E-Healthcare activities and International collaboration with Australia

1. E-Healthcare activities and International collaboration with Australia Professor Peter Yellowlees P.Yellowlees@mailbox.uq.edu.au

6. Sex 10m Money 9m Microsoft 10m God 4m Bible 3m Tax 4m Australia 7m Beatles 4m Pam Anderson 0.1m Bill Gates 0.3m Jesus 2.5m Coca Cola 0.3m Simple searches

7. Death 5m Birth 6m Disease 3m Hospital 3.5m Medicine 5m Medication 0.3m Therapy 1.7m Patient 2m Nurse 0.6m Physician 1m Doctor 2m Therapist 0.2m Alcohol 1m Depression 0.6m “Health” 27 million pages

8. E-book

9. Three Forces of Change • An empowered Consumerate creates impatient Patients • E-Health adaptability equals survival, especially with broadband • Genomics shifts healthcare from cure to prevention

11. Source: PWC HealthCast2010, 1999

12. Health research and Internet2 Two areas of collaborative international research • Virtual Reality • Global Health Service Delivery Both involve the use of internet2 for the research process itself, as well as in development of health products.

13. Research in Virtual Reality Present day psychiatric successes • Use of Psychosis Tapes for Teaching • Success in Phobia Treatment

14. The Basic Idea • To develop virtual reality three dimensional environments to allow patients to build precise models and descriptions of their perceptual states, including symptoms such as hallucinations and passivity phenomena, and to use these environments for teaching and preventive health activities.

15. Possible Virtual Reality uses in Psychiatry • Development of standardised experiences of psychosis and depression (and other less prevalent disorders) • Development of patient driven simulated environments for monitoring, diagnostic reviews and use in rehabilitation and to drive behavioural change • Education of clinicians and carers • Development of reliable stimuli for use in functional imaging (fMRI)

16. The Problems VR Rooms can solve in psychiatry • Diagnosis is often subjective and depends on interpretation by clinicians of perceptions described by patients • Clinicians observe physical and mental characteristics (including facial movements etc) but these have never been standardised or reliably quantified • Clinicians and carers cannot truly understand the experience of mental illness unless they have suffered it themselves. • It is sometimes very hard to identify quantitative effects of treatment, or outcome improvements – patients and carers tend to have differing ideas of what is a successful outcome

17. Functional MRI and Virtual Reality • The lack of standardised stimuli for patients undergoing fMRI is a major problem. • Personalised virtual reality scenarios, mimicking illness, or mimicking specific symptoms that are being investigated, could greatly help our understanding of the significance of physiological changes noted on the fMRI.

18. Virtual Reality for prevention/education – the use of “Active Worlds” • Available to educational institutions, teachers, students and individual programs. • Explore new concepts, learning theories, creative curriculum design, discover new paradigms in social learning. • Over 80 worlds available plus others from the main Active Worlds site.

19. Participants • Over 80 in total but little health activity • Fairholme College • Flinders Medical Centre Rural and Remote Mental Health Services • Griffith Uni, School of Arts • RMIT, Dept. of Visual Communication • UNSW, Faculty of Built Environment • USA, School of Art

23. The Link with Internet2 and Highbandwidth/Computing Capacity • These projects would undoubtedly create massive amounts of data incorporating three dimensional perspectives, signal processing for facial and movement analysis,and multiple video analyses. • Initially the projects would be for research only, but in the long run high bandwidth and considerable interactivity between groups of researchers, will be necessary to unravel what is effectively a “x-ray of the perceptions and internal self”, or descriptions of entire perceptual worlds.

24. Global Health Service Delivery and Internet2

25. Australia +/- 2 time zones

26. Globalization • “the inexorable integration of markets, nation-states and technologies to a degree never witnessed before- in a way that is enabling individuals, corporations and nation-states to reach around the world farther, faster, deeper and cheaper than ever before…” Thomas L. Friedman, The Lexus and the Olive Tree, 2000

27. Health on the internet

29. E-healthcare global delivery environment Incorporates a variety of features • Videoconsultations • Electronic consumer owned health records – voice driven • Practice management and communications software • Web-based educational material – video and written • Flexible consumer focussed clinicians and health regulation environments

30. Login Screen • Quick, intuitive, secure

31. Homepage • Consistent menu at left • Clear, concise, instructions • List of previous and current consultations

32. Health Record • Supporting documentation can be uploaded for any entry • Doctor entered data highlighted

33. Health Record (charting) • Patient or doctor can chart any progressive numeric measures by clicking on a single icon

34. Doctor’s Homepage • Outstanding consults are listed immediately • Hyperlinks go straight to the consult questionnaire

35. e for people, stupid • the internet is a revolution primarily in communication, not technology. It’s about people. (Gerry McGovern, The Caring Economy)

36. An alternative view….. The medical practice of the future will have only two workers - a nurse and a dog. The nurse will be there to feed the dog, and the dog will be there to prevent the nurse touching any equipment.