Text Text Eindhoven Innovation Day

25 November 2015

High Tech Campus, Eindhoven

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Self-management of health and disease - Vision on the future Reinder Haakma Philips Research

November 25, 2015

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• Aging population with more chronic and lifestyle related diseases puts a focus on healthcare cost containment

• Fast population growth requires improved access to care

• Digital technology offers new opportunities for more outcome based health management

• In the age of the quantified self, consumers are more actively engaged in their health and health is an engine for today’s economy

A new world dynamic… requires a new approach

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We target healthcare customer and consumer needs along the health continuum

Enable more effective

therapies, faster recovery and

better outcomes

Ensure first time right diagnosis

with personalized and adaptive care

pathways

Support recovery and chronic care

at home

Enable people to manage their own health

Help people to live a healthy life

in a healthy home

environment

Improve population health outcomes and efficiency through integrated care, real-time analytics and value-added services

Monitoring, informatics and connected care

Prevention Healthy living Diagnosis Treatment Home care

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We build off strong leadership positions

1 Global leader: #1 or #2 position in the global market. Source: GfK, Nielsen, Euromonitor, Frost and Sullivan, Home Healthcare TBS, PCMS market insight.

Global top 3

Diagnostic

imaging

Global leader

Sleep & Respiratory Care

Global leader

Image-guided

interventions

Global leader

Ultrasound #1 in China

Air

Global leader1

Male electric

shaving

Global leader

Power

toothbrush

#1 in North America

Home

Monitoring

Global leader

Mother &

Childcare

#1 in North America

Cardiology Informatics

Global leader

Patient Monitoring

Monitoring, informatics and connected care

Prevention Healthy living Diagnosis Treatment Home care

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Self-management of health and disease • Main challenge in healthcare

Improve the quality and cost-effectiveness of healthcare systems

• Trends in healthcare

Self-management of health and disease • patient-centered health care • patient empowerment • taking charge of your own health • shift from care giver to patient

• increase the patient’s role and the responsibility

Boundaries between primary care and secondary care diminish • through technological advances and political intervention

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Re-thinking medical diagnosis and treatment - From patient perspective

diagnosis treatment

clinical decisions

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Technology trends

• Quantified self Acquiring self-knowledge by self-monitoring

on aspects of daily life such as • behavior and performance

(food intake, physical activity) • biometrics, physical as well as mental

(heart rate, mood, alertness) • environment

(air quality, light exposure).

• Wearable electronics

wearable sensors (EEG, ECG, video, etc.) and wearable computing as enablers of self-monitoring and self-sensing allowing people to quantify biometrics in daily life settings in a cheap and convenient way.

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Unobtrusive heart rate monitoring - Philips WeST business

Alpha 2

Forerunner 225

Cardio Runner miCoach

Smart Watch

Alpha Fit Smart

Link

Fuse

Velo

Health Watch

Jan2013 Jan2016

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Photoplethysmography

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WeST measurements

• Heart Rate beats per minute (bpm)

• VO2Max

ml/min

• Energy Expenditure

kcal/h

• Motion Cadence

cycles/min

• Respiration Rate

breaths/minute (brpm)

• Sleep Stage

• Wake, REM, Light, Deep sleep

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Self-management across the health continuum

• Self-management Enabling people/patients to manage their health on a day-to-day basis.

• Across the health continuum for cardio-vascular conditions

Overweight → Hypertension → Atrial Fibrillation → Heart Failure

Prevention Healthy living Diagnosis Treatment Home care

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Healthy living

Healthy living

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Healthy living - An ounce of prevention is worth a pound of cure

• Four healthy lifestyle factors

never smoking maintaining a healthy weight exercising regularly following a healthy diet

• together are associated with

as much as an 80 risk percent reduction of developing the most common and deadly chronic diseases.

• The risk factors of the leading health conditions are highly behavior-related.

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Activelink - A Philips – Weightwatchers collaboration

Measure

Monitor

Motivate

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Prevention

Prevention

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Hypertension and blood pressure

• Blood pressure

the pressure exerted by circulating blood upon the blood vessel walls one of the principal vital signs

• Hypertension

chronic medical condition in which the blood pressure is elevated rarely accompanied by any symptoms • identified usually through screening,

or when seeking healthcare for unrelated problems

prevalent in 30-45% of the EU population • steep increase with age

major risk factor for cardiovascular diseases • stroke, myocardial infarction, heart failure,

aneurysms, peripheral arterial disease • a cause of chronic kidney disease

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Hypertension

• World Health Organization (WHO) – Prevalence

Globally, the overall prevalence of raised blood pressure in adults aged 25 and over was around 40% in 2008.

– Impact Hypertension is the most important preventable risk factor for premature death

worldwide. Raised blood pressure is estimated to cause 7.5 million deaths, about 12.8% of the total

of all deaths. Raised blood pressure is a major risk factor for coronary heart disease and ischemic as

well as hemorrhagic stroke.

• Of those with high blood pressure

82% are aware they have it 75% are under current treatment 53% have it controlled 47% do not have it controlled

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• Office or clinic BP Sphygmomanometer • Two measurements • By clinician

• Ambulatory BP

BP at regular intervals • Every 15 to 30 minutes • Automatically operated

• Home BP

Two measurements each time Operated by user/patient

• New solutions

More easy and less obtrusive More frequent measurements

Monitoring blood pressure

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Unobtrusive, continuous BP monitoring

• Measurements Continuously PPG

• wrist & ankle Cuff measurements for calibration

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Treatment strategies - lifestyle changes

• Guidelines

Salt restriction Moderation of alcohol consumption Increased consumption of vegetables,

fruits, and low-fat dairy products Reduction of weight Regular exercise Quit smoking

• Effective lifestyle modification may lower

blood pressure as much an individual antihypertensive drug.

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Treatment strategies - pharmacological therapy

• Agreement on the major mechanism of the benefits of antihypertensive therapy is lowering of BP per se the effects on cause specific outcomes of the various agents are similar or differ by only a minor

degree the type of outcome in a given patient is unpredictable all classes of antihypertensive agents have their advantages but also contra-indications

• Classes of antihypertensive agents

diuretics (including thiazides, chlorthalidone and indapamide) beta-blockers calcium antagonists angiotensin-converting enzyme (ACE) inhibitors angiotensin receptor blockers

• Physicians should pay attention to adverse drug effects — even those purely

subjective — as they are powerful deterrents to treatment adherence.

• If necessary, doses or drugs should be changed in order to combine effectiveness with tolerability.

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Diagnosis

Diagnosis

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Atrial Fibrillation

Screening Management

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Treatment

Treatment

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Early stratification of cardio-vascular health risks

Combining available data to develop new stratification techniques on patient health and prognosis (context-dependent, personalized decision support)

Central use case: cardiac resynchronization therapy (CRT):

Heart Failure

Data sources: • electronic patient records/cardio-database:

lab results medication cardiac records measurements

• wearable personal health devices (PPG)

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Home care

Home care

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Medication management

Philips ResearchLifestyle Program

Getting New

Medication Obtaining

The Medication

Finding Out

How to Use

The Medication

Organizing

The Medication Taking

The Medication

Dealing With

Mistakes Dealing With

Side Effects

Keeping Up

With The Medication

Getting

The Medication

Reviewed

Taking

Medication

Away from Home

1 2 3 4 5

6 7 8 9 10

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Medication monitoring - for personalized titration

• Balancing act Outcome = Efficacy x Adherence QOL = outcome – side effects

• Beta blockers

Used in cardiac arrhythmia management protecting the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention).

Beta blockers have a reductive effect on heart rate Adverse drug reactions include hypotension,

fatigue, dizziness and insomnia.

• Personalized titration for

optimize dose-response minimize side effects early detection of deterioration identify drug interactions and comorbidities

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Re-thinking medical diagnosis and treatment - From patient perspective

diagnosis treatment

clinical decisions

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Wearables invade the market

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The future after 2020 …

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Text Text Eindhoven Innovation Day

25 November 2015

High Tech Campus, Eindhoven