iHealth

The NHS is facing increases in demand due to rapid rise in chronic illnesses driven by an ageing population and lifestyle choices of citizens. This demand is not effectively managed by the current risk management approaches and care delivery models. A step change is needed in the way we manage health, but this change is hindered by a number of factors. These are: (i) large amounts of fragmented data which exist in various forms; (ii) limited data analysis with time lags between collection, analysis and availability; (iii) outdated care delivery models which emphasise and reward management of disease, with few incentives for early risk identification and control, and; (iv) inadequate decision support at point of care delivery, with consequent adverse impact on quality and safety of patient care.Our aim is to develop dynamic, individualised healthcare delivery models that fully integrate personal health information and use optimisation approaches to improve health. The objective of our project is to test this vision by looking at the potential of l information and communications technology (ICT) to improve health and transform care provision within a real context to create novel individualised care delivery models that will help to improve the quality and safety of healthcare through information driven health. In this regard, specifically, we will test in real setting, at Imperial College the feasibility of: (i) data capture and integration from various sources, (ii) the creation of databases that can accommodate vast amounts of data coupled with advanced computing, analytical and statistical methods for analysis, (iii) making available relevant information to health professionals when needed, and (iv) applying this information to optimise care delivery. The project comprises four interlinked work packages (WPs) designed to test the feasibility of achieving the objectives described above in a real setting. Imperial is almost unique in the UK because it comprises a world renowned University with major research activity in Basic Medical Science, coupled to major strengths in both engineering and physical science. However, in addition, Imperial, via its associated hospitals, has a major clinical base. With the development of the new Academic Health Sciences Centre the basic research activities of the College are now being formally integrated with clinical activities. Hence, Imperial is the ideal organisation to carry out a detailed study of the application of ICT to healthcare. In this regard, this application is deliberately based only on the staff of Imperial College and its associated hospitals.The first work package will address the issue of 'vertically integrated' medicine at the systems, visceral, tissue, cell, protein, and gene levels (described in the project as the 'biological continuum'). This concept will be addressed in relation to 'horizontally integrated' delivery of clinical medicine at the primary, secondary and tertiary levels, (described in the project as the 'care continuum'). The second WP will address issues around data, databases and datamining. The third WP will consider information use for decision making, and use of optimisation techniques and modelling to develop automated decision support systems. Through an exploratory study in real setting, the fourth WP will study the whole issue of individualised and optimised care delivery, how this relates to clinical practice and the development of new care delivery models. We will use interactive workshops, mapping of existing research and activities at Imperial to identify gaps and challenges, and exploration studies using in-silico simulation exercises as well as observational studies. In order to make the work of the project realistic, we will focus on a number of case studies relating to cardiovascular disease and diabetes, disease which are priority areas for HMG and the NHS.