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


• 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.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record


UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record

UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record•Technical and communications support

•Automatic (24/7)

•Configurable web applications


UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record

UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record•Uses devices for monitoring

•Answers questionnaires

•Receives updates from physicians


UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record

UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record

•Groups patients and resources

(nursing home, residential home,…)


UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record

UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record•Controls patients trough web applications

•Communicates trough SMS messages


UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record

UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record

•Communicates with patient’s EHR

•Breaks service isolation

•Based on standards (ISO-EN 13606)


UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


Record

UsuarioPaciente

CentroDe Salud

UsuarioMédico

OficinaCoord.


Patient

HealthcareCentre

HealthcareAgent

Coord.Office

Internet/GSM


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


• 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

Ageing – a Global Challenge: eHealth and Aging: A Research Experience

Health & Medicine

Transcript of Ageing – a Global Challenge: eHealth and Aging: A Research Experience