eHealth in Europe: Need, Vision and Practice
Dr. Pepijn van de VenDr. Pepijn van de Ven
Dr. John Nelson
ESPACOMP 2010 17 September 2010
Irish way: Pub CodeAsk your taxi driver for:
Scholar’s Club
Lame Duck
5 mins
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Sports Bar
Scholar’s Club(Java’s)
Stables’
Club
Hurlers
7 mins
Ambient Wireless Assisted Living (AWAL) Group
• Part of University of Limerick’s Wireless Access Research Centre– Transmission technologies, Systems and Services, Mobility
– Bluetooth, Zigbee, IEEE 802.1x, UMTS, …
• AWAL: 2 Academics, 3 post docs, 5 postgraduate students
• Wireless sensor technologies (fall and mobility sensing experts)
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• Research, Design, Development and Commercialisation
• Sensor integration (Hardware + Software)
• Extensive experience in user trials
• Close University of Limerick collaboration in AAL with: – Dept of Physiotherapy
– Graduate Medical School
Major AAL Projects(Enhanced) Complete Ambient Assisted Living ExperimentFP6 / FP7€1.9 million€2.5 millon
MOSAICProof of Concept €106,000Fall and Mobility Sensing, Novel methods, commercialisation
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“Increasing older people’s autonomy and self-confidence by providing help in case of emergency”
Fall and Mobility Sensing
Trial coordinator (Ancona, Italy; Berlin, Germany)
FP7 €2.7 million
Mobile depression treatment system
Mobility monitoring, Social interaction monitoring, Sensor integration
eHealth in Europe: Need, Vision and Practice
• Overview of eHealth research in EU
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• High level vision and goals
• Examples of projects
• My view on adherence monitoring in these projects
• Conclusions
Need
Ageing Population
Life Style Related DiseasesChronic Diseases
• 9% of GDP to 16%
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Ageing Population • 9% of GDP to 16% by 2020 (OECD minus US)
• From tax based systems to cost sharing by patients
• Labour 80% of cost
Care for the elderly
85 million EU citizens
2008:
29% of the EU’s
2050:
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85 million EU citizens are 65 or over (~17%)
29% of the EU’s population will be 65 or
over!!
• 2030: US health care costs for seniors to rise by 25%
Chronic Diseases
Diabetes Depression
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Diabetes Depression
Cardiovascular
Constitute 60-70% of all health care costs!
Stroke, Cancer, Arthritis,…
EU Visionon Health Care
Expectations:
• Facing the demographic challenge
• Reducing cost and increasing quality of care for elderly
• Reducing costs of chronic diseases (60-70% of total health care costs)
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• Offer cross-border access to services
• Ensure patient data security / privacy
• Empowering the patient
How is this vision implemented?
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eHealth as Lead Market:Related industry turn-over €15 billion
Policies and Actions
Funding:> €1 billion for over 450 ICT for health projects in the last two decades
EU Funding• Pre and early 1990’s:
– Tools for Health Professionals (Health Telematics)• Exploratory Action, 1988, €20 million
• Advance Informatics in Medicine, 1991, €111 million
• 1990’s:– Connectivity and health information networks
• FP3, FP4
Care providercentred
Informationcentred
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• FP3, FP4
• 1999 – present– Tools for Patients: Improving Prevention and
Personalisation of Healthcare• FP5, FP6, FP7
• 2005 onwards– ICT for predictive medicine - Towards the Virtual
Physiological Human
Patientcentred
Systemcentred
eHealth as Lead Market
• Legislation: consumer certainty and confidence, cross-border functionality, patient data security
• Public Policy: encourage use through adaptation to needs, interoperability and cost effectiveness
• Standardisation: Interoperability and certification
• Complementary: mobilize public and private funding, support
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• Complementary: mobilize public and private funding, support EU-wide solutions
Source: http://ec.europa.eu/enterprise/policies/innovation/files/lead-market-initiative/action_plan_ehealth_en.pdf
Policies / ActionsPilot actions: accelerating
beneficial implementation
Health Educ.Disease prevention
Health informationnetworks
HealthCards
Inter-operability Working
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National Roadmap
Addressing common challenges
operability
MobilityPatients & Staff
Infrastructure& Technology
Legal and Regulatory
Working together
and monitoring
practice
Bench-markingDisseminating
InternationalCollaboration
PracticeAAL 2008-1AAL 2009-2AAL 2010-3FP6-IST,
ST MicroElectronics
FP5-IST, Milior
FP6-IST, Philips
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FP6, European Technology for Business Ltd
FP5-IST, Ericsson
AAL,VU Amsterdam
AAL, CERTH
FP7-CIP, SALAR
FP7-IST, Novo Nordisk
Caalyx
• Complete Ambient Assisted Living Experiment
• Jan 07 – Dec 08 - €1,850,000
• Telefonica, CorScience, INESC, UL, COOSS, University of Plymouth, Synkronix
• Increasing older people’s autonomy and self-confidence by helping them in case of emergency
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helping them in case of emergency
• Now continued in eCaalyx– “Health monitoring of older and elderly persons with multiple chronic
conditions, at home and on the move.”
• www.caalyx.eu , http://ecaalyx.org/
Caretaker
Roaming`System
Web services
Stand-Alone Application
LAN
3G + InternetSystemAdministrator
Map
Server
EmergencyService
Internet
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DoctorRelative
Home System
Web Applications
SystemAdministrator
Courtesy of TID
Caalyx• Health measurements
– Identify vital signs and patterns
• Wearable Light Device
• Social tele-assistance services
I+II V
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I+II
IIIIV
V
MyHeart
• Jan 2004 – Dec 2009 - €16 million
• Philips, Medtronic Iberica, Nokia, Vodafone, plurality of universities
• 20% of EU citizens suffer a chronic cardiovascular disease (CVD)
• 45% of EU deaths are due to CVD
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• 45% of EU deaths are due to CVD
• “The MyHeart mission is to empower citizens to fight cardio-vascular diseases by preventive lifestyle and early diagnosis.”
• Intelligent Biomedical Clothes; measurement, diagnosis, feedback, treatment.
• http://www.hitech-projects.com/euprojects/myheart/
MyHeart
• Five Application Areas:– CardioActive: Application cluster for improved
physical activity
– CardioBalance: Application cluster for improved nutrition and dieting
– CardioSleep: Application cluster for improved sleep
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cluster for improved sleep and relaxation phases
– CardioRelax: Application cluster for improved solutions to deal with stress
– CardioSafe: Applications for early diagnosis and prediction of acute events
eHealth Prospective
• Abundance of bandwidth, technologies and sensors that, combined with cloud computing, can make eHealth happen
• eHealth is highly multi-disciplinary and projects should make use of knowledge from various areas
• Sensors technologies are emerging that allow medication level
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• Sensors technologies are emerging that allow medication level monitoring
• Standardisation should be targeted
Role of Medication Adherence
• A very important issue
• Many projects have medication reminders
• But how many projects actually monitor adherence???
• There is a big opportunity for wider medication adherence
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• There is a big opportunity for wider medication adherence monitoring
• How about measuring medication concentrations?– Measurement of medication levels in sweat using ion selective electrodes
Conclusions
• eHealth Need and EU Vision are well defined
• Projects address many, but not all issues
• US likely to lead eHealth deployment initially with disparate systems. Stronger standardisation in EU may lead to more rapid mass deployment.
• Opportunities for adherence, but often investigated separately
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• Opportunities for adherence, but often investigated separately
• Technology allows for direct feedback– Measurement of medication levels
– Further research may show other interesting links between medication levels and physiological parameters.
• Interdisciplinary collaboration is a must!