Résumé des résultats (Abstract)
(Anglais)
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The objectives of the MOEBIUS project were to establish, pilot and test in a real environment:
· the integration of an IP-based mobile extranet platform,
· to use this platform for applications in different sectors, e.g. healthcare and business,
· to verify the interoperability of the various technologies,
· to provide a reliable and secure infrastructure at both network and application level, and,
· to test the application in clinical feasibility studies.
MOEBIUS used the so-called integrated mobile health care solution and disease management on the organisational level, which combines the following important tasks:
Diagnosis: Diagnostic tools incl. use of diagnostic devices. Examples: blood glucose analysis, electronic equipment for measurement of blood pressure and heart rate, tools to quantify body fat mass, etc.
Therapy: Therapeutic algorithms (treatment strategies for obesity or for cardiovascular disorders, etc).
Nursing and monitoring systems to document the patient's well-being and quality of life, the possibility of remote consulting for those needing help or some other form of assistance.
In the health care part the MOEBIUS project the following health care trials were performed with real patients:
· RRT : Risk Reduction Trial in young obese patients
· ACT - Anti-Coagulations Trial
The objectives of this part of project were to test the above mentioned two applications in the clinical context. Frequent diseases with the possibility of outcome amelioration with telemedical management were chosen.
Chronic diseases pose a major problem both to the patients concerned and society as a whole. A chronic illness can severely impair the patient's quality of life as a result of physical suffering, uncertainty and social deprivation. Frequent visits to the doctor and repeated hospital stays are required. Chronic illnesses are also problematic in a wider, social context: 15% of the Swiss population cause 90% of healthcare costs, a large part of it due to chronic diseases. In addition prevalence of diseases like asthma, COPD, heart failure and diabetes type II are steadily rising.
Chronic patients are usually managed reactively and episodically in the existing healthcare system. The responsibilities of the service providers in a 'fee for service' system are not clearly regulated. Costs are monitored exclusively on a component basis.
The aim of the MOEBIUS project was to propose and elaborate a telemedical support tool for chronically ill patients throughout the whole course of their illness and to systematically integrate the corresponding service providers into the process. In the disease management concept isolated medical consultations for managing the acute health problems or deteriorations in a chronic condition are being replaced by an integrated care program incorporating prevention, diagnosis, treatment, rehabilitation and nursing care.
The MOEBIUS RRT trial, aiming to reduce cardiovascular risik in overweight patients, was designed to include diet, exercise and drug therapy on an interactive platform forming an integrated weight control programme. Energy intake was prescribed for each subject on the basis of estimated daily maintenance energy requirements. Dieticians at the site periodically gave instructions on dietary intake; recording procedures were installed as part of a behaviour modification program. In addition, individuals were included in a physical activity program. Finally, patients were given orlistat (120 mg t.i.d.) to support the weight management program.
The outcome of the MOEBIUS health care trials can be summarised as follows: 15 patients were included in the trial, 13 successfully completed the 4 month trial. The trial was a success from the medical perspective; patients lost weight, reduced their blood pressure and showed a tendency of lower blood glucose levels; and from a technical point of view; integration of different monitoring devices on a mobile platform. 13 patients were satisfied with trial procedures and indicated that they would be willing to continue with this line of treatment.
The MOEBIUS ACT trial, aiming to monitor the effects of anticoagulation therapy on an interactive platform, is still ongoing.
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