2012/HWG/PD/002 Using Health Information Technology to Connect the Healthcare System and Improve Patient Care

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Policy Dialogue on Using Health Information Technology to Connect

1 2012/HWG/PD/002 Using Health Information Technology to Connect the Healthcare System and Improve Patient Care Submitted by: Korea Policy Dialogue on Using Health Information Technology to Connect and Strengthen the Health Care System St. Petersburg, Russia 26 June 2012

2 Using Health IT to Connect the Healthcare System and Improve Patient Care Prof. Myoungho Lee, Ph.D., Yonsei University President, Korea e-health Association Definition of u-health u-health provides medical & health promotion services (prevention, diagnosis, treatment, post control and so on) IT using ubiquitous IT Wired Network Internet-Based Web-Based Communication Medicine Medical Treatment Using IT Network Transmission of Medical Information, Remote Healthcare Telemedicine Medical & Healthcare Services through Internet A joint Use of Medical Information, Remote Heal thcare e-health Health Telematics Medical & Healthcare Services Using u-it (Sensor Network) Intelligent Healthcare Services u-health Source : Myoungho Lee, 2010 ICOST Smart Homes and Health Telematics, Seoul, Korea 2

3 Historical Transition of u-health Telemedicine 1970~1990 Telehealth 1990~2000 e-health 2000~2008 u-health Provision of Healthcare Service Encompassing Term of Telemedicine Internet- Based Health Care Delivery Web- Based Health Care Delivery Clinical Information Education Incorporation of Telecommunication System Health Informatics Health Telematics Telecare Integration of Telecommunication System Informational, Educational, Commercial Product Network Internet Mobile Informational, Educational, Commercial Product Sensor Network Web Mobile <M.H. Lee, 2009 WCID Conference, Beijing, China> 3 Changing Health Sector Domain U-Health Hospital Domain Medical Supplier Domain Patient Domain Pharmacy Domain Clinician Domain Consumer Domain Medical Supplier Domain Pharmacy Domain Classical Health Service Future Health Service

e-europe 2005 EU-CAN e-health e-canada UKeHA KeHA EUROPE WHO ASIA JAHIS N.

4 u-health is Worldwide : e-health is Worldwide Developed by Constructing e-health Portal and Adopting National e Policy in each economy. e-europe 2005 EU-CAN e-health e-canada UKeHA KeHA EUROPE WHO ASIA JAHIS N. AMERICA e-health Initiative AFRICA Health Connect Vision2020(MSC) OCEANIA e-mexico S. AMERICA Configuration of u-healthcare Service System

5 u-health Medical Sensors u-health Medical Sensors 1. Glucose 2. Blood Pressure 3. Body Temperature 4. Respiration 5. ECG, EEG, EMG 6. HRV, PPG 7. SPO2 8. EtCO2 u-health Medical Devices are based on Ubiquitous IT 7 7 Body Sensors, BAN 8

Ubiquitous Health Monitoring 2 nd TinyOS Technology Exchange 9 Ubiquitous Personal Monitoring Systems Intelligent wireless sensors communicate with each other and the personal server Personal

6 Ubiquitous Health Monitoring 2 nd TinyOS Technology Exchange 9 Ubiquitous Personal Monitoring Systems Intelligent wireless sensors communicate with each other and the personal server Personal Server -Integrate information from different sensors -Communicate with the upper layer of the organized m-health system BAN: Body Area Network LAN: Local Area Network PAN: Personal Area Network 10

ppt/ppt/g.tutprial/ppt.htm 11 from : www.

7 Micro/Nano applied to Medical Devices Taken from : 11 Micro/Nano applied to Medical Devices Taken from : 12

Micro/Nano applied to Medical Devices An implantable blood pressure sensor developed by CardioMEMS Surgical microgripper actuated by SMA Taken from http://www.ee.ucla.

pdf 13 Patient Friendly(u-Health) Sensing Diagnostics Bioelectrical and physiological measurements (ECG, arrhythmia, other heart symptoms, EEG, EMG, blood pressure,.

8 Micro/Nano applied to Medical Devices An implantable blood pressure sensor developed by CardioMEMS Surgical microgripper actuated by SMA Taken from ce/msc_2000_judy.pdf 13 Patient Friendly(u-Health) Sensing Diagnostics Bioelectrical and physiological measurements (ECG, arrhythmia, other heart symptoms, EEG, EMG, blood pressure,.) Biochemical assays (blood sugar, infarct markers, ) Safety Monitoring of chronically ill patients (heart diseases, diabetes, epileptic events), alarms Monitoring at home and in nursing homes (elderly and demented people) Sport, physical exercise, training Monitoring of physical condition and efficiency Control and feedback in training Ambient intelligence, smart devices, security Environment senses, recognizes and reacts (home, office, car) Smart user interfaces (telephone, PC, multimedia devices, digital-tv, games) 14

ECG Sensing Most widely used ECG measurement setup in clinical environment Signal is measured non-invasively with

practices This particular method was adopted due to historical reasons, now it is already rather obsolete 1.

Precordial leads: V 1 -V 6 U-health 1-Lead ECG Sensor Patient Monitor 12Ch-ECG 15 Wearable ECG Sensor Blood

and is one of the principal vital signs.

The mean BP decreases as the circulating blood moves away from the heart through arteries, has its greatest

and continues to decrease as the blood moves through the capillaries and back to the heart through veins U-health

9 ECG Sensing Most widely used ECG measurement setup in clinical environment Signal is measured non-invasively with 9 electrodes Lots of measurement data and international reference databases Well-known measurement and diagnosis practices This particular method was adopted due to historical reasons, now it is already rather obsolete 1. Einthoven leads: I, II & III 2. Goldberger augmented leads: V R, V L & V F 3. Precordial leads: V 1 -V 6 U-health 1-Lead ECG Sensor Patient Monitor 12Ch-ECG 15 Wearable ECG Sensor Blood Pressure Sensing Blood pressure (BP) is the pressure exerted by circulating blood on the walls of blood vessels, and is one of the principal vital signs. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure. The mean BP decreases as the circulating blood moves away from the heart through arteries, has its greatest decrease in the small arteries and arterioles, has its greatest decrease in the small arteries and arterioles, and continues to decrease as the blood moves through the capillaries and back to the heart through veins U-health Continuous Non-Invasive Blood Pressure measurement device for u-health system. Classic type of Blood Pressure Measurement Method Source: H,HarryASADA, Journal of Wearable technology Mobile Monitoring with Wearable Photoplethysmographic Biosensors

plethysmograph, a volumetric measurement of an organ.

which illuminates the skin and measures changes in

A conventional pulse oximeter monitors the perfusion

skin. U-health 17 SpO2 Sensing Saturation of

clinician how much oxygen is dissolved in the blood

And SpO 2 is of vital interest as it can alert

10 Photo-Plethysmogram(PPG) Sensing A photoplethysmograph (PPG) is an optically obtained plethysmograph, a volumetric measurement of an organ. A PPG is often obtained by using a pulse oximeter which illuminates the skin and measures changes in light absorption (Shelley and Shelley, 2001). A conventional pulse oximeter monitors the perfusion of blood to the dermis and subcutaneous tissue of the skin. U-health 17 SpO2 Sensing Saturation of peripheral oxygen (SpO 2 ) tells the observer or clinician how much oxygen is dissolved in the blood of the subject under observation. And SpO 2 is of vital interest as it can alert medical professionals to conditions underlying illness or disease in a patient. The normal range result of a pulse oximeter is 95% to 100%. Anything lower than that means there's not enough oxygen getting to your body. U-health 18

11 Body Temperature Sensing Contact or Noncontact Measurement Applitation Sensing Chip 2.45GHz ActiveRFID Temperature Sensor Tag thermometer 19 Sensor physics and new sensing materials Modelling and simulation Focus in microsensors, biosensors and wireless sensors Applications of commercial sensors Patient Friendly Sensing Systems 20

UWB Radar Sensor for u-health Service System What is the UWB?

spectrum of frequency, such that the energy in any frequency

Short duration pulses in the picoseconds or subnanosecond

The UWB signal can be transmitted with no carrier with a low

Promising technology for many aspects of biomedical

12 UWB Radar Sensor for u-health Service System What is the UWB? 1. Ultra-Wide-Band spread transmitting energy across a wide spectrum of frequency, such that the energy in any frequency band is below the noise floor 2. Short duration pulses in the picoseconds or subnanosecond range resulting in several GHz bandwidth. 3. The UWB signal can be transmitted with no carrier with a low power. 4. Promising technology for many aspects of biomedical applications. 21 Medical Application of UWB 1) Breathing Detecting 2) Noninvasive Glucose detecting 3) Fetal monitoring 22 4) Straight forward hearts and breath activities Monitoring

13 Infineon : Electronic Textile Sensors APEC HealthProducts Working Group e-he(alth Sensatex Smart Shirt: Electronic Textile Sensors 24

14 Vivometrics : Life Shirt 25 e-health Products Phillips : Electronic Textile Sensors 26

15 e-health Products Phillips : Electronic Textile Sensors 27 e-health Products Polar/Adidas : Electronic Textile Sensors 28

16 e-health Products Phillips : Electronic Textile Sensors 29 e-health Products Phillips : HeartCare Telemedicine Services 30

17 e-health Products Phillips : Cardiac Telemonitoring System 31 Card Guard Health Mobile Phones(Israel) 1 and 12-lead ECG event recorder Blood pressure Glucometer Thermometer Spirometer Sp0 2 32

etry 33 Products Qualcomm s Personal Health

18 2012e-Health APEC Health Working Group Products CardioNet: Mobile Cardiac Telem etry e-Health APEC Health Working Group Products Qualcomm s Personal Health MVNO, LifeComm 34

19 e-health Products Debiotech: Subcutaneous Infusion of Insulin for Diabetes 35 Gulucose Sensing Contact Lenses e-health Products 36

20 Pendrgon Medical System 37 Public/Private Health Sectors Innovation 3.1 EHR Construction <---- PHR Severance Hospital Cooperate with IT company Electronic Image Data & EHR Samsung Hospital Apply to EHR of Inpatient Apply to EHR of Outpatient Samsung/LG/TeleCom Unification of the HIS of Grand Hospital Cooperate with Hospital Market EHR EHR Seoul St. Mary s Hospital Apply to EHR of Inpatient Apply to EHR of Outpatient Asan Hyundai Hospital Cooperate with IT Company Unification of Hospital Information System (OCS, PACS, EHR) Seoul Nat l Hospital Slipless Filmless Paperless Chartless 38 Inha Hospital EHR of Outpatient the EHR of Outpatient is extending more

21 Public/Private Health Sectors Innovation u-health Hospital Construction u-health Hospitals in Korea Bed DBMS Network IT Fund (won) OCS EHR PACS Yonsei U. Severance 1,470 MS SQL Gigabit 30 billion Seoul NU. Hospital 1,546 Oracle ATM 200 billion Korea U. Hospita l 1,050 DG SQL Kyounghee U. Hospital 1,070 Cache - 14 billion Samsung Hospital 1,226 Oracle 100MPS FDDI 30 billion Gigabit 3 billion Asan- Hyundae Hospital 2,139 - Giga-bit 39 billion : 100 % : % [ Source : Datanet, Fit Hospitals Website, 2008 ] 39 Conclusions New wireless technology ( ambulatory or implantable wireless sensors) will dramatically change the way we understand healthcare today This development provides the enabling technology for real long term monitoring of physiological functions in sports, home health care as well as in hospital environment The healthcare system will become more mobile, demand driven, efficient, and person/patient friendly New wireless sensors and measurement systems have a huge market potential 40

22 Thank you for your attention!!

ADDIS ABABA UNIVERSITY CENTER OF BIOMEDICAL ENGINEERING

ADDIS ABABA UNIVERSITY CENTER OF BIOMEDICAL ENGINEERING November 2013 History of Biomedical Engineering Definition of Biomedical Engineering Achievements of Biomedical Engineering Streams in Biomedical