The document discusses predictions for IT spending in Western Europe in 2011, with total spending expected to reach 12.24 billion dollars. Spain is predicted to spend 523 million dollars (around 390 million euros depending on exchange rate), while the UK, France, Germany, Italy, and Netherlands are each predicted to spend over 500 million dollars. The document also outlines 10 ways that information technology and healthcare are expected to evolve in 2011 and beyond, such as increased use of mobile health, electronic prescribing, clinical decision support systems, and new architectures to handle growing clinical data.

1. Health 4.0
Prof. Dr. O.Ferrer-Roca

2. PREVISIONES
Con respecto a 2011, el gasto en TI de los países de la Europa Occidental se
espera que alcance los 12.240 millones de dólares, de los que 523 serían
españoles (unos 390 millones de euros, dependiendo del cambio).
Por contra :
• Gran Bretaña se iría a 4.130 m$,
• Francia a 2.203 m$,
• Alemania a 2.099 m$,
• Italia a 767 m$ y
• Holanda 543 m$.
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3. 1.
Las agendas de los Departamentos TIC vendrán fuertemente impactadas por las reformas
disruptivas de las organizaciones a las que prestan sus servicios (ahorros, racionalización de
infraestructuras, monitorización..)
2.
Habrá un importante auge de despliegues de Cloud Privados
3.
Atención Primaria será el campo más atractivo para despliegue de Cloud para la historia
clínica electrónica
4.
La revolución 2.0 disipará la m-Salud (uso de dispositivos móviles para soluciones sanitarias)
5.
Los sistemas de Historia Personal de Salud integrados promoverán la atención y monitorización
a domicilio en lugar de residencias sanitarias. Habrá foco en políticas de promoción de la salud y
de gestión de crónicos.
6.
La receta electrónica se generalizará.
7.
La colaboración de diferentes actores en el ciclo de gestión de la salud implicará inversiones
importantes en diversas áreas de seguridad y cumplimiento de normativas.
8.
Fuerte impulso de los sistemas de Inteligencia de Negocio para acercarse a una inteligencia
clínica casi en tiempo real.
9.
Se generalizará la virtualización del puesto de trabajo en el punto de cuidado al paciente para
agilizar el proceso clínico.
10. El crecimiento desbordado de los datos clínicos, en especial los multimedia, exigirán nuevas
arquitecturas orientadas a este nuevo paradigma, más abiertas y neutrales con respecto a los
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fabricantes.

4. Discriminación Sanitaria
RACIAL
SEXUAL
EDAD
DISCAPACIDAD
Faltaría incluir la discriminación
Sanitaria, según la comunidad
Autónoma en la que viva
ESTETICA
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IDEOLOGIA-RELIGIO
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5. Health 2.0 Health 3.0  Health 4.0
Prof. Dr. O. Ferrer -Roca 2010
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6. HEALTH 4.0 (
OFR2010
Ferrer-Roca 2010)
6

7. TABLETAS MEDICAS
• Ya
estan
aquí.
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8. IPS- Inter plane switching
Name
IPS
S-IPS
AS-IPS
IPS-Pro
Year
1996
1998
2002
2004
Main advance
Wide viewing
angle
Colour shift
free
High
High contrast
transmittance ratio
Transmittance 100
100
130
156
Contrast Ratio 100
137
250
313
Plane View of
Electrode
Structure and
LC Molecules
Enlarged front
view of a pixel
http://www.pctechguide.com/43FlatPanels_In-Plane_Switching.htm
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9. Ordenadores transparentes
pantalla OLED realmente transparentes en un 38%
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10. iPhone sensors.
Proximity sensor – This sensor can determine how close the iPhone is to your face. This
sensor is what helps the iPhone turn off its screen automatically whenever you hold the
phone up to your ear. This is necessary to prevent accidental button clicks by the side of your
head when talking.
Motion sensor/accelerometer – This sensor enables the iPhone’s screen to automatically
switch from landscape to portrait modes and back again based on whether you’re holding the
phone up and down or sideways. This sensor is also present in the iPad.
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11. iPhone Sensors
Ambient Light sensor – This sensor can determine how much light is available in the
area surrounding the iPhone and iPad and automatically adjust the brightness of the
screen in order to conserve battery life.
Moisture sensor - The iPhone also contains a fourth sensor, though this one isn’t
related to the interface. The water sensor is a little red tab that appears in the dock
connector when the phone has been submerged in water. It can also appear as a red
dot in the headphone jack.
iPhone 4 Gyroscope
The iPhone 4 adds another sensor: a three-axis gyroscope. When combining the
gyroscope with the accelerometer, this gives the iPhone 4 six axes on which the it can
operate. This is designed to make the iPhone 4 more sensitive, responsive, and
powerful for gaming.
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12. NFC
With rumors suggesting that
Apple may add near field
communication (NFC)
capabilities to the 5G-iPhone
to enable mobile payments,
observers have been looking
for additional signs of the
such an addition.
According to Phone Scoop,
Deutsche Telekom today gave
a presentation at Mobile
World Congress in Barcelona
outlining its adoption of NFC
technology for mobile
payments, and during the
course of the presentation
noted that it expects an NFCenabled device from Apple to
debut sometime this year.
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13. Aprobación FDA
http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHInnovation/ucm242067.htm
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14. CE-Label
Chapter 12: Quality control in Telemedicine. “CE-Label”. Prof.Dr.O.Ferrer-Roca
Advances in Telemedicine: Technologies, Enabling Factors and Scenarios,
Book edited by: Georgi Graschew,
ISBN: 978-953-307-159-6, Publisher: InTech,
Publishing date: March 2011
Type I- NON INVASIVE PRODUCTS . These comprise all
PSANI-Producto Sanitario Activo No Invasivo
INVASIVE PRODUCTS FOR A SHORT PERIOD OF TIME (less than 60
min) and those in natural orifices.
Type II-ALL INVASIVE PRODUCTS, including the
PSA-Productos Sanitarios Activos.
IIa- MDs USED for A LIMITED PERIOD OF TIME (up to 30 days).
IIb- MDs USED FOR LONG PERIODS OF TIME (more than 30 days).
http://www.intechopen.com/articles/show/title/quality-control-in-telemedicine-ce-label
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15. IMÁGENES MÉDICAS
US-images
2000: Sonda veterinaria
IMÁGENES 8 BITS- 256 niveles gris
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16. FDA,CE Mark, MD-License Health Canada.
2007: ACUSON Siemens
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17. FDA,CE Mark, MD-License Health Canada.
Signostics 2009
Diagnóstico inicial en procesos
intrabdominales, como embarazos ectópicos,
aneurismas de la aorta abdominal,
evaluaciones carotídeas en la sala de Urgencias
de pacientes con episodios transitorios de
isquemia, y también para asistir en la
colocación de una vía arterial.
Por ahora el sistema carece de Doppler para
estudios de flujo.
Incremente el número de procedimientos y
aplicaciones que pueda realizar con los transductores
de 3.5MHz ó de 7.5MHz. El cambio de una frecuencia
a otra se facilite mediante el uso de transductores
enroscables y desenroscables.
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18. FDA,CE Mark, MD-License Health Canada.
2009: VSCAN
6000€
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19. FDA,CE Mark, MD-License Health Canada.
VSCAN
•
•
•
•

400 gr peso
Doppler color
2D
60 min


PoC imaging
TM off line usando
equipo sobremesa
Sonda fija
 Grabación voz
 Estación USB

Enero-2010 – Se testea en 3 hospitales UE: Francia, Alemania y el Hospital Clínico de
Madrid. En Madrid hay 4 unidades: 2 Hospital Clínico y 2 centros de atención primaria.
El objetivo: utilizar el ecógrafo como sistema de screening e identificar pacientes que
requieren un examen más exhaustivo.
Validation: 12 leading clinical sites throughout the world to help determine how the
technology will impact patient workflow and focused exams in primary care, critical care
and the cardiology practices. The ultimate goal is to develop a structural protocol for
Vscan exams.
OFR2010
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19

20. 2009: Washington University in St. Louis
Sonda USB acoplable a los telefonos 3G-4G con
Windows mobile.
Diseño y la operabilidad de la sonda  desde
consumo electrico a velocidad transmision como el
algoritmo de generacion imagenes.
Low-power probe electronics design. He began
working on ultrasound system designs 25 years
ago, and in that span he has shrunk the
electronics from cabinet-sized to a tiny circuit
board one inch by three inches.
William D. Richard, Ph.D., WUSTL associate professor of computer science and engineering
David Zar, research associate in computer science and engineering Software open source
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21. FDA,CE Mark, MD-License Health Canada.
MobiUS from Mobisante
FDA 2011
Precio actual 10.000 $
La sonda vale 2000 $,
querían comercializarlo a
500 $.
Software MOBILEUS, o lo que es lo mismo MOBILE-US, es decir el control de las sondas de Ultrasonidos-US a través
del puerto USB de los moviles en open source. http://sourceforge.net/projects/mobileus/
Ideal para paisas en desarrollo.
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22. Sondas USB disponibles. Interson CA.
PRODUCT
http://www.interson.com/
AB 3.5 MHz Probe 99-5535
PRICE
*
$2,900
AB 5.0 MHz Probe 99-5534*
$2,900
VA 7.5 MHz Probe 99-5537 *
$3,900
EB 7.5 MHz Probe 99-5921*
$3,900
Voltaje aplicado a todos los elementos fase
Superficie plana y pequeña
No utilizan multiplexación
No necesitan circuitería adicional
3.5 a 5 MHz
Sondas Sectoriales
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23. US-iPhone
Interson Corporation a leading U.S. manufacturer of portable, point-of-care ultrasound imaging probes has had developed a Bespoke version of
VNC Pocket Office Pro for the iPad by Parys Technografx Ltd to use alongside there range of ultrasound products.
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24. Requerimientos
• Para recibir los datos:
iPad con instalación del Real time remote Ultrasound app en iTunes
•Para transmitir datos:
1. PC con una sonda de US instalada.
2. Una copia del VNC server instalada ( se recomienda el UltraVNC)
http://www.uvnc.com/download/1082/ (open source).
3. Puerto 5900 del router abierto ( redes virtuales).
http://remote.control.goverlan.com/?source=GAW_Img_GRC&gclid=CO_21bPT36cCFQMlfAodSSKk9Q
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25. http://www.singleclickconnect.com/
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26. Seguridad militar
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27. FAA.
Cabinas inteligentes en aviones
Mobile TC that delivers electronic charts (an Android app for Honeycomb tablets like the
Motorola Xoom is due later this year).
February 2011, the Federal Aviation Administration authorized
private jet charter Executive Jet Management to begin using the
app as an alternative to paper aeronautical charts.
Qantas subsidiary Jetstar is close to using iPads as in-flight
entertainment units on selected Airbus A320 and A330 aircraft
An iPad application for the wireless control of in Telemedicine
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available for aircraft equipped with an approved Wi-Fi source.
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28. FDA,CE Mark, MD-License Health Canada.
STARR- COW-VOW
COW = Computer on wheels
Global stroke interface
http://catai.net/blog/2010/01/la-primera-cow-en-vall-d%c2%b4hebron/
21 Enero 2010: El primer hospital en tener una COW (Computer on Wheel) esta en Barcelona
en el hospital de Vall d´Hebron y utiliza el RP-7 de IntouchHealth, que en España esta
distribuido por Palex Medical. Mide 1,65 m., pesa 100 Kg. , es capaz de girar 360º, cuesta
160000 euros y ya hablamos de él en entradas anteriores sobre robots quirúrgicos.
http://www.palexmedical.com/es/index.cfm
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29. FDA,CE Mark, MD-License Health Canada.
Zero footprint viewer -Telestreaming
The total market for medical applications on mobile devices is expected to total $80
million in 2010, with exponential growth anticipated in the next several years.
•The FDA approved the first diagnostic radiology application in February 2011 and
• Research teams at major hospitals worldwide are already testing iPhones and iPads
for preliminary diagnosis of selected studies.
• Hospitals are also starting to use mobile devices to provide patient images and
information to referring physicians.
As hospitals tested the use of mobile devices
for imaging applications, the major problem
reported was not image quality or security
concerns—it was extremely slow download
speeds.
A zero footprint viewer enables physicians to review patient images and reports
from a mobile device while moving within a hospital or their practice.
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30. BASIS OF zero footprint viewer
The benefits of
VirtualViewer®
Page on Demand™ provides a Web-Based Viewer that can extract single pages so
you can forget about waiting for multiple documents to download.
VirtualViewer’s document viewer technology means you view only what you
need when you need it. Forget about waiting for large multiple page documents
to download and forget about waiting for the native application to open. Page on
Demand provides the high-speed document and image viewing you need quickly
and without straining network bandwidth.
Enhance colleague collaboration through powerful document and image
redaction and annotation functionality.
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31. OSIRIX http://www.osirixviewer.com/
Requirements:
-Access to a DICOM source of images through WiFi network
-Works best with OsiriX 3.3.1 desktop software running only on a Mac available for free at www.osirixviewer.com.
Limitations:
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- images are limited to 1024x1024 pixels, bigger BW images are down-sampled and bigger RGB images are refused.

32. FDA,CE Mark, MD-License Health Canada.
OSIRIX MD- Class II MD
OsiriX MD is cleared by the FDA, as a Class II
Medical Device, for diagnostic imaging in
medicine.
OsiriX MD is based on the well known opensource project, OsiriX. OsiriX MD is not
identical to OsiriX, because of the FDA
regulations: each user is registered in our
database and have a unique serial number
to run OsiriX MD; each modification to the
software has to be validated, strictly tested
and described; each plugin has to be
cleared by the FDA.
These regulations will guarantee to the
registered users that OsiriX MD is fully certified
for medical imaging, including for primary
diagnosis.
http://pixmeo.pixmeo.com/
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33. OSIRIX-MD
OsiriX MD is the result of more than 5 years of
research and development in digital imaging.
OsiriX MD fully supports the DICOM standard for
an easy integration in your workflow
environment. OsiriX MD offers advanced postprocessing techniques in 2D and 3D. OsiriX MD
offers a complete integration with any PACS,
including the well known open-source project,
dcm4chee.
OsiriX MD supports 64-bit computing and
multithreading for the best performances on the
most modern processors. By adopting OsiriX MD,
you did the good choice: standards support,
simplicity, unlimited power and evolutivity!
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34. OSIRIX-MD
FDA-Cleared (K101342) - Class II FDA Device - 64-bit - Manual - 499$ USD
OsiriX MD is the first FDA-Cleared version, developped, validated and certified by the
OsiriX Team.
Approved for diagnostic imaging in medicine
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35. Por que la FDA?
H.264/AVC hardware encoder
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36. CLOUD
Acuo is the latest technology to join the AT&T ForHealthSM portfolio of
mHealth, cloud-based, and telehealth products and solutions.
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37. SmartPHR & HealthVault
Health Vault or Google Health access, the interoperable HIPAA-compliant
SmartPHR automatically pulls clinical summaries and diagnostic images from many
sources and pushes information you select to recipients you authorize including
your Health Vault and Google Health accounts.
Automatic and manual entries are structured
in industry-standard HL7 continuity of care
format, cannot be altered or deleted, and
identify the source of entry.
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http://www.smartphr.com/
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38. i-BUS // MD-BUS (Cerner)
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39. Microscopia-Dermatoscopia- Oftalmología
4M: Microscopios Multi-Modales Miniaturizados
Microscopios 60x por 18 €
http://www.mobile.brando.com/iphone-4-microscope-with-white-2-ledand-note-detector-led_p05863c0921d092.html
DermOscope 8€ + hardware (100€)
MERCADO NO HA ESTABILIZADO LOS PRECIOS!!
Near-Eye tool
03/12/2013
ISO 10940:1998, Ophthalmic instruments -- Fundus cameras
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40. Handyscope – 5x & 20x
590.00 €
11,99€
Data are kept in the encrypted application and can be password protected.
Also email transfer supports SSL allowing to send secure data
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41. EyeRoute Image Management System
retCam shuttle
http://www.youtube.com/watch?v=uOnoLWm-zJg
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42. PathXchange
03/12/2013
With over 8600 members from 168 countries and hosting over 2000 pathology cases,
PathXchange is the largest online pathology community
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43. Interpath v1.3
179 $
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45. eDNI en el movil
Y mañana su información genética y medica…….
Sin olvidar la biopsia y la pMedicina.
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