eHealth in Europe: Need, Vision and Practice

Dr. Pepijn van de VenDr. Pepijn van de Ven

Dr. John Nelson

ESPACOMP 2010 17 September 2010

Introduction

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IEEE Sensors Conference 2011 (Oct 28-31, 2011)University of Limerick, Ireland

Irish way: Pub CodeAsk your taxi driver for:

Scholar’s Club

Lame Duck

5 mins

3

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,…

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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

Medication Adherence related projects

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The Antiretroviral

Roll-out for HIV in India

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!

Thank You!

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Contact:

• pepijn.vandeven@ul.ie

• john.nelson@ul.ie