Prof. Elizabeth Mynatt

Elizabeth Mynatt's web page

Title: Pervasive Technology for Chronic Healthcare

Abstract: Healthcare for chronic disease is the dominant cost for many healthcare systems, now and for the foreseeable future. The unique capabilities of pervasive technologies have the potential to transform chronic healthcare practices by shifting care from acute to home settings, by enabling continuous data capture and analysis, by creating a network of communication channels, and by helping individuals engage in their own care. However this transformation requires rethinking the processes surrounding healthcare. Trying to substitute new technology into old processes will not work.
In this talk I open for discussion three complimentary issues. First, what is a chronic healthcare medical condition? Diabetes? Likely. AIDS? Cancer? Defining the shape and characteristics of chronic healthcare may be more surprising than expected. Second, what are the processes that make up the “care” in chronic healthcare? How do these processes generate new needs for healthcare technologies? And finally, what pervasive technologies seem most promising at this time?

Prof. Niilo Saranummi

Niilo Saranummi and Ilkka Korhonen, VTT Technical Research Centre of Finland, Pervasive Health Technologies, Finland, [email protected]

Title: Towards Personalized Health Services

Abstract: The continuing innovation and development in medicine, life sciences and technology are constantly creating new and improved opportunities to prevent, diagnose, treat and monitor diseases and promote health. This combines with a changing and increasing demand for health services by the population due to e.g. the ageing of the populations, changing life styles and emerging consumerism. Consequently, health expenditures are on the rise with governments trying to establish ways to contain healthcare costs. However, it's becoming clear that the demand cannot be satisfied by increasing the supply nor regulated by policies and incentives. Instead, new, radical ways are needed to tackle the demand-supply mismatch. Several converging activity threads have emerged that aim at a renewed health services environment. These can be grouped into three main categories. The first one deals with extending healthcare to health management, in other words addressing health needs pervasively 'from cradle to grave'. Industry is responding to this with activities ranging from ubiquitous computing to industry alliances, such as the Continua Alliance, to an integrated life-long electronic healthcare record. The second group of activities deals with augmenting a patient’s health and illness data with her genotype data and is leading towards personalization of diagnosis and therapy. The third group deals with 'healthcare engineering'. The aim is to turn the current disease and episodic care oriented system around to be a service environment which is proactive and engages and empowers the individual in her health and illness management. Combined these three threads point towards personalized health services where the individual is a central actor in managing her own health and the prevention, diagnosis, treatment and monitoring services are optimized based on personal preferences, life styles, medical and health history, and genetics.
The road to such a personalized health services environment is paved with challenges. These can roughly be placed into three categories with increasing difficulty of realization. If the innovation takes place within the established boundaries of healthcare professions and organizations, its diffusion will be relatively smooth provided it meets the criteria concerning cost-effectiveness, quality etc. If the innovation challenges existing boundaries, but there is evidence of its value through best practice studies (like EBM / Cochrane and HTA), it will diffuse into routine use although more slowly than in the first category. The most challenging case arises when the innovation challenges existing organizational and professional boundaries and redefines roles of actors in service delivery and in the way services are reimbursed. The presentation will be illustrated with case examples.

Dr. Juan Carlos Chachques

Juan Carlos Chachques's web page

Title: Telemonitoring in cardiology

Abstract

Background: Congestive heart failure (HF) is a serious public health problem by virtue of its prevalence, high mortality, high morbidity, and the expense of ongoing therapy. High cardiac filling pressures and concomitant volume overload are frequently the cause of hospital admission for heart failure. Effective management of heart failure is partly aimed on lowering the filling pressures and improving ventricular performance. Heart failure is associated with a high rate of hospitalization and poor prognosis. Telemonitoring could help implement and maintain effective therapy and detect worsening HF and its cause promptly to prevent medical crises.

Objective: The use of implantable hemodynamic monitors (IHMs) may assist in the management of heart failure by providing continuous ambulatory filling pressure status for optimal hemodynamic management. Measurement of intracardiac hemodynamic parameters has been limited to brief periods in the acute care setting. Implantable hemodynamic monitor that is capable of measuring chronic right ventricular oxygen saturation and pulmonary artery pressure are in development. Several potential strategies to control fluid volume status are used in the daily practice. Clinic visits for assessment of filling pressure by physical examination, multiple types of noninvasive measurements, and repeated cardiac catheterization may be employed. There is considerable cost and inconvenience for the patient associated with these strategies and, more importantly, these methods represent pressure and volume status only as one discrete point in time without the perturbance of daily activities or stress. To overcome this limitation, the role of continuous ambulatory hemodynamic information in the management of heart failure is currently under investigation.

To read more: full abstract.pdf