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Public Health England will bring together a group of experts to scale up the agency's work on "predictive prevention", enabling people to take greater control of their health and care through personalised advice and interventions, according to a new policy paper released this week. “We are testing new ways of providing people with preventative advice, using cutting edge technology often called 'predictive prevention'," the government said. "Innovations like these provide exciting opportunities for the future of health and social care - offering earlier diagnosis and more targeted treatments, supporting self-management of conditions, making health and social care more convenient, and joining up data across services securely to deliver better and more personalised care." Leveraging the use of digital technology and data, the PHE-led programme will be “founded on the highest standards of data privacy”, being compliant with the Data Protection Act 2018, the GDPR and the work of the National Data Guardian. “The Government wants to see health and social care exploring digital services that use information (which individuals choose to use) to offer people precise and targeted health advice - specifically designed for their demographic and their location; their lifestyle and their circumstances; their health needs and their health goals. “Targeting interventions this way not only means we can direct specific public health interventions towards those most at risk - it means that those who want it can have preventative care that is relevant to them and more effective than ever before,” the document reads. While no further details about the PHE project were released today, the paper outlines plans to "prevent people from becoming patients" and realise the government's vision to improve healthy life expectancy by at least five extra years before 2035, including through virtual consultations or the use of social media. A recent NHS Digital programme saw a 13 per cent increase in first time attendances for breast screening over a four-year period in Stoke-on-Trent after the North Midlands Breast Screening Service started sharing information about the process and its importance on Facebook community groups.  "The NHS must go from being the world’s biggest buyer of fax machines to the tech pioneers of the future. And I know we can do it," Health and Social Care Secretary Matt Hancock said earlier today at the annual meeting of the International Association of National Public Health Institutes in London. The government is expected to publish a green paper on prevention next year. Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

AI, machine learning, cognitive computing, neural networks? Supervised, unsupervised, semi-supervised? Object recognition, natural language processing? What does it all mean?

In July 2018, IDC Thailand named Khon Kaen as having the most outstanding smart-city project in APAC excluding Japan, alongside Phuket. The winning projects, Khon Kaen Smart Health and Phuket Smart Tourism and Living Communities won under the “Public Health and Social Services” and “Tourism, Arts, Libraries, Culture and Open Spaces” categories respectively at the 2018 IDC Smart City Asia Pacific Awards. Healthcare IT News Asia Pacific had the opportunity to learn about the latest developments of the Khon Kaen Smart Health Project from four key stakeholders involved in this pioneering digital health project. They are: -Associate Professor Cholatip Pongskul, Associate Dean for Information Technology, Faculty of Medicine, Khon Kaen University, -Dr. Apichat Jiravuttipong, Director, Srinagarind Hospital, -Dr. Chavakij Bhoomibunchoo, Associate Dean for Medical Hub, Faculty of Medicine, Khon Kaen University and -Ms. Chaturapron Chokphukhiao, Representative, Digital Economy Promotion Agency, Northeastern branch, Khon Kaen, Thailand The Khon Kaen Smart Health Project originated from the “Manee Project”. Could you tell us more about the “Manee Project”? (Response from Prof Cholatip) Manee Project is the research project funded by The Thailand Research Fund. It is aimed to find the suitable health sensor platform for monitoring health and behaviour of the household residents, mainly the elderly staying at home on their own. The data from their homes will be integrated with their medical records in order to help the doctor better analyse the health data. Its ultimate goal is preventive analytics of the individual for the purpose of changing their lifestyles from corresponding persuasive technology. Webinar: Educating the Next Generation of Physician Informaticians Khon Kaen City recently announced its integrated smart healthcare model with three components – smart ambulance, preventive healthcare service and blockchain & analytics. This Smart Health project is driven by local healthcare service providers and universities. Could you share with us which are the healthcare providers and universities that are involved in this project?   (Response from Prof Cholatip) The healthcare providers involved in the project are: (i) Srinagarind Hospital, Faculty of Medicine, Khon Kaen University (ii) Khon Kaen Provincial hospital (iii) Regional Health Promotion Centre, Khon Kaen (iv) Upper Northeastern Pharmacy Association (v) Khon Kaen Provincial Health Office Could you provide us with an update on the latest developments of each of the three components – smart ambulance, preventive healthcare service and blockchain & analytics? (Response from Ms. Chaturapron) Smart ambulance: This project is initiated by the trauma and critical care centre, Khon Kaen Provincial Hospital. It consists of the Ambulance Operation Centre or AOC, a technology designed and developed to reduce limitations caused by the distance and time taken to travel to the site.  With the AOC system, everything can be connected through the Internet and the barriers for the ambulance to reach the exact position without consuming too much time are greatly reduced. Ambulances can accurately reach the patients in a faster time. GPS will indicate the exact site and the nearest ambulance will be assigned. As such, the patient has a higher rate of survival. All necessary information for doctors to make critical decisions such as vital signs, blood pressure, patient situation are sent to the hospital in real time by snapshot or video stream displayed on the screen. Staff at the hospital can prepare appropriate methods for the patient prior to the arrival of the ambulance. (Response from Prof Cholatip) Preventive healthcare service: This service was initially launched using smart wristband to monitor the steps from the selected population. Regarding the health sensors platform, Manee Project, 30 households that have elderly residents with chronic diseases were selected for the installation of sensors. The installment has begun in October 2018 and will be expected to be completed by the end of November 2018. (Response from Dr. Apichat) Health analytics: Prototypes of the smart ICU have already been completed. Data from the respirators and vital sign monitors were sent to Google Cloud Analytics. The system can display warnings for 10 minutes before the blood oxygen desaturation. The next step is the integration of EHR data and customising it to the UI and alert system. Health information exchange via blockchain is also being developed. CAT Telecom, which is a government-held telecommunication company will provide the infrastructure for information exchange. The first project will be on drug information exchange followed by logistics and material flow. Data standards such as SNOMED CT, LOINC, GTIN, and ICD code will be used alongside the project. As part of the preventive healthcare service component, preliminary data from 30 elderly subjects indicated the acceptability of a smart wrist band, together with additional devices to monitor blood pressure, sugar levels, movements and even eating patterns/habits. How is the data from these different devices going to be integrated with electronic medical records from the healthcare providers? What are the opportunities and challenges of such an integration? Above photo: An elderly resisdent tries on smart wrist band as part of the preventive healthcare service component of the Khon Kaen Smart Health project. (Response from Prof Cholatip) Data from each device can be integrated with EMR using the Thai unique ID for identification purposes. The most important step is to apply standards for home use/wearable device connectivity such as Continua to all participating devices. The challenges are mapping values from various devices in to a single standard and getting the data from each cloud storage to a single data lake. Working with local and international device companies on behalf of the Digital Economy Promotion Agency (DEPA) and Khon Kaen Smart City will be one of the keys to the success of the project. Working with the local communities is an important part of the Smart Health Project. What are some early lessons learnt from working with the local communities? (Response from Ms. Chaturapron) Local communities such as universities, chamber of commerce, health tech associations, local drug stores and people working with sand boxes have been actively involved in this project. The Digital Economy Promotion Agency or DEPA, is the main organiser for the cooperation. Sharing the vision and knowledge is very important. Communities need ongoing support if change and sustainability are to be achieved. Are there future plans to expand the Smart Health Project to other parts of Thailand? (Response from Dr. Chavakij) Following Thailand’s 20-year-strategic plan and eHealth Thailand, the national health information system, telehealth and big data analysis are major pillars for healthcare. Our Khon Kaen Smart city project can be the spearhead to the goal. Prototypes from the project will be expanded to cover every health region in northeast Thailand in the next couple of years. Working with government organisations such as DEPA, Ministry of Public Health help us to integrate and customise our project to the whole picture of our country. Prof Cholatip is a speaker at HIMSS AsiaPac 18 in Brisbane this November.

Both the clinician and the patient hold an important piece to the care puzzle, according to Kristina Sheridan, head of the enterprise strategy and transformation department at the nonprofit MITRE Corporation.  The physician has expertise in treating illness, whereas the patient is the authority on living with the condition, she explained at the Society for Participatory Medicine in Boston this morning. But transferring the patient’s life experience into a useable dataset can pose challenges.  “We hear about patient-generated data all the time,” Sheridan said. “But when you hear about the context of that data, most of the time right now it is around wearable devices and monitoring devices. … People aren’t talking about the other type of patient-generated data, what we call active patient generated data — the patient voice.” Webinar: Big Data, Big Insight: A Conversation with Healthcare Analytics Leaders Sheridan knows about the patient perspective from her own life experiences caring for her two children, both of whom contracted Lyme disease when they were in grammar school. This condition led to major complications for her daughter. The symptoms of her condition became so overwhelming that her daughter started to think of them as the new normal and stopped mentioning them to doctors. That was when Sheridan put together an Excel spreadsheet to help keep track of her daughter’s symptoms.  “I finally had something to back up that gut feeling that something was off. When progress was slow and my treatment was plateauing, the data helped encourage me that things were still getting better,” Kate Sheridan, Kristina’s daughter who videoed into the session remotely, said. “But when things declined it was still beneficial to see. Sometimes between my myriad of symptoms it could be hard for me to identify and communicate exactly what was getting worse. Small changes in my condition could mean an infection or a bad reaction to meds and catching those symptoms prevented a trip to the emergency room. The data helped legitimize what I was feeling and gave me confidence in evaluating and communicating my own state of health. Data has power.” This experience prompted Sheridan, a trained engineer in astronautics and space, to change careers. She now works with the research nonprofit MITRE to develop a digital Patient Toolkit, which lets patients digitally record symptoms, treatments and medications. It also lets patients communicate with their providers.  While she was inspired to get involved with patient data because of her personal journey, the Patient Toolkit comes from a slew of additional research. MITRE worked with the University of Virginia to listen to what patients wanted from a tool like this. The team found patients were mostly managing their own condition without digital tools, that patients wanted to be heard by providers and felt positively towards e-health tools.  The team also worked with Carnegie Mellon to listen to what providers wanted from patient generated data. The answer was longitudinal severity and compliance data.  Sheridan pointed out that most of the patient experience happens away from provider’s office. The toolkit was developed to remedy this gap.  “I don’t know any other experts who have no tool to support them in the 99 percent of time they are applying their expertise,” Sheridan said. “Patients are at home managing their own chronic condition the majority of the time, and they are in the clinic for [a small] amount of time.” The toolkit was designed to help facilitate that patient input and let patients see their symptoms over the course of time.   “The best care is when patients are included and acting together,” Sheridan said.   

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