dice01 re life-ict-system-smartdiagn-pdw-27june2013

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/de With / SA Health Smart Diagnosis / 27 June 2013

TU/e SA Health – Smart Diagnosis

ICT System for Smart & Remote Diagnosis

Peter H.N. de WithProgram director Smart Diagnosis & C3TProfessor Imaging and AnalysisDICE – 2 July 2013


Smart Interventions

• Molecular, Cell and Tissue Engineering

• Minimal Invasive Image guided intervention

• Gas Plasma Medicine

• Virtual Physiologic Human

Smart Diagnosis

• Imaging, processing & diagnostics

• Diagnostic & sensing devices in home care ICT

architecture

• Nanotechnology diagnostics

Smart Environment

• Staying healthy

• Empowerment in daily life

• Making healthcare sustainable

Focus programs Health@TU/e

SA Health

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Drivers for Smart Diagnosis Roadmap

• Dutch industry has a few good positions

• Imaging, sensing, embedded systems, ICT

• Healthcare budgets are about to be limited/frozen

• Severe downscaling in EU, declining spending power

• Dutch Government spending on R&D lowered

• ‘Graying’ society

• Increase in age-related dysfunctions and chronic diseases

• Need for dedicated services, tools, training, … for elderly

• Intrinsic roadmap alignment

• Topsector HTSM Chapter Health, version 2012 & 2013

• 3TU ICT Roadmap 2012

- 3 -


Research objective: trend to home care

- 4 -

• Trend Northwest: lower costs for home care, even cost benefit

• ICT and Internet makes people more independent

• Technology for making this shift is there

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ICT/Internet : Trend to transformation economy

- 5 -

• People become

organized in

groups/communities

• Groups address

local issues

• Various groups or

communities share

larger global

issue(s).


Smart Diagnosis Roadmap vision

• Smart diagnosis aims for unobtrusive methods which enable

fast reliable outcome and a shift from hospital to primary care

and to self-care.

• ICT infrastructure, sensing, embedded systems, imaging are enabling technologies

- 6 -

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Smart Diagnosis fundamental issues

• Basic integrated ICT infrastructure for nomadic/home care is missing

• There is lack of control on data – personal privacy, security of data

• No integrated joint semantic models shared between institutions

• Citizens have to pay more themselves, want to be in control of data

• Connected to healthcare infrastructure, but person-centric

- 7 -


Conceptual person-centric infrastructure

• Individual persons

• Stakeholder of his own health and life processes

• Human empowerment with personal processes & applications

• Life management desktop with personal and business services

• Personal data store

• Health (service) providers

• Loss of personal data, but access to anonymous data and large-scale insight

• Possibility for intent casting, broad- or narrow-casting for services

• Health App Builders

• Registered in health eco system

• Support personal health plan, or clinical path ways

• Fit to ‘Myhealthplan’, work flows - 8 -

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ReLifE objectives

PAGE 9SA Health

• ReLifE is personal health eco-system

• Integration Project Health ICT infrastructure which is patient-centric

• Integrated patient & clinical pathways: personalized processes

• Detailed Clinical Models and modeled processes and DCM standards

• Patient empowerment

• Improved decision support through integrated data storage concepts

• Integrated care system for stakeholders

• Health eco system governance


Learning &KnowledgeRepository

SugarCRMCALL

CENTERCisco VOIP

routerEHR

Health Coach

My Devices

MyData

Patient

Specialist GP

AnalyticsFramework

Publishing

My Health PortalSocial

Publishing

DCM

My Health Tablet

Complex Event

Process’g

Nurse/Agent

Continua

Health

Alliance

social

care

MyHealthPlan

ReLifE Apps

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Conceptual person-centric infrastructure


- 11 -


ICT Infrastructure – Trust is key…

- 12 -

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ReLifE / Personal Data Store


Personal Data Store and Applications – (1)

• Personal data Store and Personal application layer

• Apps are crucial for the citizen

• easy to use

• Application layer is a way to:

• Connect all stakeholders in one single chain

• Create uniform trustworthy Health ICT infrastructure

• Participation of 1st and 2nd line care institutes should be reached

• Participation in system and exploitation of patient data

• Large-scale apps: mental disorders, heart failure and revalidation, colon/prostate etc. cancer

- 14 -

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Personal Data Store and Applications – (2)

• Vision fully aligns with

• Slimmer Leven 2020 in Brainport region

• Provinciale Staten Brabant: Notitie breedband comm.

• Smart Diagnosis wants to emphasize

• Large-scale health applications

• Create breakthrough in Health ICT infrastructure deployment

- 15 -


ReLifE / Horizontal & vertical integration

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Catharin

a

Hospital

Maxima

Medical

Centre

GGD

GGzE

LHV

(national

GPs)

DOH

regional

GPs

Patient

commun.

Patient

/citizen@

home

Diagn4U

centre

Pharma-

cies

Example / Eindhoven care chain cardio case …

ReLifE involves 3 cases in 4 regions (Ehv, Waterford,

Copenhagen, Oslo): COPD, Heart, Mental/Epilepsy

ReLifE integrates all stakeholders into the system…

ReLiFE also integrates data of those stakeholders…• Eindhoven cardio case involves CZH, MMC, RZCC, GPs, Patient

communities and at home…


Sensing devices home & nom. monitoring

• Use low-cost devices for diagnosis, support, monitoring

• Wearable

• Integrated services

• Build living lab conditions

• Examples

• Clinical decision support, automatic data gathering & models

• Sensors for life patterns and revalidation training

• Personal feedback

• Perfect area for the Brainport region

• World-class strength in Embedded Systems and emb. SW & ICT

• Fertile breeding place for SMEs and further stimulation

• Good fit between Companies and University

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Imaging for embedded applications & home care

2-7-2013 - 19

• Specific imaging at home & embedded

• Nomadic monitoring and diagnostics

• behavior & training, coaching

• Important focus areas

• Mental disorders (stress, dementia)

• Heart failure and cardio diseases

• Premature cancer detection (prostate, colon)

Concentrate on early stage diagnosis

• Chances for the Brainport region…

• TU/e is strong in multidisciplinary R&D

• Can be used for large-scale disease appli-cations supporting gen. health infrastructure

• Possible SME spin-off creation


Health Eco System – Maturity growth

- 20 -

Healthcare services grow mature over time: the patient

becomes stakeholder…

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Health Eco System – Conditions & Services

- 21 -


• Owner health and life processes

• Personal processes and applications

• Life management

• Personal data store

• Match to the actual personal status

• Every citizen a Personal Health Plan


Care communities are growing now ….

• RZCC: 4 hospitals, 80 pharmacies, 600 specialists, 400 medical doctors, 3 Million care messages/year…

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ReLifE / Possible operational structure t.b.d.

Advisory Board

ReLifE JV

company

SME app. 1

SME app. 2

SME

technol. 1

Certifi-

cation

process

Brainport

Eindhov.

TU/e,

SyngtRZCC

Govern

mt. etc.

Board of

Commissioners

ReLifE

archi-

tecture

Indep. Q Control

Certifitic.

InstituteTU/e

Certific.

company

System Design is R&D, the operation becomes a

regional company pps, with quality control & certification


ReLifE conclusions

PAGE 24SA Health

• ReLifE is personal health eco-system for all citizens, patient-centric setup

• ICT infrastructure is a backbone, open architecture connects third parties (standard interfaces & quality

• Integrates all stakeholders: hospitals, practitioners, local carers, joint data platform

• Patient empowerment: control of own data store, personalized processes

• ReLifE does not build EPDs, but integrates good proposals of stakeholders

• Trustworthy and secure data storage

• Connects patient at home…