Emerging Techologies and Their Impact on Primary Care

transcript

Damon Broyles, MD FAAFPVP, Clinical Innovation MTS

10/4/2019

Helping to pioneer

Nearly 70

10 MillionPatient records supported

Hospitals served

70,000 Epic users supported

A new model of care

1,000Technology Co-workers

EXTENDING MISSION THROUGH TECHNOLOGY For hospitals coast to coast.

About Mercy Technology ServicesWho We Are

Relevant Financial Disclosure:

Co-Founder & Chief Medical Officer of Where4.Care

©2019 Mercy Health. This material contains confidential and copyrighted information of Epic Systems Corporation. No part of this document can be stored, transmitted, photocopied or reproduced, electronically or otherwise, without the express consent of Mercy Health.

Voice & Conversational Interactions, Gestures and Virtualized Environments

New UI Tools Will Crash Like a Wave and Sweep Old Models of Human-Computer Interaction

Out to Sea Quickly

This Photo by Unknown Author is licensed under CC BY-SA

When Katsushika Hokusai created The Great Wave off Kanagawa series, Japanese politicians and art merchants did not view it as ‘real art’. Original wood block prints now regularly command $40K to $60K, and it is arguably one of the most recognizable works in all of Asian art history. The wave depicted is in fact not a tidal wave or tsunami, but rather a rouge wave.

Xerox PARC, ca. 1979As part of a deal that allowed Xerox to buy one hundred thousand shares of Apple in December 1979, Steve Jobs is given permission to see what the PARC engineers are working on. Amongst these innovations was the GUI and mouse…

It is fair to say that Xerox did not fully appreciate the fundamentally transformational aspects of the new developments they had actually created – or at the very least could not figure out how to find commercial value in new inventions that were not directly related to photocopying or printing.

Reducing EHR-Mediated Harm & Caregiver Burden

‘Hey Epic’ Voice Assistant Development Roadmap

Ambient Voice Recognition

https://bcove.video/2U49ZII

This Photo by Unknown Author is licensed under CC BY-SA

…Further Transformation of the Provider & Patient HCI

Virtual/Augmented/Mixed Reality – Examples of Potential Use Cases in Medicine

• Virtual – The entirety of the user experience is synthetic and all visual input is computer generated (‘Ready Player One’)

• Augmented – The physical world is represented with overlaid graphical interface, information or additions (‘Pokemon Go’)

• Mixed – [Spatial Computing] Digital augmentation of real space that has the capacity to respect the geometries of physical objects and respond appropriately to human activity. (‘Chess’)

Virtual/Augmented/Mixed Reality – Examples of Potential Use Cases in Medicine

Hololens 2 Capability Demonstration

https://youtu.be/uIHPPtPBgHk

We Have Many Miles to Go…But Hopefully We are on the Right Path

“How Many Laws of Good UX Does Your EHR Currently Violate…”

User Centered Design Becomes More Prominent

Color use and selection goes well beyond aesthetics and branding – it can directly impact safety

Remove unnecessary and potentially dangerous scanning eye motion & cognitive tunneling (these are well established principles and practices in high reliability organizations)

Clinical Team Members Move Away From Low Value Tasks

Robots and Robotic Process Automation (RPA)

BREAKING NEWS!!! Robot Invasion Underway!!!

• (Not Really)

Knowledge Transfer & Complex Processes Taught By Your Best Staff Without Losing Your Best Staff to Teaching

Training Automation and Workforce Solutioning*

Your New Health Technology Pitch Is Not Complete Without One of These Phrases…

AI and Machine Learning

“The World’s Most Valuable Resource is No Longer Oil…It’s Data.”

AI and the Practice of Medicine – “Primum Non Nocere”

Area Deprivation Index

• The deprivation index is on a Census block group-level, utilizing data consistent with the neighborhood of the patient

• Factors accounted for in the index include poverty, housing, employment, education

• The resulting index is standardized, setting the mean equal to 100 and the standard deviation equal to 20

• Statistical models incorporating the area deprivation index improve the accuracy of patient outcome predictions and help guide the process to improve them

Deprivation Index Visualized

Why not zip code?

Care Shifts to Virtual and Towards Home

The Entrance of a New Diagnostic Science

Machine Vision Developments

Chatbots and Natural Language Processing*

Assisting with Self Service Needs and Unlocking Unstructured Data

Bespoke Biology

3D Printing and Additive Engineering

Interesting Developments At Press Time

Autonomous Delivery, Aeronautics & Transportation

Meanwhile…

Investment in the Consumer Health Sphere by Large Companies Continues & Integrated mIoT will Become

Ubiquitous

Interesting Developments in the mIoT Realm

IoT – Internet of ThingsEmerging Technology

IoT in HealthcareEmerging Technology

Designed to remind individuals to take their medication at the right time and to ease the burden of complex medication regimens, electronic pill dispensers alert both the patient and their caregivers.

Wireless smart pill bottles measure the volume of tablets or liquid left in a bottle, while some use light and sound to signal when it’s time to take your medication. Inhaler attachments monitor where and when an inhaler is used.

Administer controlled doses of a drug at precisely the right time via a microchip inserted on the waist.

Ingestible sensors, as small as a grain of sand. Embedded in a tablet, sensors communicate with a patch worn on the stomach. This then relays information to your phone, and further to your support network and care providers.

Already designed to act as a health and fitness companion with all the capabilities of a fitness tracker, smart watches have the potential to integrate with multiple technologies.

Shifting Compute Away from Consolidated Centers to Power Connected Networks

5G and Fog/Edge Computing

FDA – Focus on New Tech and Real World Evidence

Mercy Leads the Healthcare World in Real World Insights

Product Information Integrated into Epic

Critical Step

Drozda JP Jr, et al., JAMIA 2018

Multiple Stakeholders with Multiple Valid Visions for Accessibility and Concerns: Government, Payors, Providers,

Tech and Consumer Advocates

Patient Privacy Concerns and the 3rd Party App Takeoff

Transparency & Medico(techno)legal considerations

Obstacles Encountered with Proposed Dissolution of UPI Ban, Though Strong Support May Eventually Prevail

Legislative Action Related to

‘Unique Patient Identifier’

Critical Mass for Propelling New Enterprise, Industries and Developments

St. Louis Gains Traction as a Dynamic Health and Biotech Aggregator

The St. Louis Innovation Ecosystem is Thriving – Exciting Times for Tech

Damon.Broyles@mercy.net

Linkedin.com/in/damon-broyles-md-faafp-54208347

Questions?

Emerging Techologies and Their Impact on Primary Care

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