7 min reading time

As originally asked by Carl Mayer

I wonder aloud if the industry’s words are matched by our actions. I read a lot about how big data is going to change our businesses and improve patient outcomes, but I’m not seeing much of it in practice so far.

For example, if you could get real-time data out of your already field-deployed medical devices, how would you use it? Think expansively. Would it actually contribute to better patient outcomes? A better understanding of how your products are used? More sales for you?

Do you have an infrastructure to use the data effectively? Would you build that capability?

I’m genuinely interested to know.

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Nurlan Usubaliev
For example insulin pump with feedback coupling.
Projects with small dose, built in human body “pharmacy”, based on memos.
I’ve heard (radio) news about using artificial intellect in Hitachi to manage real logistic store. AI gave orders to human. So AI uses those big data. For tens of years by logic of Tomas Kun paradigm we just collect data to make a jump.

Tom Nonnemaker
Carl, I’m working with a start up which intends to provide real time monitoring service of foot skin temperature, for diabetics with neuropathy, prone to ulcerations. this monitoring, and alerting of caregivers and insurance companies to ensure treatment can be more proactive, rather than reactive, and thus also reduce cost. www.mr3health.com

Lindsey Dvorak
Data is only as good as the people that use it. People love to mine data but so few people actually use it properly. Our industry is immersed in data that is rarely used. It can be very frustrating.

Aaron Liang
I think of how valuable real-time data is depends on the data itself, and whether or not it is quantifying something that would have been previously hard for an individual to assess effectively using conventional means.

For example, the startup I work at develops smart surgical tools that provide real-time intraoperative measurements during orthopedic surgery. This information is valuable in helping surgeons quantify data that assists with clinical judgements that they would previously have to eyeball with some uncertainty. Real-time data can also be used to evaluate and assess how well products are performing and being used in the field which can improve troubleshooting and user experience. When diagnosing complaints or other performance issues for our product having access to real-time data from the deployed device helps us in making informed decisions and narrows the scope. The opportunity exists, I think a key question is do we know how to leverage that information effectively?

56d87ef1855732.08517842@limsforum.com
You may put real-time data into the wellknown “7-Lines Diagram” (cpk) and get quality information. Could this be valuable for you?

Stewart Hardie
At GeoNavo.com we collect and use realtime data to improve the safety and quality of life for seniors in care facilities, primarily memory care.

Carl Mayer
Thank you Tom – sounds like a great idea. Is this deployed as a standalone product or would it be placed alongside another neuropathy treatment product? Will your Client offer to the end customer the data, reports, some combination, other? What in your assessment is the valuable output for the end customers?

Carl Mayer
I understand Lindsey…I have experienced that at times too. What do you think we could do to make the data more usable?

Carl Mayer
Thanks Aaron. When you say “provides real-time measurements”, is there any processing of the raw data prior to it being provided? If so, how did you determine what to provide? What backend data engine to use? It seems to me that the lack of a standard toolset for getting data from the point of care to the people who need it is the major bottleneck?

Carl Mayer
Thanks Stewart – same question here: how did you decide what metrics matter? Did you use third party database hosts (Amazon) to build your product or did you “roll your own”? BTW, my complements to you for REALLY helping to solve a big problem with your products! I have known several people including relatives with Alzheimer’s and the safety and dignity concerns were very sad.

Carl Mayer
Thank you for the idea Bertold. What quality information would I get and what would it indicate? How could I use that to improve patient outcomes? Lower healthcare cost? Increase product revenue?

Stewart Hardie
Resident Bob never gets hostile if he spends 3hrs a day with a caregiver in the lounge. There are many ways we use this data to predict behavior and with that create a greater quality of life for our seniors. Sorry for being so wordy 🙂

Stewart Hardie
Carl, Our platform is standalone but can be integrated with existing systems. The original idea behind the platform was to offer the care giver realtime notification and location when a resident is in distress wether it be a slip or fall, wandering or a resident to resident hostile situation. From this the metrics grew and we chose to emphasize the ones that can help us predict behavior in the future. The base metrics we offer are location dwell time (dining, bedroom, lounge etc.), resident to resident interaction, resident to caregiver interaction and incidents. All metrics are based on time and precise location. Our plan is to gather this data and compare it to incidents (hostile, wandering, etc.). With this data we will know time of day and location of incidents and we can look back at the residents recent movement history and learn possible triggers or preventers such as Resident Bob consistently wanders after spending too much time with resident Steve or cont…..

Stewart Hardie
When I first thought of the uses, it was response time for dementia patients in crisis, then it was more long term, predictive situations but now I can see the benefit for many situations in health care other than dementia such as psychiatric care. This technology has a lot to offer in many fields and I feel fortunate to help in any way I can.

Stewart Hardie
When I first thought of the uses, it was response time for dementia patients in crisis, then it was more long term, predictive situations but now I can see the benefit for many situations in health care other than dementia such as psychiatric care. This technology has a lot to offer in many fields and I feel fortunate to help in any way I can.

Carl Mayer
Thanks again Stewart. You appear to have started with a clear fundamental value proposition and increasing the utility as you gather more data about how you can help.

Does anyone have any insight on the evolution of tools that help to use/process the raw data into something an end user finds useful? For instance, sensors (GPS, SpO2, HR, etc.) produce the data and send it to the Cloud, but most don’t want raw data…they are looking for trending or some post-processed result. Do you see tools for making this easy or is it still a do-it-from-scratch every operation?

Dan Cilley
This discussion is occurring more and more everyday with my clients. How can we leverage this important piece of data in the short term rather than just aggregating it for a longer term strategy?
As there are resources constantly being developed to achieve this objective they are currently a piece of the puzzle not a solution. This being said it is still a from scratch scenario, but with the addition of these resources a custom solution can be created to meet the ultimate objective.
As an example, a current client of mine wanted to take the available information being provided from the device and include it within a continuum of care strategy. The data output was integrated into the patient EMR record and simultaneously used within the transition of care strategy following surgery so that all of the contributing parties could have visibility and awareness. This in turn provided a significant increase in the quality of care given to the patient.

Stephen Griffin
I have no infrastructure to objectively use such data and real-time is really not that important. But I would like data, none-the-less. Any data. I’ll build a database if I have to use IBM punch cards ;-). I send out questionnaires but the silence is deafening. (No electronics in my devices…) Good reports could aid in marketing. Bad reports would seed innovation. I’ll take anything! Would I get better (any) response rates with a web-based survey? I don’t know…

Patrick Healy
Very interesting discussion just following for now.

Monesh Patel
One way to use data more effectively is to use it for “prior information” in Bayesian statistical analyses to predict outcomes better or reduce sample sizes of clinical trials….the trick is of course to use the data “correctly” as Lindsey points out

Michael Kremliovsky
This is an interesting exchange and I would like to point out that suggestions come mostly either from a theoretical view (“great idea”) or from a startup’s position (yet to be proven). Of course, we have some elements of capturing real-time data such as in smart infusion pumps case or vital sign monitoring. However, there is very little analysis being done on that data yet and business cases are neither proven nor obvious. There are a few exceptions. Insulin pumps and glucose monitoring, for example, have systems in the operation now that deliver data and processing helping physicians and patients to adjust therapy.

Andrew Collins
It is now relatively easy to provide/collect data from technical devices, whether medical, consumer appliances, computing or others. How valuable it is depends to a large extent on the quality of both the analysis tools available and the intelligence dollies.

Andrew Collins
(Excuse my fingers!) …and the intelligence applied to that analysis. There is a huge amount of data – more than ever before and growing fast – being produced across the board, so the ability to search for relevant data and produce relevant answers to the questions that drive your business is critical.

Bobby Shah
Look at ICE “Integrated Clinical Environment” Julian Goldman Tracy Rausch Stan Schneider

Seth Whitelaw
It is a great question. In the compliance world, we’ve been hearing the same thing about how big data will transform things. So far, I have seen very few who have either the understanding or the capacity to utilize the data effectively. For most of my clients it just sits in various repositories for now.

Mike Wasyliw
I work in an operating room doing inventory of all disposable items, so around $1.5 million. If you were to get data on something like my Anspach Blu-5 drills or the Ethicon Harh36 36 cm harmonic tissue sealer, the sales rep or the nurse (hopefully someone the MD actually likes and that they are having a good day) to get the doc’s opinion as to what they think about the product. Data like what they use it for, any complaints, anything they want to improve upon, ease of use, favorable outcomes with the patient etc. Even though this would be as real time as you can get, the problem with collecting this data is most of the time the MD’s need to hustle off some place else they need to be like to the next surgery or someone code’s while on the table. Maybe collecting data at the office would be better or you send an e mail or something. As long as the doc’s don’t feel hassled.

Jennifer Papastephanou, MS, RDN, CDE
I use the BlueStar diabetes management app regularly with my diabetes patients. The app not only gets the patient organized, but provides them with real-time coaching.

Carl Mayer
Wow – great input! It appears that some are beginning to adopt various systems that allow collection and use of the data. Others only collect the data and then don’t have time to use it. And others do not have the tools or do not see the use. It appears as a very fragmented technology at this point. I reviewed OpenICE but had not heard of it in the past – not sure of how widely accepted this architecture is. Seems like someone would offer and end-to-end solution but don’t see that happening right now?