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Adolfo Muñoz Carrero
eHealth and Aging: A Research Experience
Contents:

• UITES: Telemedicine and eHealth Research Unit

• Research Scenario

• Some of our research projects

• Conclu...
Telemedicine & eHealth Research Unit

• Pertaining to the Health Institute “Carlos III”, responsible
  of research promoti...
Telemedicine & eHealth Research Unit


•   15 years of work
•   11 pilots
•   7 clinical trials
                          ...
Research Scenario

Main Idea: Insertion of New Care eServices

       Social                                   Health
    ...
Research Scenario: methodology

                                                                                Agencia Ev...
Research Scenario: methodology

                                         Agencia Evaluación
                              ...
Research Scenario: platform

                                                                      Internet/GSM
          ...
Research Scenario: platform


                         Internet/GSM
          Usuario
          Patient                   ...
Research Scenario: platform


                        Internet/GSM
          Usuario
          Patient                    ...
Research Scenario: platform


                        Internet/GSM
          Usuario
          Patient                    ...
Research Scenario: platform


                      Internet/GSM
        Usuario
        Patient                       Usu...
Research Scenario: platform

•Communicates with patient’s EHR
•Breaks service isolation Internet/GSM
          Usuario    ...
Research Scenario: platform

•Manages the resources Internet/GSM
            Usuario                      Usuario
        ...
Telemedicine & eHealth Research Unit


•   15 years of work
•   11 pilots
•   7 clinical trials
                          ...
Social Care projects

 PLATAS: Platform for the integration of Health
            and Social care services
• Information s...
Comorbidity Study

Chronic Comorbidity and resource consumption



                                 •Madrid Healthcare Are...
Associated Comorbidities


EDC (I.P.)    Nº cases       I.P.       I.P.+1    I.P.+2    I.P.+3    I.P.+4   I.P.+5 +

Diab. ...
Continuation: dependency study


Population: 200 (randomised from comorbidity
study)
Personal interviews (WHO DAS II)
G...
Project: behaviour modelling

• Objective: to assess the dependency of elderly
  people using traditional surveys and ambi...
Conclusions

Telemedicine for chronicity and dependency:

  R&D:
    - Integration & globalization of solutions (focused
...
Conclusions

Telemedicine for chronicity and dependency:

  New methodologies:
    - To facilitate the insertion of the n...
Conclusions

Aging people and ICTs:

 Results demonstrate that with its use, aging people:
    Feel safer and less lonel...
Adolfo Muñoz Carrero
   eHealth and Aging: A Research Experience


Thank you very much for
    your attention
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Ageing – a Global Challenge: eHealth and Aging: A Research Experience

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Ageing – a Global Challenge: eHealth and Aging: A Research Experience. Muñoz A. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

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Ageing – a Global Challenge: eHealth and Aging: A Research Experience

  1. 1. Adolfo Muñoz Carrero eHealth and Aging: A Research Experience
  2. 2. Contents: • UITES: Telemedicine and eHealth Research Unit • Research Scenario • Some of our research projects • Conclusions
  3. 3. Telemedicine & eHealth Research Unit • Pertaining to the Health Institute “Carlos III”, responsible of research promotion on biomedicine and health sciences • Our mission: To research, to develop and to innovate in methods, systems, and technologies to improve the health and well-being of the population through the use of ICTs Chamartín campus: Building 6
  4. 4. Telemedicine & eHealth Research Unit • 15 years of work • 11 pilots • 7 clinical trials FIS02/1156 • ≈ 2.000 patients FIS PI06-90166 PAV-020000 -2007-133 FIS PI051882 • ≈ 100 physicians (GP+SC) SBVP-1201/02 FIS080435 SBVP-1201/02 • 6 Hospitals SBVP-1396/99 FIS 02/1391 PDM 2006-171 DGVI 1054/06 • 5 Health areas FIS07-90187 FIS 01/0915 SBVP-1396/99 Health Care Social Care
  5. 5. Research Scenario Main Idea: Insertion of New Care eServices Social Health • Independent Life • Proactive Health • AAL • Prevention • Accessibility • Healthy life habits • Integration • Patient empowerment Personal and integrated eServices
  6. 6. Research Scenario: methodology Agencia Evaluación Authorities Research I+D+i Grupo Group I+D+i Grupo Tecnologías Sanitarias Supervised Use Clinical Trial Complexity of intervention Exploratory Trial Pilot ? … … • Monteagudo JL, Salvador CH, García-López F. Metodología de introducción de servicios de e-Salud para el seguimiento y control de pacientes crónicos. Rev Esp Salud Pública 2004;78(5):571-81. • Mario Pascual Carrasco. Aportaciones a un modelo de inserción de servicios asistenciales basados en telemedicina para su uso y validación en el seguimiento de pacientes crónicos. Doctoral Thesis. UPM. Junio-2008. Pascual M, Salvador CH, García-Sagredo P, Marquez-Montes J, Gonzalez MA, Fragua JA, et al. Impact of patient-general practitioner interaction on the control of hypertension in a follow-up service for low-to-medium risk hypertensive patients. IEEE Trans Inf Technol Biomed. 2008,12(6):780-91 .
  7. 7. Research Scenario: methodology Agencia Evaluación Authorities Research I+D+i Grupo Group I+D+i Grupo Tecnologías Sanitarias Supervised Use Clinical Trial Complexity of intervention Exploratory Trial Pilot ? … … Small sizesize Big Serviceby the authorities Driven testing Very small size 4 stages The service can’t be changed TechnologyObjective: Scientific evidence testing The service could be changed
  8. 8. Research Scenario: platform Internet/GSM Usuario Patient Usuario Healthcare Paciente Médico Agent Estación Central Central Station Centro Healthcare Coord. Oficina De Salud Centre Coord. Office Electronic • Salvador CH, Pascual M, et al. Airmed-Cardio: A GSM and Internet Services-Based System for Out-of-Hospital Follow-Up Healthcare of Cardiac Patients. IEEE Trans Inf Technol Biomed. 2005, 9(1): 73-85. Record • Muñoz A, Somolinos R, Pascual M, Fragua JA, González MA, Monteagudo JL, Salvador CH. Proof-of-Concept Design and Development of an EN13606-based Electronic Healthcare Record Service. J Am Med Inform Ass 2007; 14(1): 118- 129. • Salvador CH, Ruiz-Sanchez A, Gonzalez MA, Carmona M, Pascual M, García-Sagredo P, et al. Evaluation of a telemedicine-based service for the follow-up and monitoring of patients treated with oral anticoagulant therapy. IEEE Trans Inf Technol Biomed. 2008,12(6):696-706.
  9. 9. Research Scenario: platform Internet/GSM Usuario Patient Usuario Healthcare Paciente Médico Agent Estación Central Central Station Centro Healthcare Coord. Oficina De Salud Centre Coord. Office Electronic Healthcare •Technical and Record communications support •Automatic (24/7) •Configurable web applications
  10. 10. Research Scenario: platform Internet/GSM Usuario Patient Usuario Healthcare Paciente Médico Agent Estación Central Central Station Centro Healthcare Coord. Oficina De Salud Centre Coord. Office Electronic Healthcare •Uses devices for Record monitoring •Answers questionnaires •Receives updates from physicians
  11. 11. Research Scenario: platform Internet/GSM Usuario Patient Usuario Healthcare Paciente Médico Agent Estación Central Central Station Centro Healthcare Coord. Oficina De Salud Centre Coord. Office Electronic Healthcare Record •Groups patients and resources (nursing home, residential home,…)
  12. 12. Research Scenario: platform Internet/GSM Usuario Patient Usuario Healthcare Paciente Médico Agent Estación Central Central Station Centro Healthcare Coord. Oficina De Salud Centre Coord. Office Electronic Healthcare •Controls patients Record trough web applications •Communicates trough SMS messages
  13. 13. Research Scenario: platform •Communicates with patient’s EHR •Breaks service isolation Internet/GSM Usuario Usuario Healthcare Patient •Based on Paciente (ISO-EN 13606) standards Médico Agent Estación Central Central Station Centro Healthcare Coord. Oficina De Salud Centre Coord. Office Electronic Healthcare Record
  14. 14. Research Scenario: platform •Manages the resources Internet/GSM Usuario Usuario Healthcare •Controls the intervention Patient Paciente Médico Agent •Trains users (patients, physicians) Estación Central •Gathers results Central Station •PerformsHealthcareanalysis statistics Centro Coord. Oficina •Generates Centre De Salud reports Coord. Office Electronic Objective : To relieve the Public System from all non care Healthcare Record related tasks
  15. 15. Telemedicine & eHealth Research Unit • 15 years of work • 11 pilots • 7 clinical trials FIS02/1156 • ≈ 2.000 patients FIS PI06-90166 PAV-020000 -2007-133 FIS PI051882 • ≈ 100 physicians (GP+SC) SBVP-1201/02 FIS080435 SBVP-1201/02 • 6 Hospitals SBVP-1396/99 FIS 02/1391 PDM 2006-171 DGVI 1054/06 • 5 Health areas FIS07-90187 FIS 01/0915 SBVP-1396/99 Health Care Social Care
  16. 16. Social Care projects PLATAS: Platform for the integration of Health and Social care services • Information service • Video attention service • HBP monitoring service • Promotion of personal activity service • Preventive and healthy lifestyle service
  17. 17. Comorbidity Study Chronic Comorbidity and resource consumption •Madrid Healthcare Area 11 •Population: 887.134 •127 GP involved (out of a total of 521) •149.417 cases studied Doctoral Thesis, Monserrat Carmona Rodríguez
  18. 18. Associated Comorbidities EDC (I.P.) Nº cases I.P. I.P.+1 I.P.+2 I.P.+3 I.P.+4 I.P.+5 + Diab. 10.058 9,67 15,77 20,44 20,24 15,00 18,86 EDC (I.P.) Nº cases I.P. I.P.+1 I.P.+2 I.P.+3 I.P.+4 I.P.+5 + CHF 1.377 3,05 6,83 11,84 16,63 19,46 42,19 Doctoral Thesis, Monserrat Carmona Rodríguez
  19. 19. Continuation: dependency study Population: 200 (randomised from comorbidity study) Personal interviews (WHO DAS II) Gathering of information just finished “No official results yet”… but it is clear that the dependency is caused by the illness (or by its accumulation) and not by the age.
  20. 20. Project: behaviour modelling • Objective: to assess the dependency of elderly people using traditional surveys and ambient monitoring, correlating the information obtained by both methods. Scores Methodology: Items to Objective Equivalencies Equivalencias and assess Quantifiable Ambient. Monit.
  21. 21. Conclusions Telemedicine for chronicity and dependency:  R&D: - Integration & globalization of solutions (focused in the person and not in the problem) - Interoperability functional & semantic: normalization (information sharing) - To obtain scientific evidence about the utility of new eServices (decision support)
  22. 22. Conclusions Telemedicine for chronicity and dependency:  New methodologies: - To facilitate the insertion of the new eServices in the organizations - To ease the organizational and cultural changes - To share information at all health care and social care levels
  23. 23. Conclusions Aging people and ICTs:  Results demonstrate that with its use, aging people:  Feel safer and less lonely  Improve their involvement in self-care  Get healthier life habits.  Improve their communication and social participation  Improve their relation and interaction with their carers
  24. 24. Adolfo Muñoz Carrero eHealth and Aging: A Research Experience Thank you very much for your attention

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