How far is one, a patient or not, able to live undisturbed in his/her daily life, at the same time to be under a doctor's care or observation, and to carry on his/her typical daily activities, while maintaining contact with his/her doctor anywhere when needed
"Hygeian Ultimate Service"(HUS), working in the Department of Thoracic and Cardiovascular Surgery of Konkuk University Medical Center, is Signal-Status-Activated, Remote-Monitored and Remote-Controlled, Home and Mobile CVD (Cardio-Vascular Diseases) Monitoring and Screening Service, which is based on the technical concept of "UBIQUITOUS".
Mark D. Weiser introduced the term ubiquitous - (seemingly) present, everywhere simultaneously - computing, stating that it: "represents a powerful shift in computation, where people live, work, and play in a seamlessly interweaving computing environment. Ubiquitous computing postulates a world where people are surrounded by computing devices and a computing infrastructure that supports them in everything they do."
Thus far, the HUS has not only the anytime-anywhere availability, but also the real-time/instant response availability, and so reduces time loss or lag (the time required for printing and sending paper or for human-based transmission of information causes delays that may represent a major reason for revenue loss), which leverages technology to reduce the gap between when data is recorded in a system and when it is available for information processing, to reduce medium cost (the use of humans as media, i.e., human "manual" intervention as well as the handling of large amounts of paper represent major cost factors in an enterprise) and inaccuracy or deficiency in the traditional medical data flow.
And it is not the mere linking of individuals to the Medical Center with some electrical devices. Owing to wireless sensors to acquire and transmit ECG in real time, and to gain and send vital signs, mental or physiological status, activities, and environmental conditions through mobile or home communication devices, we can respond to the signals instantly, and so, in view of the results so far achieved, the HUS makes the following benefits possible: Availability and accessibility of healthcare knowledge and expertise; Availability and accessibility of quality healthcare on a more equitable basis to underserved rural and urban areas; Comprehensive availability of ubiquitous clinical services, regardless of time, specialty, and geographical location; Availability of ubiquitous healthcare services for new and alternative (non-invasive) medical procedures; Savings for ubiquitous healthcare service providers and patients in procedural, travel, and claim processing costs; Reduced use of traditional emergency services; Improved non-emergency services; Decreased waiting time for non-emergency services; Greater awareness of services among rural and remote residents and caregivers; Availability and timely accessibility of critical information in the event of emergencies.
Therefore, IT in healthcare will have three different systems, which are destined for their convergence.
Health Management Information Systems have merely focused on the application of IT in order to replace manual clerical and information-processing tasks as well as to automate information flow models that were used to simulate organizational and managerial activities in healthcare. The pieces of the health management information systems were put together to offer a comprehensive view of how IT can be applied in healthcare organizations to facilitate efficient operational and tactical planning, administration, and evaluation.
Health Decision Support Systems have concentrated on the use of IT to extend the cognitive capacity and decisional expertise not only of health administrators and policymakers but also of clinicians, nurses, and other health professionals. Hence, it has moved one step forward from Health Management Information Systems in applying the power of IT not just to achieve information-processing efficiencies but also to enhance decisional effectiveness on tasks that are mostly semi-structured and complex. Briefly, the purpose of Health Decision Support Systems is to effectively enhance human thinking and extend human knowledge, to intelligently capture the interactions between end users and their health providers, and to creatively support organizational and clinical decision tasks
Now, Ubiquitous Healthcare Information System is in line because the application of IT in healthcare is not confined to individual caregivers or even patients and not limited only to health organizations and urban communities. Indeed, if IT in healthcare is to flourish, its applications must be further enhanced with the potential for reaching the masses, especially patients in chronic diseases who require regular supervision, those who are underserved, those who are elderly, and those who have no easy access to urban health care facilities.
The basic functions of the Ubiquitous Healthcare Information System are to gather and exchange appropriate and accurate data from various sources and to respond in real time to an individual in need, and to transmit medical information, knowledge, and relevant expertise to those who are in need of care. And so it works anytime, anywhere and always on.
The HUS as a ubiquitous system has several characteristics: using devices while the user's hands, voice, eyes or attention are actively engaged with the physical environment (Wearable); performing one or a few dedicated functions (Embedded); using technology in moving (Mobile).
And it will have other features as follows: connecting devices, embedded in such a way that the connectivity is unobtrusive and always available (Pervasive); linking changes in the environment with computer systems (Context-aware); perceiving its environment and reacting accordingly (Sentient); working in concert to support people, carrying out their everyday life activities, tasks and rituals in easy, natural way by using information and intelligence that is hidden in the network connecting these devices (Ambient).
The Healthcare Prosumers and the Ubiquitous Healthcare
For centuries the medical industry operated under the following proposition or premise: doctors are smart because they have education and hands-on experience, and patients are medically dumb because they have no relevant knowledge; doctors are "health providers" and patients still their "clients" or "customers."
Alvin Toffler in his book The Third Wave suggests that for most of the last 200 years, our society has been divided into two groups: the producers, who make or deliver our goods and services, and the consumers, who use them. He believes that one of the hallmarks of the new information age is the rise of a third group, prosumers, who produce many of their own goods and services. Thus while a consumer might go to the local McDonald's, a prosumer might shop at a local natural food store, pick some vegetables from a home garden, and whip up a tasty, nutritious meal. The term "healthcare prosumer" is a most fitting term for those of us who have a strong personal commitment to self-care. Three levels of self-care involvement can be described: People minimally, moderately, and strongly committed to self-care.
Health-active prosumers, strongly committed to self-care, are the ones who feel responsible for their own health, who believe that they can do more to keep themselves healthy manage illness problems than their doctors can. They're the ones that order the vegetarian special and the salad with oil and vinegar on the side. They have a much more realistic understanding of what doctors can and can't do. They know that heart disease risk increases with smoking, stress, high blood pressure, lack of exercise, and lack of social connections, and they no longer harbor unrealistic expectations of being "saved" from self-induced illness. They work hard at keeping themselves healthy because they know that if they fall ill, there may not be much their doctors can do.
If Health-active prosumer are clad in ubiquitous armor from head to foot, there is a dramatic change from current practice, which may happen in a dialectic manner or in dissipative but self-organized way. Alvin & Heidi Toffler in their book Revolutionary Wealth points out, 'unfortunately, well-intentioned reforms based on industrial-age assumptions only make matters worse. To cut costs, politicians typically seek "efficiencies" that translate into assembly-line health-care, a "managed" system offering one-size-fits-all, standardized treatment.'
Based on seamlessly coordinated health knowledge, including real world data with collaboration on a global scale, Ubiquitous Healthcare Prosumer will be under an end-to-end healthcare, from birth registries to "cause-of-death" registries, from prevention and screening to follow-up, from emergency intervention to home or mobile care.
