Microsoft AZURE IoT Connect 2017 #IoTconnect

¡Da vida a tus cosas y aprovecha todo el poder de tus datos! Fernando Moreno – Digital Advisor - Connecting technology, administration, and care

Healthcare Systems

Administration and Care

Compliant Tools Resources Community

Systems Asset Risk Secure mobile Data, statistics, Claims Education, Electronic Clinicians Providers Patients and apps management management devices metrics, and billing research, records and reports and training Integrated health transformation pillars

• Integrate systems that effectively bridge care and patient

• Track data and communications to enable accountable care Digital • Empower caregiver and patient to help Health improve outcomes Integrate. Track. Empower. Connecting patients with healthcare

Laboratory Video reporting Hospitalization and testing and diagnoses and hospice Test and laboratory alerts

Outpatient care Therapy and Patient rehabilitation portals Health Digital history and Patients records Healthcare Personal device access Preventative care Office and in-home visit Electronic health Case scheduling and medical Regulatory compliance management records and risk management Deliver actionable health insights

Patient and health data Predictive health queries and reports modeling and visualization

Identification of Alignment of health and claims patient data with Aggregate Analyze patterns health benchmarks Compilation Visualization and statistics

Data source Patient data identification alignment and and integration interpretation Apply Insights Improved Dynamic, data-supported validated healthcare decisions patient insights

Predictive health analytics, workflow management, and best practices Customer Use Case | Remote Patient Monitoring

DT Pillars: Engage Customers Business Process: Service Delivery

Sensors Increase accuracy Use Case Overview Centrally located data Remote Patient Monitoring involves following people with chronic Activity Trackers Reduce cost of care diseases and monitoring all data that comes from the patients using a Customize care plan variety of devices. Analysis of data helps detecting anomaly situations Smartphones and taking preventive actions before problem becomes crisis. Provide proactive care Advanced Analytics EHR Data Remote Patient Monitoring helps create care plans and take corrective Reduce hospital admissions actions that prevent hospital admissions. Patient Surveys Automate alerts

DATA INTELLIGENCE ACTION

Business Drivers Digital Capabilities Business Outcomes Get Started

» Meeting increased demand due to » Customer data management and » Reduced hospital admissions and COO Book of Dreams growing and aging population analytics readmissions Healthcare Book of Dreams » Shifting from reactive to proactive » Complete hybrid cloud approach » Enhanced patient care and safety Patient Engagement Playbook health system providing health organizations with » Physicians providing optimal care with Healthcare Digital Maturity Model » Responding to individual’s health system flexibility actionable data Intelligence Suite Essentials status in real time » Robust data protection practices while » Preventive action for patient before Customer Stories » Reducing hospitalization of people with retaining full ownership & control of problem becomes crisis sensitive data chronic diseases » View to patient’s personalized care » Monitoring people at home instead in » Address wide range of international, plan country & industry-specific regulatory an elderly or care home Reduced emergency room visits requirements » Predictive Human Telemetry

The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company Anywhere, anytime patient care Empowered care The solution securely connects to smartphones and devices such as blood pressure and glucose meters in patients’ homes, and integrates the data with a program prescribed by a Kaiser Permanente clinician. Real-Time Data Enhances patient care and safety through near-real-time, remote monitoring of vital signs and automated alerts Improving efficiency •Provides better insight into patient data, improving efficiency and workflow for nurses, dietitians and other staff. Rehabilitation Kinect Hololens Assisted Rehabilitation Experience

The project aims to support remote rehabilitation scenarios, with the support of motion detection to track the quality of the exercises and to give the physician a way to figure out how the patient is performing

Real-Time Data The Kinect recording is analyzed in near-real time and scored using Stream Analytics and Machine Learning Fastest recovery Continuous Improvement

Training partner The Golf training solution is observing the body movement using Kinect and can analyzes and corrects your body motion throughout your swing. The trainer can predict the height and distance of the stroke and the development over time during several training sessions Real-Time Data The Kinect recording is analyzed in near-real time and scored using Stream Analytics and Machine Learning Improving efficiency Provides better golf statistic over time and have the ability to replay captured training session with an professional golf instructor to get recommendations on how to improve IoT Integrated Architecture Capture and analyze biometrics

Connect and scale Analyze and act Integrate and transform with efficiency on new data business processes

Analytics

Device Registry

Real-time Rules and Actions operating And systems more Dashboards & Visualization Accelerate time to value with preconfigured solutions

Get started in minutes with 2 Expand with other human biometrics devices and and one of the partner solutions build your own healthcare solution

Highly visual for your real-time operational data Explore the near-real time capabilities Integrate with back-end systems Predictable Human Telemetry Framework Our approach to a remote monitoring project

Imagine if you could monitor health of thousands of people located around the world without physically inspecting them. Or use Kinect and wearable sensors to accelerate rehabilitation or to improve performance of sports athletes.

Establish Profile the Determine Categorize Define Operationalize 1 monitoring 2 devices 3 additional 4 the data 5 alerts and 6 the solution objectives involved solution actions and scale and components requirements

Meet Dr Mark

Mark is part of an ever aging workforce, looking after an ever aging group of people! Mark wants to help as many people as he can, of course, and is eager to use Predictive Human Telemetry to help more patients improve more over time.

It’s a different way of working for sure, but his knowledge gets to help more people, and he likes that.

Goals Help patient get better faster Help more patients in the same time Meet Sarah

Sarah has lived a long and good life with her husband, Otto. They are both retired for 15 years and live a quiet but comfortable life at home. Sarah was recently diagnosed with COPD and low blood pressure. She is struggling to stop smoking, but is determined to do it, for her health, and for Otto. She is frail in general and needs extra oxygen a lot of the time.

Goals Managing her condition Leading a better life in the time she has left

Wears Oxygen wristband Blood pressure checker Microsoft Band Smart Phone with an Health app At-home blood pressure When her wristband notified her measurement on to attach her blood pressure Microsoft Band cuff to get a reading.

”The system speaks for me when I’m not with you”, Dr Mark explained to her. She trusts Dr Mark, even if she doesn’t trust technology just yet…

The data is automatically collected and stored in her records. Sarah’s blood pressure has been lower than usual for several consecutive days.

The system has identified a negative trend in Sarah’s blood pressure data, which triggers a notification.

Thanks to machine learning, Dr Mark is able to monitor his patients even though they never leave their home.

He is kept up to date on everyone’s status, and is able to identify potential problems and take action much sooner than he would otherwise have. Demo

Remote health monitoring using Microsoft Band and Band Sensor Monitor Meet Teresa

Teresa is an adventurous lady with a busy schedule but a lot of willpower and some discipline. She plays golf with more enthusiasm than skill, but wants to take the step up to competitive level. To do this she has the support of a personal trainer to create her exercising schedule, but she does most of the work on her own, independently. Well… she gets a little help from technology.

Goals Get fit Qualify for the local golf competition finals

Wears Microsoft Band Smart socks Teresa and her personal trainer (PT) set up an optimized training schedule together.

The PT explains how everything will work, utilizing the mirror neurons, when she works out by herself. When she starts the system at home, she is automatically logged in to her profile, just by standing in front of the Kinect. When logged in, she can see all her exercises, her personal Making sure it’s you… profile.

There is a lot of predictive data for each exercise. It will take a lot of time to get to her goal, clearly, even though she is helped by the mirror neuron stimuli, but Teresa is willing to invest in it. Mirror neurons Kinect She finds the appropriate exercise and watches the video.

Her mirror neurons are activated, mimicking the motions in her brain, as she watches the instructor perform the exercise.

Her brain learns to perform the motion, even without her doing anything, her personal trainer explained. It’s quite fascinating! Almost there, straighten your After watching the video, she front knee to 90 repeats the exercise. degrees.

Her devices gathers data about motions, heartrate, temperature.

When she doesn’t do it right, the system helps her get there by providing useful feedback in real time. After her workout is done, she can review the data. As can her PT!

They both have a look at the actual data, and compare it to the desired state. Together they can work on how to improve over time. Every day Teresa also practices her golf stroke in front of the system. She watches the expert in the video, and then repeats it herself.

Kinect Microsoft Band After each session she looks at all the data in detail.

By analyzing and aggregating data, and comparing it to historical data, the system gives her incredible help to improve even as she gets a lot better, because the data is so precise.

She can see the evidence in the data, that her hard work is really paying off! She really is continuously improving, ever so slightly every day. It took a lot of time and hard work; first her brain learned to perform the tasks, then after a lot of hard work, so did her muscles.

Teresa improved her skill tremendously, and played one of her best rounds of golf ever when the day came!

Thanks to KHARE, Teresa is in better shape than ever before, and has raised her level of golf skill from casual to competitive level in just some months time! Demo Claudia Claudia, today…

• got injured and needs rehabilitation frustrated

annoyed Thanks to KHARE, tomorrow, Claudia…

• Will be able to do part of the rehab at home

• will not need to go everyday Natural User Interface

Capture of gestures and movements to see and interact with virtual and added elements.

Microsoft Kinect

Kinect HoloLens* Assisted Rehabilitation Experience goes beyond video communication adding three-dimensionality and intelligence. It helps the doctor to verify the quality of the exercises while assisting the patient in the execution. * Hololens integration, will be added in future release Future improvements- Augmented reality

The doctor can see the movements of the patient in a three-dimensional space without the need for the latter to have expensive and sophisticated medical devices.

• Delocalization • Telemetry • Data collected when doctors are not present Patient experience journey map Discuss satisfaction Chat with with others physician or nurse Use portal or apps to about symptoms schedule an appointment or receive guidance Choose physician, Schedule an Schedule if needed, based appointment by appointments Receive reminders on evaluations Experience ? self or with with care team Meet with care for follow-up care symptoms assistance members team members, as needed Access history, Visit the physician in lab results, person or remotely insurance claims Visit pharmacy Report symptoms for prescriptions Obtain prescription Receive refills treatment plan Treat issues Receive lab orders Chat or meet with Chat or meet physician or nurse with physician to discuss progress Schedule about results appointment with lab Visit lab for tests

Digital Hotspots • Interactions with other care team members • Seeking health information online • Appointment scheduling • Filling, refilling and approving refills for prescriptions • Choosing a physician or facility for • Accessing electronic health records (EHR) treatment • Reporting satisfaction • Sharing EHR /EMR with other physicians • Remote interactions with physician and • Ongoing patient care and patient clinicians • Digitally receiving prescriptions reminders 37 The network of physical

objects that contain “ ” embedded technology to communicate and interact with their internal states or the external environment.

Source: Gartner IT Glossary http://www.gartner.com/it-glossary/internet-of-things/

Kaiser Permanente Anywhere, anytime patient care

Objectives Tactics Results Kaiser Permanente was A remote patient • Enhanced patient care and safety exploring ways to provide care monitoring system based through near-real-time, remote to its patients in the most on Microsoft technology monitoring of vital signs and convenient place for them, that securely connects to automated alerts while improving connectivity smartphones and devices • Reduced outpatient visits for routine between hospitals, clinics and like glucose meters, and checks and reporting of vital signs medical devices to enable integrates the data with a • Improved insight into patient data secure, remote access to program prescribed by a patient data. clinician.

“There’s far less expense in having the patient record their vitals remotely from home, instead of coming to the clinic… And because it’s easier for the patients, they’re more willing to participate.”

Mehul Shah Associate Director of Product Engineering, Cognizant Technology Solutions D+R Therapy Improving physical therapy with mobile app

Objectives Tactics Results D+R Therapy sought to Created a motion-sensing • Enhanced communication between increase post-op physical mobile app that enables therapists and patients, resulting ing therapy success by improving physicians to plan better care and fewer repeat injuries communications between the treatments for each patient, • Increased patient capacity by patient and physical therapist. reminds them to complete allowing therapists to monitor the regimen, and ensures patients with fewer in-person at-home exercises are appointments performed properly. • Ensured the safety of patient data by storing on a secure database

“Microsoft was vital to us getting D+R Therapy HIPAA compliant, which opens up the US market for the app. Because of Microsoft, we have been able to expand the business overseas much faster than we anticipated.” Vivian Austin Technical Lead, D+R Therapy Care Innovations Remove communication barriers

Objectives Tactics Results Create healthcare technologies Using Microsoft • Migrated over 4,000 residences and that foster healthy independent technology, GE and Intel 50 facilities to new system living at home and in senior partnered to • Created easy-to-deploy system for housing, and to reduce the add predictive analytics and new IoT sensors and connected barriers to adopting remote simplified update devices care management solutions deployment to their data • Analyzed over 6.8 billion data points involving IoT. management platform, to provide treatment simplifying IoT sensor recommendations integration.

“We can show customers that they can cut costs and improve patient adherence to treatment protocols. For example, if we can keep a diabetic’s blood glucose level steady, that is a huge value to the patient as well as to those who pay for that patient’s care.”

Kumar Subramaniam Chief Information and Technology Officer, Care Innovations Dartmouth-Hitchcock Proactive, personalized healthcare

Objectives Tactics Results Providing a technology A cloud-based system that • Saved millions of dollars in platform to health synthesizes vast amounts readmission costs, unnecessary organizations that ensures of real-time and historical visits, and missed work healthier people who are more patient data from myriad • Improved patient monitoring with in control of their own well- sources to predict when real-time 360-degree views of being, receiving proactive care care is needed and create health, mood, and behavior at home where they are most personalized, evidence- comfortable. based treatment plans.

“It’s a seamless technology solution.”

Nathan Larson Director of Remote Medical Sensing, Dartmouth-Hitchcock https://blogs.microsoft.com/business- matters/2015/07/13/dartmouth-hitchcock-ushers-in-a-new-age-of- proactive-personalized-healthcare-using-cortana-analytics-suite/

http://www.cio.com/article/2954656 /healthcare/how-predictive- analytics-will-revolutionize- healthcare.html References and Virtual Care Rooms (Sweden) customer quotes Virtual health room is a customized, unstaffed healthroom with the aim of staying open 24 hours a day for recipients of care in rural areas. It will also be possible to install the virtual health rooms of the future in people’s own homes or on their mobiles. If necessary, doctors and other health professionals will be able to connect to these rooms via video and the rooms will be equipped with a range of devices. The solution is running on Azure as platform.. “We will see a clear improvement. Accessibility for residents is one of the benefits, as well as taking services out to patients and reducing the cost of travel and transport” Björn Eriksson of Region Jämtland Härjedalen. Link to customer story St. Olavs Hospital Home Patient Monitoring (Norway) References and The project is called HelsaMi and implemented by customer quotes Microsoft partner Imatis and aims to help patients with chronic illness to take care of their own health at home with remote support of health service professionals and improve the wellbeing of patients with chronic disease while at home. “HelsaMi is a project which defines the overall strategy in Trondheim based on a technological model which aims to help people feel safer while living at home and to simplify the interaction of health services within the municipality and hospitals.” Helge Garasen Director for Health and Welfare, Trondheim Municipality Link to customer video

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