Towards remote monitoring and remotely supervised training
Towards remote monitoring and remotely supervised training
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DOI：
10.1016/j.jelekin.2008.10.004
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发表时间：
2008-12-01
影响因子：
2.5
通讯作者：
Vollenbroek-Hutten, Miriam M. R.
中科院分区：
文献类型：
--
作者：
Hermens, Hermie J.;Vollenbroek-Hutten, Miriam M. R.
在我们西方社会，越来越多的老年人和慢性病患者给我们的医疗体系带来了如此大的压力，以至于需要创新的方法来使我们的医疗保健更有效、更有效率。创新医疗保健的一种方式是引入新的服务，支持和使这些老年人和慢性病患者能够更独立地生活，并自我管理他们的疾病。这类服务的例子是远程监测和远程监督培训(RMT)。远程监测侧重于持续监测健康状况，并保证在需要时提供援助。远程监督培训侧重于高效、有效、随时随地为个人量身定做的培训，其强度在校内环境下是不可行的。预计远程监测和远程监督治疗服务将变得至少对患者(安全、更可控、方便)、医疗保险(效率、成本降低)和医疗服务提供商(更有效的护理)变得重要。RMT系统通常是相当复杂的分布式信息和通信技术(ICT)系统。RMT系统集成了移动感应来测量相关的生物信号和(可能)受试者的背景信息，安全的数据传输和存储，适当的决策支持系统，以协助技术和临床决策，并向患者和护理提供者反馈信息。对于患者来说，反馈对于让他们意识到自己的健康状况，给他们一种安全感，以及激励和使他们能够改变/改善自己的健康状况是必不可少的。向医疗保健专业人员反馈信息使他们能够做出适当的决定，并监控患者健康状况的变化/改善。尽管表面上很复杂，但这些系统必须非常可靠，才能在医疗保健环境中被接受和使用。在过去的几年里，随着RMT系统的构建块的发展，获得了知识和经验。同时，在临床环境中使用RMT系统所涉及的挑战方面也获得了经验。例如：下腰痛的活动监测，痉挛的监测，颈、肩和下背痛受试者的肌肉反馈，以及康复后的家庭训练。到目前为止，主要的焦点一直是它的传感和传输部分的技术实现。智能决策支持系统的开发仍处于起步阶段，如何实施这些服务以及如何使其盈利的临床验证研究和模型在很大程度上是滞后的。总之，生物医学工程与信息和通信技术的结合开辟了一个新的广泛的研究和开发领域，具有对我们未来医疗保健产生重大影响的巨大潜力。(C)2008爱思唯尔有限公司。保留所有权利。
The growing number of elderly and people with chronic disorders in our western society puts such a pressure on our healthcare system that innovative approaches are required to make our health care more effective and more efficient. One way of innovating healthcare call be obtained by introducing new services that support and enable these elderly and people with chronic disorders in a more independent living and in self management with respect to their disorders. Examples of such services are remote monitoring and remotely supervised training (together RMT). Remote monitoring focuses on continuous monitoring of the health status with the assurance of assistance whenever required. Remotely supervised training focuses on efficient and effective individually tailored training anywhere and anytime with intensity not feasible in an intramural setting. It is expected that services of remote monitoring and remotely supervised treatment will become important for at least patients (safety, more in control, convenience), health care insurances (efficiency, cost reduction) and healthcare service providers (more effective care).RMT systems are in general quite complex distributed Information and Communication Technology (ICT) systems. RMT systems integrate ambulant sensing to measure relevant biosignals and (possibly) subject's context information, secure data transport and storage, appropriate decisions support systems to assist in both technical and clinical decision making but also feedback on information to both patients and care providers. Feedback is essential for patients to make them aware of their health status, to give them a feeling of safety and to motivate and enable them to change/improve their health status. Feedback of information to healthcare professionals enables them in making appropriate decisions and to monitor changes/improvements in a patient's health status.Despite this apparent complexity, these systems must be very dependable to be accepted and used in a healthcare setting. During the past years knowledge and experience has been gained with the development of the building blocks of RMT systems. In parallel, experience has been gained with respect to the challenges involved when using RMT systems in a clinical environment. Examples are: activity monitoring in low back pain, monitoring of spasticity, myofeedback in subjects with neck shoulder and lower back pain and post rehabilitation home training. Until now, the main focus has been on the technical realization of the sensing and transportation part of it. The development of intelligent decision support systems is still in its infancy and clinical validation studies and models how to implement these services and how to make them profitable are largely lacking.In conclusion, the combination of Biomedical Engineering with Information and Communication Technology has opened a new extensive area of research and development with a high potential to have substantial impact on our future healthcare. (C) 2008 Elsevier Ltd. All rights reserved.