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/de With / SA Health Smart Diagnosis / 27 June 2013
TU/e SA Health – Smart Diagnosis
ICT System for Smart & Remote Diagnosis
Peter H.N. de With
Program director Smart Diagnosis & C3T
Professor Imaging and Analysis
DICE – 2 July 2013
/de With / SA Health Smart Diagnosis / 27 June 2013
Smart Interventions
• Molecular, Cell and Tissue Engineering
• Minimal Invasive Image guided intervention
• Gas Plasma Medicine
• Virtual Physiologic Human
Smart Diagnosis
• Imaging, processing & diagnostics
• Diagnostic & sensing devices in home care ICT
architecture
• Nanotechnology diagnostics
Smart Environment
• Staying healthy
• Empowerment in daily life
• Making healthcare sustainable
Focus programs Health@TU/e
SA Health

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/de With / SA Health Smart Diagnosis / 27 June 2013
Drivers for Smart Diagnosis Roadmap
• Dutch industry has a few good positions
• Imaging, sensing, embedded systems, ICT
• Healthcare budgets are about to be limited/frozen
• Severe downscaling in EU, declining spending power
• Dutch Government spending on R&D lowered
• ‘Graying’ society
• Increase in age-related dysfunctions and chronic diseases
• Need for dedicated services, tools, training, … for elderly
• Intrinsic roadmap alignment
• Topsector HTSM Chapter Health, version 2012 & 2013
• 3TU ICT Roadmap 2012
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/de With / SA Health Smart Diagnosis / 27 June 2013
Research objective: trend to home care
- 4 -
• Trend Northwest: lower costs for home care, even cost benefit
• ICT and Internet makes people more independent
• Technology for making this shift is there

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/de With / SA Health Smart Diagnosis / 27 June 2013
ICT/Internet :
Trend to transformation economy
- 5 -
• People become
organized in
groups/communities
• Groups address
local issues
• Various groups or
communities share
larger global
issue(s).
/de With / SA Health Smart Diagnosis / 27 June 2013
Smart Diagnosis Roadmap vision
• Smart diagnosis aims for unobtrusive methods which enable
fast reliable outcome and a shift from hospital to primary care
and to self-care.
• ICT infrastructure, sensing, embedded systems, imaging are
enabling technologies
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/de With / SA Health Smart Diagnosis / 27 June 2013
Smart Diagnosis fundamental issues
• Basic integrated ICT infrastructure for nomadic/home care is missing
• There is lack of control on data – personal privacy, security of data
• No integrated joint semantic models shared between institutions
• Citizens have to pay more themselves, want to be in control of data
• Connected to healthcare infrastructure, but person-centric
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/de With / SA Health Smart Diagnosis / 27 June 2013
Conceptual person-centric infrastructure
• Individual persons
• Stakeholder of his own health and life processes
• Human empowerment with personal processes & applications
• Life management desktop with personal and business services
• Personal data store
• Health (service) providers
• Loss of personal data, but access to anonymous data and
large-scale insight
• Possibility for intent casting, broad- or narrow-casting for
services
• Health App Builders
• Registered in health eco system
• Support personal health plan, or clinical path ways
• Fit to ‘Myhealthplan’, work flows
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/de With / SA Health Smart Diagnosis / 27 June 2013
ReLifE objectives
PAGE 9
SA Health
• ReLifE is personal health eco-system
• Integration Project Health ICT infrastructure
which is patient-centric
• Integrated patient & clinical pathways:
personalized processes
• Detailed Clinical Models and modeled
processes and DCM standards
• Patient empowerment
• Improved decision support through integrated
data storage concepts
• Integrated care system for stakeholders
• Health eco system governance
/de With / SA Health Smart Diagnosis / 27 June 2013
Learning &
Knowledge
Repository
SugarCRM
CALL
CENTER
Cisco VOIP
router
EHR
Health Coach
My Devices
MyData
Patient
Specialist GP
Analytics
Framework
Publishing
My Health
Portal
Social
Publishing
DCM
My Health Tablet
Complex
Event
Process’g
Nurse/Agent
Continua
Health
Alliance
social
care
MyHealthPlan
ReLifE
Apps

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Conceptual person-centric infrastructure
• Individual persons
- 11 -
/de With / SA Health Smart Diagnosis / 27 June 2013
ICT Infrastructure – Trust is key…
- 12 -

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/de With / SA Health Smart Diagnosis / 27 June 2013
ReLifE / Personal Data Store
/de With / SA Health Smart Diagnosis / 27 June 2013
Personal Data Store and Applications – (1)
• Personal data Store and Personal application layer
• Apps are crucial for the citizen
• easy to use
• Application layer is a way to:
• Connect all stakeholders in one single chain
• Create uniform trustworthy Health ICT infrastructure
• Participation of 1st and 2nd line care institutes should
be reached
• Participation in system and exploitation of patient data
• Large-scale apps: mental disorders, heart failure and
revalidation, colon/prostate etc. cancer
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/de With / SA Health Smart Diagnosis / 27 June 2013
Personal Data Store and Applications – (2)
• Vision fully aligns with
• Slimmer Leven 2020 in Brainport region
• Provinciale Staten Brabant: Notitie breedband comm.
• Smart Diagnosis wants to emphasize
• Large-scale health applications
• Create breakthrough in Health ICT infrastructure deployment
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/de With / SA Health Smart Diagnosis / 27 June 2013
ReLifE / Horizontal & vertical integration

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/de With / SA Health Smart Diagnosis / 27 June 2013
Catharin
a
Hospital
Maxima
Medical
Centre
GGD
GGzE
LHV
(national
GPs)
DOH
regional
GPs
Patient
commun.
Patient
/citizen@
home
Diagn4U
centre
Pharma-
cies
Example / Eindhoven care chain cardio case …
ReLifE involves 3 cases in 4 regions (Ehv, Waterford,
Copenhagen, Oslo): COPD, Heart, Mental/Epilepsy
ReLifE integrates all stakeholders into the system…
ReLiFE also integrates data of those stakeholders…
• Eindhoven cardio case involves CZH, MMC, RZCC, GPs, Patient
communities and at home…
/de With / SA Health Smart Diagnosis / 27 June 2013
Sensing devices home & nom. monitoring
• Use low-cost devices for diagnosis, support, monitoring
• Wearable
• Integrated services
• Build living lab conditions
• Examples
• Clinical decision support, automatic data gathering & models
• Sensors for life patterns and revalidation training
• Personal feedback
• Perfect area for the Brainport region
• World-class strength in Embedded Systems and emb. SW & ICT
• Fertile breeding place for SMEs and further stimulation
• Good fit between Companies and University
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/de With / SA Health Smart Diagnosis / 27 June 2013
Imaging for embedded applications & home care
2-7-2013 - 19
• Specific imaging at home & embedded
• Nomadic monitoring and diagnostics
• behavior & training, coaching
• Important focus areas
• Mental disorders (stress, dementia)
• Heart failure and cardio diseases
• Premature cancer detection (prostate, colon)
Concentrate on early stage diagnosis
• Chances for the Brainport region…
• TU/e is strong in multidisciplinary R&D
• Can be used for large-scale disease appli-
cations supporting gen. health
infrastructure
• Possible SME spin-off creation
/de With / SA Health Smart Diagnosis / 27 June 2013
Health Eco System – Maturity growth
- 20 -
Healthcare services grow mature over time: the patient
becomes stakeholder…

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/de With / SA Health Smart Diagnosis / 27 June 2013
Health Eco System – Conditions & Services
- 21 -
• Individual persons
• Owner health and
life processes
• Personal processes
and applications
• Life management
• Personal data store
• Match to the actual
personal status
• Every citizen a
Personal Health
Plan
/de With / SA Health Smart Diagnosis / 27 June 2013
Care communities are growing now ….
• RZCC: 4 hospitals, 80 pharmacies, 600 specialists,
400 medical doctors, 3 Million care messages/year…
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ReLifE / Possible operational structure t.b.d.
Advisory Board
ReLifE JV
company
SME app. 1
SME app. 2
SME
technol. 1
Certifi-
cation
process
Brainport
Eindhov.
TU/e,
Syngt
RZCC
Govern
mt. etc.
Board of
Commissioners
ReLifE
archi-
tecture
Indep. Q Control
Certifitic.
Institute
TU/e
Certific.
company
System Design is R&D, the operation becomes a
regional company pps, with quality control & certification
/de With / SA Health Smart Diagnosis / 27 June 2013
ReLifE conclusions
PAGE 24
SA Health
• ReLifE is personal health eco-system for all citizens,
patient-centric setup
• ICT infrastructure is a backbone, open architecture
connects third parties (standard interfaces & quality
• Integrates all stakeholders: hospitals, practitioners,
local carers, joint data platform
• Patient empowerment: control of own data store,
personalized processes
• ReLifE does not build EPDs, but integrates good
proposals of stakeholders
• Trustworthy and secure data storage
• Connects patient at home…