technology trends in health care

7/30/2019 Technology Trends in health care

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Technology Trends

I n

Healt h Care

Poornima Mohanachandrani2iTeleSolutions

[email protected]



Out line of my talky Healthcare Challenges

y Cardiac Monitoring

y Medical Imaging

y Tele Medicine

y Summary and Q&A



Global Burden of Diseases

Communicable diseases,maternal and prenatal conditions

and nutritional deficiencies

Injuries

Chronic (non-communicable) diseases

Sources: WHO study on Burden of Diseases



Prevent ive Care & Disease ManagementThe Wor ld’s 15 ‘Oldest ’ Count r ies

Sources: Carl Haub, 2006 World Population Data Sheet .

Percent Age 65 or Older



Diabetes

Sources: WHO report on diabetes



Diseases - I ndiaBlindness Diabetes Cardiac Diseases

37 Million Blind inthe world

12 Million Blind inIndia

India has highest # of

Blind People in theWorld

60% of world’s cardiacdiseases will be fromIndia by 2010

In case of emergencyit takes an average of300 minutes to

reach a hospital in India

India has highest # ofDiabetic patients in theWorld

Presently 40 Million are

Diabetic In India

* Data courtesy International Diabetes foundation, WHO

80% are preventable



Technology I nnovat ionJourney so far & Fut ure



ECG1901 : Einthoven’s ECG

2009

NICT Japan has entered the fray by developing a wearable ECGCreated in collaboration with the Yokohama City University and

Research & Innovation for the Environmental Health Medicine, .The device uses short-distance wireless communication technology



12 lead ECG



CARDI AC Monit or ingHolter monitor is a machine that continuously records the heart's rhythms. The monitoris usually worn for 24 - 48 hours during normal activity

Event monitor records short term EKG rhythm patterns, for 30sec-1 minute.

Typically the wearer triggers the recording when an event happens.



CARDI AC Monit or ingThe electrophysilogy study or EP study involves a catheter with electrodesprobing the endocardium and testing the conduction pathways. In the EPS,specialized catheters are placed into the heart. These catheters can be used to

"pace" the heart, and also to record the electrical activity of the heart, fromvarious locations within the heart



Vit al Signs Monit oringA medical monitor or physiological monitor is an electronic medical devicethat measures a patient’s vital signs and displays the data so obtained.

Bedside Monitor Central Station



Vital Signs Monitoring – New generat ion

Recent technology advances in wireless networking, micro-fabrication, and integration ofphysical sensors, embedded microcontrollers and radio interfaces on a single chip,promise a new generation of wireless sensors suitable for many applications, such as

stroke rehabilitation, physical rehabilitation after hip or knee surgeries, myocardialinfarction rehabilitation, and traumatic brain injury rehabilitation.



Data Analysis

Analysis – Large amount of Data Generated, Aid disease

detection, Disease quantification

Heart Sound AnalysisECG waveform Analysis using Labview



ECG Data Analysis for Heart

Rate Var iabil it y

RR Interval (Ventricular cardiac cycle)

Poincare Plot



Pat ient Monitoring - Market• Global Patient Monitoring Market – 4.9B (2008) to 7B (2015)

• Includes Multiparameter patient monitor, wireless & ambulatory monitors,non invasive BP monitors,Remote patient monitors & MEMS based systems

• Wireless and ambulatory monitoring and micro-electromechanical systems

to be the key segments driving growth globally

• Growth drivers:•Tertiary care, Life Style disease management, Home monitoring

• Areas of focus by manufactures:• Interoperability• Development of IT integrated Patient Monitoring systems• Information Management Systems

Ref: e-health online



Pat ient Monit or ing –

I ndia Market

Indian Patient Monitor Market : Rs 200 Cr

Technology Trends:

Wired /Wireless Transfer of Vital Parameter DataInformation Management

ChallengesLack of Regulations for medical devices

Ref: Medical Buyer



Medical I maging

y Medical imaging detects critical illnesses at their most curable

stage‐and,

in

many

cases,

when

they

are

least

costly

to

treat.

Medical imaging is at center‐stage in prevention and early detection. Molecular imaging allows physicians to go even

further, detecting disease at the cellular level, before any symptoms or signs are noticeable.

y The impacty Early /accurate diagnosisy Informed treatment decisionsy Fewer invasive proceduresy Better patient care



Echo cardiogram -Ult rasound



Coronary Angiography



Cardiac CT

Coronary Arteries and Surrounding LungThe coronary arteries and the surrounding

lung tissue are shown in this normal CTA ofthe heart.Image from Toshiba’s new CT, using 320 rowdetector

Study of Coronary arteries using CT

64 slice CT scanner - GE



X-Ray I maging

FILM BasedFILM to be processed

No Soft CopyNot easily sharable

Cassette scannedSoft Copy available

Not Real time

Real Time Digital CaptureNo retake Needed

Lower Radiation Dosage

ANALOG Computed Radiography Digital Radiography



DR Systems

‐Electronics

Digital Detectors

X Ray

Scintillator

Light

Photo diodes

Read Out CktCharge

Digital Data

Higher Resolution Analog

Multi channel conversionLow powerSpecial Packaging

High Performance processors



Medical I maging :I ncreasing Use

30-60% Increase in one decadeCT,US & MR images on increase

Ref: American Journal of Radiology

USA UK

32% increase in imagingIncreased usage of new modalities

Ref : Data as published by NHS



Expert ise Shor tage

N u m b e r o f F T E R a d

i o l o g i s t s

Year

Projected Supply

and

Demand

of

Radiologists

Demand of Radiologists

Supply of Radiologists

USA

32% increase in imaging Increased usage of new modalities Ref: American Journal of Radiology



Diabet ic Ret inopathyDiabetic Retinopathy isretinopathy(damage to the retina)caused by diabetes, which caneventually lead to blindness. It affects

80% of all patients who have had

diabetes for 10 years or more

Small blood vessels – such as those in the

eye- are impacted



Ret inopathy of Prematur it y

(ROP)Retinopathy of prematurity

(ROP), is an eye disease thataffects prematurely born babies

ROP occurs when the development of the

retinal vasculature is arrested and

then proceeds abnormally



Aid Disease Detect ion - Data t o I nformat ion

The retina is the innermost layer ofthe eye. It is composed of severalimportant anatomical structureswhich can indicate many eye

diseases such as glaucoma, diabeticretinopathy

Vessel Extraction



Medical I maging- Market• Global Diagnostic Imaging Market – 15.8 B (2008) to 24.6B (2015)

• Growth drivers:• Patient Demands• Independent Diagnostic centers (outside of hospitals)• UltraSound will be 23% of mkt (2015)

• USA, China, India markets

• Areas of focus by manufactures:• Fusion Modalities• Data Analysis Software

• IT Integration – Image transmission & Storage•Information Management Systems

Ref: Global Markets Direct



Expert ise Shor tage

10,000 People / Cardiologist

100,000 People / Ophthalmologist

Th f l i i f i d



Tele Medicine

The use of electronic information andcommunications technologies toprovide and support health care when

distance separates the participants.



Health Parameter Aggregation

H.264JPEG 2000

Hospital Information System Integration

PACS / EMR

Image & Data Archival / Work Flow Management

Data / ImageCompression /Transmission

Video/Audio Conferencing

Health Parameter Aggregation

Monitoring / Screening

Telemedicine Stack

The Six Vit al Element s

Microsoft

HealthVault



mHealth ‐ Why



1G1G

AnalogCellular

Voice only

2G2G

DigitalCellular

Voice Pager

10kbps data

3G3G

Wide-BandDigital

Cellular Video

300kbps-14Mbps

2.5G2.5G

Voice

Email

Photos

Web ~100kbps

data

TodayWireless Market Evolut ion

DigitalCellular

4G /LTE4G /LTE

Wide-BandDigitalCellular

Video

High-end

gaming ~100 Mbps

10msec

Flexiblebandwidth

1 Medication Reminder



mHealth

Concern from Physicians on accuracy and validity of instructions!!

Around 6000 Consumer Health Applications

Medpage TodayBreaking Medical News

Epocrates

Drug Information,Dosage CalculationMedscapeLargest,Most comprehensiveMed App

1 2 3 4

E-VAl MD

Medical History,examination details

1 Medication Reminder2 Appointment Reminders3 Appointment reminders

4 Medical Data on SIM card5 Patient information to Relatives6 Post Cardiac surgery report7 Access to Dietary Information

Etc etc



mHealth

4

Electronic Pill Reminder

Modified Nokia phone with breath

analyzer – from AppliedNanodetectors

Built in ECG recording –EPI Life – Singapore based Ephone International



ReportingModules

41OphthalmicCamera

RemoteViewing 32

OphthamicTelePACSServer

Upload

OR

iPhone

PC

Secure WEBDownload

Progressive

Viewing

Ophthamic Worklist

Ophthalmic Viewer

Ophthalmic Worklist

Ophthalmic Viewer

Tele Opht halmology Archit ecture



Summary

y Many advances in Patient Monitoring

y Many advances in Medical Imaging

y Expertise Gap

y

Role

of

communication

Technology

in

Healthcare

y m Health



Questions ?



Radiat ion DosagesImaging Technique Effective Radiation

Doses (mSv)

Approximate Period of

Natural Background

Radiation

Background Radiation 3.6 1 Year

Chest X‐ray 0.06 6 Days

Spine X‐ray 2.1 7

Months

Mammography 0.6 2 Months

CT Head 1.8 6 Months

CT Pelvis/Abdomen/Chest ~7.5 2 Years, 1 Month

CT Whole Body 22.5 6 Years, 3 Months

PET Whole Body 14 4 Years

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