it application in healthcare

8/9/2019 IT Application in Healthcare

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IT Application in Alzheimer's disease

managementAuthor : Abhimanyu yadav (9810003)

Department of Management studies, Indian Institute of Technology, Roorkee

Abstract With the Advances in information technology provide multiple

opportunities for the improvement of healthcare delivery in diagnosis,

management, and support of disease. Improved automated decision support

systems, coupled with evidence based medicine, form the basis for important aids

that assist the physician in the diagnostic process. In addition, telemedicine

provides the ability to monitor and evaluate treatment effectiveness for patients

who have difficulty visiting the physician and is particularly useful for healthcare

follow up in rural areas. Web-based information sources can benefit all patientsand their caregivers. Online support groups as well as web-based sources of

support can ease the burden of caregivers. Combinations of technologies that

address the delivery of healthcare from diagnosis to management permit the

development of patient-specific models that can impact disease management from

the patient's perspective. Transfer of these techniques into clinical practice is

illustrated here for diagnosis, management, and support of dementia(Alzheimer

disease).

Introduction :

The health sector has always relied on technologies. According to WHO (2004),

they form the back- bone of the services to prevent, diagnose, and treat illness and

disease. Given the right policies, organization, resources, and institutions, ICTs can

be powerful tools in the hands of those working to improve health. Many aspects

of information technology have advanced rapidly over the last few years resulting

in an impressive array of new applications. Due to inherent complexities, medical

applications have lagged behind. The stage is now set for the rapid application of

new technologies to healthcare delivery, resulting in improved paradigms in

diagnosis, treatment, and management of disease.

Traditionally, medical decision support systems have focused on development of

automated aids for diagnosis of disease. While new methodologies have led to the

development of more comprehensive diagnostic tools, this is but one area in which

information technology can be used in disease management. From the patient per-

spective, diagnosis is only the first stage of healthcare. Management of disease


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encompasses not only direct therapy but also coping mechanisms for the patient

and caregivers. Telemedicine and web-based services can contribute to effective

disease management by providing enhanced monitoring capabilities, detailed

disease information, and access to external support mechanisms. These capabilities

are particularly important in rural areas where medical professionals may be

located at a substantial distance from the patient . The overall structure for

incorporation of emerging technologies in healthcare delivery at all stages for the

diagnosis, staging, and management of dementia(Alzheimer disease), an area that

involves more complex structures, as the patient is often unable to participate

directly in the process can be described and simplified by use of IT application in

healthcare.

The following steps will describe how information technology interacts diagnosis,

patient management, and social support.


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Figure 2 :

Computational architecture for diagnosis of disease in patient.

Figure 1 : IT model for diagnosis, treatment and support(grey area represents

IT use).

Cooperative systems based on intelligent agents can seamlessly incorporate a

variety of techniques to aid in the overall process as well as provide the ability toinclude additional methodologies that customize the approach for each particular

problem.

In the diagnostic model(fig. 2), an intelligent agent approach is used. Intelligent

agents had their origins in distribute artificial intelligence and have been used

success- fully in specific medial applications. Each agent is an independent

methodology with reasoning capabilities working on a prescribed task. The goal of

the overall system is to provide a cooperative environment in which two or more

agents can be combined to solve a problem through the use of a mediator or

facilitator. A major role of the facilitator is to provide a common means of

communication. The intelligent agent approach is a natural extension of hybrid

systems for combining various methodologies without altering the independent

agents or algorithms.


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The various intelligent agents are medical professional (MP), knowledge based

system (Emerge), Neural network model(hypemet), Chaotic Analyser(CATS).

Patient Management comprises direct treatment of disease, communication with

the patient and/or caregiver, and patient evaluation either in person or using

telemedicine.

Treatment

Established protocols are used in the evaluation of treatment modalities as well as

evidence-based medicine as a tool for searching and evaluating recent results.

Patient CommunicationsDisease-specific information can be found on the web, but it is important for the

physician to identify reliable sources to assist the patient in acquiring accurate

information. List-serves also exist for communication among individuals with

similar diagnoses.

Patient Monitoring andEvaluationThe progress of the patient can be monitored through the use of a simplified

telemedicine set-up.

Social Support - In addition to communications listed above, many support

organizations exist for patients and family members with specific diseases.

Extensive information on these resources is available on the web, including both

governmental and non-profit organizations.

Application in Alzheimer's disease

With our increasingly aging population, cortical dysfunction due to AD and stroke

is becoming increasingly common. Alzheimer's (AD) afflicts its patients with a

dementia that increases in malignance over time: the older an AD patient is, the

worse the dementia is. Dementia is a result of the loss of neurons in the brain that

assist in engagement of intellectual activities. The loss of neurons specifically

affects the hippocampus, which is a central region for memory operation, and the

cerebral cortex. The cerebral cortex is also involved in memory functions, but also

works to accomplish reasoning and language functions.

Memory loss is the most common and well known symptom for Alzheimer's

disease. Other symptoms include loss of cognitive abilities, judgment, thinking and

disorientation to place and time.

The diagnosis in alzheimers disease is done by Intelligent agent systems. In

addition to disease-specific agents, appropriate sources of information must be


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developed. These fall into two categories: expert-supply information and informa-

tion extracted from data .

Figure : Agent Information flow

Emerge combines input from CATS and Hypemet using expert-supplied rules to

identify complex events in the electroencephalogram (EEG) analysis as well as to

combining symbolic and numeric input to form an overall decision. Hypemet

combines clinical parameters with EEG parameters to develop a decision model.

CATS identifies events in the EEG and determines the degree of variability in each

channel of the time series. The information is sent to Emerge, which does channel

comparisons and correlates brain wave activity with level of patient activity and

also to Hypemet that develops an overall model based on channel activity.

ForTreatment and Patient management in alzheimers disease models are

complicated by the varying levels of cognitive functioning of the patients. In early

stages of dementia, the patient may function quite well and be able to participate in

technologybased aspects of care. In above figure for Agent information flow,

dotted arrows indicate links that may or may not be suitable for the patient. Family

members andor caregivers can take over these activities when the patient is unable

to participate directly. Online support groups are of particular importance for care

givers of dementia patients as they are often confined due to the need to provide

24-hour care. This group can substantially benefit from interactions with othersfacing similar circumstances.

Future Trends :


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The model described for Dementia(AD) has two basic components: establishment

of techno- logical implementation and definition of disease-specific attributes and

knowledge bases. The second component must be addressed for each disease.

Future work includes further development of expert-supplied knowledge and

accumulation of larger databases for use in the refinement of data-based models

with a final evaluation of overall effectiveness for each of the three stages:

diagnosis, treatment, and support.

Conclusion :

Information technology plays a vital role in identification of the genes that are

causing AD, disease management, progression and online data collection using

electronic medical records for future research. The use of technology has thepotential to help the patients to be more independent and reduce stress on the care

giver. The use of Information technology is might be worth pursuing if technology

advances faster than a treatment or cure.

The shift in focus of online systems from concentration on only the diagnostic

phase to addressing the broader problem of effective patient-specific healthcare

delivery has the potential for more effectively reducing the burden of disease from

the patient sperspective.

it application in healthcare

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