Post on 07-Jan-2016
description
Total Body Scanning
Longitudinal Health Record
Total Body Scanning
Longitudinal Health Record
Richard M. Satava, MD FACSProfessor of Surgery
University of Washingtonand
Senior Science AdvisorUS Army Medical Research and Materiel Command
Richard M. Satava, MD FACSProfessor of Surgery
University of Washingtonand
Senior Science AdvisorUS Army Medical Research and Materiel Command
National Forum on the Future of the Defense Health Information System ASD(HA) and Georgetown University
Arlington, VAMarch 26, 2008
National Forum on the Future of the Defense Health Information System ASD(HA) and Georgetown University
Arlington, VAMarch 26, 2008
and theand the
Disruptive Visions
http://depts.washington.edu/biointel
“The Future is not what it used to be !”
- Yogi Berra
“The Future is here …
. . . it’s the Information Age”
“The Future is here …
. . . it’s the Information Age”
Current Visions
SATAVA 7 July, 1999DARPA
The Information Age is NOT the Future
The Information Age is the Present ...
There is something else out there . . . .
Scientific Method . . .. . . is DEAD?
HISTORYObservation, PhenomenonExperimentScientific method, …?
Not all science is explainable using scientific methodIntuitionCreativityQuantum mechanicsEMERGENT PROPERTIES
What comes BEFORE the hypothesis?
Observation, phenomenon, experiment, scientific method, …?
A new “science” may need to be invented
THE STRUCTURE
OF SCIENTIFIC
REVOLUTIONS
THOMAS S. KUHN
SCIENTIFIC METHODControlled, randomized, double-blind trial
Control GroupNo Parachute
Test GroupParachute
Still looking for volunteers for the control groupStill looking for volunteers for the control group
Scientific MethodA Paradigm Change in Evolution
Hypothesis Study Design Experiment Results Reporting
Hypothesis Study Design Modeling & Experiment Results Reporting Simulation
Modeling & Simulation
New technologies that are emerging from Information Age discoveries are driving our basic approach in all areas of healthcare
. . . For example, the LHR
New technologies that are emerging from Information Age discoveries are driving our basic approach in all areas of healthcare
. . . For example, the LHR
Fundamental Concept
Preventive Acute/chronic Proactive Reactive Predictive Retrospective Parametric Qualitative Point of care Centralized .
Visual Text
Preventive Acute/chronic Proactive Reactive Predictive Retrospective Parametric Qualitative Point of care Centralized .
Visual Text
The Five Ps of Precision Healthcare
It’s Time to TransitionHow we populate the LHR - the ContentHow we populate the LHR - the Content
The Fundamental Change
What do these have in common with the LHR?
Venus of Willendorf 24,000 BC
Visual Cortes
It’s Time to Transition
Healthcare has only begun to realize the potentialof high performance computing
By 2015 a laptop will compute at 1 TeraHz - today’s supercomputer
Atari 1977 Mac 1984 ? 2015
Courtesy A. TsiarasAnatomic Travelogue
How we view the LHR - the InterfaceHow we view the LHR - the Interface
Why modeling & simulation, imaging and robotics• Healthcare is the only industry without a computer representation of its “product”
•A robot is not a machine . . .it is an information system with arms . . .
• A CT scanner is not an imaging system it is an information system with eyes . . .
thus
• An operating room is an information system with . . . * “The Information Age is about changing from objects and atoms to bits & bytes”
Nicholas Negroponte “Being Digital” - 1995
Information basis for Medicine
Borrow from Industry – eg,CAD/CAM
Information basis for Medicine
Borrow from Industry – eg,CAD/CAM
The Fundamental Change
Healthcare has only begun to realize the potential
The Industry StandardCAD/CAM
Virtual Prototyping
Virtual Medical Design
Virtual Testing
HolomerTotal body-scan
for total knowledge
Satava March, 2004Virtual Soldier Program
Information Representation of a PatientInformation Representation of a PatientMedical equivalent of CAD/CAMMedical equivalent of CAD/CAM
Multi-modal total body scan on every trauma patient in 15 seconds
* Battlefield Medical Information System – Tactical - deployed to 3000 medics in IraqReal time data display from demo in which data drives image and prediction July, 2005
The Virtual Soldier
The Media PerceptionSeattle Times
By Brier Dudley, Seattle Times Mar. 17, 2008-A few years from now, when you drive into a McDonald's parking lot, your dashboard computer will start beeping. The computer is synced to your phone, and both deviceshave geographic location services. They know where you are and, based on your credit-card activity, they guess you're about to order another burger and supersized fries. But because you've subscribed to Microsoft Personal Trainer 2015, a premium feature of the online health-management system you've been using since 2012, technology intervenes. The services are gathering information on your behalf, using a new software platform that began taking shape in 2008. When your car stops moving, the phone projects your image on the windshield, similar to R2D2 played the holographic image of Princess Leia in "Star Wars."
Mar. 17, 2008-A few years from now, when you drive into a McDonald's parking lot, your dashboard computer will start beeping. The computer is synced to your phone, and both deviceshave geographic location services. They know where you are and, based on your credit-card activity, they guess you're about to order another burger and supersized fries. But because you've subscribed to Microsoft Personal Trainer 2015, a premium feature of the online health-management system you've been using since 2012, technology intervenes. The services are gathering information on your behalf, using a new software platform that began taking shape in 2008. When your car stops moving, the phone projects your image on the windshield, similar to R2D2 played the holographic image of Princess Leia in "Star Wars."
On the windshield, you're looking chubbier than you do in the rear-view mirror, because the image shows what you'll look like if you keep eating this way. Superimposed on the image is your current weight, the cholesterol reading from your last checkup and -- highlighted in red -- a notation that you haven't used your Web-connected treadmill for over a month. The image flickers and zooms ahead two years, showing how you'll appear after gaining an extra 30 pounds and being diagnosed with diabetes. With the ka-ching sound of a slot machine, it starts calculating what will happen to your health and life-insurance premiums. Somewhere in the background, it sends an update to your physician. The image on your windshield is more than virtual. It's reality, based on the
On the windshield, you're looking chubbier than you do in the rear-view mirror, because the image shows what you'll look like if you keep eating this way. Superimposed on the image is your current weight, the cholesterol reading from your last checkup and -- highlighted in red -- a notation that you haven't used your Web-connected treadmill for over a month. The image flickers and zooms ahead two years, showing how you'll appear after gaining an extra 30 pounds and being diagnosed with diabetes. With the ka-ching sound of a slot machine, it starts calculating what will happen to your health and life-insurance premiums. Somewhere in the background, it sends an update to your physician. The image on your windshield is more than virtual. It's reality, based on the
Microsoft's Future Vision (Healthcare)Microsoft's Future Vision (Healthcare)
Virtual Autopsy . . .
Wound Tract
Less than 2% of hospital deaths have autopsy
Statistics from autopsy drive national policies
. . . is a SIMULATED Autopsy. . . is a SIMULATED Autopsy
Total Integration of Surgical Care
Courtesy of Joel Jensen, SRI International, Menlo Park, CA
Minimally Invasive& Open Surgery
Pre-operative planningSurgical Rehearsal
Intra-operative navigation
Remote Surgery
Simulation & TrainingPre-operative Warmup
Endovascular Simulators(Surgical rehearsal)
Graphicoverlay
Patient specific image
From tissue and instruments
to
Information and energy*
From tissue and instruments
to
Information and energy*
* “The Information Age is about changing from objects and atoms to bits & bytes”Nicholas Negroponte “Being Digital” - 1995
The Fundamental Change
Information and computersCornerstone of Systems Integration
Single instrument which
- performs both diagnosis & therapy - in real time - can be autonomous - feedback from data in the EHR
Single instrument which
- performs both diagnosis & therapy - in real time - can be autonomous - feedback from data in the EHR
What possible importance does LHR have for technical proceduresWhat possible importance does LHR have for technical procedures
Smart Surgical ToolsInstrumented ScalpelInstrumented ScalpelXACTIX
XACTIX
CONVENTIONAL
MEMS SharpsMEMS Sharps
Courtesy: E.C. Benzel, L.A. Ferrara, A.J. Fleischman, S.Roy
Information on the Battlefield
BMIS-T
Holomer on battlefield video click hereHolomer on battlefield video click here
The LSTATLife Support for Trauma and Transport
Courtesy of Integrated Medical Systems, Signal Hill, CA
“ . . . with a fully functional ICU ”
• Defibrillator
• Ventilator
• Suction
• Monitoring
• Blood Chemistry
Analysis
• 3-Channel Fluid/Drug
Infusion
•Data Storage and
Transmission
• On-board Battery
• On-board Oxygen
• Accepts Off-Board
Power and Oxygen
Total Patient Awareness
Bring the hospital to the casualty, not the casualty to the hospital . . .
212th MASH Deployed with LSTAT - Combat Support Hospital
LSTAT Deployment to Kosovo - March 2000
Courtesy of Integrated Medical Systems, Signal Hill, CA
Confidential
If you are not making mistakesyou are not working hard enough … … and that’s a big mistake! Anonymous
Experience is the name everyone gives to their mistakes - Oscar Wilde
Be careful ofunintendedconsequences
Do Robots Dream ?http://depts.washington.edu/biointel