E-health reference framework for personalised information provision to promote sound lifestyles

In the present context of increased healthcare demand and costs, health maintenance by prevention is a major strategic objective of public health systems. Western societies increasingly suffer from lifestyle-related diseases triggered by an unbalanced diet, physical inactivity, smoking or alcohol abuse. The majority of these diseases can be eliminated through preventative action, such as promoting positive health determinants. Focus of healthcare needs to gradually move out from the acute-care hospital, to the patient; interventions should move from the acute phase of the disease, and towards prevention monitoring and screening, detection and treatment. The possibilities of ICT (Information and Communication Technologies) are fully exploited to provide life related information and services, consistency and personalization and ubiquity for health in order to strengthen prevention and treatment trends as well as to provide continuity of care demands. Prevention healthcare communication needs to be conveyed from the public health authorities to the population. This communication is essential so as to engage individuals with the policy envisaged by the public healthcare authorities and provide them with the relevant information to feel empowered. In order to be effective, there is the need to analyse how to deliver these messages with the use of new technologies. In this sense, there are a few personalised healthcare communication methodologies to deliver tailored information to individuals in the field of healthcare promotion. However, these methodologies do not take into account how this information would be delivered by means of new ICT; there is the need of structured healthcare communication to be delivered by means of e-health to provide personalised information. This research intends to understand whether tailored communication is effective in enhancing the capacity of individuals to be empowered regarding their healthcare knowledge. Besides, it is envisaged to work out whether the use of e-health systems can be boosted by personalising the provision of information. As such, a novel framework to deliver a personalised healthcare communication has been conceived, designed, implemented and evaluated. This framework contemplates the use of e-health in order to support individuals and empower them to take an active control of their healthcare. The proposed framework is a modification of an existing healthcare communication methodology that was enhanced in order to adapt it to the provision of information by new ICT devices. The first steps of the methodology were modified to create a new tailored information model to be delivered through new technological devices. In order for the personalised information delivered to be more effective a new dimension was considered: the acceptance of ICT. In this sense, this research proposes, a new e-health acceptance framework that adds a deeper insight to previous existing initiatives and by considering different elements of individuals’ behaviours regarding both the healthcare dimension as well as the acceptance of technology. Further to the conception of the new model, new tools to create the personalised information were conceived, designed and implemented together with the assistance of healthcare professionals. This would entail the possibility of an intervention by means of an e-health application to follow the same protocols as a face-to-face process. Hence, tailored information to individuals could be delivered depending on a number of psychological and physical factors. These intermediate tools made possible the development of the entire healthcare communication framework, and although they are not part of the hypothesis as such, their development has proved to be essential for the whole implementation of the e-health communication framework. In subsequent stages, the communication strategy was implemented by building a personalised e-health system to delivered information in the field of healthcare promotion. This system was implemented by using the most up-to-date Internet technologies to make the most out of the user experience, both in terms of human-computer-interaction and in the way the information is presented. In this way, the process by which individuals are empowered in order to take proactive decisions concerning their healthcare is clearly enhanced. Finally the complete framework was evaluated at different stages with the various stakeholders in order to understand whether personalised e-health platforms are more efficient in empowering individuals than general information e-health systems. SINOPSIS Cerca del 80% de las enfermedades cardiovasculares, la diabetes mellitus tipo 2 y el 40% de la incidencia de cáncer se podrían evitar con una dieta sana, una actividad física regular y la supresión del uso del tabaco. Sin embargo, la responsabilidad de esta mejora en la calidad de vida recae cada vez más sobre el propio individuo, haciendo de la motivación y de la facilidad de acceso a la información, así como de la confianza en ésta, los principales pilares de la promoción de la salud. Es importante concienciar a los ciudadanos de que ser responsables de su propia salud ofrece ventajas sustanciales. Estar bien informado sobre temas relacionados con la salud y los servicios ofrecidos por las distintas instituciones supone una mayor autonomía y un mejor control de la propia vida. Las Tecnologías de la Información y las Comunicaciones (TIC) son consideradas una respuesta potencial a la demanda de un mejor cuidado de la salud, mejoras en resultados médicos, y el mantenimiento de una calidad de vida relativamente alta. Entre las características de las TIC, se puede citar la actualización automática de la información y la adaptación y personalización de la misma. Sin embargo, a pesar del creciente interés en la adopción y puesta en práctica de las TIC en el sector de e-health, aún hay una enorme carencia de teorías que definan cómo el uso de dichas tecnologías puede asistir al usuario para cambiar con eficacia su estilo de vida. La Informática de Salud Pública trata de comprender, entre otros aspectos, los mecanismos de comunicación de información relativa a la prevención y promoción de la salud. En este campo, numerosas teorías de comunicación buscan entender los mecanismos que llevan a los individuos a tomar una actitud frente al cambio (por ejemplo, dejar de fumar, hacerse una mamografía, etc). Sin embargo, no existe ningún marco de comunicación que contemple cómo esta información puede ser provista por medio de las TIC, con el fin de aunar los beneficios que trae consigo la prevención y promoción de la salud, y el hecho de que se usen las TIC para su difusión. En esta tesis doctoral se propone un nuevo marco de actuación que tiene como objetivo la provisión de información de prevención sanitaria personalizada por medio del uso de las nuevas TIC. En este sentido, se presenta una revisión del estado de la cuestión en la actualidad, para posteriormente realizar un nuevo modelo de provisión de información personalizada, que incluye distintas facetas hasta ahora no contempladas, tales como, el tener en cuenta los aspectos que influyen en los individuos acerca de su relación frente a la salud y al uso de la tecnología. Posteriormente, se han realizado diversas tareas como la creación de herramientas específicas que ayudan a la clasificación de los individuos con el fin de proveer información relevante. Además se han creado los distintos mensajes de información personalizada con la ayuda de profesionales en comunicación de salud, así como médicos expertos en el área, intentando recrear una intervención presencial a lo largo del tiempo, para ser provista mediante el uso de las TIC. Para demostrar las hipótesis de partida, se han implementado dos aplicaciones que tienen como fin la provisión de información personalizada a través del uso de las TIC. Estas dos aplicaciones abarcan distintos ámbitos; la primera se desarrolla en el entorno de la promoción de una dieta sana, y tiene como fin proporcionar información sobre los beneficios de comer equilibradamente. Esta información se facilita a través de tecnologías Web. La segunda, se centra en la prevención secundaria y tiene como objetivo, fomentar la actividad física a través del teléfono móvil. Finalmente, la evaluación del marco de información personalizada mediante el uso de las TIC ha revelado el interés de este tipo de plataformas; a este respecto, los individuos encuestados afirman que el hecho de que la información sea personalizada les impulsa a un mayor uso de las plataformas de e-health al ser la información presentada relevante y acorde a sus necesidades. Éstos afirman sentirse más empoderados mediante este tipo de sistemas a tomar decisiones fundamentadas con respecto a su salud

Heart Failure Monitoring System Based on Wearable and Information Technologies

In Europe, Cardiovascular Diseases (CVD) are the leading source of death, causing 45% of all deceases. Besides, Heart Failure, the paradigm of CVD, mainly affects people older than 65. In the current aging society, the European MyHeart Project was created, whose mission is to empower citizens to fight CVD by leading a preventive lifestyle and being able to be diagnosed at an early stage. This paper presents the development of a Heart Failure Management System, based on daily monitoring of Vital Body Signals, with wearable and mobile technologies, for the continuous assessment of this chronic disease. The System makes use of the latest technologies for monitoring heart condition, both with wearable garments (e.g. for measuring ECG and Respiration); and portable devices (such as Weight Scale and Blood Pressure Cuff) both with Bluetooth capabilitie

SYMBIOmatics: Synergies in Medical Informatics and Bioinformatics – exploring current scientific literature for emerging topics

Background: The SYMBIOmatics Specific Support Action (SSA) is "an information gathering and dissemination activity" that seeks "to identify synergies between the bioinformatics and the medical informatics" domain to improve collaborative progress between both domains (ref. to http://www.symbiomatics.org). As part of the project experts in both research fields will be identified and approached through a survey. To provide input to the survey, the scientific literature was analysed to extract topics relevant to both medical informatics and bioinformatics. Results: This paper presents results ofa systematic analysis of the scientific literature from medical informatics research and bioinformatics research. In the analysis pairs of words (bigrams) from the leading bioinformatics and medical informatics journals have been used as indication of existing and emerging technologies and topics over the period 2000-2005 ("recent") and 1990-1990 ("past"). We identified emerging topics that were equally important to bioinformatics and medical informatics in recent years such as microarray experiments, ontologies, open source, text mining and support vector machines. Emerging topics that evolved only in bioinformatics were system biology, protein interaction networks and statistical methods for microarray analyses, whereas emerging topics in medical informatics were grid technology and tissue microarrays. Conclusion: We conclude that although both fields have their own specific domains of interest, they share common technological developments that tend to be initiated by new developments in biotechnology and computer science

Medical informatics and bioinformatics: a bibliometric study.

International audienceThis paper reports on an analysis of the bioinformatics and medical informatics literature with the objective to identify upcoming trends that are shared among both research fields to derive benefits from potential collaborative initiatives for their future. Our results present the main characteristics of the two fields and show that these domains are still relatively separated