Towards Home Healthcare Informatics

IEEE 2nd International Conference on
Human System Interaction
University of Catania, Catania, Italy, May 21-23, 2009

Towards Home Healthcare Informatics

Stefano BONACINA, Sara MARCEGLIA, Luca MAZZOLA and
Francesco PINCIROLI

e-Health Lab - www.sanitadigitale.polimi.it
Dipartimento di Bioingegneria

Agenda

1. Authors and the Context

2. Healthcare Informatics as enabling factor

3. Focus of our research

4. The three tools
 The FAMILY MEDICAL LEXICON
 HMFD (Hystoria Medica Familia Digitalis)
 Monitor System for Helping the Personal Management of Drugs

5. Conclusions

S. BONACINA, S. MARCEGLIA, L. MAZZOLA and F. PINCIROLI

Authors ...

• Stefano Bonacina (corresponding author)
 deputy director at Laboratorio di Informatica BioMedica e Sanità
Digitale - Dip. di Bioingegneria, Politecnico di Milano, Milan - Italy
 lecturer of Medical Informatics
• Sara Marceglia
 researcher at Clinical Center for Neuronanotechnology and
Neurostimulation - Fondazione IRCCS Ospedale Maggiore, Policlinico,
Mangiagalli e Regina Elena, Milan - Italy
 lecturer of Elements of Medical Informatics
• Luca Mazzola (presenter)
 researcher at USI-Com ITC & NewMinE – New Media in Education
Lab, Università della Svizzera italiana, Lugano - Switzerland
 lecturer of Elements of Medical Informatics
• Francesco Pinciroli
 director of the Laboratorio di Informatica BioMedica e Sanità Digitale
- Dip. di Bioingegneria, Politecnico di Milano, Milan - Italy
 full professor at Dip. di Bioingegneria, Politecnico di Milano, Italy

...and the Context

• The 'Laboratorio di Informatica BioMedica e Sanità Digitale - Dip.
di Bioingegneria, Politecnico di Milano, Milan – Italy' is
 Research laboratory to explore new approaches in biomedical
and e-health fields
 Didactic laboratory for students to develop:
• Thesis
• Activities inside curricular course
• Projects and practical experiences

• Our interest is devoted to support health related process with
the help of ICT
 At the central and peripheral healthcare point
 In hospital
 In the home environment

→ “Serving Patients by serving Doctors and Institutions”


Healthcare Informatics as enabling factor

• ICT as supporting tool for healthcare:
 From professional side
 From patient side
 From administrative side
• Paradigms:
 From technology-driven
 To patient-oriented
 To consumer-oriented
 To family based
 To vertical family based (multi-generational family)
• Usability issues:
 Search for a common language (as communication aspect)
 Easy management of family medical history
 Support during active home healthcare


Focus of our research

by exploring the
family health-related
lexicon
UNDERSTAND
by monitoring
some active
phases of
health care at
home (drug ENABLE
SUPPORT
administration)

by helping in tracking
the family health status

The three tools

• The three tools
 The FAMILY MEDICAL LEXICON
• UNDERSTAND
• The common vocabulary as tool to enable the effective
communication between actors in the health field
 HFMD (Hystoria Medica Familiae Digitalis)
• ENABLE
• The history of the multi-generational family as one of the
fundamental information to enable maintaining, enhancing
and restoring the individual's health
 A Monitor System for Helping the Personal Management of
Drugs
• SUPPORT
• The scheduling, tracking and security verification for home
medicaments assumption as one of the key factor to
enhance the recovery of patient's healthy state

The FAMILY MEDICAL LEXICON (1/3)

• The FAMILY MEDICAL LEXICON
– Tool for screenshot the common dictionary: LEXICON CAMERA
• Source
• Real availability
• Diffusion
• Reliability
• Possible sources (mayor issue)
– TV serials (no textual transcript available)
– Family medical encyclopaedias (no real feedback on learning)
– General websites (reliability of information)
• Use of medical supplement of some important newspapers
• → Italian YAHOO!health web sites
– Directed to common citizen
– Responsibly signed → content quality guaranteed
– Open-access modality → available


• Some numbers
– Articles between September 2003 to March 2008 (batch)
– More than 19,000 articles
– More than 6.7 millions words taken into account

• We developed some predefined stored procedures to
– Extract single frequency
– Restrict the time slice
– Calculate the correlation of word with the yearly period
– Retrieve the correlation between two different words

Todo → Real testing phase with some experimental protocol



• Some conclusion:
– A correlation between recent findings or events and words used to
describe them (like chicken flue)
– A switch from more general term to more specific one (like
headache to cephalgia)
– A seasonal trend for terms related to periodical illness (like flue)
WORD # Occ #Art #Art | #Occ>4 Max_Occ
Patient(s) 26,618 8397 2939 37
illness 9321 4089 720 41
therapy 6983 3374 496 15
care 4689 3388 109 14
cancer 3610 1543 317 13
tumor 5457 1934 560 18
pregnancy 2490 999 243 23
vaccine 1706 518 185 22


HFMD (Hystoria Medica Familiae Digitalis) (1/2)

A software tool to manage all the multi-generational family health-
related clinical documents
• Vertical Family as people:
– Living together
– Sharing the most part of the health history
– With the same risk factors
• One of the parent is the responsible for all the family medical
data (→ has motivations and skills)
– Need a good acknowledgement between members
– Could provide a solution to digital-divide and low health-literacy
• Flow:
– Manager inserts all the family members, then inserts the actual
health-related documents and associates it with labels
– A validator remotely accept or reject the document with the
labels attached
– On request, print (screen or paper) and research are available

HFMD (Hystoria Medica Familiae Digitalis) (2/2)

• Issues to take into account:
– Validation of medical data → medical verification
– Privacy and security issues
– Central storing facilities and web access
– User-friendly interface → usability
– Interoperability/Independence of client part

• Key points:
– Low cost tool, but rarely implemented (poor quality, accuracy,
consistency,... )
– Query could be done at family level → data mining about
genetic susceptibility, environmental, cultural and behavioural
impact

See the presentation → http://www.youtube.com/user/EHealthLab


Monitor System for Helping the Personal
Management of Drugs (1/3)

General aim : a web-based software system for monitoring the entire
process of drug therapy (from the acquisition to the administration)
– Acquisition of drug information in the most automatic way
possible, also by using barcode reader if available;
– Connection to the central server of Healthcare Service provider
(assessed available) to inquiry drugs databases and drug-
drug interactions databases;
– Connection to the central server of Healthcare Service provider
(assessed available) to inquiry electronic medical dictionary
also regarding pathological and physiological condition;
– Automatic generation of a plan for drug administration;
– Validating the plan avoiding probable Adverse Drug Events
(ADEs) → securing the plan
– Graphical representation of the generated plan for low-
literacy patients → avoid misunderstanding
– Checking drug administration “events” → diary, logs



Drug Prescriber Prescription Carrier

Knowledge Bus

Patient
Administrator Pharmacist
Objects

Actors
Knowledge
Drug Report of HMFD Report

Conclusions

“Serving Patients by serving Doctors and Institutions” but also
enabling patients to be active part in the healthcare process

→ home as the future environment/background for healthcare
→ ICT as supporting tool

Providing tools to actors in healthcare process:
Easily available (avoid digital-divide)
User-friendly interfaces (→ understandable to common citizens)
Remotely accessible
Able to ensure the expected level of privacy and security
Integrated in a meaningful and seamless way

With a final objective: offer a better level of healthcare
Both at family/individual than at global level

Questions

Thanks for your attention
luca.mazzola@lu.unisi.ch
luca.mazzola@polimi.it

Questions?

Towards Home Healthcare Informatics

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