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스마트의료기술 Mobile health

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국가표준 코디네이터 스마트의료기술 세미나 발표자료입니다.

발표 : 2014.11

Publié dans : Santé
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스마트의료기술 Mobile health

  1. 1. □Mobile Health (mHealth) 모바일디바이스로지원받는의학및공중건강업무행위(WHO, 2011) 모바일기기(일반적으로스마트폰뿐만아니라전문의료모바일기기포함) 이용을통해건강관리나건강관련정보들을제공받는것(GSMA, PwC, 2012) -모바일헬스케어는모바일기기(의학용기기나센서) 뿐만아니라건강관리를비롯하여SMS와원격진료로제공되는개인건강지침시스템(Personal guidance system), 건강정보및약복용알람(medication reminders) 등기기와연결된애플리케이션을포함함(European Commission, 2014) □Mobile Health 주목받는배경 모바일기술의진화와폭발적인가입자증가때문 -세계모바일기기의이용자수는약32억명, 2017년까지7억명증가하여2018년에는세계인구40억명돌파예측 -모바일네트워크기술의진화와함께센서기술의발전, 센서의가격하락으로보급확산 인구고령화와만성질환자의증가로인한의료비급증때문 -건강보험에서노인의료비비중2007년28.2%, 2011년33.3% 지속적증가 -개인별소득대비의료비비율은40대5.4%, 60대21.5% 인구고령화가속에따른의료비증가 Mobile Health 기술개요
  2. 2. □Solution across the Patient Pathway Wellness: Fitness Monitoring Prevention: Information Tips Diagnosis: Interaction Consultation Treatment: Reminders, Compliance Trackers Monitoring: Activity Trackers □Healthcare system Strengthening Emergency Response Healthcare Practitioner Support -의료관련종사자의Medical Information 지원 Healthcare Surveillance (평가관리∙인증) Healthcare Administrator mHealth Service Categorization (자료: GSMA & PwC Analysis)
  3. 3. 국외정책동향 □유럽연합(EU) 모바일헬스케어의도입목표: 의료비절감(선진국), 기초의료의접근성증진(개발도상국) -사회경제의비용절감, 라이프스타일개선, 자원효율성향상(European Commission, 2014) -2013년까지U-Health에6억유로투입, AAL (고령자에게IT기기/ 서비스제공) 프로젝트진행 덴마크: 원격의료주류화를주도하는국가, 「원격의료실천계획, Telemedicine Action Plan」’12.09수립 -ICT 스마트헬스케어국가표준수립, ICT기반의「Super Hospital」16개신설, Connected Healthcare표준화추진 -유럽연합의Continua Health Alliance 가이드라인및플랫폼기초로진행 □미국 2014년까지전국민에게EHR 시스템구축진행, Health IT 계획, U-Health 선진화계획추진중 의료용모바일앱규정마련, 「FDA 모바일앱의료기기규제에관한가이드라인」(’13.9) -의료기기규정을기반, 모바일앱의위험수준을분류하여적용(Class I, II, III) 건강정보보안문제의공론화유도 □일본 「국가Brand Design의Healthcare 정보화」, 모바일헬스산업집중육성대상선정 -전국민의PHR 시스템운용시작(’13) , 의료기관간보건정보교류EHR 구축완료(’15), 헬스케어벤처회사10조엔투자 -일본후생성, 「원격방사선진단, 원격병리진단, 협동의료, 원격가정간호」등의원격사업진행및서비스확대중
  4. 4. 국내정책동향 □박근혜정부, 신의료·융합서비스발전을위한제도및정보화기반을조성 140대국정과제중하나,보건·고령친화산업을미래성장사업으로육성하기위해유헬스추진 □부처별정책 보건복지부, 의사와환자간원격진료를허용하는의료법개정 -환자와의사간원격진료허용을골자로하는의료법개정안을입법예고(‘13.10) 지식경제부, 「2018년의료기기5대선진강국으로도약」위한추진전략및장단기추진과제 -디지털병원수출, U-Healthcare 신사업창출, 국제기준적합화지원, 임상시험지원강화에집중 -스마트케어사업, 총300억의예산을투입, 만성질환자1 만명대상으로u-Health 서비스를세계최대규모제공(‘10) 산업통산자원부, 의료및엔터테인먼트용웨어러블컴퓨터기술개발에역량을집중, 산업기술혁신계획 -「u헬스케어산업의신성장동력화를위해헬스케어신시장창출전략(2014~2021년)」발표(‘13.11) 미래창조과학부, 「바이오헬스신시장발굴을위한미래부연구개발(R&D) 추진방안」(‘14.04) -생애단계별8대건강문제해결을위한연구개발(R&D) 추진전략 -바이오·의료기술개발사업등총3개사업, 12개분야의신규과제를선정 -「창조비타민프로젝트추진계획」7대분야중‘보건의료’를선정, 생애주기별개인맞춤형의료서비스를제공(‘13.11) -사용자중심의공공의료서비스제공을위해원격의료, 응급, 안전관리등U-헬스서비스모델을개발적용(’06)
  5. 5. □전세계mHealth 시장규모230억$, 유럽및아시아큰시장으로성장(GSMA, 2012) 2017년기준, 230억$로성장예상, 유럽과아시아는각30%의시장차지 선진국의경우헬스모니터링분야, 개발도상국의경우진단, 처치분야의시장이유망 -유럽(기타48%, 독일15%, 프랑스12%, 러시아11% 이탈리아8%, 영국6% 순) -아시아(중국37%, 일본21%, 인도8% 순) □모바일헬스케어시장, 2016년이용자가300만명(영국, JeniperResearch) 모바일헬스케어의료관련앱다운로드수, 2012년4400만건2016년1억4200만건으로증가전망 2015년까지전세계5억명스마트폰이용자가의료용모바일앱이용예상(KotraGlobal Window, 2013) 피트니스, 헬스케어웨어러블디바이스시장규모2013년16억$ 2016년50억$ 전망(Gartner) 해외시장동향 (자료, KT 경제경영연구소)
  6. 6. □국내U-Health 서비스시장전망(KHIDI, 2010) □삼성전자, LG전자, SK텔레콤등스마트폰제조사와통신사들은모바일헬스케어산업을미래의신수종사업으로선정하고, 대대적인투자를감행 삼성전자, 갤럭시S4, S5 시리즈에S헬스기능탑재, 기어, 헬스체중계등SAMI 아키텍처기반생태계구축중 SK텔레콤, ICT 기반의스마트의료구축사업을위한다양한모바일솔루션개발B2C 사업 -서울대병원과합작사, 헬스커넥트설립(2011), 헬스온서비스구축 -예방, 진단, 치료, 관리를연계한차세대의료서비스모델개발 KT, U-Health 센터를중심으로공공보건의료서비스및지자체별서비스모델사업 -독거노인, 만성질환자관리, 헬스파크 -연세대의료원과합작사, 후헬스케어설립(2012), 스마트의료사업을추진 국내시장동향 시장 2010 2011 2012 2013 2014 평균증가율 U-Medical 3,238 3,724 4,282 4,925 5,663 11.8% U-Silver 3,351 3,677 4,033 4,424 4,854 7.7% U-Wellness 10,260 12,100 14,261 16,814 19,824 14.1% (자료: KHIDI, 2010, 단위: 억원)
  7. 7. 기술동향1 □모바일헬스케어스마트센서기술 MEMS(Micro Electromechanical System), SoC(System on Chip), 임베디드SW등을센서기술과융합적용 □모바일헬스케어어플리케이션구현응용기술 PHR(Personal Health Record) 및방대한자료분석기술(빅데이터)을통한맞춤형의료정보기술분야로연구 모바일건강관리앱을위한기술연구(실시간전송, 피드백처리, 앱간상호연계, 데이터기술, 채널중계등) 모바일헬스케어응용서비스를위한Wearable Device 융합기술 -활동측정(Activity Tracker) 기술, 수면추적, 스마트양말(Owlet Sock), Beddit, Fitbit Flex, Misfit Shine, Jawbone Up, -생체정보기반건강상태측정기술, Nike Plus, Sonar Vision (시각장애인), 임산부용건강체크복대 -통증완화용패치(TENS Path), 건강상황모니터링(BodyMedia), 시차조정기(ReTimer), 스마트언더웨어, 바이오패치 -반사형녹색LED 센서(맥박측정), 차세대의류(Fitness SHIRT), 피부임플란트형혈액검사, 로봇외골격, 전자칩자동투약, 이미지센서 광학신호를전기신호로변경하는반도체, CCD,CMOS 고화소기술 의료영상처리응용 관성센서 가속도를측정하는센서로모션센서, 항법센서, IR센서등의결합기술 피트니스모니터용 헬스케어센서 진단, 검사중심질병검사용센서, 혈당센서, 심박수센서등 사전예방위한측정용 바이오센서 바이오리셉터(효소, 항체, DNA, 세포등)의반응, 결합을신호변환측정 질병진단, 감염진단용
  8. 8. 기술동향2 □모바일헬스케어플랫폼& 데이터허브, Apple Healthkit Apple의헬스데이터통합및채널관리를통한사용자경험의지속유지확보전략 mHealth 개방형플랫폼공유지향, 다양한3rd개발유도 강력한파트너쉽구축: Mayo Clinic (의료기관), Epic (EHR IT회사), Nike 등연계 헬스데이터수집∙확보계획: iWatch 액티비티앱(Activity App), 워크아웃앱(Workout App) • Mayo Clinic, 15,000Mobile Device -Synthesis Mobile : 의료진Full EMR Access -Mayo Clinic Quarterly : 내부연락 -Patient: 환자자신의의료정보Access -Ask Mayo Expert : 병원내질병전문가검색 Activity (움직이기, 운동하기, 일어나기) • EPIC, 의료IT밴더1위(KLAS Research, 2010) -Healthkit 통합MyChart personal health record -단말기수요증대요소인EHR 사업에비중 • iWatch Wearable Device Workout (묙표설정, 미리알림, 달성)
  9. 9. 표준동향 □ISO/TR : Technical Report 19231 「개발도상국을위한모바일헬스표준안」출판예정(2015) 17522,「Provisions for Health Applications on Mobile/Smart Devices」출판예정(2015) □ISO/NP : New Work Item Proposal 20055, 「Person-owned Document Repository for PHR Applications and Health Information Exchange」 -Survey of mHealth Projects in Low and Middle Income Countries (LMIC): 프로젝트리더, 김일곤교수 -후진국가모바일헬스서비스의다양한사례를분석하고, -후진국가들이추구해야할모바일헬스기술표준프레임워크를생성할수있는표준기술들을제시 -모바일환경에서환자·의사모두가필요한요구사항을교환할수있도록하는모바일헬스표준 -모바일헬스기술표준프레임워크, 환자와의사의쉬운의료정보접근, 활용, 의료전달체계의효율성향상 -병원중심의진료정보교류교착상황을심층분석: 이해당사자간의충돌, 적절한보상체계미비등문제점 -고객/환자주도로쉽게해결할수있는환자중심의진료정보교류체계에관한기술표준안제안 -현실적인진료정보교류뿐아니라, 모바일·클라우드등최신서비스플랫폼기반의다양한PHR 응용가능 -프로젝트리더, 삼성서울병원이병기수석연구원
  10. 10. □헬스케어관련국내특허출현순위 고령화가빠르게진행됨에따라, 이와관련된모바일헬스케어기술분야선점위한출원경쟁치열 헬스플랫폼, 제조사및통신사들의헬스케어분야의핵심원천기술확보에투자가지속될전망 R&D 스마트폰기반의모바일헬스케어기술776건특허출원 -국가별/출원인국적별특허동향으로볼때, 미국과한국이2/3 정도차지, 모바일헬스케어의연구분야주도국 -50% 이상, 의료네트워크기술491건, 단말기를이용한만성생활습관질환센싱하는기술313건(특허청, 2012.12) •모바일을이용한원격모니터링(29.7%), 데이터송수신및저장기술(24.3%) 이큰비중을차지 -삼성전자의경우,특허출원등의독자적기술개발강화와함께의료기기업체인지멘스와원천특허공유추진중 특허동향 106 93 81 44 43 39 35 33 30 28 0 50 100 150 건… (출처, 전자신문14.03) (출처, R&D특허센터12.12)
  11. 11. 현장적용사례1 □라이프로그용Activity Tracker 몸에착용하거나이용하여활동량이나에너지소비량을분석해기록하는모바일헬스케어디바이스 24시간, Wearable 기반의착용감, 편리성, 저전력, 데이터동기화등의핵심기술 Swaive Thermometer HAPI fork & HAPI Track Larklife •스마트체온계 •Healthkit 플랫폼통합 •가족관리,응급병원연계 •블루투스, 낮은가격(79$) •식전및식후운동조절용 -식습관속도개선(포크) -식후운동습관개선(트랙) •입술접촉여부센서감지 -포크의진동으로경고피드백 •모바일기반자동로그 •수면체크및운동측정 -수면의질과습관관리 -일반인들과비교정보제공 •진동알림피드백인지 •블루투스, 단점개선, $150
  12. 12. 현장적용사례2 □의료현장용중심mHealth 서비스 몸에착용하거나이용하여활동량이나에너지소비량을분석해기록하는모바일헬스케어디바이스 24시간, Wearable 기반의착용감, 편리성, 저전력, 데이터동기화등의핵심기술 Visible Body VaxNation Asthma Sense Cloud •3D 해부학앱, 의학학습 -풍부한2,500여개의구성체계 -신체기관, 혈관, 장기등묘사 •EHR 연계사용가능 •이용자의백신접종관리 -연령별,상황별, 이력별관리 -이용자맞춤형배신추천 -가족단위, 접종기록관리 •백신정보추천알림 •천식관리자가진단서비스 •환자들의호흡체크판단 -미국립보건원기준상태파악 -긴급상황발생시응급환경연계 •AirSonea연동, 의료기록연계
  13. 13. 성공사례1 □HealthTap, 맞춤형질의응답의료서비스 2011년오픈, 이용자가의사에게질문을올리면실시간으로답변을받아보는서비스, 62,000명의사참여 커뮤니티기반의플랫폼을미리구축, 충분한이용확보(1억명이상이용)인프라위에Tele-health로진화 핵심통합Service -Learn Service : 의료소식, 추천의료App -Get Help Service : 의사상담, 처방 -Take Action: 맞춤형건강체크제공 Service 비용 -월99$, 가족1명추가마다10$ -정기가입자만이용가능 의의 -단계적의료서비스의진화(상담진료) -가족단위개인맞춤형건강관리 -Activity Tracker 차별화된사용 http://www.fastcoexist.com/3033649/healthtap-wants-to-be-your-new-on-call-doctor#1
  14. 14. 성공사례2 □WellDoc의BlueStar, 당뇨병관리서비스 2형당뇨병, 미FDA 최초승인, 민간의료보험적용 의사처방받은사람만사용 -Patient Coach : Personalized guidance -Clinical Decision Support : Analysis, Easy tracking -Social Engagement : Easy sharing 미국Allscripts EHR과결합 -의사에게CDSS 지원, 더좋은진료를제공하도록도움 -George Washington University Medical Center 대규모외부투자지원($3,500만) -Merck Global Health innovation Fund 등$2,000 의의 -서비스개발기간은오래걸리지않았으나, -EMR/HER 연동, FDA승인, 보험회사적용많은소요
  15. 15. □웨어러블기기이용패턴(「Inside Wearables」Endeavour Partners, 2014.1) 미국18세이상의성인의약10%, Jawbone, Fitbit, Nike, Misfit 등다양한웨어러블기기보유(’13.9) 연령별이용률25~34세는25%, 35~44세는19%로해당연령층의사용자가가장많음 웨어러블기기사용하는기간은6개월이후, 약30%가사용중단, 1년이상사용하는경우50% 미만 -행동추적(Activity Tracker)의단기적이고한시적이용으로는이용자의행동과습관을형성하는것을실패, -장기적인이용패턴을형성하도록유도해야해야함, (건강한사람들이굳이살필요가없는센서들의이슈극복) -순환적인모바일생태계를구축의핵심은「데이터」, 활성화유도전략고민필요 실패사례 ※ Percent of Activity Tracker Owners vs. Percent of U.S. Population By Age ※ Declining Rate of Sustained Activity Tracker Use Over Ownership (Endeavour Partners, 2013.9)
  16. 16. □현재성숙분야(센싱, 송수신, 보안등) 모바일환경을이용한원격모니터링영역, 데이터송수신및저장기술 만성생활습관질환을센싱하는기술(비만진단영역, 고지혈증및고혈압진단영역등) 의료전용정보보호및추적기술 □현재미성숙분야(통합, 평가, 연계등) 단일화된채널을통합하거나중계하는기술의등장 웨어러블헬스케어장비코디네이션을통한모바일헬스케어어플리케이션의데이터통합관리 모바일헬스평가인증Framework 영역 □Ecosystem 구축을위한과제 모바일헬스의기술∙ 서비스특성상, PHR/EHR을염두하여독자적추진보다는전략적통합을고려 전자의무기록(EHR/EMR) 서비스를연계, 모바일헬스단말기및솔루션의부가가치창출확산가능 이용자의건강및의료데이터를수집, 축적, 가공하는만큼데이터보안을담보하는문제가장중요 향후발전방향1
  17. 17. □모바일헬스의생태계성숙을위한연구과제영역도출 안전∙효율성:무선네트워크환경의최적화된이용성 관리호환성: 상호운영성과통합이가능한관리환경 표현유연성: 데이터변환기반의Contents 고활용성 정보신뢰성: 보안성기반의추적이가능한고품질성 향후발전방향2 의료데이터압축전송기술 Selective N-Screen 기술 기기간섭∙보정기술 반응형의료데이터변환기술 모바일채널중계기술 모바일의료데이터보안기술 모바일헬스인증평가기술 Enterprise HealthAppStore 관리기술 웨어러블헬스데이터코디네이션기술 이기종모바일서비스호환플랫폼기술 표현유연성확보 관리호환성확보 안전∙효율성확보 정보신뢰성확보
  18. 18. □모바일헬스의서비스측면기능성 시중에존재하는모바일헬스어플리케이션기능의한계 -대부분행동추적기능을활용한피트니스분야에집중 -의학분야의App은병원과의소통정도, 진단, 치료, 경과관리등의학관련애플리케이션의부족 지속적활성화유도하는전략의부재, 긍정적인변화를얻을수없었던이용자의사용포기 □환자안전, 의료데이터수집및보안의중요성 환자안전, 데이터보호, 보안에대한충분한고려없이개발되는면이있음을지적 이용자들이신뢰하고자신의헬스데이터수집을동의할수있는보안역량을갖추는것도중요 □의료데이터통합관리전략부재 mHealth 시장의주도권, 스마트단말기이용자의건강및의료데이터수집역량좌우 비표준플랫폼업체상호운영성, 통신∙ 제조사중심의플랫폼개방형표준평가방법필요 이용자들이신뢰하고자신의헬스데이터수집을동의할수있는보안역량을갖추는것도중요 상용화이슈1
  19. 19. □기존국내법제도완화 「과학기술부규제개선방안」(’13.12 국무회의), 허가제완화가가능한IT 융합의료기기분야개선공감 의료기기품목허가및고비용불가피, 철처한안전관리와동시에합리적허가관리제도개선 -FDA 미국, 「의료용모바일앱최종가이드라인」(13.9.25) 분류기준고려인허가관리대상의등급정비필요 -국내는기기에서수집정보를전송받아사용하는모바일앱과가정용체지방계등도의료기기의료기기인허가필요한관리대상으로분류, 최소6개월이상심사 복잡성, 진입장벽, 발전저해요소의제거 □가치중심의상용화 안전성, 효과성, 적합성, 비용대비효과성에대한충분한평가를거쳐의학적의미있는방향으로사용 지속적활성화를위한이용을촉진헬스+재미를결합한Healthtainment서비스요소발굴 단말기표준화, 초저전력기술개발, 낮은단말기가격 □상호보완적서비스육성을위한충분한논의 모바일헬스, 원격진료등활용에따른책임문제에대한명확한법적제도마련 모바일헬스가대면진료를대체하도록기능해서는안됨(2014, 세계의사회WMA 더반총회) 상용화이슈2

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