Adam Hill: Applying insights in digital health

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Dr Adam Hill, Chief Medical Officer at McLaren Applied Technologies discusses applying insights from optimising performance in motorsports to implementing digital health.

This presentation was recorded at our Digital Health and Care Congress 2017 on 11 July 2017.

Transcript

In 1980 Ron Dennis bought what was an ailing company, an ailing motor sport company, and merged it with his own.  The adage goes that in order to make millions in Formula One you need to start with more millions and so it’s not a business.  So you need to be able to use it as a sandpit for other activities and Ron recognised that very early on and developed two things in the same year; the first was our car company but equally we developed a technology company and the technology company that was first established to commercialise sensors in Formula One, that first sensor was an accelerometer something that measures whether you’re accelerating or decelerating and how fast you happen to be doing that.  Critical if you’re a racing driver because racing is won in the corners and braking late into the corner is the way to win races.  It wasn’t just one sensor it was up to 400 sensors on board a car and they were collecting data at anywhere between once every ten seconds and 960,000 times a second at the centre of an internal combustion engine.  They were processing data on the edge of the network, they were pushing data to the pit wall for engineers and strategists to make sense of that data with the use of analytic tools, a visualisation platform and some decision support tools and ultimately act upon that data in order to optimise your chance of winning the race.

Indeed today what you see if you stand in a garage on the Formula One grid is one team participating in what is probably the largest science experiment on Earth and it’s being performed every other weekend with up to 80 gigabytes of data generated per car and 40 data scientists sat behind every single car on the grid.

So what does that mean?  Well it gives us pedigree in capturing data, moving data from one place to another, analysing data in real time and near to real time and deriving decisions off that data set which is of course relevant in other industries.  We see there being huge opportunities through the use of this sort of approach to continuous improvement and the technology components that support that in targeting the right intervention for the right patient at the right time, leveraging the potential distributed wearable sensors to make clinical decisions in real time, to better integrate the potential of companion technologies in disease management and increase early diagnosis and improve treatment prevention and reduce downstream systemic costs. 

A most recent piece of work that we have done is in identifying novel biomarkers of disease progression post stroke for the assessment of anti‐myelin associated glycoprotein.  Neurological disease is great actually for the application of this sort of companion technology or digital therapeutic because often its onset and progression is relatively insidious and difficult to measure and many of the tools used to determine whether an intervention has had an impact are subjective and clunky.  So digital interventions are very relevant but there is no substitute for capturing really, really good data at the point of initial capture and so we’ve worked in this space. 

A great example is a smart Inhaler and not the sort of smart inhaler that monitors whether you open or close a cap but indeed whether you open and close the cap, you’ve depressed the MDI canister, whether you’ve inhaled rather than exhaled and also estimating what percentage of that powder has been deposited within your lung field.

The final example I’ll leave you with we worked with a relatively forward thinking primary care group that were interested in prescribing exercise therapy to patients with a BMI over 35 and they had been doing so for about two years but unfortunately hadn’t seen a reduction in weight as they had hoped despite the fact that they built and opened a gym on their own facility.  What they wanted to do in the first instance was just understand whether these patients that were being prescribed exercise therapy were actually being compliant or indeed just signing in to the gym and so we developed a device that not only demonstrated that the patients were being compliant but also gave the patients an idea of how much energy they were burning every time they did turn up and do an exercise session and two remarkable things happened.  The first is that of course the group started to lose weight but secondly when the device was removed after about twelve weeks the group continued to lose weight and so a small amount of insight provides education which will persist or the effects of which will persist beyond the use of the initial device was the preliminary findings that we made during this pilot. 

The world is changing, it’s changing rapidly.  We do need to engage with the technology industry because it is desperately trying to have an impact and have an impact upon health outcomes but without guidance and a steer from the clinical community it just won’t get there on its own.