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

1. Adolfo Muñoz Carrero
eHealth and Aging: A Research Experience

2. Contents:
• UITES: Telemedicine and eHealth Research Unit
• Research Scenario
• Some of our research projects
• Conclusions

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Adolfo Muñoz Carrero
eHealth and Aging: A Research Experience
Thank you very much for
your attention