Transcript 0:00 [on-hold music] Talk to me. Information, news and entertainment on demand. WUS radio.com. 0:10 [on-hold music] Welcome to The Peggy Smedley Show, the voice of IoT in our connected world with your host, Peggy Smedley. [on-hold music] Hello, listeners, and welcome back to The Peggy Smedley Show. 0:26 My first guest today is a designing and strategist of healthcare technology with work and experience in telemedicine. 0:34 His work examines how emerging technologies can allow for the improvement of healthcare services that support behavioral change. 0:43 Please join me in welcoming Samir Chatterjee, Fletcher Jones, chair of technology design and management, Claremont Graduate Use- University. Samir, welcome to the show. [on-hold music] Samir, are you there? 1:00 Yes, I am. Well, Samir, welcome. 1:03 I'm really delighted to have you on here because the things that you are doing right now, I think in trying to help improve chronic diseases, diabetes, the whole idea in trying to look at healthcare in a different way, I think is amazing. 1:19 I'd love for you to talk a little bit. I think one of the things-- I, I looked at a report that you did dating back into twenty thirteen, and you talked about how the US spent two point three trillion in healthcare. 1:33 I think that number now is probably minimal to what we do now, and you're looking at, I think, some new trials with the Loma Linda Hospital to, uh, prevent heart failure. There's all kinds of things that you're doing. 1:47 I'd love for you to just kinda start and talk about why you're really looking at helping and looking at remote monitoring technology to help us kinda have healthcare in, in place as we age. 2:02 You know, this is a big area that you're really looking at. So I'd love maybe to start, we should say, tell us how you, you got involved in this, why this is so important to you. Great. Sure. Absolutely. 2:14 So first, let me begin by going back to that data that you mentioned. So United States, uh, spends the most amount of money in healthcare, and yet when we rank ourselves with rest of the world, we are not at the top. 2:31 Okay? 2:33 And if you look at that two point seven or nine trillion, which it is now roughly about seventeen or eighteen percent of the GDP spent on healthcare, ninety-five percent of that money is spent on six to seven chronic diseases. 2:50 So it's astounding. And when you look at these chronic diseases such as diabetes, heart failure, stress, anxiety, COPD, cancer, 3:02 one of the recurring themes is that many of these chronic diseases is driven by human behavior. Simple things as, do we watch our diet? Do we exercise on a daily basis? Do we take our medications on time? 3:19 Do we adhere to certain self-management principles that are recommended by the physicians and the hospitals? And the answer is, increasingly, we don't. 3:30 So I got fascinated with this, and I, I, I kind of got into this by saying, "Okay, I'm a technology designer, and my whole training is, you know, innovation. We have to start thinking differently." 3:43 So if doctors, hospitals, and providers are saying certain things to people, and they're not doing it, so my first question is, why aren't they doing it? And it turns out that we as humans have a tendency to cut corners. 4:00 Basically, we are often lazy. So if there's a medication that can cure me, I will not do anything else but take that medication. 4:07 If there is some kind of a surgery that can be done on me, I would rather go that route but not improve. So, so I really got focused into this whole emerging world of technology-driven prevention. 4:22 And that's where I started thinking that today people have smartphones. Today, people use apps. People are using the internet for so many things. 4:33 Why can't we look into this combination of information and communication technology that can start to alter the attitude, alter our behavior, and steer it in the ri-- the right direction? 4:49 So that's really how I, I got this, into this. 4:52 And in many ways, you know, the, the timing was interesting because technology advances in sensors, in location management, in software and apps have been advancing at a rapid speed. 5:05 So we in my lab in Claremont, you know, we are focused exclusively on, um, on, on these big health disease areas, which is diabetes, COPD, heart failure, cancer, 5:17 and we are building technologies and systems by which we can persuade that necessary behavior change. So that's the- Can you make a good- In a nutshell, you know, my, my current work. 5:30 And I think it's amazing because can remote monitoring now take us out of this habit? And I don't wanna pick on doctors, but we put every patient in a certain bucket, that we have certain ranges. 5:42 But because everybody's unique, are-- is there a way now to use remote monitoring to look at individuals' behaviors differently now? 5:52 So we don't have to say everybody has to be in a certain range because now we can look at each individual uniquely and now extend the data 'cause we always say data is about everybody should be this way. 6:06 Are we going to be able to use the data to look at patients uniquely and be able to find things individually? A-absolutely. 6:13 In fact, that is the focus of most of the exciting research in this space.So, you know, it is easy to collect data today. 6:23 You know, data can be obtained from apps, from wearables, from sensors, from accelerometers, but data is just half the story. 6:31 The next step is how do we analyze the data and convert that into actionable messages that can be prompted to the patient or the subject so that the person can do something with it. 6:45 You know, so it's, it's most important is not to display a histogram of your trend that you have been increasingly ac-- you know, physically active, but what else can you do with that data, right? 6:56 And that's where tailoring comes in. You know, one of the principles of persuasive technology is how we tailor, uh, the messages so that it, it works on the individual, and it is not one-size-fits-all. 7:12 So when I say tailoring, you know, we are beginning to consider, uh, personality traits, and we cannot assume everybody will be same. 7:22 So we can create buckets of personality traits, and then when we craft the messages based on the data, they are tailored to that personality trait. We are looking at tailoring in a cultural sense. 7:32 African Americans are different from Hispanics, they are different from Asians, and they are different from Caucasians. What does it mean so that we can have those effective messages? 7:42 So, so there's a lot of, you know, customization and tailoring, but I don't think we have kind of, you know, reached a solution on that, but that is where mo-much, much of the current focus is on my work and some of my colleagues. 7:58 Now, you just completed a heart failure trial at Loma Linda Hospital. What did you discover from the trial? Okay. So this has been a fascinating journey. 8:08 Um, I received a phone call from the chief cardiac nurse at Loma Linda, and she said that she has heard from a colleague that I do persuasive technology, and she just told me, "I have two problems." She said, 8:22 "I get a lot of patients who come to my ICU and clinic. We treat them for two days, three days, and then we release them, 8:32 and we tell them that you have to now do these things at home, which is manage your low sodium diet, moderate exercise, do not forget to take your medications, measure your blood pressure, report any symptoms. 8:44 But what happens is, as soon as those patients leave the clinic, they are gone." She kind of said, "We have no visibility into their lives." 8:53 And the second thing is, "But we see increasing number of them coming back to the hospitals, and that is now termed as a hospital readmission. 9:03 In fact, as much as thirty to forty percent of patients released within a month are admitted back into the hospital." 9:10 Now, when that is happening, there is a deeper consequence to the hospital, which is because of the changes in healthcare and reimbursement laws, they're not being reimbursed at the same level as before, and they will be penalized if that hospital readmission number exceeds the national average. 9:29 So it is in the interest of the provider to actually keep the patient in the home, but how do you do that? Remote monitoring comes in, telemedicine technologies. 9:38 So we were able to design an app by which the patient could interact, measuring their vital parameters, interact using, uh, the symptoms. All the data is sent through Wi-Fi and internet back to a dashboard. 9:53 And now the physicians and clinicians are able to see all the data on a daily basis. We built rules inside the system so that we can begin to risk classify the patient as red, orange, and, and green. 10:06 Green means everything is looking good. Red means some parameter is exceeding the range and must be looked at. 10:13 And we have notifications going into the providers and physicians, so they can log into the dashboard, connect and see the data, and then make a phone call intervention, so that the whole idea is to keep the patient in the home. 10:27 So this is a trial that we did with about ten patients, a pilot trial. Not one of them were readmitted, as opposed to the original values of thirty percent coming back. 10:39 There was one patient who had to be brought into the ER because she was having flu and her heart rate was very low. And so this was very encouraging that we were actually able to keep them in the home. 10:51 And how did we do that? The nurses and the physicians had all the data in front of them. They would call in, and they would say, "Hey, change your diuretics. Uh, watch that diet. 11:01 Uh, you may have to report the symptoms on a, on a regular basis." And just a simple intervention because they had the data in front of them enabled us to keep all the patients in the home. 11:12 On the flip side, the patients were extremely happy using our system. Uh, they were actually bringing the app in their regular checkups to their cardiac physician and showing them like, "Look, I'm, I'm exercising more. 11:25 You know, my weight is managed. My blood pressure is being managed." So they were taking ownership of the, the app and the data in some sense. So this gave, uh, me and my members here a lot of confidence. So I... 11:38 If, if I'm allowed to say this, since that point, you know, this has now become a startup. So we have a commercial venture, and we are launching, uh, much more- Sameer, we're out of time. 11:47 We're out of time, but I hope you'll come back and tell me how the trial continues, okay? Hey, listeners, stick around. We got more to come right here on The Peggy Smedley Show. [upbeat music] Education. 11:58 Industry experts. Back to the basics. Is your company using the Internet of Things to its fullest potential? 12:03 Enlist the Peggy Smedley Institute and its team of experts to create a customized plan for how to apply the IoT to your specific needs. 12:12 Learn everything you need to know to achieve tangible business outcomes in today's digital economy. 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