Yi-ju Tseng*, National Taiwan University, Taipei, Taiwan, Province of China Feipei Lai, National Taiwan University, Taipei, Taiwan, Province of China Pei-chun Lin, National Taiwan University, Taipei, Taiwan, Province of China Chia-ping Shen, National Taiwan University, Taipei, Taiwan, Province of China Jui-hung Kao, National Taiwan University, Taipei, Taiwan, Province of China Jin-ming Wu, National Taiwan University, Taipei, Taiwan, Province of China Shih-ting Liu, National Taiwan University, Taipei, Taiwan, Province of China Weizhi Zhou, National Taiwan University, Taipei, Taiwan, Province of China Hani Ousamah Jamleh, National Taiwan Universtiy, Taipei, Taiwan, Province of China Chung-ping Charlie Chen, National Taiwan University, Taipei, Taiwan, Province of China Track: Practice Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Rapid-Fire Presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: C-Rotunda Room Date: 2012-09-15 11:00 AM – 11:45 AM Last modified: 2012-09-12

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Background: As the aging Taiwanese society is becoming significantly more health conscious, the perception to healthcare has been shifted from short term/single-event physician visit to long term enhancement program with preference to prevention. Chronic diseases, in particular, are becoming the prominent issue for many as the life expectancy of the public increases. Continuous care with personalized follow-up and nonstop condition monitoring is highly beneficial. To effectively deliver such care with constrained medical resources, a complete healthcare service solution is needed.

Objective: Our project provides an infrastructure towards a continuous and personalized healthcare service. We have constructed a comprehensive platform, integrating medical records from hospitals, self-managed health data, and information gathered from personalized web portal. The infrastructure heavily emphasizes the usage of mobile devices such as smart phones for both patients and physicians. Mobile applications for health management play a major role in our system.

Methods: Diabetes is classified as a typical chronic disease. In addition to general personal health record dietary record should also be documented. The American Association of Diabetes Educators (AADE) has been advocating actively the concept of AADE7 to change self-care behaviors in patients. AADE7 includes the seven evaluation items, namely; healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, and healthy coping. Our system assists patients in many ways including scheduling physical activities, planning meals, and providing medication reminders, to name a few. In addition, our system provides care for cardiac arrhythmia as well, such as the analysis of heart variability. With the cooperation and assistance of medical professionals, we have translated the medical knowledge needed to our information system successfully.

Results: According to the experiment we designed, the results reveal that the level of HbA1C in 66.6% patients in the intervention group is reduced compared to only 40% of the control group after three months. The platform not only assists patients in being actively involved in their own personal health records, but improves their health status as well. We also have built up a complete diagnosis system which has demonstrated its effectiveness and efficiency in solving problems such as cardiac arrhythmia detection in ECG. These signals are real-time processed in a smart phone and then forwarded to the Telecare provider’s server via 3G network or Wi-Fi for more in-depth analysis by cloud computation techniques. In addition, web service will link to our server for ECG anomaly detection system to read in the ECG data. The status of ECG data will be analyzed and then the results will be returned back to the smart phone of users promptly.

Conclusion: Our aim is to help patients with chronic diseases like diabetes and heart failure to record their medication information, vital signs, and behavior, and to interact with case managers. Eventually, the telecare system can assist people in maintaining a healthier lifestyle.