Smart Home and remote health services

Health services in the European Economic Area (EEA) address many stakeholder, like round 1.8 million health professionals and 7.3 million nurses and midwives, working in thousands of hospitals and clinics in 28 Member States (MS). EEA counts 500+ million citizens and with this, potential patients. A huge IT-system is need in different institution, like at the family doctor’s office, at the pharmacist, at the insurance organization, at the hospitals and for a broad range of emergency service provider. Round 1.5 trillion € are in rotation in this service domain, every calendar year in the EEA.

Between 2008 and 2014, the EU has sponsor a large-scale pilot, called European Patient Smart Open Service (epSOS), to verify, that secure exchange of patient data across EU MS would be possible.

Some MS has start with digitalization of patient identification. They have issued health patient card as well as health professional cards, as access tool to the IT-system, for identification and authentication. Also national telematics infrastructure are issued in some MS, to connect all key stakeholder along the country, like health professionals in their offices, clinics and hospitals, with insurance organization, to generate automatically patient medical records, transmit this to insurance organization and to start the reimbursement processes.

The next step would be in some MS the roll out of electronic health record (EHR) systems and the artificial analytics (AI) of the EHR-data as assistance systems for the health professionals, to increase the quality and decrease the financial effort in the health service domain.

On what to focus in CONCORDIA?

As society ages more and more citizens, need medical care in their house or apartment. In this case, meaning health service I home in a remote modus, three elements are important:

• Secure digital identification of patient,
• Secure patient data storage,
• Secure infrastructure at home and
• Secure communication over web, net and/or cloud,

to address security and privacy and use telemedicine and other online-services. COVID-19 has shown, that the use case in CONCORDIA TP2.4 on remote health service get more and more momentum. This is one pillar in CONCORDIA.

Another trend was recognize in patient transport service. In the past, an ambulance vehicle was a transport system for a fast transport service, e.g. from home or accident place to the emergency station in hospitals. In the future, we talking on “hospitals on four wheels”. More and more equipment are used in the ambulance, more data would be generate in the vehicle and more data would be transferred to health professionals in clinics and hospitals to get remotely order of the emergency treatments. This would be the 2nd pillar in CONCORDIA.

Both use cases in the CONCORDIA pilot in health domain are independent from any existing or developing national telematics infrastructure and other key components and systems, such as patient card, card-reader, health data and reimbursement processes in MS.

What we want to achieve?

In both use-cases, remote health service of patients, living at home and emergency medicine, in CONCORDIA we would

• describe a reference architecture, which would be capture security and privacy,
• take into account new technologies, like 5G connection in ambulance and at home
• follow new certification schemes, as announced along the EU Cybersecurity Act (EU) 2019/881,
• following the GDPR requirements,
• review the impact of new regulation, such as Medical Device Regulation (MDR) 2.0 in this field,
• deploy guideline for consumer, who buy mobile and/or stationary medical equipment for home application,
• deploy guideline for emergency service provider, who invest in new ambulance vehicle,
• demonstrate commercial of the shelf medical equipment, connected in home area network (HAN), to store recorded data and to transfer to the outside world,
• mirror the smart phone in smart home, using for health data storage, analytics and transmission.

(By Detlef Houdeau, Infineon)