MobiGuide: an Ubiquitous Knowledge-driven and Context-aware Clinical Guidance System

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September 27th, 2013 (Heraklion, Crete) MobiGuide: an Ubiquitous Knowledge-driven and Context-aware Clinical Guidance System Arturo González-Ferrer, University of Haifa Clustering Event: Ambient Intelligence Advanced Technologies in Support of Healthcare and Assisted Living

Outline About MobiGuide 5 Objectives What we did for the 12-month demo (Sep 2012) What we are focusing now 2

MobiGuide Project (2011-2015) UNIVERSITY OF HAIFA (HU), Israel BEN-GURION UNIVERSITY OF THE NEGEV (BGU), Israel UNIVERSITA DEGLI STUDI DI PAVIA (UNIPV), Italy UNIVERSITEIT TWENTE (UT), Netherlands TECHNISCHE UNIVERSITAET WIEN (TUV), Austria MOBIHEALTH BV (MHBV), Netherlands FONDAZIONE SALVATORE MAUGERI CLINICA DEL LAVORO E DELLA RIABILITAZIONE (FSM), Italy UNIVERSIDAD POLITECNICA DE MADRID (UPM), Spain CORPORACIO SANITARIA PARC TAULI DE SABADELL (CSPT), Spain ATOS SPAIN SA (ATOS), Spain BEACON TECH LTD (BTL), Israel ZorgGemak BV (ZORG), Netherlands ASSOCIACIO DE DIABETICS DE CATALUNYA (ADC), Spain www.mobiguide-project.eu 6 universities, 4 companies, 2 hospitals, 1 patients association 3 Partner s logo clinical domains: GDM (Spanish hospital) and AF (Italian hospital)

Motivation (1) What do patients and their care providers (CP) want? Patients go on with their daily life while being safe Mobile monitoring devices (BAN) and decision-support (DSS) can identify states that require attention DSS is proactive and interactive DSS based on current evidence-based clinical GLs System check compliance and outcomes and can suggest modifications for evolving clinical guidelines System is secure & available any time, everywhere DSS distributed: main DSS Server + light mobile DSS 4

Motivation (2) Automatic decision support is specific to patient data Integrated PHR, accessible by CPs & patients Decision-support suited to patient s current personal context and changes in technological context What are these contexts? Which are relevant to GLs? Activate predefined guideline plans per relevant context Shared decision-making Continuous guidance for mobile patients patients more involved Mobi-Guide Clinical-guideline guidance 5

Guideline-based DSSs: any time everywhere BAN Personalized DSS EMR1 EMR2 PHR Computer-interpretable guideline (CIG) 6

Objectives Objective 1: involving patients; PGS promotes collaboration of patients and care providers -Person- Patients -Person- Caregivers -Person- Knowledge engineering team -Person- System Support team -Person- Researchers User Interfacing Objective 3: Interoperating with wearable monitoring devices Patient Data Acquisition (BAN) Objective 4: Distributed, contextspecific DSS Decision Support Objective 2b: security Security & &privacy Administration Overall Data Collection And Storage (PHR) Obj. 2a: PHR semantically integrates patient data from hospital EMRs, sensors &DSS mdss Backend DSS Knowledge Collection & Storage Objective 5: data analysis for knowledge generation -system- EMRs

First iteration: day in the life of AF patient 3 users 20 components 8 partners GUI Shared DM DSS-PHR-BANtMediator Data integration

HelloTallinn scenario part II Maria is a paroxysmal AF diagnosed woman of 48 that regularly visits her cardiologist John. She is hemodynamically stable and her perception of symptoms is acceptable. John suggests to Maria to use MG. Maria is given a sensor belt, MG smartphone and pin code to start the MG app on the smartphone. John enrolls Maria to MG via DSS. PHR is initiated. Future: EMR periodic export into the PHR is initiated DSS checks which guideline plans should be initiated. Thromboembolism prevention plan is considered. Its exclusion criteria is automatically checked against PHR data and confirmed by the doctor. Decision support begins EMR 9

Decision support begins (M12 demo) Last year, we have analyzed and demonstrated: Shared decision-making for anti-thromboembolism Pill in the pocket advisory for patterns of AF events Advice for heart rate which is too high for current physical activity intensity 10

Demonstration scenario part IV BAN collects ECG data and abstracts it to 1 sessions. Detected AF sessions stored in PHR. DSS instructs t-mediator to monitor for patterns of 2 or more sessions with AF in a period of 10

Partners collaboration: Review (Brussels)

Y2 demo: Hello Pavia (Oct 7-10) Gestational diabetes advice on: Blood glucose and ketonuria monitoring Diet compliance Exercise compliance Standardized PHR CIG Customization & personalization DSS distribution & K projection Security 13

Questions? Thanks! 14