Presentation (pdf 1.3Mb) - ICMCC

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Presentation (pdf 1.3Mb) - ICMCC

Swamy Laxminarayan Lecture

Semantic Interoperability for

Personal Health – A Paradigm

that Moves the

Patient in the Centre

Bernd Blobel

eHealth Competence Center, University of Regensburg Medical Center

Regensburg, Germany

ICMCC 2007


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“e-health” – Interaction and

integration path

E

H

R

General

Practitioner

ECG

E-Letter

E- Consultation

Ultrasound

...

Specialist

Electronic

Health

Record

Hospital

H

I

S

Pharmacy

...

HL7

Monitor

IC

U

Manager

Intensive

Care Units

...

IHE

Pump

Agent

PDMS

Respi

rator

Agent

...

11073 / VITAL

DICOM

R

I

S

Radiology

L

I

S

PoC

POCT

1-A

CT

MR

X-Ray

Analyser

Analyser

Lab

PoC ...

E-prescription

Pharmacies

Insurance

Companies

Labs, Care

services etc.

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Robotersystem daVinci

©Firma Intuitive Surgical (Mountainview, CA)


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Mobile

Computing

Accessability

Tele-consultation


“e-health” – Interaction and

integration path

E

H

R

General

Practitioner

ECG

E-Letter

E- Consultation

Ultrasound

...

Specialist

Electronic

Health

Record

Hospital

H

I

S

Pharmacy

...

HL7

Monitor

IC

U

Manager

Intensive

Care Units

...

IHE

Pump

Agent

PDMS

Respi

rator

Agent

...

11073 / VITAL

DICOM

R

I

S

Radiology

L

I

S

PoC

POCT

1-A

CT

MR

X-Ray

Analyser

Analyser

Lab

PoC ...

E-prescription

Pharmacies

Insurance

Companies

Labs, Care

services etc.

?


Home / mobile

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Pervasive

Computing

Location-independent

service provision

Telematics,, Telemedicine

Mobile

Computing

Accessability

Tele-consultation

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Personal Care Scenario

e-Health Integration

(Source: Positionspapier

der Arbeitsgruppe

Telemedizin/Disease

Management

in Rahmen der

VDE Initiative

MikroMedizin)

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Gap between

physical and

informatics world

Manual data

entry

Language-based

data entry

Barcode

scans

Passive tags

Active tags

Informatics world (“Bits”)

• Intra- and extra-organisational

information systems (e.g.

ERP)

• Local, regional and global

communication networks

(e.g. Internet

Data entry

costs

Physical world (“Atoms”)

• Human beings

• Means of production

• Products

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Human intervention

required

No human intervention

required


Smart Microsystems – the other

end of the interoperability chain

IMEX* IEC standard draft for cross-vendor micro-system

interoperability

*German VDE / BMBF IMEX Project: „Implantierbare und extrakorporale modulare Mikrosystemtechnikplattform“

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Vision: Intelligent BSU-Plaster +

miniaturized BCU

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Telehealth

Application Framework

(includes: user

interfaces, patient

record management

and processing)

Specialised Systems

Teleultrasound, Teledermatology,

Telelearning,

Teleradiology,

Teleconsulting, etc)

Communication

Controller (computer)

and Network

Operating Systems

Input Devices

(includes: analogue

and digital data)

Telehealth

System

Output Devices

(includes: analogue

and digital data)

Reliability, Availability,

Security, Maintenance

and Diagnostics

Training, Policies,

Operational

Procedures

Environmental

and Safety

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Pervasive

Computing

Location-independent

service provision

Telematics,, Telemedicine

Ubiquitous

Computing

Autonomic

Computing

Self-organisation

Health information

systems

Mobile

Computing

Accessability

Tele-consultation

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Domain n

Enterprise View

Information View

Computational View

Engineering View

Technology View

Business Concepts

Relations Network

Basic Services/Functions

Basic Concepts

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Component View

Domain 2

Domain 1

Component

Decomposition


Talking Organs: Talking Hand

• Phenotyping of persons

– eHealth card

– ePatient record

• Person monitoring

– Attention

– Concentration

– Coordination

– Reactivity

• Symptom assessment of neuromotor dysfunctions caused by diseases e.g.

– Parkinson

– Multiple Sclerosis

– Infarct

– Stroke

• Symptom assessment and therapy in psychology and education e.g. ADHD

• Patient monitoring and medication control (remote and mobile)

– Telemedicine

– Homecare

– Clinical trials: testing drug administration and dosage

• Monitoring of humans on drugs or under physical or mental stress

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Talking Organs: Talking Eye

• Retinal microangiopathy

• Retinal bleedings

• Micro-infarction of the retina

• Diabetic alteration

• Swelling of the optical nerve

• Atrophy of the optical nerve

• Glaucoma

Prevention and therapy

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Promises of Bioinformatics to

Health Sciences (After Brendan McConkey)

• Genetic profiling

– Identification of genetic predispositions

• Prognosis and treatment

– Prediction of response to treatment

– Tailoring treatment to tissue subtype

• Diagnostics – early detection of disease

– Serum protein biomarkers

• Identification of novel drug targets

• Application to multi-factor diseases

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Biochips

Injectable ID Biochip Implant

VeriChips Corporation

According to The Word & I, rumors at Stanford University claim,

"that a microchip implanted in Chelsea Clinton's neck broadcasts

her location to a satellite. . ." (Craig Dees, Watching From Inside.

Vol. 13, The World & I, 02-01-1998, p. 150)

“The ressource Cell Manipulation System Development designs,

develops and applies microsystems useful for automated,

synchronized selections, transports and manipulations (e.g. gene

transfer) of cells. Local, electric drug delivery devices can be

created for invasive applications. Computer based simulation and

modelling of electrical properties of cell and tissue models are

evident for excellent design and fabrication processes of biohybrid

mircosystems.”

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University of Southampton

Lund University

Artificial Hand Project

Kevin Warwick

Radcliffe Infirmary, Oxford

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Artificial Retina


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Artificial Retina


©wikipaedia.org

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Conclusions 1

• Health telematics and telemedicine necessitate

requirements on interoperability between clinical and

health policy processes as well as stakeholders.

• “Personal Care“ and personal ubiquitous health services

extend “e-Health” and require the integration of

personal, body worn or implanted mobile systems as

part of the health telematics infrastructure.

• Mobile Body Area Networks are an essential platform for

future personal ubiquitous health services.

• Interoperability implies different concepts ranging from

functional interoperability up to the comprehensive

semantic interoperability.

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Conclusions 2

• For essential function areas, international standards are

available or established, resp.

• Interoperability of personal mobile systems includes all

7 layers of the ISO / OSI Reference Model including

terminology, knowledge concepts, coding aspects, etc.

• The CEN ISO/ IEEE 11073 standard family contains

corresponding profiles for all 7 ISO/OSI layers, which

can be used for personal systems too.

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Conclusions 3

• Micro-systems are essential components for Personal

Health structures, requiring the extension of existing

approaches and interoperability chains.

• Personal Health requires the integration of medical

informatics, telemedicine, biomedical engineering and

bioinformatics/genomics

• Semantic interoperability enables ubiquitous and

permanent Personal Health.

Personal Health is indisputably bound

to huge ethical challenges, e.g., …

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Thank you very much!

Contact:

Bernd Blobel Ph.D.

Associate Professor

eHealth Competence Center

University Hospital Regensburg

Franz-Josef-Strauß-Allee 11

D-93042 Regensburg

Email: bernd.blobel@ehealth-cc.de

Questions?

ICMCC 2007

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