iHealth

由于人口老龄化和公民生活方式的选择导致慢性疾病的迅速增加，NHS正面临着需求的增加。目前的风险管理方法和医疗服务模式无法有效管理这一需求。我们管理健康的方式需要逐步改变，但这种改变受到许多因素的阻碍。它们是：(i)以各种形式存在的大量碎片数据；（ii）数据分析有限，在收集、分析和可用性之间存在时间滞后；过时的保健提供模式强调并奖励疾病管理，很少鼓励及早发现和控制风险；（iv）在提供护理时决策支持不足，从而对患者护理的质量和安全产生不利影响。我们的目标是开发动态的，个性化的医疗保健服务模式，充分整合个人健康信息，并使用优化方法来改善健康。我们项目的目标是通过观察信息和通信技术（ICT）的潜力来测试这一愿景，在真实的环境中改善健康和改变护理提供，创造新的个性化护理提供模式，通过信息驱动的健康来帮助提高医疗保健的质量和安全性。具体来说，在这方面，我们将在帝国理工学院的实际环境中测试以下方面的可行性：(i)从各种来源获取和整合数据；（ii）创建能够容纳大量数据的数据库，并结合先进的计算、分析和统计方法进行分析；（iii）在需要时向卫生专业人员提供相关信息；（iv）应用这些信息优化护理服务。该项目包括四个相互关联的工作包，旨在测试在实际环境中实现上述目标的可行性。帝国理工大学在英国几乎是独一无二的，因为它是一所世界知名的大学，主要研究领域是基础医学，再加上工程和物理科学的主要优势。然而，除此之外，帝国医院通过其附属医院，拥有一个主要的临床基地。随着新的学术健康科学中心的发展，学院的基础研究活动现已正式与临床活动相结合。因此，帝国理工学院是开展信息通信技术在医疗保健领域应用的详细研究的理想机构。在这方面，本申请故意仅以帝国理工学院及其附属医院的工作人员为基础。第一个工作包将在系统、内脏、组织、细胞、蛋白质和基因水平（在该项目中称为“生物连续体”）上解决“垂直整合”医学问题。这一概念将与初级、二级和三级临床医学的“横向整合”提供（在该项目中称为“护理连续体”）有关。第二个WP将解决有关数据、数据库和数据挖掘的问题。第三个工作计划将考虑用于决策的信息使用，以及使用优化技术和建模来开发自动化决策支持系统。通过在真实环境中的探索性研究，第四个工作计划将研究个性化和优化护理服务的整个问题，以及这与临床实践和新护理服务模式的发展之间的关系。我们将使用互动研讨会，绘制帝国理工学院现有研究和活动的地图，以确定差距和挑战，以及使用计算机模拟练习和观察研究进行探索研究。为了使该项目的工作切实可行，我们将把重点放在一些与心血管疾病和糖尿病有关的案例研究上，这些疾病是卫生和保健部门和国民保健服务的优先领域。

The NHS is facing increases in demand due to rapid rise in chronic illnesses driven by an ageing population and lifestyle choices of citizens. This demand is not effectively managed by the current risk management approaches and care delivery models. A step change is needed in the way we manage health, but this change is hindered by a number of factors. These are: (i) large amounts of fragmented data which exist in various forms; (ii) limited data analysis with time lags between collection, analysis and availability; (iii) outdated care delivery models which emphasise and reward management of disease, with few incentives for early risk identification and control, and; (iv) inadequate decision support at point of care delivery, with consequent adverse impact on quality and safety of patient care.Our aim is to develop dynamic, individualised healthcare delivery models that fully integrate personal health information and use optimisation approaches to improve health. The objective of our project is to test this vision by looking at the potential of l information and communications technology (ICT) to improve health and transform care provision within a real context to create novel individualised care delivery models that will help to improve the quality and safety of healthcare through information driven health. In this regard, specifically, we will test in real setting, at Imperial College the feasibility of: (i) data capture and integration from various sources, (ii) the creation of databases that can accommodate vast amounts of data coupled with advanced computing, analytical and statistical methods for analysis, (iii) making available relevant information to health professionals when needed, and (iv) applying this information to optimise care delivery. The project comprises four interlinked work packages (WPs) designed to test the feasibility of achieving the objectives described above in a real setting. Imperial is almost unique in the UK because it comprises a world renowned University with major research activity in Basic Medical Science, coupled to major strengths in both engineering and physical science. However, in addition, Imperial, via its associated hospitals, has a major clinical base. With the development of the new Academic Health Sciences Centre the basic research activities of the College are now being formally integrated with clinical activities. Hence, Imperial is the ideal organisation to carry out a detailed study of the application of ICT to healthcare. In this regard, this application is deliberately based only on the staff of Imperial College and its associated hospitals.The first work package will address the issue of 'vertically integrated' medicine at the systems, visceral, tissue, cell, protein, and gene levels (described in the project as the 'biological continuum'). This concept will be addressed in relation to 'horizontally integrated' delivery of clinical medicine at the primary, secondary and tertiary levels, (described in the project as the 'care continuum'). The second WP will address issues around data, databases and datamining. The third WP will consider information use for decision making, and use of optimisation techniques and modelling to develop automated decision support systems. Through an exploratory study in real setting, the fourth WP will study the whole issue of individualised and optimised care delivery, how this relates to clinical practice and the development of new care delivery models. We will use interactive workshops, mapping of existing research and activities at Imperial to identify gaps and challenges, and exploration studies using in-silico simulation exercises as well as observational studies. In order to make the work of the project realistic, we will focus on a number of case studies relating to cardiovascular disease and diabetes, disease which are priority areas for HMG and the NHS.