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Keynote |
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A
Road to Disease Prevention through Telemedicine and eHealth
Prof. Luis Kun
Ph.D.,
FAIMBE, FIEEE
Senior Research Professor of Homeland Security
National Defense University / IRMC
Fort Lesley McNair Washington, DC 20319
Phone: 202-685-2786 - fax: 202-685-3827
Chairman Global Citizen Safety and Security WG - IFMBE
Founding Chair Critical Infrastructure Protection Committee IEEE-USA
Founding Chair Bioterrorism & Homeland Security WG -Medical
Technology Policy Committee
American Association of Engineering Societies (AAES) Board of
Directors
IEEE Society on Social Implications of Technology - Board of
Governors
Abstract
For the past thirty years the author has worked in environments
(industry, government and academia) where multiple efforts have
been tried for creating an electronic health record as well as
the highway for its use. All along technical, social and
economic forces have raised multiple challenges. The transition
from a paper based system to an electronic one is or was a major
one, however, the standardization of a “unique – interoperable –
format” has been as daunting. Helped by a very large “moving
population” the healthcare system in the US has shifted from a
“hospital based” one into a distributed one that includes
homecare system with treatment and management of chronic
diseases for the elderly via Internet. In parallel from major
medical research the emergence of clinical and health data
repositories or “Intelligent Data Warehouses” that contain not
only include traditional clinical data, but also advanced
imaging, molecular medicine, tissue micro-array analysis and
other bioinformatics information. 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 pharmacovigilance. Many believe that
the next generation Longitudinal Health Record (LHR) will be
able to acquire multi-modality medical data, fuse it into
clinical records along with laboratory, anatomical pathology,
pharmacy, imaging and even bio-molecular data; and create from
the existing EHR. Some major roadblocks are the privacy and
confidentiality of these information as well as the ethical
issues surrounding it. 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”. During and since 2007 the US public has
learnt through successive media stories related to: the death of
pets due to food-import contamination, children’s toys imports
containing lead paint, food contamination, drug contamination,
drug ingredients contaminated, etc. This is also a “local”
problem. So far during 2008 we heard about: People getting very
sick from fish containing the ciguatera toxin (FDA, February 6)
and Tab / drinking water containing about 36 different
medications, e.g., antibiotics, antidepressants, etc. (AP story,
March). Still the perfect opportunity to finally shift our
health care systems from diagnosis treatment and curing of
diseases to a strategy of disease prevention and wellness is in
the horizon. Using information technology as an enabler, we can
encompass a wide range of opportunities that can start at the
cellular, molecular and genetics levels and go as far as
population / public health. Initial immunization studies show
the level of antibody titers against viral diseases depends on
the circadian time of inoculation. The concepts of chronobiology
and chronotherapeutics can be used to generate disease
prevention strategies based on these circadian-rhythm
dependencies.
About
the Speaker

Prof.
Luis Kun is a Senior Research Professor of Homeland
Security at the IRM College of the National Defense University
where he developed and is the Course Manager for the following
curricula: Homeland Security Information Management (HLS),
Homeland Security Information Management: Tools & Techniques (HST),
Protection of Critical Infrastructures and Key Assets (CIP),
Geographical Information Systems (GIS), Intelligent Agents and
Decision Support Systems. He graduated from the Merchant Marine
Academy in Uruguay and holds a BSEE; MSEE and Ph.D. degree in
Biomedical Engineering all from UCLA. After a 14 year career
with IBM, Dr. Kun was the Director of Medical Systems Technology
and Strategic Planning at Cedars Sinai Medical Center in LA.;
the Senior IT Advisor to the Agency for Health Care Policy and
Research where he formulated the IT vision and was the lead
staff for HPCC program and Telehealth. He co-authored the
Reports to the Congress on Telemedicine (1997) and on HIPAA
Security. In July of 1997, he was invited speaker to the White
House. He was largely responsible for the Telemedicine portion
of the bill that became part of the Balanced Budget Act of 1997.
Dr. Kun represented the DHHS Secretary at a Pan American Forum
of Health Care Ministers on Telecommunications and the Health
Care Industry in Mexico in 1997. As a Distinguished Fellow at
the CDC (1999-2001) he was the Senior Computer Scientist for the
Health Alert Network for Bioterrorism and later the Acting Chief
Information Technology Officer for the National Immunization
Program (NIP) where he formulated their IT vision on 10/2000.
Dr. Kun has made numerous seminal contributions to the
information technology, healthcare and public health
disciplines. He received many awards including the “2002 -
IEEE-USA Citation of Honor Award”: “For exemplary contributions
in the inception and implementation of a health care information
technology vision in the United States. He is a Fellow of the
IEEE and the American Institute of Medical and Biological
Engineering (AIMBE). He is the Founding Chair of the IEEE-USA:
Critical Infrastructure Protection Committee; the Bioterrorism &
Homeland Security WG (for the Medical Technology Policy
Committee) and the Electronic Health Record and High Performance
Computers and Communications WG (former HCEPC). He is currently
the Editor in Chief of the “Handbook of Biomedical Information
Technology” for Academic Press / Elsevier. He is a member of the
Executive Board and the Board of Directors of AIMBE and the
American Association of Engineering Societies (AAES). He also is
an Advisor to many National and International diverse
organizations such as: Advisory Board (AB) to Caring
Technologies /TalkAutism; AB the Boston Children’s Hospital (at
Harvard and MIT) Biodefense Project (Information Systems for
Bioterrorism Preparedness project); AB to Spain’s Telemedicine
Networks (ISCIII); Member of the Joint WG on Telemedicine;
Scientific AB – Medical and Care Compunetics (Netherlands);
Advisory Committee of Collaborative Communications Summit
(Health and IT) He has lectured on medical and public health
informatics, information technology and biomedical engineering
in over 50 countries. He is in the IEEE Computer Science and the
Engineering in Medicine and Biology Distinguished Visitor
Program and is/was in the advisory board of many magazines and
professional journals. He has served as an invited: Conference,
track, session, tutorial, special symposia chair and/or
publications, speaker / keynote speaker and in conference
scientific committees, etc. over 250 times. He was recently
elected to the IEEE –Society of Social Implications of
Technology Board of Governors.
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e-Health from the hands of patients
Prof. Yu-Chuan (Jack) Li
Ph.D.,
M.D.
President, Asia Pacific Assoc for Med Info
Professor and Chair, Institute of Biomedical Informatics
National Yang-Ming University ,
Taipei , Taiwan, Email: jackli@ym.edu.tw
Abstract
Building an interoperable EHR has been one of the top
priorities of fundamental health information infrastructure
world-wide. However, the heterogeneity and complexity of
hospital information systems as well as the competition among
health care organizations have prevented this vision from
realizing in large scale. A patient-initiated EHR exchange (PIX)
is proposed and implemented in Taiwan. The PIX approach involve
a set of standard EHR templates that encompass more than 25,000
data items and an exchange architecture that is patient-centric,
patient-iniated and patient-owned. Eleven major teaching
hospitals (total 27,000 beds) joined the first phase project and
the first batch of 2,000 patients will be enrolled before the
end of June in 2008.
About
the Speaker

Prof. Jack Li has been a pioneer of Medical Informatics
research in Taiwan. He is the founder of the Graduate Institute
of Medical Informatics in Taipei Medical University and also the
President of Taiwan Association for Medical Informatics from
1999 to 2003. Due to his achievement in establishing Medical
Information exchange mechanisms among hospitals and his
dedication to information technology application in patient
safety and care, he was awarded as one of the Ten Outstanding
Young Persons of the Year in 2001. He has been the Principle
Investigators of many national projects in Electronic Health
Record, Patient Safety Informatics and Medical e-learning. He is
also author of 80 scientific papers and 3 college-level
textbooks.
Currently, he is the Professor and Chair of the Institute of
Biomedical Informatics of National Yang-Ming University. He is
the President of Asia Pacific Association for Medical
Informatics.
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