Monday, June 13, 2011

First Visiting Innovator presents sustainable health concepts

Recently, the Sheikh Zayed Institute welcomed our first Visiting Innovator to Children’s National. Inas Khayal, PhD, a bioengineer, studies sustainable health initiatives at Masdar Institute in Abu Dhabi.

Dr. Khayal’s presentation to the faculty laid out the case for a new way to think about health care. The Masdar Institute in Abu Dhabi is dedicated to identifying sustainable and efficient ways to live. Many of their research studies fall in categories one might expect, for example reducing energy inefficiencies and finding environmentally friendly building alternatives. Dr. Khayal’s research, however, looks at how today’s health system could become more sustainable, too. After her presentation, she took some time to answer our questions about sustainable health.

How did you get involved in the study of sustainable health?

The work I was doing looked at biomarkers for early warning signs of disease, or to identify types of disease, including subtypes of tumors. We found that earlier detection had much to do with survival. We moved up the imaging data to the earliest time point we could.

But we really need to move into a space where you collect health-related information before people need to come into the clinic. Our health is not sustainable, and our health costs are not sustainable. We should put effort where the problems are, and answer tough questions. I am interested in looking for innovative solutions to these problems.

How do you envision such sustainable health working in practice?

The idea is that you are looking preventively enough to see patterns that might suggest things that will lead to problem areas. To look at health at that level, we would need to collect information on behavior, environment, and many other sources on a regular, ongoing basis. All this collected information will require new algorithms to detect and communicate patterns. At that stage, someone could intervene. It could be a doctor, but more likely a nurse or (health) coordinator. That could happen once a year when you visit your doctor, or perhaps more immediately depending on the severity. In some cases, information itself can be an intervention. Look at energy use—one natural experiment looked at homes that have the power meter in a visible location of a home in comparison to ones that were in the basement. The researchers found that the pattern was different just by seeing what the usage was. Just the fact that you could see it every day impacted energy use.

Think of transportation as an example—the ability to have GPS on cars helps traffic planners gauge highway volumes, congestion and determine patterns of how people get to where they are going.

Where would this information come from?

We already generate significantly useful information in our interactions day to day. Think of GPS, accelerometers and other data-collecting sensors on our mobile phones. It could be a patch or an application that collected health related data regularly as well.

Are there places in the health care sector collecting this type of information and using it to improve health care delivery?

Many startups are looking at that in areas like pharmaceutical study recruitment, medication adherence, etc.. Mostly at this point the information is retrospective. We see the beginnings of it in the geomapping of asthma and infectious diseases, as well as in disaster planning.

What about privacy concerns for collecting this type of data?

Privacy is about information you are assuming will not be shared or visible to everyone, but these days people are providing a lot more information, willingly, on sites, through texts, etc. Lots of people are working on ways to secure this information and still share it so that you get benefit out of it and are protected from a risk perspective.

Why did you elect to take this work to the Masdar Institute?

Many reasons: First, the opportunity presented itself at the right time and the Institute has strong collaborations with a strong university (M.I.T.), and the right people, funding and other support were already in progress. Second, the vision that the Masdar Institute stood for: the idea of sustainability and the idea of being able to assess everything together. Energy is one part of sustainable health too—everything is connected.

How long do you think it will take for sustainable health, and the data collection it requires, to be possible?

It could happen fast—the technology is there, even today on our mobile phones. But there’s a system change requirement: We’d need to set up the system, make sure it can take in information at the right time, send it to the right people, and figure out a way to feed it back correctly. That’s a big task. But it’s definitely possible.

On recent trips to the U.A.E., Sheikh Zayed Institute doctors and staff have visited the Masdar Institute. Read more: December 2010 and January 2011.

Photo: Institute faculty and the Institute's first Visiting Innovator, Inas Khayal, PhD. Front row (left to right): Drs. Sze, Khayal, and Quezado. Back row (left to right): Drs. Hoffman, Nadler, Cleary, Mahan, Shekhar, Peters.

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