Enabling ubiquitous patient monitoring: Model, decision protocols, opportunities and challenges

Healthcare costs in the US are approximately 15% of GNP and are anticipated to reach 17% of GNP in the near future. Management of chronic diseases via technology based ubiquitous patient monitoring services has been widely proposed as a viable option for economizing healthcare resources, and providing efficient, quality healthcare. The process of ubiquitous patient monitoring is information intensive, the information generated is not only fragmented but also spans multiple processes, artifacts, parameters, and decision criteria. The current study explores the complexities associated with the process of ubiquitous patient monitoring and the enabling technologies. The key contribution is a framework that captures the complex processes, the parameters involved, and the decision criteria for ubiquitous patient monitoring. The decision protocols and enabling technologies supporting the processes are detailed in the study along with the opportunities and challenges of ubiquitous patient monitoring. A conceptual model of ubiquitous patient monitoring is developed by leveraging the proposed framework and is validated by a usage scenario. Finally, the implications of future research and contributions of the current research are discussed. Healthcare forms an indispensable constituent of the modern society, representing a large percentage of Gross National Product (GNP) and sustaining a high political profile and strong public interest [5]. In the wake of the 21st century, healthcare systems around the globe are faced with an exponential rise in expenses, heavy utilization of services associated with a steep rise in aging population, and limited financial as well as human resources to manage the growing healthcare needs [13,48]. The current healthcare expenses in the US are approximately 15% of the GNP [25] and projected to reach 17% of the GNP by 2011 [6]. Another trend observed parallel to the rising healthcare costs is the " graying of the globe " — the worldwide population of adults over 65 years of age is on the rise and is expected to reach 761 million by 2025 [46,63]. Fig. 1 depicts the changing global demographics, the resultant increase in the number of aging patients, and the corresponding strain on both the human as well as financial resources of the healthcare sector. Multiple studies in the past have noted the prevalence of chronic diseases in the aging population — seven of the most prevalent chronic illnesses in the US (and their associated in-patient expenses) include: coronary artery diseases ($25.6 billion), heart failure ($15.2 billion), chronic obstructive pulmonary diseases ($6.2 billion), mental …