This document provides directions for ICT research in disease prevention. It discusses using ICT to enable citizens to be co-producers of their own health by providing health information, knowledge, and decision support. This includes developing personal guidance systems that integrate data, information, and knowledge from various sources to support citizens in preventing diseases through lifestyle choices and navigation of their healthy life trajectory. The document also discusses characterizing different types of medical knowledge and how decision support can draw on evidence to provide citizens information on reducing disease risk through behaviors like diet, exercise, and limiting risk factors.

1. Directions for ICT Research in Disease Prevention
FT7-ICT-2009.5.1 – Support Action
D2.1 – Relevant Diseases and
Conditions
Workshop
Barcelona 16th March 2010
This project is partially funded under the 7th Framework Programme by the European Commission

2. The Citizen as Co-producer of Health –
enabled by Information and Communication Technology
Health Service Delivery
Citizen as proactive subject
Client Centred Approach
Patient Centred Medicine Citizen as co-Producer of Health
Disease prevention
Disease compensation
Model & (Disease cure)
Concepts
Assisted living
Maturity of ICT
User as Operator
Expert Systems User as User
Corporate Centred Contemporary Layman Systems
State of the Art Individual Centred
in ICT and Ambient Assisted Living
Empowerment
Citizen as object

3. Data–Information–Knowledge-Decisions
Data is a simple value-set without context, than can be
stored and exchanged electronically - if there is
technical interoperability (Exercise amount= 567 Watts)
Information is a simple message where the value-set
is provided in a predefined context. Information can be
exchanged electronically if there is semantic interoperability
(This food item contains 257 cal served on Italian bread, 10 grams of sugar and E4711)
Knowledge is information provided in a dynamic personal
and organisational context and with relations to other
knowledge.
Knowledge can be utilized and exchanged using computer-
models and ontologies
Decisions are made on the basis of knowledge

4. Team
work Knowledge
Manual
work
Technology

5. The Health-PGS Service-model
(Co-produced prevention as example)
Commodity service providers
Information
Health providers
Knowledge
Data
Citizen
HEALTH-
PERSONAL GUIDANCE
Exercise SYSTEM

6. Characterizing medical knowledge
Intuitive (I)
Experimental (E)
Precision (P)
I
Diseases and
E health problems
can be positioned
to this continuum
P
Diagnostics / Therapies
Figure by Niilo Saranummi

7. Characterizing medical knowledge –
(knowledge types)
Intuitive (I)
Experimental (E)
Precision (P)
Christensen’s book
is based on the
I idea that different
business models
Diseases and are needed when
health problems dealing with
E health problems
can be positioned
to this continuum for which medical
knowledge is
intuitive,
P experimental or
precise.
Diagnostics / Therapies
Figure by Niilo Saranummi

8. Knowledge
Philosophical Abstract models,
theories, paradigms
layer
(abstract)
Heuristic
Mechanisms, archetypes, patterns
layer methods
(general)
Phenomenological
layer Phenomenons, problems, acts
(specific)

9. The healthy life trajectory is like a
journey - navigation is crucial.
Heath-navigation is based on
shared decisions
of which pathways to follow

10. The Health Personal Guidance System
Intuitive knowledge
Information
Model (Experimental knowledge) from and to
ECO-system
Precise knowledge
(Personal knowledge)

11. Decision support – in prevention - Example
Evidence of food having impact in Cardio Vascular Disease
CVD=Cardiovascular Disease,
CI = Confidence interval
Reduction i CVD
disease risk (%) Reference
(95% CI)
Wine 32 ( 23-41) Circulation 2002;105:2836-44
(150 ml/day)
Fish 14 (8-19) Am J Cardiol 2004;93:1119-23
(114 gr 4x/week)
Dark chocolate 21 (14-27) JAMA 2003;290:1029-30
(100g/day)
Fruit and vegetables 21 (14-27) Lancet 2002;359:1969-74
(400 g/day)
Garlic 25 (21-27) Arch Intern Med 2001;161:813-24
(2.7 g/day)
Almonds 13 (11-14) Circulation 2002;106:1327-32
(68 g/day) Am J Clin Nutr 2003;77:1379-84
Combined effect 76 (63-84)
Franco OH et al. BMJ 2004;329:1447-50.
A “polymeal” of the above would cost 21.60 Great British Pounds per week (2004)
and give an average increase in life expectancy of 6.6 years for men and 4.8 years for women
And give men 9.0 years more life without heart disease for women (8.1 years).

12. The Health-PGS Communication (diabetes as example)
General Super-
Practice market
Specialist- Restaurant
centre
Car
Pharmacy
Farm
Museum
Hospital
Home Sports centre Work

13. Apoteket

14. Apoteket

15. Conventional
Co-production
Gaining Knowledge
Research
Clinical
encounter
EHR
HMO/ Research/
Region Pharmaceutical Co HealthGPS
Quality (digital avatar)
Assurance
Patient-NGO
Hospital

16. Evidence Based Associations between Risk Factors and Conditions
Diseases and Disorders Risk Factors
Type 2-diabetes Tobacco smoking
Preventable cancer Alcohol consumption
Cardiovascular disease Diet
Osteoporosis Physical activity
Musculoskeletal disorders Obesity
Hypersensitivity disorders Accidents
Mental disorders Working environment
Chronic obstructive pulmonary disease Environmental factors

17. PREVE partners
Valtion teknillinen tutkimuskeskus, VTT
Aarhus University
Fondazione Centro San Raffaele del
Monte Tabor
Universidad Politécnica de Valencia