VIDEO: Using patient information, data in diabetes care

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A third area that I'm interested in is all the types of information that's become available for people with diabetes. Much of it is from glucose values but there's other information. Pretty much anything a person does, any result of a test a person has, and about the last 10 years or so, we've been starting to gather a lot of data in the electronic health record. And it's now starting to be used where if you have the right software or the right approach or you have an information technology person at your healthcare organization who knows what they're doing they can do a search for certain types of people in the system. So you may say you have a question about what percentage of people with a certain problem go on to develop a second problem, or what percentage recover, or what percentage have a certain side effect or if you use this drug in this type of patient, what's likely to happen? And up until now, it's been really hard to get information from a lot of patients. There may be a doctor this, "Oh I've used this on 10 patients, here's what happened." But imagine if you could do this with a hundred million patients. And it is possible, there's a company that's working in this field that can actually look at the records of a hundred million people and see what are those relationships.

Another area that information has to be used properly is cybersecurity. Anytime a person has a wearable device or something they're carrying which I'll call a carriable device, we have to be sure the patient and the doctor that the information coming from that is accurate. Now, there's three features that are particularly important. The information has to be confidential so it doesn't leak and nobody knows what it is except the person who's wearing it which is generally we call it the patient. The data has to have proper integrity. If it gets altered, then of course everybody's going to think the patient is different than they really are. And a recent report, which was not a wearable but it could be applied to wearables was done by some security researchers in Israel where they took picture of some lung x-rays and they digitally added little white spots to them and it looked like this person had metastatic cancer, but they didn't, and it could fool doctors. So imagine what would happen if you had information from a sensor and it said your blood sugar was really high, you needed insulin when you didn't, you might be taking insulin that you didn't need. It might be too much, it could cause low blood sugar. So it's really important that we have data integrity with our sensors. That again, means you need good cybersecurity. Finally, the information has to be available. What good is it if the device has been hacked and it's turned off? So I would say that companies are starting to realize the importance of sound cybersecurity.

And I recently led an effort through IEEE which is the world's largest technology organization for professionals to create a cybersecurity standard for diabetes devices which is the first medical device cybersecurity standard that has both performance and assurance requirements that tells the manufacturer what to do. And then it has provisions for how the manufacturer must have the device tested. The types of exercise with dietary information. And there are now types of sensors that can give a person an idea of that they're eating and they can record what they're eating because it automatically triggers when a person's jaw is chewing. Geographic information. For example, if you're at a fast food restaurant and then your blood sugar goes up real high, there's a way to put that together. So when you assemble all this type of information from a patient, which is really, really new, you have something called precision medicine. And you can say, what's going on with this person? So it would be like the difference between having a coat measured and somebody looks at you and then they make some measurements versus going to a store where you can get a coat with exact measurements, your sleeve and your waist and your chest and your arms and your back and everything. And with this information, doctors can say, well we really understand what your features are through digital health because your features have been converted into digital information. And we can find whatever is the best treatment for someone with your characteristics. So we're going to see more precision medicine and well.