M-health review: joining up healthcare in a wireless world

In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint

Making sense of wearables:new-emerging markets and mediascapes

This document reports on the events of the networking/embedding event, organised by the Epinet WP3 team in Brussels Nov 2013. It summarises observations and key findings. The aim of the event was to involve the expertise of professionals from a range public and private agencies involved in the development of wearable sensor technologies and ICT innovation policy. We learn from their input of new-emerging roles for wearable sensors, how they are situated in visions of the future of healthcare and self care, of changing lifestyles and occupations. We learn of complications in clinical practice and in medical devices regulation. We learn of expectations, of what personalisation can stand for, of conceptions of behaviour and of well-being more generally. Finally, we observe a distinct disconnect between top-down policy developments on the future delivery of personalised healthcare to European citizens and grass-roots developments in self care and in the self-management of medical conditions. The results of this consultation are key to finalising the embedding stage of the case study on wearable sensors, and they provide major input into our attempts to integrating the many different assessments of this innovation domain

P5 eHealth: An Agenda for the Health Technologies of the Future

This open access volume focuses on the development of a P5 eHealth, or better, a methodological resource for developing the health technologies of the future, based on patients’ personal characteristics and needs as the fundamental guidelines for design. It provides practical guidelines and evidence based examples on how to design, implement, use and elevate new technologies for healthcare to support the management of incurable, chronic conditions. The volume further discusses the criticalities of eHealth, why it is difficult to employ eHealth from an organizational point of view or why patients do not always accept the technology, and how eHealth interventions can be improved in the future. By dealing with the state-of-the-art in eHealth technologies, this volume is of great interest to researchers in the field of physical and mental healthcare, psychologists, stakeholders and policymakers as well as technology developers working in the healthcare sector

Clinical evaluation of a novel adaptive bolus calculator and safety system in Type 1 diabetes

Bolus calculators are considered state-of-the-art for insulin dosing decision support for people with Type 1 diabetes (T1D). However, they all lack the ability to automatically adapt in real-time to respond to an individual’s needs or changes in insulin sensitivity. A novel insulin recommender system based on artificial intelligence has been developed to provide personalised bolus advice, namely the Patient Empowerment through Predictive Personalised Decision Support (PEPPER) system. Besides adaptive bolus advice, the decision support system is coupled with a safety system which includes alarms, predictive glucose alerts, predictive low glucose suspend for insulin pump users, personalised carbohydrate recommendations and dynamic bolus insulin constraint. This thesis outlines the clinical evaluation of the PEPPER system in adults with T1D on multiple daily injections (MDI) and insulin pump therapy. The hypothesis was that the PEPPER system is safe, feasible and effective for use in people with TID using MDI or pump therapy. Safety and feasibility of the safety system was initially evaluated in the first phase, with the second phase evaluating feasibility of the complete system (safety system and adaptive bolus advisor). Finally, the whole system was clinically evaluated in a randomised crossover trial with 58 participants. No significant differences were observed for percentage times in range between the PEPPER and Control groups. For quality of life, participants reported higher perceived hypoglycaemia with the PEPPER system despite no objective difference in time spent in hypoglycaemia. Overall, the studies demonstrated that the PEPPER system is safe and feasible for use when compared to conventional therapy (continuous glucose monitoring and standard bolus calculator). Further studies are required to confirm overall effectiveness.Open Acces

Medical Devices Information Systems in Primary Care

People who suffer from chronic diseases are becoming more involved in remote monitoring processes each year. The market acceptance of remote care programmes, connecting patients through medical devices as part of the treatment regime, is spreading worldwide. Healthcare providers use medical devices to monitor, in various ways, the chronically ill population, namely people with diabetes and hypertension. However, most hospital and service provider information systems do not conform to the same important data standards, making interoperability and information sharing difficult. In this sense, the Multimorbidity Health Information System (METHIS) project is a multidisciplinary, goal-oriented, design-science-based intervention aiming to improve physician-patient communication and patient engagement. It focuses on multimorbidity and ageing, encompassing patients with more than one chronic disease and over 65 years old. The proposed solution is a Clinical Medical Devices Information (CMDI) system and data model which contains standardised information about chronic patients, medical devices and other data sets to be included in the METHIS System. With this framework, the system can perform consistently and reliably while meeting all relevant regulatory requirements or standards. Based on this dissertation and the METHIS project’s complementary work, implementing the CMDI in various Family Health Unit (FHU) in Portugal will make it possible to combat the diversity and loss of telemonitoring information.A cada ano, os doentes crónicos estão mais envolvidos em processos de telemonitorização. A aceitação pelo mercado de programas de cuidados à distância, ligando doentes através de dispositivos médicos como parte do regime de tratamento, está a espalhar-se por todo o mundo. Os prestadores de cuidados de saúde utilizam dispositivos médicos para monitorizar, de várias formas, a população cronicamente doente, nomeadamente as pessoas com diabetes e hipertensão arterial. No entanto, a maioria dos sistemas de informação dos hospitais e prestadores de serviços não estão em conformidade com as mesmas normas, o que dificulta a interoperabilidade e a partilha de informação. Neste sentido, o projeto METHIS é uma intervenção multidisciplinar, baseada em Design Science, que visa melhorar a comunicação entre médico e doente e o envolvimento do mesmo. Tem como foco a multimorbidade e o envelhecimento, englobando doentes com várias doenças crónicas e com idade superior a 65 anos. A solução proposta é um sistema e o correspondente modelo de dados CMDI que contém informação padronizada sobre doentes crónicos, dispositivos médicos e outros conjuntos de dados a serem incluídos no Sistema METHIS. Com este modelo de dados, o sistema possui a informação para poder funcionar de forma consistente e fiável, cumprindo todos os requisitos ou normas regulamentares relevantes. Com base nesta dissertação e no trabalho complementar do projeto METHIS, a implementação da base de dados CMDI em vários Unidades de Saúde em Portugal tornará possível combater a diversidade e a perda de informação na telemonitorização

ICT-Enabled Social Innovation to support the Implementation of the Social Investment Package: Mapping and Analysis of ICT-enabled Social Innovation initiatives promoting social investment in integrated approaches to the provision of social services: IESI Knowledge Map 2015

This report presents the analysis of the Mapping 2015 of the project 'ICT-enabled Social Innovation to support the Implementation of the Social Investment Package' (IESI). It provides an enriched picture of the existing knowledge base and evidence of how ICT-enabled social innovation initiatives that promote social investment through integrated approaches to social services delivery can contribute to the policy objectives of the EU Social Investment Package (SIP) to support the achievement of the goals of the EU 2020 strategy in terms of inclusive growth and employment. After having introduced the policy and research background outlining the overall objectives and scope of the IESI research and the aim of the mapping 2015, the report provides an overview of the methodology followed for enriching the IESI inventory of ICT-enabled social innovation initiatives through a structured dynamic database and by conducting the mapping and analysis of a selected sample of 210 initiatives. The report then updates the review of the literature and practice in domains related to the role and impact of ICT-enabled social innovation promoting social investment, with a specific focus on the area of active and healthy ageing and long-term care for older people, particularly the theme: prevention, health promotion and rehabilitation. In reviewing the state of the art the report discusses the degree of deployment of ICT-enabled social innovations that promote social investment through integrated approaches to social services provision in terms of geographical spread and different areas of social services covered, providing insight into the levels and types of deployment achieved. Further, the IESI conceptual framework which underpins the research and which has been used to guide the mapping and analysis of initiatives is discussed, proposing additional dimensions in order to enrich the framework of analysis itself. Evolving theoretical approaches are taken into account, the aim being to better explain the implications ICT-enabled social innovation initiatives have or may have for social policy reforms. This is followed by an overview of the consolidated results of the analysis of the initiatives collected as part of the IESI mapping exercise in 2014 and 2015. The analysis presents the IESI Knowledge Map 2015, which aims to provide a better understanding of the main characteristics and patterns of the initiatives identified, according to the IESI conceptual framework. Reference is also made to the different welfare systems and social services delivery models which characterise various EU countries in order to contextualise the potential role played by ICT-enabled social innovation to promote social investment through integrated approaches to social services delivery. The findings of specific thematic analyses conducted on a set of selected topics: 1) the role of social enterprise-driven ICT-enabled social innovation initiatives in support of social services delivery; and the implications of ICT-enabled social innovation that promote social investment through integrated approaches to social services delivery in support of: 2) active inclusion of young people; and 3) active and healthy ageing and long-term care for older people, particularly as regards prevention, health promotion and rehabilitation are then presented. Finally, the main conclusions deriving from the analysis of the mapping in terms of the contribution made by ICT-enabled social innovation promoting social investment through integrated approaches to social services delivery to the implementation of the SIP are outlined. This is complemented by an analysis of the gaps identified; the limitations of the current mapping exercise and recommendations for future research, as well as implications and possible directions for policy.JRC.J.3-Information Societ

State of the art on ethical, legal, and social issues linked to audio- and video-based AAL solutions - Uploaded on December 29, 2021

Ambient assisted living (AAL) technologies are increasingly presented and sold as essential smart additions to daily life and home environments that will radically transform the healthcare and wellness markets of the future. An ethical approach and a thorough understanding of all ethics in surveillance/monitoring architectures are therefore pressing. AAL poses many ethical challenges raising questions that will affect immediate acceptance and long-term usage. Furthermore, ethical issues emerge from social inequalities and their potential exacerbation by AAL, accentuating the existing access gap between high-income countries (HIC) and low and middle-income countries (LMIC). Legal aspects mainly refer to the adherence to existing legal frameworks and cover issues related to product safety, data protection, cybersecurity, intellectual property, and access to data by public, private, and government bodies. Successful privacy-friendly AAL applications are needed, as the pressure to bring Internet of Things (IoT) devices and ones equipped with artificial intelligence (AI) quickly to market cannot overlook the fact that the environments in which AAL will operate are mostly private (e.g., the home). The social issues focus on the impact of AAL technologies before and after their adoption. Future AAL technologies need to consider all aspects of equality such as gender, race, age and social disadvantages and avoid increasing loneliness and isolation among, e.g. older and frail people. Finally, the current power asymmetries between the target and general populations should not be underestimated nor should the discrepant needs and motivations of the target group and those developing and deploying AAL systems. Whilst AAL technologies provide promising solutions for the health and social care challenges, they are not exempt from ethical, legal and social issues (ELSI). A set of ELSI guidelines is needed to integrate these factors at the research and development stage

State of the art on ethical, legal, and social issues linked to audio- and videobased AAL solutions

Working Group 1. Social responsibility: Ethical, legal, social, data protection and privacy issuesAbstract Ambient assisted living (AAL) technologies are increasingly presented and sold as essential smart additions to daily life and home environments that will radically transform the healthcare and wellness markets of the future. An ethical approach and a thorough understanding of all ethics in surveillance/monitoring architectures are therefore pressing. AAL poses many ethical challenges raising questions that will affect immediate acceptance and long-term usage. Furthermore, ethical issues emerge from social inequalities and their potential exacerbation by AAL, accentuating the existing access gap between high-income countries (HIC) and low and middle-income countries (LMIC). Legal aspects mainly refer to the adherence to existing legal frameworks and cover issues related to product safety, data protection, cybersecurity, intellectual property, and access to data by public, private, and government bodies. Successful privacy-friendly AAL applications are needed, as the pressure to bring Internet of Things (IoT) devices and ones equipped with artificial intelligence (AI) quickly to market cannot overlook the fact that the environments in which AAL will operate are mostly private (e.g., the home). The social issues focus on the impact of AAL technologies before and after their adoption. Future AAL technologies need to consider all aspects of equality such as gender, race, age and social disadvantages and avoid increasing loneliness and isolation among, e.g. older and frail people. Finally, the current power asymmetries between the target and general populations should not be underestimated nor should the discrepant needs and motivations of the target group and those developing and deploying AAL systems. Whilst AAL technologies provide promising solutions for the health and social care challenges, they are not exempt from ethical, legal and social issues (ELSI). A set of ELSI guidelines is needed to integrate these factors at the research and development stage. Keywords Ethical principles, Privacy, Assistive Living Technologies, Privacy by Design, General Data Protection Regulation.publishedVersio