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Keynote


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.

 


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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