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7/30/2019 Technology Trends in health care
http://slidepdf.com/reader/full/technology-trends-in-health-care 1/41
Technology Trends
I n
Healt h Care
Poornima Mohanachandrani2iTeleSolutions
7/30/2019 Technology Trends in health care
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Out line of my talky Healthcare Challenges
y Cardiac Monitoring
y Medical Imaging
y Tele Medicine
y Summary and Q&A
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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
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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
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Diabetes
Sources: WHO report on diabetes
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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
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Technology I nnovat ionJourney so far & Fut ure
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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
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12 lead ECG
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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.
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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
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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
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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.
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Data Analysis
Analysis – Large amount of Data Generated, Aid disease
detection, Disease quantification
Heart Sound AnalysisECG waveform Analysis using Labview
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ECG Data Analysis for Heart
Rate Var iabil it y
RR Interval (Ventricular cardiac cycle)
Poincare Plot
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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
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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
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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
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Echo cardiogram -Ult rasound
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Coronary Angiography
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Expert ise Shor tage
10,000 People / Cardiologist
100,000 People / Ophthalmologist
Th f l i i f i d
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Tele Medicine
The use of electronic information andcommunications technologies toprovide and support health care when
distance separates the participants.
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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
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mHealth ‐ Why
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mHealth ‐ Why
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1G1G
AnalogCellular
Voice only
2G2G
DigitalCellular
Voice Pager
10kbps data
3G3G
Wide-BandDigital
Cellular Video
300kbps-14Mbps
2.5G2.5G
Voice
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
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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
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mHealth
4
Electronic Pill Reminder
Modified Nokia phone with breath
analyzer – from AppliedNanodetectors
Built in ECG recording –EPI Life – Singapore based Ephone International
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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
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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
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Questions ?
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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