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EB5205 Clinical Health Analytics

Module 1.1: Introduction to Health


Analytics
Dr. Matthew CHUA, PhD
Institute of System Science, NUS
About Me

PhD, Biomedical
Engineering from NUS
Faculty of Engineering,
Singapore, in 2015.
Research Interests: Artificial
Organs, Medical Devices
Design, Soft Robotics and
Optimization.
Joined ISS in 2016 June.
Some Photos of My Life
About the Course
ONE week of E-learning on final week (Week 5)
Consisting of a Lecture in the morning and Tutorial in the
Afternoon
Class information, lectures and materials can be found on IVLE.
Do not email me questions, instead post it on the IVLE module
forum so that we can all learn.

Term project (in groups) - 35%

Weekly Forum Participation 5%

Final Examination 60%


Course Outline
Week 1
Introduction to Health Analytics
Fundamentals of Biostatics
Biosignals
Week 2
Fundamentals of Medical Imaging
Intelligent Systems for Healthcare Transformation
Week 3
Analytics for Clinical Health Research I
Week 4
Analytics for Clinical Health Research II
Week 5
Medical Image Database
Main References

1. https://www.infosys.com/digital/white-
papers/Documents/digital-healthcare-ecosystem.pdf
2. http://www2.deloitte.com/content/dam/Deloitte/uk/Docu
ments/life-sciences-health-care/deloitte-uk-connected-
health.pdf
3. https://www.accenture.com/sg-en/insight-new-sg-patient-
engagement-survey
4. http://nuviun.com/content/the-role-of-digital-health-in-
singapores-healthcare-landscape
5. https://www.siam.org/meetings/sdm13/sun.pdf
Contents of this lecture:
Introduction

Health Digitalization in a Smart Nation


IoT Healthcare devices and systems
Telehealth and Telemedicine
Health Wearables
Health Gamification
E-Health Cloud

Role of Big Data in Health Analytics

Term Project Briefing and Selection (hosted by Duke-NUS and i2R)


Introduction to Digital Healthcare (1)

Digitalization of healthcare is the enhancement of


healthcare through technological means

Multidisciplinary involvement between healthcare


providers, IT professionals, engineers and analytics

Focuses heavily on data acquisition, processing, storage


and analysis
Introduction to Digital Healthcare (2)
Current Healthcare Needs and Trends (1)

The THREE Ps of healthcare:


Due to improved life expectancy and population boom
Results in:
Current Healthcare Needs and Trends (2)

The current healthcare needs in SG:

Ageing population

Shortage of healthcare workers

Rising costs

Shortage of healthcare infrastructure


(beds, diagnostic equipment etc)
Current Healthcare Needs and Trends (3)

http://www.nmrc.gov.sg/content/dam/nmrc_internet/documents/nmrcAwards/2015/slides/hsr/Mr%20Fernando%20Erazo%20-
%20Co-Creating%20Efficient%20Care%20Models%20To%20Unlock%20Population%20Health%20In%20Singapore.pdf
Current Healthcare Needs and Trends (4)

Current Digital Healthcare Trends in SG:


Increase in wearables and health apps usage
40% in 2014 to 44% in 2016

Increase in telehealth innovations and projects

Moving towards preventive rather than curative


Through lifestyle monitoring and changes

Government focus on Smart Nation initiative


Telehealth & Telemedicine What is it?

Differentiating between Telehealth and


Telemedicine:

Telemedicine: The use of technologies to remotely


diagnose, monitor, and treat patients

Telehealth: The application of technologies to help


patients manage their own health through self-
monitoring and access to support systems
Telehealth & Telemedicine Why the trend?

Cost Effectiveness and Efficiency

Source: Marketing and Planning Leadership Council interviews


and analysis. Advisory Board
Telehealth & Telemedicine Networks and
Applications

Source: Marketing and Planning Leadership Council interviews and analysis. (Advisory Board)
Telehealth & Telemedicine Benefits

Better access to healthcare services


Increased access to specialists and healthcare providers
Enhanced quality of care
Less hospitalizations/emergency room visits
Cost effective service
Mutually beneficial to doctors and patients
Telehealth & Telemedicine Current
Bottlenecks

Fragmented and slow

Difficulty in integrating telehealth into routine


care (lack of impetus)

Resistance to change
Telehealth Case Study 1

Telehealth monitoring of blood


pressure from 1,300 patients

Prof James Yip from NUHS

Second phase: use of Heal my Heart


app to remind patients to take
medicine
http://www.straitstimes.com/singapore/tel
ehealth-helps-spread-medical-net-wider
Telehealth Case Study 2

Home telerehabiliation of stroke


patients using iPads

Pioneered by Prof Gerald Koh from


NUS

Focus on keeping SG aging population


http://www.straitstimes.com/singapore/telehe healthy and reduce strain on
alth-helps-spread-medical-net-wider
physiotherapists.
Telehealth Case Study 3

Telehealth programme for heart failure patients in SG

Partnership between Eastern Health Alliance and Changi


General Hospital

Patients provided with personal health tablet, a weighing


machine and blood pressure monitor.

Parameters are uploaded into the system daily for monitoring


Smart Wearables for Health What is it?

They are health monitoring


technologies that are worn
or integrated into wearables

Can come in the form of a


watch, headband, shoe and
many more
Smart Wearables Three layers mechanism

Cloud layer-
analyze data and
give user
outcome
Connectivity and
control layer shift
from smart phones to
the wrist
Battery life is the basic layer for
small interfaces that are placed
close to body
Smart Wearables Three layers mechanism

Not yet
Cloud layer- attained
analyze data and
give user outcome at the
moment
Connectivity and control
layer shift from smart
phones to the wrist
Battery life is the basic layer for
small interfaces that are placed close
to body
Smart Wearables Benefits

Continuous health monitoring ( good for patients susceptible to sudden


health attacks)

Allows users to track and make improvements to life style

Can sync with telehealth to provide remote monitoring of patients

Seamlessly integrated into daily living


Smart Wearables Current Findings

Consumers have not fully health monitoring wearable technologies.

Most consumers do not want to pay for their device and rather be paid to
use them.

Few consumers are interested in sharing health data

Consumers are concerned about privacy of their data and are sceptical of
the data usage.
Smart Wearables EEG-based ( My project)

Enabling locked-in patients


or patients with ALS to
communicate

EEG offers an avenue for


disabled patients to control
their environment

The future in EEG


wearables is promising
Smart Wearables Watches

Garmin Vivofit

Monitors physical Fitbug Orb


activities
Wellograph And notify users if too Measures steps taken,
sedentary calories and sleep
Heart rate monitoring
and running watch
Smart Wearables Local Case study 1

Healthstats wrist monitor Pro

Monitors patients blood pressure


round the clock

More effective than instantaneous


measurement at clinic

Developed by Dr Ting Choon


Meng
Smart Wearables Local Case study 2

Intel Edison-powered
wearable monitoring watch
that ease suffering of
Parkinsons disease patients

Developed by NUS students


in 2015

Onboard algorithm analyzes


users gait cycle and alerts
user if he is about to fall.
Health Gamification What is it?

Gamification is the use of game elements and game design


techniques for healthcare by changing the patients behaviour.

Gamification Paradigm
Health Gamification - Taxonomy

Categorizing the different types of games used in Healthcare

http://gtl.hig.no/images/4/40/McCallum2012.pdf
Health GamificationBenefits

Users are more motivated to achieve their health goals through


the games.

Reaping double benefits of fun and beneficial


Health GamificationChallenges

Measuring effect:
Two different users playing the same game might have
different experience and tastes.
Selection bias in data collection

Quality of games:
Difficult to design a good game of an adequate addictive
nature

Intrinsic vs extrinsic motivator:


Games may only provide temporary extrinsic motivation
and effect will wear off after novelty is gone
Health Gamification Local Case Study 1

Pokemon GO

Users are motivated to


travel on foot to
different regions of the
country to catch
Pokemon

Sign up of more than


100 million users
Smart Wearables Local Case study 1

Virtual reality game designed


by Tan Tock Seng Hospital

Staff navigate a 3D virtual


hospital to identify diseases
and use the right protective
equipment

Another app for rehabilitation


of brain injuries survivors
E-Health Cloud- What is it?

E-Health Cloud is defined as a systematic collection of electronic


health info about individual patients or populations.

It is a record in digital format and has the potential of being


shared across different health care settings

Contains a range of data like demographics, medical history,


medicationsetc
E-Health Cloud Limitations of current
systems

Costly to maintain

Fragmentation of data storage systems and insufficient exchange


of patients data between hospitals and clinics

Lack of regulation and law governing the use and protection of


patients data.
E-Health Cloud-Benefits

Unified patient medical record database

Reduced cost due to sharing of overhead costs amongst


participants

Overcome shortage of IT infrastructure

Support research, national security and strategic planning


E-Health Cloud-Risks

Data security risks

Loss of data

Risks of server and system unavailability during


maintenance
E-Health Cloud-Local Case Study

H-Cloud or Health Cloud is a consolidated and virtualized data centre


to host all mission critical systems for all public hospitals in SG

Developed and supported by IHiS (Intergrated Health Information


System)

Consolidates all the data centres in all hospitals in SG into a single


hub

Won the prestigious DataCloud Enterprise Cloud Award in Monaco


in 2 Jun 2015
Future of Digital Healthcare (1)

Augmented reality of patients

Allows doctor to quickly access


history of walk in patients

Plastic surgery planning


Future of Digital Healthcare (2)

Retinal scans

Storage and retrieval of records using


patients retina

Prognosis and diagnosis using retina


scans
Future of Digital Healthcare (3)

E-tattoo

On board solar-panel supply

Measures hydration, heart rate,


glucose levels and activity levels.

2D flexible circuit

Seamless integration with user


Role of Big Data in Health Analytics
Definition of Big Data
A collection of large and complex data
sets which are difficult to process using
common database management tools or
traditional data processing applications.

Big data refers to the tools, processes


and procedures allowing an organization
to create, manipulate, and manage very
large data sets and storage facilities

The challenges include capturing, storing,


searching, sharing & analyzing.
Reasons for Abundance of Healthcare Data
Standard medical practice is moving from relatively ad-hoc and subjective
decision making to evidence-based healthcare.

More incentives to professionals/hospitals to use EHR technology.

Additional Data Sources


Development of new technologies such as capturing devices, sensors, and
mobile applications.
Collection of genomic information became cheaper.
Patient social communications in digital forms are increasing.
More medical knowledge/discoveries are being accumulated.
Big Data Challenges in Healthcare
Inferring knowledge from complex heterogeneous patient sources.
Leveraging the patient/data correlations in longitudinal records.
Understanding unstructured clinical notes in the right context.
Efficiently handling large volumes of medical imaging data and extracting
potentially useful information and biomarkers.
Analyzing genomic data is a computationally intensive task and
combining with standard clinical data adds additional layers of
complexity.
Capturing the patients behavioral data through several sensors; their
various social interactions and communications.
Goals of Big Data Analytics in Healthcare

Take advantage of the massive amounts of data and provide right


intervention to the right patient at the right time.
Personalized care to the patient.
Potentially benefit all the components of a healthcare system i.e.,
provider, payer, patient, and management.
Analytics Platform
End of Module 1.1