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Future information technology for the health sector

English version
: Cuhls, K.; Oertzen, J. von; Kimpeler, S.

Stuttgart: MFG-Stiftung Baden-Württemberg, 2007, 186 pp.
FAZIT Forschung. Schriftenreihe, 6
Fraunhofer ISI ()

Information technology in the health sector will (continue to) be an important topic in the oncoming years. This offers interfaces for new market potential for IT companies. However, which information technologies bring about change? This was the initial question for the Delphi study at hand in the context of the FAZIT project (research project for current and forward-looking information and media technology and its use in Baden-Wurttemberg). In order to find answers to this question, information technological developments were identified, which could become relevant during the next 20 years. Literature was sought, experts were consulted and a workshop was organised to generate the theses, focus on them and to phrase each individually. During the selection period of the theses there was a first curious finding: The task instructed to phrase technical theses, which could have a beneficial effect on the health sector. However, those developments which have a strong impact on cost cutting and solving of problems cannot always be assigned to technical areas, they are moreover closely correlated to the German health care system, regulatory issues and organisational challenges. Correspondingly one finding of this study describes that although technical obstacles are a major hindrance, other obstacles play a significant role as well, e.g. the acceptance by parties involved and users, too.
To answer further questions on technological methods and their use, in a two-step online Delphi survey, the theses phrased in detail were evaluated by experts from scientific research organisations, companies, healthcare facilities and societies respectively associations in terms of the theses ' importance, feasibility, desirability and obstacles.
In the first round 203 persons filled out the questionnaire completely or partially, in the second round, this was accomplished by 86 persons. This way, the results are fairly significant. Among the persons answering there were seven percent females, which resembles the share of the gender among researchers and technological developers in Germany. Differences in the answers between gender or age could not be detected. Many of the technical solutions described in the theses which can lead to new markets consist of low-profile unspectacular developments. Some of the theses consist of scenarios that employ the use of a technology that, already today, is in use, e.g. telemonitoring of risk patients. However, it has turned out that, although there have been tests and first applications, monitoring on a closely-meshed base in the sharpened phrasing of the Delphi study as a "standard" this is not yet reality. In the overview all theses near-future realisations as well as later ones are xpected to evolve around the year 2025, which means that future developments of individual theses display very different dynamics.
Theses which capture the industry's interest, e.g. technologies that can be applied to other sectors as well, should be more closely observed in the future. They are the important and interesting issues of the study: In the evaluation of realisation time and importance they are not among those expected in the near future, but are rather located in the chronological higher respectively early mid-table and are all considered desirable by most of the Delphi participants.
On the other hand, theses which employ applications which "get under the skin" are very controversial. In the Delphi study at hand all theses that involve implantation (e.g. retina implants, artificial kidneys, electrodes in the brain in order to prevent epileptic seizures, artificial heart and lung implant etc.) as well as transdermal intervention (e.g. biopsy robots) are considered desirable, however, desirability does not extend to the stage of other theses. Besides ordinary technical problems data ntegrity and data protection or acceptance by the persons concerned are often stated as obstacles.
For new markets in the sector of ICT-based health applications topics such as proteomics, telemonitoring, expert systems and databases, voice entry as documentary means or external data access are especially interesting and they receive the highest rating with respect to their importance in cost cutting, improving the healthcare system or the quality of healthcare. The topic "ambient intelligence" will particularly contribute to improving the quality of life. All theses with high market potential for the IT industry are extremely knowledge-intense in their development and realisation. Correspondingly, some of the theses are to be found in the topic areas of the Federal Government's high-tech strategy (BMBF, 2006b and 2007). The few controversial theses of the Delphi study at hand refer to a higher investment risk for developers and manufacturers. Many of the theses are not strictly limited to the health sector, but are rather important in other sectors in the future, too. Nearly all the phrased theses are considered feasible; nevertheless, experts see obstacles in their development in certain fields. Technical problems are predominantly mentioned. These are foremost in developments such as retina implants, artificial organs, micromachines and implantable minimal systems, voice recognition or genome analysis as standard health care applications. For other theses, they concern issues of data protection and data safety and thus regulative issues, which still need to be adapted to, e.g. radio frequency identification (RFID) or ambient intelligence. In a few cases, e.g. when considering surgery-executing micromachines, there are other, legal, questions (liability etc.). Very often, high expenditure (initial investment or maintenance costs) is mentioned as an obstacle for realisation. For certain theses, on the one hand expenditure is considered an obstacle, on the other hand technology is rated as important for cost cutting. This, for instance, can be applied for ambient intelligence for monitoring patients at home or for non-invasive long-term blood pressure sensors. In these cases the odds must be weighed as to whether or not investing in the future is worthwhile. The Delphi results merely deliver starting points for further going discussion or measures. All in all, it can be said that chances for the realisation of many of the phrased theses in the upcoming 10 to 15 years are not bad. While technical obstacles cannot be disregarded, they are, however, surmountable. New markets for ICT in healthcare applications are especially expected in the areas of voice recognition, virtual reality and simulations, databases, sensors, Radio Frequency Identification (RFID) or new management and planning systems.