Catálogo de publicaciones - libros

The increase in prevalence of chronic disorders in modern societies has resulted in increasing organizational and financial pressure on healthcare systems. The challenge of adequate care delivered to patients with chronic conditions, who want to remain in their social context, promotes the search for effective models of care. Adequate use of information and communication technology may be an appropriate response to this challenge. Chronic patients require repetitive interactions with the healthcare system. High-quality care adhering to evidence-based medicine strategies must be delivered to a vast population of patients in a continuous manner. The experience from studies and pilot implementations of information technology tools in specific groups of patients suffering from chronic diseases indicates that considerable benefits may be gained related to improved cost-effectiveness and simultaneously maintained quality of care. It seems that e-health strategies may help to fulfill two contradictory requirements — provision of high-quality medical services and preservation of the cost-effective approach. Available evidence supports the use of e-health solutions for care delivery. The results of trials based on the use of integrated IT-enhanced model of care with focus on patient empowerment and better interdisciplinary team communication demonstrated improvement of such outcome measures like hospitalization rate, frequency of ambulatory visits and level of quality of life in populations of chronic patients. However, it must be emphasized that a new model of care based on the effective use of e-health solutions cannot be implemented without adherence to legal, ethical and psychosociological requirements existing in the healthcare environment.

Telemedical services have begun to play a more and more important role in our everyday life. As a discipline which unites medical and computer sciences, telemedicine is very demanding and telemedical applications need to be built with deep knowledge and understanding of both domains. The chapter depicted the most important requirements of such systems and emphasized the importance of choosing the proper architecture for them.

The chapter presented applications developed or co-developed at the Department of Computer Science within the confines of a few telemedical projects. They address the issue of remote access to medical information. Applications have been received with interest by the South Poland medical environment and participants of medical conferences showing that there is substantial acceptance and demand for such services.

Biosignal monitoring and recording are an integral part of medical diagnosis and treatment control mechanism. These methods mark the transition from point oriented measures to continuous measures in medicine. This transition is much more appropriate to the dynamics of physiological regulation in health and disease. Modern approaches for sensor technology, for new analysis algorithms and for database technologies help to move this emerging area forward. Technical advances originating in computer technology, in consumer electronics and microtechnology can support these technological advances.

This chapter has analyzed the importance of specific medical studies and computer-based support for them. Main standardization organizations were presented, such as AICC, ADL, IMS and others. Some distance learning platforms were described including two case studies of solutions from AGH University of Science and Technology.

Severe floods, windstorms, heat-waves and cold-waves have caused dramatic political, social, environmental and health consequences in Europe over the past few years. In response to these events, ministries of health and other public health authorities, along with national and international meteorological services and organizations, are focusing increased attention on developing appropriate strategies and measures to prevent health effects from extreme weather and climate events in the future. Efforts are being made to understand the lessons learnt from recent events, to evaluate the effectiveness of the measures taken and early warning systems in place, and to use the knowledge gained to target future activities. The recent events have also increased interest in whether the intensity and frequency of future extreme weather and climate events could be expected to change as one result of a changing climate.

With this in mind, a working group organized by the World Health Organization (WHO) and the European Environment Agency (EEA) has made the following recommendations.

1. The political, social, environmental and health consequences of extreme weather events have increased in Europe in recent years. We recognize that the climate is already changing, and that the intensity and frequency of extreme weather events, such as floods, heat-waves and cold-waves, may change in the future. These events will continue to pose additional challenges to current and future populations, in terms of health risk management and the reliability of infrastructure, including health services, power supply and others.

2. There is a need for ministries of health and other ministries to recognize that actions must be taken to reduce the current and future burden of disease due to extreme weather and climate events and to include the prevention of health effects due to weather and climate extremes among national health priorities.

3. We urge ministries of health and other ministries, as well as research institutions, to improve our understanding of the regional and national burden of disease due to weather and climate extremes and to identify effective and efficient interventions, such as early warning systems, surveillance mechanisms and crisis management.

4. We urge effective and timely coordination and collaboration among public health authorities, meteorological services and agencies (national and international), emergency response agencies and civil society in developing local, regional and national monitoring and surveillance systems for the rapid detection of extreme weather events and their effects on public health; developing civil emergency and intervention plans, including activities to prevent morbidity and mortality due to weather and climate extremes; and improving public awareness of extreme weather events, including actions that can be taken at individual, local, national and international levels to reduce impacts.

5. We call on WHO, through its European Centre for Environment and Health, in collaboration with the World Meteorological Organization, the European Commission, EEA and other relevant organizations, to support these commitments and to coordinate international activities to this end. In particular, there is a need to develop guidelines for estimating the burden of disease due to weather and climate extremes; to develop indicators for intercountry and intracountry comparison and monitoring of progress; to coordinate the development of new methods, including sentinel monitoring and surveillance systems, to provide timely information on the health impacts of weather and climate extremes at the European level; to develop and evaluate more effective and efficient interventions, such as early warning systems, to reduce negative impacts; and to harmonize interventions across regions and countries to facilitate the sharing of data and lessons learnt.