Wearable eHealth Systems For Personalised Health Management: State Of The Art and Future Challenges

The health sector today faces great challenges. Health is an informationintensive sector where Information and Communication Technologies (ICTs) could significantly contribute to efficiency and productivity gains. European Union is looking at the different facets of eHealth and mainly at the following three: a) Research and development, in particular to support the development of several regional health information networks, telemedicine services, and personal health systems for patients and citizens. b) Regulatory framework and standardisation, which ensure competition, interoperability and, at the same time, the confidentiality of personal data. c) Promotion of eHealth best practices through various eEurope 2002 and 2005 initiatives. After the pharmaceutical and radiology industry, eHealth is now the third industrial pillar for health. This emerging sector forms the backbone for the reengineering of health systems. It actually improves the access to and quality of care and places citizens at the very centre of its concern. 1. Challenges of the Health Sector All European countries are currently trying to find ways to sufficiently address the challenges the health sector faces. The citizens demand more efficient and responsive health care services. However, this can not be easily done without significant increases in operational costs. The recent economic slowdown in conjunction with the ageing problem does not leave enough space to the policy makers for significant increases of the health budgets. With a considerable rise in average life expectancy gains2 and with more citizens passing this critical age threshold the required public finances for covering healthcare costs have been in steady increase. The problems, thus, is how to improve the quality of the provided healthcare services without increasing the costs in a challenging social and economic environment. Infor1The views developed in this paper are that of the author and do not reflect necessarily the position of the European Commission 2According to the projections of the United Nations, OECD countries are likely to experience increases of between 3 and 4 years in the life expectancy of their populations up to 2030 (OECD, 1998). It is anticipated that rates of growth in numbers of people passing the age of 80 across OECD countries average to 70 per cent (OECD, 1995). In addition, persons aged 80 and over are the heaviest users of medical care. 2 R. Zobel / Health in the Information and Knowledge Economy Age mation and Communication Technologies (ICT) have proven to contribute to the productivity gains of institutions and the consequent reduction of the related costs. ICTs are used already with great success for administrative and healthcare purposes. However, as the ICTs are becoming smaller, faster, wireless and remotely controlled, new opportunities are being created for new medical tools and systems. Recently, the Internet and the web have opened up new opportunities for improving the response time of health care services and simultaneously reducing the costs (e.g. through telediagnosis). As the penetration of PCs and the Internet in Europe is increasing, a critical mass of general practitioners and users for the provision of online health care services is being created. Eurobarometer surveys have showed a steady rise in the rate of Internet connections by general medical practitioners. The 2002 survey showed that, on average, 78% of EU medical general practitioners were connected to the Internet, with 100% connected in the UK and 98% in the Nordic countries. The use of the Internet to deliver patient care is also growing. On average, 48% of medical practitioners use Electronic Health Care Records and 46% use the Internet to transmit patient data to other care providers for the purposes of continuity of care. However, a fully interactive use of the Internet to deliver care to patients through the provision of, for example, e-mail consultation (12%) or allowing patients to book appointments on line (2%) appear to be in its early stages. It becomes evident that we are at the early stages of a new era that will completely change the way the healthcare services are/will be offered. Significant efforts should be devoted to the research, development, promotion, and diffusion of new eHealth services and technologies. According to a study realised by Deloitte & Touche, the eHealth or Health Telematics sector is becoming the third industrial pillar of healthcare area after the pharmaceutical and the medical (imaging) devices industries. It is estimated that the health expenditure on ICT systems and services would rise from 1 % in 2000 to 5% by 2010, and that the market would offer reliable and affordable personal health systems assisting citizens to manage their lifestyle. 2. The eHealth RTD Activities The last ten years the eHealth3 activities of the Directorate General, Information Society at the European Commission have funded through several Framework programs (e.g. Telematics and Information Society Technologies) innovative research and development actions in several areas. The final goal of these activities is to contribute to the Lisbon Strategy through RTD in intelligent environments that enable ubiquitous management of citizens’ health status and assist health professionals in coping with major health challenges.