Advancements in pervasive computing in healthcare – Prospects and clinical applications

Demographic change leading towards elderly populations is expected in many countries in the world. The effects with regard to WHO’s potential support ratio (PSR) will be very similar in Germany and China (expected PSR in 2050: 2:1). The positive trend towards a rising life expectancy will bring about many challenges to health care systems, because elderly persons are more often affected by diseases or functional impairments. A review of current prediction data shows that the most important diseases of the future in terms of disability and loss of quality of life will be cardiovascular diseases, malignant diseases and neuropsychiatric diseases. Among the latter, unipolar depressive disorders are the most relevant ones. Apart from these ‘impairment-led’ considerations, primary prevention such as lifestyle changes should be addressed by pervasive health systems. When developing such systems, the integration into current and the design of future health information systems needs to be addressed. Decision support systems regarding all different sources of data and incorporating a standardized representation of medical decision logic are of paramount importance in this context.

Among the services of pervasive health and smart environment systems are emergency detection and alarm, disease management, health status feedback and advice, communication and social interaction, support for daily life and activities, entertainment, information and education. These services can be identified in exemplary current research systems, e.g. in rehabilitation training control for COPD patients, fall detection and prediction or smart-phone-based identification of bipolar depressive episodes.

Pervasive health systems using wearable technologies promise benefits in clinical or home environments, yet more clinical or field application studies are necessary as well as a sound concept for the integration into health information systems and their architectures. The author has founded an international working group for “wearable sensors in healthcare” (www.wearable-sensors.org) and invites all interested persons to join the group and its mailing list.

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