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P5 Ehealth: an Agenda for the Health Technologies of the Future Gabriella Pravettoni Stefano Triberti Editors P5 eHealth: An Agenda for the Health Technologies of the Future P5 eHealth: An Agenda for the Health Technologies of the Future Gabriella Pravettoni • Stefano Triberti Editors P5 eHealth: An Agenda for the Health Technologies of the Future Editors Gabriella Pravettoni Stefano Triberti Department of Oncology and Department of Oncology and Hemato-Oncology Hemato-Oncology University of Milan University of Milan Milan, Italy Milan, Italy Applied Research Division for Cognitive Applied Research Division for Cognitive and Psychological Science and Psychological Science European Institute of Oncology (IEO) European Institute of Oncology (IEO) IRCCS IRCCS Milan, Italy Milan, Italy ISBN 978-3-030-27993-6 ISBN 978-3-030-27994-3 (eBook) https://doi.org/10.1007/978-3-030-27994-3 © The Editor(s) (if applicable) and The Author(s) 2020. This book is an open access publication. Open Access This book is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made. The images or other third party material in this book are included in the book’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the book’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG. The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface The idea of this book emerged within the discussion of the implementation and resources of a Europe-funded project (IManage), especially regarding the utiliza- tion of an eHealth platform. eHealth is regarded as a fundamental resource for care nowadays, to the point that a growing number of scientific publications involve some form of web-based and/or immersive technologies devoted to improve patient adherence to treatment and healthy activities, patient education, and even the moni- toring of mental health outcomes such as stress, emotions, as well as biases poten- tially affecting health-related decision-making. However, by analyzing the literature on these topics, we realized that eHealth evolution still tends mostly to the implementation and exploitation of technological advancement, but the consideration of behavioral, psychological, and emotional aspects often remains on the background. Some years ago, the first editor of this book proposed the concept of P5 medicine, by adding one-fifth requirement for the evolution of medicine to the original ones in the well-known P4 approach. This last P was related to psycho-cognitive characteristics of patients; specifically, besides being preventive, personalized, predictive, and participatory, medicine should become able to: 1. Engage patients in personalized treatment as well as management plans: patients should become competent, active, responsible managers of their own health 2. Analyze and improve quality of life not as a secondary but as a primary objective of the care process In order to achieve such aims, medicine should turn to psychology and cognitive sciences in order to understand how patients interpret and use information on their own healthcare and also how they do develop intentions and behavior which could be more or less useful toward their health and wellness improvement. Also, health- care should develop and master its own techniques and psychometric instruments to be included in care practices to account for these aspects. Originally, the P5 approach as described here was not explicitly related to tech- nology, but of course, eHealth constitutes an unprecedented opportunity to pursue all the five Ps within the healthcare process. In light of this concept, the present v vi Preface book is aimed to give examples, guidelines, suggestions, and methods to achieve the development of health technologies able not only to support health management but also to capture and exploit the personologic uniqueness of each individual. In the contemporary scenario, where the main challenge faced by the healthcare systems worldwide is not to cure a specific disease but to support the management of incurable, chronic conditions and to guarantee long-term care to patients and survivors, such approach could be crucial to ensure that health technologies will be used and demonstrate their utility in the long term. In this book, each one of the 5 Ps will be explained in depth by the authors with a specific expertise, with a focus on how they could be achieved through the use of specific health technologies; secondarily, other contributions will explore important aspects of eHealth design, implementation, and management. Chapter 1, written by the editors of this book, will present the P5 approach and link it to eHealth, along with a short resume of health technologies themselves and considerations about their present and future. Chapter 2 will present the IManage project and its technologies, in order to elab- orate on them as an example of eHealth platform that has been designed and will be improved exactly on the basis of the P5 approach. Chapter 3 will explore the first P, namely, prevention: the opportunities of new technologies for the forecast of future diseases and health issues will be described. Chapter 4 will explore the concept of personalized medicine and will show that digital media can be used by patients both to express themselves and to communi- cate with health providers and by health providers to better comprehend patients’ personal experience. Chapter 5 will be focused on computational model and approaches to analyze and interpret data in order to predict future state of patients and illnesses; according to recent studies, this could be done not only with genetic and anatomical data but also with psychological and behavioral information. Chapter 6 will present and comment on examples of specific technological fea- tures (coming from IManage technologies again and from other digital solutions) that could be used effectively to promote the active participation of patients to their own care, in order to advance toward activation and engagement. Chapter 7 will explore the psycho-cognitive characteristics of patients, by remarking upon the importance of them in diagnosis and intervention; secondarily, persuasive technologies will be presented as one possible resource toward the implementation of behavioral and cognitive strategies within the technologies them- selves, in order to promote positive behavioral change in patients. Chapter 8 will present innovative technologies used in oncology and cancer care; indeed, also, diagnostic and research technologies should be taken into consider- ation when considering health technologies. Chapter 9 will provide a brief history of the disciplines related to technology evaluation (e.g., ergonomics, usability, user experience), in order to promote the adoption of state-of-the-art methodologies for the design and evaluation of P5 eHealth solutions. Preface vii Chapter 10 will explore ethical issues related to the adoption of different health technologies (e.g., privacy) and suggest ways to effectively deal with them at an organizational level. In the end, the objective of the present book is to set the grounds for the further development of P5 as a concept able to guide the growth of medicine, as well as the virtuous utilization of technological tools with the aim of improving human health and well-being. Milan, Italy Gabriella Pravettoni Stefano Triberti Contents Part I Foundations for P5 eHealth 1 A “P5” Approach to Healthcare and Health Technology . 3 Gabriella Pravettoni and Stefano Triberti 2 The Development of iManageCancer: The Experience of a Personalised eHealth Platform for Cancer Patients’ Empowerment ������������������������������������������������������������������������������������������ 19 Chiara Crico and Chiara Renzi Part II The 5 Ps and eHealth 3 The Prevention of Chronic Diseases Through eHealth: A Practical Overview . 33 Dario Monzani and Silvia Francesca Maria Pizzoli 4 An Introduction to Personalized eHealth ���������������������������������������������� 53 Valeria Sebri and Lucrezia Savioni 5 Predictive Precision Medicine: Towards the Computational Challenge �������������������������������������������������������������������������������������������������� 71 Cosimo Tuena, Michelle
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