RESUMEN
The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).
Asunto(s)
Envejecimiento , Conductas Relacionadas con la Salud , Población Blanca , Accidentes por Caídas/prevención & control , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Conducta Cooperativa , Europa (Continente) , Anciano Frágil , Humanos , Afecciones Crónicas Múltiples , Innovación Organizacional , Polifarmacia , Encuestas y CuestionariosRESUMEN
Successful management of health conditions in older population is determined by strategic involvement of a professional team of careers and by empowering patients and their caregivers to take over a central role and responsibility in the daily management of condition. Identifying, structuring and ranking the most important needs related to these aspects could pave the way for improved strategies in designing systems and technological solutions supporting user empowerment. This paper presents the preliminary results of a study aiming to elicit these needs. Healthcare professionals, working together in the European and Innovation Partnership on Active and Healthy Ageing (EIP-AHA) initiative, have defined a set of needs and factors that have been organized in two hierarchies around the concepts of patient activation and proactive and prepared care team, defined in the Chronic Care Model. The two hierarchies have been mapped, by a team of experts in computer science, with technologies and solutions that could facilitate the achievement of the identified needs.
Asunto(s)
Envejecimiento , Educación en Salud/métodos , Conocimientos, Actitudes y Práctica en Salud , Participación del Paciente/métodos , Poder Psicológico , Humanos , Grupo de Atención al Paciente/organización & administración , Participación del Paciente/psicologíaRESUMEN
The present work presents the comparative assessment of four glucose prediction models for patients with type 1 diabetes mellitus (T1DM) using data from sensors monitoring blood glucose concentration. The four models are based on a feedforward neural network (FNN), a self-organizing map (SOM), a neuro-fuzzy network with wavelets as activation functions (WFNN), and a linear regression model (LRM), respectively. For the development and evaluation of the models, data from 10 patients with T1DM for a 6-day observation period have been used. The models' predictive performance is evaluated considering a 30-, 60- and 120-min prediction horizon, using both mathematical and clinical criteria. Furthermore, the addition of input data from sensors monitoring physical activity is considered and its effect on the models' predictive performance is investigated. The continuous glucose-error grid analysis indicates that the models' predictive performance benefits mainly in the hypoglycemic range when additional information related to physical activity is fed into the models. The obtained results demonstrate the superiority of SOM over FNN, WFNN, and LRM with SOM leading to better predictive performance in terms of both mathematical and clinical evaluation criteria.
Asunto(s)
Glucemia/análisis , Diabetes Mellitus Tipo 1/sangre , Modelos Estadísticos , Monitoreo Fisiológico , Redes Neurales de la Computación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
This paper describes the design and development of a system for cardio rehabilitation of patients that suffered a myocardial infarction. The proposed solution focuses on exercise prescriptions and the encouragement of healthy behaviors. The innovative strategy of the design takes into account health promotion models to provide safe, assistive exercise training sessions, personalized feedbacks, and educational contents.
Asunto(s)
Sistemas Especialistas , Monitoreo Ambulatorio/instrumentación , Infarto del Miocardio/rehabilitación , Modalidades de Fisioterapia/instrumentación , Autocuidado/instrumentación , Telemedicina/instrumentación , Terapia Asistida por Computador/instrumentación , Diseño de Equipo , Análisis de Falla de Equipo , Humanos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Interfaz Usuario-ComputadorRESUMEN
The aim of this paper is to describe and present the results of the automatic detection and assessment of bradykinesia in motor disease patients using wireless, wearable accelerometers. The current work is related to a module of the PERFORM system, a FP7 project from the European Commission, that aims at providing an innovative and reliable tool, able to evaluate, monitor and manage patients suffering from Parkinson's disease. The assessment procedure was carried out through a developed C# library that detects the activities of the patient using an activity recognition algorithm and classifies the data using a Support Vector Machine trained with data coming from previous test phases. The accuracy between the output of the automatic detection and the evaluation of the clinician both expressed with the Unified Parkinson's disease Rating Scale, presents an average value of [68.3 ± 8.9]%. A meta-analysis algorithm is used in order to improve the accuracy to an average value of [74.4 ± 14.9]%. Future work will include a personalized training of the classifiers in order to achieve a higher level of accuracy.
Asunto(s)
Actigrafía/instrumentación , Diagnóstico por Computador/instrumentación , Hipocinesia/diagnóstico , Monitoreo Ambulatorio/instrumentación , Enfermedad de Parkinson/diagnóstico , Máquina de Vectores de Soporte , Adulto , Anciano , Diseño de Equipo , Análisis de Falla de Equipo , Femenino , Humanos , Hipocinesia/etiología , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/complicaciones , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Telemetría/instrumentaciónRESUMEN
Parkinson's disease (PD) predominantly alters the motor performance of the affected individuals. In particular, the loss of dopaminergic neurons compromises the speed, the automaticity and fluidity of movements. As the disease evolves, PD patient's motion becomes slower and tremoric and the response to medication fluctuates along the day. In addition, the presence of involuntary movements deteriorates voluntary movement in advanced state of the disease. These changes in the motion can be detected by studying the variation of the signals recorded by accelerometers attached in the limbs and belt of the patients. The analysis of the most significant changes in these signals make possible to build an individualized motor profile of the disease, allowing doctors to personalize the medication intakes and consequently improving the response of the patient to the treatment. Several works have been done in a laboratory and supervised environments providing solid results; this work focused on the design of unsupervised method for the assessment of gait in PD patients. The development of a reliable quantitative tool for long-term monitoring of PD symptoms would allow the accurate detection of the clinical status during the different PD stages and the evaluation of motor complications. Besides, it would be very useful both for routine clinical care as well as for novel therapies testing.
Asunto(s)
Aceleración , Actigrafía/instrumentación , Trastornos Neurológicos de la Marcha/diagnóstico , Trastornos Neurológicos de la Marcha/etiología , Monitoreo Ambulatorio/instrumentación , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico , Actigrafía/métodos , Diseño de Equipo , Análisis de Falla de Equipo , Humanos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Telemetría/instrumentaciónRESUMEN
Exploiting the full potential of telemedical systems means using platform based solutions: data are recovered from biomedical sensors, hospital information systems, care-givers, as well as patients themselves, and are processed and redistributed in an either centralized or, more probably, decentralized way. The integration of all these different devices, and interfaces, as well as the automated analysis and representation of all the pieces of information are current key challenges in telemedicine. Mobile phone technology has just begun to offer great opportunities of using this diverse information for guiding, warning, and educating patients, thus increasing their autonomy and adherence to their prescriptions. However, most of these existing mobile solutions are not based on platform systems and therefore represent limited, isolated applications. This article depicts how telemedical systems, based on integrated health data platforms, can maximize prescription adherence in chronic patients through mobile feedback. The application described here has been developed in an EU-funded R&D project called METABO, dedicated to patients with type 1 or type 2 Diabetes Mellitus.
Asunto(s)
Diabetes Mellitus/terapia , Retroalimentación , Cooperación del Paciente , Autocuidado , Diabetes Mellitus/psicología , HumanosRESUMEN
Several students of Bioengineering complain about the excess of theoretical classes and the difficulty to assimilate the subject taught. This work presents a strategy to mix theory and practice when teaching, thus motivating students to engage in their studies.
Asunto(s)
Enfermedad Crónica/terapia , Manejo de la Enfermedad , Unión Europea , Humanos , Interfaz Usuario-ComputadorRESUMEN
The current work describes a methodology to automatically detect the severity of bradykinesia in motor disease patients using wireless, wearable accelerometers. This methodology was tested with cross validation through a sample of 20 Parkinson's disease patients. The assessment of methodology was carried out through some daily living activities which were detected using an activity recognition algorithm. The Unified Parkinson's Disease Rating Scale (UPDRS) severity classification of the algorithm coincides between 70 and 86% from that of a trained neurologist depending on the classifier used. These severities were calculated for 5 second segments of the signal with 50% of overlap. A bradykinesia profiler is also presented in this work. This profiler removes the overlap of the segments and calculates the confidence of the resulting events. It also calculates average severity, duration and symmetry values for those events. The profiler has been tested with a bogus dataset. Future work includes better training for the severity classifier with a larger sample and testing the profiler with real, longterm patient data in a projected pilot phase in three European hospitals.
Asunto(s)
Aceleración , Diagnóstico por Computador/instrumentación , Diagnóstico por Computador/métodos , Hipocinesia/diagnóstico , Monitoreo Ambulatorio/instrumentación , Monitoreo Ambulatorio/métodos , Enfermedad de Parkinson/diagnóstico , Adolescente , Diseño de Equipo , Análisis de Falla de Equipo , Femenino , Humanos , Hipocinesia/etiología , Masculino , Enfermedad de Parkinson/complicaciones , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Personalized health devices are the novel paradigm to reduce healthcare costs and to improve the quality of health services. At the same time, health interventions and promotion of self behaviors generate benefits to healthcare and allow citizens to be more involved in their own health management. This paper describes the process followed in HeartCycle project to design education and coaching services to promote self-behaviors in a closed loop monitoring system for patients with coronary heart diseases that suffered a myocardial infarction.
Asunto(s)
Enfermedad Coronaria/fisiopatología , Conductas Relacionadas con la Salud , Autocuidado , Humanos , Monitoreo Fisiológico , Educación del Paciente como AsuntoRESUMEN
Current trends in healthcare technology include mobile-based applications. Relevant advances in the integration of vital signs monitoring devices with mobile platforms are widely reported nowadays. In this context, conceiving and designing an interoperable application is essential due to the growing necessity of integrating a huge and heterogeneous amount of biomedical data, coming from a wide range of devices and sensors. In this paper the key research issues associated with such integration are presented as well as a specific proposal to solve these problems. It is based on a middleware architecture for the integration of biomedical sensors with mobile devices, derived from the ISO/IEEE 11073 standards family. The application has been developed in the framework of an EU-funded R&D project called METABO.
Asunto(s)
Técnicas Biosensibles/instrumentación , Técnicas Biosensibles/normas , Guías como Asunto , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/normas , Adhesión a Directriz , InternacionalidadRESUMEN
Losing weight can be one of the toughest objectives related to diabetes treatment, especially for Type 2 diabetes mellitus. This paper describes a tool to set goals to achieve lifestyle behavioral changes, and keep track of the benefits derived from these changes. This strategy leans on the capability of evaluating users' compliance to treatment, identifying key points where the lack of motivation causes therapy dropping, and on the better resources that physicians will have to adjust the treatments and the prescriptions.
Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Promoción de la Salud/métodos , Estilo de Vida , Educación del Paciente como Asunto/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Gráficos por Computador , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Motivación , Cooperación del Paciente , Comunicación Persuasiva , Programas Informáticos , Interfaz Usuario-ComputadorRESUMEN
Cardiovascular diseases (CVDs) account for 45% of all deaths in the western world according to the 2004 World Health Organization statistics report. Heart failure (HF), CVD's primary paradigm, mainly affects people older than 65. The European MyHeart Project's mission is to empower citizens to fight CVD by leading a preventative lifestyle and allowing early diagnosis. This paper presents the iterative design and development of the HF management system, part of MyHeart Project. The system daily measures vital body signals to assess HF. The methodology applied herein has involved stakeholders in an iterative process: concept validation, feasibility, efficiency, patients' experience, and patients' acceptance. The final solution allows patient self-management of their chronic condition.
Asunto(s)
Insuficiencia Cardíaca/prevención & control , Informática Médica/métodos , Monitoreo Ambulatorio/métodos , Telemetría/métodos , Anciano , Anciano de 80 o más Años , Vestuario , Diseño de Equipo , Humanos , Interfaz Usuario-ComputadorRESUMEN
In the Western World, cardiovascular diseases (CVD) are the leading source of death. Only in Europe, they cause 45% of all deaths. Besides heart failure, the paradigm of CVD, affects mainly people older than 65. Facing this reality, the European Union has funded MyHeart Project, whose mission is empowering citizens to fight CVD by means of a preventive lifestyle and an early diagnosis. This paper presents the design and development of the user interaction for a heart failure management system. This system consists on wearable and mobile technologies which monitors the vital body signals in a daily basis, providing a continuous assessment of this chronic disease.
Asunto(s)
Vestuario , Insuficiencia Cardíaca/prevención & control , Informática Médica/métodos , Monitoreo Ambulatorio/métodos , Consulta Remota/métodos , Terapia Asistida por Computador/métodos , Interfaz Usuario-Computador , Biotecnología/métodos , Diagnóstico por Computador/métodos , Insuficiencia Cardíaca/diagnóstico , Humanos , Autocuidado/métodosRESUMEN
We developed an integrated model of telemedicine services in emergency medical care. The architecture was designed to support pre-hospital management. The experimental work was carried out with the collaboration of the emergency medical services (EMS) in Madrid. Two different study populations were defined: a control population using conventional EMS protocols and a population using the telemedicine system. The telemedicine system was based on a telepresence service; electrocardiograms and images were transmitted from the ambulance to the health emergency coordination centre. The cost of dealing with 100 patients using telemedicine was C6030 less than the cost of conventional care. The response times using telemedicine were significantly lower.
Asunto(s)
Servicio de Urgencia en Hospital/organización & administración , Telemedicina/organización & administración , Actitud del Personal de Salud , Conducta Cooperativa , Costos y Análisis de Costo , Prestación Integrada de Atención de Salud , Servicio de Urgencia en Hospital/economía , Humanos , España , Telemedicina/economía , Factores de TiempoRESUMEN
We have developed a system for supporting people with special needs. It allows remote monitoring of electrocardiographic and other signals together with multimode environmental control. The multimodal approach allows users with disabilities to interact more with the home environment. Telemedicine devices were integrated into the system to provide a link to health services. The system provided support for the independent living of people with special needs. The pilot site was a rehabilitation service attached to the National Paraplegic Hospital of Toledo, Spain. During the six-week trial period, the system did not fail, nor was any unauthorized access reported. Twelve people with special needs and three staff evaluated aspects of the system on a scale from 0 to 9, on which higher scores indicated a positive assessment. The mean score for efficiency was 7.8, for satisfaction 8, for helpfulness 7.4, for controllability 7.2 and for learnability 8.
Asunto(s)
Personas con Discapacidad , Servicios de Atención de Salud a Domicilio/organización & administración , Telemedicina/métodos , Electrocardiografía , Planificación Ambiental , Humanos , Dispositivos de Autoayuda , España , Telemedicina/instrumentaciónRESUMEN
We have made a theoretical study of the potential for televisiting. All journeys made by the home care support team in an area of Madrid were reviewed to study the possibility of using televisiting. During the year 2000 the team provided an average of seven home visits a day. The home visits took 30 min on average, and the journey time was 30 min for urban areas and 45 min in the suburbs. We estimated that two of each day s visits could be carried out by telemedicine, with a mean duration of 15 min each. A model was used to calculate the resource demands and the potential cost-savings of televisiting compared with traditional home care. Using televisiting, 62% more suburban oncology patients could be managed and a cost reduction of euro;6 per visit could be achieved after 10 weeks.
Asunto(s)
Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Consulta Remota/estadística & datos numéricos , Anciano , Costos y Análisis de Costo , Servicios de Atención de Salud a Domicilio/economía , Servicios de Atención de Salud a Domicilio/organización & administración , Humanos , Neoplasias/terapia , Consulta Remota/economía , España , Factores de Tiempo , ViajeRESUMEN
Centralized testing demands costly laboratories, which are inefficient and may provide poor services. Recent advances make it feasible to move clinical testing nearer to patients and the requesting physicians, thus reducing the time to treatment. Internet technologies can be used to create a virtual laboratory information system in a distributed health-care environment. This allows clinical testing to be transferred to a cooperative scheme of several point-of-care testing (POCT) nodes. Two pilot virtual laboratories were established, one in Italy (AUSL Modena) and one in Greece (Athens Medical Centre). They were constructed on a three-layer model to allow both technical and clinical verification. Different POCT devices were connected. The pilot sites produced good preliminary results in relation to user acceptance, efficiency, convenience and costs. Decentralized laboratories can be expected to become cost-effective.
Asunto(s)
Sistemas de Información en Laboratorio Clínico/organización & administración , Redes de Comunicación de Computadores/organización & administración , Pruebas Diagnósticas de Rutina , Sistemas de Atención de Punto , Telemedicina/organización & administración , Grecia , Humanos , Italia , Modelos Organizacionales , Proyectos Piloto , Integración de Sistemas , Telemedicina/métodos , Interfaz Usuario-ComputadorRESUMEN
Home telecare services based on broadband communication were established in five locations in Europe. Two different types of telecare unit were developed: one based on a PC or set-top box containing a videoconferencing codec and another on off-the-shelf videoconferencing units. The participants in the project were 13 medical staff, 135 patients and 88 people informally caring for the patients. Questionnaires were used to evaluate user satisfaction with eight telecare services. Almost all participants rated the usability of the system as good or excellent. A total of 105 telecare sessions were scored by the medical staff. Overall, the quality of audio and video communication was judged satisfactory. For the patients and carers, the perceived quality of communication was also satisfactory and did not vary significantly between sites. The medical staff were reasonably satisfied with how the service supported them in their work. Except for the item about being able to support patients in a critical situation, medical staff agreed that an improved quality of health services was offered through telecare. All participants agreed that personal information was treated confidentially and that there was little risk in using the telecare services. The medical staff trusted the assessments they could make remotely while using the telecare system. Although the findings cannot be generalized due to the small number of telecare sessions and the relatively short duration of the experiment, the results encourage further research.
Asunto(s)
Servicios de Atención de Salud a Domicilio/organización & administración , Satisfacción del Paciente , Telemedicina/normas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Actitud del Personal de Salud , Cuidadores/psicología , Niño , Preescolar , Europa (Continente) , Femenino , Servicios de Atención de Salud a Domicilio/normas , Humanos , Lactante , Masculino , Persona de Mediana Edad , Calidad de la Atención de Salud/normasRESUMEN
Nowadays, there are a very large number of patients that need specific health support at home. The deployment of broadband communication networks is making feasible the provision of home care services with a proper quality of service. This paper presents a telehomecare multimedia platform that runs over integrated services digital network and internet protocol using videoconferencing standards H.320 and H.323, and standard TV set for patient interaction. This platform allows online remote monitoring: ECG, heart sound, blood pressure. Usability, affordability, and interoperability were considered for the design and development of its hardware and software components. A first evaluation of technical and usability aspects were carried forward with 52 patients of a private clinic and 10 students in the University. Results show a high rate (mean = 4.33, standard deviation--SD = 1.63 in a five-points Likert scale) in the global perception of users on the quality of images, voice, and feeling of virtual presence.