Intel® Technology Journal
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9/4/09 8:28:45 AM Intel® Technology Journal Technology Intel® SEPTEMBER 2009 in the Home Enabling Healthcare INTEL® TECHNOLOGY JOURNAL | ENABLING HEALTHCARE IN THE HOME VOL 13 | ISSUE 03 | SEPTEMBER 2009 35858 21143 77 ISBN 978-1-934053-23-2 9 781934 053232 $49.95 US Copyright © 2009 Intel Corporation. All rights reserved. Intel, and the Intel logo, are trademarks of Intel Corporation in the U.S. and other countries. Copyright © 2009 Intel Corporation. More information, including current and past issues of Intel Technology Journal, can be found at: at: Journal, can be found Technology Intel issues of and past including current information, More http://developer.intel.com/technology/itj/index.htm ITJ9-3_Cover_BFC_39spn_090409.indd 1 About the Cover Enabling Healthcare in the Home is the theme of the Intel Technology Journal, Volume 13, Issue 3. The physician in the foreground (1) is remotely performing a house call. The doctor is able to see the patient (2) and to obtain diagnostic information, such as blood pressure and pulse vitals. The patient is able to remain at home, which is helpful and efficient for those with ambulatory or transportation issues. Next door (3) is an elderly person who can safely live independently because the home is out- fitted with sensors (the yellow spots) that monitor motion. Family caregivers located elsewhere can be aware that this individual is performing routine tasks. Upstairs is (4) someone sleeping. Sensors measure nighttime activity, which can be an indicator of health risk. Also upstairs (5) is a child or an elderly person for whom reading is difficult. The child or elder can snap-shot a page and listen to the words. Thus, technology can enable healthcare in the home for all ages. ITJ9-3_Cover_BFC_39spn_090409.indd 2 9/4/09 8:28:46 AM Intel® Technology Journal | Volume 13, Issue 3, 2009 Intel Technology Journal Publisher Managing Editor Content Architects Richard Bowles David King Doug Busch Eric Dishman Program Manager Technical Editor Technical Illustrators Stuart Douglas Marian Lacey Richard Eberly Margaret Anderson Technical and Strategic Reviewers Steve Agritelley Alan Boucher Doug Bugia Doug Busch Eric Dishman Farzin Guilak Kristina Kermanshasche George Korinsky Brad Needham Kevin Rhodes Intel® Technology Journal | 1 Intel® Technology Journal | Volume 13, Issue 3, 2009 Intel Technology Journal Copyright © 2009 Intel Corporation. All rights reserved. ISBN 978-1-934053-23-2, ISSN 1535-864X Intel Technology Journal Volume 13, Issue 3 No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 750-4744. Requests to the Publisher for permission should be addressed to the Publisher, Intel Press, Intel Corporation, 2111 NE 25th Avenue, JF3-330, Hillsboro, OR 97124-5961. E-mail: [email protected]. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. 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Publisher: Richard Bowles Managing Editor: David King Library of Congress Cataloging in Publication Data: Printed in the United States 10 9 8 7 6 5 4 3 2 1 First printing September 2009 2 | Foreword Intel® Technology Journal | Volume 13, Issue 3, 2009 INTEL® TECHNOLOGY JOURNAL IMPROVING Healthcare THROUGH TECHNOLOGY AND Innovation Articles Foreword ���������������������������������������������������������������������������������������������������������������������������������������������������������������� 4 Powering Healthcare Visions: Taking Advantage of Complexity, Connectivity, and Consumerism ������������������������ 6 From People to Prototypes and Products: Ethnographic Liquidity and the Intel Global Aging Experience Study �������������������������������������������������������������������������������������������������������������������� 20 Adapting Technology for Personal Healthcare ����������������������������������������������������������������������������������������������������� 40 Healthcare IT Standards and the Standards Development Process: Lessons Learned from Health Level 7 �������������������������������������������������������������������������������������������������������������������������������� 58 Healthcare Information Integration: Considerations for Remote Patient Monitoring �������������������������������������������� 80 Personal Health Device Interoperability ������������������������������������������������������������������������������������������������������������� 104 A Common Personal Health Research Platform — SHIMMER™ and BioMOBIUS™ ��������������������������������������� 122 Gathering the Evidence: Supporting Large-Scale Research Deployments �������������������������������������������������������� 148 Assistive Technology for Reading ����������������������������������������������������������������������������������������������������������������������� 168 Developing Consumer and IT Platforms in a Regulated Medical Device Environment �������������������������������������� 188 Table of Contents | 3 Intel® Technology Journal | Volume 13, Issue 3, 2009 FOREWORD Douglas F. Busch Vice President Chief Technology Officer Digital Health Group Intel Corporation Fundamental medical science has made enormous strides over the past several Eric Dishman decades, and the length and quality of life in developed countries has improved Intel Fellow remarkably. However, trends in demographics, lifestyles, and treatment Digital Health Group practices are making our healthcare systems unsustainable. Improving access Intel Corporation to healthcare and controlling healthcare costs are two of the most contentious current issues in United States politics, and are a huge concern in most other countries also. Better use of technology in healthcare is an obvious strategy to help solve these problems by applying innovation to how and where we deliver care. Science and technology have been applied aggressively to clinical diagnostics and treatment. Diagnostic imaging, advanced surgical techniques, and sophisticated pharmaceuticals have all had strong positive benefits. We have not “Better use of technology in healthcare yet seen the benefits of applying everyday technologies that we take for granted in other aspects of our lives, though. Much attention is now being given to is an obvious strategy to help solve applying information technology to record keeping and communication in clinical settings. The recent American Recovery and Reinvestment Act (part these problems by applying innovation of the 2009 economic stimulus package) focuses strongly on deployment and to how and where we deliver care.” meaningful use of Electronic Medical Records. This is not enough. To really impact the availability and cost of healthcare, and improve the quality of our citizen’s lives, we need to shift some of the focus of healthcare from the clinical setting to the home. Just as much of banking has moved from marble lobbies filled with tellers to a self-service model enabled by technology, we can use readily-available technologies to move some aspects of healthcare from clinical settings to the home. We can also use technology to allow our aging population to stay in their homes longer, living independently. Both of these approaches have the potential to improve quality of life and reduce the cost of providing the healthcare and living assistance our population needs. We need to really understand how to use technology effectively