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Architecting health data for the cloud

Bayer HealthCare recently announced plans to improve health data and reduce pain management cases.

Even as the move towards electronic health records has made existing medical processes more efficient, it has thus far done little to bring real innovation to healthcare in general. At the Quantified Self Conference (QSC) in San Francisco, leading healthcare enterprises, including Bayer HealthCare, showed how they are leveraging cloud infrastructures and innovating new processes for medical applications.

On display at QSC were a variety of fitness and health information products that gather data from a mobile phone, smart watch or purpose-built device and archive it in the cloud. These devices, such as FitBit, BodyMedia FIT, Apple Watch and Nike+ Fuelband, through their mobile- and Web-based applications, allow consumers to track their sleep, weight, changes in heart rate and emotional well-being. Intel has also introduced a new experimental program for aggregating data from QS devices and services called DataSense.

On the news front, Bayer HealthCare announced an ambitious challenge to rethink pain management. While Bayer might best known for its pain-relieving pharmaceuticals, it also provides a number of information services for the healthcare industry. Jay Morgan, VP of Global Innovation and Design at Bayer, said, "It is about the outcome of the human experience and not just resolving disease. Chronic pain impacts more people than cancer and diabetes combined, and 100 million in the US alone. Chronic pain is the number one cause of disability of people under 45."

Hacking a better process

Bayer's challenge is being organized by Quantified Self Labs, an offshoot of the Quantified Self Movement that has grown to hundreds of chapters worldwide and thousands of members. Participants are early adopters of innovative technologies for measuring different metrics related to health and well-being, including fitness tracking, sleep, brain performance and physiology. Morgan said they intend to pick three winners of the challenge that could be incorporated into new Bayer HealthCare applications and services.

The goal of the challenge is not about selling more pills, but to provide a better process for managing pain.
Jay MorganVP of Global Innovation and Design, Bayer

Those building applications and services that leverage medical related data in a mature way face a number of hurdles, including addressing GRC mandates, HIPAA requirements, FDA regulations and the development of new business processes. Morgan said Bayer will invite the contest winners to work with its business development, regulatory, leg and marketing staffs to develop viable new applications and services for pain management.

The opportunities for pain solutions providers could be enormous, said Morgan. About a third of all people have suffered chronic pain at one time or another, and pain management represents over $500 billion in medical and health related costs worldwide.

Health tracking challenges abound

There are also several challenges related to integrating the information from the wide variety of consumer tracking appliances and applications into enterprise grade applications such as FDA regulations, the quality of data, data integration and healthcare provider acceptance. Furthermore, innovators are still working out the best practices around how to present the information from these devices to consumers and healthcare practitioners in a meaningful and actionable way, said Morgan.

The first generation of Quantified Self wearables focused on simple metrics like step counting and weight. Now these devices are getting better at tracking heart rate, blood pressure, sleep data, brain state and emotional well-being. Until recently, these comprised a murky area of FDA medical device regulation, but as a result, a consumer fitness heart rate tracker like FitBit sells for a few hundred dollars in contrast to the thousands spend on a medical grade heart rate monitor. Notwithstanding, the FDA has recently proposed regulatory guidance for low-risk devices.

There are also differences in the physiological metrics gathered by these devices for seemingly straightforward measurements like heart rate, observed Juliana Chua, principal of the business innovation group at Zensorium, which makes an emotion tracking watch. These differences can be caused by the location of the sensors themselves as well as factors like noise and movement of the wearer. For example, devices can measure heart rate using chest straps, the front of the wrist, back of the wrist, ears and even finger tips.

Another challenge lies in aggregating data from multiple devices to generate a meaningful measure of health or fitness. "There can be wide differences in the number of footsteps counted by different devices," said Anne Wright, director of operations, BodyTrack Project at Carnegie Mellon University, which provides a QS data aggregation service. Also the APIs for gathering data from the cloud backends and supporting APIs for these devices make it easy for applications to count footsteps twice because they don't properly support time zone information. This can lead to inconsistent readings and misleading users.

Rethinking the future of healthcare

Low cost fitness and health tracking information delivered to the cloud has the potential to enable doctors and patients to make better decisions or notice trends that might not be visible in sporadic clinic visits. But owing to the novelty of these services and the limitations described above, many QS attendees reported a reluctance by most doctors to consider this data. As a result, many attendees reported seeking out QS-friendly doctors to get better care.

In the long run, efforts like Bayer's Pain challenge promise to help bridge the gap between the cloud services behind these new devices and traditional medical care. Bayer's Morgan said, "The goal of the challenge is not about selling more pills, but to provide a better process for managing pain."

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