Research and Innovation in ICT for Health European Priorities G. Comyn ICT for Health DG Information Society & Media European Commission

Research and Innovation in ICT for Health European Priorities G. Comyn ICT for Health DG Information Society & Media European Commission

Challenges for European Health Systems Pressure on healthcare systems Demographic changes more people will require prolonged care Increased prevalence of chronic diseases substantial part of the overall healthcare costs Citizens expectations and demands for high-quality care Inadequate safety standards and quality control Medical accidents Inefficiencies and staff shortages Reactive model of healthcare delivery treatment after appearance of symptoms Rising healthcare costs faster than the economic growth itself How to offer high-quality & affordable care?

Needs and Trends Require changes in the way: Healthcare is delivered Medical knowledge is managed & transferred in clinical practice Emphasis on: Improved illness prevention/prediction and safety of care enhanced quality of life avoid costly treatments - reducing healthcare costs avoid medical accidents Individual citizen with stronger role in healthcare process Remote monitoring and care continuity of care - health services outside hospitals Efficient, personalised disease management and care

Research Aims Multidisciplinary research to support: Improved productivity of healthcare systems better management of chronic diseases at the point of need quicker transfer of knowledge to clinical practice Continuous and personalised care solutions participation of patients in care and prevention processes respond to the needs of elderly people Savings in lives and resources focus on prevention and prediction of diseases Higher patient safety optimise medical interventions and prevent errors New ICT-based environments for biomedical research and predictive medicine push technology boundaries: grid computing, modelling & simulation Industrial leadership European ehealth and medical imaging/devices industry attract pharmaceutical research back in Europe

Strategic Research Orientations Three main directions: Personal Health Systems Patient Safety Virtual Physiological Human

Patient Safety Improved patient safety in surgery through advanced ICT applications Bridging the ICT gaps between clinical research and medical practice Enhanced health security through innovative event-based surveillance tools Accelerated adoption of electronic health record systems supported by more user-friendly interfaces Improved patient safety through framework for interoperability testing of solutions for exchange of healthcare information

Virtual Physiological Human The Virtual Physiological Human is a methodological and technological framework that once established will enable the investigation of the human body as a single complex system. The VPH research roadmap developed by project STEP in 2007: www.europhysiome.org - Personalised (patient-specific) healthcare solutions - Early diagnostics & predictive medicine -Understanding diseases across several biological levels

Personal Health Systems - PHS A relatively recent concept Introduced in the 1990s Place the individual citizen in the centre of the healthcare delivery process Key facilitators for: Continuity of care Preventive & personalised care Citizen-centred care citizen empowerment preventive lifestyle & early diagnosis disease management independent living for ageing society

PHS characteristics Realised as: Wearable, implantable, portable systems Integration of various components and technologies e.g., sensors, implants, signal processing algorithms, user interfaces, mobile and wireless communications Used by the patient or healthy individual Coupled with telemedicine platforms to provide personalised services Non-/minimally-invasive monitoring and management Remote & continuous health status monitoring, early diagnosis and disease management Adapted to the circumstances of the individual user Personalised medical advice, recommendations & treatment Available at anytime and location beyond hospitals

Prototype PHS for monitoring Examples Wrist-worn devices Body Sensor Networks Biomedical clothes AMON MOBIHEALTH MYHEART WEALTHY

Personal Health Systems: the bigger picture Data acquisition Data processing & analysis RR [msec] SBP [mmhg] SCMI [%] Risk [--] 1500 1000 Tilt Sympthoms 500 200 400 600 800 1000 1200 1400 1600 1800 2000 2200 t [sec] 150 100 50 200 400 600 800 1000 1200 1400 1600 1800 2000 2200 100 t [sec] 50 0 200 400 600 800 1000 1200 1400 1600 1800Positive 2000 VVS 2200 Risk 0.5 t [sec] 0-0.5 200 400 600 800 1000 1200 1400 1600 1800 2000 2200 t [sec] Medical expertise Health / call Centre Sensors for multi-parametric monitoring Intelligent analysis Hospital Treatment, Rehabilitation Support to diagnosis decision & treatment Data communication and feedback

The m-health approach m-health comprises: Mobile monitoring of health status Wireless body sensors Measurement of vital signs (ECG, heart rate, blood pressure, blood glucose, ) Communication networks Wirelessly from sensor network to PDA or mobile phone GPRS / UMTS mobile networks to servers in medical centres Services Health service providers Linked with health professionals Real-time feedback to patient Messages, reminders

The Benefits of m-health Practical: More than 2.2 billion mobile phone users worldwide Quick and low-cost solution for a large population Clinical: Patient mobility Evidence from trials on cardiovascular diseases (Source: Ericsson & HealthServices24): Admissions reduced by 60% 90% of the patients claimed to feel more reassured Economic: Evidence from COPD trials (Source: Ericsson & HealthServices24): Reduced hospitalisation days 38% reduction in patient costs Potential of Mobile Monitoring in Germany (Source: GesundheitScout 24 GmbH & Bayerisches Rotes Kreuz): Up to 1.5 billion/year savings through early patient discharge Assuming 3 days less hospital stay for 20% of patients

Sensors for healthcare applications Remote and continuous monitoring Respiratory diseases (e.g. COPD, asthma) Oximetry (SpO 2 ) Sensors Cardiovascular diseases (e.g. Heart failure) Textile Electrodes to measure ECG and heart rate Neurodegenerative diseases (e.g. Parkinson s) Microsensors and microelectrode arrays Diabetes Transdermal sensors to measure blood analytes at the skin surface Cancer Lab-on-Chip, microfluidics, integrated biosensors Daily activities and location Motion (inertial) sensors, accelerometers, location sensors For: Disease Management Rehabilitation Prevention

Besides sensors. Networking issues Body area networks Wireless (Bluetooth, ZigBee, ) Power autonomy (desirable) Low power consumption Power recharge/scavenging Data processing Powerful portable (on-body) electronics Reliable & secure communication of health data User interfaces Promoting interaction between patients and health professionals User friendly interfaces for users on both sides

Personal Health Systems Benefits for all: Health conscious who wish to stay fit Healthy individuals at risk who wish to maintain normal health status Chronically ill patients Elderly persons or people in need, who want to live independently outside care institutions Health professionals support by provision of monitoring and diagnostic data assistance in making accurate decisions

Personal Health Systems Examples of FP6 projects MYHEART (http://www.hitechprojects.com/euprojects/myheart/) Wearable systems (intelligent textiles) for prevention, early diagnosis and management of cardiovascular diseases OFSETH (www.ofseth.org) Textiles with optical sensors for physiological monitoring HEARTFAID (www.heartfaid.org) Knowledge-based platform for heart failure management SMARTHEALTH (www.smarthealthip.com) and MICROACTIVE (www.sintef.no/microactive) Point of care devices for cancer screening (breast, cervical and colorectal cancer)

Thank you very much for your attention Contacts: Gérard Comyn, Ilias Iakovidis & Loukianos Gatzoulis DG Information Society and Media Unit ICT for Health gerard.comyn@ec.europa.eu ilias.iakovidis@ec.europa.eu loukianos.gatzoulis@ec.europa.eu