Ageing – a Global Challenge: eHealth and Aging: A Research Experience
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Transcript of Ageing – a Global Challenge: eHealth and Aging: A Research Experience
Adolfo Muñoz Carrero
eHealth and Aging: A Research Experience
Contents:
• UITES: Telemedicine and eHealth Research Unit
• Research Scenario
• Some of our research projects
• Conclusions
Telemedicine & eHealth Research Unit
• Pertaining to the Health Institute “Carlos III”, responsible
of research promotion on biomedicine and health sciences
• Our mission: To research, to develop and to innovate in
methods, systems, and technologies to improve the health
and well-being of the population through the use of ICTs
Chamartín campus:
Building 6
Telemedicine & eHealth Research Unit
• 15 years of work
• 11 pilots
• 7 clinical trials
• ≈ 2.000 patients
• ≈ 100 physicians (GP+SC)
• 6 Hospitals
• 5 Health areas
Health Care Social Care
SBVP-1396/99SBVP-1201/02
SBVP-1396/99
SBVP-1201/02
DGVI 1054/06
PAV-020000-2007-133
PDM 2006-171
FIS07-90187
FIS PI051882
FIS PI06-90166
FIS 01/0915
FIS 02/1391
FIS02/1156
FIS080435
Research Scenario
Main Idea: Insertion of New Care eServices
• Independent Life
• AAL
• Accessibility
• Integration
• Proactive Health
• Prevention
• Healthy life habits
• Patient empowerment
Personal and integrated eServices
HealthSocial
Research Scenario: methodology
• Monteagudo JL, Salvador CH, García-López F. Metodología de introducción de servicios de e-Salud para el seguimiento y control de pacientes crónicos. Rev Esp Salud Pública 2004;78(5):571-81.
• Mario Pascual Carrasco. Aportaciones a un modelo de
inserción de servicios asistenciales basados en telemedicina
para su uso y validación en el seguimiento de pacientes
crónicos. Doctoral Thesis. UPM. Junio-2008.
Pascual M, Salvador CH, García-Sagredo P, Marquez-Montes
J, Gonzalez MA, Fragua JA, et al. Impact of patient-general
practitioner interaction on the control of hypertension in a
follow-up service for low-to-medium risk hypertensive patients.
IEEE Trans Inf Technol Biomed. 2008,12(6):780-91 .
Grupo I+D+iGrupo I+D+iAgencia Evaluación
Tecnologías Sanitarias
Exploratory Trial
Grupo I+D+iAgencia Evaluación
Tecnologías SanitariasGrupo I+D+iGrupo I+D+iGrupo I+D+iGrupo I+D+iResearch Group
Pilot
?
……
Clinical Trial
Supervised Use
Authorities
Co
mp
lexit
y o
f in
terven
tio
n
Research Scenario: methodology
Grupo I+D+iGrupo I+D+iAgencia Evaluación
Tecnologías Sanitarias
Exploratory Trial
Grupo I+D+iAgencia Evaluación
Tecnologías SanitariasGrupo I+D+iGrupo I+D+iGrupo I+D+iGrupo I+D+iResearch Group
Pilot
?
……
Clinical Trial
Supervised Use
Authorities
Co
mp
lexit
y o
f in
terven
tio
n
4 stagesVery small size
Technology testing
Small size
Service testing
The service could be changed
Big size
The service can’t be changed
Objective: Scientific evidence
Driven by the authorities
Research Scenario: platform
• Salvador CH, Pascual M, et al. Airmed-Cardio: A GSM and Internet Services-Based System for Out-of-Hospital Follow-Up of Cardiac Patients. IEEE Trans Inf Technol Biomed. 2005, 9(1): 73-85.
• Muñoz A, Somolinos R, Pascual M, Fragua JA, González MA,
Monteagudo JL, Salvador CH. Proof-of-Concept Design and
Development of an EN13606-based Electronic Healthcare
Record Service. J Am Med Inform Ass 2007; 14(1): 118-
129.
• Salvador CH, Ruiz-Sanchez A, Gonzalez MA, Carmona M,
Pascual M, García-Sagredo P, et al. Evaluation of a
telemedicine-based service for the follow-up and monitoring of
patients treated with oral anticoagulant therapy. IEEE Trans
Inf Technol Biomed. 2008,12(6):696-706.
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
Research Scenario: platform
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record•Technical and communications support
•Automatic (24/7)
•Configurable web applications
Research Scenario: platform
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record•Uses devices for monitoring
•Answers questionnaires
•Receives updates from physicians
Research Scenario: platform
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
•Groups patients and resources
(nursing home, residential home,…)
Research Scenario: platform
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record•Controls patients trough web applications
•Communicates trough SMS messages
Research Scenario: platform
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
•Communicates with patient’s EHR
•Breaks service isolation
•Based on standards (ISO-EN 13606)
Research Scenario: platform
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
UsuarioPaciente
CentroDe Salud
UsuarioMédico
OficinaCoord.
EstaciónCentralCentralStation
Patient
HealthcareCentre
HealthcareAgent
Coord.Office
Internet/GSM
ElectronicHealthcare
Record
•Manages the resources
•Controls the intervention
•Trains users (patients, physicians)
•Gathers results
•Performs statistics analysis
•Generates reports
Objective : To relieve the Public
System from all non care
related tasks
Telemedicine & eHealth Research Unit
• 15 years of work
• 11 pilots
• 7 clinical trials
• ≈ 2.000 patients
• ≈ 100 physicians (GP+SC)
• 6 Hospitals
• 5 Health areas
Health Care Social Care
SBVP-1396/99SBVP-1201/02
SBVP-1396/99
SBVP-1201/02
DGVI 1054/06
PAV-020000-2007-133
PDM 2006-171
FIS07-90187
FIS PI051882
FIS PI06-90166
FIS 01/0915
FIS 02/1391
FIS02/1156
FIS080435
Social Care projects
PLATAS: Platform for the integration of Health
and Social care services
• Information service
• Video attention service
• HBP monitoring service• Promotion of personal
activity service
• Preventive and healthy
lifestyle service
Comorbidity Study
Chronic Comorbidity and resource consumption
•Madrid Healthcare Area 11
•Population: 887.134
•127 GP involved (out of a total of 521)
•149.417 cases studied
Doctoral Thesis, Monserrat Carmona Rodríguez
Associated Comorbidities
Doctoral Thesis, Monserrat Carmona Rodríguez
EDC (I.P.) Nº cases I.P. I.P.+1 I.P.+2 I.P.+3 I.P.+4 I.P.+5 +
Diab. 10.058 9,67 15,77 20,44 20,24 15,00 18,86
EDC (I.P.) Nº cases I.P. I.P.+1 I.P.+2 I.P.+3 I.P.+4 I.P.+5 +
CHF 1.377 3,05 6,83 11,84 16,63 19,46 42,19
Continuation: dependency study
Population: 200 (randomised from comorbidity
study)
Personal interviews (WHO DAS II)
Gathering of information just finished
“No official results yet”… but it is clear that the
dependency is caused by the illness (or by its
accumulation) and not by the age.
Project: behaviour modelling
• Objective: to assess the dependency of elderly
people using traditional surveys and ambient
monitoring, correlating the information obtained
by both methods.
EquivalenciasEquivalenciesItems to
assess
.
Scores
Ambient
Monit.
Methodology:
Objective
and
Quantifiable
Conclusions
Telemedicine for chronicity and dependency:
R&D:
- Integration & globalization of solutions (focused
in the person and not in the problem)
- Interoperability functional & semantic:
normalization (information sharing)
- To obtain scientific evidence about the utility of
new eServices (decision support)
Conclusions
Telemedicine for chronicity and dependency:
New methodologies:
- To facilitate the insertion of the new eServices in
the organizations
- To ease the organizational and cultural
changes
- To share information at all health care and
social care levels
Conclusions
Results demonstrate that with its use, aging people:
Feel safer and less lonely
Improve their involvement in self-care
Get healthier life habits.
Improve their communication and social
participation
Improve their relation and interaction with their
carers
Aging people and ICTs:
Adolfo Muñoz CarreroeHealth and Aging: A Research Experience
Thank you very much for
your attention