Digital Health: Health for All?

Transcription

1 Digital Health: Health for All? Thomas Karopka EFMI LIFOSS WG co-chair IsfTeH CCTOS WG co-chair LIFOSS WG EFMI LIFOSS WG / IMIA OS WG 1

2 Agenda Does DH provide solutions for low resource settings? What is Digital health? Universal Health Coverage (UHC) Global Burden of Disease Study 2017 Dominating Trends: mhealth, Big Data and AI in Medicine Examples: Point of care testing (POCT) Examples: Mobile Health Free and Open source approaches FLOSS ecosystem for health care Conclusions 2

3 What is Digital Health? Definition: Digital health is the convergence of the Digital and Genomic Revolutions with health, healthcare, living, and society. As we are seeing and experiencing, digital health is empowering us to better track, manage, and improve our own and our family s health, live better, more productive lives, and improve society. It s also helping to reduce inefficiencies in healthcare delivery, improve access, reduce costs, increase quality, and make medicine more personalized and precise. Source: 3

4 What is Digital Health? Source: 4

5 Universal Health coverage (UHC) Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. Source: 5

6 Universal Health coverage (UHC) This definition of UHC embodies three related objectives: Equity in access to health services - everyone who needs services should get them, not only those who can pay for them; The quality of health services should be good enough to improve the health of those receiving services; and People should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm. Source: 6

7 Global Burden of Disease Study 2017 The Lancet , DOI: ( /S (18) ) Copyright 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions 7

8 Gapminder Source: 8

9 Source: 9

10 Source: 10

11 AI in Medicine 11

12 Mobile Diagnostic 12

13 The Malaria System MicroApp: A New Mobile DeviceBased Tool for Malaria Diagnosis Conclusions The development of a low-cost, rapid, and accurate diagnosis tools for mobile phones and tablets that can be used in health centers in remote communities without the need for specific expertise could help break the accessibility barriers of low-resource countries. The tool that we developed can achieve this by virtue of its accessibility and on the spot, real-time diagnostic potential that may facilitate immediate treatment. Oliveira, Allisson Dantas, Clara Prats, Mateu Espasa, Francesc Zarzuela Serrat, Cristina Montañola Sales, Aroa Silgado, Daniel Lopez Codina, Mercia Eliane Arruda, Jordi Gomez i Prat, und Jones Albuquerque. The Malaria System MicroApp: A New, Mobile Device-Based Tool for Malaria Diagnosis. JMIR Research Protocols 6, Nr. 4 (25. April 2017). 13

14 AI for malaria diagnostics 14

15 Example: The BLINK Box: Open diagnostic platform for point of care testing (POCT) 15

16 Example: The BLINK Box: Open diagnostic platform for point of care testing (POCT) The BLINK Box has the capacity to combine different diagnostic concepts, new biomarkers and analytical processes together into one single, coherent testing solution. The system is designed to receive and process from standardized sample collection tools. The new BLINK format will dramatically reduce cost and improve test performance. The product architecture will provide the operator with the ability to create individual test menus for each sample. For the first time test random access is being brought to the point of care. 16

17 Example: The BLINK Box: Open diagnostic platform for point of care testing (POCT) 17

18 mhealth studies in HICs and LMICs According to the WHO [1], non-communicable diseases (NCDs) cause 38 million deaths each year, nearly 75% (28 million) of which occur in LMICs. CVDs are responsible for most NCD deaths, namely 17.5 million people annually, followed by cancers (8.2 million), respiratory diseases (4 million), and diabetes (1.5 million). The four main NCDs combined account for 82% of all NCD deaths. In addition to study distributions, these numbers necessitate the examination of NCD studies appearing in our review among HICs and LMICs [2] [1] World Health Organization. Noncommunicable diseases. [Internet] [cited 2017 Feb 21] (2) Abaza, Haitham, and Michael Marschollek. MHealth Application Areas and Technology Combinations*. A Comparison of Literature from High and Low/Middle Income Countries. Methods of Information in Medicine 56, Nr. 7 (8. August 2017): e

19 mhealth Diabetes Studies in HICs and LMICs Abaza, Haitham, and Michael Marschollek. MHealth Application Areas and Technology Combinations*. A Comparison of Literature from High and Low/Middle Income Countries. Methods of Information in Medicine 56, Nr. 7 (8. August 2017): e

20 487 mhealth programmes between 2006 and 2016 in sub-saharan Africa Kenya: 71 Uganda: 54 Tanzania: 50 20

21 Standard and Tools for mhealth integration 21

22 22

23 23

24 District Health Information System 2 24

25 The i2b2 transmart Foundation is a member-driven non-profit foundation developing an open-source / open-data community around the i2b2, transmart and OpenBEL translational research platforms. The i2b2 transmart Foundation enables effective collaboration for precision medicine, through the sharing, integration, standardization and analysis of heterogenous data from healthcare and research; through engagement and mobilization of a life sciences focused open-source, open-data community. 25

26 FLOSS in health care in 2008 Approx. 80 Systems registered in 2008 Source: 26

27 358 projects 111 companies 422 publications 27

28 Terms in the context of FLOSS in PubMed Search term Whole manuscript Title Open source software Free software Free and open source software Open access Open data Open science Open standards Open hardware Open drug discovery 2131 (2000) 568 (1990) 87 (2004) 256 (1999) 57 (1990) 11 (2008) 5965 (1973) 938 (1990) 454 (2003) 100 (1982) 34 (2009) 9 (2012) 1611 (1973) 161 (2000) 109 (2005) 17 (1993) 14 (2013) 4 (2012) EFMI LIFOSS WG / IMIA OS WG 28

29 Bioinformatics Software Source: 29

30 30

31 FLOSS in Health Care recognized by report of the Federal Ministry for Economic Cooperation and Development of Germany Report recommends open digital ecosystems based on open source Systems mentioned: OpenMRS, DHIS2, ipath 31

32 FLOSS in health care ecosystem 32

33 What is needed for a successful uptake of Digital health? First of all: An open Digital Ecosystem Interoperability: Standardized open interfaces Education: Digital skills of the health care work force Digital health literacy of citizens Professional Support services for Health IT Open Hardware plattform(s) Mobile solutions for citizens..collaboration ;-) 33

34 Thanks for your attention Contact: Thomas Karopka Mobile: