, setting breathing sessions(1-5 min) and coaching by the app. Mostly Meditation Apps Recommended 3rd-party apps: Headspace Meditation, Calm Nutrition-> Encourages to eat healthier and allows to keep track of everything you eat Recommended 3rd-party apps: Loose it! Calorie Counter, Lifesum: Diet & Macro Tracker Body Measurment -> Body Fat Percentage Health Records -> Integration with Health Institutions Heart -> Heart Rate, Heart Rate Variability Reproductive Health -> Sexual Activity, Menstruation Results -> Blood Alcohol Content, Insulin Delivery, Oxygen Saturation Vitals -> Blood Pressure, Body Temperature, Respiratory Rate Medical ID(emergency) -> Allows first responders to access your critical medical information
- Integration with App Store Apps Fitness: such as Nike Running Club or Aaptiv (on demand workout coaching) Health: what specialized health apps? Lifestyle Sleep Diet Lose It!(Calorie Counter) or Weight Watcher
- Research kit: It’s an open source development platform for medical, clinical and healthcare research (study). It gather a robust amount of data regarding specific medial research. It’s mainly directed towards academic health research (such as universities), but also used by medical providers. It has the ability to turn iPhones and Apple Watches into a medical research lab, regardless the location. The more users it capture, the more powerful insights it could produce. Current major studies: Parkinson, Autism, Heart studies. Users can: Track their progress, symptoms, issues, or any variables related to the health issue being researched. Use apple hardware within the iOS devices: Gyroscope: track movement Camera: capture image, face recognition, video, etc. Care Kit: An open source development platform for medical care outside the hospital or medical providers. It allows the user/patient to continue their care at home and manage their medical conditions through technology. It supports post-incident recovery, care and general medical continuity. Current major uses: Heart attack recovery, diabetes, childcare. Users can: View a consolidated plan of their recovery and care actions Prescriptions Medicine schedules Track care actions Medication intake Physical activity Medical providers can review all the data entered by the patient and determine if they need to go back to see a doctor. Health Records Third party integration with hospitals and medical providers to pro
- Apple Watch (series 4) Accelerometer and gyroscope Movement and physical activity Electro-Cardiogram sensor (ECG) Collects more accurate heart rate monitoring data than the optical heart rate sensor.
- The healthcare industry has lagged in terms of data innovation, consolidation, strategy and technology. The US is one od the countries that spend the most in Healthcare. It spends around 17% of its GDP in Healthcare programs (public and Private) https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-u-s-health-spending-growth-higher-1980s-similar-since Most of the investment goes to medical equipment and infrastructure, as well as administrative costs of healthcare programs. The investment in data-driven strategies is not tangible from the Government expenditure point of view. The disruption and unleash of massive health data is leaded by health tech startups and tech corporations that aren’t necessarily based in the Healthcare Industry.
- The health information is scattered in different sources Own data and third party data are all over the place. While the Health app records native movement and physical activity, its stored only in health app. Some third party apps don’t store the info on apple health app, which causes that you have different databases for your health data. The Information form Care Kit and Research Kit is specialized and it’s not massive. It depends on the developers how they use that data in the end. Currently the Health app is not using predictive models for the public The Health app is more of a repository for many apps and OWN information. It doesn’t present any integration with SIRI It doesn’t not chow predictive capabilities (machine learning/AI) Apple still lacks additional health metrics The Apple Health App doesn’t have too much historic health data cause it was introduced recently (in the past 5 years). Genetic information doesn't’t come from neither of the data sources mentioned before.
- The health information is scattered in different sources Own data and third party data are all over the place. While the Health app records native movement and physical activity, its stored only in health app. Some third party apps don’t store the info on apple health app, which causes that you have different databases for your health data. The Information form Care Kit and Research Kit is specialized and it’s not massive. It depends on the developers how they use that data in the end. Currently the Health app is not using predictive models for the public The Health app is more of a repository for many apps and OWN information. It doesn’t present any integration with SIRI It doesn’t not chow predictive capabilities (machine learning/AI) Apple still lacks additional health metrics The Apple Health App doesn’t have too much historic health data cause it was introduced recently (in the past 5 years). Genetic information doesn't’t come from neither of the data sources mentioned before.
- Our strategy is push towards a total data centralization of health, lifestyle, activity and related data in order to create ENHANCE AN EXISTING PRODUCT: Apple Heath We can to convert Apple Health into an intelligent health app that can analyze, predict and communicate as many health-related issues. Responsive Predictive Intelligent
- CENTRALIZE Although a lot of data is stored in the Data, some data is spread across different apps and databases. Some apps don’t automatically store the health and activity data in the Health App. They either have the option but it’s quite hidden. Or they don’t have integration with the Health App at all Redirect as much information as possible to the Health app, coming from other App store apps. Force third-party apps to store their data in the Health App, while keeping the option to turn it off available for the user. Centralize and store all health, activity and lifestyle information coming from third-p[arty apps in the App Store.
- EXPAND EXISTING INFORMATION Introduce new information that hasn’t been collected so far: DNA testing and records By aggregating genetic information and analyze individually, and collectively. What are the drivers for specific induvial illnesses Allow us to determine what treatments and cures are best for each individual. Determine pre-dispositioned diseases and medical issued based on your DNA. They allow us to uncover new health insights about treatments, prevention, causes etc. How to obtain Partner with DNA analysis companies 23&Me (currently owned by Google) Partner with medical providers that are already working in in analyzing genetic Big Data Mount Sinai Access Medical Databases Access public and private medical databases in order to integrate them with DNA analysis and data that is already in the Health App. Government databases Hospital and medical providers databases Academic and University research and data Private companies with medical big data
- EXPAND EXISTING INFORMATION Introduce new information that hasn’t been collected so far: DNA testing and records Apple collects DNA through Research kit but the samples and scope of collection are limited to the study. Apple doesn’t collect massive DNA information form regular individuals. By aggregating genetic information and analyze individually, and collectively. We can determine what are the drivers for specific induvial illnesses. Allow us to determine what treatments and cures are best for each individual. Determine pre-dispositioned diseases and medical issued based on your DNA. They allow us to uncover new health insights about treatments, prevention, causes etc. How to obtain Partner with DNA analysis companies 23&Me (currently owned by Google) Partner with medical providers that are already working in in analyzing genetic Big Data Mount Sinai Access Medical Databases Access public and private medical databases in order to integrate them with DNA analysis and data that is already in the Health App. Government databases Hospital and medical providers databases Academic and University research and data Private companies with medical big data https://www.technologyreview.com/s/537081/apple-has-plans-for-your-dna/ https://en.wikipedia.org/wiki/23andMe
- EXPAND EXISTING INFORMATION Introduce new information that hasn’t been collected so far: DNA testing and records Apple collects DNA through Research kit but the samples and scope of collection are limited to the study. Apple doesn’t collect massive DNA information form regular individuals. By aggregating genetic information and analyze individually, and collectively. We can determine what are the drivers for specific induvial illnesses. Allow us to determine what treatments and cures are best for each individual. Determine pre-dispositioned diseases and medical issued based on your DNA. They allow us to uncover new health insights about treatments, prevention, causes etc. How to obtain Partner with DNA analysis companies 23&Me (currently owned by Google) Partner with medical providers that are already working in in analyzing genetic Big Data Mount Sinai Access Medical Databases Access public and private medical databases in order to integrate them with DNA analysis and data that is already in the Health App. Government databases Hospital and medical providers databases Academic and University research and data Private companies with medical big data https://www.technologyreview.com/s/537081/apple-has-plans-for-your-dna/ https://en.wikipedia.org/wiki/23andMe
- PREDICT Integrate Health App with SIRI in order to convert the Health App from historic to predictive. High performance Super computers
- PREDICT Integrate Health App with SIRI in order to convert the Health App from historic to predictive. High performance Super computers
- PREDICT Integrate Health App with SIRI in order to convert the Health App from historic to predictive.
- New Apple Health Functionality Predictive Analysis Give us predictive analysis of our activity, exercise and lifestyle. Short term, simple Weekly, monthly alerts Predict more serious diseases that you are prone to acquire or that you are prone to have based on Constantly monitor and analyze medical information in real time in order to predict potential diseases. Predictive weight control and tracking. What diseases are you building up with time. Reactive Emergency Alerts Alert the user whenever vital signs are in danger Cardiac arrest Strokes Integrate with emergency medical services 911 Specific care provider integrated though the health app Integrate with family/friend’s contacts in order to alert accidents
- Revenue Streams: Heath Analytics as a Service (HAaas). Charge the individual consumer for advanced health analytics. Create tailored health adn activity reports for integrating all health data Predict specific diseases and predispositions. Track specific diseases Track progress and care With this data, apple could also develop: New health, fitness and lifestyle applications Fitness personal coaching New analytics apps New medical hardware and wearables That have more health capabilities That have specific uses (maybe for people who have specific diseases) That are more oriented toward complex medical research and purposes. That gather more specific activity data (more depth in sports). B2B and B2C health data to create monetization opportunities (POTENTIAL, needs additional research) Sell information to medical providers, universities, doctors Act as a medical database for both public and private clients Provide important health population information to governments. Heath Analytics as a Service (HAaas) HAaaS combines the on-demand aspects of cloud computing with the democratization of information enabled by big data analytics. Whilst collecting both real time and retrospective analytics, there is potential capability to provide all 4 types of analytics, that is, descriptive, predictive, prescriptive, and discovery in a service-oriented fashion. It leverages the latest technologies and best practices for big data analytics and also utilizes the security and privacy measures appropriate for health and medical data. Utilizing this paradigm of computing in health informatics will benefit patients, care providers, and governments significantly.
- CYBERSECURITY The current security infrastructure is not ready to store that amount of sensitive data FRONT END Apple’ 2-factor authentication(login into Apple device and also login again in cloud) is not enough for personal health data privacy protection. Since the Health App is going to store much more data. It needs to have more encryption and security layers that before. BACK END security Personal health data(if include personal DNA data) is encrypted in both Apple device or Cloud is not enough. Who knows someone can hack into in the future? Working with third-party, partnership, or centralize all the personal health data in the database in hospital would be a potential risk. DATA PRIVACY With more information being sotred in the Health App, there’s higher concern about the use and access to that information Working with third-party, partnership, or centralize all the personal health data in the database in hospital would be a potential risk. POSSIBLE SOLUTIONS 1. Separate the name and other information(disease, DNA, etc)? 2. Export health data without the name or with ID but no name? 3. Third party and partnership need to have the same level data privacy protection. 4. Tokenization? Encryption? Maybe not enough. 5. Data access governance: Providing visibility into what and where sensitive data exists, and data access permissions and activities, allowing organizations to manage data access permissions and identify sensitive stale data. These tools help automate, at scale, the challenge of addressing the low-hanging fruit of data protection—sensitive data discovery and cleaning up data access permissions to enforce least privilege—as data volumes skyrocket https://www.cnet.com/news/tim-cook-nods-to-privacy-concerns-during-apple-product-reveal/ https://mashable.com/2018/01/24/apple-medical-records-health-app-watch-iphone/#6BDss7Kgqmqc https://theoutline.com/post/3467/everyone-can-hear-your-heart-beat?zd=1&zi=vp4fcrzh http://www.markwk.com/data-analysis-for-apple-health.html
- Public legislation (such as HIPAA) doesn’t address healthcare data stored on a mobile device. HIPAA “safe harbor” guidelines require removing specific dates from patient data, for individual privacy As an example, only the year when symptoms emerged or treatments were tried can be shown. So which treatment was tried first? And for how long? Was the patient hospitalized before the treatment or three months later? All of a sudden, the data aren’t so helpful. The coverage of HIPAA and related laws to the data collected by the Apple Watch depends on who is storing and using the data, as well as to the creation, maintenance, reception and transmission of the data. An example of such a case would be when a user (a patient of Mayo) transmits health data from an Apple Watch or health app to the Mayo Clinic App. At the point the health data is received by Mayo, since Mayo qualifies as a covered entity under HIPAA, then the health data qualifies as protected health information and is HIPAA-protected. https://www.americanbar.org/groups/health_law/publications/aba_health_esource/2015-2016/september/applewatch/ FDA APPROVALS Class III products, or technologies that might have higher risk but also a higher benefit. (Think: implantable pacemakers.) For Class II and Class I, the FDA doesn’t give “approval,” it just gives clearance and Class I and Class II products are lower-risk products Class I example is something like a tongue depressor — and it’s much easier to get clearance than approval The Apple Watch is in Class II, however, has emphasized that it has received a “de novo” classification for the EKG feature. That means that, although it’s still in Class II in terms of risk and hasn’t gone through as much testing as an “approved” device, it’s unlike anything else on the market. It is the first direct-to-consumer EKG wearable. Apple got Class II this year for advanced method of monitoring the heart called an electrocardiogram (EKG), and the other is the Watch’s ability to detect and notify the user of an irregular heart rhythm. The irregular heart rhythm came through the research with the Sandford University in the Research Kit https://www.theverge.com/2018/9/13/17855006/apple-watch-series-4-ekg-fda-approved-vs-cleared-meaning-safe