E-HEALTH

Technology and health =

a match

The impact of smart technologies like AI and machine learning on the e-health care sector is enormous. There are cameras that diagnose a patient by measuring body temperature. Cloud expert Ivo Haagen explains how this works. Moreover, diabetic patient Chris Houtmeyers clarifies how an automatic insulin pump improves the treatment.

THE ROLE OF THE CLOUD IN E-HEALTHCARE

Will we soon be operating from a distance?

How do technologies such as artificial intelligence and machine learning help to promote e-healthcare and what role does the cloud play here? The view of Ivo Haagen, Product Manager Cloud at Proximus. The cloud: evolution or revolution? Ivo Haagen, Product Manager Cloud at Proximus: “Switching to the cloud is becoming more and more important to make applications and programs accessible everywhere. The public cloud plays a major role here. But things are evolving rather slowly. Belgium in particular is proving fairly conservative. However, under pressure from major cloud players, companies are now racing to prepare applications for the cloud.”

New technologies and privacy restrictions New technologies mean that more and more data are generated and stored. And there are new privacy rules now, too. Ivo: “That’s right, but privacy is just as important as it ever was. Te only difference is the way we use data. Because applications are integrated and users often only have to log in once, extra reliable means should now be used to collect data.” Ivo: “That is why new technologies are evolving partly based on data protection and the confidence that the end user has to have in them. For example, there is a move towards multi-factor authentication, and we are also seeing a trend towards saving biometric data by means of eye scans, fingerprints and the like. Responsibility for security also lies partly with the end user, who can download, modify and delete his data.” Data protection Proximus complies with all privacy and data laws. Data are stored in a closed system. “With cloud computing, the engineers must be able to get to the data. This is why patient data are anonymized. The data remain available in the public cloud, but the patients’ names are replaced by numbers. So, you can still use these data to make calculations, for instance, without knowing who the patient is,” Ivo adds.

IVO HAAGEN is Azure Practice Lead Benelux at Proximus. He helps you with your digital transformation to the cloud. Having spent time at the Cronos Groep, Xylos and itnetX Belgium, among others, he has built up end-to-end experience in the public cloud.


Smart cameras, voice technology and face recognition Various technologies are in the pipeline, such as distance operations using robots. Azure Kinect is another example of a new technology. The Microsoft smart camera detects patterns in movements thanks to artificial intelligence and machine learning. “In departments for people with dementia, doors open and close automatically with Azure Kinect. If a patient feels the urge to wander off, the camera warns the right people. Voice technology and face recognition are ready, for example, to prompt dementia patients to take their medicine by means of a familiar voice and a digital assistant such as Cortana. This gives nurses more time for better quality care.”

Automatic follow-up of medication Proximus also makes it possible to follow up on medication end-to-end via smartphone, from prescribing to ordering and administering. “This means that the effect of medicines can be measured far more accurately: what effect does it actually have and what should it be doing? The doctor can also check whether the drugs are being taken at the right time. You can send an Alzheimer’s patient a reminder to take his medication. And your smartphone can tell you whether a side-effect of a drug is normal or not.” The possibilities and benefits are huge.

“AUTOMATIC FOLLOW-UP OF MEDICATION OFFERS A WHOLE HOST OF POSSIBILITIES AND BENEFITS. SO FAR, WE ONLY KNOW A HANDFUL OF THEM.”

Ivo Haagen, Product Manager Cloud at Proximus

A more normal life thanks to automatic insulin pump

What impact are smart technologies having on the treatment of diabetes? Chris Houtmeyers, Customer Solution Architect at Proximus, has diabetes himself and knows better than anyone how technology can change and improve treatment of the disease. What is diabetes and what types are there? Chris Houtmeyers, Customer Solution Architect at Proximus: “Diabetes is a chronic disease that occurs when the glucose level in your body is not correctly regulated. Your pancreas does not work properly and does not produce enough insulin. Too little insulin means that your body does not absorb the glucose in your blood or does not do so properly. As a diabetes patient you have to seek the right balance between the sugars you get from your food, physical exertion and the insulin that you need for this. That is extremely difficult and changes from day to day.” Chris: “There are two types of diabetes. With type 1, your body makes far too little or no insulin at all. You have to inject insulin several times a day or wear an insulin pump. With type 2, your body still makes insulin, but not enough. I myself am a type 1 diabetes patient.” What treatments are available? Chris: “The standard finger prick tells you how much glucose you have in your blood. The disadvantage is that the mutual insurance fund reimburses you for a maximum of four finger pricks per day. This means you can’t get an accurate picture of how the glucose in your body is evolving. With Continuous Glucose Monitoring (CGM), a sensor measures how much glucose there is in the tissue between your body cells every five minutes. That’s 288 times per day. That way, you can see the glucose in your body evolving and you can predict when you are going to need insulin. The technology can also be used to set alarms when there is too much or too little glucose in your blood. The disadvantage of this continuous measuring is the time lapse. The quantity that you see was the amount in your blood 15 minutes earlier.”

Chris: “You can inject the insulin yourself. There are slow-acting and fast-acting insulins. Slow-acting insulin works for 24 hours, fast-acting starts working after 20 to 30 minutes. Insulin pumps deliver a continuous amount of fast-acting insulin, which you can set yourself. The latest-generation pumps, such as the Hybrid Closed Loop pump, carry out continuous measurements and automatically regulate the quantity of insulin. In that case, you have to inject yourself with fast-acting insulin via the insulin pump before every meal so that your body can process the sugars from your food. Hence the name hybrid.”

CHRIS HOUTMEYERS is Customer Solution Architect at Proximus. He began his career 30 years ago with Telindus, where he was in charge of data communication. He stayed on board after the takeover by Belgacom and then the name change to Proximus and now develops customized solutions for companies.


“The next generation of insulin pumps regulates everything automatically, so that as a diabetes patient you can live a normal life.”
Chris Houtmeyers, Customer Solution Architect at Proximus

How does technology play a role in the treatments? Chris: “As a diabetes patient, you have to take about 180 extra decisions per day, compared with healthy people. That’s a heavy burden, made more tolerable by the insulin pump that you carry in your inside pocket. With the Full Closed Loop pump, the next generation is ready. It regulates everything automatically, so that as a diabetes patient, you can live the life of a normal person. A bionic or artificial pancreas goes a step further and automatically decides when your body needs insulin or glucagon. Glucagon is a hormone that has the opposite effect to insulin and works to increase the glucose in the blood. The two systems are awaiting approval.”

“WE ARE EVOLVING TOWARDS DISTANCE MONITORING OF DIABETES, WHICH IS FAR LESS COSTLY FOR SOCIETY THAN ALL THE CONSULTATIONS AND COMPLICATIONS THAT HAVE TO BE TREATED NOW.”

Chris Houtmeyers, Customer Solution Architect at Proximus


How are the data shared between patients and doctors? Chris: “An insulin pump is connected to the cloud and automatically uploads all the measurements. All the data sent from the sensor to the pump and from the pump to the cloud are encrypted. As a patient, you determine who can see your data. The Gasthuisberg hospital in Leuven, for example, links the Medtronic diabetes platform with the electronic patient’s file. This means that the doctors and endocrinologists always have the most recent data available. That enables distance monitoring. They can also request reports to see whether your diabetes regulation is under control.”

Are there any drawbacks? Chris: “Technology is not infallible. From time to time, as a patient you still have to intervene and prick your finger if you notice that a measurement is not right. The industry needs to look for sensors that measure more quickly and that significantly increase reliability. That way, the periods when you, as a patient, no longer have to take a manual measurement to calibrate the pump if any abnormalities occur will lengthen. And the pumps still mean that patients have to make an extra effort. But the advantages definitely outweigh the disadvantages.”

THE ADVANTAGES FOR DOCTORS

Higher efficiency

Remote observation, the patient has to visit the doctor less

Improved aid thanks to data

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