Workshop on Personal Health Systems for Chronic Diseases at Pervasive Health 2015

Supported by the COMMODITY12 Project (http://www.commodity12.eu)

Located at Pervasive Health 2015 (http://pervasivehealth.org)

With the advent of new mobile technologies and new portable sensors, systems to monitor patients affected by chronic diseases have become a reality. With the aging of society and the surge of patients with chronic conditions the development of monitoring infrastructures has become a major goal for the developing and developed countries. Despite the importance of this goal, the first generation of personal health systems (PHSs) failed to reach a wide adoption, largely due to the excessive amount of information presented to patients and doctors and lack of interoperability with standard formats such as HL7. Second generation PHSs are now focusing on processing the data to provide medical doctors and patients with prefiltered, structured and interoperable information, in which the human computer interfaces (HCI) are user friendly and the handling of the co-morbidities is done by means of evidence-based medicine.

Within this workshop we will focus on advancements in the area of personal health systems, dealing with problems concerning: complex patients, chronic diseases monitoring, big data analysis, machine learning in medicine, intelligent sensors, information compression, predictive models, interoperability, expert systems, evidence based medicine, HCI.

Name, Affiliation, postal address, and email of each organizer

Dr Stefano Bromuri, University of Applied Sciences Western Switzerland, Sierre, Rue de Technopole 3, CH 3960, Switzerland, email: stefano.bromuri@hevs.ch

Prof. Przemyslaw Kardas, First Department of Family Medicine, ul.Narutowicza 60, Łódź, Poland,  email: pkardas@csk.umed.lodz.pl

Dr Andrea De Gaetano, CNR-IASI, Largo Agostino Gemelli 8, 00185, Rome, Italy, email: andrea.degaetano@biomatematica.it

Dr Oliver Keller, DFKI, Gebäude D3 4 (Neubau), Stuhlsatzenhausweg 3, D-66123 Saarbrücken, Germany, email: oliver.keller@dfki.de

Olivier Marchesini, Portavita Postbus 1287, 1000 BG Amsterdam Oostenburgervoorstraat 100 1018 MR Amsterdam, Netherlands, email: o.marchesini@portavita.eu

Regina Preysing, Requirement Engineer at BodyTel GmbH, Germany, Hufelandstrasse 14, D – 34537 Bad Wildungen, email: regina.preysing@bodytel.com

Background and Motivation

With the advent of new mobile technology capable of performing cheap mobile computing, the health paradigm has begun to change considerably. Since the introduction of the first smart phones, the application market has seen a proliferation of applications to monitor health, connect to sensors, save data remotely and even produce reports on the health status of the individual, giving rise to the m-health paradigm.

However, m-health applications have so far mostly been separate from the healthcare system and the integration with e-health has also been difficult, mainly because of the interoperability challenge. Despite standardization efforts such as the Continua alliance [1], the data collected by such applications cannot be used by medical e-health systems deployed in hospitals because the effort to translate such data to a format that would be understandable by such system is too big in terms of time and money. Despite this limitation, telemedicine systems are slowly being accepted by hospitals and medical doctors as systems that can relieve the burden of monitoring patients affected by chronic conditions.

Nowadays, several attempts have been made to create telemedicine systems to monitor chronic diseases and their most common comorbidities [2,3,4]. This is becoming possible because most of the sensors are becoming compatible with Bluetooth technology and can be connected to smart phones. Nevertheless, they remain poorly accepted by the patients, who find the idea of wearing multiple sensors all at once uncomfortable. A more acceptable solution has been to consider integrated sensors that monitor physiological values all at once, such as the well-known Bioharness sensor [5]. Furthermore, the patients have diverse preferences about the treatment they undergo, so there is a need to personalize the treatment against several dimensions:

• Number and type of sensors to be used;
• Drugs and protocols;
• Number of interactions with the doctors;
• Adherence of the patients to the treatment and type of treatment;
• Intersection of multiple co-morbidities and treatments;
• Genetic profile of the patients.

Given the growing market of chronic illnesses, the need of data that is structured and easy to access is becoming a mandatory requirement. Furthermore, in addition to the ability to monitor the chronic illnesses, there is also a need to interpret the physiological signals. Even assuming a situation where the doctor can in principle have access to all the data produced by sensors attached to the body of the patient, the amount and nature of this data makes it difficult to understand for medical doctors, limiting their interest in m-health systems.

In these settings, there is the need of m-health systems that can perform an intelligent filtering of the information, pointing out to the medical doctors areas of interest in the stream of physiological values associated to the patient, that may contain some interesting event associated to the illness of the patient. At the same time, the streams of physiological values contains, many times, partial information about what could happen in the future of the patient. In these terms, prognostic reasoning has been identified as an important area of research with respect to medical systems such as m-health ones. Additionally telemedicine and m-health are both becoming approaches that are pervasive and that can reach large number of patients and practitioners. This brings out the necessity of using a pervasive computation approach, where the data of the patient is analysed by the sensor of mobile smarthub on the spot, without the need of a centralised server that can perform heavy computations.

The PHSCD workshop is motivated by problems at the intersection between:

• Medical devices;
• Interoperability;
• Telemedicine monitoring systems;
• Data mining, machine learning and signal processing;
• Expert systems;
• Chronic Illnesses;
• Complex patients affected by many co-morbidities;
• Telemedicine and patient's adherence issues;
• And m-health.

As a case study and example of a system involving the issues mentioned above, the workshop will involve, the participation of researchers and industry stakeholders that participated to the FP7 COMMODITY12 project and similar projects.

Objectives

The central topics and research questions for the PHSCD workshop can be listed as follows:

1. How to ensure interoperability of telemedicine systems?
2. How can we take decisions when dealing with multiple comorbid patients despite the lack of evidence?
3. How to create integrated sensor solutions, easily acceptable by the patients?
4. How to increase acceptance of telemedicine solutions by ageing population?
5. What are the best artificial intelligence and data analysis approaches to streams of physiological values?
6. How can we predict adverse outcomes by using the data of the patients and their previous history?
7. How can we personalize the treatment of the patient according to his/her genetic profile?
8. How can we personalize the treatment of the patient in order to increase compliance?
9. What are the best approaches to compress data?
10. How to deal with complex patients with multiple chronic illnesses?
11. What are the legal and ethical issues concerns of PHSs?
12. What are the costs associated to these solutions, also in relationship to insurances?

The PHSCD workshop will focus on these questions and bring together practitioners from the telemedicine area to create a forum with the aim of discussing the future of the research in PHS.

Format

The workshop will include presentation of papers and round table discussions. We plan to have an involvement of 20-30 researchers in the workshop, so this will imply several paper presentations.

Session I, Data Analysis and Data Representation in Personal Health Systems

09.00: Welcome
09.20: First paper presentation
09:40: Second paper presentation
10:00: Third paper presentation
10:20: Fourth paper presentation
10:40: Coffee break
11:00: Invited speaker, Stephan Schraps, CEO of BodyTel, Germany, Talk Title: “Challenges ahead for business in m-Health.”
11:30: Invited Speaker, Dr Andrea De Gaetano, Head of Biomatlab Laboratory at CNR-IASI, Italy, Talk Title: “Stochastic differential modelling of continuous glucose monitoring data streams”

Session II, M-health and E-health applications for complex patients

13.00: Invited Speaker, Evert Jan Hotjink, CEO of Portavita, Amsterdam, Talk title: Implementing a successful care management system and the COMMODITY12 experience.
13.30:14:00 Invited Speaker, MD Dr Przemyslaw Kardas, UMED, Talk title: Results of the COMMODITY12 telemedicine system validation in diabetes type 2 patients: medical outcomes, patient comoliance, and patients’ acceptace.
14.00: First paper presentation
14.20: Second paper presentation
14.40: Third paper presentation
15:00: Fourth paper presentation
15:20: Closing discussion about research concerning data analysis, complex patients handling and mobile applications.

Within the round table discussion we will develop the discussion further concerning:

• The need to define prediction models for patients affected by chronic illnesses
• The current obstacles in telemedicine and how to overcome them
• The current issues concerning treatment compliance for patients affected by multiple comorbidities
• The issue of following guidelines when multiple comorbidities are involved.

The roundtable discussion will have the goal to identify project ideas and new research directions to define systems in the area of pervasive health and mobile health.

Selecting Participants

The selection of the participants will be performed by means of a program committee, which will be formed by contacting experts in the sector of personal health systems, m-health and machine learning applied to medical data. In particular the criteria for acceptance of a paper to the PHSCD workshop will be on:

• Originality of the idea (1-5);
• Technical Quality (1-5);
• Related Work (1-5);
• Presentation (1-5);
• Relevance (1-5).

The paper will be peer reviewed by at least two members of the PC. The workshop will focus on papers coming from an industrial, medical or academic background, to reflect the existing intersection between these areas in the context of PHSs.

Important Dates

• Submission deadline for the workshop: 15 March 2015 (Strict deadline)
• Notification of acceptance: 1 April 2015
• Camera Ready version of workshop papers: 10 April 2015 (Strict deadline)

Submission Process, Proceedings and Templates

All submissions of the workshop papers will be done via “Easychair” (details to be provided by Feb 6th). Later on we will use “confy” (www.confy.eai.eu) for the Camera Ready papers (details to be provided).

All accepted workshop papers shall follow the PH2015 submission templates (IEEE, see main PH website for details http://pervasivehealth.org/2015/show/home).

All accepted workshop papers will be included in the conference proceedings and published in the IEEE Library. They will also be indexed in: Thomson Reuters Conference Proceedings, SCOPUS, DBLP, and ScienceDirect.

Organizers

Dr. Stefano Bromuri is a senior research scientist at HES-SO, and he obtained his PhD at Royal Holloway university of London in October 2009, with a thesis on distributed agent environments titled Generalised Ontological Environments for Multiagent Systems (GOLEM). Dr Bromuri was directly involved with the EU FP6 ARGUGRID project where he was in charge of the implementation and testing of the infrastructure. In particular, Dr Bromuri expertise lays in distributed multi-agent systems with particular focus on the concept of agent environment, combining the concept of agent environment with multiple areas such as pervasive computing for assisted living, semantic Web combined with argumentation theory and distributed event based systems. At HES-SO, he is working as a working package leader in the EU FP7 COMMODITY12 project, in which he also leads the technical development of the project. Furthermore, Dr Bromuri works on innovative ways to manage pervasive healthcare environments for assisted living as co-investigator of the project G-DEMANDE and MONDAINE.

Prof. Przemyslaw Kardas, MD, PhD is Head of the First Department of Family Medicine at the Medical University of Lodz, Poland. His professional activities focus on patient adherence to medication, e-Health, and management of chronic conditions in outpatient settings. He is the author of a number of peer reviewed scientific publications and conference presentations, as well as two monographs. He is a member of several editorial boards and a reviewer for a number of medical journals. He serves as an expert to European Commission in Public Health. He was a Scientific Director of the European research initiative Ascertaining Barriers for Compliance (www.ABCproject.eu) under the 7th Framework Programme (2009-2012), and President of the European Society for Patient Compliance, Adherence, and Persistence (ESPACOMP) scientific association (2010-2011).

Dr Andrea De Gaetano holds a medical degree from the Catholic University of Rome with a speciality in emergency surgery, an M. Sc. in applied mathematics from the UMBC (University of Maryland at Baltimore County), a Ph.D in applied Mathematics at the Universite' de Pau et des Pays de l'Adour, Pau, France and he is a Juris Doctor at the University of Urbino. He is currently leading the BioMatLab at the CNR-IASI institution and his research interests include: advanced models for glucose metabolism and long-term diabetes development, efficient algorithms for (population) parameter estimation, the application of modeling for preparedness against health crises (in particular regarding the physiological assessment of a large number of trauma victims), the geostatistical evaluation of pollution and respiratory epidemiological data in Palermo, the development of diagnostic procedures for Cerebral Auto-Regulation dysfunction, the extension of estimation techniques to Individual Based Models and the modeling of violence outbreaks as a support to security decision-makers.

Dr. Oliver Keller is manager of the research department Agent and Simulated Reality at DFKI. Dr. Keller has been involved in the administrative management of European funded projects at DFKI since 2002. He was responsible for the administrative co-ordination of a European network of excellence for Computational Logic (CoLogNet), several FP6 STREP projects (CASCOM, 511632; VITAL, 030600) and is currently leading an FP7 collaborative project (COMMODITY12, 287841).

Olivier Marchesini is Quality & Compliance manager at Portavita. Olivier Marchesini was the business Development manager of the insurance company which founded Portavita in 2001. He finally joined the company in April 2010. He is responsible for quality development and compliance to the ICT and Health norms and standards. He participates in the NEN (Dutch CEN correspondent) committees on ICT in health care and Software as medical devices. He worked previously has consultant at Philips, Cap Gemini and A.T. Kearney and as manager at a health insurance company (Agis Verzekeringen) and a health knowledge institute (Prismant) Olivier Marchesini has a degree in mechanics from the Ecole Centrale de Lyon (FR) and in business administration from the University of Twente (NL).

Regina Preysing is Requirement Engineer and System Architect. She has joined BodyTel in January 2013. She is responsible for the definition and successful implementation of project scopes, requirements of new products and enhancements of the BodyTel telemedical system. Prior to her assignment she has worked since 1998 as Software Engineer in various positions, finally as IT Architect in a globally acting IT company in consulting projects for various ERP and workflow software projects. She has also a proven knowledge on medical issues regarding both health and the German health system. Regina Preysing holds a university diploma in electrical engineering.

Bibliography

[1] http://www.continuaalliance.org/
[2] http://www.commodity12.eu/
[3] http://www.reaction-project.eu/news.php
[4] http://www.nephronplus.eu/