smart ehealth solutions – closed loop health care · 2011-10-27 · mcd media content...
TRANSCRIPT
![Page 1: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/1.jpg)
Smart eHealth Solutions – Closed Loop Health Careusability, security, added value
Helmut Leopold
AIT Austrian Institute of TechnologySafety & Security Department
ETSI, France October, 2011
![Page 2: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/2.jpg)
Medical Infrastructure
Health Care Trends
Increase in life expectancy and
Focus on value added services
Source: Statistik Austria;
Hilfswerk
Modern citizens within the health care system
2
expectancy and chronicle diseases
Cost problem
New technologies and processes for health care
services
Citizens take responsibility
Transparency and Information
Health care situation (Austria):
14% persons receiving nursing allowance
11% Home nursing care
Health system expenses increase more rapidly
than GDP!
![Page 3: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/3.jpg)
Smart eHealth: Next Generation eHealth Architecture for Telemedicine – AIT strategy
StandardisationMarket
Penetration
SensorsVital-Data
CommunicationGateway
AnalyticseHealth-
Information System
Doctor + AIT ICT-Expertise � Medical Application
PatientAdded Value
for doctors & patients
Usability Security Medical Added Value
3
![Page 4: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/4.jpg)
AIT KeepInTouch (KIT) Set based on NFC technology for easy to use vital parameters measurement
� Highest Usability and data safety� High security� Patient ID (registration)� Blood sugar
• Medicine (Insulin, OAD)• Bread units
� Blood pressure (systolic, diastolic), pulse rate� Weight� Personal feeling & activity
• kind, intensity, duration• Medication
� Reminder and Feedback
![Page 5: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/5.jpg)
Austrian wide Proof of Concept 1: Telemonitoring for Diabetes Mellitus
Workflow - DiabMemory - Gesundheitsdialog
PatientMeasurements (daily / weekly)
� blood sugar� blood pressure� weight
Doctor/ Nurseverification by doctors and nurses
feedback
� weight
Data Collection (parameters)� personal feeling� medication� activity
Data TransferReceiving FeedbackData aggregation: mobile
verification by doctors and nursesdocumentation of the intervention
feedback messages
5
Data Centerdata processing (analytics)verification of rulesreminders
![Page 6: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/6.jpg)
Improvement of the Diabetes Therapy …
High values in the morning
� More and updated information� More knowledge on trends� Improved therapy parameters� Efficient patient care
![Page 7: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/7.jpg)
Proof of Concept 2: Telemonitoring for Heart Disease
Workflow - ELICARD
Patient
Doctor / NurseMeasures (daily / weekly)
� blood sugar� blood pressure� weight verification by doctors and nurses
feedback
727/10/2011
Data Center
� weight
Data Collection (parameters)� personal feeling� medication� activity
Data TransferReceiving Feedback
data processingverification of rulesreminders
verification by doctors and nursesdocumentation of the intervention
feedback messages
![Page 8: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/8.jpg)
Successful telemedical intervention for upcoming issues (increase of diuretics)
Improvement of Heart Disease Therapy …
Parameters show changes before affecting the patient
![Page 9: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/9.jpg)
Proof of Concept (POC) - Results
� Acceptance only when added value for
� Patient, doctor and health insurance company
� Validated by doctors
Standardisierung für AAL/eHealth — 9
� Increased health for the patient
� Increased comfort for doctors
� Basis for lowering cost for the health system
![Page 10: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/10.jpg)
Standardization for eHealth and AAL
1027/10/2011
![Page 11: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/11.jpg)
Continua Health Alliance� Continua Health Alliance is a Forum which aims at interoperable products for
health and care� 236 members (mainly CPE manufacturers, operators)� Area of work is personal health with the following subjects:
� Healthcare and Wellness� Aging Independently (main area of AAL)� Chronic Disease Management
� Continua Health Alliance is not a classical standardization body. It promotes
Standardisierung für AAL/eHealth
— 11
� Continua Health Alliance is not a classical standardization body. It promotes available standards and recommends their application. By selecting appropriate standards and options interoperability shall be ensured.
.
![Page 12: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/12.jpg)
Continua Health Alliance – Architecture
Blood Pressure-Monitor
Pulse Oximeter
Medication Dosing Sensor
Phone/mobile Phone
o Supporting family members o Monitoring of elderly o Diet advice o Fitness Coach o Doctor o Data Base
PAN
Appl.
Standardisierung für AAL/eHealth — 12
Glucose Meter
Weighing Scale
Fall Sensor
Gas Sensor
Personal Health System
PC WAN Internet
. . .
Sen-sor LAN
Server
Back-End System
Net Appl.
Server
![Page 13: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/13.jpg)
Continua Health Alliance – Protocollstack PAN-IF/LAN-IF
ISO/IEEE 11073-20601 Optimized Exchange Protocol
ISO/IEEE 11073-10404 Pulse Oxymeter
ISO/IEEE 11073-10407 Blood Pressure Monitor
ISO/IEEE 11073-10408 Thermo-meter
ISO/IEEE 11073-10472 Medicaton Monitor
.......
Standardisierung für AAL/eHealth — 13
IEEE 802.15.4
ZigBee 2007 ZigBee 2007
ZigBee Cluster Library
ZigBee Health Care Profile
Bluetooth
USB
Bluetooth Health Device Profile
USB Personal Healthcare Device Class Specification
PAN-IF (Sensor) -LAN-IF
![Page 14: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/14.jpg)
Health Level Seven International (HL7)
� Health Level Seven International (HL7) is a non-commercial standardization organization which is accepted by ANSI and ISO.� 2300 Members, 57 working groups
� Goal are standards for the exchange, integration, retrieval and common use of electronic information
Standardisierung für AAL/eHealth
— 14
retrieval and common use of electronic information within the health sector.
� The name was derived from the OSI protocol model where layer 7 is dedicated to the application (L = level 7; H = Health). Focusing on Data Formats for the exchange of information within eHealth domain� patient data records, insurance data records
� Huge amount of information available!
![Page 15: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/15.jpg)
IHE – Goal
� Goal of IHE is the support of a co-ordinated application of well establishes standards e.g. from DICOM and HL7.
� In order to achieve this, IHE is defining Technical Frameworks for the Implementation of these standards for the message exchange in the clinical area.
� Basis of the Technical Frameworks are Integration Profiles.
Standardisierung für AAL/eHealth — 15
� Basis of the Technical Frameworks are Integration Profiles.� A strict auditing process shall ensure that the Frameworks are
implemented correctly.� Tutorials, training and exhibitions are offered during fairs in order to
demonstrate the advantage of the framework and to support ist application.
� IHE is similar to Continua Health Alliance – application of standards for interoperability for defined use cases – but for the clinical IT domain
� 423 members
![Page 16: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/16.jpg)
ETSI – eHealth activities
ETSI ProjectsETSI Projects
ETSI Technical CommitteesETSI Technical Committees
ATTMAccess, Terminals, Transmission and
Multiplexing
MSGMobile Standards
Group
MTSMethods for Test-ing & Specification
PLTPowerline
TISPANTISPAN
RRSReconfigurable
eHealthCoord.Activities
Health ICT DomainDECT
AEROAeronautics
BRANBroadband Radio Access Network
CLOUDIT-Telecom
Convergence
M2MMachine-to-Machine
Comm.
MCDMedia Content
Distriibution
1627/10/2011
ETSI Partnership Projects
ETSI Partnership Projects
BROADCASTEBU/CENELEC/
ETSI on Broadcasting
EEEnvironmentalEngineering
ERMEMC and Radio
Spectrum Matters
ESIElectronic
Signatures and Infrastructures
HFHuman Factors
LILawful Interception
Powerline Telecommuncation
SAFETYSafety
SESSatellite Earth Sta-tions and Systems
STQSpeech Proces-
sing, Transmission & Quality Aspects
Reconfigurable Radio Systems
DECTDigital Enhanced Cordless Telec.
RTRailway
Telecommunic.
SCPSmart Card
Platform
TETRATerrestrial Trunked
Radio
3GPPThird Generation
Partnership Project
Convergence
ITSIntelligent Transport
Systems
INTIMS Network
Testing
![Page 17: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/17.jpg)
ETSI eHealth activities – critical evaluation
� Limited activity of ETSI Project (EP) eHealth
� small number of participants, few working items
� The TC Human Factors (HF) is important, if usability is the major concern
� The TC Machine -to-Machine Communication (M2M) is very
Standardisierung für AAL/eHealth
— 17
� The TC Machine -to-Machine Communication (M2M) is very active !
� The basic work (Architecture, Functions, Interfaces) represents an important starting point
� The work-item eHealth within TC M2M should be improved
� The TC EMC and Radio Spectrum Matters (ERM) covers only the limited subject of radio technologies for implants
![Page 18: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/18.jpg)
Open issue for defining a standardization Roadmap� The standardization activities are enormous large and not easy to be
understood by new actors� A standardisation Roadmap should be process- or use-case oriented !� New standardisation activities should be aligned to IHE Integration Profiles � The total number of standards and documents are not manageable for
many eHealth and AAL service operators� Missing concepts for security and privacy� More work is needed to define clear and accepted System-Architecture
� Many technical solutions are in contradiction to national security guidelines (e.g. the remote closing of doors)
� How to deal with person related data, in distributed IT systems and several service operators ? (e.g. location data of individuals)
� Limited NFC activities so far (initial step: NFC Forum has begun defining the use of IEEE 11073 Personal Health Device (PHD)
18
![Page 19: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/19.jpg)
Conclusion - Recommendation
� Current available standards, frameworks and profiles are covering eHealth and AAL very well.
� The multitude of bodies and the complexity of the documents require the user to work hard to get familiar with the subject.with the subject.
� Therefore it is now urgent to guide the user to enable him to achieve this.
� No new standardization bodies shall be founded in this area. Instead the application of the existing standards shall be promoted.
![Page 20: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/20.jpg)
Danke !
Merci !
Grazie !
Tack ! Hvala !
Thank
Efcharisto !
20
Danke !
Gracias !Köszönom !
Grazie ! Thank You !
![Page 21: Smart eHealth Solutions – Closed Loop Health Care · 2011-10-27 · MCD Media Content Distriibution 27/10/2011 16 ETSI Partnership Projects BROADCAST EBU/CENELEC/ ETSI on Broadcasting](https://reader033.vdocument.in/reader033/viewer/2022050505/5f972ad4ba28a421cb6335cd/html5/thumbnails/21.jpg)
AIT Austrian Institute of Technologyyour ingenious partner
DI Helmut LeopoldHead of Safety & Security [email protected]