The Future is Now

The Practice of Medicine Has Left the PatientHouse calls by doctors:• 1960 - 40% of doctor-patient meetings• 1980 - 0.6% of doctor-patient meetingsPossible causes for such a steep decline are concerns about:• Time inefficiency • Inconvenience (for the doctor)• Lack of resources in patient’s homeWe are now starting to see a renewed interest in house calls with the practice of concierge medicine

The Vanishing House Call

Hospitals often acted as sanatoriums and a place to send sick people keeping them away from everyone else while we hoped they got better

Tuberculosis and other infectious disease

Mental health issuesIn modern times AIDS

The technology available was not advanced and care provided would often seem barbaric by today’s standards

Hospital Care

Hospitals, Asylums and Sanatoriums

20th Century Medicine

Modern medicine became centered around the local hospitalHospitals had the facilities for complex care:

Emergency services Imaging Surgery

If doctors wanted to practice medicine they needed to be affiliated with a hospital

Analogy between evolution of medical practice and the advance of computing technology

Medicine used to be practiced in the community and in peoples homesIn order to practice medicine one had to have a terminal into the mainframe (hospital)

First computers took up an entire room

Mainframe Computers

Terminals

Micro ComputersHome Computers?

Personal Computers

Personal Computers

The PC Revolution

The PC Revolution

IBM Home Computer

The PC Revolution

Chips With That

DynaTAC

The Mobile Era

2005

2013

Smartphones go Mainstream

Today’s Technology Used to be for Superheroes and Science Fiction

Wearables, Trackers, andQuantified Self

Fitbit Garmin

Wearables, Trackers, and Quantified SelfApple Does it Again

Hospital High on a Hill

Hospital ConsolidationMERGERS WILL CONTINUE…

MAINFRAME ORGANIZATION:an entity that incorporates into its own architecture the essential functions and information required to do its job.

NETWORKED ORGANIZATION:a collection of interconnected entities that share resources and information in order to do its job.

SMART

What is Blockchain? • Open-source software upon which Bitcoin and other

cryptocurrencies run– A technology protocol layer like TCP/IP

• A decentralized database/ledger – It’s like a huge ‘interactive Google doc spreadsheet’ that

anyone can view and administrators (miners) continually verify and update to confirm that each transaction is valid

– Secure network where any transaction can be independently confirmed as unique and valid without a centralized intermediary

• Blocks (batches) of transactions posted sequentially to a ledger (chain)

Blockchain is…

• A decentralized database, a transaction ledger • A new form of information technology• A globally-distributed always-on database system for

secure, permanently-recorded independently-validated transactions

• A universal organization and coordination system

The ONC Blockchain Challenge

The “Use of Blockchain in Health IT and Health-related Research” Ideation Challenge solicited white papers on the topic of Blockchain Technology and the potential use in Health IT to address privacy, security, and scalability challenges of managing electronic health record and resources.

The ONC Blockchain Challenge

Out of more than 70 submitted white papers ONC received from individuals, organizations, and vendors, they picked 15 final winners that are awarded a cash prize; Eight winners were invited to present their papers at a workshop co-hosted with the National Institute of Standards and Technology and the ONC

Blockchain Health Applications

Immediate Near-Future Longer-term Future

Universal EMR Smart Contracts and Health Insurance

Blockchain Happiness: Personal Development Chains

Health Databanks Smart Property: Drug and Inventory Management

Virtual Patient Modeling

Quantified Self Data Commons

Health Token: HSN, Research

Blockchain AI Applications:

Big Data File Storage, Access, and Analysis

Smarthome, Personal Robotics, QS IOT

Friendly AI

Health Document Notarization and Tracking

Environmental Monitoring Blockchain Deep-Learners

Identity Verification Demurrage Redistributions Blockchain Health AdvocatesHealth Vendor RFPs Health Policy Voting Digital Services

HSN: Health Social Network, IOT: Internet of Thingshttp://www.amazon.com/Bitcoin-Blueprint-New-World-Currency/dp/1491920491

We are in yesterday’s future today

10 Finalists• DYNAMICAL BIOMARKERS

GROUP TAIWAN - TEAM LEADER: CHUNG-KANG PENG

• FINAL FRONTIER MEDICAL

DEVICESUNITED STATES - TEAM LEADER: BASIL HARRIS

• INTELESENS-SCANADU

UNITED KINGDOM - TEAM LEADER: JIM MCLAUGHLIN

• AEZONUNITED STATES - TEAM LEADER: TATIANA RYPINSKI

• CLOUDDXCANADA - TEAM LEADER: SONNY KOHLI

• DANVANTRIINDIA - TEAM LEADER: SRIDHARAN MANI

• DMIUNITED STATES - TEAM LEADER: EUGENE CHAN

Today we use technology to check the news, the weather, our emails, Facebook, our texts and our Tweets. Yet, with this wealth of information gathering, we don’t check our bodies. Medical providers around the globe are taxed for resources. It’s time individuals start taking charge of their own health. The Qualcomm Tricorder XPRIZE is making that possible. By virtue of the Qualcomm Tricorder XPRIZE, Team Aezon is taking on the challenge. Aezon formed in September 2012 to tackle the Qualcomm Tricorder XPRIZE and is composed of students from Johns Hopkins University in partnership with the developers of Biomeme, Symcat, Spirosmart, and Aegle.

Augmented Reality

Virtual Reality

PatientsLikeMe

23andMe

It Is Who We Are

On January 20, 2015, President Obama announced the Precision Medicine Initiative (PMI) in his State of the Union address. Through advances in research, technology and policies that empower patients, the PMI will enable a new era of medicine in which researchers, providers and patients work together to develop individualized care.

Many disparate data types and streams Integrated computing

Genomics

Clinical

Claims & transactions

Meds & labs

Patient experience

Personal data

Genomic Singularity Is Near

Illumina MyGenome App

Questions?