Initial+Background+Research+Appendix

Product Strategy Specification

Initial Background Research Resources

====__Statistics regarding physician availability, population groups without physicians, doctors` visits:__ ==== 5 million Canadians (about 15% of population) do not have a family physician -23% of Canadians were unable to see a physician on the same day they needed one -among 6 countries studied (including US and Australia), Canada was last for Doctor-patient ratio -we have 2 physicians per 1000 people - putting us 24th out of 28 OECD countries and last among G8 countries

-study in 2001 (Canadian Family Physician) reported 1 out of 7 people do not have a regulat doctor (based on a survey of 15,777 people) Profile of those without doctors: they were statistically more likely to be: -younger -male -single -poorer -perceived themselves as being in good health -recent immigrants -without confidants -smokers

The article suggested that targeted care reform is needed to provide health care to under-serviced people (especially young males without confidants)

-those without doctors were 3.5-times more likely to use the hospital emergency room (costly!) -78% of those without physicians seek healthcare elsewhere - 64% use walk-in clinics, 12% the emergency room, 10% community health clinics

-medicine in walk-in clinics poor for those with chronic health problems (like cardiovascular disease) -those without doctors are also less likely to recieve diagnostic services (like pap smears) and less likely to have blood pressure checked - therefore not getting primary prevention of health problems - also leads to higher health care costs and more diseas

//On Regular check-ups//

-3.4 million people in Ontario go for a regular check-up with their physician each year - 63% go for reassurance that they are healthy (costly!)

//What are the important health care indices to monitor to prevent illness and disease?// -in terms of health care costs - the most money saved would come from detecting cancers -tumour markers are available for assessing treatments in some cancers (eg. ovarian) and can be accessed from a blood sample - research is moving in direction of being able to detect cancers by markers in bloodwork (not there yet)

-in terms of mortality and morbidity - strokes and cardiovascular disease are the highest rates -best indicators are regular blood pressure monitoring and blood tests for glucose and cholesterol -can also use blood tests for kidney function, liver function, pancreatic function, integrity of muscle, immunology, bone stability (and many others)

====__How to save time in the process of doctor visit - lab test - doctor visit; where to get more information on recommended tests:__ ==== -family history very important - lots of programs available to physicians (equations) where you enter demographic info (age, gender), measures such as HDL (high density lipoproteings) and other blood results - and it calculates your risk of various diseases -also need to consider family history and lifestyle risk factors (nutrition, environment, smoking, drug use)

-another important area is emotional health - often brings people to health care -monitoring mood with questions to detect depression important -can monitor intellect eg. mini mental status exam - use to indicate dementia

-osteoporosis - a very high cost disease (bone density loss - leads to falls in elderly and large health care costs) - can measure bone density (scan) to indicate risk (could this be done with a bracelet x-ray type device?)

info on recommended screening tests for various age groups [1]


 * -Information about Type 2 diabetes, an expensive disease to treat, and it's estimated that by 2020 it will cost the Canadian healthcare system $16.9 billion per year. It's also a disease that requires constant monitoring and comes with early warning signs [2] **

====__Research into costs, methods and waiting times of the current healthcare system.__ ==== ====-An article from the CBC that had an article that dealt with Canadian healthcare spending in 2009. [3] ====

Article summary:

- Summary on wait times from a study done in 2005 from Statistics Canada. In general, people waiting to see a specialist or to have diagnostic tests had average wait times between 3-4 weeks. [4]


 * Article summary: **


 * - Information regarding surgery wait times in Canada [5] **


 * **The topic of current technologies addressing our inquiry is covered by the below links/documents:**

__Monitoring systems for the elderly.__
- Response and alert services for the elderly [6],[7] and [8]

====__Available or emerging technology for various areas of individual health__ ==== - small devices for heart rate monitoring, portable ECG card and technologies adopted in sports

- Technology developed for NASA astronauts from the John Glenn Biomedical Engineering Consortium that is making its way to civilians: a wireless device for real-time monitoring of patients, nanoporous filters that could help with care for kidney disease, blnon-invasive blood glucose monitor, cataract and ocular sensor to assess eye condition. [9]

summary of the technology, full length description from NASA:

- research on drug interaction software

- An ECG monitoring glove [10] - cool looking insulin pumps that could inspire the look of our device [11] - the Swatch brand is known for thin, lightweight and stylish timepieces and accessories for men and women, one can customize to suit their own style [12] - personal tech - fitness monitoring ideas [13] - health and well-being gadgets [14] - biosensors in vivo [15] - health care system idea from Asia [16] - potential testing requirements for a test to detect certain indicators [17] - medical devices in the home - needs and requirements [18] ,[19] - thoughts for design considerations - user requirements [20] - needle-less syringes - they work with pressure to put medication under the skin. Unfortunately, nothing works in reverse to draw blood from vessels [21] - abstract describing infrared spectroscopy which has potential for a number of non-invasive measures via blood vessels (such as oxygenation) [22] - blood pressure monitoring using the finger. An example of a system [23] Review and comparison of home based blood pressure monitoring [24]

- blood glucose testers from Bayer summary Blood Glucose Testers from Bayer.docx

- studies have been done measuring pain response to needle pricks - 0.15 mm diameter is the smallest available and has been shown to be "pain-free" [25] - found while perusing Google with the search "implantable biosensor". It highlights the challenges between implantable (long life and biocompatible) versus external (patients forgetting and carrying multiple monitors). [26] - see page 22 of this link for the book on Body Sensor Networks [27] - Health Hero Network - health network tailored to individual health care monitoring [28] - a business perspective on mobile devices in healthcare "How Can Mobile Phones Transform Healthcare" [29] - heart rate monitors in exercise equipment from Wikipedia [30]