La révolution numérique … un remède digital?

Bruno SchroderBeLux Technology OfficerMicrosoft brunosch@microsoft.com

@bruno_schroder

• Qui parmi vous est un utilisateur de services internet ou cloud?

• - oui• - non

Qui parmi vous est un utilisateur de services internet ou cloud?

1 - oui

2 - non

86%

14%

• Qui parmi vous utilise un smartphone?• - oui• - non

Qui parmi vous utilise un smartphone?

1 - OUI

2 - NON

90%

10%

• Qui parmi vous a un profil Facebook?• - oui• - non

Qui parmi vous a un profil Facebook?

1 - oui

2 - non

43%

57%

• Quelle sera l’augmentation de la puissance de calcul des ordinateurs dans les 10 années à venir?

• - de 1 à 10 fois plus puissants• - de 10 à 100 • - de 100 à 1000 • - de 1000 à 10.000

Quelle sera l’augmentation de la puissance de calcul des ordinateurs

dans les 10 années à venir?1 - de 1 à 10 x + puissant

2 - de 10 à 1003 - de 100 à 1000

4 - de 1000 à 10.000

0%

10%

17%

72%

Image of CPU

Intel ASCI RED

•1 TeraFlops•12TB de données•9298 processeurs •114 racks•230M²

•Active till September 2005

Top computer in 1999

512 GFLOPS peak

10 Years Later …

June 2011: 10.5 petaflops• Asia has come out swinging

at the top of June 2011’s Top500 list, which rates the world’s fastest computers based on the LINPACK benchmark. Leading the list is the K Computer, which achieved 10.5 quadrillion floating-point operations per second (petaflops) (Source: Communications of the ACM, Copyright 2011)

12 years of Moore’s law: 256Real life: > 10.000

~ 3.000.000 in 25 years

+

• Hotmail• 1.3 billion mailboxes• 155PB storage, growing 2PB per month (70.000 LTE)

• Windows Live Messenger• 300 million users• 76 countries, 48 languages• ~40 million people simultaneous connections• 9.9 billion messages a day via Windows Live Messenger

• 600 million unique users every month on Windows Live & MSN• 1M Business Productivity Online Suite users in 36 countries & regions• 5 petabytes of content served by Xbox Live during Christmas week• 1 Petabyte+ of updates served every month by Windows Update to

millions of servers and hundreds of millions of PCs worldwide

A worldwide infrastructure

• http://www.petapixel.com/2011/07/27/turning-the-eye-into-a-camera-sensor/

+World changes:

• Indian entrepreneurs apply mass-production Indian entrepreneurs apply mass-production techniques to sophisticated services. Aravind, the techniques to sophisticated services. Aravind, the world's biggest eye-hospital chain, performs 200,000 world's biggest eye-hospital chain, performs 200,000 operations a year. Four operating tables are laid side operations a year. Four operating tables are laid side by side as two doctors operate on adjacent tables. by side as two doctors operate on adjacent tables. When the first operation is done, the second patient is When the first operation is done, the second patient is already in place. (Economist, April 2010) (already in place. (Economist, April 2010) (link))

• Dr Shetty is only one of many Indians who are applying Henry Ford’s principles to health care. LifeSpring has reduced the cost of giving birth in a private hospital to $40 by looking after many more mothers.

• Quel pourcentage de la population mondiale dispose d’un GSM?

• 27%• 47%• 67%• 87%

Quel pourcentage de la population mondiale dispose d’un GSM?

1 - 27%

2 - 47%

3 - 67%

4 - 87%

10%

21%

45%

24%

Associated behavior, here

The power of anonymity and IT as social breaker

… and there.

• Quel pourcentage d’internautes a obtenu des informations médicales en ligne?

• - 35%• - 55%• - 75%• - 95%

Quel pourcentage d’internautes a obtenu des informations médicales en

ligne?

1 - 35%2 - 55%3 - 75%4 - 95%

11%

11%

46%

32%

• 75% of internet users have obtained health or 75% of internet users have obtained health or medical info online, more than those who medical info online, more than those who have checked news (71%), watched video have checked news (71%), watched video online (48%), and paid for digital content online (48%), and paid for digital content (28%). (Pew, 2009)(28%). (Pew, 2009)

The Social Proof

• http://techcrunch.com/2011/11/27/social-proof-why-people-like-to-follow-the-crowd/

The task is not so muchto see what no one yet has seen, butto think what nobody has yet thoughtabout that which everyone sees

– Schopenhauer

The Knowledge Paradox. Cooperation

• Twitter comme indexeur

• Facebook deviendra-t-il:• - un centre de formation médicale continuée?• - le lieu sécurisé des interactions avec les

patients• - l’annuaire médical?

Facebook deviendra-t-il:

1 - un centre de formation médicale continuée?

2 - le lieu sécurisé des interactions avec les patients

3 - l’annuaire médical?

38%

38%

23%

CareMore• CareMore started over 15 years caring

for seniors as a Medical Group. Years later, CareMore began serving seniors as a Health Plan and continues to do so today through our Provider partners and as a Medical Group. CareMore is dedicated to the senior market in 3 states and we have plans for future expansion.

• http://www.caremore.com/About.aspx• http://www.facebook.com/

CareMoreHealth

Healthcare Spending• With technology and preventive measures, With technology and preventive measures,

CareMore - with its 26 care centers - has a CareMore - with its 26 care centers - has a hospitalization rate that's 24% below average, hospitalization rate that's 24% below average, hospital stays that are 38% shorter, and am hospital stays that are 38% shorter, and am amputation rate among diabetics that's 60% amputation rate among diabetics that's 60% lower than average. The overall member costs lower than average. The overall member costs are also 18% below the industry average are also 18% below the industry average (CareMore, January 2011).(CareMore, January 2011).

• The United States spends $2.1 trillion on health The United States spends $2.1 trillion on health care, $650 billion above expectations. (MGI, care, $650 billion above expectations. (MGI, November 2008) (November 2008) (link))

Doximity and Sermo

• Professional Networks for Physicians

• Launched a little more than a year ago, Doximity now has 9% of all U.S. physicians as members.

• Sermo has over 125,000+ physicians in 68 specialities

• https://www.doximity.com/

• http://www.sermo.com/

Recent ArticlesComplex Disease Management: What’s next for mHealth LinkedIn Co-Founder Konstantin Guericke Joins Doximity’s Board of Directors Doximity Partners with Stanford on Alumni App Why Social Media is Just What the Doctor Ordered Now on Our Site: Doximity Product Videos Why Online Social Networking Should Change What We Know about Health Care Social Media and Health Care: The Power of Networked Physicians The Rebirth of Primary Care Doximity Notes from the Road: SXSW Recap Getting to a Better Patient Handoff

Que peut faire un smartphone?•téléphoner•diagnostiquer la malaria•dépister le mélanome•prise de tension•ecg•Stéthoscope

Que peut faire un Smartphone?1 - téléphoner

2 - diagnostiquer la malaria

3 - dépister le mélanome

4 - prendre la tension

5 - un ecg

6 - diagnostiquer une pneumonie

7 - un stéthoscope

75%

59%

66%

56%

56%

47%

63%

Silver Edison Award• http://eyenetra.com/netra-g.html

Anatomy Of A Handheld Hospital1 Processor that can power a pacemakerSmartphones run superfast (in excess of 1 GHz) without consuming much power, much like top-notch pacemakers and cardiac defibrillators.2 Display that can assess an ultrasoundThe iPhone 4S's resolution (300 pixels per inch) is on par with most hospital-grade ultrasound monitors, and small screen size won't matter once projection tech takes off.3 Camera that can capture cellsThe HD video camera, which shoots 30 frames per second, is more advanced than some of the ones in colonoscopes, which doctors use to seek out potentially cancerous tissue.4 Accelerometer that can guide physical therapyThe three-axis accelerometer captures the same subtle movements--tilts, shocks, rotations--as APDM motion sensors, which are used to monitor patients' Parkinson's disease and help them through physical therapy.5 Microphone that can hear your heartBecause of its flat-frequency response rate--which drastically reduces noise distortion--a smartphone mic (with help from an amplifying attachment) can detect a heartbeat almost as well as a $500 electronic stethoscope.

•http://www.fastcompany.com/magazine/162/health-industry-smartphones-tablets

Mobile Health

• In 2011, 14% of all adult Americans (approximately 31 million), up from In 2011, 14% of all adult Americans (approximately 31 million), up from 9%, will use a mobile health application to manage their health, wellness, 9%, will use a mobile health application to manage their health, wellness, and chronic conditions. (IDC, December 2010) (link)and chronic conditions. (IDC, December 2010) (link)

• 14% of adult Americans will use a mobile health application to manage 14% of adult Americans will use a mobile health application to manage their health, wellness, and chronic conditions in 2011. (IDC, December their health, wellness, and chronic conditions in 2011. (IDC, December 2010) (link)2010) (link)

• There are 17,000 mHealth applications in major app stores, 74% of them There are 17,000 mHealth applications in major app stores, 74% of them adhering to the paid business model. (research2guidance, November adhering to the paid business model. (research2guidance, November 2010) (link)2010) (link)

• Ford researchers demonstrate a series of possible in-car health and Ford researchers demonstrate a series of possible in-car health and wellness connectivity services and apps aimed at helping people with wellness connectivity services and apps aimed at helping people with chronic illnesses or medical disorders such as diabetes, asthma or allergies chronic illnesses or medical disorders such as diabetes, asthma or allergies manage their condition while on the go. (Ford, May 2011)manage their condition while on the go. (Ford, May 2011)

• 500 million of 1.4 billion smartphone users in 2015 will be running some 500 million of 1.4 billion smartphone users in 2015 will be running some kind of mobile healthcare application. (research2guidance, November kind of mobile healthcare application. (research2guidance, November 2010) (link)2010) (link)

• Shimba Technologies plans a Yelp-like feature for Shimba Technologies plans a Yelp-like feature for mobile health app MedAfrica so that users can mobile health app MedAfrica so that users can comment on doctors in order to provide context comment on doctors in order to provide context for who is better out of a "laundry list" of for who is better out of a "laundry list" of providers (Technology Review, December 2011).providers (Technology Review, December 2011).

• Of ther 25,000 people who have downloaded Of ther 25,000 people who have downloaded mobile health app MedAfrica between late mobile health app MedAfrica between late November and mid-December 2011, 60% are November and mid-December 2011, 60% are "active users" (Shimba Technologies, December "active users" (Shimba Technologies, December 2011).2011).

Medical Records and Research

• One vision of digital technologies bringing about true prevention includes telemonitoring moves One vision of digital technologies bringing about true prevention includes telemonitoring moves from mobile apps to nanosensors to measure BP, respiration, blood glucose, cholesterol, and other from mobile apps to nanosensors to measure BP, respiration, blood glucose, cholesterol, and other physiological indicators (National Heart, Lung & Blood Institutde, December 2011).physiological indicators (National Heart, Lung & Blood Institutde, December 2011).

• A review of randomized studies of mobile apps for smoking cessation found that they helped in the A review of randomized studies of mobile apps for smoking cessation found that they helped in the short term, but that there is insufficient research to determine long-term benefits (National Heart, short term, but that there is insufficient research to determine long-term benefits (National Heart, Lung & Blood Institute, December 2011).Lung & Blood Institute, December 2011).

• By preemptively identifying who's in which half of the population that are helped by certain drugs, By preemptively identifying who's in which half of the population that are helped by certain drugs, genomics might keep patients, private insurers, and Medicare from wasting tens of billions of genomics might keep patients, private insurers, and Medicare from wasting tens of billions of dollars a year (Technology Review, December 2011).dollars a year (Technology Review, December 2011).

• Every minute of the most commonly used high-resolution video in surgeries generate 25 times the Every minute of the most commonly used high-resolution video in surgeries generate 25 times the data volume (per minute) of even the highest resolution still images such as CT scans, and each of data volume (per minute) of even the highest resolution still images such as CT scans, and each of those still images already requires thousands of times more bytes than a single page of text or those still images already requires thousands of times more bytes than a single page of text or numerical data. (McKinsey Global Institute, 2011)numerical data. (McKinsey Global Institute, 2011)

• More than 95% of the clinical data generated in health care is now video. Multimedia data already More than 95% of the clinical data generated in health care is now video. Multimedia data already accounts for more than half of Internet backbone traffic (i.e., the traffic carried on the largest accounts for more than half of Internet backbone traffic (i.e., the traffic carried on the largest connections between major Internet networks), and this share is expected to grow to 70% by 2013. connections between major Internet networks), and this share is expected to grow to 70% by 2013. (McKinsey Global Institute, 2011)(McKinsey Global Institute, 2011)

• 1,900 physicians in Ghana have logged 1M+ 1,900 physicians in Ghana have logged 1M+ calls to patients since 2008 thanks to MDNet; calls to patients since 2008 thanks to MDNet; a system that allows users in Ghana and a system that allows users in Ghana and Liberia to call or text doctors for free Liberia to call or text doctors for free (AfricaAid, December 2011).(AfricaAid, December 2011).

• QuantifyMe• HealthVault >< GoogleHealth

Big Data

• If the US health industry would use big data If the US health industry would use big data creatively and effectively to drive efficiency creatively and effectively to drive efficiency and quality, the potential value could be $300 and quality, the potential value could be $300 billion every year, two-thirds of which would billion every year, two-thirds of which would be in the form of reducing national health be in the form of reducing national health care expenditures by about 8%. (McKinsey care expenditures by about 8%. (McKinsey Global Institute, 2011)Global Institute, 2011)

Big Data/ Data analysis saves life

Uncovering New Ways the Human Immune System Fights HIV

http://research.microsoft.com/en-us/collaboration/stories/hiv_research_za.aspx

Adjusting Pneumonia Vaccination to Save Liveshttp://research.microsoft.com/en-us/collaboration/stories/pneumonia-vaccination.aspx

A database that could save Healthcare:

• On May 22 a new nonprofit called the Health Care Cost Institute will roll out a database of 5 billion health insurance claims (all stripped of the individual health plan’s identity, to address privacy concerns).

• http://mobile.washingtonpost.com/rss.jsp?rssid=615&item=http://www.washingtonpost.com/Fragment/SysConfig/WebPortal/twpweb/feeds/BlogsMobileIndividual/mobile-blogs.jpp%3Fid%3D1000.4.1601919935%26wprss%3D&cid=-1&spf=1

• En 2016, quel dispositif permettra de suivre sa glucomètrie en temps réel:

• - un GSM• - des lentilles de contact• - un T-Shirt?

En 2016, quel dispositif permettra de suivre sa glucomètrie en temps réel:

1 - un GSM

2 - des lentilles de contact

3 - un T-Shirt?

52%

31%

17%

Functional Contact Lens Monitors Blood Sugar Without Needles

• Researchers from the University of Washington (UW) and Microsoft Research Connections (MRC) are working together to develop a non-invasive, technological solution that promises to improve both the health and overall quality of life for diabetics: a contact lens that monitors blood glucose levels. This innovative solution represents a trend in technology, the Natural User Interface (NUI).– http://research.microsoft.com/apps/video/

default.aspx?id=150832

• Surgeons at a Toronto hospital are using Microsoft’s Xbox 360 motion sensor Kinect to call up images during operations, saving around 20 minutes each time. (Winnipeg Free Press, March 2011)

• http://www.bright.nl/chirurgen-gebruiken-kinect-voor-fotos-de-operatiekamer?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+brightmagazine+(B+R+I+G+H+T+-+innovative+lifestyle)

• Quelle est la distance maximum possible entre un ophtalmologue et son patient?

• - 1 mètre • - 5 mètres• - 20.000 kilomètres

• Connexion par la pensée?• Le singe à 3 bras

• Combien de professionnels de la médecine faudrait-il en 2050 pour assurer une couverture correcte en soins de santé à la totalité de la population de notre planète?

• - pas plus• -2 fois plus• -3 fois plus• -10 fois plus

Combien de professionnels de la médecine faudrait-il en 2050 pour assurer une couverture

correcte en soins de santé à la totalité de la population de notre planète?

1 - pas plus

2 - 2 fois plus

3 - 3 fois plus

4 - 10 fois plus

62%

28%

3%

7%

Global Health Workforce Service Providers

Current: 39 470 000Ideal Today: 84 138 046Ideal in 2050: 110 220 046 (x2.8)Missing till 2050: 70 740 046

40 years to x2.8

Source: www.who.int/whr/2006/overview fig6 en.pdf

Quelles sont les données médicales qui devraient être libre d’accès?- aucune- toutes- celles que le patient accepte de partager- celles que le médecin accepte de partager- toutes mais anonymisées

Quelles sont les données médicales qui devraient être libres d’accès?

1 - aucune

2 - toutes

3 - celles que le patient accepte de partager

4 - celles que le médecin accepte de partager

5 - toutes mais anonymisées

0%

4%

43%

7%

46%

À qui appartiennent les données médicales d’un patient? •- à son médecin•- au patient•- à la sécurité sociale?•- à la communauté médicale•- autre

À qui appartiennent les données médicales d’un patient?

1 - à son médecin

2 - au patient

3 - à la sécurité sociale?

4 - à la communauté médicale

5 - autre

14%

62%

10%

31%

3%

Transformation par la technologie

Les technologies permettent la capture, la distribution et l’utilisation répétitive de la compétence créatrice de valeur

Connexion Induit des économies d’échelle

Crée les effets réseaux

AbstractionLes généralistes remplacent les

spécialistes

Réduit la complexité

TranscriptionRend explicites les

compétences tacites et implicites

Formalise la connaissance

Dans 10 ans:la transformation algorithmique*

Transcription

Abstraction

Connexion

Réalité augmentée simple, naturelle

et adaptative

Formalisation et transcription de

modèles abstraits massifs

Réseaux autonomes ad-hoc

omniprésents

Calcul illimité

Stockage illimité

Bande passante illimitée

*Prof. John Zysman, BRIE – UC. Berkeley

Loi de Clark: “Toute technologie suffisamment avancée est assimilée à de la magie…”

La révolution technologique …

… est surtout une révolution des données et passe par un changement de mentalité.

À quand un docteur électronique?- jamais- dans 5 ans- dans 20 ans- Il est déjà là

À quand un docteur électronique?

1 - jamais

2 - dans 5 ans

3 - dans 20 ans

4 - Il est déjà là

59%

4%

11%

26%

Future is the only way forward!

Anonymous techno freak – Internet 2010