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Pervasive Health Management: New Challenges for Health Informatics

This special issue addresses the area of Pervasive Health Management, which is beginning to challenge the twentieth century model of delivery, in which healthcare was organised in specialist locations and administered to patients by healthcare professionals. Thus primary care provides the initial contact, large hospitals administer specialist intervention and disease management, and long term hospital or rest-home care is provided for those with special needs and chronic debilitating conditions. This is still the predominant mode of healthcare interaction, but the contributions in this volume indicate the potential of the new mode of delivery and the challenges posed for health informatics. There are many factors which have contributed to this potential shift in focus. Significant advances within the realms of Information and Communication Technology (ICT) include the availability of high speed Internet communications, the proliferation of wireless and mobile devices, the deployment of low cost sensor technology, and the embedding of intelligence within devices. There is of course consumer demand, which is transforming the discipline of health informatics and raising expectation of healthcare delivery. Wilson et al. [P. Wilson , C. Leitner and A. Moussalli, 2004] state that “…eHealth, like eGovernment and eCommerce, is about placing citizens at the centre of the circle and easing the interaction with the wide range of people who look after their needs”. There is also the economic reality of the cost of healthcare, particularly chronic disease management as people obtain greater longevity. The World Health Organisation has identified that chronic conditions will be the leading cause of disability by 2020 and that if not successfully managed, will become the most expensive problem for healthcare systems. In the Western Economies the implications of an aging population will increase expenditure on healthcare to a level which many experts consider unsustainable. This is based on predictions of ratios of people of working age to those dependent on pension provision. Predictions of increased working life beyond current retirement age have been suggested as a means of reduction of expenditure on pensions but healthcare provision will require more efficient means of delivery in order to meet these needs. In the United States, where significant healthcare is privately funded the overwhelming opinion is that costs will rise considerably. Competition within the private sector will seek market driven solutions to new and innovative means of