ABSTRACT

Socioeconomic status and gender .................................................. 7 1.3 The healthcare model: Transforming with technology........................... 8

1.3.1 Home-and community-based health ............................................ 9 1.3.2 Outpatient care ................................................................................ 11 1.3.3 Hospitals ........................................................................................... 13 1.3.4 Assisted-care communities and institutions............................... 15

1.4 Conclusions................................................................................................... 17 References .............................................................................................................. 18

1.1 Introduction This chapter summarizes the impact of current trends in disease and disability on the delivery of healthcare using pervasive technology. We review the remarkable demographic shifts of the past century that have been driven by increases in life expectancy as a result of advances in public health as

well as in medical technology. The impact of these trends is further discussed with regard to the need to focus healthcare not only on its traditional core (providing point of care diagnosis and acute intervention) but also increasingly on managing growing numbers of people aging with chronic disease outside of traditional hospital or clinic settings. In this context we review how a broad range of technologies using pervasive computing may provide important new approaches to improve the provision of healthcare. How these technologies may affect diagnosis and treatment in specific settings such as the home or doctor’s office or as a hospitalized patient or resident of a continuing care facility are considered in turn with special emphasis given in conclusion to the power of pervasive computing to effectively integrate and blur the boundaries of these conventionally isolated healthcare settings. Finally, we conclude with a consideration of what these new technologies will require to become widely adopted such as standardization and adequately powered clinical trials demonstrating efficacy and safety.