The rapid changes in both societal environment and lifestyle threaten global health. Chronic conditions are now recognized as a compelling challenge to all of the communities rather than just a private matter. Although the risk of outbreaks, such as a new influenza pandemic, will require constant vigilance, it is the “invisible” epidemics of heart disease, stroke, diabetes, cancer, and other chronic diseases that, for the foreseeable future, will take the greatest toll in terms of deaths and disability. The WHO offers the health community a new global goal: to reduce death rates from all chronic diseases by 2% per year over and above the existing trends during the next 10 years. This global action to prevent chronic diseases would result in saving the lives of 36 million people who would otherwise have died due to chronic diseases by 2015. The achievement would also result in appreciable economic benefits for all countries.2
A rapid response, above all, must be forward-looking. To raise all citizens’ awareness of the importance of health promotion and disease prevention, the involvement of all areas of society and a creative approach are indispensable. A variety of policies, strategies, and activities are now being initiated nationwide in Japan at all levels, from administration and community groups down to the individual.
A 12-year government-sponsored campaign for health promotion, known as “Healthy Japan 21”, has been advocated nationwide since the year 2000.9
In addition, the Japanese parliament10
issued a “health promotion law” to define individual responsibility and interactive coordination among citizens, communities, organizations, and government administrations. The law reconfirms that the national goal of medical insurance reconstruction is health promotion and disease prevention.
Founded in 2005, the Japan Mibyou System Association (JMSA) defined “mibyou” (hypohealth) as a state between health and disease.11
The JMSA is committed to the better control of the hypohealth state in order to improve human wellness. It has established a series of educational programmes and an official accreditation system for health promoters that aim to provide wholesome and secure care to all citizens.
More and more professional communities, research institutions, and industrial sectors across the world have been committing to daily health care. Many studies place high priority on personal lifelong health information infrastructure for the mass population in daily application.
The “Health Data Bank” application service provider service platform was released as a multifaceted aid for the management of corporate employee’s medical examination results.12
The service supplies health care personnel with a set of tools for effective employee health guidance and counseling. It takes into account factors such as an employee’s current physical condition, living habits, environment, and age-related changes in longitudinal management. Each employee can browse his or her personal data through internet channels and can view self-records of check-ups and graph detailing historical changes over a long period.
“Health Vault” is a universal hub of networks to connect personal health devices and other services. It helps to store and manage personal medical information in a single central site on the World Wide Web.13
It aims to provide a seamless connection interface for various home health and wellness monitoring devices, such as sport watches, blood glucose monitors, and blood pressure monitors, marketed by different manufacturers worldwide.
“Google Health” gathers personal medical records from doctors, hospitals, and pharmacies; manages medical history profiles, such as health conditions, medications, allergies, and laboratory results; and shares personal health information with family members, doctors, or caregivers.14
Philips proposed “the Complete Care Cycle” from prevention to telemedicine, aiming to cover paradigms of prevention, diagnosis, treatment, rehabilitation, and management. Its goal is to build a secure and personalized health care platform that provides a remote connection between chronically ill patients and their health care providers. It also aims to promote patients’ behavior change, expand care providers’ reach into homes, and improve clinical staff efficiency and effectiveness.15
To provide more effective vital sign monitoring suitable for daily use, a variety of pervasive computing technologies have been widely developed for health care applications.
Since the first accurate recording of an electrocardiogram (ECG) reported by Willem Einthoven in 1895, heartbeat measurement has come a long way and are now available for use in various situations. Whenever a person sits on a chair16
or on a toilet,17
sleeps in a bed,18
sits in a bathtub,20
or even takes a shower,21
the heartbeat can be monitored conveniently, without disturbing the person.
Over 50 home-oriented devices, such as pulse oximeters, ECG monitors, glucose monitors, insulin pumps, blood pressure monitors, spirometers, pedometers, body composition meters, and weight scales, have emerged in the personal health care market. Most of them are for both general wellness and chronic conditions, such as congestive heart failure, chronic obstructive pulmonary disorder, asthma, hypertension, diabetes, and obesity. Some of them include MedStar,22
Viterion Telehealth Life Center,23
Commander Home Monitor,24
Carematix Wellness System,25
Sentry Telehealth Monitor,32
Advanced care and alert portable telemedical MONitor,35
and the Wellness phone.37
These products commonly characterize a home terminal connected to the internet or a telephone line and one or more wearable or portable devices that are able to measure various physiological data, such as body weight (BW), blood pressure, blood glucose, peak flow, oxygen saturation, heart rate and respiration rate, body fat and body temperature (BT), sleep, and energy expenditure.
A Canadian company, Care In Motion Technology Inc, has released an appealing solution called “Care in Motion”. It includes distributed earphone-like devices and a central data server to provide a seamless health care service suitable for various daily life scenarios. Instead of using multiple disparate sensors, the earphone-like device adopts a unique scheme to monitor up to 20 physiological parameters, such as pulse rate, respiratory rate, SpO2
, BT, sleep, and activity, continuously in real time. It is so small that it is promoted as “wear and forget”.38
Most current efforts are directed toward developing a series of pervasive vital sign monitoring technologies, such as “plug and play”,36
“wear and forget”,38
and “plug is all”.18
However, an investigation from the WHO reported that most current health care systems still have common problems that need to be addressed: a) the difference between acute and chronic care is not sufficiently emphasized; b) patients are rarely supported by either a simple means of involving themselves in self-management or essential information to enable them to manage their condition to the greatest extent possible; c) patients are seldom provided with a long-term management plan for chronic conditions to ensure the best outcomes.39
Such problems remain to be solved by a systematic scheme. This system should stress several aspects in 1) how to facilitate physiological data collection seamlessly and persistently in the daily environment, 2) how to apply data mining algorithms to perform comprehensive interpretation of multifarious long-term data fusion, and ultimately, 3) how to build a scalable health care integrated platform for individualized lifelong health management.40