Biomedical Monitoring Technologies and Future Healthcare Systems

  • Marie Chan The University of Toulouse
  • Eric Campo The University of Toulouse
  • Damien Brulin The University of Toulouse
  • Daniel Est`eve The University of Toulouse


Healthcare Systems (HCSs) throughout the world undergo important changes driven by aging populations and advances in biomedical technologies. At the same time, in the current economic climate, many Western countries are struggling to reduce public spending on all kinds of services, including healthcare. With this tension between tightening budgets and skyrocketing costs, many countries are seeking to identify ways of using Information Technology (IT) and Monitoring Technologies (MTs) to improve the efficiencies of HCSs while not reducing, or possibly even improving, the quality of healthcare and their delivery. Many experiments have been in progress since the 1990s. This paper has conducted a review evaluating such HCSs in terms of advantages and drawbacks. The objective of this review is to provide some illustrative publications and works and examples of Health Information Technology (HIT) systems to finally determine the place of biomedical MTs in the future HCS. We present the healthcare delivery system (HCDS) organization with roles of the different stakeholders, state initiatives in healthcare information delivery systems and the new relation between the hospital and the home though a new equilibrium. We mentioned the increasing role of telemedicine (TM), telecare (TLC) and telemonitoring (TLM) and expectations for monitoring the elderly. These expectations lead to preventive approaches based on monitoring technologies and pervasive healthcare (PH) which made healthcare improvements and cost reductions possible. Finally, we show the challenges and opportunities of the hospital versus home healthcare delivery.


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[1] R. Lenz and M. Reichert, “It support for healthcare processes? premises, challenges, perspectives,” Data & Knowledge Engineering, vol. 61, no. 1, pp. 39–58, 2007.
[2] A. Rosenthal, P. Mork, M. H. Li, J. Stanford, D. Koester, and P. Reynolds, “Cloud computing: a new business paradigm for biomedical information sharing,” J. of Biomedical Informatics, vol. 43, no. 2, pp. 342–352, 2010.
[3] P. Simon and D. Acker, “La place de la t´el´em´edecine dans l’organisation des soins.” Available at: final Telemedecine.pdf. Accessed 12 Dec. 2016.
[4] N. van den Berg, M. Schumann, K. Kraft, and W. Hoffmann, “Telemedicine and telecare for older patients? a systematic review,” Maturitas, vol. 73, no. 2, pp. 94–114, 2012.
[5] C. Milligan, C. Roberts, and M. Mort, “Telecare and older people: Who cares where?,” Social Science & Med., vol. 72, no. 3, pp. 347–354, 2011.
[6] L. M. Kern, Y. Barr´on, R. V. Dhopeshwarkar, A. Edwards, R. Kaushal, and H. Investigators, “Electronic health records and ambulatory quality care,” J. of General Internal Med., vol. 28, no. 4, pp. 496–503, 2013.
[7] R. E. Scott, “e-records in health–preserving our future,” Int. J. of Medical Informatics, vol. 76, no. 5, pp. 427–431, 2007.
[8] D. Salvi, J. Gorman, M. T. Arredondo, C. Vera-Munoz, M. Ottaviano, and S. Salvi, “A platform for the development of patient applications in the domain of personalized health,”Computer Methods and Programs in Biomed., vol. 107, no. 1, pp. 45–52, 2012.
[9] S. Rao, C. Brammer, A. McKethan, and M. B. Buntin, “Health information technology: transforming chronic disease management and care transitions,” Primary Care: Clinics in Office Practice, vol. 39, no. 2, pp. 327–344, 2012.
[10] J. R. Shah, M. B. Murtaza, and E. Opara, “Electronic health records: challenges and opportunities,” J. of Int. Technology and Inf. Management, vol. 23, no. 3, pp. 189–204, 2014.
[11] I. R. Bardhan and M. F. Thouin, “Health information technology and its impact on the quality and cost of healthcare delivery,” Decision Support Systems, vol. 55, no. 2, pp. 438–449, 2013.
[12] A. T. Association, “Arizona and montana governors sign telemedicine bills into law.” Available at: Accessed 12 Dec. 2016.
[13] A. L. Neves, “French boost european telemedicine,” Canadian Medical Assoc. J., vol. 183, no. 7, pp. 387–388, 2011.
[14] P. Suter, W. N. Suter, and D. Johnston, “Theory-based telehealth and patient empowerment,” Population Health Management, vol. 14, no. 2, pp. 87–92, 2011.
[15] C. Juhne and A. C. M¨ uhlbacher, “Patient-centeredness in integrated healthcare delivery systems - needs, expectations and priorities for organized healthcare systems,” Int. J. of Integrated Care, vol. 13, p. e051, 2013.
[16] L. R. Martin, S. M. Williams, K. B. Haskard, and M. R. DiMatteo, “The challenge of patient adherence,” Therapeutics and Clin. Risk Management, vol. 1, no. 3, pp. 189–199, 2005.
[17] P. A. Clark, K. Capuzzi, and J. Harrison, “Telemedicine: Medical, legal and ethical perspectives,” Medical Science Monitor: Int. J. of experimental and Clin. Research, vol. 16, no. 12, pp. 261– 272, 2010.
[18] G. Siegal, “Telemedicine: licensing and other legal issues,”Otolaryngologic Clinics of North America, vol. 44, no. 6, pp. 1375–1384, 2011.
[19] “S´ecurit´e sociale.” Available at: http://www.securitesociale. fr. Accessed 12 Dec. 2016.
[20] “Health at a glance in europe 2014.” Available at: en.pdf. Accessed 12 Dec. 2016.
[21] “Oecd reviews of health care quality: Denmark - raising standards, oecd publishing.” Available at:
[22] C. Georges, D. Whitehouse, and P. Duquenoy, eHealth: Legal, Ethical and Governance Challenges. Springer-Verlag Berlin Heidelberg, 2013.
[23] T. Marmor and C. Wendt, “Conceptual frameworks for comparing healthcare politics and policy,” Health Policy, vol. 107, no. 1, pp. 11–20, 2012.
[24] R. Thakur, S. H. Y. Hsu, and G. Fontenot, “Innovation in healthcare: Issues and future trends,” J. of Business research, vol. 65, no. 4, pp. 562–569, 2012.
[25] R. A. Rosenblatt and L. G. Hart, “Physicians and rural america,”Western J. of Med., vol. 173, no. 5, pp. 348–351, 2000.
[26] R. Amarasingham, L. Plantinga, M. Diener-West, D. J. Gaskin, and N. R. Powe, “Clinical information technologies and inpatient outcomes, a multiple hospital study,” Archives of Internal Med., vol. 169, no. 2, pp. 108–114, 2009.
[27] P. Vegoda, “Introducing the ihe (integrating the healthcare enterprise) concept,” J. of Healthcare Inf. Management, vol. 16, no. 1, pp. 22–24, 2002.
[28] C. M. Desroches, R. G. Campbell, S. R. Rao, K. Donelan, T. G. Ferris, A. Jha, and al, “Electronic health records in ambulatory care? a national survey of physicians,” New England J. of Med., vol. 359, no. 1, pp. 965–970, 2008.
[29] J. Adler-Milstein and D. W. Bates, “Paperless healthcare: progress and challenges of an it-enabled healthcare system,”Business Horizons, vol. 53, no. 2, pp. 119–130, 2010.
[30] R. G. Fichman, R. Kohli, and R. Krishnan, “The role of information systems in healthcare: current research and future trends,” Inf. Systems Research, vol. 22, no. 3, pp. 419–428, 2011.
[31] C. Wendt, “Mapping european healthcare systems: A comparative analysis of financing, service provision and access to healthcare,” J. of Eur. Soc. Pol., vol. 19, no. 5, pp. 432–445, 2009.
[32] J. E. Bardam, “Pervasive healthcare as a scientific discipline,”Methods of Inf. in Med., vol. 47, no. 3, pp. 178–185, 2008.
[33] K. Hobson, “Critics take aim at high-tech care,” U.S News & World Report, vol. 146, no. 7, pp. 76–78, 2009.
[34] H. Lester and F. D. R. Hobbs, “Major policy changes for primary care : potential lessons for the us new model of family medicine from the quality and outcomes framework in the united kingdom,” Family Med., vol. 39, no. 2, pp. 96–102, 2007.
[35] J. M. Renard, R. Beuscart, D. Delerue, and J. M. Geib, “The inter-regional medical information system: a new form of communication between healthcare providers,” ITBM-RBM, vol. 21, no. 5, pp. 275–280, 2000.
[36] J. M. Renard, J. F. Kulik, R. Beuscart, and J. M. Geib, “Intermediation: a new concept for medical data exchanges,”in First Joint BMES/EMBS Conference, vol. 2, (USA (Atlanta, GA)), October 1999.
[37] C. Abraham, E. Nishihara, and M. Akiyama, “Transforming healthcare with information technology in japan: a review of policy, people, and progress,” Int. J. of Medical Informatics, vol. 80, no. 3, pp. 157–170, 2011.
[38] F. Barbarito, F. Pinciroli, J. Mason, S. Marceglia, and L. Mazzola, “Implementing standards for the interoperability among healthcare providers in the public regionalized healthcare information system of the lombardy region,” J. of Biomedical Informatics, vol. 45, no. 4, pp. 736–745, 2012.
[39] N. Al-Qirim, “Championing telemedicine adoption and utilization in healthcare organizations in new zealand,” Int. J. of Medical Informatics, vol. 76, no. 1, pp. 42–54, 2007.
[40] A. Lymberis and S. Olsson, “Intelligent biomedical clothing for personal health and disease management: State of the art and future vision,” Telemed. J. and e-Health, vol. 9, no. 4, pp. 379–386, 2003.
[41] B. Charles, “Telemedicine can lower costs and improve access,”Healthcare Financial Management Assoc., vol. 54, no. 4, pp. 66–69, 2000.
[42] S. Edelstein, “Careful telemedicine planning limits costly liability exposure,” Healthcare Financial Management Assoc., vol. 53, no. 2, pp. 63–69, 1999.
[43] M. Chan, D. Est`eve, C. Escriba, and E. Campo, “A review of smart homes-present state and future challenges,” Computer Methods and Programs in Biomed., vol. 91, no. 1, pp. 55–81, 2008.
[44] J. Flower, The future of healthcare. Encyclopedia of the Future, Macmillan and Company, 1996.
[45] N. Genet, W. G. W. Boerma, D. S. Kringos, A. Bouman, A. L. Francke, C. Fagerstr¨om, M. G. Melchiorre, C. Greco, and W. Devill, “Home care in europe: a systematic literature review,” BMC Health Services Research, vol. 11, pp. 16–18, 2011.
[46] N. M. Hjelm, “Benefits and drawbacks of telemedicine,” J. of Telemed. and Telecare, vol. 11, no. 2, pp. 60–70, 2005.
[47] A. G. Ekeland, A. Bowes, and S. Flottor, “Effectiveness of telemedicine: A systematic review of reviews,” Int. J. of Medical Informatics, vol. 79, no. 11, pp. 736–771, 2010.
[48] A. K. Parekh, R. A. Goodman, C. Gordon, and H. K. Koh, “Managing multiple chronic conditions: A strategic framework for improving health outcomes and quality of life,”Public Health Reports, vol. 126, no. 4, pp. 460–471, 2011.
[49] S. C. Inglis, R. A. Clark, F. A. McAlister, S. Stewart, and J. G. Cleland, “Which components of heart failure programmes are effective? a systematic review and meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged cochrane review,” European J. of Heart Failure, vol. 13, no. 9, pp. 1028–1040, 2011.
[50] G. Gibelli, B. Gibelli, and F. Nani, “Thyroid cancer: possible role of telemedicine,” Acta Otorhinolaryngol Italica, vol. 28, no. 6, pp. 281–286, 2008.
[51] H. Hoenig, J. A. Sanford, T. Butterfield, P. C. Griffiths, P. Richardson, and K. Hargraves, “Development of a teletechnology protocol for in-home rehabilitation,” J. of Rehabilitation Research and Development, vol. 43, no. 2, pp. 287–298, 2006.
[52] N. V. Halifax, J. A. Cafazzo, M. J. Irvine, and al, “Telemanagement of hypertension: A qualitative assessment of patient and physician preferences,” Canadian J. of Cardiology, vol. 23, no. 7, pp. 591–594, 2007.
[53] S. McLean, D. Chandler, U. Nurmatov, J. Liu, C. Pagliari, J. Car, and A. Sheikh, “Telehealthcare for asthma: a cochrane review,” Canadian Medical Assoc. J., vol. 183, no. 11, pp. 733–742, 2011.
[54] J. Franek, “Home telehealth for patients with chronic obstructive pulmonary disease (copd),” Ontario Health Technology Assessment Series, vol. 12, no. 11, pp. 1–58, 2012.
[55] “World population ageing 2013.” Available at: Accessed 12 Dec.
[56] M. C. McDermid, H. T. Stelfox, and S. M. Bagshau, “Frailty in the critically ill: a novel concept,” Critical Care, vol. 15, no. 1, p. 301, 2011.
[57] Q. L. Xue, “The frailty syndrome: definition and natural history,” Clinics in Geriatric Med., vol. 27, no. 1, pp. 1–15, 2011.
[58] S. Hagler, D. Austin, T. L. Hayes, T. Kaye, and M. Pavel, “Unobtrusive and ubiquitous in-home monitoring: a methodology for continuous assessment of gait velocity in elders,”IEEE Trans. on Biomed. Eng., vol. 57, no. 4, pp. 813–820, 2010.
[59] J. Vermeulen, J. C. L. Neyens, E. van Rossum, M. D. Spreeuwenberg, and L. P. de Witte, “Predicting adl disability in community-dwelling elderly people using physical frailty indicators: a systematic review,” BMC Geriatrics, vol. 11, no. 1, p. 33, 2011.
[60] Z. Bien and S.W. Lee, “Learning structure of human behavior patterns in a smart home system,” Quantitative Logic and Soft Computing (Advances in intelligent and Soft Computing), vol. 82, pp. 1–15, 2010.
[61] W. Bourennane, Y. Charlon, F. Bettahar, M. Chan, D. Est`eve, and E. Campo, “Ambient intelligence for monitoring alzheimer patients,” Int. J. of E-Health and Medical Communications, vol. 4, no. 1, pp. 23–35, 2013.
[62] W. Bourennane, F. Bettahar, and E. Campo, “Self adaptive trajectory learning for monitoring the elderly wandering,” in Int. Conference on Biomedical Engineering (BIOMED), (Austria (Innsbruck)), p. 6p, February 2013.
[63] S. C. Peirce, A. R. Hardisty, A. D. Preece, and G. Elwyn, “Designing and implementing telemonitoring for early detection of deterioration in chronic disease: defining the requirements,”Health Informatics J., vol. 17, no. 3, pp. 173–190, 2011.
[64] J. C. van Haastreqt, E. van Rossum, J. P. Diederiks, L. P. de Witte, P. M. Voorhoeve, and H. F. Crebolder, “Processevaluation of a home visit programme to prevent falls and mobility impairments among elderly people at risk,” Patient Education and Counceling, vol. 47, no. 4, pp. 301–309, 2002.
[65] E. R. Larsen, L. Mosekilde, and A. Foldspang, “Determinants of acceptance of a community based program for the prevention of falls and fractures among the elderly,” Preventive Med., vol. 33, no. 2, pp. 115–119, 2001.
[66] E. Dishman, “Inventing wellness systems for aging in place,”
Computer, vol. 37, no. 5, pp. 34–41, 2004.
[67] D. Hoch and T. Ferguson, “What i’ve learned from e-patient,”PloS Med., vol. 2, no. 8, p. e206, 2005.
[68] M. M. Funnell, “Helping patients take charge of their chronic illnesses,” Family Practice Management, vol. 7, no. 3, pp. 47–51,2000.
[69] “Insee.” Available at: document.asp?ref id=ip1340. Accessed 12 Dec. 2016.
[70] S. Koch, M. Marschollek, K. H. Wolf, M. Plischke, and R. Haux, “On health-enabling and ambient-assistive technologies - what has been achieved and where do we have to go?,” Methods of Inf. in Med., vol. 48, no. 1, pp. 29–37, 2009.
[71] L. P. Kaelbing, M. L. Littman, and A. W. Moore, “Reinforcement learning: A survey,” J. of Artificial Intelligence Research, vol. 4, pp. 237–285, 1996.
[72] M. Chan, E. Campo, and D. Est`eve, “Prosafe, a multisensory remote monitoring system for the elderly or the handicapped,”in Int. Conference On Smart homes & health Telematics, (Canada (Montreal, PQ)), p. 7p, June 2011.
[73] T. S. Barger, D. E. Brown, and M. Alwan, “Health-status monitoring through analysis of behavioral patterns,” IEEE Trans. on Systems, Man and Cybernetics, part A: Systems and humans, vol. 35, no. 1, pp. 22–27, 2005.
[74] R. Hamid, S. Maddi, A. Johnson, A. Bobick, I. Essa, and C. Isbell, “A novel sequence representation for unsupervised analysis of human activities,” Artificial Intelligence, vol. 173, no. 14, pp. 1221–1244, 2009.
[75] P. Rashidi, D. J. Cook, L. B. Holder, and M. Schmitter-Edgecombe, “Discovering activities to recognize and track in a smart environment,” IEEE Trans. on Knowledge and Data Engineering, vol. 23, no. 4, pp. 527–539, 2011.
[76] J. Boger, J. Hoey, P. Poupartg, C. Boutilier, G. Fernie, and A. Mihailidis, “A planning system based on markov decision processes to guide people with dementia through activities of daily living,” IEEE Trans. on Inf. Technology in Biomed., vol. 10, no. 2, pp. 323–333, 2006.
[77] T. Tamura, J. Zhou, H. Mizukami, and T. Togawa, “A system for monitoring temperature distribution in bed and its application to the assessment of body movement,” Physiological Measurement, vol. 14, no. 1, pp. 33–43, 1993.
[78] M. Chan, D. Est`eve, J. Fourniols, C. Escriba, and E. Campo, “Smart wearable systems: Current status and future challenges,” Artificial Intelligence in Med., vol. 56, pp. 137–156, 2012.
[79] R. E. Herzlinger, “Healthcare reform and its implications for the u.s. economy,” Business Horizons, vol. 53, no. 2, pp. 105–117, 2010.
[80] Z. Ma, “An electronic second skin,” Science, vol. 333, no. 6044, pp. 830–831, 2011.
[81] A. J. Chung, D. Kim, and D. Erickson, “Electrokinetic microfluidic devices for rigid, low power drug delivery in
autonomous microsystems,” Lab on Chip, vol. 8, no. 2, pp. 330–338, 2008.
[82] J. Lueke and W. A. Moussa, “Mems-based power generation techniques for implantable biosensing applications,” Sensors, vol. 11, no. 2, pp. 1433–1460, 2011.
[83] A. R. Eliakim, “Video capsule endoscopy of the small bowel (pillcam sb),” Current opinion in gastroenterology, vol. 29, no. 3, pp. 133–139, 2013.
[84] Carmat. Available at: Accessed 12 Dec. 2016.
[85] AWAK, “Automated wearable artificial kidney.” Available at: Accessed 12 Dec. 2016.
[86] A. Davenport, “Portable or wearable peritoneal devices - the next stop forward for peritoneal dialysis?,” Advances in Peritoneal Dialysis, vol. 28, pp. 97–101, 2012.
[87] H. D. Humes, D. Buffington, A. J. Westover, S. Roy, and W. H. Fissel, “The bioartificial kidney: current status and future promise,” Pediatric Nephrology, vol. 29, no. 3, pp. 343–351, 2014.
[88] T. S. Dahl and M. N. K. Boulos, “Robots in health and social care: A complementary technology to home care and telehealthcare?,” Robotics, vol. 3, no. 1, pp. 1–21, 2013.
[89] P. Dario, P. F. M. J. Verschure, T. Prescott, G. Cheng, G. Sandini, R. Cingolani, and al, “Robot companions for citizens,”Procedia Computer Science, vol. 7, pp. 47–51, 2011.
[90] H. M. Gross, C. Schroeter, S. Mueller, M. Volkhardt, E. Einhorn, A. Bley, C. Martin, T. Langner, and M. Merten,
“Progress in developing a socially assistive mobile home robot companion for the elderly with mild cognitive impairment,”in IEEE/RJS, Int. Conference on Intelligent Robots and Systems, (USA (San Francisco, CA)), pp. 2430–2437, September 2011.
[91] M. G. Aspinall and R. G. Hamermesh, “Realizing the promise of personalized medicine,” Harvard Business Review, vol. 85, no. 10, pp. 108–117, 2007.
[92] “Population reference bureau.” Available at: Accessed
12 Dec. 2016.
[93] “Eurostat.” Available at: en. Accessed 12 Dec. 2016.
[94] A. Piau, Y. Charlon, E. Campo, B. Vellas, and F. Nourhashemi, “A smart insole to promote healthy aging for frail elderly individuals: Specifications, design, and preliminary results protocol,” JMIR Rehab. and Assist. Technol., vol. 2, no. 1, p. e5, 2015.

How to Cite
CHAN, Marie et al. Biomedical Monitoring Technologies and Future Healthcare Systems. Journal of Science and Technology: Issue on Information and Communications Technology, [S.l.], v. 3, n. 1, p. 59-75, mar. 2017. ISSN 1859-1531. Available at: <>. Date accessed: 29 may 2020. doi: