The Future is Cyber-Healthcare

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Payam BarnaghiInstitute for Communication Systems (ICS)/5G Innovation Centre University of SurreyGuildford, United Kingdom

The Future is Cyber-Healthcare?

3IBM Mainframe 360, source Wikipedia

Apollo 11 Command Module (1965) had 64 kilobytes of memory operated at 0.043MHz.

An iPhone 5s has a CPU running at speeds of up to 1.3GHzand has 512MB to 1GB of memoryCray-1 (1975) produced 80 million Floating point operations per second (FLOPS)10 years later, Cray-2 produced 1.9G FLOPS

An iPhone 5s produces 76.8 GFLOPS – nearly a thousand times more

Cray-2 used 200-kilowatt power

Source: Nick T., PhoneArena.com, 2014image source: http://blog.opower.com/

Computing Power

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−Smaller size−More Powerful−More memory and more storage

−"Moore's law" over the history of computing, the number of transistors in a dense integrated circuit has doubled approximately every two years.

Smaller in size but larger in scale

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The old Internet timeline

7Source: Internet Society

The World Wide Web

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Tim Berners-Lee

Connectivity and information exchange was (and is ) the main motivation behind the Internet; but Content and Services are now the key elements;

and all started growing rapidly by the introduction of the World Wide Web (and linked information and search and discovery services).

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Early days of the web

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The Internet/Web in the early days

1111

Source: Intel, 2012

13P. Barnaghi et al., "Digital Technology Adoption in the Smart Built Environment", IET Sector Technical Briefing, The Institution of Engineering and Technology (IET), I. Borthwick (editor), March 2015.

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Sensor devices are becoming widely available

- Programmable devices- Off-the-shelf gadgets/tools

Internet of Things: The story so far

RFID based solutions

Wireless Sensor andActuator networks

, solutions for communication

technologies, energy efficiency, routing, …

Smart Devices/Web-enabled

Apps/Services, initial products,

vertical applications, early concepts and demos, …

Motion sensor

Motion sensor

ECG sensor

Physical-Cyber-Social Systems, Linked-data,

semantics, M2M, More products, more

heterogeneity, solutions for control and

monitoring, …

Future: Cloud, Big (IoT) Data Analytics, Interoperability,

Enhanced Cellular/Wireless Com. for IoT, Real-world operational

use-cases and Industry and B2B services/applications,

more Standards…

1G

AMPS, NMT, TACS

2G

GSM. GPRS, TDMA IS-136, CDMA IS-95, PDC

3G

UMTS, CDMA2000,

4G5G

LTE, LTE-A

PeopleThings

Voice

Text

Data

5G technologiesand standards

Connection + Control M2M/IoT

Communication technologies

5G – Vertical Applications

17Image source: The Brain with David Eagleman, BBC

Speed of light?

The IoT is a dynamic, online and rapidly changing world

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Conventional (Big) Data Analytics

IoT Data Analytics

Image sources: ABC Australia and 2dolphins.com

Motion sensor

Motion sensor

ECG sensor

Live data

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3D Map- Alexandra Institute, Aarhus, Denmark

Live events

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Extracting city events

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http://iot.ee.surrey.ac.uk/citypulse-social/

Nazli FarajiDavar, Payam Barnaghi, "A Deep Multi-View Learning Framework for City Event Extraction from Twitter Data Streams", submitted to ACM Transactions on Intelligent Systems and Technology (TIST), Nov. 2015.

Medical/Health Data

− The average person is likely to generate more than one million gigabytes of health-related data in their lifetime. This is equivalent to 300 million books.

− Medical data is expected to double every 73 days by 2020.

− 80% of health data is invisible to current systems because it’s unstructured.

− Less than 50% of medical decisions meet evidence-based standards. (source: The rand corporation)

22Source: IBM Research

Unstructured data!

Heterogeneity, multi-modality and volume are among the key issues.

Often natural language!

We need interoperable and machine-interpretable solutions…

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Device/Data interoperability

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Medical/Health decision making

− One in five diagnoses are incorrect or incomplete and nearly 1.5 million medication errors are made in the US every year.

− Medical journals publish new treatments and discoveries every day.

− The amount of medical information available is doubling every five years and much of this data is unstructured - often in natural language.

− 81 percent of physicians report that they spend five hours per month or less reading journals.

25Source: IBM Research

Medical/Health data in decision making

− Patient histories can give clues. − Electronic medical record data provide lots of

information.− Current observation and measurement data and

fast analysis of the data can help (combined with other data/medical records).

− This needs fast/accurate/secure data: − Collection/retrieval− Communication− Sharing/Integration− Processing/Analysis − Visualisation/presentation

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IBM Watson

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Watson can process the patient data to find relevant facts about family history, current medications and other existing conditions.

It can combines this information with current findings from tests and instruments and then examines all available data sources to form hypotheses and test them.

Watson can also incorporate treatment guidelines, electronic medical record data, doctor's and nurse's notes, research, clinical studies, journal articles, and patient information into the data available for analysis.

Source: IBM

Watson can read 40 million documents in 15 seconds.

Sensely

28Source: http://sense.ly/

kHealth for Asthma

29Source: Kno.e.sis, Wright State University

Healthcare data analytics

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Technology Integrated Health Management (TIHM)

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Internet of Things testbed for healthcare

The Health Challenge: Dementia 16,801 people with dementia in Surrey – set to rise to

19,000 by 2020 (estimated) - nationally 850,000 - estimated 1m by 2025 (Alzheimer’s Society)

Estimated to cost £26bn p/a in the UK (Alzheimer’s Society): health and social care (NHS and private) + unpaid care

Devices in the IoT will provide actionable data on agitation, mood, sleep, appetite, weight loss, anxiety and wandering – all have a big impact on quality of life and wellbeing

TIHM

The Health Challenge: Falls Surrey spends £10m a year on fracture care –

with 95% of hip fractures caused by falls

People with dementia suffer significantly higher fall rates that cause injury – with falls the most common cause of injury-related deaths in the over-75s

Devices in the IoT will monitor location, activity and incident, supporting health/care staff and carers, enabling early intervention

TIHM

The Health Challenge: Carers 5.4m carers supporting ill, older or disabled family

members, friends and partners in England - expected to rise by 40% over the next 20 years.

Value of such informal care estimated at £120bn a year – but carer ‘burnout’ a key reason why loved ones require admission to a care/nursing home.

Devices in the IoT will support carers in their caring asks – and support their own health and wellbeing.

TIHM

Infrastructure

Interoperability, integration

Security

Data governance

Scalability

Technical Challenge

Innovation Partners Nine companies with 25+ devices and services, including monitors, sensors, apps, hubs, virtual assistants, location devices and wearables

Device/Data interoperability

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Gateway 1

Gateway 2

Gateway 3

Proprietary Cloud/Data Services

TIHM Cloud

HyperCAT

HyperCAT

HyperCAT

Multiple providers/multiple gateway (not ideal)

TIHM Middleware

Connectivity/Device Association Layer

Data Exchange/Interoperability Layer

Service/Application Layer

Bluetooth

WiFI

ZigBEE

TIHM CloudHyperCAT

REST

API

ProprietaryCloud/Data

Services HyperCAT

HyperCAT

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“Each single data item is important.”

“Relying merely on data from sources that are unevenly distributed, without considering background information or social context, can lead to imbalanced interpretations and decisions.”?

KAT- Knowledge Acquisition Toolkit

http://kat.ee.surrey.ac.uk/F. Ganz, D. Puschmann, P. Barnaghi, F. Carrez, "A Practical Evaluation of Information Processing and Abstraction Techniques for the Internet of Things", IEEE Internet of Things Journal, 2015. 41

https://github.com/UniSurreyIoT/KAT

Health and Safety Monitoring and Alert

Privacy

Security

Tru

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De

pe

nd

ab

ilit

y

Gateway

Gateway

Data Analytics Engine

IoT Test Bed Cloud

External NHS, GP IT systems

Possible links toOther Test Beds

HyperCat

Gateway

HyperCat

HyperCat

HyperCat

Data-driven and patient centered

Healthcare Applications

TIHM Testbed Architecture

Extend into homes – year 1 via two CCG areas, rolling out across four more CCGs in year 2

Reach 350 homes – with a control group of 350 – via dementia register

Focus on most effective product combinations – with potential for more via an open call

Roll Out

NE Hants & FarnhamLiving Lab

Guildford & Waverley

Rest of Surrey

And beyond…

TIHM

In Conclusion

− Great opportunities and many applications;− Enhanced and (near-) real-time insights;− Supporting more automated decision making and

in-depth analysis of events and occurrences by combining various sources of data;

− Providing more and better information to citizens;− Citizens in control − Transparency and data management issues

(privacy, security, trust, …)− Reliability and dependability of the systems

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More connected wearable devcies

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Boundary between human, technology and devices

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Cognitive systems era

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connected and intelligent systems

Accumulated and connected knowledge?

49Image courtesy: IEEE Spectrum

Other challenges and topics that I didn't talk about

Security

Privacy

Trust, resilience and reliability

Noise and incomplete data

Cloud and distributed computing

Networks, test-beds and mobility

Mobile computing

Applications and use-case scenarios

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Q&A

− Thank you.

http://personal.ee.surrey.ac.uk/Personal/P.Barnaghi/

@pbarnaghi

p.barnaghi@surrey.ac.uk

http://www.sabp.nhs.uk/tihm