Mobile Patient Monitoring: the MobiHealth system - ICMCC

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Mobile Patient Monitoring: the MobiHealth system - ICMCC

Mobile Patient Monitoring: the

MobiHealth system

2 June 2004

Aart van Halteren


Health insurers, doctors & hospitals

– why worry?

Demographic

shift: we are

getting older

Patient

empowerment

Chronic

diseases are

on the

increase

Costs, budget

deficits rise and

can’t be

controlled

2


Scenarios for the future development

of the health care sector

PATIENTS’ ROLE

Patients Rule !

• convenience, quality

of life

Active

Empowered Managed Care

• individualized, interactive

health & patient management

Observe

Manage

PAYERS’ ROLE

Nobody Cares

• traditional marketing,

me-too products

Passive

Payers Rule !

• only cost matter

3


What is patient management?

Program and services which support chronically ill

patients to cope with their disease:








Monitor disease progression

Alert doctors and patients in cases of emergency

Remind patients to be therapy compliant

Optimise treatment

Motivate patients to take responsibility

Support patients in leading a normal life

Decrease all disease depending costs

4


Savings through patient management -

some facts on Diabetes

• 5% of Germans suffer from Diabetes:

‣ 300.000 Type I diabetics

‣ 5 mill Type II diabetics

• Costs per diabetic patient per year:

‣ well managed disease and glucose levels: € 7.000

‣ badly managed disease and glucose levels: € 9.000

Efficient patient management can save insurers more

than 20% of yearly disease related costs!

Source: BKK, Preussen Elektra, Hannover

5


Savings through patient management -

some facts on Diabetes

• Costs of late stage diabetes related diseases 1) per year in Germany:

‣ Diabetic foot and related diseases: € 1 bill

‣ Kidney diseases and dialysis:

€ 1.5 bill

• Costs of late stage diabetes diseases can be reduced by 50-60%

through effective disease and glucose management

(DCCT-Study)

An efficient patient management can save insurers between

€ 1.25 and 1.5 bill/year for treatment of late stage diabetes

complications!

1) retinopathy, neuropathy, nephropathy

6


Patient management needs to be

simple, interactive, mobile

Patient

• Reminders,

questions

• Treatments

• Information

• Sensor

readings

Patient Data

Push

Pull

Content

Management

Data

warehouse

Analysis

Doctors

Call Center

Mobile applications are a pre-requisite for

successful patient management !

7


The MobiHealth project

The MobiHealth vision is to introduce ICT that allows

patients to have a more active role in the care process while

at the same time healthcare payers can manage the costs .

The patients wear a

lightweight monitoring

system - the MobiHealth

BAN (Body Area

Network) - which is

customized to their

individual health needs.

• Sensor

readings

Patient Data

Professionals

How can Body ambulant Area Network patient monitoring

benefit from GPRS or UMTS technology ?

8


Current trials in Netherlands

• Integrated Homecare in women with high-risk

pregnancies

• Tele Trauma Team

Let’s see how this works…

3 min video clip

9


Goals and challenges

• Health monitoring

• Bridging the

distance gap

• Offering sense of

security to wearer

• Long distance

• Large amounts of data

• Work everywhere

• Customizable

MobiHealth: How can ambulant patient monitoring

benefit from GPRS or UMTS technology ?

10


Solutions: BAN + M-health service provider

M-health

service

provider

BAN

Value added services

•BAN registration

•BAN discovery

• BAN configuration

• Authentication / authorization

• Data acquisition control

Monitoring and alarm

• Intermediate storage

Healthcare

professional

11


The Mobihealth system

WSB

SH+LUS+BDR

Internet

GPRS/UMTS

1

M-health

provider

domain

2

3

Body Area Network

Healthcare

domain

12


1

Wires

BT/ZigBee

GPRS/UMTS

Sensor

ExG electrodes

Actuator

Front-End

BANware

Java VM

Native OS

Front-end

Sensors &

Actuators

Mobile Base Unit

Body Area Network

TMSi Mobi

HP iPAQ

13


BAN - Front-end and sensors

Wires to … sensors

Front-End

14


The Mobihealth system

WSB

SH+LUS+BDR

Internet

GPRS/UMTS

1

M-health

provider

domain

2

3

Body Area Network

Healthcare

domain

15


• Scalability

Technical challenges

– From small clinical trials (10-100 BANs) …

– to large patient management programs (100.000+

BANs)

• Security

– Confidentiality

–Integrity

– Availability

• Mask inverted producer-consumer problem

16


Wireless Internet access–

producers/consumers

2.5/3G wireless

network

Internet

Mobile terminal

Request

Web server

Consumer

Reply

Producer

17


MobiHealth

Inverted producer/consumer

2.5/3G wireless

network

Internet

Obstacles:

• Network address translation

• Private IP addresses

• Limited processing power

• Limited battery power

• Temporary unavailable

Healthcare

professional

BAN

Reply

Producer

Request

Consumer

18


MobiHealth service platform

Applications Applications Applications

BANware

BANware

BANware

Java VM

Java VM

Native OS

Native OS

Body Area Network

M-health

provider

domain

Healthcare

domain

19


Deployment MobiHealth system

• Sweden

• Netherlands

• Spain

• Germany

• 50+ BANs

operational

• Physical activity and impediments for activity in

women with RA.

Monitoring of vital parameters in patients with

respiratory insufficiency

• The Lighthouse Alarm and Locator Trial

• Integrated Homecare in women with highrisk

pregnancies

• Telemonitoring of patients with ventricular

arrhythmia

• Outdoors patient's rehabilitation

• Support of home-based healthcare services

• Home care and remote consultation for recently

released patients in a rural area

• Tele Trauma Team

20


Wrapping up…

• Empowered managed care can result in

significant cost reduction

• New public wireless infrastructures:

– Opportunities for mobile patient monitoring

• Mobihealth consortium explores this

opportunity at multiple fronts

– Body Area Network: we’ve built it!

– 2.5/3G public wireless infrastructures: we’re using it!

– M-health service provider: we’re offering it!

Mobile patient monitoring: we’re doing it!

www.mobihealth.org

21

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