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Challenge 5: Towards Sustainable and Personalised Healthcare: Current State-of-the Art and Opportunities Within the FP7 ICT Call 1

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Title: Challenge 5: Towards Sustainable and Personalised Healthcare: Current State-of-the Art and Opportunities Within the FP7 ICT Call 1


1
Challenge 5 Towards Sustainable and Personalised
Healthcare Current State-of-the Art and
Opportunities Within the FP7 ICT Call 1
  • Panagiotis BAMIDIS
  • Lab of Medical Informatics, Medical School,
  • Aristotle University of Thessaloniki,
  • Thessaloniki, Greece

2
Talk Roadmap
  • Healthcare in EU
  • eHealth
  • Before FP7
  • To FP7

3
Challenges of Health Sector
  • better, faster and more responsive health care
    services for the citizens
  • more sophisticated and user friendly medical
    equipment, systems and tools for practitioners
  • more efficient and cost effective management of
    services for managers
  • faster and efficient supply of medical products
    for suppliers
  • better co-ordination and management of health
    care services at European level for policy makers
  • Source R. Zobel, eHealth 2003 Conference

4
What is eHealth?
  • ICT for Health (also known as eHealth) describes
    the application of information and communications
    technologies across the whole range of functions
    that affect the health sector, from the doctor to
    the hospital manager, via nurses, data processing
    specialists, social security administrators and -
    of course - the patients.
  • http//ec.europa.eu/information_society/activities
    /health/whatis_ehealth/index_en.htm

5
eHealth support in EU
  • eHealth is developing in at least three areas
    research and technology development policy and
    applications and deployment.
  • European Community research programmes have been
    supporting eHealth for the last two decades,
    co-financing research projects to the tune of
    500 million.
  • The European Unions Member States are committed
    to sharing their best practices and experiences
    to create a European eHealth
  • eHealth which once had purely a research and
    development profile is now moving ever closer
    to deployment and use of actual applications.
    (see the eTEN programme)
  • http//ec.europa.eu/information_society/
  • activities/health/index_en.htm

6
RD activities at EC
  • Medical Informatics - standalone PC era
  • Systems for the storage, retrieval, sharing and
    optimal use of biomedical data, information and
    knowledge
  • Health Telematics - early telecommunication days
  • Regional health care networks, remote diagnosis
    and telemedicine applications
  • eHealth - Internet era
  • Internet-based applications and services, medical
    content for prevision, intranets for the
    management of health services
  • Personalised eHealth - Ambient Intelligence era
  • health knowledge infrastructure, wearable and
    implantable systems, Biomedical informatics for
    personalised health, Health GRIDs

Source R. Zobel, eHealth 2003 Conference
7
RD activities at EC (cont)
FP2 ESPRIT
FP3 RACE/AIM
FP4 TELEMATICS
FP5 IST/Health Applications
FP6 eHealth
Medical Informatics
Health Telematics
eHealth
Personalised eHealth
1991
2002
Total 600M (15Years)
  • 20M
  • 30 Projects
  • Feasibility Study
  • 100M
  • 63 Projects
  • AIM Community
  • 140M
  • 158 Projects
  • 1st wave of products
  • 200M
  • 125Projects
  • EU Telematics Industry

Source R. Zobel, eHealth 2003 Conference
8
Personalized eHealth
Medical Informatics
Bio Informatics
  • Electronic Health Records
  • Medical Imaging
  • Clinical Decision Support
  • Telemedicine
  • Functional Genomics
  • Proteomics
  • Computational Biology

Personalised eHealth Knowledge
Neuro-Informatics
  • Machine Learning
  • Knowledge Discovery
  • Human Computer Interfaces

Source R. Zobel, eHealth 2003 Conference
9
Personal Health Systems - PHS
  • A relatively recent concept
  • Introduced in the 1990s
  • Place the individual citizen in the centre of the
    healthcare delivery process
  • Key facilitators for
  • Continuity of care
  • Preventive personalised care
  • Citizen-centred care
  • citizen empowerment
  • preventive lifestyle early diagnosis
  • disease management
  • independent living for ageing society
  • Source Loukianos Gatzoulis, IST event 2006,
    Helsinki

10
Personal Health Systems
  • In the form of
  • Wearable, implantable, portable systems
  • Point-of-care systems
  • Non-/minimally-invasive monitoring
  • Remote and continuous health status monitoring
  • Personalised medical advice, recommendations and
    treatment as necessary
  • Emphasis so far
  • Physiological monitoring (vital signs)
  • Physical activity monitoring (body-kinematics)
  • Functional stimulation (post-event
    rehabilitation)
  • Molecular diagnostics for screening applications
    (e.g. cancer)

Source Loukianos Gatzoulis, IST event 2006,
Helsinki
11
ICT for health FP6 focus
  • Research funded under the eHealth Strategic
    Objective of the IST research programme aimed at
  • creating an 'intelligent environment' allowing
    ubiquitous management of each person's health
    status
  • assisting health professionals in coping with
    major health challenges.
  • The focus was on
  • key technologies (biosensors and secure
    communications, 'smart clothes' and implants,
    which help patients - and their doctors - monitor
    and manage health status)
  • software tools to help health professionals take
    the best possible decisions assuring patient
    safety
  • networking multidisciplinary researchers in the
    fields of bio-informatics, genomics, and
    neuro-informatics to help create a new generation
    of eHealth systems to assist the
    'individualisation' of disease prevention,
    diagnoses and treatment

12
ICT for health FP6 calls
  • Under the Sixth Research Framework Programme
    (FP6), the Commission has sought proposals for
    eHealth research projects twice
  • the 1st Call for Proposals, which closed on 24
    April 2003
  • the 4th call for proposals, which closed on
    22/03/05 (http//ec.europa.eu/information_society/
    activities/health/docs/projects/fp6call4projects-s
    tudies.pdf)
  • There was also a joint call on bio-sensors for
    Diagnosis and Healthcare in June 2004
  • Call 6 The Strategic Objective 'Ambient Assisted
    Living (AAL) for the Ageing Society' (closed
    25/04/2006)

13
Personal Health Systems
  • Examples of FP6 projects
  • MYHEART (http//www.hitechprojects.com/euprojects/
    myheart/)
  • Wearable systems (intelligent textiles) for
    prevention, early diagnosis and management of
    cardiovascular diseases
  • OFSETH (www.ofseth.org)
  • Textiles with optical sensors for physiological
    monitoring
  • HEARTFAID (www.heartfaid.org)
  • Knowledge-based platform for heart failure
    management
  • SMARTHEALTH (www.smarthealthip.com) and
  • MICROACTIVE (www.sintef.no/microactive)
  • Point of care devices for cancer screening
    (breast, cervical and colorectal cancer)

14
Challenges for European Health Systems
  • Pressure on healthcare systems
  • Citizens expectations for high-quality care
  • Demographic changes
  • more people will require prolonged care
  • Increased prevalence of chronic diseases
  • substantial part of the overall healthcare costs
  • Medical accidents
  • Staff shortages
  • Reactive model of healthcare delivery
  • after appearance of symptoms
  • Rising healthcare costs
  • faster than the economic growth itself
  • How to offer high-quality affordable care?
  • Source Gérard Comyn, IST event 2006, Helsinki

15
Strategic Directions
  • Mix of policy and research actions
  • Shift from hospital-centred to person-centred
    systems
  • Shift from reactive to proactive (preventive)
    healthcare
  • Policy instrument
  • Action Plan for a European eHealth Area
  • COM(2004) 356
  • Research instrument
  • Seventh Framework Programme for Research (FP7)

Source Gérard Comyn, IST event 2006, Helsinki
16
FP 7 - Challenge 5
  • ICT WP 2007-08 - Strategic Objective Personal
    Health Systems for Monitoring and Point of Care
    diagnostics
  • Strategic Research Orientations
  • Personal Health Systems
  • Patient Safety
  • Virtual Physiological Human

17
FP7 Objective 3.5.1.1
  • Focus on
  • (a) Personalised (health status) monitoring
  • For people at risk or chronically ill
  • Wearable or portable/mobile ICT systems
  • Enable remote monitoring care
  • Multi-parametric information (physiological
    biochemical activity, location, social and
    environmental context)
  • Intelligent systems to correlate multi-parametric
    data with expert biomedical knowledge
  • aid diagnosis
  • user support
  • Interoperable with electronic medical records

18
FP7 Objective 3.5.1.1 - (2)
  • Focus on
  • a1) Chronic disease management
  • intelligent closed-loop approaches
  • detect and assess trends and episodes
  • facilitate adaptive care
  • remote management, avoiding hospitalisation
  • promote doctor-patient interaction
  • potential for integration in the healthcare
    process
  • a2) Preventive monitoring for people at risk
  • identify evolving patterns/trends in health
    lifestyle parameters
  • indicate elevated risks of disease development
  • reveal episodes at early stages
  • facilitate personalised guidance
  • encourage citizen compliance
  • prompt for early medical intervention

19
FP7 Objective 3.5.1.1 (3)
  • Focus on
  • (b) Point-of-Care diagnostics
  • Multi-analyte screening at primary care (GP
    offices)
  • Portable or handheld devices (based on LoC,
    microarrays, etc.)
  • Multiple tests (e.g. genome, proteome, metabolome
    levels)
  • Identify disease predisposition
  • Early diagnosis of diseases their recurrence
  • Assistance to treatment
  • dosage advice
  • suitability of drug use
  • Significant advances in
  • sensitivity and specificity
  • data processing, analysis and quality control
  • Interface with hospital and laboratory
    information systems electronic medical records

20
FP7 Objective 3.5.1.1 (4)
  • (c) Additional Support Actions on
  • RD roadmap on Personal Health Systems
  • emerging technologies and potential applications
  • user demand and business aspects
  • ethical and legal considerations
  • Wireless transmission of health-related
    information
  • reliability aspects
  • need for exclusive radio frequency bands?
  • Interoperability of Personal Health Systems with
    other eHealth systems
  • promotion and recommendations for continuous care

21
FP7 Objective 3.5.1.1 (5)
  • Expected Impact
  • Higher quality care at the patient location
  • Better support and reassurance to people at risk
  • Stabilise the cost of health delivery systems
  • Reinforce leadership of the EU Personal Health
    Systems industry
  • Call 1 funding

22
More on ICT WP 2007-08Challenge 5
  • Advanced ICT for Risk Assessment and Patient
    SafetyObjective IST-2007.5.2

23
Research proposed in Objective IST-2007.5.2
  • Advanced computerised adverse event systems
  • New tools for identification, prediction,
    detection and monitoring of adverse events and
    other relevant information.
  • Based on innovative data mining and integration
    techniques of existing databases and specific
    applications.
  • Emerging technologies like semantic mining should
    be explored through multimedia databases.
  • Include validation leading to quantitative
    benefits.

24
Research proposed in Objective IST-2007.5.2
  • New risk prediction for large scale events
    -local, regional or even global adverse health
    events (infectious outbursts, bioterrorism)
  • new risk prediction, assessment and management
    tools for preparation, surveillance, support and
    intervention in case of large adverse health
    events.
  • complement DG SANCO Health Emergency Operations
    Facility

25
Research proposed in Objective IST-2007.5.2
  • Specific International Cooperation Actions
    (SICAs) with Latin America countries
  • foster cooperation, transfer of technology and
    undertake demonstration activities in the area of
    alert and decision support systems based on
    Electronic Health Records.

26
Funding in Objective IST-2007.5.2
27
ICT in support of patient safety and risk
management in healthcare
Source Symbion Communications- and Technology
Research, IST event 2006, Helsinki
28
ICT in support of patient safety and risk
management in healthcare
ICT in Clinical Settings EHR (Electronic
Healthcare Record) CPOE (Computerized
Prescription Order Entry System) DSS (Decision
Support tools) EBM (Evidence Based Medicine,
guidelines) Source Symbion Communications-
and Technology Research, IST event 2006,
Helsinki

29
More eHealth in FP7
  • The Virtual Physiological Human(VPH)...

30
Biomedical informatics background
  • Biomedical information is collected, stored and
    processed on/at
  • Different Levels molecule, cell, tissue, organ,
    patient, population
  • Different Context - care, research, education,
    policy/management
  • Different Representation format, structures,
    ontologies,..
  • Different places
  • - Clinical info resources health records,
    clinical research databases, pharma databases
  • - Biomolecular info resources DNA protein
    sequences, microrarray data, protein
    interactions, human genome annotations ..
  • - Public health info resources epidemiological
    data and studies, national and WHO databases on
    diseases,

Source Joël Bacquet , IST event 2006, Helsinki
31
Synthesis of all Health information levels
BMI enables integration of biomedical data for
better health (Molecular medicine)
Public Health Informatics
Population
Patient
INFORMATICS
Medical Informatics
Tissue, organ
Cell
Bioinformatics
Health Information levels
Molecule
Based on Fernando Martin Sanchez
32
The Virtual Physiological Human - concept
Basis is the International physiome project
www.physiome.org
Computer models of the human physiology, which
includes the interaction across temporal and
spatial scales from molecules to cells, tissues,
organs, up to the whole human body
New basis for Personalised (Patient-specific)
healthcare solution Early diagnostics
Predictive medicine
Source Joël Bacquet , IST event 2006, Helsinki
33
Neurotransmitter studies Transmitter-Receptoc
Fingerprints
Animal Experiments
Molecules
Multi-parameter Analysis
AnatomyCytoarchitectonic info
Ontologies for semantic deposit and extraction of
knowledge
Single neuron recordings
EPSPs
IPSPs
Multi neuron recordings
EEG
MEG
Behavioural/Cognitive/SocialStudies
Other functional Neuroimaging(Blood flow)
Genetic Studies
Search for biologicalbasis of social cognition
PET
fMRI
Functional Neuroimaging of genetic variation
Bridge gap b/w morphology physiology
inconsistencies
34
Imaging Genomics
Complex functional interactions Behavioural
phenotypes
genes
cells
systems
behaviour
  • Increasingly divergent path from genes to
    behaviour.
  • Need estimation of genetic effects at the level
    of brain information processing, which represents
    a more proximate biological link to genes and
    behaviour.

35
Objective 3.5.2.1 Virtual Physiological Human
  • Technical focus on
  • Patient-specific modelling and simulation
  • Target molecular, cell, tissue, organs or
    systems
  • Modelling simulation of organs/systems
    targeting specific clinical needs.
  • Go beyond the state of art of available models
  • Models should be multilevel when appropriate
  • Better understanding of the functioning of the
    organs
  • New insight into the response to physiological
    changes

36
Objective 3.5.2.1 Virtual Physiological Human
  • Technical focus on
  • Data integration and knowledge extraction
  • Target creation and formalisation of patient
    specific knowledge from multi-level integration
    of biomedical data
  • Requirement open distributed health
    infrastructures and tools
  • Focus
  • Coupling scientific research data with
    clinical/empirical databases
  • Linking genotype data (genetic markers, pathways)
    with phenotype data (clinical data)
  • Image processing assessing disease
    evolution/presence
  • Data mining and image processing across many
    biological levels

37
Objective 3.5.2.1 Virtual Physiological Human
  • Application focus on
  • Patient-specific modelling and simulation b)
    Data integration and knowledge extraction to be
    demonstrated on c) following clinical
    applications
  • Medical simulation environments for surgery
  • Environment used for simulation, training and
    planning of surgeries
  • Prediction of disease or early diagnosis (patient
    specific)
  • knowledge and predisposition obtained from lab
    tests, biomedical imaging (imaging bio-markers
    and other data)
  • assessment of efficacy/safety of drugs
  • Use patient specific computational models to
    assess the drugs.
  • Alternative screening for clinical trials

38
Objective 3.5.2.1 Virtual Physiological Human
  • Networking action (NoE)
  • in multilevel modelling and simulation of human
    physiology
  • sharing of knowledge
  • multidisciplinary training programmes
  • reusable software tools
  • Coordination Support Actions
  • Enhancing security and privacy in modelling and
    simulation addressing
  • patient data processed over distributed networks
  • use of genetic data
  • Trustworthy environment
  • International cooperation on health information
    systems based on Grid capabilities

39
Funding for Objective 3.5.2.1
  • When Call 2
  • Instruments (Draft not yet agreed)
  • (a-c) CPs 62M (minimum 22M for IP and
  • Minimum 22M for STREPs)
  • (d) Integrating action NoE max 8M
  • (e) Coordination Support Actions CSAs
  • Max 1M per action

40
The future will tell
41
Thank you for your attention and time!
Panos Bamidis, Ph.D. Lecturer in Medical
Informatics Lab of Medical Informatics, Medical
School, Aristotle University of Thessaloniki,
Thessaloniki, Greece bamidis_at_med.auth.gr http//l
omiweb.med.auth.gr
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