Digital medicine comes of age - ISDM E-Newsletter Feb 2020
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This newsletter discusses the growing use of digital technologies in healthcare. It covers how digital tools are being used to track and model the spread of coronavirus. It also discusses applications of virtual reality for medical training, pain management, and personal health. Upcoming events on digital therapeutics and innovation in healthcare are also listed.
Digital medicine comes of age - ISDM E-Newsletter Feb 2020
- 1. February 2020 Digital Medicine Comes of Age Digital Medicine and Pandemics Virtual Reality and Immersive Experiences in Healthcare Virtual Reality and Medical Training Digital Therapeutics Bridging the Gap Midlands Conference Upcoming Events Calendar. This edition of the ISDM Europe E-Newsletter reflects on the growing use and value of disruptive digital technologies within the medical profession, evolving from their use in clinical diagnostics towards their approval for use as prescriptive medicines to address physical and mental conditions. This comes at a time when we are responding to the Coronavirus tragedy in China and its global impact. Digital technologies developed for applications outside the medical profession are likely to play a vital role in the prevention and impact mitigation of instances of new viruses such as SARS, MERS and now CORONAVIRUS. I am pleased to include a guest article from Todd Maddox and Tim Fitzpatrick of IKONA Health in the USA on the use of virtual reality and immersive experiences in training and education. In this Edition • Digital Medicine and Pandemics • Virtual Reality and Immersive Experiences in Healthcare • Virtual Reality and Medical Training • Digital Therapeutics • Bridging the Gap Midlands Conference • Upcoming Events Calendar. Digital Medicine and Pandemics Map tracks coronavirus outbreak in near-real time
- 2. A team at the Johns Hopkins Center for Systems Science and Engineering has built a map that shows the spread of the coronavirus in near-real time. The map is regularly updated with data from the WHO, CDC, and other sources, and illustrates how the virus is spreading in China and beyond. This information comes from Spatial Source with more details available from their web site at https://www.spatialsource.com.au/gis-data/map-tracks-coronavirus-outbreak-in-near-real-time This is an example of how a multi-disciplinary approach enabled by digital technologies can be very valuable in tackling a global emergency. Data collected from a variety of sources, analysed using big data techniques and presented visually on a map in near- real time not only supports executive decision making but also brings an understanding of the seriousness of the situation and contributes to predictive modelling tools. Previous experience gathered from the SARS and MERS pandemics has been invaluable in predicting how Coronavirus is likely to spread and informs measures to mitigate its impact but the characteristics of Coronavirus and its transmission from human to human before any symptoms emerge adds a new and very serious dimension to the situation. It means that there are potentially large numbers of carriers who are unaware of their condition and can consequently infect many more people before they can be identified. This raises not only technological issues around how sufferers and their movements can be identified and tracked but also moral and ethical issues around human rights and privacy. The technologies exist in smartphones and wearable devices for both location tracking and health monitoring that would be invaluable in early recognition and management of pandemics but data privacy issues limit their potential on a large scale. In the past, I have suggested the idea of a citizen’s health charter designed to encourage citizens to use advances in consumer wearable technologies for personal health management with incentives to voluntarily share this data (properly anonymised) for both personal health management and public health policy making. This concept is not far removed from the incentives given by the insurance industry to users of wearable devices willing to share details of their physical activity and health. Virtual Reality and Immersive Experiences in Healthcare Virtual Reality Applications for Clinical Diagnosis and Treatment Like many technologies developed for consumers, virtual reality technologies are finding a place in clinical practice in a growing range of application areas. Significantly, we are beginning to see applications developed for virtual reality headsets receiving FDA approval for medical practice for both physical and mental conditions. I envisage that this will become a major growth area as an alternative to pharmaceutical drug interventions. I have listed below some of the developments and application areas. VR and Immersive Experiences for Pain Relief One of the earliest examples of the use of VR and games for Pain relief was the “Snow World” research project in which burns patients wore a VR headset whilst having their dressings changed. Through the use of brain scans during the treatment, clinicians were able to show that patients using the headset and game experienced less pain than other patients. VR and Immersive Experiences for Pre-Operation Preparation
- 3. As with the use of VR and games for pain relief, there are already research projects exploring the potential of immersive experiences for use both before and during surgical operations as an alternative and/or supplement to anaesthetics. It is the experience of being totally immersed that shifts the patient mental focus away from the procedure and reduces the need for pharmaceutical interventions VR and Immersive Experiences for Personal Health Management Oculus recently announced a Beta version of a VR platform called Alcove for use with headsets such as the Oculus GO and Quest. There are many potential clinical applications for this environment but the Beta version includes a virtual patio area with artefacts that include VR based exercises designed for personal health management. VR and Immersive Experiences for Dementia and Cognitive Development Mental Health, stress and burn-out are growing problems in today’s society. A tranquil virtual environment with appropriate sound and visual cues, coupled with exercises that test and develop cognitive functions has already gained FDA approval in the USA. A series of applications developed by XR Health test reactions times and short term memory functions that can not only help to indicate early signs of dementia but also support its treatment. There is also a project in the UK in a hospital for patients with moderate to severe dementia using VR headsets to immerse patients in a range of different environments to improve their sense of well-being. VR and Immersive Experiences for Physical and Mental Rehabilitation Using virtual reality headsets to undergo physical and/or mental training exercises could be used to help patients focus on effective therapies by increasing motivation and/or exposing patients to positive experiences that can impact both the sense of well-being and motivation to address clinical issues. VR and Wearables – Future Developments One of the challenges of using any clinical intervention is finding reliable ways to accurately determine effectiveness at a personal level. This is because the impact of almost every medical intervention to address a chronic condition is either not obvious immediately or can only be measured over a long period. I envisage that next generation consumer wearables capable of accurate real-time monitoring of vital signs will be able to be linked to adjust VR experiences based on the clinical outcomes of the experiences. As an example, imagine a patient being exposed to a tranquil immersive environment being monitored in real-time with a combination of Artificial Intelligence and wearable device data being used to adjust the environment and sounds/music to suit the patient. Virtual Reality in Medical Education and Training I am grateful to Todd Maddox of Ikona Health for submitting this article. Todd and Ikona Health have published many papers to share on the Linkedin platform.
- 4. The Promise of VR in Healthcare Education and Training “Learning is an experience. Everything else is just information.” Albert Einstein This quote from Albert Einstein is supported by the neuroscience of learning, memory and performance, and is the primary reason why virtual reality (VR) is so effective in healthcare education and training. VR is grounded in experiential learning, but also broadly engages experiential, cognitive, behavioral and emotional learning centers in the brain in synchrony. Although each of the four learning systems in the brain are distinct, they all reside within the same brain with massive, dependent interconnections. In nearly all healthcare situations information needs to be stored and retained (cognitive), motor skills must be perfected (behavior), situational awareness must be strong (emotional), and all of these must be present within the relevant work context (experiential). In other words, ideally all four learning and performance systems in the brain should be activated in synchrony. That is exactly what VR does to the brain! Patient education and training: This is an area where VR can add significant value. Although 84% of adults have contact with their primary care provider each year, comprising 883,700,000 office visits, only 1 in 10 patients are health literate. Low health literacy increases stress and anxiety in patients costing the U.S. economy $238 billion annually. The two primary education methods – written materials and one-on-one interactions – are not working. Although cheap, scalable, and available, written materials are usually poorly suited for explaining complex medical situations and conditions, making cognitive processing difficult and error prone. Although experiential and personal, one-on-one interactions are often inconsistent and are not scalable. VR has all of the pros and alleviates all of the cons of these two primary educational methods. VR is experiential, personal, consistent, scalable and available 24/7. VR can enhance patient education, familiarization and training around medical conditions, medical procedure and device training, and hospital familiarization to name a few. This reduces patient stress and increases patient confidence and satisfaction. Provider education and training: In much the same way that VR can enhance patient education and training, VR is equally valuable in provider education and training. Provider education is dominated by written materials, and one- on-one interaction. VR has all of the strengths of these educational tools, but also addresses all of the concerns. VR is experiential, personal, consistent, scalable and available 24/7. Critically, providers can obtain VR experiences as many times as they like. This builds expertise, confidence and satisfaction and allows providers to develop the broad-based situational awareness that is so important when dealing with ever changing healthcare settings. Finally, and perhaps most importantly, VR is an ideal tool for empathy building in healthcare providers. The ability to “walk a mile in someone else’s shoes” allows providers to see and feel what it is like to be a patient. This facilitates effective communication and understanding. The future of VR in patient and provider education and training is now. With VR patients and providers can enhance their understanding – one experience at a time. For a more detailed examination of the Promise of VR in Healthcare follow this here. For peer reviewed research focused on VR in healthcare follow this link. -- Todd Maddox, Ph.D., Learning Scientist at IKONA Health Tim Fitzpatrick PhD, Co-Founder and CEO of IKONA Health Digital Therapeutics The London Digital Therapeutics Event
- 5. Examples of Companies involved in Digital Therapeutics Imaginary (Italy) Milan-based serious games specialists Imaginary have pioneered the use of serious games and immersive technologies for digital therapeutics. One of their Flagship projects is REHABILITY (www.rehability.me) which uses games technologies and mechanics to develop, monitor and feedback progress on rehabilitation programmes for a variety of clinical conditions including strokes and parkinsons disease. These rehabilitation programmes not only guide patients through exercises in their own homes instead of at expensive rehabilitation clinics, they also use gamification strategies to motivate patients and capture progress data for remote clinical support. Imaginary have also worked on an EU project targetting autistic children (https://www.youtube.com/watch?v=4Sn9jEKvjlo&t=23s) and a gamified application for sufferers of cystic fibrosis https://www.youtube.com/watch?v=DJ8pP2aFmFc&t=35s Totem Learning (UK) Totem Learning, a leading UK based digital learning company, is currently doing a lot of interesting work within the health care sector including mental health awareness, Stroke rehabilitation, care home training, emergency building evacuation for disabled people, and a variety of independence building apps for people with sight loss. Their solutions include the use of virtual reality, apps that employ accessibility functions both standard and customised by the team, scenario exploration and social rehabilitation worlds. Their clients include the Canadian National Institute for the Blind the NHS and specialist players across the healthcare and rehabilitation fields. Totem is also in the early stages of a collaboration with a leading Autism research charity. Helen Routledge, CEO, Totem Learning said "digital tools are perfect for use in health care, the work we are doing means that wherever you are based geographically you can access help and learning materials from your home and get support where you need it most. Most of all, our solutions are helping people be more confident in themselves; confident to talk about difficult subjects such as mental health, confident to attend appointments and confident to improve their own lives." DTx London 2020 Conference As a follow up to my thoughts on the role of virtual reality and immersive experiences for clinical interventions, I have included a paragraph from the organisers of the Digital Therapeutics event, DTx London 2020 to be held on June 9-11. There is a link to the web site in the upcoming events table below. “We are very excited to announce the official launch of DTx London held 9-11th June. The DTx event series is regarded as the meeting place for the digital therapeutics industry attracting leading digital therapeutics companies, pharma, payors, providers and others who make up the infrastructure of the space. Having begun in February of 2018, the DTx event series now boasts up to 300 senior attendees and is what we like to call a Goldilocks event: attracting enough senior leaders to have everyone who needs to be there in attendance, but small enough to allow for intimate and in- depth conversations. If digital therapies are in your wheelhouse, DTx London is the place to be." Christopher Goy Conference Producer Bridging the Gap Midlands – Innovation and the NHS Jimmy Endicott of ChatHealth Keynote Presentation
- 6. Encouraging innovation and supporting entrepreneurs to bring digital health solutions to the NHS was the theme of a one day conference in Hinckley on January 30th . There were some inspiring and practical presentations on a range of topics including :- • NHSX work on digital innovation • AHSN and the Innovator featuring the experience of Entrepreneur Jimmy Endicott (see above image) • Skills Labs on :- o Gathering Real World Evidence o NHSX Digital Standards o Export and Overseas Trade o Navigating the NHS o How to develop a Business Case o Regulations and NHS requirements • The Accelerated Access Collaborative • The Association of British Healthtech Industries Alongside the presentations and skills lab workshops were networking opportunities, special business clinics and a central exhibition area. It was an excellent event and particularly inspiring were the practical experience of presenters like Jimmy Endicott of ChatHealth sharing his experience of bringing and innovative mobile personal mental health app to market in partnership with the NHS and Nick Brown, Commercial Manager of the East Midlands Academic Health Sciences Network, with some very useful guidance on developing a business case that has maximum chance of success of gaining entry into the NHS market. Upcoming Digital Health Events Date Event Location Web Address Feb 4 Introduction to NHS Market Access Leicester, UK https://www.medilinkem.com/event/introduction-to- nhs-market-access/ Feb 7 EAI HealthWear 2020 - 2nd EAI International Conference on Wearables in Healthcare Lecco, Italy http://healthwear-conference.org/ Mar 9-13 HIMSS Global Health Conference Orlando, Florida https://www.himssconference.org/ Mar 10-11 Digital Health Technology Show 2020 London, UK https://www.digitalhealthtechshow.com/seminars.aspx Mar 17-19 Smart Devices Symposium Osaka, Japan http://www.bitcongress.com/sds2020/ Mar 24-25 Digicare 2020 Santiago, Chile http://digicare-conf.org/ March 26-28 Nursing 2020 Singapore https://nursingresearchconference.com/ April 1-2 Med-Tech Innovation Birmingham, UK https://med-techexpo.com/event/en/page/home April 8-9 International Conference on Mental Health and Psychiatry Amsterdam, Netherlands https://mentalhealth.gavinconferences.com April 12-13 Biomedicine, Bioinformation and Intelligent Computing 2020 (BBIC2020) Hangzhou, China http://www.bbic2020.org/
- 7. April 20-21 7th International Conference on Public Healthcare and Epidemiology Tokyo, Japan https://public-healthcare.pulsusconference.com/call- for-abstracts April 29-30 11th Medical Innovations Expo Milton Keynes, UK https://www.ebme.co.uk/seminar/registration May 5-6 World Digital Healthcare Congress London, UK https://digitalhealthcareworldcongress.com/ May 11-12 50th World Congress on Advanced Nursing Research Vienna, Austria https://nursingresearch.nursingmeetings.com/ May 18-19 2nd World Congress on Nursing, Healthcare and Hospital Management Valencia, Spain https://conferenceera.com/nursing-healthcare- hospital-management-conference/ May 18-20 Pervasive Health 2020 Atlanta, USA http://pervasivehealth.org/ May 21-22 Humanoid Robotics,Artificial intelligence and Automation London, UK https://humanoid.annualcongress.com/ May 26-28 Healthcare Asia Week Singapore https://www.asiahealthcaresummit.com/ May 26-28 HIMSS Health 2.0 Helsinki, Finland https://www.himsseuropeconference.eu/ Jun 9-11 Digital Therapeutics DTx London London, UK https://www.dtxlondon.com/ Jun 10-11 Wear It Innovation Summit Berlin, Germany https://www.wearit-berlin.com/ July 22-23 Medical and Clinical Case Reports Global Congress London, UK https://globalcasereports.gavinconferences.com/ July 23-24 Medical Tourism 2020 Dubai, UAE https://www.longdom.com/medicaltourism August 3rd International Digital Medicine Conference (ISDM 2020) Guiyang, China TBA Sept 22-24 International conference on Nursing & Healthcare Paris, France https://nursing.magnuscorpus.com/ Oct 19-21 5th Nursing World Conference (NWC 2020) Orlando, USA https://nursingworldconference.com/ Nov 9-11 The 4th International Biotechnology Congress (IBC-2020) Dubai, UAE https://www.bitcongress.com/ibc2020
- 8. If you would like any presentations, videos or documents circulated to the ISDM network, I am happy to provide this service free of charge for any material relevant to readers of this newsletter. If you are interested, contact me at [email protected] The views and opinions expressed in this newsletter are personal. Best Wishes David Wortley FRSA President International Society of Digital Medicine (European Chapter) Landline: +441327811827 Mobile Phone : +447896659695 Email : [email protected] Web: http://www.isdm.eu If you no longer wish to receive these newsletters, simply reply with the word UNSUBSCRIBE and I will remove you from the mailing list. Our GDPR Policy You are receiving this e-newsletter as a result of previous interest in Digital Technologies for Medicine, Health and Well-being. Our GDPR policy is only to store non-personal information securely and to use solely to maintain contact with you through our e-newsletters. If you no longer wish to receive these newsletters, simply reply with the word UNSUBSCRIBE and I will remove you from the mailing list.