"Healthcare & public health: Perspectives on wearable computing, augmented reality and the veillances"

Abstract

In the past decade during IEEE sponsored professional meetings2, 3the theme of “Global Health Transformation through true Interoperability” was brought to the forefront in the inaugural keynotes. Some technologies that started with the monitoring of hemodynamic variables of astronauts by NASA in the 60s were further developed by the Department of Defense for the purposes of treating their injured in the battlefield via Telemedicine. By August 5th, 1997 President Clinton signed the first piece of legislation that was allowing the concepts of homecare to be tried to measure cost and medical effectiveness. With the development of Internet, the World Wide Web (WWW), social media, intelligent agents, mobile technology, sensors, and pieces of clothing containing them a new generation of devices have been created offering new possibilities for improvements particularly in areas such assist of living (for those suffering from chronic conditions), and homecare in general. The use of wearable computing in general and the use of augmented reality in the developed world in particular offer some unique opportunities to improve outcomes. In the 21st Century and as the Health Care and Public Health infrastructure intersect deeper into the many Information Technology (IT) subfields, abundant and formidable changes can occur that will allow society to shift current systems into some where wellness and disease prevention will be the focus. Many changes can affect positively medical and cost effective outcomes as well as the elimination of medical errors and patient safety for example. In these arenas, with the convergence of science, technology and with Information Technology acting as a catalyst for change, health care systems around the world are slowly shifting from “hospital based” ones into distributed systems that include: hospitals, clinics, homecare systems with treatment and management of chronic diseases for the elderly via Internet, etc. In order to achieve such visions, multiple efforts have been tried for creating electronic health record as well as the information highway for their use. In the US the health system is very scattered and most hospital systems do not contain for example mental health, dental health and or vaccine registry information. On one hand through major medical research the emergence of clinical and health data repositories or “Intelligent Data Warehouses” that not only include traditional clinical data, but also advanced imaging, molecular medicine, tissue micro-array analysis and other bioinformatics information is available. These increasingly multi-modality data warehouses are constantly updated, continuously expanded and populated with millions of records. Although these repositories of electronic information can be leveraged not only to improve point of care clinical decision-making for individual patients, they can also support population health chronic and infectious disease analytics (i.e., epidemiology and surveillance), cost efficient multi-center (e.g., and multi-country) clinical trials, and comprehensive post-market pharmaco-vigilance. On the other hand the integration of healthcare and public health is a major concern as well. Globalization (i.e., the interdependencies that each country has with many others) for example has raised the sense of awareness through “the information highway”. In 2004 the total production of flu vaccines coming to the US from the UK's Chiron had to be thrown away (approximately in the range of 42 to 44 million vaccines).