By Mark D. Wiederhold & Brenda K. Wiederhold
Innovations in technology have aided healthcare throughout the world in diverse ways such as developing new methods for prevention, rehabilitation or surgery, and have alleviated some of the pressures put on healthcare systems to treat a rapidly increasing population. eHeath especially has grown throughout the years and is a main area of study for many trying to make healthcare more efficient and less expensive for both patients and healthcare providers. The development of Information and Communication Technologies (ICT), which uses telecommunications to transfer information and communicate easier and faster than ever before, has allowed eHealth to branch out into personalized methods of treatment that are both cost efficient and more individually designed to patients allowing for more accurate care and independence. Personalized Health Systems encompass an array of different eHealth technologies that range from electronic health records, to body monitors and implantable systems, all of which have helped improve healthcare, especially with an aging population and prices of treatment constantly rising.
Electronic Health Records
Electronic health records have slowly edged their way into the medical system, replacing paper documentation and all forms of administrative information. Electronic health records make data storage more organized and help to cut down on time and space needed to collate and file paper documents. It also makes transporting records less time consuming, as well as allows for multiple copies to be created more efficiently and is less expensive than duplicating paper records. Furthermore, electronic health records would also give patients better access to their own health information because the records can be sent directly over the Internet. Administrative tasks would also be made easier, since scheduling and follow-ups could be easily updated on a computer database, and would allow doctors to order prescriptions, tests, and lab results with the click of a button. Although electronic health record programs have been around for the past few decades, many healthcare providers are reluctant to adopt the new system. Unfamiliar with how the system works, many would require technical training in order to use the programs, and maintenance and system incompatibility have turned some away from using electronic health record systems. Another important issue circulating is the concern for privacy. With everything digitalized, unauthorized access of medical records is harder to manage and could threaten patient privacy. However, despite these potential setbacks, electronic health records provide a more cost and space efficient alternative to paper records that is growing in popularity, and making shared information more accessible.
Medical professionals and researchers are also striving to create a collection of all data pertaining to the human body on a large online database called the Virtual Physiological Human (VPH). The framework would be all encompassing, not separating information by discipline or regions of the body, and would provide intersecting studies of both patient-specific and general data. This will be used a reference tool that would help provide the most comprehensive and thorough treatment possible, and will grow along with the medical field.
Wearables and Remote Monitoring
ICT has also paved the way for more convenient methods of monitoring patients outside medical facilities by improving medical wearable devices. Medical wearables can be as simple as a bracelet imbedded with a microchip that contains a person’s medical information, to more complex tools and devices like clothing and bio-medical sensors that constantly measure vital signs such as temperature, heart rate, and glucose levels. Patient monitoring through wearable body sensors previously relied on devices that collected data off-line. However, ICT technologies now allow for data to be collected wirelessly. Personal and body area networks (PAN/BAN) bypass uncomfortable wires that accompanied traditional body sensors, and transmit data wirelessly to a medical profile in real-time, storing the data in one place. These wireless intelligent sensor networks (WISE), have given doctors the ability to monitor patients from remote locations, cutting down on related costs and time for doctor’s visits and hospitalization, while giving patients more freedom to live independently, despite having an otherwise debilitating medical condition. Remote monitoring can be used for a number of different conditions ranging from high blood pressure, diabetes, and heart attack, to keeping an eye on post-surgical patients and the elderly.
MyHeart, a European collaborative project funded by the European Commission, is in the process of developing a monitoring system for cardiovascular diseases (CVD). Billions of dollars have already been spent to help treat CVD, a leading cause of death in the west, and MyHeart strives to cut costs through preventative monitoring. Early detection is key in fighting CVD. MyHeart provides patients constant monitoring through the use of pressure sensors in textiles, for example, on bed linens to monitor breathing habits while users are sleeping, and t-shirts equipped with ECG electrodes, called intelligent biomedical clothes. MyHeart gives a personalized reading of patients’ condition, allowing for treatment aimed at helping patients’ specific condition to be improved, and will help make diagnoses and prevention easier. Feedback devices linked to the sensors will also give patients the power to self-monitor, as well as allow healthcare professionals to monitor patients remotely, making treatment more affordable and efficient.
Some monitoring devices, like the EUfunded REACTION which measures glucose and insulin levels of diabetes patients, will trigger an emergency alarm alerting a physician when vitals reach a dangerous level for the patient, ensuring immediate care. This allows patients to live more comfortably knowing that their condition is constantly being watched by their doctor. Treatment is further enhanced since a patient’s medical profile is always being recorded and updated, allowing physicians to devise a more individualized treatment plan for specific conditions.
Mental healthcare sectors have also benefited from improved remote monitoring systems and medical wearable technology. Bio-medical sensors can be designed to measure vitals linked to depression, and also can be designed to monitor eating habits, daily activities, and sleep habits, like the MONARCA project (MONitoring, treAtment and pRediCtion of bipolAr disorder episodes), that help to regulate and treat bipolar disorders. Others utilize Virtual Reality (VR) technologies to help treat psychological disorders. The EU-funded project INTERSTRESS (Interreality in the Management and Treatment of Stress-Related Disorders), utilizes Interreality (a combination of VR and monitoring systems) to help assess and control psychological stress. INTERSTRESS monitors patients’ emotional and physical activity with biomedical sensors while immersed in a virtual world. The goal is that real life behavior and experiences in the virtual world will influence each other so that over time the patient will learn to cope with stress using what is learned in the virtual environment. It can be used in a clinical setting along with an immersive VR world, and also at home or on-the-go through mobile phones and the Internet, allowing for more immediate care.
Implantable systems and the Future of ICT
One of the next steps in ICT is developing implantable systems capable of wirelessly transmitting data. Current implantable medical devices are able to monitor and treat conditions, like the Implantable Cardioverter Defibrillator (ICD) which detects heart arrhythmias and sends low to high electrical impulses to the heart when necessary to restore a normal heart rhythm. However, these systems are limited in their monitoring capabilities. ICT systems will allow medical professionals to remotely monitor a patient’s condition, as well as control the device itself. The P.CÉZANNE project is in the process of producing an implantable nano-sensor device that constantly monitors blood glucose levels in diabetes patients and stores the data through wireless transmission to a mobile device. It will also be capable of regulating glucose through an insulin pump linked to the device, releasing insulin into the body when needed.
The P.CÉZANNE project is only the start of technologies of this nature and future projects will continue to seek ways to increase patient autonomy so that they can live uninhibited by medical conditions.
Mark D. Wiederhold, M.D., Ph.D., FACP Virtual Reality Medical Center San Diego, California email@example.com
Brenda K. Wiederhold, Ph.D., MBA, BCIA Virtual Reality Medical Institute Belgium firstname.lastname@example.org
President of Virtual Reality Medical Institute (VRMI) in Brussels, Belgium. Executive VP Virtual Reality Medical Center (VRMC), based in San Diego and Los Angeles, California. CEO of Interactive Media Institute a 501c3 non-profit Clinical Instructor in Department of Psychiatry at UCSD Founder of CyberPsychology, CyberTherapy, & Social Networking Conference Visiting Professor at Catholic University Milan.