New paradigms in telemedicine: ambient intelligence, wearable, pervasive and personalized.

After decades of development of information systems dedicated to health professionals, there is an increasing demand for personalized and non-hospital based care. An especially critical domain is cardiology: almost two third of cardiac deaths occur out of hospital, and victims do not survive long enough to benefit from in-hospital treatments. We need to reduce the time before treatment. But symptoms are often interpreted wrongly. The only immediate diagnostic tool to assess the possibility of a cardiac event is the electrocardiogram (ECG). Event and transtelephonic ECG recorders are used to improve decision making but require setting up new infrastructures. The European EPI-MEDICS project has developed an intelligent Personal ECG Monitor (PEM) for the early detection of cardiac events. The PEM embeds advanced decision making techniques, generates different alarm levels and forwards alarm messages to the relevant care providers by means of new generation wireless communication. It is cost saving, involving care provider only if necessary and requiring no specific infrastructure. This solution is a typical example of pervasive computing and ambient intelligence that demonstrates how personalized, wearable, ubiquitous devices could improve healthcare.