E-Healthcare activities and International collaboration with Australia

Professor Peter Yellowlees P.Yellowlees@mailbox.uq.edu.au

Simple searches

Sex 10mMoney 9mMicrosoft 10mGod 4mBible 3mTax 4m

Australia 7m Beatles 4m Pam Anderson

0.1m Bill Gates 0.3m Jesus 2.5m Coca Cola 0.3m

“Health” 27 million pages

Death 5m Birth 6m Disease 3m Hospital 3.5m Medicine 5m Medication 0.3m Therapy 1.7m

Patient 2m Nurse 0.6m Physician 1m Doctor 2m Therapist 0.2m Alcohol 1m Depression 0.6m

E-book

Three Forces of Change

An empowered Consumerate creates impatient Patients

E-Health adaptability equals survival, especially with broadband

Genomics shifts healthcare from cure to prevention

Source: PWC HealthCast2010, 1999

Health research and Internet2

Two areas of collaborative international research

Virtual RealityGlobal Health Service Delivery

Both involve the use of internet2 for the research process itself, as well as in development of health products.

Research in Virtual Reality

Present day psychiatric successes

Use of Psychosis Tapes for Teaching

Success in Phobia Treatment

The Basic Idea

To develop virtual reality three dimensional environments to allow patients to build precise models and descriptions of their perceptual states, including symptoms such as hallucinations and passivity phenomena, and to use these environments for teaching and preventive health activities.

Possible Virtual Reality uses in Psychiatry

Development of standardised experiences of psychosis and depression (and other less prevalent disorders)

Development of patient driven simulated environments for monitoring, diagnostic reviews and use in rehabilitation and to drive behavioural change

Education of clinicians and carers

Development of reliable stimuli for use in functional imaging (fMRI)

The Problems VR Rooms can solve in psychiatry

Diagnosis is often subjective and depends on interpretation by clinicians of perceptions described by patients

Clinicians observe physical and mental characteristics (including facial movements etc) but these have never been standardised or reliably quantified

Clinicians and carers cannot truly understand the experience of mental illness unless they have suffered it themselves.

It is sometimes very hard to identify quantitative effects of treatment, or outcome improvements – patients and carers tend to have differing ideas of what is a successful outcome

Functional MRI and Virtual Reality

The lack of standardised stimuli for patients undergoing fMRI is a major problem.

Personalised virtual reality scenarios, mimicking illness, or mimicking specific symptoms that are being investigated, could greatly help our understanding of the significance of physiological changes noted on the fMRI.

Virtual Reality for prevention/education – the use of “Active Worlds” Available to

educational institutions, teachers, students and individual programs.

Explore new concepts, learning theories, creative curriculum design, discover new paradigms in social learning.

Over 80 worlds available plus others from the main Active Worlds site.

Participants

Over 80 in total but little health activity

Fairholme College Flinders Medical Centre Rural and

Remote Mental Health Services Griffith Uni, School of Arts RMIT, Dept. of Visual Communication UNSW, Faculty of Built Environment USA, School of Art

The Link with Internet2 and Highbandwidth/Computing Capacity

These projects would undoubtedly create massive amounts of data incorporating three dimensional perspectives, signal processing for facial and movement analysis,and multiple video analyses.

Initially the projects would be for research only, but in the long run high bandwidth and considerable interactivity between groups of researchers, will be necessary to unravel what is effectively a “x-ray of the perceptions and internal self”, or descriptions of entire perceptual worlds.

Global Health Service Delivery and Internet2

Australia +/- 2 time zones

Globalization

“the inexorable integration of markets, nation-states and technologies to a degree never witnessed before- in a way that is enabling individuals, corporations and nation-states to reach around the world farther, faster, deeper and cheaper than ever before…”

Thomas L. Friedman, The Lexus and the Olive Tree, 2000

Health on the internet

E-healthcare global delivery environment

Incorporates a variety of features Videoconsultations Electronic consumer owned health

records – voice driven Practice management and

communications software Web-based educational material –

video and written Flexible consumer focussed clinicians

and health regulation environments

Login Screen

Quick, intuitive, secure

Homepage

Consistent menu at left

Clear, concise, instructions

List of previous and current consultations

Health Record

Supporting documentation can be uploaded for any entry

Doctor entered data highlighted

Health Record (charting)

Patient or doctor can chart any progressive numeric measures by clicking on a single icon

Doctor’s Homepage

Outstanding consults are listed immediately

Hyperlinks go straight to the consult questionnaire

e for people, stupid

the internet is a revolution primarilyin communication, not technology. It’s about people. (Gerry McGovern, The Caring Economy)

An alternative view…..

The medical practice of the future will have only two workers - a nurse and a dog.

The nurse will be there to feed the dog, and the dog will be there to prevent the nurse touching any equipment.