CHIRON INTEGRATED HEALTHCARE APPROACH FOR HOME, MOBILE AND CLINICAL ENVIRONMENTS
Click here to print

RATIONALE: the need of a change in healthcare and the role of ICT

Present day healthcare is under strain due to demographic and socio-economic challenges:

  • Population is ageing (percentage of 65+ population in the EU15 will grow from the current 17.1% to the 25% expected in 2030, i.e., in absolute value from 85 million in 2008 to 120 million in 2030)2; life expectancy will go up to 81.4 years in 2030 from the 75.9 years of 2008 (“demographic challenge”).
  • In parallel, we have a continuous growth of the number of people with chronic diseases often with co-morbidities and of people with some kind of impairments (vision / hearing / dexterity problems, cognitive decline)3 (see graph below).
  • Chronic diseases represent the greatest cause of early death and disability. Cardiovascular disease (CVD) is the leading cause of death in Europe and in the industrialized countries.
  • Migration of people across the overall world is determining a “globalization” of healthcare; specific diseases are no longer restricted to some geographical regions and this will ask for a more knowledgeable medical community.
  • Citizens are becoming more demanding in terms of quality of care and well-being.
  • Healthcare and social costs are exploding (from a worldwide average of 9% of the GDP in 2005 to 11% expected in 2015). Most EU member states spend around 30% – 40% of the total health expenditure on elderly population and long-term care (as an example, Europe expenses for treating CVD cost around 3% of the GDP4 ).
  • There is a shortfall of medical professionals and medical infrastructures.
Older population and chronic diseases

To cope with these challenges major changes will be needed in the delivery and management of care in order to get improvements in efficiency and effectiveness (improved efficiency of the hospital work flow , integration of diagnosis and treatment and reduction of the average length of hospital stay for acute care).


The need of a change is recognized at all levels and it is clearly indicated in the objectives of the Sub-programme ASP2 (Person-centric health management) of the Artemis Programme: “to move away from ‘health care’ to ‘health management’ i.e., from ‘how to treat patients’ to ‘how to keep people healthy’ “.

“Many healthcare systems around the world will become unsustainable by 2015. The only way to avoid this critical situation is to implement radical changes” (from a report of the Institute for Healthcare Improvement, 2007).

THE ROLE OF ICT

ICT can play an important role in this change (see – as an example – the Action Plan on ICT for Ageing in the framework of the EC i2010 initiative).
ICT can, among the other benefits:

  • Support the medical professionals in getting higher productivity and better accuracy in their critical tasks,
  • Break the physical distance between the physician and his patient through tele-consultancy,
  • Allow continuous monitoring of the health status of patients rather than episodic checks during the ambulatory visits,
  • Provide collection and analysis of a large quantity of data related to the specific patient and to previous clinical studies (knowledge-based medicine),
  • Emphasize the central role of the patient in a person-centric healthcare approach.

Better leveraging of the potential provided by ICT represents a challenge and at the same time an economic opportunity. Nevertheless it has become evident that market forces alone have been insufficient to ensure the realization of this potential.5

Tele-monitoring, i.e. the integration of healthcare, telecommunications and information technology, is considered as one of the most important directions in the future development of healthcare. Although the idea of tele-monitoring is not new, only the ubiquitous availability and access to ICT technology as well as to broadband and mobile networks have spurred the wide deployment of solutions, both within home and hospital environments. The main objective of tele-monitoring application is to reduce duration of the stationary treatment and to increase the mobility of the patients. On one hand, this improves the quality of care and the quality of life (the predominant number of those patients is very satisfied); on the other hand, the costs for treatment and monitoring can be significantly reduced.

Another emerging sector in healthcare is the medical imaging.
The market for medical imaging technology is characterized by continuous and sustainable growth. This development is supported by external market observers. The market research institute TriMark Publications published in August 2007 a study that estimates the current value of the global market for medical imaging technology in USD 20.1 billion and predicts an increase to USD 27.9 billion until 2010.
Due to the increasing needs for an individualized patient treatment, at least the same market growth can be expected for image-based software applications that support the diagnostic and therapeutic processes in the healthcare domain.
Within the medical imaging market, the following general market trends can be identified:

  • usage of digitized medical images allowing for integrated diagnosis;
  • higher resolution of the used images;
  • move towards multi-modality imaging;
  • move towards “quantitative imaging”.

Given the market trend and analysis, there is a big opportunity for a new generation of medical imaging products for early detection and preventive diagnosis. The new generation of medical imaging devices should be faster and more accurate.
Faster solutions will result in an estimated 20% reduction in procedure time; more precise imaging systems will generate – among the other benefits – cost reduction since it has been estimated that each percentage point reduction in faulty decisions generates an expected 10% saving per system per annum.

E-health is a market still in its nascent phase.
According to a recent report (“ICT and Ageing”) issued by Empirica on October 2008, the home telehealth market6 is “very fragmented and – although a considerable range of promising services and systems has emerged from RTD efforts – wider mainstreaming of ICT-enabled solutions with real world service settings has to a large extent yet to occur”.
In any case few examples of mainstream implementations are available and we have just various initiatives and various pilot / trial activities.
Also in North America – even if the level of mainstreaming is much higher than in Europe – e-health market is still in its nascent phase and does not yet fully ensure the availability and take up of the necessary ICT-enabled solutions coming out from the Research laboratories.

2 Population Projection EUROPOP 2008 – http://epp.eurostat.ec.europa.eu – November 4, 2008
3 According to the European Action Plan 2006-2007 issued by the European Commission there are currently approximately 45 million people in Europe who report a long standing health problem or disability; according to the World Health Organization data the total number of persons chronically ill are 860 million at a worldwide level.
4 See Frost & Sullivan “Preparing for an aging society: challengers faced by healthcare system in European Union, Japan and United States” -2009.
5 The demographic change – Impact of new technologies and Information Society” – report issued by Empirica in 2005 with the support of the European Commission.
6 For home telehealth services we intend medical oriented services delivered to the patients and to the citizens outside the conventional clinical setting (hospitals, ambulatories, etc.). They include telemonitoring, teleconsulting, telerehabilitation and self management of disease.
top