NIHR CRN Specialty Cluster co-Lead and Emeritus Professor of Primary Care at the UCL
The lecture will consider the opportunities for moving behavioural monitoring and interventions into the digital era as well as the challenges posed by such a move. It will illustrate the relevant issues with specific reference to the speaker's leadership of an international research programme exploring the potential to digitalise screening and brief interventions for risky drinking. It will also consider recent developments in the use of digital technologies to enable patients to monitor aspects of their behaviour and wellbeing, and explore the impact which such technologies can have on wellbeing. The potential to deploy a whole population approach to digital technologies for behavioural monitoring and interventions will be described in relation to an initiative currently in development in the North of England
Paul’s career in academic primary care spans more than 30 years and his research has been primarily focussed on alcohol and health and the application of digital technologies for the improvement of health care. He was chief investigator on the early Medical Research Council pioneering studies on the detection and management of patients with excessive alcohol consumption in general practice. This work paved the way for a series of major international trials which established the key role of screening and brief intervention for alcohol problems. Paul subsequently developed a programme of research on the role of telemedicine at the interface between primary and secondary care. The main component of this was a large scale multicentre randomised controlled trial of Virtual Outreach involving more than 2000 patients referred in rural and inner city settings. He currently leads an international programme of research into the effectiveness of digitally mediated screening and brief interventions for alcohol problems in primary care settings. He has authored more than 100 papers and book chapters, and has been involved in the development, evaluation and dissemination of digital applications for alcohol reduction in a number of countries. Paul is a past President of the European General Practice Research Network and was one of the founding members of the European Society of General Practice/Family Medicine. He is also a past President of the Telemedicine Section of the Royal Society of Medicine, and is a Fellow of the Royal College of General Practitioners and the Faculty of Public Health Medicine at the Royal College of Physicians. In 2013 he was awarded the Royal College of General Practitioner’s President’s Medal.
Professor for eHealth at Edinburgh Napier University
Due to demographic and socio-economic challenges and also powered by technological progress the way healthcare is being delivered is undergoing an accelerating rate of change. The healthcare model is in transition from a centralised, institutional focused system to a distributed, patient centric model. In the future more and more care will be delivered in surgeries, care homes, day-clinics – and over the Internet. In order to deliver the innovation that is in the pipeline of the pharmaceutical Industry, Telecom vendors, IT companies, the IOT community, payers and regulators potential solutions have to be adjusted to the requirements of “critical Infrastructures” in the health domain to allow for a more distributed, parallelised approach under control of the patients who, in accordance with the general understanding in the Eurozone and elsewhere, own their data. The keynote will outline how the delivery of care will change, highlight the relevant technologies and discuss some critical regulatory aspects. It will also introduce new business models arising from the new economic realities around the health and care domains.
Christoph Thuemmler is Professor for eHealth at Edinburgh Napier University and is a recognised expert on Digital Health including the relevant interfaces with 5G, IOT and Big Data Analytics. He studied Medicine, Political Science and Education at Heidelberg University and completed a PhD on Cerebral Hemodynamics. Christoph completed specialist training in General Medicine and Geriatric Medicine and worked in the US, the UK and Germany. His current focus is on application research to support the implementation of next generation digital health technology across the IT, telecommunication and health care domains. Christoph has held several advisory roles to the EC and is a IEEE Senior Member.
Professor of Psychology and Director of the USC Dornsife Center for Self-Report Science at the University of Southern California
Over the last 40 years there has been a pronounced shift in the techniques of measuring self-reports: it is now relatively common for ambulatory methods to query participants about their thoughts, feelings, social and physical environments, and symptoms. There nevertheless remain several issues that diminish the impact and application of real-time collection of self-reports, some of which have been mentioned in prior reviews. Among the issues to be discussed are: the self–selection of persons in to real-time studies and into completed momentary self-reports, both of which are influenced by burden; the inadequacy of our psychometric understanding of momentary reports and the lack of application of “modern” psychometric techniques; that we do not have a thorough understanding of the meaning of questions asked in the moment; the nagging issue of reactivity of monitoring; and, the difference between truly momentary reports versus “momentary” assessments that cover a longer period. I argue that these issues call out for timely study and suggest several paths for doing so.
Arthur A. Stone was trained as a clinical psychologist and is currently Professor of Psychology and Director of the USC Dornsife Center for Self-Report Science at the University of Southern California. He is also Emeritus Distinguished Professor of Psychiatry and Behavioral Science at Stony Brook University. Stone's early work was concerned with improving the measurement of life events and coping with the goal of understanding how events and coping impact our susceptibility to somatic illnesses. These studies led to an interest in psychobiology with a particular emphasis on how environmental events affect the immune system and the endocrine system. At the same time he was researching how people self-report information about their psychological and symptom states. This led to the development of various kinds of daily diaries that measured end-of-day and within-day phenomena, which ultimately yielded a set of techniques known as Ecological Momentary Assessment. More recently, Stone has been involved with the development of alternative methods for capturing the ebb and flow of daily experience for large-scale surveys, including the development of the Day Reconstruction Method. He is also been involved with the development of questionnaires for use in clinical trials (the PROMIS project), which has been supported by a consortium from the National Institutes of Health.
Director of the USC mHealth Collaboratory at the University of Southern California’s Center for Economic and Social Research
We generate vast amounts of personal data that could, on a day-to-day basis, be saving our lives. However, these data vary greatly in their accessibility and are often siloed and/or unmergable. These data also differ in the nature of the measure, type of inference, frequency of capture, precision, and rate/trajectory of change. We need dynamic models that learn as they go. These dynamic models should be seeded with received knowledge about groups (‘cold’ models). However, as they ‘learn’ the individual and grow along with the individual, they should become highly personalized ‘warm’, ever-adapting models. These are the kind of models that are needed to be able to intervene in real time, when people are in need and available. We have major transdisciplinary tasks ahead of us to develop modeling techniques that will optimize utilization of this multilevel, multidimensional data. This talk will offer some ideas on what might help us to get from here to there, using food intake as a case study.
Donna Spruijt-Metz is Director of the USC mHealth Collaboratory at the University of Southern California’s Center for Economic and Social Research, and Research Professor in Psychology and Preventive Medicine. Her research focuses on childhood obesity and mobile health technologies, and she works predominantly with minority populations. In 2015, she received the Obesity Society’s eHealth/mHealth Pioneer Award for Excellence in the Field. Her main interests include using mobile technologies to develop data sets that combine sensor and self-report data that is continuous, temporally rich, contextualized. Using this data along with innovative modeling techniques, she wants to develop dynamic, contextualized mathematical models of health-related behavior. She was one of the first to undertake a just-in-time, adaptive intervention (JITAI) in youth, and envisions most or all interventions being JITAI in the future. Current projects include the Monitoring & Modeling Family Eating Dynamics (M2FED) project, funded by the National Science Foundation (NSF). She led an NSF/EU/NIH-funded workshop in Brussels on building new computationally-enabled theoretical models to support health behavior change and maintenance in 2012. This workshop led to several publications, and a host of new collaborations. In September 2016, she led a follow-up NSF-funded international workshop in London. Her work meshes 21st century technologies with transdisciplinary metabolic, behavioral and environmental research in order to facilitate the development of dynamic, personalized, contextualized behavioral interventions that can be adapted on the fly.