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Production et transmission des données de suivi des patients atteints de maladies chroniques dans un contexte de télémédecine et intégration dans un système d'information pour l'aide à la décision

Abstract : The current trend in aging population leads to an increasing number of chronic diseases cases and consequently, to an increase of the number of medical examinations and hospital stays. Telemedicine system can contribute to both increase or maintain care quality and safety, as well as to reduce costs. In spite of this potential, telemedicine deployment is currently limited. We identified the most frequent chronic diseases consistent with telemedicine, namely heart failure, diabetes, respiratory failure and kidney failure. This study highlighted a number of comorbidities associated to these four diseases, reflecting the need for overall patient care. A state of the art report on worldwide Telemedicine experiments for the four chronic diseases showed that the current applications are partially redundant and hardly interoperable. Thus, the same measure can be performed twice for the same medical examination, but for two different diseases. These two problems can induce redundant developments, a risk of a decreased efficiency of a telemedicine application during its deployment, as well as risks of making the patient health worse when the intervention of a healthcare professional can have an impact on another chronic disease. Furthermore, this study revealed common requirements for these chronic diseases and their specific features. We developed a generic architecture that allows different telemedicine applications associated with specific diseases to share a common technical platform. The original aspects of this work are first, a study of communication standards to achieve an interoperable system, and, on the other hand second, a health data model for the patient's vital signs. This model contains all the necessary information to interpret the results, such as the date and time of the measurement, the acquired data format and the sensor characteristics. To validate our telemedicine application model, we conducted two experiments. The first one was a collaboration with AZNetwork company. It consisted in the development of a digital platform to collect and archive seniors' data in the context of the Silver@Home project. The second experiment was a partnership with the TELAP network on the Domoplaies project. It allowed us to extend our telemedicine model to a medical data exchange system among healthcare providers. This led us to propose a telemedicine application model, which is not only in conformity with the Health Information Systems Interoperability Framework (HIS-IF) of the "Agence des Systèmes d'Information Partagés de Santé" (ASIP Santé), but also constitutes a proposed extension of this framework to the patient's home.
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Submitted on : Tuesday, February 13, 2018 - 5:13:06 PM
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Philippe Finet. Production et transmission des données de suivi des patients atteints de maladies chroniques dans un contexte de télémédecine et intégration dans un système d'information pour l'aide à la décision. Traitement du signal et de l'image [eess.SP]. Université Rennes 1, 2017. Français. ⟨NNT : 2017REN1S072⟩. ⟨tel-01708532⟩

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