Microsoft is applying the same model it used to launch its quantum computing and chatbot efforts to innovation in healthcare, signaling the company’s ambition and optimism about the transformative potential of artificial intelligence technologies in this enormous endeavor. Peter Lee is the Microsoft Research executive in charge of the NExT initiative—an effort quietly begun in 2014 by CEO Satya Nadella and Harry Shum, head of the company’s A.I. division, to convert select projects from the company’s global research apparatus into business opportunities. Lee says he and his team work like venture capital investors inside Microsoft (NASDAQ: MSFT), evaluating what amount to startup pitches from researchers and other employees of the company. The people behind the best ideas are given internal resources—engineering talent and capital—and a structure “to help them grow with the ultimate goal of compelling Microsoft to make some big new bets,” he says. “The culture is that you are running a startup here and your intention is to grow big and take this all the way.” Graduates of the NExT initiative include Microsoft’s push into quantum computing, its Bot Framework, work on reconfigurable computer chips, and systems to enable real-time A.I. applications. About 10 months ago, Nadella tasked Lee with applying this model to help organize and accelerate the company’s work in healthcare. Lee, who will share more details at Xconomy’s sold-out Healthcare + A.I. Northwest conference in Seattle on Thursday, often likens the task—and the enormity of the healthcare industry—to “being thrown into the middle of the Pacific Ocean and asked to find land.” Microsoft already has a huge healthcare business, and a long history of innovation efforts, with varying degrees of success. Well over 100,000 healthcare enterprises are paying customers, Lee says. “The entire universe of electronic health records systems runs almost exclusively on Microsoft SQL Server,” he says. “So, the whole digitization of health records is fundamentally running on Microsoft products.” The Healthcare NExT effort, as the name suggests, is focused on the future, “and a bet that the cloud and A.I. services in the cloud are going to be really meaningful for improving healthcare—making it more efficient, providing better access for people,” Lee says. Here are excerpts from an interview with Lee last week, in which he discusses a new partnership to design “digital hospitals of the future”; HIPAA-compliant healthcare chat bots; near-term A.I. applications in radiology; the healthcare data challenge; and how his own view of technology has evolved from unbridled optimism to greater caution. Focus areas: Lee says Healthcare NExT groups its projects into three large areas: Near-term applications of A.I. to clinical practice; life sciences applications in areas such as genomics, which lend themselves to cloud-first and A.I.-first approaches; and healthcare data. Raw material: More and more researchers—both at Microsoft and through its extensive network of academic and industry collaborations—are “motivated by problems in healthcare,” Lee says. “Digital hospitals of the future”: The growing health system attached to the University of Pittsburgh, UPMC, announced last week a $2 billion investment to build three new specialty care hospitals focused on transplants, cancer, and vision and rehabilitation, with Microsoft collaborating on technology design. Microsoft Healthcare NExT was already working with UPMC. Lee, a former Carnegie Mellon University computer science professor and department head, says UPMC makes for an interesting partner because it is doing its own research and development in natural language processing, machine learning, and other A.I. technologies—an effort led by one of Lee’s former students at CMU. One goal of the partnership is to use A.I. technologies to relieve some of the burden on overworked healthcare providers, who, by some estimates spend 100 minutes a day entering data into forms, Lee says. He won’t reveal specifics, but says there’s great potential to use A.I. and cloud technologies “to enable more personal and more relaxed interactions between clinicians and their patients.” Beyond that, it’s still early in the process of designing these modern UPMC hospitals. “It’s a very unique opportunity,” Lee says. “It’s scary, too. It’s a little daunting to confront a clean sheet of paper, but there is a lot of optimism right now just on the basis of the early collaborations we’ve been working on.” InnerEye: When radiologists make a therapy plan for a cancer patient, they must manually click through images to identify and measure different anatomy. Lee says the experimental Microsoft product InnerEye combines state-of-the-art machine learning and computer vision technologies to automate that process. The system learns by observing the habits of radiologists and codifying them. “When you observe what good radiologists do, there’s some artistry, but in the grand scheme of the workflow, the artistry comes in a very small amount of time, and it’s then buried in hours of incredibly mundane just tapping on pixels,” Lee says. “And so the opportunity here is, through machine learning, to understand the workflow, stay out of the way of the creative part of it, and then automate away the mundane parts.” Researchers are working closely with clinicians on the system, and Microsoft plans to present it during a plenary session at RSNA, the top medical conference for radiology, later this month. [Paragraph updated to clarify that InnerEye is not currently in clinical trials.] Why radiology is ripe for AI: “We’ve just had this amazing set of advances in computer vision,” Lee says. Also, computer scientists are starting to understand the radiologist’s workflow, which is creating a level of comfort and acceptance within the medical specialty. “They know that their own creative input isn’t being overridden by machine intelligence. Machine intelligence is augmenting what they do,” Lee says. “So there’s a popular misconception that A.I. will replace radiologists. I don’t think that’s coming. It’s certainly not true today.” Chatbots: Microsoft’s Bot Framework, including its suite of machine learning models covering speech and language processing, entity extraction, and other cognitive services, is finding applications in healthcare. But in order to build voice-enabled or conversational services that would deal directly with protected patient health information, the underlying technology must be compliant with the Health Insurance Portability and Accountability Act (HIPAA). Lee says Microsoft’s health bot is HIPAA compliant, and partners are building applications such as a self-service medical triage bot. It engages in a conversation to help ascertain symptoms and then connects the patient to the right human clinician, who is provided with a concise triage report, Lee says. Other applications include answering health insurance benefits questions and connecting patients to clinical trials that may be appropriate for them. Data sharing: The least exciting but perhaps most important part of the Healthcare NExT portfolio involves healthcare data. Lee is convinced that A.I. technologies are ready to make real, positive impacts in healthcare. He cites a project in India that applied machine learning models to a huge trove of image data from eye exams. Those models can now aide in early detection and tracking of myopia, a disease that leads to blindness, but can be reversed with early intervention. It’s still early, but this effort could prevent blindness “in potentially millions of children,” Lee says. While technology and healthcare companies have been eager to strike data deals, strategic, regulatory, and technological issues limit the amount of usable data available to researchers developing new healthcare A.I. applications, Lee says. Some amount of privacy regulation is “absolutely necessary,” but within those confines, he sees the opportunity to share more. “I’d love to expose all the health data to all of our researchers here at Microsoft,” he says. “I’d love to expose that data to all of the innovative startups on Azure right now, but to get to that point has been very hard. You’re going through a funnel, and by the time you get down to the bottom, you have a very small number of those initial data deals that actually turn into data that can fuel an innovation ecosystem.” Lee says policy and regulatory work surrounding existing data is progressing, but it isn’t enough. New forms of healthcare data—such as that produced by connected medical devices—is proliferating, often without the structures and policies in place to enable sharing and use for A.I.- or cloud-based applications, Lee says. Even organizations that want to share data for research purposes often don’t know how to do it, he adds. Microsoft is developing what Lee describes as a “standard operating procedure” for healthcare data sharing. “What I think is missing is guidance for individual organizations and for consortia of organizations that see a value in migrating and sharing and standardizing data,” Lee says. “So, what are the step by step instructions for doing this that will keep you out of trouble from a compliance standpoint, and put you in direct contact with a larger community of innovators?” “Double-edged”: In computer science today, “there’s much more thought given to the fundamental fact that all technologies are double-edged. I think when I started in computing, I had, personally, the ethos that technology is good, more technology is better. And I think that ethos fueled all of the optimism in the tech industry for a long time. I think it was never true because there are always bad uses of technology, there are always unintended consequences that could be positive or negative, from any technology. It takes real thoughtfulness and intentionality to stay on top of that and maximize the good, minimize the bad.” That’s especially true in healthcare applications, he says. Moreover, computer scientists applying A.I. to healthcare must respect the traditions of medicine. “Medical science has been very disciplined about having an experimental side of things that is statistically correct, and not fooled by correlations,” Lee says. “It really tries to understand causation. And this is where the tradition of randomized trials and having clarity about controls comes into play. When we’re talking about applying today’s machine learning in the medical space, by and large, we’re doing various forms of correlation detection, various kinds of classification, ranking, and other kinds of pattern recognition. So, there’s always a danger of getting fooled by a correlation that may not actually lead to a valid causal influence.” It can be tempting, Lee says, “to draw firm causal conclusions from the patterns that we’ll be able to pluck out of very large amounts of data.” A.I. researchers must remain disciplined, he says. And they must be aware of potential biases in data used to train learning systems. Examples of this are proliferating in other applications, and researchers should proceed with caution and humility, Lee says. “This is all uncharted territory for us,” he says. “We have to go there because the positive potential for human health is so enormous, but at least speaking for Microsoft, we are under no illusion that we understand all of the issues that we’ll need to confront and solve there.” Source : https://www.xconomy.com/seattle/2017/11/08/microsofts-strategy-for-finding-whats-next-in-healthcare-a-i/

The outpatient sector in Europe, long fragmented into millions of providers, is the new frontier for consolidation. And no market is bigger than Germany where medical offices accounted for €51.5 Billion of expenditure in 2016 and statutory insurers spent €13.7 Billion alone on dentistry. Many investors and entrepreneurs have the sector in their sights. That is mainly because it is now clear that almost all forms of outpatient care can be consolidated, despite regulations designed to ensure that these businesses remain owned by medical professionals. All you need is to create a two-tier shareholder structure in which the partners are professionals, but services are provided by an investor-owned vehicle. To go nationwide, you need to buy a small hospital. The penny on this has dropped in the last five years, along with the realisation that, properly organised, there is big money in outpatient. Andre Schmidt, CEO of Median, the biggest inpatient rehab chain, says that the excitement is tangible in the outpatient sector. “There is a new generation of far more entrepreneurial doctors and many family offices and private equity are piling in.” We look at the imaging services sector here where there are at least half a dozen identifiable players. The same is true in dentistry. We are told that the main reason EQT paid so much for the Pan-European dentistry Curaeos platform is that it was already active in the vast German market. And then there is ophthalmology, where the auction of the Ober Scharrer chain is being watched closely. Tim Clover, a former CEO of the Optegra chain and now at Rayner, a maker of intraocular lenses, reckons that in Germany the top three players – Artemis, Ober Scharrer and Optegra – together have less than 10pc of the market. Low margins also deter investors. Schmidt says that rents are rising and margins are low particularly in small facilities. “We get paid less and we can only make money five days a week. Inpatient rehab rates are higher and we get paid 7 days a week.” Yet Schmidt says chains make sense. “They allow costs to be spread, more complex services to be offered, with a wider range.” It is only in the last few years that the details of many of these business models have been explored. In imaging, for instance, we are now told that by devoting each facility in an area to a particular piece of human anatomy, you can abolish setting up times thus enabling 10-14 patients to be seen an hour. Patients are also willing to travel a long way to attend a specialist centre. You can also tie a chain into a facility such as a lab, thus catching a referral stream. That is the rationale behind Medicover’s recent expansion. What really attracts is the size of the sector. Take dentistry. Include private insurance and the sector is over €17bn. That is just about twice the UK dentistry market and more than twice the size of the UK private hospital market. So far one group has been absent from the feeding frenzy – the big German hospital groups. That may be about to change in the latest round of deals. But their absence may reflect an abortive early foray which saw Rhoen and Helios buying up doctor seats to gain patient flow. That led to a powerful backlash from outpatient doctors and the groups have not come back in a big way since. We’d be willing to bet that this will change as conditions tighten for their inpatient work. Max Hotopf is the Editor and CEO of Healthcare Business International. He has previously worked for the Daily Mail and has written for the Financial Times, The Telegraph and The Guardian. A Durham University graduate, he set up the business in 2008. He is particularly interested in healthcare reform, brand and the impact of the web on patient choice and behaviour. Source : https://www.healthcarebusinessinternational.com/the-next-frontier-the-german-outpatient-sector-2/

The use of robots can help transform the way our healthcare system is managed, says Stephen Sutcliffe, director of Finance and Accounting at NHS Shared Business Services. In his speech at the Health and Care Innovation Expo in Manchester earlier this year, the health secretary Jeremy Hunt outlined the digital standards he expects to see in place for all NHS patients by the end of 2018. And he is right. In today’s world, where it’s the norm for many of us to be functioning online, both at work and at home, why shouldn’t we have the option to use the same modern technology to access our medical record, book an appointment, or get a repeat prescription online? But away from the more headline grabbing digital initiatives that will undoubtedly benefit frontline patient care, there is also a – perhaps less glamorous, but no less crucial – transformational journey taking place in the NHS back office. For those of us concerned with optimising NHS business functions in light of the ongoing pressures facing our hospitals and other healthcare providers, the importance of embracing new technology cannot be overstated. The recent annual report from the Care Quality Commission (CQC), for instance, found the NHS is operating at ‘full stretch’ with ‘unprecedented pressure on the system’. It is against this backdrop that the need to introduce the most up-to-date technology to further modernise traditional NHS business processes – and to channel the subsequent staff time and financial savings into other areas – can be seen more clearly than ever. Whilst automation has already started to replace many paper-based manual processes, helping forward-thinking NHS organisations save money and make better use of their workforce, the introduction of Robotic Process Automation (RPA) promises even greater opportunities for wide-scale efficiencies. RPA is the latest in processing technology, utilising the most recent desktop and device automation technologies and applying innovative RPA solutions to carry out repetitive data entry and processing tasks. Any process that has traditionally relied on labour-intensive manual interventions, will begin to see greater consistency, better controls and improved quality. Because guess what? Robots don’t make mistakes, robots can work around the clock and robots do the same thing over and over again without getting bored. So employing robots to carry out the simple and mundane frees up humans to do what you want people to be doing – thinking, questioning and adding value. It is inevitable, of course, that with any new technology comes a certain level of resistance. But RPA should not be feared. Indeed, in many aspects of everyday life it’s already working successfully all around us. And with the efficiency improvements that hospitals and other parts of the NHS need to meet, this technology will become increasingly important to back office processing. At NHS SBS, for example, we provide finance and accounting services to almost 70 NHS provider trusts and all of the country’s NHS commissioning organisations. On this scale, the benefits of introducing RPA across some of our 500 plus prospective financial processes are obvious. Transformation is a term that is used a lot in relation to healthcare. But, in this instance, it perfectly describes how RPA – which by definition will become ever more sophisticated over time – will ensure that resources in the NHS back office are better deployed for years to come. Stephen Sutcliffe Director of finance and accounting at NHS Shared Business Services https://www.sbs.nhs.uk NHS Shared Business Services is a unique joint venture between the Department of Health and Sopra Steria. We're proud to be the only company which is part of the NHS family, with over 30% of the market using one or more of our products. Our mission is to deliver £1 billion savings back to the NHS by 2020. We've already delivered audited savings of over £400 million to our NHS clients. As an industry innovator, we use data, intelligence and technology to revolutionise NHS back office functions and support services to maximise performance. Source : https://www.sbs.nhs.uk/blogs-robots-will-transform

Studies show that over half of people in the UK are now looking online for advice on how to improve their health and wellbeing, a number sure to increase as more children are born into the digital age. With only a small minority of users starting their search at recognised sites such as NHS Choices, WebMD, Wikipedia or Facebook, Doctor Google remains the first port of call for gaining insight into all aspects of healthcare. Healthcare enquiries make up a huge proportion of search engine traffic. According to Pew Research Centre, a US based think tank organisation, they rank as the third most popular type of Google search. With millions of health related searches conducted each day, both by patients and healthcare professionals, the ways in which we deal with health issues on a day-to-day basis have changed dramatically. Data collected from searches has enormous potential in terms of research, which Google’s analytics team have already harnessed to help track and predict possible health scares and pandemics such as influenza. As Eric Schmidt states in an address to Stanford Business School, Google can evaluate the popularity of a health query by location and then use this information to find patterns and warn health departments of an impending outbreak before it occurs. This gives medical teams the chance to prepare themselves and undertake preventative measures ahead of schedule. The Reformation In an article for the British Medical Journal, chair of NHS direct, Joanne Shaw has even likened the new accessibility of health information on the web to the Reformation period. Just as the sixteenth century laity were able to interpret the Bible directly with the advent of the printing press, people today have the newfound freedom to involve themselves heavily in their own healthcare through online tools. While clergymen feared that the laity would not be capable of interpreting the complexities of biblical text, responses from the medical team have also been mixed in regards to the accuracy rates of online self-diagnoses. Many doctors today remain sceptical that patients can be trusted to evaluate their own condition and give suggestions for treatment. This patient centred approach, however, is here to stay. The rate at which people are using online diagnostic tools shows no sign of slowing and medical professionals can only help regulate and improve the information available to the public. Responsibility to the public This online information is generated from sources ranging from regularly updated, reputable sites including NHS Choices, Boots or Macmillan Cancer Research to forums such as Mumsnet or Yahoo Answers, which usually contain information from ordinary people who have encountered similar problems. Google and other search engines have a huge responsibility to deliver only the most relevant, consistent and high quality information and sift through what is considered less reliable. Yet even if Internet users do access reliable information, there is a chance that the symptoms searched for will be too general to generate accurate diagnoses. Medical professionals with experience and background knowledge are far more adept at obtaining correct information from search engines. Of course, Doctor Google cannot give a right answer if the question is wrong. Quality of search results In a study conducted by a team of physicians, 15 out of 26 cases were diagnosed correctly in Google’s top results after only three to five search terms were entered for each case. As search engines become increasingly sophisticated it is reasonable to assume that accuracy levels will also increase, provided that the right key words are used. Nevertheless, Google can only go so far. For anything other than minor, common problems, most of us know that a proper diagnosis can only be undertaken by a trained professional. Furthermore, Internet users might discover information about their particular health problem online and use basic self-help remedies but when it comes to seeking proper medical treatment, we should still turn to our local GP. Unfortunately, while access to health information has gone through what some may call a ‘Reformation period’, access to professional healthcare has been slow to evolve. This is why sites like Zesty, the online booking platform for healthcare, are working to provide a quick and easy way for patients to book appointments online. Google has undoubtedly helped shape a new approach to healthcare, one that will continue to evolve to become more patient-centred and allow for greater transparency in the healthcare process. The value, however, of face-to-face interaction between patients and medical professionals must not be underestimated. While Google may serve as a useful tool for dealing with a cold or flu, when in doubt, always book an appointment :)

The 2017 Nobel Prize in Physiology or Medicine is awarded to Jeffrey C. Hall, Michael Rosbash and Michael W. Young for their discoveries of molecular mechanisms that control circadian rhythms. Circadian rhythms are driven by an internal biological clock that anticipates day/night cycles to optimize the physiology and behavior of organisms. Observations that organisms adapt their physiology and behavior to the time of the day in a circadian fashion have been documented for a long time, but the existence of an endogenous circadian clock would only finally become established well into the 20th century. In 1971, Seymour Benzer and Ronald Konopka identified mutants of the fruit fly Drosophila that displayed alterations in the normal 24h cycle of pupal eclosion and locomotor activity. Experiments suggested that the mutations involved the same gene, later named period. A decade later, Hall and Rosbash, collaborating at Brandeis University, and Young, at Rockefeller University, isolated and molecularly characterized the period gene. However, its structure and sequence did not immediately suggest a molecular mechanism for the circadian clock. A series of breakthroughs, including the identification of other genes that partner with period, from Hall, Rosbash and Young eventually led to the notion of a TranscriptionTranslation Feedback Loop (TTFL). In this mechanism, the transcription of period and its partner gene timeless are repressed by their own gene products – the PERIOD (PER) and TIMELESS (TIM) proteins, generating an autonomous oscillation. At the time, a transcriptional mechanism was not obvious, and the discovery of the self sustained circadian TTFL was a new paradigm. Further studies revealed a series of interlocked transcription-translation feedback loops, together with a complex network of reactions. These involve regulated protein phosphorylation and degradation of TTFL components, protein complex assembly, nuclear translocation and other post-translational modifications, generating oscillations with a period of ~24 hours. Circadian oscillators within individual cells respond differently to entraining signals and control various physiological outputs, such as sleep patterns, body temperature, hormone release, blood pressure, and metabolism. The seminal discoveries by Hall, Rosbash and Young have revealed a crucial physiological mechanism explaining circadian adaptation, with important implications for human health and disease. The discovery of self-sustained transcription/ translation feedback loops as the central component of the molecular mechanism by which clock genes control circadian oscillations in cells and tissues has led to a new paradigm in our understanding of how organisms anticipate and adapt to the regular daily environmental cues such as light. Since the seminal discoveries by the three laureates, elucidating a fundamental physiological mechanism, circadian biology has developed into a vast and highly dynamic research field, with important implications for our health and wellbeing. Circadian clock The circadian clock has an impact on many aspects of our physiology. This clock helps to regulate sleep patterns, feeding behaviour, hormone release, blood pressure and body temperature. A large proportion of our genes are regulated by the clock. Source : https://www.nobelprize.org/nobel_prizes/medicine/laureates/2017/advanced-medicineprize2017.pdf

The technology could improve connectivity of IoT devices in the healthcare sector, but policies and standards must evolve to allow the tech to reach its full potential. Last week, Qualcomm announced that it has created a working 5G chip and completed its first test of 5G connectivity on a mobile device. The news follows similar announcements from Ericsson and Orange, Sprint and T-Mobile, which point to the industry steadily pushing a transition from 4G to 5G. And Nokia just recently said it’s bringing 4.5G Pro to mobile providers, with a plan for 4.9Gs in the near future. AT&T and Verizon have been testing 5G in a number of controlled sites, with plans to roll out more trials over the next 10 years. While Qualcomm’s successful test wasn’t the first for wireless carriers, it focused highly on both power and constraints of a smartphone. The test reached gigabit speeds, but won’t hit 5G speeds until full 5G deployments are completed. The company’s 2019 timeline is aggressive with its planned offerings of 5G-enable handsets. But once these networks take off, it will provide a necessary platform for the healthcare industry’s IoT and medical devices. What makes 5G superior It’s important to note that 5G isn’t just an extension of 3G and 4G networks. The tech is rather a network that combines 4G, Wi-Fi, wireless access technologies and millimeter wave. It also leverages cloud infrastructure, intelligent edge services and virtualized network core. What’s interesting is 5G’s use of a computing model that pulls insights from data with billions of devices. “Four factors distinguish 5G from its predecessors: connected devices, fast and intelligent networks, back-end services and extremely low latency,” according to a report by the Center for Technology Innovation at Brookings’ Founding Director Darrell West. “These qualities enable a fully connected and interactive world with a variety of applications.” By 2020, the 5G network will support more than 20 billion connected devices, 212 billion connected sensors and enable access to 44 zettabytes of data gathered from a wide range of devices from smartphones to remote monitoring devices, the report found. Further, “researchers estimate that this connected ecosystem will make it possible to utilize a much larger percentage of digital data (35 percent) than before (5 percent).” Where 5G fits into healthcare The technology opens the door to planned healthcare models like value-based care, which will be propelled by 5G’s connections: massive multiple input multiple outputs and signal amplitude. These are crucial to achieving the necessary data speed and capacity demands for IoT devices. And that power will be imperative to support the healthcare landscape as it moves into a more consumer-centric, value-based care model. “Cellular, Wi-Fi and Bluetooth will enable IoT communications across use cases and 5G is the network that will connect these things,” West wrote. “IoT devices are going to have varying capabilities and data demands and the 5G network needs to support them all.” “With the internet of things, we are going to see services that only need a tiny amount of data and a long battery life as well devices that require fast speeds and reliable connectivity,” he continued. Adding to the need for 5G is the increase of wearable technology and the need for solid battery-life and security for those devices. “The phrase that most pithily captures the impact of 5G within the healthcare sector is the ‘personalization of healthcare,’” according to the authors of a recent report from the Haas School of Business, U.C. Berkeley. “The much greater ability to continuously gather patient-specific data and the ability to process, analyze and quickly return processed information and recommended courses of action to the patient will give patients greater ability to manage conditions on their own,” the authors continued. For example, the report found that 5G will better support continuous monitoring and processing sensory devices, which will support the continuous monitoring of patients. The tech will “substantially increase the effectiveness of preventative care.” Predictive analytics will also improve under 5G through the growth of continuous monitoring. While 5G’s ability to continuously monitor data will develop new data streams, it will also use distributed computing to power analytics and intelligent care. 5G on the horizon The technology isn’t quite ready to be harnessed, but by 2019 the first vendors plan to bring this technology to its full potential. In fact, an IHS Market report found that sales to enable 5G tech will reach over $1.1 trillion in the global healthcare market by 2035, which represents over nine percent or $12.3 trillion of the global 5G economy in that year. The impact “is roughly equivalent to adding an economy the size of India to the present global economy.” Further, value chain associated with 5G will be about $3.5 trillion in output, with an added 22 million jobs around the globe, according to the report. To get there, it will take more than fully harnessing the tech. The industry has begun to shift into outcome-based models of care, but governmental policy changes will help speed up the process: things like taxation and policies to incentivize providers. Policies also need to change toward innovation and intellectual property to ensure 5G developers are compensated accordingly. “Public policy can also affect the realization of the potential benefits discussed above by affecting the incentives to deploy the technology,” the report authors wrote. “Public policy that allows or incentivizes existing actors within the healthcare sector to resist change will reduce the actual benefits that are realized from 5G.” “Conversely, public policy that encourages or incentivizes organizational changes that are responsive to technological changes will help in achieving large potential benefits,” the authors continued. The report suggests that 5G should be embedded into standards, while there should not be competing and mutually incompatible versions of the tech: “devices that follow standards allow for interoperability and compatibility.” Collaboration is the last component to ensure 5G reaches its full potential, according to a recent Ericsson study. Not just within the healthcare sector, but with major innovators like Microsoft, Google and Apple. In addition, healthcare providers can improve its own connectivity by partnering with medical device vendors to develop wearable technology that can connect without the use of the patient’s smartphone. “The key challenge going forward is to expand technological opportunities and make 5G and the health internet of things a reality and not just a hope,” wrote West. To West, there are a number of steps needed to advance 5G in healthcare: infrastructure development; spectrum harmonization; adequate technical standards; effective regulation; and changes in reimbursement policy, privacy protection, and research data. “To ensure all of this becomes a reality, though, work needs to be done to facilitate an end-to-end system,” West wrote. “Devices must connect to networks and the cloud in ways that are interoperable and secure. That will enable health providers and patients to receive the benefits of digital innovation for wellness and healthcare.” “If we can overcome these barriers, both healthcare consumers and providers will see substantial advances in medical treatment,” he added. Twitter: @JessieFDavis Email the writer: jessica.davis@himssmedia.com Source : http://www.healthcareitnews.com/news/5g-coming-2019-heres-what-hospitals-should-know-about-it

Technology plays a big part in all of our day to day lives, whether it is at home or at work. Innovative developments such as virtual reality can often make our lives easier, improve processes and health and safety. Walter Greenleaf, PhD Expert on The Medical Applications of Virtual Reality Technology has said “Although entertainment, social connection and gaming will drive the initial adoption of Virtual Reality technology, the deepest and most significant market for VR will be in clinical care and in improving health and wellness”. According to Bloomberg, some of the world’s biggest tech companies have invested over $4 Billion in virtual reality since 2010 and the healthcare industry plays a big part in these investments. Virtual reality headsets make you feel like you’re actually in the room, the doctor’s office or anywhere you want to be, making it a great tool in facilitating patient care. VR is also an amazing tool that can aid in education and training in the healthcare industry, providing more realistic experiences. Proximie is a great example that uses augmented reality technology to bring cutting edge, collaborative, visualisation tools to the operating room. Proximie enables clinicians to virtually scrub into clinical setting, in real time, increasing access to high quality surgical care, improving patient outcomes, reducing costs and delivering a highly engaging training experience. VR has the power to transform the healthcare industry. Here’s how: 1) Real time hands-on experience in medical education In 2016, Dr Shafi Ahmed performed an operation to remove cancerous tissue from a patient’s bowel, live streamed in VR with the hope that it will make the healthcare industry fairer and boost training. Additionally, allowing medical students, trainee surgeons and curious members of the public to involve themselves in the procedure in real time via the Medical Realities website. This enables medical students to acquire knowledge and understanding about the human body. Students can perform ‘hands on’ procedures but in a safe and controlled setting where they are able to make mistakes and learn from them without any risk to a patient, then applying the skills learnt to a real life case. 2) Improved patient education From learning about diagnoses and medications to understanding tests and procedures, VR enables patients to learn about what is involved in the clinical trial and conveys it as an interactive experience which decreases distraction and offers visualisations that can promote better understanding about their conditions. 3) Helps patients manage stress VR technology helps patients manage stress by giving them easy to understand information and help them feel more in control and comfortable. OnComfort is a start-up that is using virtual reality to aid patients diagnosed with cancer. They have created five VR apps to reduce patients stress, anxiety and need for pain medication. These have been tested by doctors on more than 1,500 patients in the U.S. and Europe and have produced positive results. Breast cancer patients who used OnComfort’s VR apps saw 50% reduction in anxiety, 80% reduction in the use of pain medication and a 40% decrease in overall pain. 4) More detailed medical imaging Through EchoPixel’s True 3D system, VR has the ability to provide 3D forms of CT scan and MRI images to physicians which enhances the understanding of patient structures and diseases. This in turn enables doctor’s to produce better outcomes for patients, in less time. 5) Faster rehabilitation Stroke and Brain injury victims can use immersive virtual reality therapy created by MindMazeto to regain motor and cognitive function faster than physical therapy. The virtual exercises and real time feedback are made to feel like games, helping to motivate patients to practice activities every day, as well as assisting physiotherapists in making decisions whether the person is ready to carry out tasks. VR and AR is an exciting space in Health Tech. It’s early days and funding is still a challenge for these innovations. The technology is developing so rapidly, AR and VR offers a significant opportunity to disrupt the status quo. The technology is becoming more economically feasible and there is little doubt that is does assist healthcare providers to deliver and patients to receive the best possible care.

The year is 2027. Dorothy visits her GP about panic attacks she's been getting at work. Before prescribing any treatment, the doctor looks at her genetic history for markers that could affect her response to certain drugs. The GP is looking in particular for CYP2C19 polymorphism, which would mean Dorothy can't metabolise a group of medicines (SSRIs); and at the same time, she examines her patient's sequenced DNA to see if she carries the genetic mutation responsible for panic disorder. Dorothy is a heavy drinker and her doctor sees that she carries a risk gene for alcohol dependence. She considers a drug that could modulate the gene. Dorothy leaves with a smartwatch to log her daily life for the next week: her quality of sleep, diet, exercise, stress, mood and activity. In the room next door, Fred is talking to a specialist about his Parkinson's symptoms. He was prescribed a drug recently for the subtype of Parkinson's he has and, for the first time, there were no side effects. In the past, Fred and the specialist used trial and error to find the right medication. But ever since computers have been able to process exabytes of data, scientists have found patterns and trends that allow them to treat Parkinson's with greater efficiency. Better still, through using an app on his phone, Fred has realised that taking his medicine at night affected his sleep; so he's started taking it at lunchtime instead. Valerie has a migraine again. Like many young people these days, she had her DNA sequenced for her 18th birthday and discovered that she's one of the 7 per cent of Europeans who can't convert codeine into morphine. She inherited her response to the drug from her mother. Valerie knows to mention this to her doctor who prescribes her a non codeine-based painkiller. The doctor also considers what impact Valerie's gut flora and microbiome might have on medication. At its simplest, precision medicine is ultra-tailored healthcare. When President Obama announced the Precision Medicine Initiative in 2015, he put it this way: "delivering the right treatments, at the right time, every time, to the right person." Precision medicine, also known as personalised medicine, is being heralded as the next major breakthrough in healthcare. In Britain, the NHS is "on a journey towards embedding a personalised medicine approach into mainstream healthcare." While medical care has always been tailored to the individual to an extent, the degree to which it can be personalised today is unprecedented because of new technology. Equipment that would have been the stuff of science fiction 20 years ago is now available in many universities. Three key advancements combine to make medicine more precise: patient-generated data through smartphones and wearable tech, genomic medicine and computer science. First, patients can quickly and easily log their daily symptoms with apps on their phones or wearable technology to understand their illnesses better. Detailed records also aid doctors in the way they treat patients and provide data for research. Second, technology is allowing us to sequence DNA at a faster rate and a cheaper cost than ever before; and scientists are understanding the genetic markers of disease at a significant rate. Estimates suggest the cost of sequencing the very first genome could have been as high as $1bn. By 2016, the cost had dropped below $1,500. The process now takes hours rather than weeks. Third, in the age of big data, computers are allowing scientists to analyse vast amounts of data with greater precision than ever before. Machine-learning algorithms accelerate analysis of data sets which result in rapid discoveries. Precision medicine is charged by a need to address the sheer variety of people's reactions to things going wrong in their bodies. From neurological disorders to strokes, cancer to depression, infections to alcoholism, each patient is unique; so ultimately the treatment should be unique, too. Parkinson's is one of the first diseases precision medicine is being applied to. It's a heterogeneous disease, which means there is a lot of variability in how patients progress. In its early stages, the disease can manifest itself with symptoms very different from the tremors most associated with it. Patients may have motion-related issues with walking, posture or movement of the fingers; but they may also experience cognitive and memory problems, depression or lose their sense of smell. Because the early signs are so varied, it is difficult to predict the progression in individual patients. Dr Duygu Tosun-Turgut of the University of California won the 2016 data challenge set by the Michael J Fox Foundation for Parkinson's research. Her aim was to discover whether the progression rate of Parkinson's disease could be predicted. If doctors could predict the speed of a patient's decline, it could affect both treatment and prognosis. It would also assist with clinical trials, as it is better to recruit patients in swift rather than slow decline. In these patients, changes and improvements – and therefore efficacy of treatment – are demonstrated more dramatically. To define the progression rate, Dr Tosun and her team looked at all the clinical data available, captured from multiple patient visits to clinics. This included, for example, the results of memory tests, the total number of times patients could sit down and stand up over a 30-second period or changes in sleeping habits and sense of smell. Dr Tosun then looked for a pattern using data-driven machine-learning algorithms. Two groups were identified. One was slow progressing and the other was fast progressing. The next step was to find out if there were any baseline assessments that could be used to predict the rate of progression. At this point they looked at genetic makeup, fluid biomarkers, imaging MRI data and other factors. "The body is a whole, everything is so connected. There might be something dominant but it affects other systems in the body. It's the same in the brain," says Dr Tosun. She discovered that if patients arrived with more motor-related symptoms on their first visit, they would decline faster. She also identified a brain region with degenerated white matter fibres. She found that the more degenerated the structures were in these regions, the faster the patient declined. Data was collected from people with a family history of Parkinson's or those who exhibited early signs to see if the same measure could be used to detect the disease before the symptoms started appearing. The goal would be to intervene before the disease started to progress. "It's very difficult to reverse neurodegeneration," says Dr Tosun. "If [a patient is] progressing fast, or if they have the markers telling us they're going to progress fast, you need to progress faster." Now Dr Tosun has turned her focus on the earliest mechanisms that trigger neurodegeneration. If it is known what triggers the disease, there may be precautions people can take to avoid developing Parkinson's. "It can be diet, supplements, physical activity or cognitive activity," she says. "It's very important to understand everything about that patient," says Dr Tosun. "Not just their symptoms: their environment, their background, the state of their brain and body. The more we learn about the patient, the more the we can model the disease and treatment better." With advancements in computer science, algorithms and hardware, scientists like Dr Tosun are at the point where they can look at all the data at one time to better understand disease, health, prognosis and treatment. Finding patterns will help answer different questions. The vast capacity of big data is crucial. Dr Beckie Port, senior research communications officer at Parkinson's UK, says, "The more people you put in your experiments, the more you can iron out some of the complexities and start to see trends, It's going to be a mammoth mission to start teasing out individual factors that could be used for personalised medicine, but it's not impossible." Personal technology – wearable tech such as fitbits and smartphone apps – is another important element in precision medicine. It is already being used in the field of Parkinson's. uMotif is a 'patient data capture platform' that allows patients with long-term conditions to track their symptoms using an app. A patient inputs information about symptoms every day, including non-motor symptoms. How did you sleep? What's your mood like today? How about stress levels? What did you eat? How's your pain? Do you have nausea? With this information, researchers and clinical teams can understand the disease better; and patients can have more useful conversations with their clinicians. The patient becomes an active participant rather than a spectator. "How you feel your Parkinson's is a very important thing in quality of life and good treatments," says uMotif's co-founder and chief executive Bruce Hellman. The data capture for a major study into Parkinson's is just finishing. Over 4,221 people tracked their health for 100 days and donated the data to academic research. Already, the feedback suggests the technology is having a positive effect on individual lives. Since using the app, Mick, a Parkinson's patient, reports feeling more assured in talking about his condition with a neurologist because he has a record of what's been happening and how he's felt. "It teaches you, 'Don't beat yourself up because you can't do what you used to do, look at what you are doing'," he says. Through plotting her feelings each day, Sam now realises that she was managing her life with Parkinson's better that she thought. She'd been getting anxiety attacks in the morning and it suddenly dawned on her that changing taking her medication from the evening to the morning might help ease the attacks. It worked. "I'm in control of my health," she says. "One of the problems people have," says Dr Port, "is that when they go to the doctor's they may be having a very good or bad day but it might not reflect what they're like on an everyday basis, That snapshot the specialist sees could influence [the patient's] drugs for the next six months." "People with Parkinson's often only visit a doctor twice a year," says Hellman, "so knowing more about their health will help them to bridge the gap between health visits and better understand their symptoms. Health is done to you at the moment but in the future it should be done with you." The 100,000 Genomes Project is planning to sequence 100,000 genomes from around 70,000 people. The largest national sequencing project of its kind in the world, it aims to create a new genomic medicine service here in the UK. At the time of writing, the 20,429 genomes that have so far been sequenced are split 50/50 between cancer and rare diseases. It covers a large geographical area: England already has 13 genomic medicine centres covering 85 NHS trusts. "Genomic medicine is right at the vanguard of personalised medicine," says Tom Fowler, deputy chief scientist and director of public health at Genomics England. He points out the role it can play in treating rare diseases, where unmet diagnostic needs are of paramount importance. "For people with a lifetime of wondering why they or their child is affected, the benefit [of genomic medicine] is being able to answer that question. It also can improve existing or potential treatment and help with making reproduction choices." Thanks to genomoic medicine, numerous diagnoses have been possible. The gene mutation causing four-year-old Jessica's rare disease was identified by researchers after her parents spent years not knowing what was wrong. Jessica's treatment is simply a special diet that enhances glucose production in the brain. After a month on the regime, Jessica's parents "noticed a big improvement in her speech, energy levels and general steadiness," according to consultant Maria Bitner-Glindzicz of Great Ormond Street hospital. "Overall, she is better and brighter in herself and her parents don't worry about her having fits on a daily basis as they used to." The project anticipates a 25 per cent diagnostic rate in rare diseases but Fowler says the remaining 75 per cent don't just get put aside, the data goes into research environments where it will be worked on: "It's the start, not the end, of the journey." A small group of Parkinson's patients is included in the 100,000 Genomes project because early onset Parkinson's is considered rare and it's more likely to contain a genetic factor. It is estimated that around 5 per cent of Parkinson's cases have a genetic link; but Dr Port thinks the role of genetics in the disease is probably a lot larger. The challenge now is how to move this kind of healthcare into the mainstream as part of routine healthcare. Fowler hopes that will happen in the next five years. In 2015, in partnership with Health Education England, nine universities introduced master's degrees in Genomic Medicine. "A legacy of upskilling staff so they understand information will make the long-lasting difference," says Fowler. "If we build an infrastructure and workforce that can cope with genomic medicine, as new discoveries happen we've got the ability to adapt and take them on board." Genetic testing can already reveal the potential for future illness and allow for proactive and preventative decisions. When Angelina Jolie, for example, discovered she carried BRCA1, the genetic marker for breast cancer that her late mother carried, she had a double mastectomy. People with a BRCA1 mutation have a 65 per cent chance of developing breast cancer, according to the National Cancer Institute. At the moment the number of people who've had their genes sequenced is fractional but it could become more commonplace. Will everyone have genetic testing eventually? "At the current time it's difficult to see how that would step out into the mainstream," says Fowler. "There may well be a time where that is the case and we move towards it." The NHS wouldn't be expected to pay for that, he adds. People are already paying to have their genes tested. Companies like 23andMe of gene testing home-kit services, which offer the possibility of finding out if you have a genetic variant that could put you at risk for certain traits or conditions. They range from serious conditions (cancer, Alzheimer's) to traits (caffeine metabolism, alcohol flush reaction, coriander aversion and sensitivity to the sound of chewing). Critics of precision medicine say that the word 'precision' is an unrealistic, inflated, hyperbolic term. They caution that there are many things happening in the human body, as well as genetics. In the journal Clinical Pharmacology & Therapeutics, Canadian doctor Dan Roden wrote, "Patients are more than collections of genomes and gene-environment interactions; they are individuals influenced by experience, culture, education, upbringing, and innumerable other factors." Still, there have already been some major success stories in genomic medicine. Most recently, DNA sequencing has led to a 'miracle' drug that treats spinal muscular atrophy (SMA), the most common genetic cause of death in childhood. The drug has recently been approved by the FDA. Combined with patient-generated data and computer-powered analysis of big data, precision medicine seems like an obvious next step. It will take time and cost money but once the task of digitising healthcare is finished, it promises a slicker, more efficient system with better diagnosis and treatment. "You can't assume everyone has average Alzheimer's, Parkinson's, or depression. They have their own properties," says Dr Tosun. "Precision Medicine is the solution, it's something we need to do." Source : https://thelongandshort.org/life-death/precision-medicine

These days, more people are working from home, shopping from home, and yes, even seeing the doctor from home. Last year more than a million people traded the waiting room for the comfort of their own couch—which sure beats thumbing through a sad collection of creased magazines. Today, telehealth is touted as one of the chief ways to deal with rural residents left behind by hospital consolidation, as well as the 20 million new patients the Affordable Care Act brought into the health care system. Its value hinges on the premise that patients will use telehealth options instead of going to the doctor or the urgent care clinic. But a new study released today shows that people are using phone-a-physician services in addition to in-person visits, not as a substitute. And the result of the Uber-ization of health care is an increase in overall costs. In April 2012, CalPERS Blue Shield started covering telehealth visits for their 300,000 insurance enrollees. Over the next year and half, 2,943 of them came down with a respiratory infection. Two-thirds of those cough-stricken Californians went straight to the doctor. The other third picked up the phone first, using the newly covered direct-to-consumer service offered by a telehealth company called Teladoc. This seemed like good news—using Teladoc brought down the cost of the average bronchitis episode because patients avoided unnecessary testing and imaging. But when researchers at RAND, a public policy thinktank, looked at whether those calls replaced in-person visits over those 18 months, they found that happened less than 12 percent of the time. In the long-term, spending actually went up $45 per Teladoc patient. They weren’t going to the doctor any less frequently. “If you make something easier to access, people will use it,” said Lori Uscher-Pines, one of the authors of RAND’s paper, published today in Health Affairs. “That lower threshold means that people are using this as an add-on service.” Patients who use telehealth on top of their normal health care visits add strain to an already overburdened health care system. RAND found that patients who used Teladoc tended to be younger, healthier, tech-savvy city dwellers—not the rural and elderly populations the technology is supposed to be targeting. And because the service takes place outside of the normal health care flow, the physicians on the other end of the line don’t usually have access to each patient’s health records, and the visit may not make it into the patient’s history. Health care experts call this “fragmentation.” “Telehealth has to be integrated fully into a total care system,” says Mario Gutierrez, executive director of the Center for Connected Health Policy. “It can’t just be a one-off. That’s not health care.” He’d like to see telehealth move away from the convenience economy model where you only dial up when you’re feeling down and out. Instead, he sees a huge opportunity to use it to manage chronic disease and engage people in preventive care. That means embracing telehealth as an essential service, not an add-on. A few institutions have a jump on this. The US Veterans Administration has reduced hospital admissions by 20 percent and costs per patient by $1,600 each year with its telehealth program. In the world of private health care, Kaiser Permanente leads the pack; last year more than half of its 110 million patient interactions happened online or over the phone. When patients call or set up a video consultation through Kaiser’s web portal, they get a few options. They can schedule a call or appointment with their primary physician (which could take a day or could take weeks), or they can talk to an on-call emergency room physician right away. If they choose that option, they might get Dennis Truong on the other end, an ER doc who also leads Kaiser’s telemedicine and mobility efforts in the mid-Atlantic region. Truong can pull up patients' health histories, and he can easily transfer them to an urgent care clinic or a specialist within the Kaiser network. “An integrated system is the backbone of what telehealth should be for patients,” he says. “I can hand off their care to the next physician who sees them, whether that’s later today or a year from now. It closes the loop.” Integration might be the gold standard, but not everyone in the telehealth industry is keeping up as well as Kaiser and the VA. In 2016 Teladoc recorded 952,081 virtual visits, up from 600,000 in 2015, and 300,000 the year before that. By 2020, the telehealth industry is estimated to be worth $34 billion. It could make a big dent in America’s overextended health care system, if providers and patients use it responsibly. Truong, who trained in the emergency rooms of Detroit, spent his early days as a doctor treating people who treated the ER as their first and last stop for health care. Their records were incomplete, fractured. It made it hard to care for them. “We couldn’t get down to the meat and bones,” he says. “That’s how I feel about a lot of these companies. There’s no closing the loop.” To do that, policy and technology can do a lot of the heavy lifting by providing coverage and incentives in the right places. But for telehealth to fully deliver on its promise, people have to start treating their health care less like an Uber you summon in a thunderstorm, and more like a car that has to carry you the next 500,000 miles. Source : https://www.wired.com/2017/03/telemedicine-great-people-stopped-using-like-uber/

Sugarpod wins the Alexa Challenge Luminary Labs has announced that the winner of the $125,000 grand prize is Sugarpod by Wellpepper, chosen from among five finalists who presented their prototypes on demo-day in New York. The challenge called on innovators to create Alexa voice-enabled solutions to improve the lives of patients with type 2 diabetes. "Technology advances are creating digital health opportunities to improve support for people managing life with a chronic disease," said Tony Alvarez, president, primary care business line and customer strategy at Merck, which sponsored the challenge. "A purpose of the Alexa Diabetes Challenge was to identify new ways to use the technology already present in a patient's daily routine. The winner of the Challenge [Sugarpod] did just that," Mr Alvarez said. Sugarpod is an interactive diabetes care plan solution that provides tailored tasks based on patient preferences. The solution is a "comprehensive end-to-end plan. The team is very excited about this win," Anne Weiler, cofounder and chief executive officer (CEO) of Wellpepper, told Medscape Medical News. Remarking on the other four finalists, Ms Weiler noted that they were also of a very high quality and highlighted the benefits of going deeper into specific aspects of care. Alexa is Amazon's voice-activated digital assistant that provides real-time information through devices including Amazon Echo and Echo Dot. Alexa is one of several new digital assistants, such as Apple's Siri and Microsoft's Cortana. Life with Type 2 Diabetes An estimated 27.5 million people live with type 2 diabetes in the United States. Thanks to greater awareness and better treatments, many who have been diagnosed with the disease are living longer, healthier lives. But diabetes requires changes and considerations that permeate throughout every aspect of life. It’s easy to feel overwhelmed and isolated on the path to self-management, especially for people who are newly diagnosed. The Opportunity What if help managing type 2 diabetes was only a voice command away? Amazon Alexa is becoming a familiar presence in homes. More than a device, Alexa is a partner to make navigating daily life a little bit easier. But voice is just the entry point that connects people to the information they need by leveraging a larger world of supporting technology, from applications to databases and cloud services. By tapping into this digital ecosystem, the universe of possibilities expands, and with it the potential to transform diabetes self-management and improve the lives of millions of people. How You Can Participate April 10th 2017,The Alexa Diabetes Challenge is looking for comprehensive solutions that use Amazon’s voice technology to improve the experience of those who have been newly diagnosed with type 2 diabetes. The Challenge seeks patient-centric solutions that reduce the friction of self management, while also considering the needs of stakeholders (e.g., caregivers, healthcare providers, payers, etc.) and the broader healthcare system. Glossary of Alexa Alexa. The voice service that powers Echo, provides capabilities, or skills, that enable customers to interact with devices in a more intuitive way using voice. Voice-enabled technology. Any technology that leverages the unique capabilities created by a voice interface. Alexa’s supporting technology. The software, databases, web services, hardware, or additional cloud and non-cloud based tools with which Alexa interfaces to perform her various tasks. Skills. Capabilities that enable customers to interact with devices in a more intuitive way using voice. Examples of Alexa skills include the ability to play music, answer general questions, set an alarm or timer, and more. Meet the five finalists July 13th 2017, Amazon are proud to announce the five finalists whose concepts utilize artificial intelligence-powered technology, virtual coaching, personalized nutrition assistance, and even a smart foot scanner to improve the lives of those with type 2 diabetes. Each will receive $25,000 and 10,000 AWS promotional credits and advance to the Virtual Accelerator. DiaBetty, University of Illinois at Chicago: A virtual diabetes educator and at-home coach that is sensitive and responsive to a patient’s mood. It provides patients with context-dependent, mood sensitive, and emotionally aware education and guidance, enhancing patient skills for self-management. My GluCoach, HCL America, Inc.: A holistic management solution, developed in partnership with Ayogo, that blends the roles of voice-based diabetes teacher, lifestyle coach, and personal assistant to serve the individual and specific needs of the patient. It leverages health pattern intelligence from sources such as patient conversations and wearable and medical devices. PIA: Personal intelligent agents for type 2 diabetes, Ejenta: A connected care intelligent agent that uses NASA-licensed AI technology integrated with IoT device data to encourage healthy habits, detect at-risk behaviors and abnormalities, and alert care teams. Sugarpod, Wellpepper: A multimodal solution that provides specialized voice, mobile, video, and web interactions to support patient adherence to comprehensive care plans. It offers education, tips, and tracking tools, including a smart foot scanner, which uses a classifier to identify potential abnormalities. T2D2: Taming type 2 diabetes, together, Columbia University: A virtual nutrition assistant that uses machine learning to provide in-the-moment personalized education and recommendations as well as meal planning and food and glucose logging. Its companion skill authorizes caregivers to connect with a patient’s account to easily engage from afar. The finalists will advance to the Virtual Accelerator and receive expert mentorship as they continue to develop their proposals. To kick off this phase of the Challenge, Luminary Labs will host an Innovators’ Boot Camp for the finalists at Amazon’s Seattle headquarters. Virtual Accelerator The Virtual Accelerator will commence with an in-person Boot Camp at Amazon in Seattle, Washington* where experts will provide teams with guidance as they develop prototypes. At the conclusion of the Virtual Accelerator, finalists will present their iterated solution to the judges and a live audience of influencers, investors, and media on Demo Day at AWS Pop-up Loft in NYC*. After Demo Day, judges will select one winner from the pool of finalists to receive the $125,000 grand prize. What is Alexa? - An Introduction to Amazon's Voice Assistant

The economist, Richard Thaler, has just been awarded a Nobel Prize for his work in what has come to be called Nudge Theory. The impetus behind Nudge Theory was a problem with the discipline of economics in general. The basic theories of economics were built on the idea that people broadly act in their own self-interest. Yet we clearly don’t. Sometimes we’re simply altruistic (to our children, for example). Sometimes we don’t have full information available (e.g. when we buy terrible financial products). And sometimes we’re even capable of self-deception (not changing our diets until we get diabetes). Much of the activity in modern economic theory – and much of Thaler’s work – has been in aligning economics with psychology, to better map out what people are likely to do in a particular situation. One result has been Nudge Theory, the idea that very subtle changes to government policy; not necessarily the traditional carrots of financial incentives or the sticks of tax or legal sanction; can encourage us to do the right thing. Thaler said: “By knowing how people think, we can make it easier for them to choose what is best for them, their families and society,” This is clearly something that has been missing in healthcare, and particularly healthcare technology. Back in 2011, I worked with an e-learning business in healthcare. We were partnered with a major diabetes medication brand with a view to improving programme adherence. The plan was to design a fairly omni-present e-learning course which would help diabetes patients understand their condition and maintain drug adherence more effectively. As part of my role, I interviewed both diabetes specialists and patients. I found myself in a ward on the South Coast speaking to a charming lady who was about to have her leg amputated. “Oooh”, she said. “It’s not nice of course, but I do love my snacks”. And that was the day that I realised that while technology is fabulous, human motivation is much more powerful. You want more examples? Take a look at the share price of Fitbit – the doyen of personal trackers. It’s worth one quarter of its peak value. Sure, that’s partly because smartphones have replicated much of these devices’ functionality. But it’s also because personal trackers don’t ultimately help most people get fitter or lose weight. The lead researcher of one report from the University of Pittsburgh in the US said: "People have a tendency to use gadgets like these for a while and then lose interest with time as the novelty wears off.” In other words, just as with my e-learning plan for diabetics, technology doesn’t make it easier to stick to the programme. And then check out this recent damning report from the University of Wisconsin, which found that telehealth systems actually increase patient office visits and show no discernible improvement in health outcomes. The researchers say “The problem is that healthcare is much more complicated [than routine questions] - patients may overreact to minor symptoms or not be clear enough in describing their situation and that leads to doctors feeling obligated to schedule an office visit.” This is not quite the same as patients failing to help themselves; but it is another example of technology failing to deliver value because it fails to account for the infinitely human aspects of healthcare – in this case the pure value of contact, of speaking eye-to-eye, and the worry of physicians themselves that they might not have done a thorough job. From all these examples, you might think that the future of healthtech is bleak. I don’t think so – in fact, I think it is unstoppable. If nothing else, it is the only way we will care for an aging population with ever more complex needs in a commercially viable way. But we will need to account for human frailty and the psychology of patients. Healthtech needs its nudges. nick@wellspark.co.uk

At iCarbonX, Jun Wang aims to establish a big data platform for health management. What if you could know exactly how food or medication would impact your health -- before you put it in your body? Genomics researcher Jun Wang is working to develop digital doppelgangers for real people; they start with genetic code, but they'll also factor in other kinds of data as well, from food intake to sleep to data collected by a "smart toilet." With all of this valuable information, Wang hopes to create an engine that will change the way we think about health, both on an individual level and as a collective. This talk was presented at an official TED conference, and was featured by our editors on the home page. What is TED TED is a nonprofit devoted to spreading ideas, usually in the form of short, powerful talks (18 minutes or less). TED began in 1984 as a conference where Technology, Entertainment and Design converged, and today covers almost all topics — from science to business to global issues — in more than 100 languages. Meanwhile, independently run TEDx events help share ideas in communities around the world. TED is a global community, welcoming people from every discipline and culture who seek a deeper understanding of the world. We believe passionately in the power of ideas to change attitudes, lives and, ultimately, the world. On TED.com, we're building a clearinghouse of free knowledge from the world's most inspired thinkers — and a community of curious souls to engage with ideas and each other, both online and at TED and TEDx events around the world, all year long. In fact, everything we do — from our Conferences to our TED Talks to the projects sparked by the TED Prize, from the global TEDx community to the TED-Ed lesson series — is driven by this goal: How can we best spread great ideas? TED is owned by a nonprofit, nonpartisan foundation. Our agenda is to make great ideas accessible and spark conversation. History of TED How did a one-off conference about technology, entertainment and design become a viral video phenomenon and a worldwide community of passionate people? TED was born in 1984 out of Richard Saul Wurman's observation of a powerful convergence among three fields: technology, entertainment and design. The first TED, which he co-founded with Harry Marks, included a demo of the compact disc, the e-book and cutting-edge 3D graphics from Lucasfilm, while mathematician Benoit Mandelbrot demonstrated how to map coastlines using his developing theory of fractal geometry. But despite a stellar lineup, the event lost money, and it was six years before Wurman and Marks tried again. This time, in 1990, the world was ready. The TED Conference became an annual event in Monterey, California, attracting a growing and influential audience from many different disciplines united by their curiosity and open-mindedness -- and also by their shared discovery of an exciting secret. Success of TED In the fall of 2012, TED Talks celebrated its one billionth video view. As TED Talks continue to be watched around the world, with an average of 17 new page views a second, TED conferences and events continue to inspire, motivate and thrill attendees. In 2014, the annual TED Conference celebrated its 30th anniversary in Vancouver, Canada. The theme of this milestone conference: "The Next Chapter," both a reflection on developments of the past 30 years as well as a look at what's ahead. Source : https://www.ted.com/talks/jun_wang_how_digital_dna_could_help_you_make_better_health_choices