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___________________________________________________________________________
2012/HWG/PD/002
Using Health Information Technology to Connect the Healthcare System and Improve Patient Care
Submitted by: Korea
Policy Dialogue on Using Health Information Technology to Connect and Strengthen the
Health Care SystemSt. Petersburg, Russia
26 June 2012
Using Health IT to Connect theHealthcare System andImprove Patient Care
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Prof. Myoungho Lee, Ph.D., Yonsei UniversityPresident, Korea e-Health Association
Republic of Korea
u-Health provides medical & health promotion services (prevention, diagnosis, treatment, post control and so on)
using ubiquitous IT
Source : Myoungho Lee, 2010 ICOST Smart Homes and Health Telematics, Seoul, Korea
Medicine
IT
Internet-Based
e-Health u-HealthTelemedicine
• Medical Treatment Using IT Network
•Transmission of Medical Information, Remote Healthcare
• Medical & Healthcare Services through Internet• A joint Use of Medical
Information, Remote Healthcare
• Medical & Healthcare Services Using
u-IT (Sensor Network)
• Intelligent Healthcare Services
Wired Network Communication
Definition of u-Health
2
Web-Based
Health Telematics
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Clinical InformationEducation
Encompassing Term of
Telemedicine
Provision ofHealthcare Service
Informational, Educational, Commercial
Product
Internet-Based
Health CareDelivery
Incorporation ofTelecommunication
System
NetworkInternetMobile
Integration ofTelecommunication
System
Health InformaticsHealth Telematics
Telecare
Telehealth
1990~2000
Telemedicine
1970~1990
e-Health
2000~2008
Historical Transition of u-Health
Web- Based Health Care
Delivery
Informational, Educational, Commercial
ProductSensor
NetworkWeb
Mobile
u-Health2008 +
<M.H. Lee, 2009 WCID Conference, Beijing, China>3 Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
HospitalDomain
PatientDomain Clinician
DomainConsumerDomain
Classical Health Service
Future Health Service
PharmacyDomain
PharmacyDomain
MedicalSupplierDomain
MedicalSupplierDomain
Changing Health Sector Domain U-Health
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
u-Health is Worldwide : e-Health is Worldwide Developed by Constructing e-Health Portal and Adopting National ‘e’ Policy in each economy.
EUROPEASIA
N. AMERICA
S. AMERICA
OCEANIA
AFRICA
e-Europe 2005
Health Connecte-Mexico
KeHA
e-Canada
e-Health Initiative
EU-CAN e-Health
JAHIS
UKeHA
Vision2020(MSC)
WHO
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Configuration of u-Healthcare Service System
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
u-Health Medical Sensors
1. Glucose
2. Blood Pressure
3. Body Temperature
4. Respiration
5. ECG, EEG, EMG
6. HRV, PPG
7. SPO2
8. EtCO2
u-Health Medical Sensors
u-Health Medical Devices are based on Ubiquitous IT
77 Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
8
Body Sensors, BAN
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
2nd TinyOS Technology Exchange
9
Ubiquitous Health Monitoring
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
10
Ubiquitous Personal Monitoring Systems Intelligent wireless sensors communicate with each other and
the personal serverPersonal Server
-Integrate information from different sensors
-Communicate with the
upper layer of the organizedm-Health system
BAN: Body Area Network
PAN: Personal Area Network
LAN: Local Area Network
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Micro/Nano applied to Medical Devices
Taken from : http://mems.colorado.edu/c1.res.ppt/ppt/g.tutprial/ppt.htm
11 Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Micro/Nano applied to Medical Devices
Taken from : www.heartcenteronline.com
12 Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Micro/Nano applied to Medical Devices
An implantable blood pressure sensor
developed by CardioMEMS
Surgical microgripper actuated by SMA
Taken fromhttp://www.ee.ucla.edu/~jjudy/publications/conferen
ce/msc_2000_judy.pdf
13 Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Patient Friendly(u-Health) SensingDiagnostics
– Bioelectrical and physiological measurements (ECG, arrhythmia, other heart symptoms, EEG, EMG, blood pressure, ….)
– Biochemical assays (blood sugar, infarct markers, …)
Safety– Monitoring of chronically ill patients (heart diseases, diabetes, epileptic
events), alarms– Monitoring at home and in nursing homes (elderly and demented
people)
Sport, physical exercise, training– Monitoring of physical condition and efficiency– Control and feedback in training
Ambient intelligence, smart devices, security– Environment senses, recognizes and reacts (home, office, car)– Smart user interfaces (telephone, PC, multimedia devices, digital-TV,
games)14 Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
ECG Sensing
15
• Most widely used ECG measurement setup in clinical environment
• Signal is measured non-invasively with 9 electrodes
• Lots of measurement data and international reference databases
• Well-known measurement and diagnosis practices
• This particular method was adopted due to historical reasons, now it is already rather obsolete1. Einthoven leads: I, II & III2. Goldberger augmented leads: VR, VL & VF3. Precordial leads: V1-V6
Patient Monitor 12Ch-ECG
U-health1-Lead ECG Sensor
Wearable ECG Sensor
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Blood Pressure Sensing
16
• Blood pressure (BP) is the pressure exerted by circulating blood on the walls of blood vessels, and is one of the principal vital signs.
• During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure.
• The mean BP decreases as the circulating blood moves away from the heart through arteries, has its greatest decrease in the small arteries and arterioles,
• has its greatest decrease in the small arteries and arterioles, and continues to decrease as the blood moves through the capillaries and back to the heart through veins
U-health
Classic type of Blood Pressure Measurement Method
Continuous Non-InvasiveBlood Pressuremeasurement devicefor u-Health system.
Source: H,Harry ASADA, Journal of Wearable technology“Mobile Monitor ing with Wearable PhotoplethysmographicBiosensors”
16 Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Photo-Plethysmogram(PPG) Sensing
17
• A photoplethysmograph (PPG) is an optically obtained plethysmograph, a volumetric measurement of an organ.
• A PPG is often obtained by using a pulse oximeter which illuminates the skinand measures changes in light absorption (Shelley and Shelley, 2001).
• A conventional pulse oximeter monitors the perfusion of blood to the dermis and subcutaneous tissue of the skin.
U-health
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
SpO2 Sensing
18
Saturation of peripheral oxygen (SpO2) tells the observer or clinician how much oxygen is dissolved in the blood of the subject under observation. And SpO2 is of vital interest as it can alert medical professionals to conditions underlying illness or disease in a patient.
The normal range result of a pulse oximeter is 95% to 100%. Anything lower than that means there's not enough oxygen getting to your body.
U-health
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Body Temperature Sensing
19
Sensing Chip
Contact or Noncontact Measurement
2.45GHz ActiveRFID Temperature Sensor Tag
Applitation
thermometer
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
• Sensor physics and new sensing materials
• Modelling and simulation • Focus in microsensors,
biosensors and wireless sensors
• Applications of commercialsensors
20
Patient Friendly Sensing Systems
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
21
UWB Radar Sensor for u-Health Service System
What is the UWB?
1. Ultra-Wide-Band spread transmitting energy across a wide spectrum of frequency, such that the energy in any frequency band is below the noise floor
2. Short duration pulses in the picoseconds or subnanosecond range resulting in several GHz bandwidth.
3. The UWB signal can be transmitted with no carrier with a low power.4. Promising technology for many aspects of biomedical applications.
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
22
Medical Application of UWB
1) Breathing Detecting2) Noninvasive Glucose
detecting
4) Straight forward hearts and breath activities Monitoring3) Fetal monitoring
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
23
Infineon : Electronic Textile Sensors
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-He(alth Products
24
Sensatex –Smart Shirt: Electronic Textile Sensors
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
25
Vivometrics : Life Shirt
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
26
Phillips : Electronic Textile Sensors
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
27
Phillips : Electronic Textile Sensors
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
28
Polar/Adidas : Electronic Textile Sensors
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
29
Phillips : Electronic Textile Sensors
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
30
Phillips : HeartCare Telemedicine Services
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
31
Phillips : Cardiac Telemonitoring System
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
– 1 and 12-lead ECG event recorder– Blood pressure– Glucometer – Thermometer– Spirometer – Sp02
32
Card Guard Health Mobile Phones(Israel)
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
33
CardioNet: Mobile Cardiac Telemetry
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
34
Qualcomm’s Personal Health MVNO , LifeComm
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
35
Debiotech: Subcutaneous Infusion of Insulin for Diabetes
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
e-Health Products
36
Gulucose Sensing Contact Lenses
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
37
Pendrgon Medical System
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Examples of u-Health Products
EHREHR
SliplessSeoul Nat’l Hospital
Paperless
Filmless
Chartless
Samsung/LG/TeleComUnification of the HIS
of Grand Hospital
Cooperate with Hospital Market
Seoul St. Mary’s Hospital
Samsung HospitalApply to EHR of Inpatient
Apply to EHR of Outpatient
Inha HospitalEHR of Outpatient
the EHR of Outpatient is extending more
Severance HospitalCooperate with IT company
Electronic Image Data& EHR
Asan Hyundai HospitalCooperate with IT Company
Unification of Hospital Information System (OCS, PACS, EHR)
EHR
38
Apply to EHR of Inpatient
Apply to EHR of Outpatient
Public/Private Health Sectors Innovation 3.1 EHR Construction <---- PHR
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Republic of Korea
○ : 100 % △ : 50-80 %
○○○○○○PACS
○○△△○○EHR
○○○○○○OCS
39 billion
30 billion14 billion3
billion200
billion30 billionIT Fund(won)
Giga-bit100MPS
FDDI-Giga-
bitATMGigabitNetwork
-OracleCacheDG SQLOracleMS SQLDBMS
2,1391,2261,0701,0501,5461,470Bed
Asan-HyundaeHospital
SamsungHospital
KyoungheeU. Hospital
Korea U. Hospita
l
Seoul NU.Hospital
Yonsei U.Severance
[ Source : Datanet, Fit Hospitals Website, 2008 ]
u-Health Hospitals in Korea
39
Public/Private Health Sectors Innovation u-Health Hospital Construction
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Republic of Korea
40
Conclusions• New wireless technology ( ambulatory or implantable
wireless sensors) will dramatically change the way we understand healthcare today
• This development provides the enabling technology for real long term monitoring of physiological functions
in sports, home health care as well as in hospital environment• The healthcare system will become more mobile, demand
driven, efficient, and person/patient friendly• New wireless sensors and measurement systems have a huge
market potential
Republic of Korea
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)
Republic of Korea
Thank you for your attention !!
2012 APEC Health Working GroupHealth Policy Dialogue(HWG-PD)