Ubiquitous healthcare

Tatara, N., Koizumi, H., Mino, S., Hayashida, S., Aihara, K., et al., 2007. A novel blood pressure monitoring device for ubiquitous healthcare services. In Proceedings of the 29th Annual International Conference of the IEEE EMBS, Lyon, France. 

Ubiquitous Healthcare A Fundamental Right in the Civilized World... 

Asia-Pacific Ubiquitous Healthcare Research Centre, University of New South Wales, Australia... 

Ubiquitous healthcare (u-Health) is the next step to electronic health (e-Health) that is becoming a major agenda in the goals of international development to help bridge the gap between developed and developing countries. Until recently, approximately 40% of the population in developing countries have not had basic healthcare. In this domain, computer communication technologies could play a major role, as per the recent e-Health communique from the World Health Oi anization (WHO) [ 1 ]. 

Y. T. Zhang, C. C. Y. Poon, S. D. Bao, and K. C. Liu, A wearable and cuffless device for the continuous measurement of arterial blood pressure, in Proceedings of the International Ubiquitous-Healthcare Conference, Korea, 2004. 

As shown in Table 28.2, the three types of AR are complementary. For example, VSAR violates user privacy however, WSAR and OUAR do not violate privacy. OUAR is usually limited to the home environment, whereas WSAR and VSAR can work outside home. In our ubiquitous healthcare (uHealthcare) project, we tried to combine these three approaches for our uHealthcare applications [34-35]. 

Extending the scope of already ubiquitous promotions about "post-nasal drip, unsightly rashes, or cures for baldness has little to do with educating patients or relieving suffering. It will, however, inevitably drain healthcare dollars, dramatically increase unnecessary prescribing, and strain patient-doctor relationships. ... 

In healthcare, we are today at a crossroads of yet, another of many notable technical developments. Personal computers have become ubiquitous and easier to use for healthcare professionals and patients. The newly available mobile or handheld devices have become more practical for real-time computing. Through the Internet or hand-eld device, there is ready access to a patient s medical information. With these tools, the art of practicing medicine is truly about to change. An electronic information resource for the Internet and for handheld devices, as for other platforms, requires that the data meet specific standards of reliability. First DataBank information is tried and true, a tested, authoritative source of such information. 

Healthcare in remote regions of the world, and in remote parts of many developed countries, is poorer than in urban areas. This is due to shortages of trained personnel, medical facilities, funds, data communications, and many other things, including health records. All these factors are not "ubiquitous," at least not in remote regions. 

Health data are collected either by the individual or by healthcare workers who interview and evaluate the individual. The data are stored on paper and/or on a local electronic system and/or on a distant electronic system. Table 14.1 gives a few examples [4-5], including some which are "almost PHRs" or almost ubiquitous. 

Constraints in Remote Regions Healthcare Workers and the Web Are Not Ubiquitous... 

Even developed countries such as the United States and Australia acknowledge a shortage of qualified healthcare workers in remote regions. The situation in developing countries is not better. Therefore, PHRs which require the participation of healthcare workers struggle to be ubiquitous in such remote regions. 

The disadvantages of paper medical records filed in private clinics or hospital store rooms have been discussed many times, but those systems do not pretend to be PHRs. The paper records kept by patients in Vietnam, parts of Africa, or Sarawak (East Malaysia) are still not quite ubiquitous. Data entry is by healthcare workers during meetings with the patients, so it is episodic and not ubiquitous in time. The records are accessible wherever the patient is (or has them) but not by anyone remote from the patient, so they are not ubiquitous in location. 

Most of these systems allow data to be collected by the individuals (anytime) and by healthcare workers (during encounters with patients), which makes them ubiquitous in that respect. Some also allow data collection from registered devices. Being web based, for data retrieval they are ubiquitous as far as the web is concerned. 

Although many apps appear in such a search, few of them are comprehensive PHRs. Some of those are specialized or are related to specific healthcare organizations. One, motion-PHR Health Record Mngr (at https //play.google.com/store/), claims to be a ubiquitous... 

Connected devices can upload health records to a central online server. Whether such systems are ubiquitous depends on where the data are stored, and that depends partly on who collects the data (Table 14.1). Healthcare workers mostly work for organizations which have web-based health records, as the following examples show they rarely store PHRs on mobile devices. In addition, the devices used by healthcare workers generally stay with them, so are not available to their individual patients at any time. 

The OpenMRS project (http //www.openmrs.org/) is an outstanding example of this approach to ubiquitous health records. Its purpose is to provide healthcare support in developing countries, and one of if s outstanding features is the facility for remote data collection using handheld devices. Although at first it was developed to provide tracking and treatment of HIV in Africa, lafer it became general-purpose software that supports many kinds of medical freafmenfs. 

The lack of ubiquitous availability of the web and of healthcare workers implies that the only way to achieve a ubiquitous PHR for remote regions, such as that shown in Figure 14.2 [18-19], is to utilize what is available, i.e., the people themselves and the existing communication network (which in most places is at least a GSM network). This happens to be quite compatible with many government initiatives toward patient participation and self-monitoring. 

The aim of this chapter has been to try to demonstrate that making PHRs really ubiquitous in remote regions requires extra effort. The regional shortages of healthcare personnel and of Internet connectivity mean that PHRs must be in the hands of the local inhabitants, on devices which are always available to them (i.e., mobile phones), and that PHRs must be able to communicate with the online world through simple mobile networks. PHRs should also include important contextual information for diagnosis and epidemiology. 

Industrial gases have become over a period of more than a century ubiquitous ingredients of our daily activities, e.g. metal fabrication, metallurgy, petrochemicals, food processing, healthcare, and many more. 

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