Eric Horvitz, MD, PhD co-director, Microsoft Research

• from data to predictive models to decision-making
• costly challenge of re-admissions: they worked with Washington Medical Center, which had been accumulating lots of data on ER visits. Built a predictive model of readmissions: identified relevant evidence out of 25,000 indicators: if “fluid” is in the record, that’s an indicator the person will be readmitted.
• Created tool called “Readmissions Manager.
• running this program worldwide
• example of Congestive Heart Failure. $35 b. annual cost. Should you invest in an intervention program?
• another big challenge is hospital-associated infection. $20 b.  a year cost. In top 10 causes of deaths in the US. Beyond looking at EMR, they introduced analysis by space and time. Another factor is the patient’s path through various parts of the hospital: could predict what % of the patient population got infections in what part of the hospital. Analyzed various factors, such as which unit of hospital they were in, who was the attending doc.
• New kinds of predictions: “surprise models” — looked at people who were re-admitteed in 72 hrs. for a condition that wasn’t on chart before.
• new set of data: patients searching web. For example, nutritional content in logs of downloaded recipes. (Maine people downloaded a lot of recipes with high carb content). This was because they found a lot of older ppl in DC area had downloaded recipes with high sodium content in holiday season.
• looked at Twitter feeds about birth of child — overlaid lots of people who’d just had babies: about 12% of women showed signs of crashing in terms of mood (post-partu m depression is underreported). Suggests you might be able to intervene in advance to help them.

• Connected Wellness
  • patient controls record
  • each patient has “personal circle of care” — providers, relatives, etc.
  • plain-English plans from templates
  • links to videos, etc.
  • can track vital signs, subjective feelings, etc.
• Reflexion Health
  • platform to reach patient in home. TV perhaps most used device in home? Why don’t we use it for health?
  • Use Kinect
  • TV-based PT
  • 40-50 exercises in system now

Carl Dvorak, ceo of EPIC, talked about amazing range of ways they’re using apps to integrate patients into EMRs:

• lots of emphasis on mobile devices
• messaging & e-visits
• mobile check in
• patient-reported outcomes

Presentations @ Center for Connected Health Symposium:

• Michael McGarry, Ascension Health
  • directs their Innovations Accelerator Team.
  • how do we engage patients during 99% of time when they’re not getting care?
• Eric Rock, CEO, Vivify Health
  • emphasis on connection and simplifiecation
• Dr. Dmitri Talantov
  • he’s with Janssen Healthcare Innovation @ J & J
    • integrated care systems,
    • focus on orthopedic, cardio-vascular rehab
    • need strong incentives for providers to engage under new delivery systems
• how do you engage consumers?
  • barriers: need is for high-risk patient who doesn’t understand the tech
  • new incentives in several states for daily reporting
  • may have population that doesn’t want to engage — want to sit on couch!
  • “restaurants probably have more impact on their condition than anything we can do”
  • “insane opportunity in keeping people healthy!”
• how do you sell virtual care to providers?
  • “pay them!”
  • simplicity for them
  • can’t expect them to interrupt their routines for something new.
• patients own their data