Post on 21-Jan-2018
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
Steven Tucker, MD, FACP, FAMS Founder & Medical Director Tucker Medical, Singapore
Background0
42% Direct Medical
58% Indirect Costs Productivity
$7,678 Average Cost per Worker
DIABETES BURDEN 2010
Png et al. BMC Public Health (2016) 16:153
1Billion SGD
HEMOGLOBIN A1C > 5.8%
44%
Bancks et al. PLoS ONE (2105) 10(3)
Perc
ent A
ge 6
5+
8
16
24
32
40
Age 65+2010 2035
20.5
11.2
DIABETES & AGEING
Wong et al. J Diabetes. (2017) 9(1):65-75.
Num
ber o
f Cas
es250000
500000
750000
1000000
Prediabetes Diabetes2010 2035 2010 2035
823,802903,596
373,104434,685
WE ARE AT WAR
THE WAR ON DIABETES
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
THE EXPANDING INFLUENCE OF DIGITAL TOOLS ON HEALTHY BEHAVIORS
Remote Sensing1
Smart Phones2
SENSORS EVERYWHERE
SOCIAL MEDIA
E-COMMERCE
TRAVEL
EDUCATIONAL
BEHAVIOURAL
SENSORS + IOT
SOCIAL
BEHAVIOURAL
TRAVEL
EDUCATION
PERSONAL DIGITAL BEHAVIOUR
FINANCIAL
DIGITAL BEHAVIOR
Personalized Health3
DNA IS NOT A TEST
DNA IS A RESOURCE
GENOTYPING
55,685 PARTICIPANTS ACROSS 4 STUDIES
N Engl J Med 2016; 375:2349-2358.
55,685 PARTICIPANTS ACROSS 4 STUDIES
55,685 PARTICIPANTS ACROSS 4 STUDIES
55,685 PARTICIPANTS ACROSS 4 STUDIES
55,685 PARTICIPANTS ACROSS 4 STUDIES
GENETIC RISK SCORE
N Engl J Med 2016; 375:2349-2358.
N Engl J Med 2016; 375:2349-2358.
N Engl J Med 2016; 375:2349-2358.
RISK OF CORONARY EVENT ACCORDING TO NATURE & NURTURE
N Engl J Med 2016; 375:2349-2358.
RISK OF CORONARY EVENT ACCORDING TO NATURE & NURTURE
RISK OF CORONARY EVENT ACCORDING TO NATURE & NURTURE
N Engl J Med 2016; 375:2349-2358.
RISK OF CORONARY EVENT ACCORDING TO NATURE & NURTURE
A Research Tool and
A Research Tool and
+genome_STEVEN_TUCKER_Full.txt
A Research Tool and
+ =genome_STEVEN_TUCKER_Full.txt
TYPE 2 DIABETES
BREAST CANCER
ALZHEIMER DISEASE
Personalized Medicine4
PHARMACO-GENOMICS
Odd
s R
atio
0
50
100
150
200
250
Malaysian Han Chinese Thai Overall
Genotyping for the HLA-B*1502 allele prior to the initiation of carbamazepine therapy in patients of Asian ancestry is the standard of care.
JAMA Dermatol. 2013;149(9):1025-1032
Cas
es
0
6
12
18
24
30
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Neurology 79(12) 1259-1267.
Genotyping is standard of care
No new cases of SJS/TEN since 2014.
CODEINE - CYP2D6
CLOPIDROGEL - CYP2C19
CLOPIDROGEL - CYP2C19
PROTON PUMP INHIBITORS - CYP2C19
Platforms5
DIGITAL BEHAVIOURSENSORS + IOT
COMMUNICATION
TRAVEL
EDUCATION
PERSONAL DIGITAL BEHAVIOUR
FINANCIAL
FAMILY
DIGITAL BIOLOGYGENOME / GRS
PHARMACOGENOME
EXPOSOME
PHENOME
CLINICAL DATA
PERSONAL DIGITAL BIOLOGY
MICROBIOME
DIGITAL HEALTHGENOME / GRS
PHARMACOGENOME
EXPOSOME
PHENOME
CLINICAL DATA
PERSONAL DIGITAL BIOLOGY
MICROBIOME
SENSORS + IOT
COMMUNICATION
TRAVEL
EDUCATION
PERSONAL DIGITAL BEHAVIOUR
FINANCIAL
FAMILY
NO SHORTAGE OF TOOLS
NO SHORTAGE OF TOOLS
NO SHORTAGE OF TOOLS
NO SHORTAGE OF TOOLS
NO SHORTAGE OF TOOLS
DIABETES PLATFORMS
DIABETES PLATFORMS
DIABETES PLATFORMS
DIABETES PLATFORMS
DIABETES PLATFORMS
Takeaway6
Takeaway6 How will we manage chronic disease as we age?
CONTEXTUALIZE DATA
CONTEXTUALIZE DATA
CONTEXTUALIZE DATA
CONTEXTUALIZE DATA
CONTEXTUALIZE DATA
CONTEXTUALIZE DATA
CONTEXTUALIZE DATA
CONTEXTUALIZE DATA
CONTEXTUALIZE DATA
PREVENTION > TREATMENT
PREVENTION > TREATMENT
PAY FOR NEW OUTCOMESMedical Health
PAY FOR NEW OUTCOMESMedical Health
Medical Treatment Health Maintenance
PAY FOR NEW OUTCOMESMedical Health
Medical Treatment Health Maintenance
NEW PROVIDERS
NEW PROVIDERS
NEW PROVIDERS
NEW PROVIDERS
EPISODIC TO CONTINUOUSPersonal Risk
Personal Intervention
Risk Reduction
BRANDED SUCCESSPersonal Risk
Personal Intervention
Risk Reduction
BRANDED SUCCESSPersonal Risk
Personal Intervention
Risk Reduction
BRANDED SUCCESSPersonal Risk
Personal Intervention
Risk Reduction
BRANDED SUCCESSPersonal Risk
Personal Intervention
Risk Reduction
BRANDED SUCCESSPersonal Risk
Personal Intervention
Risk Reduction
The Kodak Moment7
WHAT BUSINESS AM I IN?
N Engl J Med 2012; 367:888-889
THANK YOUFor your /me & a4en/on