Biological Models to Better Understanding of Diseases


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Biological Models to Better Understanding of Diseases. Purcarea O, Frangi A, Hernandez V. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

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Biological Models to Better Understanding of Diseases

  1. 1. ICT for a global infrastructure for health research Dr Octavian Purcarea Global Industry Manager
  2. 2. Challenges for eHealth implementation • Usability • Trust • Sustainability (economic model) • Implication of different actors (empowerment) • Bringing closer the clinical practice and clinical research
  3. 3. Challenges for clinical research • Only 7% of eligible patients enrol in a clinical trial. • Only 3% of eligible cancer patients enrol. • 86% of all trials fail to enrol on time. • 85%-95% study days beyond original study timetable are due to not recruiting subjects on time. • Women, minorities, children and special populations are underrepresented. • Only 3% board-certified physicians participate in clinical trials. • The number of clinical investigators dropped 11% between 2001 and 2003. Michael G. Kahn MD, PhD University of Colorado The Children’s Hospital, Denver
  4. 4. EPR usability EPR Usability in the daily practice of the GPs Belgian Study USE OF DATA FROM THE PRIMARY CARE EPR - RESISTANCES AND SOLUTIONS Prof Dr Marc VANMEERBEEK DUMG 2004 Analysis of the database records of the EPR in 8 Medical Homes, 3 years, 133.0000 contacts « 6, 7% of the contacts were recorded in the database » « exasperation of the user » « It seems illusory to continue an IT program without a rapid response to the numerous improvement demands »
  5. 5. EPR usability EPR Usability in public health and quality management Belgian Study QUALITY IMPROVEMENT IN THE PRIMARY CARE BASED ON DATA COLLECTION OF DIABETES AND HYPERTENSION RELATED CONSULTATIONS Vandenberghe H., Bastiaens H., Jonckheer P., Orban T., Declercq E.,Lafontaine M.-F.,Van Casteren V. Service d’Epidémiologie Institut Scientifique de la Santé Publique, 2003, Bruxelles Exploration of the feasibility of data collection for quality improvement interventions .Two groups: paper based data collection and EPR based data collection Conclusion “40% of the physicians from the EPR based group finally didn’t send the data” « The quality indicators are strongly divergent for the 2 methods”
  6. 6. EPR usability EPR Usability for GPs German Study PRAXISNETZ STUDIE 2006 MANAGEMENT -PROZESSE –INFORMATIONSTECHNOLOGIE Günter Schicker und Oliver Kohlbauer , Wirtschaftsinformatik II Universität Erlangen-Nürnberg Analysis of the practice mangement and IT situation of GP Associations in Germany and Switzerland ; ( 72 deutsche Praxisnetze und 18 Schweizer) Conclusions - only 20% of care networks have electronically data exchange - only 9% have enough structured data - only 3% can document the care processes electronically
  7. 7. Clinical Software for USABILITY 1. Software behavior should reflect the work process of the user (workflow ) 2. Software objects should reflect the mental model (concepts) of the user (terminology ) Usability threshold Terminology + ----------------------------------------------------> Clinical Process Models
  8. 8. Trends : the Expansion of Networks: Numbers of Connected Devices • ‘60s 10s • ‘70s 100s • ‘80s 1,000s • ‘90s 1,000,000s • ‘00s 1,000,000,000s • ‘10s 1,000,000,000,000s • ‘20s 1,000,000,000,000,000s
  9. 9. Platforms, not technologies, Create Economic Value • Consistent APIs Cloud • Standards for interoperability Web • Available at scale • Compelling business model LAN Personal
  10. 10. Why Cloud changes the rules • Instant global scale service creation: Creates major opportunity for startups • Adds value to all existing platforms: Software + Services • Interoperability based on open standards: Broadest device, client and data accessibility
  11. 11. Enhanced GUI NUI Voice Handwriting Single Touch
  12. 12. Data Input
  13. 13. Innovative interfaces
  14. 14. 10 Year View: An Algorithmic* Transformation • Automation of the routine Moore’s Law • Network Embedding of specialized + knowledge and processes Cloud • Massive expansion of networked + service value chains Ubiquitous • Value creation moves from Networking specialized to generalized skills + NUI *Prof. John Zysman, BRIE – UC. Berkeley
  15. 15. Implications: Healthcare Providers • Will need to add semantic interoperability to automated processes and knowledge networks • The role of the GP will change dramatically as patients become increasingly educated, networked • Real-time monitoring and sensor based diagnostics will transform working practices • Massively increased competition in health services provision
  16. 16. Implications: Patients • Move towards ‘end to end’ health and wellness management strategies • Increased choice as providers compete with monitoring and diagnostic services • Much higher expectations from service providers • Increased concern about privacy as health services and data go online
  17. 17. Implications: Research Integrating Electronic Health Records (EHR) with Electronic Data Capture (EDC) systems used in clinical trials: • avoid duplicated data entry • assist in automatic identification of patients for clinical trials • enable early detection of potential patient safety issues. • Take into account multiple parameters (environmental, physical, genetical)
  18. 18. A Fundamental Change is Underway - World Health Organization
  19. 19. HealthVault = Health Application Platform
  20. 20. Personal Health & Wellness Patients can: •store health information Health & Fitness Physicians Device Manufacturers from many sources •access a range of health Health Plans Laboratories and fitness apps •upload data from health Hospitals Employers and fitness devices •share health information Healthcare with those they trust. Associations Pharmacies & PBMs Schools Application Providers
  21. 21. Future plans Towards full picture of individual’s health status Biosensors Biochips Environmental Genomic data Data Phenomic data Integrated Health Records
  22. 22. Connected Health Platform Connected Health Platform Infrastructure & Platform Offerings Application Platform for Health Business Productivity Infrastructure for Health Core Infrastructure for Health Connected Health Framework – Architecture and Design Blueprint Resources available at:
  23. 23. Knowledge Driven Health Create a Technology Foundation Microsoft Connected Health Framework
  24. 24. Seamless Integration of External Services: EPR side Seamless integration at user interface Exchange of key patient data
  25. 25. Integration of the HIS side: Microsoft Amalga Unified Intelligence System
  26. 26. Data Citizens Integration System Contributors Health Domain PHR Applications Aggregation & Personal Health Insight System Record System Interoperability Tools Healthcare Providers Primary Care Provider Social Worker Care Manager Specialty Care ED Physician Case Manager
  27. 27. Data Citizens Contributors BizTalk Server HealthVault Applications - Partners Connected Health Connected Health Platform & Partner Interoperability Tools Healthcare Providers Primary Care Provider Social Worker Care Manager Specialty Care ED Physician Case Manager
  28. 28. What We Need to Make It Happen? • Support (fund) semantic interoperability including human resources. • Involve, empower the individuals in management of their own Health, involve from the beginning in your projects the Health Professionals; • designing an organisational architecture that bolsters the interest of health professional, promoting the early assessment of new therapies for their inclusion among the reimbursable treatments, fostering the validation of clinical trials protocols based on Evidence Based Medicine and additionally, on Evidence Based Management. • validating new reimbursement schemas, assessing the need for incentives for health professionals and patients involved in clinical trials, and devising new adherence strategies with patients and health professionals. • Think in terms of pay per performance, quality related indicators, incentives, trust and usability.
  29. 29. For More Information about Microsoft Health • Health Web site: • Health Blog: www.blogs/ • EMEA Health Blog: • Information on Amalga and Health Vault can be found at: • You can find information on the Common User Interface and the design guides at: • Here is the link to the CHF (Connected Health Framework) material: • For MedStory (now called Live Search – Health) go to or E-mail:
  30. 30. © 2010 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.