Pascal ZELLNER MD/PHD IFREMMONT. 3Ecare IT. A new step for remote health care

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Lawrence Carson
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1 Pascal ZELLNER MD/PHD IFREMMONT 3Ecare IT A new step for remote health care

2 The only one idea to remember Data + Model = Information

3 3Ecare architecture & Fundamentals

4 3Ecare architecture & fundamentals Practician Patient Physician Models Research Analysis Protocols Reports Alerts Physician Files National Files Patient biomedicaldiary Sensors APP Androïd Device Import Data Analysis Inference Engine Engine settings Models Injection Rules for inference engine are fundamental, like the doctor the engine must know what he is looking for, diagnostic assumptions, the physiological model.

Data Analysis Inference Engine Engine settings Models Injection Rules for inference engine are

5 3Ecare a global health improvement A new link with physician Education, prevention Assistive environment A new medical tool Many care levels A lot of use cases Which health insurance system Which sensor : chest, smartwatch, wrist, ear?

new medical tool Many care levels A lot of use cases Which

6 Is it working your thingy? Using HTrainer to improve fitness, a major public health challenge?

7 3Ecare, sport use case, HTrainer Fitness / sport At Home At Work GP / Physician Call Center / Coach Work Physician Medical, Fitness Chain

8 HTrainer & 3Ecare Cloud System Benefits on training and health of 70 sportsmen's on

9 HTrainer architecture & fundamentals solo Coach Patient Physician Patient Workbook Models Research Analysis Protocols Reports Alerts Physician Files National Files Patient biomedicaldiary Sensors APP Androïd Device Import Data Analysis Inference Engine Engine settings Models Injection

Physician Files National Files Patient biomedicaldiary Sensors APP

10 HTrainer patient/sportman workbook

11 HTrainer architecture & fundamentals team Coach Sportif Médicale Recherche Modèles Analyse Protocoles Rapports Alertes Dossier Médecin Team Statistic Carnet entrainement du sportif, du patient Sport Sensors Androïd Device Local Server Import Data Analyse Moteur Inférence Réglage Moteur Injection Modèles Statistic Recorder

Carnet entrainement du sportif, du patient Sport Sensors Androïd Device Local

12 HTrainer physiological model for test Rest Check-up: heart rate variability data mining and analysis Exercise heart rate variability (HRV) analysis & respiratory thresholds Exercise heart rate zone analysis & alerts Exercise protocol manager & time in zone analysis Exercise respiratory rate analysis & respiratory thresholds Exercise core temperature, heart rate & alerts HRV Check-up evolution & analysis, alerts TRIMP calculation & TRIMP objective management TRIMP / EPOC evolution & alerts

time in zone analysis Exercise respiratory rate analysis & respiratory thresholds Exercise core temperature, heart rate &

13 HTrainer physiological model for test HF LF SDNN RMSSD FCD FCA 09/01/ /01/ /01/ /01/ /01/2002 / / cos sin k1.g t k2. h t

14 HTrainer test methodology Data Analysis during 3 months Hockey Team 30 players Training Monitoring HTrainer test Trailers High Altitude Trailers 30 runners 10 runners Match Monitoring Training Monitoring Prediction Charge Comparaison Stapes monitoring Altitude Acute Sikness Prediction

Trailers 30 runners 10 runners Match Monitoring Training Monitoring

15 HTrainer & Hockey Team Monitoring Predictive model aiming at decreasing injuries & over training

16 Stage 1 (3 months) Stage 2 (2 months) Stage 3 (2 months) Players wear only a chest sensor, No player feedback No automatic alerts A sport physician checks assumptions, he doesn t know players Coach Sportif Médicale 2 trainings / week, 2H /training : 1150 h recorded for the team FDA approved, CE tagged chest sensor Data is collected on 3Ecare cloud Recherc he Modèles Analyse Protocol es Rapports Alertes Dossier Médecin Team Statistic Carnet entrainement du sportif, du patient Sport Sensors Androï d Device Local Server Import Data Analyse Moteur Inférence Réglage Moteur Injection Modèles Statistic Recorder

tagged chest sensor Data is collected on 3Ecare cloud Recherc he Modèles Analyse Protocol es Rapports Alertes Dossier Médecin Team Statistic Carnet

17 HTrainer Hockey Test Stage 1, analysis Players were tagged red, orange, green by 3Ecare Fitness / sport 24 players accepted to wear the sensor : NB in Resacore series with old persons, the project membership was 100% Risk GP / Physician 24 players were secondary checked by the doctor 2 red players had really a serious medical problem! 1 case of hypertrophic cardiomyopathy Vert Orange Rouge 1 case of drug use (psychotropic drugs) Vert Orange Rouge 4 orange players were over trained All green players had a good exam

secondary checked by the doctor 2 red players had really a serious medical problem!

18 Stage 1 (3 months) Stage 2 (2 months) Stage 3 (2 months) Single chest sensor, No player feedback Automatic alerts Test of statistic module A sport physician checks assumptions, he knows players Coach Sportif Médicale 2 trainings + 1 match/ week: 1150 h recorded for the team 3Ecare Live system execute protocols model, only the staff can see live alert. Doctor sees cloud alerts and analysis Recherch e Modèles Analyse Protocoles Rapports Alertes Dossier Médecin Team Statistic Carnet entrainement du sportif, du patient Sport Sensors Androïd Device Local Server Import Data Analyse Moteur Inférence Réglage Moteur Injection Modèles Statistic Recorder

19 HTrainer Hockey Test Stage 2, analysis Fitness / sport 23 players wore the sensor : 80% of training on inappropriate zone! Time in red zone (>88% HRMax) > 50% training time Manager did not follow alerts Training Zone Green Zone Orange Zone Red Zone GP / Physician 23 players were regularly checked by the doctor Number of over trained players increase with time Alerts increase with time Injuries increase with time All parameters evolved according to the injected model! Green Zone Red Zone Orange Zone OverTrained Injuries Alerts/players SDNN < 5

Physician 23 players were regularly checked by the doctor Number of over trained players increase with time Alerts increase with time Injuries

20 Stage 1 (3 months) Stage 2 (2 months) Stage 3 (2 months) Doctor trained players and staff and taught appropriate behaviors in reaction to alerts. 2 trainings + 1 match/ week: 1150 h recorded for the team A sport physician checks assumptions, he knows players Coach Sportif Médicale 3Ecare Live system execute protocols model, players can see alerts on regular reports. Doctor see cloud alerts & analysis Recherche Modèles Analyse Protocoles Rapports Alertes Dossier Médecin Team Statistic Carnet entrainement du sportif, du patient Sport Sensors Androïd Device Local Server Import Data Analyse Moteur Inférence Réglage Moteur Injection Modèles Statistic Recorder

protocols model, players can see alerts on regular reports.

21 HTrainer Hockey Test Stage 3, analysis Fitness / sport GP / Physician 5 0 OverTrained Injuries Alerts/players SDNN < Training Zone Green Zone Green Zone Red Zone Orange Zone Red Zone Orange Zone Risk on stage 2 Green Orange Rouge Green Orange Rouge Risk on stage 3 Green Orange Rouge Green Orange Rouge

22 HTrainer & High Altitude Race Predictive model using comparison between runners

23 HTrainer & High Altitude Race SoluKhumbu Trail 330 km with m D+ Average altitude : m 10 runners with a chest sensor Rest Check-up every morning Parameters were recorded during each stages (17). A stage : 8H, device respected model protocols and gave alerts to the runner Each days data were transmitted to 3Ecare using a satellite network, 3Ecare gave only HRV alerts Two medical teams : Nepal & Chamonix (F)

24 HTrainer & High Altitude Race solo Coach Patient Physician Patient Workbook Models Research Analysis Protocols Reports Alerts Physician Files National Files Patient biomedicaldiary Sensors APP Androïd Device Import Data Analysis Inference Engine Engine settings Models Injection

25 HTrainer & High Altitude Race Results 9 High Altitude Sickness & RMSSD Alert + Alert - RMSSD + RMSSD - Finish MAM 3

26 Cloud Computing Monitoring A new kind of highly versatile medical device

27 CC Monitoring, 3Ecare Conclusions Data + Model = Information Bio medical model is the main tool! CC Monitoring can predict some risks and some pathologies CC Monitoring improves health & performance CC Monitoring will give a new type of clinical signs which can be integrate in a global diagnose CC Monitoring brings a new link between physician and patient

28 CC Monitoring, 3Ecare Future Practician Patient Physician Models Research Analysis Protocols Reports Alerts Physician Files National Files Patient biomedicaldiary Sensors APP Androïd Device Import Data Analysis Inference Engine Engine settings Models Injection Medical File

29 Thank you Pascal ZELLNER MD/PHD CEO - IFREMMONT pascal@ifremmont.com CTO 3ECARE pascal@3ecare.ch 3ecare.ch

Introduction Who Uses PSM? PSM Training Applications PSM Training Advantage

Introduction Who Uses PSM? PSM Training Applications PSM Training Advantage Introduction The Zephyr Physiological Status Monitoring (PSM) Training system takes the market leading BioHarness technology and integrates it with Zephyr s OmniSense TM software delivering team measurement