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Roche Diabetes Care Inc - eHealth: the future we create today
Horst Merkle, Directeur de Diabetes Management Solutions, Roche Diabetes Care Inc
Friday, June 3, 2016 · 10:49 a.m. · 23m 18s
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Thing everybody thank you very much for
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inviting me to this conference is the
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first time back to Switzerland for
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three four years. And I heard here is
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the with the the the place where the
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sun shines maybe so now I'm standing
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between you and the break so I try to
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stay in the my allotted time but I'm
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open for questions anytime. Let me
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change a little bit here back to
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something that is on the line will be
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talk they date on my opinion that is
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access to data ideas how do we actually
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you can only do something this data
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once have access to data which brings
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also something back we discussed before
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we should not be afraid of the data.
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And start discussion was all the
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problems that we create if you have to
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pay to being a privacy did security I'm
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I'm a strong believer once we know
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wouldn't get the data you are intended
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halogen people you figure it out what
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how to protect data. I and that's
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reason my talk today more about things
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like inter operability and how to
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create the access. And leave it up to
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other speakers talk about how what to
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do with data and leave too maybe two
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next station to talk about privacy in
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these type of things that very
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interesting conversation last night. So
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here's a quote from me no sideburns she
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is the commission of the FCC the
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federal communication commission united
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states and the speech at the cut the
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connected helps conference last year in
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Washington she says infrastructure is
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the foundation for innovation
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innovation creativity let it sink in
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for just a second what that means that
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means without the infrastructure be
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actually hampering innovation. And we
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will talk about what that
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infrastructure means nikos goes back to
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what I said is about accessing the data
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to first that which is one
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infrastructural thing because they in
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itself has basically no value you'll
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only trade in value by putting it in
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context in the context creates then the
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content people look for the
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information. And that information and
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last but not least everything you heard
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this morning is about how you create
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decision making processes and tools
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that help to make decisions being in
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clinical decisions. But also lifestyle
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decisions. Um efficiency productivity
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decisions. So all that needs
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infrastructure before continue with all
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the boring technical Semite technical
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process process issues couple of
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remarks to bring back the emotions this
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is a picture from one of my or our
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favourite. Um vacation spaces British
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virgin islands last April we were
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sitting at dinner. And a couple next us
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overheard be my fiance and I talking
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about health site you she's a nurse so
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we talk a lot about this type of
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things. And the person next ask came
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over to husband came over and said are
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you a doctor and I said no one that
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well we have this problem you on the
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cruise here. And my mother had
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abdominal pain nonspecific abdominal
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pain she was admitted seven hours of
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going to the hospital here the local
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possible hospital very modern hospital.
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And excel seven hours ago and they
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still have no diagnosis and they're
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going to open her abdomen right what
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does this have to do with data if that
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person would have been able to give
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consent to data create access to data
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it would have helped that that
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situation to actually improve the
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diagnoses now sees thousands Miles away
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from the hospital no way to to get
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access to data again it is axes of
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detente guess what at that moment
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there's no there's no reluctance E to
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open it up and just throw overboard
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privacy and all the things you need
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help like just when we talk about data
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models new business model think a
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little bit those about those use cases
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where is okay and what I'm sure we can
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develop technologies way say you get
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access to the data for the moment. And
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then you raise it from the database and
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and then the technology's already out
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there and I'm I'm sure they're
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intelligent people who can do that my
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next example this is under on eleven
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years old three years ago he was
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diagnosed with diabetes type one by
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diabetes. And this is the moment but
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the life changes that very moment ago
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walk into the doctor's office. And the
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doctors that you have diabetes for the
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rest of your life you will take insulin
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and what do we give these people but
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glucose meter an insulin pen a china
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book and a pencil this is for most
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countries and this is and the lives in
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a very developed country not in
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Switzerland that's what we that's the
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standard of get still today think about
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that. We would never accept anything in
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our professional life that's based on
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paper anymore. But this is what we have
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given. So this is what we give them to
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manage diabetes but what is do we give
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that that guy to manage is live sports
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school would sleep is father is like me
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travels a lot. He Boris every time is
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on somewhere six hours eight hours time
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difference what is on the billboard is
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on the doing no way to share has to
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call in the middle of the night it
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doesn't know what's happening is this
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information age question mark. This is
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one of my favourite quotes type B this
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happens between doctors good this it's
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every three months that'd be a diabetic
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has somewhere between eight and fifteen
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minutes is about but what is with the
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rest of those hours in the three months
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in the vaults. So just let that sink in
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and now we switch here. And talk a
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little bit about the fact so how we
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meet our future with data which new
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devices which variables all the things
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we had this morning if one of the
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biggest problem is actually the lack of
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health care professionals UWOJO
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estimates that over the next ten years
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we will lack around thirteen million
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healthcare professionals to three
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people in the world. You in the US the
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the gap is somewhere around in the next
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five years fifty thousand healthcare
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professionals not taking care of
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patient and where does it happen in
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areas similar to here where you are not
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in the metropolitan area there will be
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another problem in in in Boston in in
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Chicago or new York but it will be
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problem in smaller outside cities that
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smaller cities and rural areas next
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problem. First sixty percent that's WH
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always sixty percent of that that is
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that plot is is assigned to not
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communicable can communicable diseases
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chronic diseases in the EU it's
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estimated be closer to ninety percent
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because you know in other areas it's
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high incidence of infections and so on
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trips. And seventy percent of the you
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have to cost discourse by chronic
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diseases in the US it's more closer to
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eighty four percent. So there's a big
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problem right sup rising health care
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costs what is the concept to get out of
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that it is we have to empower the
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patience. And here I'm not I I I wanna
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have a discussion with you your your
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notion about don't treat the patient as
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a consumer I think I understand with
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what but what what where you go with
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that but I only partially creature that
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right because we need to empower there
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that person to that that patient to
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care for themselves with that in mind
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yes no other choice no how do we do
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that we wanna use technologies the
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problem is technology driven health has
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shown it's very messy it is really
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messy to just throw out no more devices
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that just create more they don't know
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is and it's not organised what we what
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the professionals look for is easy
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secure data exchange of high quality
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and the removal patient information
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that's what they want you heard form a
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speaker talking about a process and
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healthcare professional doesn't wanna
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very awake again can get and get woken
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up in the middle of the night was not
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alarm simply because somebody can't
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sleep. So how do we how do we
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differentiate between noise and and
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good in for informational alerts
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patients one have access to user
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friendly to secure digital help secure
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that's what they want and user friendly
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that's where are you say yeah we have
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to in this regard treat me like the
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consumer to make it easy to baby. B
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three. BB propose solutions to patients
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that are designed for health care
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professionals. I think that's that's
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what I tried to say it has to be really
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user friendly you cannot use the same
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portal you put in front of a health
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care professional for your patience and
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we say to see that over and over again.
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And held systems they're interested in
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overall health management population
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have seen trends and and low and really
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sore solving the bigger problems
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overall there's need for structure and
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standards. So let's talk a little bit
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about standards and what we do so I
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miss rose that's correct but
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approaching engaged for the past ten
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years in trading standards of inter
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operability. And so I'm also on the
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board serving on the board of the
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person connect connected else alliance
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you can read this all for yourself
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what's important is that we created
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design guidelines for inter operability
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and an only eight iteration of those
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guidelines that I improve and improve.
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And it's I think it's an important
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message for all those smaller startup
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companies to say there is an
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infrastructure out there to share that
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data in the standard format. So it
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shouldn't come as a surprise there when
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I tell you that I'm not the favour of
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APIX right. It's a nice thing to say
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hey. I tell you how I transmit your
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data right why do we need thousands of
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API is let's say there is nowadays
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activity tracking money taurus systems
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I would I know of at least a hundred
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different companies. And and each of
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these guys have their own a PI to
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transmit the same data why like Lucas
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me just the same thing about twenty
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thirty significant manufacturers in the
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world. They all of a different way to
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transmit the same result right. So why
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is this and this is what we try to
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solve what goes along is not only
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guidelines is also we have a belief
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that you need to be able to certify
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products tested against sosa to test it
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so it it's guarantee you have inter
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operability as expected and for that we
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work with policymakers regulatory with
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but with marketeers around the world so
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it's not only standards it's also
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creating the whole environment in which
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standards and operability has to live
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today and then in the future and we
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organise some it's around the world to
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basically put out the message get the
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information mission out to the users to
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the industry into health care systems
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the design guidelines are based on and
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a reference architecture. It's very
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basic right be defined three interface
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this one is the device interface. So
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you have your health fitness whatever
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device device this side and then you
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get it into what we call a personal
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hells gateway that could be anything it
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could be computer system could be an
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application that could be a a a set top
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box it could be some proprietary box to
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get the data in the forties then handed
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over the service interface into health
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and fitness services clout service
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let's say and last but not least be
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also work together with other with
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point I HE on how to improve the inter
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operability into hell circuit system
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which is the biggest problem. Because
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you have players that don't wanna play
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the box right they wanna play that
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there or that one thing. So if somebody
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would ask me what is one of the major
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obstacles in inter operability it's
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certainly not technology I don't need
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to tell you that it is the business the
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business models around that and so if
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we talk about a down data data analytic
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stay data access don't forget that a
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lot of business models sent around not
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sharing data. So and I think that is
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slowly softening up but they're still
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these type of thinking and and to be
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honest. We in the industry our
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competitors and and you you have been
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like that for four years and say if I
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hold on to my data I I I keep my
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clientele. So and this is a a a we
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thinking that takes years but I said I
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have been working as a rhino for ten
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years. And still I would direct
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competitors there's only one company
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that participates in PCAJ of our
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competitors because we are still a
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frame in this mines they five on the
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data and keep the data to myself I keep
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my customer. So which is I think very
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short I'm thinking alright what about
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adoption of standards question who in
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the rule knows clean or personal
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connected health alliance okay there's
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a but even ten people the that is
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sobering right. But this this we we
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have been called one of the best kept
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secrets in the industry right. So so
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and it's really hard to break that we
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on organisation have hundred you have a
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hundred twenty members entail become is
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oracle some some big companies and
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still be don't get the word so isn't
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that interesting. So we have been
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working. So what we did yes we started
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working mainly with hell's ministries
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and started in scandinavian by now
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after we started the right around two
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thousand twelve in Denmark by now all
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scandinavian countries have adopted to
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a larger less a decree the continual
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held attack and in your architecture as
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a framework with their personal hells
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IT and they have actually created a
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reference architecture you can download
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that and I I spoke last week in the
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now. And the question to the audience
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similar to you that one here was I
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think within your experience that the
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architecture quick where they had like
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you know also yes if nothing speaks
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again so we did something right. So the
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nordic we have been talking to austria.
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And and basically what we do is now I
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speak here. BBB start circling round
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this one right mid April I talk in
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Berlin totally different totally
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different conversation Germany Germany
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I'm German right. So Germany has one
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problem politician told we want the
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problem in Germany is you can lose an
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election which held like but you cannot
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win one right. So politicians are
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channel and it's generalised. They are
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afraid of the topic. And leave it a
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little bit up to the implementors like
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health insurance and they take a very
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active role the big decals insurers in
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Germany they put things like health and
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I clean motion and that's good enough
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for the politician to rely on that
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there is no mandate from the top like
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in the nordic this this yes we bill
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bill eighty house psyches
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infrastructure for our for citizens
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that is not there it is that okay you
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have models we do pilots and try to
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pass it. So that leads to lot of pilot
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it is in in in Germany that every two
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years to millions are spent on pilots
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to show the effect of "'em" hells he
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helps connect that held over and over
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and but it is it there's shy to really
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iman implementation alright. So the
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nordic explode that the nordic say when
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we put out an RFP for products over the
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next two years two thousand starting to
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than sixteen be building on in the
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operability and if you could do not
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follow standards you will not be
00:18:24
participating in this RFP it's a major
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step but a step in the right direction
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a limit doing in time three minutes
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easy alright Ross we did something to
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use the standard Nevada first snow
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industry to put a clue to lose leds
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standard base connectivity in our blood
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glucose meter added an at a backend
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system that enables now chain where a
00:18:53
child coming back to and fun I can do
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is sports her sports measures
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automatically goes to the at the at
00:19:02
alerts caregivers parents from ever
00:19:05
ever is automatically forwarded into a
00:19:08
cloud system which can be accessed by
00:19:10
health care professionals with their
00:19:12
own views or can be refuted by the
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patient on the patient portal yes the I
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don't know is it would've that knows
00:19:24
it's lose all right it is not yet
00:19:27
available in in Switzerland it was
00:19:29
started as a pilot so be are rolling
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out next so if you know right I run to
00:19:33
the the pharmacy and and try to get
00:19:36
that meter you won't get it here but
00:19:38
you can go across the border to Germany
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they have it so so you the next wave of
00:19:44
meters is based on that standard we
00:19:47
have made a commitment that all our
00:19:49
devices including insulin pumps will be
00:19:53
will be standard space to be created an
00:19:56
insulin pump communication standard new
00:19:59
industry standard the same as for CGM
00:20:01
for continuous monitoring. So looking
00:20:04
really that I had was given that the
00:20:06
future bitrate today. So we you really
00:20:09
looking and try to look in the future.
00:20:11
But soon what's more important then we
00:20:13
do our own thing is what it allows is
00:20:17
that this meter no shares data on the
00:20:20
standardised format and who ever once
00:20:22
it can get the data. So we don't insist
00:20:26
that the patient a care professional
00:20:29
uses our data solutions we have since
00:20:33
it was launched fifteen months ago we
00:20:35
have been no of seventy five companies
00:20:40
extracting the data from other blood
00:20:41
Lucas me and this is it may not sound
00:20:45
much five years ago when we did
00:20:48
research of all database be estimated
00:20:52
that only about four percent of our
00:20:55
blood glucose meters. I downloaded by
00:20:59
patients four percent if you have two
00:21:02
today we can estimate of this meter we
00:21:05
had about twelve to fifteen percent to
00:21:08
people that it's not much. It's three
00:21:10
times more than five years ago. I think
00:21:14
you see slowly the uptake of something
00:21:16
like data data looking into data data
00:21:20
data sharing last slide continue over
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when a second to know about
00:21:27
standardisation works. That's the big
00:21:29
message I wanna send out think about
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infrastructures like in operability S
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gateway for data access which allows
00:21:38
you to create content right you need
00:21:40
that data. So it works. What are the
00:21:43
opportunities manufactures before you
00:21:46
spend all your brain power in creating
00:21:50
a new communication we think about
00:21:52
standards go out look it up and
00:21:55
therefore free you don't charge
00:21:57
anything you can download it at the
00:22:00
ITUT that side or the company website
00:22:02
for free. And built a product on the
00:22:05
side of a certified base you don't need
00:22:08
to be certified but be complying then
00:22:10
it allows you to share with others your
00:22:13
data policy major makers and strategist
00:22:18
this is important. I think we need to
00:22:22
create policies that insist on
00:22:26
standards based health IT and it's
00:22:29
possible regulators oops regulators
00:22:34
continued is a TFT A.'s in the world
00:22:37
they already go down the past
00:22:39
encouraging data exchange this much
00:22:41
easier than it used to be and it is all
00:22:44
about the balanced risk approach to say
00:22:49
okay balance the risks and don't stop
00:22:51
it in in in the tracks automatically.
00:22:54
And last not by but at least is health
00:22:57
care professionals talk to your
00:23:00
associations and tell "'em" I don't
00:23:02
wanna have in non interoperable systems
00:23:05
in my my house. That's it from my side.
00:23:09
Thank you very much. Open for
Conference Program
Ouverture de la journée e-Health 2016
Sébastien Mabillard, Coordinateur projets e-health, Fondation The Ark
June 3, 2016 · 9:08 a.m.
222 views
Mots d'introduction du Canton du Valais
Victor Fournier, Chef du service de la santé
June 3, 2016 · 9:11 a.m.
193 views
Mots d'introduction de la Fondation The Ark
François Seppey, Président de la Fondation The Ark
June 3, 2016 · 9:18 a.m.
Mots d'introduction des Instituts de la HES-SO Valais-Wallis
Laurent Sciboz , Directeur des instituts informatiques
June 3, 2016 · 9:26 a.m.
Boston Scientific - Medtech: quel business model pour l' “Internet du Patient”?
Frédéric Briguet, EU Digital Health Engagement
June 3, 2016 · 9:38 a.m.
424 views
Q&A - Boston Scientific - Medtech: quel business model pour l' “Internet du Patient”?
Frédéric Briguet, EU Digital Health Engagement
June 3, 2016 · 10:02 a.m.
151 views
Patientslikeme - The Power of We
Chris Fidyk, Vice-président et head of business development chez Patientslikeme
June 3, 2016 · 10:08 a.m.
184 views
Q&A - Patientslikeme - The Power of We
Chris Fidyk, Vice-président et head of business development chez Patientslikeme
June 3, 2016 · 10:39 a.m.
Roche Diabetes Care Inc - eHealth: the future we create today
Horst Merkle, Directeur de Diabetes Management Solutions, Roche Diabetes Care Inc
June 3, 2016 · 10:49 a.m.
230 views
Q&A - Roche Diabetes Care Inc - eHealth: the future we create today
Horst Merkle, Directeur de Diabetes Management Solutions, Roche Diabetes Care Inc
June 3, 2016 · 11:13 a.m.
Withings: du quantified self à la médecine préventive
Alexis Normand, Directeur du développement Santé chez Withings
June 3, 2016 · 11:40 a.m.
Q&A - Withings: du quantified self à la médecine préventive
Alexis Normand, Directeur du développement Santé chez Withings
June 3, 2016 · 12:04 p.m.
Groupe Mutuel - Ignilife: le coach santé au quotidien
Stéphane Andenmatten, Responsable Marketing - Membre du Management chez Groupe Mutuel
June 3, 2016 · 12:12 p.m.
609 views
Q&A - Groupe Mutuel - Ignilife: le coach santé au quotidien
Stéphane Andenmatten, Responsable Marketing - Membre du Management chez Groupe Mutuel
June 3, 2016 · 12:34 p.m.
145 views
Gérer ses données, ou être géré par ses données, quels futurs nous dessinent le big data et le quantified self ?
Stéphane Koch, Spécialiste des questions numériques
June 3, 2016 · 12:43 p.m.
303 views
Safe Host - La Suisse, le coffre-fort numérique mondial
Sylvain Bremond, Business Development Manager chez Safe Host
June 3, 2016 · 1:13 p.m.
111 views
Q&A - Safe Host - La Suisse, le coffre-fort numérique mondial
June 3, 2016 · 1:28 p.m.
Cipret - 7000 Romands arrêtent de fumer via facebook
Alexandre Dubuis, PhD, Responsable du CIPRET Valais
June 3, 2016 · 2:37 p.m.
Q&A - Cipret - 7000 Romands arrêtent de fumer via facebook
Alexandre Dubuis, PhD, Responsable du CIPRET Valais
June 3, 2016 · 2:49 p.m.
L.I.F.E. - express your truth through your accurate data
Dario Ossola, PhD, Algorithm R&D Coordinator, L.I.F.E. Corporation
June 3, 2016 · 2:52 p.m.
105 views
Q&A - L.I.F.E. - express your truth through your accurate data
Dario Ossola, PhD, Algorithm R&D Coordinator, L.I.F.E. Corporation
June 3, 2016 · 3:07 p.m.
ISyPeM2 - de l’individualisation des posologies aux bases de données médicales
Séverine Petitprez et Alevtina Dubovitskaya, Resp. collaboratrice scientifique, pharmacologie clinique, CHUV , et assistante de recherche, HES-SO Valais-Wallis
June 3, 2016 · 3:14 p.m.
1091 views
Q&A - ISyPeM2 - de l’individualisation des posologies aux bases de données médicales
Séverine Petitprez et Alevtina Dubovitskaya, Resp. collaboratrice scientifique, pharmacologie clinique, CHUV , et assistante de recherche, HES-SO Valais-Wallis
June 3, 2016 · 3:26 p.m.
Karmagenes - Be a game changer: meet yourself
Kyriakos Kokkoris, CEO de Karmagenes
June 3, 2016 · 3:30 p.m.
102 views
Q&A - Karmagenes - Be a game changer: meet yourself
Kyriakos Kokkoris, CEO de Karmagenes
June 3, 2016 · 3:39 p.m.
Table ronde - eDocteur et ePatients, une eRelation à créer...
Dr Jean-Gabriel Jeannot, Pierre-Mikael Legris, Dr Pietro Scalfaro, Christine Bienvenu, David-Zacharie Issom
June 3, 2016 · 3:42 p.m.
225 views
Synthèse et conclusion
Sébastien Mabillard, Responsable des projets E-Santé
June 3, 2016 · 4:39 p.m.
Recommended talks
Team Gamified Multi-sensory Stroke Rehab
Jean-Luc Turlan et J-P. Ghobril, Lauréats Arkathon 2018
June 15, 2018 · 3:22 p.m.
320 views