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Dr.Emre TAVŞANCIL Manager / Mobile Health MHealth and its Role in the Advancement of Smart Homes November 4, 2014 Amsterdam
Dr.Emre TAVŞANCIL Manager / Mobile Health
M-‐Health and its Role in the Advancement of
Smart Homes
November 4, 2014 Amsterdam
Agenda
• Where do we go? • Some demographics & epidemiologic
• Some more healthcare trends
• Some definiFons
• DomoFcs?
• Assisted domoFcs? • Consumer engagement
• A real case study: What we have learned from diabetes paFents?
• Some do’s and dont’s
Turkey: Booming Economy with Considerable Size
Source: Medium term program announced by the Government (9 October 2012)
GDP GROWTH (%)
0,7%
-‐4.7%
8.9% 8,5%
2,2% 4,0%
2008 2009 2010 2011 2012 2013E
• A hub for the region • 3rd fastest growing economy aZer China and ArgenFna with GDP growth of 8.5% in 2011
• Fastest growing economy in Europe in 2011
• 5th largest economy when compared with the EU countries
Turkcell Group: Regional Leader
TURKCELL GROUP
Turkcell Turkey
9 countries 70 million mobile
subscribers Leadership in the region
#1 35.1 Turkcell Superonline (fiber broadband)
#1 0.4
Northern Cyprus #1 0.4
Belarus #3 1.1
Ukraine #3 11.1
Kazakhstan* #1 13.5
Azerbaijan* #1 4.4
Georgia* #1 2.1
Moldova* #2 1.3
Germany -‐ 0.3
Market Posi2on
Subscribers (mn)
REVENUE GROWTH YoY : 12% • #1 country in the world in
terms of mobile network coverage
• first among 53 countries for 3G data download speed
Life & Health Mega Trend’s
What’s happening, what should happen next?
...move from reacFve treatment (@hospital, with doc’s) to prevenFve medicine pracFce (@home, with beloved one’s)
Crossing Mega Trend’s
A new ecosystem of healthcare provisioning...
*According to PwC Fortune 500 research
Health & PopulaFon in Turkey
• PopulaFon: 80 mio (increase rate of 13%/year*) • Elderly populaFon (65+): 8% (will be 21% in 2050) • Life expectancy >72 year
• People suffering from mulFple chronic diseases: 22 mio (Age >15, 30% of all populaFon)**
• 10 mio diabetes (Type I & II) • 16 mio high blood pressure • 1 mio Alzheimer, Parkinson, etc.
* Turkish Sta2s2cal Ins2tute, **Ministry of Health sta2s2cs
Cost of Chronic Diseases
• Cost of CD in the World will reach 47 trillion USD in 2030* • Cost of CD in USA reached 1 trillion USD (75% of total healthcare expenditures)
• Cost of CD is close to 10% of whole Turkish Economy • Diabetes costs 7 billion EUR/year** • Costs rising from avoidable complicaFons: 65%
* World Economic Forum, ** Turkish Social Security Agency
Mobile Health... InnovaFon?
Focused Communica`on
More Efficient Processes
Increase in
Quality Efficient Follow Up
Accurate Informa`on
Role & Business Opportunity for a GSM Operator
AssisFve Technologies
Framework
• Technologies • Equipment • Automated
housework or household acFviFes
Smart Home
• Embedded Health Systems
Sensors and processors in appliances, furniture, clothing's • Private Health
Networks Wireless tech to connect portable devices and home h/c database's
Medical Tech.’s
• Smart Medical Home Increase Safety, Maintain health, detect diseases, manage current illnesses in home. Measure tradi2onal vital signs (blood pressure) and new "vital signs" (sleep, rehabilita2on and behavior paLerns)
Assisted Domo`cs
Assisted DomoFcs
• Remote Monitoring • MedicaFon reminders • Daily medical tesFng • Remote medical consultaFon • Medical care coordinaFon
Health Care
• Family caregiving coordinaFon • CommunicaFon • RelaFonships • FighFng loneliness or depression
Long distance care giving
• Fall prevenFon • Security • LighFng
Home safety
Assisted DomoFcs www.strategicbusinessinsights.com
Domo`c Apps: Enabling technologies (Smartphones, tablets, touchscreens, mul@media, sensors, and automa@on) form a plaform.
Home As A Second Brain: Home automa`on related technologies will remind where your keys are, to take pills, or what a recipe is
Next Genera`on Ea`ng: Food is gehng smarter. Food prep, diet customiza`on, and food-‐safety will become automa`c processes
Home Robots: The demands of an aging popula`on drive demand for domes`c robots significantly by 2025
Assisted DomoFcs / Signposts & ImplicaFons
• Apple increase role in home aut. • Microsoi bring interac`vity into surface • Wonderwall
• Internet of Things devices for Alzheimer and “mentally fragile pa`ents”
• Social alarms • Video palern recogni`on
techs
• Specific food needs for ageing people
• Future kitchen concepts from IKEA, Electrolux, Whirlpool
• 3D food prin`ng
• People prefer care homes or care robots?
• Spin-‐offs: Security-‐bot, physical assist-‐bot, health monitoring-‐bot
Examples
• Financed by EC • 22 Countries partner states
• IniFally set up for 6 years
• Planned total budget 700 M€
• 50% is public funding
• Enhance the quality of life of older people
• Strengthen the industrial base in Europe through the use of ICT)
Engagement
A Real Case and Lessons Learned
Turkcell Health Monitoring Main Features
7/24 Medical Call Center Support
Turkcell Chronic Disease Management System
-‐30,0
-‐25,0
-‐20,0
-‐15,0
-‐10,0
-‐5,0
0,0
5,0
10,0
15,0
20,0
TeleDiab Grubu Kontrol Grubu
-‐26,2
-‐11,9 -‐13,5
-‐8
-‐26
-‐12,3
-‐27,2
19 Ba
şlan
gıca göre AK
G fa
rkı (mg/dL)
0-‐3. Ay 0-‐6. Ay 0-‐9. Ay 0-‐12.Ay
*Çalışmada 12. ayını tamamlayan hasta sayısı azdır: TeleDiab Grubu (n=21), Kontrol Grubu (n=4).
TeleDiab: 0-‐3.ay: p=0.007, 0-‐9.ay: p=0.034
BLOOD GLUCOSE IMPROVEMENT
%16 compared to reference group
10% -‐> 40% in MI
-‐1,0
-‐0,9
-‐0,8
-‐0,7
-‐0,6
-‐0,5
-‐0,4
-‐0,3
-‐0,2
-‐0,1
0,0
TeleDiab Grubu Kontrol Grubu
-‐0,67
-‐0,32
-‐0,71
-‐0,35
-‐0,69 -‐0,62
-‐0,96
-‐0,67
Başlan
gıca göre Hb
A1c farkı (%)
0-‐3. Ay 0-‐6. Ay 0-‐9. Ay 0-‐12. Ay
*Çalışmada 12. ayını tamamlayan hasta sayısı azdır: TeleDiab Grubu (n=21), Kontrol Grubu (n=4).
TeleDiab: 0-‐3. ay, 0-‐6. ay ve 0-‐9. ay: p<0.001, 0-‐12. ay: p=0.001 Kontrol: 0-‐3. ay: p=0.039, 0-‐6. ay: p=0.018, 0-‐9. ay: p=0.005
HbA1c IMPROVEMENT %1.1
1% -‐> 21% in Deaths
0
5
10
15
20
25
30
35
40
45
3. Ay 6. Ay 9. ay
41 37
25
38
26
13
HbA1
c ko
ntrolü sa
ğlan
an hasta (%
)
TeleDiab
Kontrol
*HbA1c ≤%7 bulunan hasta oranı.
IMPROVEMENT IN TREATMENT COMPLIANCE 25%
10% -‐> Blood
Glucose %1
What Did Happen?
• 30% LeZ the 100% Free of Charge project:
• Didn’t want to be far from physician contact, • “Technological monitoring” vs “human”
• Does it really work? • Usability
• Didn’t want to be “monitored remotely” • Intervene to privacy • Dictator ship of paFent relaFves • Showing off the illness
• Didn’t want unnecessary “reminding” • Non criFcal guidance
• Why this box? Diversity of pa`ents
Cogni`ve differences
Poor usability of systems
Customer? Values?
Elderly people Physically challenged paFents
Their relaFves
increasing the autonomy self-‐confidence mobility maintaining health
funcFonal capability enhance the security prevent social isolaFon
Promote bexer lifestyle support carers increase the efficiency
ProducFvity in ageing socieFes maintaining a network extend the good life
Value ProposiFon
• Help paFents who otherwise might not be able to stay in home
• Avoid having to move into assisted living or healthcare center
• Make help available as-‐needed with automated sensors
• RelaFves will be comforted by knowing their pa2ents can get help
• Reduce governmental expenditures and other related costs.
Obstacles... Problems... Barriers... PercepFon of elderly people about OUR smart technologies*:
* Older Adult Percep@ons of Smart Home Technologies: Implica@ons for Research, Policy & Market Innova@ons in Healthcare
Pa`ent-‐centered care : Providing care that is respeczul of and responsive to individual paFent preferences, needs, and values, and ensuring that paFent values guide all clinical decisions.
Obstacles... Problems... Barriers...
“The number one benefit of technology is that it empowers people to do what they want to do. It lets people be creaFve. It lets people be producFve. It lets people learn things they didn't think they could learn before, and so in a sense it is all about potenFal”
Steve Ballmer • Avoiding distorFon, let the natural evoluFon!
* Smart home with healthcare technologies for community-‐dwelling older adults
Examples
CALL 1 ICT based soluFons for PrevenFon and Management of Chronic CondiFons of Elderly People
Examples
CALL 2 ICT based soluFons for Advancement of Social InteracFon of Elderly People
Examples
CALL 3 ICT-‐based SoluFons for Advancement of Older Persons’ Independence and ParFcipaFon in the “Self-‐Serve” Society
