Source: INFORMATICS FOR HEALTH & SOCIAL CARE Volume: 33 Issue: 2 Pages: 77-89 Published: 2008
Times Cited: 3 References: 60 Citation Map
Abstract: Background. Progress in information and communication technologies (ICT) is providing new opportunities for pervasive health care services in aging societies.
Objectives. To identify starting points of health-enabling technologies for pervasive health care. To describe typical services of and contemporary ICT architecture paradigms for pervasive health care.
摘要：背景。進展信息和通信技術（ICT）的提供新的機會無處不在衛生保健服務老齡化社會。
目標。為了確定起點的健康有利的醫療保健技術的普及。為了描述的典型和現代信息和通信技術服務的體系結構模式的普及衛生保健。
Methods. Summarizing outcomes of literature analyses and results from own research projects in this field.
方法。總結成果的文獻分析和結果從自己的研究項目，在這一領域。
Results. Basic functions for pervasive health care with respect to home care comprise emergency detection and alarm, disease management, as well as health status feedback and advice. These functions are complemented by optional (non-health care) functions. Four major paradigms for contemporary ICT architectures are person-centered ICT architectures, home-centered ICT architectures, telehealth service-centered ICT architectures and health care institution-centered ICT architectures.
結果。基本功能為普及衛生保健方面的家庭護理包括緊急檢測和報警，疾病管理，以及健康狀況的反饋意見和建議。這些職能的補充，可選（非保健）的功能。四是當代信息和通信技術的主要範式架構是人為本信息和通信技術架構，以家庭為中心的信息和通信技術的體系結構，遠程保健服務為中心的信息和通信技術架構和衛生保健機構為中心的信息和通信技術架構。
Conclusions. Health-enabling technologies may lead to both new ways of living and new ways of health care. Both ways are interwoven. This has to be considered for appropriate ICT architectures of sensor-enhanced health information systems. IMIA, the International Medical Informatics Association, may be an appropriate forum for interdisciplinary research exchange on health-enabling technologies for pervasive health care.
結論。健康有利的技術可能會導致兩種新的生活方式和保健的新途徑。這兩種方式相互交織。這必須考慮適當的信息和通信技術體系結構的傳感器，加強衛生信息系統。伊米亞，國際醫學信息協會，可能是一個合適的論壇，跨學科的研究交流有關健康有利的醫療保健技術的普及。
Document Type: Article
Language: English
Author Keywords: health-enabling technologies; pervasive health care; ambient assisted living; sensor-enhanced health information systems; IMIA
KeyWords Plus: MEDICO-LEGAL MODEL; INFORMATION-SYSTEMS; PART 1; PATIENT RECORDS; SECTION; ELECTROCARDIOGRAPHY; INTEROPERABILITY; SUSTAINABILITY; CHALLENGES; PROGNOSIS
Reprint Address: Haux, R (reprint author), Tech Univ Carolo Wilhelmina Braunschweig, Inst Technol, Peter L Reichertz Inst Med Informat, Muehlenpfordtstr 23, D-38106 Braunschweig, Germany
Addresses:
1. Tech Univ Carolo Wilhelmina Braunschweig, Inst Technol, Peter L Reichertz Inst Med Informat, D-38106 Braunschweig, Germany
2. Hannover Med Sch, Hannover, Germany
3. Tech Univ Carolo Wilhelmina Braunschweig, Inst Technol, Inst Gerontopsychol, D-38106 Braunschweig, Germany
E-mail Addresses: Reinhold.Haux@plri.de
Publisher: INFORMA HEALTHCARE, TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND
Subject Category: Health Care Sciences & Services; Medical Informatics
IDS Number: 352LO
ISSN: 1753-8157
DOI: 10.1080/17538150802127140
文件類型：第
語言：英語
作者關鍵詞：健康，有利的技術;普及衛生保健;環境輔助生活;傳感器加強衛生信息系統;伊米亞
關鍵字加：法醫模型;信息系統第1部分;病歷;科;心電圖;互操作性;可持續性;挑戰;預後
轉載地址：歐村，住宅（轉載作家），布倫瑞克技術大學 Carolo威廉明娜，研究所技術，2008彼得L賴歇茨研究所醫學板機，Muehlenpfordtstr 23個 D - 38106 Braunschweig，德國
地址：
1。布倫瑞克技術大學 Carolo威廉明娜，研究所技術，2008彼得L賴歇茨研究所醫學板機，個 D - 38106 Braunschweig，德國
2。漢諾威醫學附表，漢諾威，德國
3。布倫瑞克技術大學 Carolo威廉明娜，研究所技術，2008研究所Gerontopsychol，個 D - 38106 Braunschweig，德國
電子郵件地址：Reinhold.Haux @ plri.de
出版商：Informa的醫療，電話樓 69-77保羅街，倫敦 EC2A 4LQ，英國
主題分類：醫療保健科學與服務;醫學信息
IDS的號碼：352LO
ISSN：1753-8157
個人主頁：10.1080/17538150802127140
Change and potential progress in health care are influenced by many factors.
Two important factors today are: (1) the continuously increasing life expectancy, leading to aging societies, with consequences for health care services [1,2]; and (2) progress in information and communication technologies (ICT), leading to new pervasive or ubiquitous ICT, providing new opportunities to support or even enable new types of health care services [3–13, see 14 and 15 for some broader perspectives].
變化和潛在的醫療保健方面的進展是受多種因素影響。
今天的兩個重要因素：（1）預期壽命不斷增加，導致老齡化社會，其後果對醫療服務的[1,2]和（2）進展信息和通信技術（ICT）的，並導致新無孔不入或無處不在信息和通信技術，提供新的機會支持，甚至使新類型的衛生保健服務 [3-13，見 14和15的一些更廣泛的觀點]。
In this context we wanted to explore answers to the following questions:
1. What are typical starting points to pervasive health care with respect to ICT architectures, leading to sensor-enhanced health information systems? Which major conflicts may occur? (Section 3)
2. What are typical services, resp. functions, offered by health-enabling technologies for pervasive health care? (Section 4)
3. Which are important contemporary paradigms for ICT architectures for health-enabling technologies? (Section 5)
4. Which are appropriate steps to obtain sustainable, efficient ICT architectures from the viewpoint of sensor-enhanced health information systems? (Section 6)
在這方面，我們要探索回答下列問題：
1。什麼是典型的出發點，以普及衛生保健方面的信息和通信技術架構，導致傳感器加強衛生信息系統？可能發生重大衝突哪？ （第3）
2。什麼是典型的服務，RESP的。功能，所提供的醫療應用技術的普及保健？ （第4）
3。哪些是重要的現代信息和通信技術體系結構模式為健康有利的技術？ （第5條）
4。哪些適當步驟，以取得持續，有效的信息和通信技術架構的角度傳感器，增強衛生信息系統？ （第6條）
The suggested answers are on the one hand based on some of the authors’ literature analyses in this field [10,16–18].
On the other hand they are results of discussions and outcomes of our own research projects in this field during the past years.
We felt that it may be useful to communicate the outcome of our investigations and to give reference to recent research.
Nevertheless there may be a certain subjective bias, particularly in identifying paradigms for ICT architectures
建議的答复是，一方面根據一些作者的文學分析，在這一領域 [10,16-18]。
另一方面他們的討論結果和結果我們自己在這一領域的研究項目在過去幾年。
我們認為，它可能是有益的溝通，我們的調查結果，以及最近的研究提供參考。
不過，可能會有一定的主觀偏見，尤其是在確定信息和通信技術的範例架構。
First, in Section 2, we try to outline why there is an urgent need to act today for exploring and assessing pervasive health care through health-enabling technologies.
In addition we summarize potential benefits and give an example for financial implications.
Finally, in Section 7, suggestions are made concerning international research exchange.
首先，在第二節中，我們嘗試勾劃出為何有迫切需要採取行動今天探討和評估，通過普及醫療衛生應用技術。
此外，我們總結的潛在好處和舉一個例子，對金融的影響。
最後，在第7條建議提出的關於國際研究交流。
2. Pervasive health care in aging societies
2。普適保健老齡化社會
In order to better understand the relevance of pervasive health care in aging societies, let us have a look at Tables I and II with recent data from the United Nations Population Division
為了更好地了解相關的醫療保健普遍老齡化社會，讓我們來看看表一和附件二的最新數據來自聯合國人口司
We can see in Table I that worldwide the number of persons, aged 15–64 years relative to the number of persons aged 65 years or older, is decreasing.
This potential support ratio (PSR) is an indicator for personal support.
It has decreased from 12 in 1950 to 9 for today and is estimated to become 4 in 2050. The data for Europe in Table II show that the PSR in this continent will probably even drop to 2 by 2050.
我們可以看到在表一，全球有多少人，年齡 15-64歲的人數相對於 65歲的人或老年人，都在下降。
這種潛在的支持比率（PSR）共同指標是對個人的支持。
它由12個下降到1950年9今天，預計在2050年成為 4。歐洲的數據表二顯示，在這個大陸的PSR甚至可能會下降到2，到2050年。
Both Tables also show the significantly increasing numbers of persons aged 80 years or older.
For the year 2050 these are estimated to be 4.4% of the population worldwide and to
approach 10% in Europe.
這兩個表也顯示著越來越多的人80歲或以上。
對於 2050年這些估計為 4.4％的人口和全球
方法10％在歐洲。
As mentioned in reference [19], most readers may well agree that we are fortunate to live today, in a world where life expectancy is higher than ever before in the history of humankind.
Yet, many might also agree that there is an urgent need to reshape health care for our rapidly changing societies.
Informatics support through health-enabling technologies leading to pervasive health care is one important option to be seriously considered.
正如上文提到[19]，大多數讀者可能會同意，我們有幸生活在今天，在世界上的預期壽命高於以往任何時候都在人類的歷史。
然而，許多人也許還同意有迫切需要重塑健康照顧我們迅速變化的社會。
信息支持通過衛生技術的領先，以使醫療服務是一個普遍的重要選擇加以認真考慮。
2.2. Potential benefits—Saranummi’s ‘3Ps’
2.2。潛在的好處，Saranummi的'3聚苯乙烯'
Potential benefits of such pervasive health care services have been recently described by Niilo Saranummi as the ‘3Ps’ [20]:
1. Pervasive technologies shall enable semantically integrated, interoperable platforms to access, communicate and store health data and the use of health-enabling technologies [13].
2. Personal services, using sensor technologies [21] for continuously measuring healthrelated data of an individual aim to support this individual in her or his specific health problems including disease management and prevention.
3. Personalized decision support, adapted, ‘tuned’ to the individual’s norm, not to averages in populations, has the potential to lead to more specific care for an individual.
Considering an individual’s norm is of particular importance for the elderly [22].
這種普遍的潛在好處的醫療服務已被形容尼洛Saranummi最近的'3牧師'[20]：
1。普遍的技術，應當使語義集成，可互操作的平台，接入，數據通信和存儲的健康和使用醫療應用技術 [13]。
2。個人服務，利用傳感器技術 [21]，不斷測量健康相關數據的個人目的，以支持這個人在她或他的具體的健康問題，包括疾病管理和預防。
3。個性化決策支持，適應，'調整'的個人的規範，而不是平均的人口，有可能導致更多的具體照顧個人。
考慮到個人的規範，是特別重要的老人[22]。
2.3. Potential financial implications—an example
2.3。潛在的財務影響，例如
To our knowledge financial implications of pervasive health care using health-enabling
technologies is under researched and this is unfortunate.
We can, however, get a rough estimate of the possible economic impact of new health-enabling technologies, based on current figures from the German Federal Statistical Office (Statistisches Bundesamt) [23]with respect to health care in Germany.
就我們所知的財政影響的普遍使用衛生保健啟用
技術正在研究，這是不幸的。
我們可以，不過，得到一個粗略的估計可能出現的經濟影響的新的醫療應用技術，根據目前的數字，德國聯邦統計局（Statistisches Bundesamt）[23]關於醫療保健在德國。
Using the statutory rates for the three different care levels we can calculate the amount of money paid by the German care insurance (Pflegeversicherung) in the year 2005.
For the 665761 persons living in nursing homes 814 million Euros were paid from this type of insurance, and 335 million Euros for the 471 543 persons who lived at home and received assistance from professional nursing services.
The estimated average stay in a nursing home is expected to be 3 years, resulting in about 221 920 people moving to nursing homes per year.
Let us assume new health-enabling technologies could delay the admission to a nursing home for 3 months.
Let us further assume these 3 months are just shifted from nursing home to ambulatory professional nursing services.
This would result in a monthly saving of 511.56 Euros per person and month concerning this care insurance.
Multiplying these calculated values we end up with a potential overall saving of *340 million Euros per year in Germany.
These are just the savings for this care insurance, not taking into account further costs of nursing homes [24].
For the overall savings, the costs for required new technologies have to be subtracted from these possible savings.
使用法定稅率為 3個不同的護理水平，我們可以計算的數額的錢支付了德國醫療保險（Pflegeversicherung）在2005年。
為 665761人生活在養老院支付了8.14億歐元從這種類型的保險，和335萬歐元的471 543人誰住在家裡收到的援助和專業護理服務。
估計平均入住養老院預計為 3年，造成約 221 920人轉移到療養院一年。
讓我們假設新的健康有利的技術可能會推遲進入療養院 3個月。
讓我們進一步假設這 3個月只是轉移至家中日間護理專業護理服務。
這將導致每月節省 511.56歐元每人每月就這一醫療保險。
這些計算值乘以我們最終與一個潛在的整體節能 * 340萬歐元，每年在德國。
這些僅僅是儲蓄這個醫療保險，沒有考慮到其他費用療養院 [24]。
對於整體儲蓄，成本所需的新技術都必須減去這些可能的節餘。
Although a simple and very rough approximation, this calculation may demonstrate the
economic impact that new health-enabling technologies might have on health care. Compared with the same figures from the 2003 statistics, the amount of potential savings is increasing.
A projection to the year 2020 shows an increase in the number of people in Germany, who are in need of care, from 2.04 million in the year 2001 to 2.83 million.
In the same period their percentage of the total population will increase from 2.5% to 3.4% [25].
雖然簡單，很粗略的估計，這可能表明計算
經濟影響，新的健康有利的技術可能對衛生保健。與前相同的數字從 2003年的統計，節省的金額可能增加。
甲預測到2020年顯示了增加的人數在德國，誰的需要照顧，從 204萬在2001年的2.83億美元。
在同一期間，在總人口中的比例將增加至2.5％至3.4％[25]。
In the face of the aging population in Europe and all other continents with increasing costs
for care for the elderly the necessity of all kinds of health-enabling technologies becomes
evident.
在面對人口老齡化在歐洲和其他大陸的所有費用增加
為照顧老人的必要性，各種形式的健康有利的技術成為
明顯。
3. ICT architectures: approaches and conflicts
3。信息和通信技術架構：方法和衝突
