mobihealth health care today - aristotle university of...
TRANSCRIPT
1
© 2002 The MobiHealth consortium1
MobiHealthIST-2001-36006
http://www.mobihealth.org
Dimitri KonstantasVal JonesRichard Bults
Rainer Herzog
University of Twente (NL)CTIT – APS
Ericsson Consulting Germany
© 2002 The MobiHealth consortium2
Health care todayProblems and issues
• Life expectancy increases• We have more chronic disease patients
(diabetes, cardiovascular, asthma etc)• Patients and non-patients seek medical
advice more often • People becoming health conscious• Hospitals face worsening resource problems
(time, space, resources, costs ..)
© 2002 The MobiHealth consortium3
Scenarios for the future development of the health care sector: how to meet the challenges
PATIENTS’ ROLE
PAYERS’ ROLE
Passive
Active
ManageObserve
Empowered Managed Care? individualized, interactive
health & patient management? managed costs
Payers Rule !? pharmacoeconomics,
only cost matter
Patients Rule !? convenience, quality
of life, DTC
Nobody Cares? traditional marketing,
me-too products
© 2002 The MobiHealth consortium4
Dissolving the boundaries of traditional point of care
Prescription
Diagnosis Consulting
Monitoring of patient’s status /
progression
Monitoring of patient’s status /
progression
Managing patient’s compliance
Managing patient’s compliance
Quick handling of emergency situations
Quick handling of emergency situations
Adaptation of treatment
Adaptation of treatment
Doctor’s Office
Patient’s Home
© 2002 The MobiHealth consortium5
Wouldn’t it be nice ...
• To have the same level of health care while continuing a normal active life, instead of being stranded at the hospital?
• To have your health status monitored without having to go to health center?
© 2002 The MobiHealth consortium6
It can be done today ...
• Available technology – Mobile medical sensors– Widely available public wireless network
• Acceptance of new services– GSM telephone based services– Internet
2
© 2002 The MobiHealth consortium7
The Dream ...
GPRS
UMTS
© 2002 The MobiHealth consortium8
Mobile patient management :Individualized dialog in real time
Datawarehouse
Pull
Push Content
Management
Analysis
Doctor
HealthBroker
Hospital
UMTS
GPRS
SMS
WAP
Patient
? Sensor readings
? Data
? Reminders, questions
? Treatments? Information
© 2002 The MobiHealth consortium9
Diabetes 5.000.000 500.000 1.000.000
Stroke 1.500.000 150.000 300.000
Asthma 4.000.000 400.000 800.000
Hypertension 17.600.000 1.760.000 3.520.000
CAD 1.500.000 150.000 300.000
Total potential users 2.960.000 5.920.000
Disease PrevalenceAcceptance*
10% 20%
* Estimated acceptance rates for mobile disease management programs
Disease prevalences (Germany) and acceptance rate of mobile patient management
© 2002 The MobiHealth consortium10
Patient management leads to significant savings for insurers
Source: BKK, PreussenElektra, HannoverMcKinsey
Efficient patient management can save approx. 20% of yearly treatment costs and between 50-60% of costs due to late stage diseases.
Cost Basis forInsurers
Savings inTreatment
Costs
New claimsdue to PM
Costs of PMProgram
Total Costs
Net Savings forInsurers
30 - 40
100
5 -10
5 -10
70 - 90
10 - 30
EXAMPLE 1:Percentage of yearly treatment costs per patient for Asthma, (100=€5,000)
• 5% of all Germans suffer from Diabetes? 300.000 Type I diabetics? 4-5 mill Type II diabetics
• Disease related costs per patient and year:? well monitored diabetics: € 6.500
? badly monitored diabetics: € 8.500? € 2.000
• Costs caused by diabetes related late stage diseases:
? Diabetic Foot: € 1 Bil.? Renal diseases and dialysis: € 1,5 Bil.
EXAMPLE 2:Overview of disease related costs of Diabetes in Germany
© 2002 The MobiHealth consortium11
Personal mobile health care
• Vital signal information to the health broker over public network
• Personalized measurements • Personalized follow-up and advice• Health record
© 2002 The MobiHealth consortium12
Requirements
• Flexibility and personalization– Different persons have different needs
• Reliability– Comparable to clinical measurments
• Privacy and security• Non-intrusive – freedom of movement
3
© 2002 The MobiHealth consortium13
Wireless medical telemetry
Patients wear sensors which measure biosignals and transmit them in real time over wireless communications link
eg. EMG, ECG, respiration, BP…..
NB cardiac and respiratory monitoring can already be done using an ordinary mobile phone….
© 2002 The MobiHealth consortium14
Application Areas
• Home care– In home and out of home health monitoring
• Post treatment follow up• Pharma research• Sports and recreation• Chronic disease research• Trauma care
© 2002 The MobiHealth consortium15
Virtual Trauma Team
• emergencies, accidents, disaster sites
Mobile devices plus wireless comms to allow emergency staff to communicate with hospitals/specialists to facilitate:
- remote assessment of patient- early intervention- preparation (eg. of theatre)
© 2002 The MobiHealth consortium16
theatre ER
Paramedic/patient BAN
(bluetooth, GPRS ..)
© 2002 The MobiHealth consortium17
Virtual Home careThe “patient” is equiped with a
personalized set of sensors/actuators and is connected (via UMTS/GPRS) to a health center.– Intensive care at home– Sports and recreation– Medical follow up– Medical research
© 2002 The MobiHealth consortium18
Mobile Health Body Area Network
ECGGlucowatch
EEG
headsetBlood pres/pulse
services
4
© 2002 The MobiHealth consortium19
Mobile Health Operational Overview
Health broker
Wireless data services
Public Operator
Hospital
UMTS
Call centerGeneral practitioner
© 2002 The MobiHealth consortium20
Issues for Mobile Health BAN
• Quality of service– Security, privacy, performance, network
segmentation• Social acceptance
– Health risks, economic issues• Legal issues
– Accreditation of the devices and applications– Legal restrictions for health care – Hospital responsibilities for patient treatment
© 2002 The MobiHealth consortium21
Why UMTS ?
• Bandwidth – Need more than 9 kbps – 13 kbps
• Data transmission delays– No connection delay
• Cost – per KB instead per minute
© 2002 The MobiHealth consortium22
Why UMTS - bandwidth as the basis for mobile applications
DATA QUANTITY TRANSMISSION SPEEDS
photo 100 KBweb 30 KBmovie 3000 KB
EDGE 384 Kbps UMTS 2 Mbps
GSM 10 Kbps HSCSD 58 KbpsGPRS 115 Kbps
2G wireless(GSM)
Basic wireline(analog )
Enhanced wireline(ISDN)
HSCSD
Enhanced wireless(adding GPRS )
3G wireless
1 hour1 min 10 min10 sec
E-mailWeb
PhotoVideo clip
TRANSFER TIME
© 2002 The MobiHealth consortium23
? The successor of present day mobile standards
? Main advantages:
? better utilisation of the frequencies
? high data transmission rates of up to 2 Mbs
? always connected, always on-line
? charging of data volume, not connection time
? Enables the simultaneous transmission of pictures/videos,
speech and data in multimedia applications
? UMTS creates new distribution channels as well as new
competitive advantages for innovative companies
Why UMTS - more convincing advantages
© 2002 The MobiHealth consortium24
The MobiHealth ProjectIST 2001-36006
• Overall objective The development and trial of new services and applications in the area of mobile health, promoting the use and deployment of GPRS and UMTS.
5
© 2002 The MobiHealth consortium25
MobiHealth targets
• Development of new m- health services and methodologies for their evaluation
• Integration of a generic m- health Body Area Network (BAN)
• Validation of GPRS and UMTS networks for m- health services via large scale trials
• Validation of the accuracy of measurements and data capture
• Validation of medical, social/ ethical and economic advantages of the new m- health applications
© 2002 The MobiHealth consortium26
MobiHealth BAN
MBU
internalcommunication
links
sensor
0...n
actuator
0...m
externalcommunication
link
© 2002 The MobiHealth consortium27
MobiHealth architecture\
Home care Home
Pharma Testing
Sports
Hospital patient management system
BAN Operating System
Communications Management
IP Interface
2.5G 3G 4G
Traumacare
© 2002 The MobiHealth consortium28
MobiHealth Trials
• 4 trial sites– The Netherlands, Enschede– Spain, Barcelona – Sweden, Lulea – Germany
• Trials will start in late spring 2003 • Multiple scenaria will be trialed
© 2002 The MobiHealth consortium29
Trial Scenaria
Examples of potential trial scenaria (to be finalized end of June 2002, the list is not complete)
• Home care and follow up for chronic patients
• Virtual trauma team• High risk pregnacies• Monitoring of respiratory insufficiency
© 2002 The MobiHealth consortium30
MobiHealth organization
• Project start : May 1st 2002• Project Duration : 18 months• Project Budget : 8.2 MEU• EU contribution 4.9 MEU• 6 partners – 8 members
6
© 2002 The MobiHealth consortium31
The MobiHealth Consortium
• Ericcson Consulting GmbH (DE)– Gsout
• Telia (SE)– University of Lulea
• University of Twente (NL)– MST, TMSI, Compaq, Yucat
• Telefonica moviles (ES)– Consorti Sanitari Clinic, University Pompeu Fabra
• Phillips Research (UK)• CMG Wireless Data Solutions (NL)
© 2002 The MobiHealth consortium32
Contactshttp://www.mobihealth.org
Mr. Rainer HerzogSenior Consultant
Maximilianstr. 36D-80539 MünchenGermanyTel.: +49 89 25543713Mobile.: +49 178 534 0067mailto: rainer.herzog@ ericsson.com
Ericsson ConsultingUniversity of Twente
Prof. Dr. Dimitri Konstantas Dr. Val JonesMr. Richard Bults
CTIT – APSP.O.Box 217 NL-7500 AE EnschedeThe NetherlandsTel.: +31 53 489 3784 / 4018mailto: [email protected]: [email protected]: [email protected]
© 2002 The MobiHealth consortium33
Summary