WO2007023027A2 - Methode et systeme pour fournir un enseignement a un individu et pour guider cet individu afin qu'il modifie son mode de vie et un comportement malsain, methode et systeme pour traiter un tel individu - Google Patents

Methode et systeme pour fournir un enseignement a un individu et pour guider cet individu afin qu'il modifie son mode de vie et un comportement malsain, methode et systeme pour traiter un tel individu Download PDF

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Publication number
WO2007023027A2
WO2007023027A2 PCT/EP2006/064129 EP2006064129W WO2007023027A2 WO 2007023027 A2 WO2007023027 A2 WO 2007023027A2 EP 2006064129 W EP2006064129 W EP 2006064129W WO 2007023027 A2 WO2007023027 A2 WO 2007023027A2
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Prior art keywords
individual
health
teaching
book
program
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PCT/EP2006/064129
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English (en)
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WO2007023027A3 (fr
Inventor
Kin-Yuan Lin
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Congener Wellness Corp.
Microlife Intellectual Property Gmbh
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Publication of WO2007023027A2 publication Critical patent/WO2007023027A2/fr
Publication of WO2007023027A3 publication Critical patent/WO2007023027A3/fr

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    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance

Definitions

  • the invention relates to a method and a system for teaching and guiding an individual in changing the lifestyle and to a method and a system for treating an individual.
  • Health care systems in most industrialised countries are in an urgent need for reforming. Costs for health care systems are continuously increasing. In parallel, health problems of societies are rather increasing than decreasing despite highly sophisticated medical systems.
  • a disruption of the Health Care Industries is proposed on the basis of providing general practitioners with a tool to treat maladies which previously required the intervention of highly trained surgeons or specialists, enabling nurses or physician assistants to perform activities in outpatient centres that are currently performed by hospital doctors or also by creating inexpensive products and services that enable individuals with less specialized training to accomplish tasks inexpensively and in a more convenient setting. Consumers could buy such services or products or learn to manage their health on their own.
  • a method and system according to a further aspect of the invention should help to treat ill patients in a more integrated, conven- ient setting and help them to avoid costly interactions with the traditional health care system.
  • the system and method according to the invention will eventually reduce the health care cost in most of the modern societies.
  • the system and method shall also provide prevention against illnesses .
  • one important aspect of the invention are products and services that place the responsibility of health management and self care back into the hands of the consumers and empower them to take this responsibility.
  • a method of teaching and guiding an individual in changing his or her lifestyle is used to build up a healthy or healthier behaviour of the individual.
  • a basic assessment of the individual is made.
  • specific lifestyle health problems or potential health risks of the individual are defined.
  • the term of health problems or potential health risks includes specific health problems the individual is aware of, potential health risks the individual is aware of but also problems or health risks which may be unknown to the individual but which may cause a certain risk for the individual to develop health problems at a later stage.
  • This basic assessment, a so called primary prevention screening can be done in any easily accessible place, e.g.
  • a community based outpatient clinic or setting but also e.g. in a Drug Store. It can be operated by a general practitioner (GP) . Such place may also be operated by a physician assistant or a professional nurse supervised by a general practitioner to reduce the operation cost.
  • GP general practitioner
  • At least one program is defined to which the individual should attend.
  • one or a plurality of teaching and/or learning programs are provided to the individual .
  • Each of said programs includes teaching, guiding and actively involving the individual in individually gathering personal objective information represented by at least one health indicator.
  • this is a health indicator which relates to the lifestyle health problem or potential health risks which have been identified during the basic assessment.
  • the individual is taught in accordance with a specific learning program in view of understanding a relationship between the objective information which has been previously gathered and a phenomenon or a symptom caused by pathology or by a functional deficiency in context with the health problem or the health risk.
  • the individual is given a tool to set a specific health problem or risk in context with the objective information previously gathered.
  • the individual is taught and guided in view of understanding the effect of a specific behaviour or a spe- cific lifestyle on the pathology or functional deficiency in context with the health problem or the health risk.
  • the individual begins to understand that by changing a specific behaviour or lifestyle, the individual can influence a pathological situation or a functional deficiency.
  • a realistic goal to be achieved by the individual at the end of the program under the support of the coach is set.
  • the individual is guided and taught to identify specific actions and how to carry out these actions which can be taken in view of improving the health, reducing health problems or reducing health risks, in particular by changing the lifestyle or building up a healthy or healthier behaviour.
  • SOAP Subjective, Objective, Assessment and Plan/Prescription.
  • the initial portion of a SOAP note consists of subjective information verbally expressed by the patient.
  • the next part of the notes includes objective observations. These observations include symptoms which can be measured or seen. Included in objective observations are also medical parameters such as temperature, pulse, respiration and the results of specific diagnostic tests.
  • the objective observation is followed by assessment. Assessment is the diagnosis of the patient's condition.
  • the last part of the SOAP note is a Plan or Prescription. The plan may include further tests, medication, treatments, education and referral of a patient.
  • the whole process may last from a few minutes to an hour in most outpatient settings.
  • the involvement from the patient side is very low.
  • the present invention is based on the concept, that the individual is actively involved not only in the subjective step, but also in the subsequent 0, A and P steps, except in the basic assessment.
  • the individual's knowledge and awareness of the health problems and counter solutions and the individual's willingness to comply with a plan is increased.
  • Such a plan may include which medication shall be taken, how to take the medication or a change of the lifestyle.
  • the whole strategy about actions and the reasons for these actions are revealed to the individual.
  • the individual understands the causes for health problems or health risks (know why) , and is actively involved in taking measures (know how), in order to improve the situation.
  • the individual has all of the knowledge, responsibility and tool to control and manage his own health.
  • the individual may be taught in view of understanding short to medium term actions to be taken to relieve symptoms caused by said pathology or functional deficiency.
  • the short medium term actions are developed according to evidence based clinical guidelines. This step including taking actions will increase the confidence, value and good feeling to the individual .
  • the step of defining actions may further include guiding and teaching the individual to identify actions in view of a long term plan for improving the health or reducing health problems or risks .
  • lifestyle, environment and gene represent 89% of the determining factor for health.
  • Each individual should completely know that his health status may gradually degrade from healthy to a precondition to develop a disease and finally develop into disease.
  • the health indicator which represents personal objective information typically may be a lag pathology or disease indicator, a leading functional deficiency indicator or a pre-deposition indicator.
  • a pre-deposition indicator typically may be e.g. a genetic indicator indicating that there is a certain risk for the individual to suffer from a disease or another health problem.
  • a leading functional deficiency indicator typically is an indicator which shows that the individual has a certain functional deficiency which may lead to future health problems although currently there is no specific health problem.
  • a lag pathology or disease indicator typically indicates an occurred pathological situation of the individual.
  • the individual should be aware thereof and control his or her own health and adopt appropriate counter measures in advance .
  • the program to which the individual should attend further may also include the step of teaching and guiding the individual in accordance with a learning program in view of understanding that a determining factor of health is at least one physiological process in interaction with the living environment and gene through specific individual's behaviour.
  • a process typically may be selected from the group of a food intake and metabolism process, a Psycho-Neuro-Immuno process and a biophysical muscle skeleton process.
  • the inventors of the present invention have found that by analysing the relationship between these three processes and the chronic diseases of modern society, almost all major health problems caused by improper lifestyle and behaviour may be properly addressed by the treatment proposed in this invention.
  • the method according to the present invention further may also include a treatment step.
  • a choice of treatment in a specific facility is made. This facility is selected from a facility specialised in treatment of a specific class of complex health problems, a facility for improving the individual's health, in particular by means of a holistic treatment and a facility for guiding and teaching the individual to change his/her lifestyle and build up a healthier behaviour. This choice or selection is typically made on the ba- sis of the result of the basic assessment. A choice may also be made following the steps of gathering the objective information or following an assessment during the period when the individual attends the program. If in the basic or in a following assessment, it is determined that the individual has a serious health problem, a treatment in a facility specialised in treatment of complex health problems may be necessary.
  • the individual also may be classified in one of a plurality of health categories.
  • the categories are the category (1) healthy, (2) a chronic precondition or a genetic predisposition for developing a health problem or a health risk and (3) of a complex chronic condition.
  • different treatments may be necessary or appropriate.
  • the method also includes a step of remote monitoring or follow- ing-up at least one health parameter of the individual.
  • Remote monitoring compliance of the individual with a specified program e.g. an exercise schedule or a medication schedule may also be possible.
  • This further step allows for verification whether the method was successful for the individual and whether the individual continuously has changed his/her lifestyle or has complied with the program.
  • the teaching and guiding program may include a plurality of different subjects or class rooms. These subjects may also be selected on the basis of the basic assessment. Subjects typically are selected from the group of the subject of environmental influence on the health, genetic predisposition for a health risk, food intake and metabolism, physical and body knowledge, mind- body interaction and medication knowledge. It has been found that these subjects are especially important in view of teaching a individual to change his/her lifestyle and to empower individuals for self caring themselves.
  • the program which deals with the environmental influence on the health may e.g. contain information about specific toxic products which may be present in the environment or to the way and knowledge to avoid such toxic products .
  • the program directed to genetic predisposition for a health risk may include gathering and understanding genetic information from the individual and increasing the individual's awareness in view of a risk of suffering from a specific disease and the way and knowledge to avoid such disease by adopting certain measures in the individual's daily life.
  • the subject relating to food intake and metabolism especially shall show the individual how and why a change in diet nutrition or taking certain nutrition supplements that can have positive effects to his/her health.
  • the subject of physical and body knowledge deals with individualized problems or potential problems in the joint, muscle, bone or skeleton.
  • the individual typically learns to use correct posture of the body in daily life. Knowledge and skills are practised and the individual learns to make exercises in a right way and at a correct frequency.
  • the subject of mind-body interaction teaches the individual in context with the influence of mental well being or physical well being.
  • the knowledge and skill to have a clear and focused mind or a a sharp memory and ways to be free of stress are taught.
  • Medication knowledge is important for the individual in view of understanding the reason and also the function of certain medication which is prescribed. Medication may be prescribed in view of certain short to medium actions dealing with health problems which are determined in the basic assessment or following the steps of gathering objective information and following an assessment during the period the individual attends the program.
  • the program typically is selected form the group of a prevention program and an improvement program in view of a chronic lifestyle condition.
  • such chronic lifestyle conditions may be cerebral cardiovascular diseases, type 2 diabetes, overweight and obesity, maldigestion, malabsorption and deficiency of liver detoxification. These problems typically are related to the physiological process of food intake and metabolism.
  • the program also may be directed to health problems such as depression, alzheimer, allergies, asthma, autoimmune diseases, cancer and hormone imbalance. These health problems basically are related to the physiological process of the Psycho-Neuro- Immuno system and/or the hormone process.
  • the program may also be directed to scoliosis, chronic back pain and poor fitness, poor muscle tone or poor joint flexibility. These problems are related to the physiological process of the physical structure and bone structure.
  • the programs for teaching the individual further may also include self-care programs in view of chronic fatigue, stress, anaemia, menstrual cramp, cold, headache, insomnia, abdominal discomfort, adrenal fatigue, bone loss or menopause problems.
  • the teaching program may be primarily designed in view of understanding at least one process which selected from the group of the process of flow of nutrient, the neuro signal in the autonomic nervous system, the hormone process or the process of mechanical force and the interaction between these processes.
  • the individual thereby shall be provided with a systematic and comprehensive understanding and with the knowledge of the function of the human organism in order to allow self care disease prevention, management and improvement.
  • the program may be further designed in view of increasing the individual's awareness of the relationship which may exist between a symptom which is present in the daily life and the lifestyle of the individual. Thereby, the individual's capacity for self-care disease prevention and health management shall be increased.
  • short term measures in view of immediate relief from specific health problems may be prescribed to the individual depending on the result of the assessments. This is especially important for individuals who suffer from specific severe or acute health problems.
  • the individual In the course of the program, it is furthermore preferable to provide the individual with teaching material, in particular with at least one book directed to the program.
  • the book may include information in view of a specific health problem or health risk.
  • the book is designed to be completed with personal data individually by the individual. Because the individual is personally in charge of reading and understanding the book and to complete the book with personal data, the individual's willingness and readiness to change his/her lifestyle and improper health behaviour is increased.
  • personal data which is to be entered into the book may include the personal objective information which is individually gathered by the individual in accordance with the present invention.
  • the book may also include information to the individual in view of so-called trial behaviour and skill development. Once the individual has a certain awareness that a change of lifestyle may be necessary, he/she needs to try how a change in lifestyle feels in a trial phase. In this context, it is also important to develop skills for changing an improper lifestyle. This basic concept is described in theory in more detail by Girdano and Dusec .
  • the book may also include information and procedures in view of assuring that the knowledge and the information contained in the book are read and understood and are used properly by the individual. Typically, this may include test questions to be answered or certain trial behaviour and skill to be practiced and demonstrated or check lists to be completed by the individual.
  • an electronic interactive book may include information in relation to the program. Furthermore, the book may be designed for interaction with the individual. Thereby, entry of personal data into a memory of the book is possible. In particular, such personal data may also include the personal objective information which has been previously gathered. If such an electronic book is used, there is also a possibility of data processing of said data. Furthermore, it is also possible to directly link such an electronic book with measuring devices for measuring medical parameters such as blood pressure monitors, glucose monitors or the like.
  • Such an electronic book with a communication capability, e.g. a bidirectional communication, such as to form a personal terminal for remote monitoring or for a follow up system.
  • a communication capability e.g. a bidirectional communication
  • Such a terminal may further increase the compliance to a program such as a medication schedule or behaviour change schedule for the individual who attends the program.
  • an information technology platform is used for administration of an organisation which carries out the method according to the present invention.
  • a platform may be used for operating, e.g. continuously maintaining or developing a program database or for maintaining or updating an individual database.
  • the platform may also be used for bookkeeping or for making appointments with a plurality of individuals.
  • a centralised information technology platform may also provide up to date information including the medical or health records to teachers or coaches .
  • a learning platform for teaching guides, coaches, teachers or care persons to carry out the method according to the present invention.
  • Such a learning platform can be partially made electronically by means of E- learning.
  • Other platforms are, however, conceivable.
  • the method comprises a further step of defining and operating a re- ward program for the individual.
  • the individual is provided with a reward if a predetermined individual goal has been achieved by the individual.
  • One major problem in context with programs for changing lifestyle or improper health behaviour of individuals is a lack of motivation of the individual.
  • the present invention primarily addresses this problem by actively involving the individual.
  • the motivation of the individual may be increased, if certain rewards are granted. Rewards typically might be monetary rewards or vouchers for institutions supporting the change of lifestyle such as fitness studios or wellness facilities.
  • a permission to charge the attending fee for the program from the tax free Health Saving account (HSA) is another alternative for increasing the motivation.
  • HSA Health Saving account
  • the reward may also be a share or stock option of an organisation which carries out the method according to the present invention.
  • a reward program may have a leverage effect. If the individual becomes a shareholder in such an organisation he or she will get a personal interest in the organisation. The motivation to continue to attend programs proposed by the organisation is thus increased. Furthermore, such a reward may also be an incentive to the individual to motivate friends to attend to such programs .
  • a system for teaching and guiding an individual to change the lifestyle and to build up a healthy or healthier behaviour there is provided a system for teaching and guiding an individual to change the lifestyle and to build up a healthy or healthier behaviour.
  • a major component of this system is at least one program to which the individual should attend.
  • the program includes means for teaching, guiding and actively involving the individual in individually gathering objective information represented by at least one health indicator relating to the health problem or to a potential health risk.
  • the system furthermore comprises means for teaching the individual in accordance with a specific learning program.
  • the learning program is directed to understand the relationship between symptoms which are caused by pathology or by a functional deficiency in context with the health problem or with a potential health risk on the one hand and said objective information on the other hand.
  • This system furthermore includes means for teaching and guiding the individual to understand the effect of a specific behaviour or lifestyle on the pathology or functional deficiency.
  • the individual shall understand that the specific behaviour or lifestyle may influence pathology or a functional deficiency in context with the health problem or the health risk.
  • This system also includes means for guiding and teaching the individual to identify actions to be taken for changing the behaviour in view of reducing health problems or health risks.
  • this system is used for operating a method as outlined above.
  • Appropriate means for carrying out such a method are provided.
  • This system furthermore may comprise one or more facilities.
  • these may be facilities which are specialised in treatment of a specific class of complex chronic conditions, facilities for improving the individual's inner or self-healing power by means of a holistic treatment and also facilities for teaching the individual to change his or her lifestyle and to build up a healthy or healthier behaviour. By providing such facilities, individuals with different types of health condition can be appropriately treated.
  • Part of this system may also be means for remote monitoring or following-up health parameters of the individual or compliance of the individual with certain programs . While such remote monitoring means as such are known in the art, they may be particularly advantageous in context with a system according to the present invention.
  • the means for teaching or guiding typically are selected from the group of written or electronic books .
  • Such electronic books typically may be provided with a wire or wireless link to medical parameter measuring devices such as e.g. blood pressure monitors, weight scales, glucose monitors or the like. It is also possible to provide such an electronic book with e.g. bidirectional communication capabilities such as to form a personal terminal for remote monitoring or following up to enhance the compliance of the individual with prescribed medication or exercise schedules.
  • the method and system further may comprise at least one device for recording and storing data, in particular multimedia data such a sound, pictures or video.
  • a device for recording and storing data, in particular multimedia data such a sound, pictures or video.
  • Such a device can be adapted for direct or indirect connection with a personal electronic device used by the individual, e.g. an electronic book as described hereinabove.
  • treatment is to be understood not only in the classical term of treatment of a specific disease.
  • treatment may be a treatment directed to healing a patient but also a treatment in view of prevention against health risk or in view of improving the health of the individual.
  • an assessment of the individual for defining at least one health problem or health risk is made.
  • this health problem or health risk is defined, the individual is classified in a class of problems which are primarily related to at least one specific physiological process. Differentiation between the processes of food intake and metabolism, the Pyscho- Neuro-Immuno process and a biophysical process is made.
  • biophysical process relates to processes which are in context with the physical aspects of the body, e.g. joints, bones, muscles .
  • the individual is then treated in a facility which is specialised for treatment of health problems or health risks lying in this class of problems.
  • the focus of the method according to the present invention is thus physiological process and patient centric. Treatment is not made in view of symptoms or in view of treatment of specific parts of the body but rather in view treating the individual as a whole by analysing and treating said specific process or processes.
  • the individual further may be classified into a category relating to the severity of the health problem or health risk.
  • the individual is classified in a category which is selected from one of the following categories: (1) a healthy condition, (2) a chronic precondition or a predisposition for developing health problem or a health risk and (3) a complex chronic condition. Depending on this category, different treatments may be helpful or necessary.
  • improving the health is made by increasing an inner healing power of the individual.
  • Treatment of a pathological situation is made through a medical procedure or through medication. This treatment may be followed by improving the healing power of the individual as mentioned above.
  • a further aspect of the invention refers to a system for treatment of an individual, in particular for carrying out the above- mentioned method.
  • This system comprises at least one facility for treatment of health problems or health risks.
  • the facility is specialised for treatment of a class of problems which are related to at least one specific physiological process.
  • the process is selected from the group of food intake and metabolism process, a Psycho-Neuro-Immuno process and a biophysical process .
  • a method for treating an individual where in a first step an assessment of the individual in view of defining one health problem or health risk is made.
  • a treatment in a specific facility is chosen.
  • This facility may be a facility specialised in healing a specific class of health problems, a facility for improving the individual's health by means a holistic treatment and a facility for teaching and guiding the individual to change his/her lifestyle and to build up a healthy or healthier behaviour.
  • a system for treating an individual which comprises a facility specialised in treatment of a specific class of health problem, a facility for improving the individual's inner healing power, in particular by means of a holistic treatment and a facility for teaching the individual to change his or her lifestyle or behaviour.
  • Figure 1 shows a flow chart of a schematic overview of one aspect of the present invention
  • Figure 2 schematically shows by way of example a relation between the etiology and the progress of heart disease and stroke and risk factors
  • Figure 3 schematically shows by way of example a relation between etiology and the progress of heart disease and stroke and risk factors and lifestyle
  • Figure 4 shows a block diagram showing processes and causes leading to hypertension
  • Figure 5 shows a flow chart for operating a method according to the present invention
  • Figure 6 shows a more detailed service flow chart for operating a system according to the present invention
  • Figure 7 shows an embodiment of an electronic interactive book
  • Figure 8 shows a block diagram of an electronic interactive book
  • Figure 9 shows an overview of a treatment system according to the present invention and possible treatments
  • Figure 10 shows different health status and a health status Progress
  • FIG. 11 schematically shows three basic physiological processes
  • Figure 12 schematically shows a structure for operating a reward program
  • Figure 13 schematically shows an IT platform for running the method and system according to the present invention
  • Figure 14 schematically shows a remote monitoring system
  • Figure 15 shows an example of a skill learning tool.
  • a method of the present invention is based on personally, individually involving the individual in a modified SOAP procedure.
  • the modified SOAP procedure is shown in the flow chart of figure 1.
  • one specific program is selected to which the individual shall enrol.
  • the individual then proceeds with a modified SOAP procedure.
  • subjective symptoms or complaints are first revealed and recorded by the individual in the so-called S step.
  • direct causes or reasons causing these symptoms are analysed and the functional status of the individual is evaluated, e.g. by means of tests.
  • these objective steps 0 are made with the participation of the individual by individually gathering objective information.
  • the individual is taught how to make measurements, e.g. of physical parameters such as the blood pressure and is guided and coached during the analysis process.
  • the assessment steps A the individual is taught to correlate a symptom or complaint with the objective information.
  • a prescription step Pl the individual is further guided in view of providing a short to medium term solution in view of immediate relief of health problems on the basis of test results.
  • a prescription step P2 the etiology and pathology and the progress of a disease is taught. This step includes teaching the effect of improper lifestyle, behaviour or genetic or environmental influences.
  • a step P3 personal goals are set.
  • long term strategies in view of change of lifestyle are taught and learned by the individual .
  • the following examples indicate the differences between traditional methods and a method according to the present invention seen from the individual's perspective by way of example in context with hypertension.
  • individuals do self reports of all possible symptoms or complaints without much knowledge about diseases or the function of the body, e.g. about hypertension or clinical conditions caused by hypertension.
  • individuals are made reading an example case which illustrates possible symptoms for hypertension or clinical conditions caused by hypertension. Individuals can better note symptoms which they did not know previously. Background knowledge will be built up at this point in time.
  • the objective phase 0 involves the coach demonstrating how a blood pressure monitor is operated, and the standard operation procedure to take the blood pressure correctly.
  • the basic mechanism of the blood pressure monitor is explained. It is made sure, that patients can correctly operate a blood pressure monitor at home. Individuals can relate knowledge learnt during this stage with knowledge which they previously learned during the subjective phase. A neural network starts to emerge in the individual's mind.
  • a doctor gives the individual a diagnosis without explaining the cause of e.g. hypertension.
  • the doctor or the professional coach gives the individuals a diagnosis and also reveals the reasons behind such diagnosis.
  • the individual is educated about basic pathology of hypertension.
  • Individuals may also be given a general, simplified overview of hypertension. Typically, this overview may include reasons and root causes for hypertension, related symptoms and improvement, prevention of hypertension. Individuals then have a more complete knowledge in sion. Individuals then have a more complete knowledge in view of hypertension (see also Fig. 4) .
  • drugs for patients may be prescribed. There is usually no explanation, why this kind of drugs is prescribed. Patients traditionally are forced to follow blindly a drug solution. This is one of the major reasons why the compliance with medication programs usually is low.
  • the doctor or the professional coach explains possible long and short term solutions. The individuals together with a coach work out solutions which are suitable for them. Before the solution which usually includes a lifestyle change is implemented, a goal to be achieved is set. According to the invention, the individual will be inspired and given a hope that other options are available besides taking drugs for the rest of his or her life.
  • tests typically include genomic and predisposition tests, digestion and metabolism tests, psycho-neuro-immunology tests, hormone related tests and tests in view of incorrect posture and physical functional tests.
  • Table 1 a typical set of full spectrum tests is summarised:
  • Table 3 shows a summary of exemplary contents of a text book in view of a cerebral-cardiovascular disease prevention and improvement program according to the present invention.
  • Stepl Injury on endothelium of blood vessel
  • Step2 To form the plaque on endothelium of blood vessel
  • Step3 Blockage on blood vessel
  • every individual shall be capable to promote cerebral-cardiovascular health and keep his/her cardiovascular function in the best possible condition.
  • Table 4 shows exemplary contents of a check and practice manual part of text book (not shown in detail) in context with a program for cerebral-cardiovascular disease prevention and improvement according to the present invention.
  • Part 1 A true case story of cerebral-cardiovascular disease
  • Part 4 The excellent tools to improve cerebral-cardiovascular disease
  • Part 6 To learn how to stay away from cerebral-cardiovascular disease
  • Reading the auxiliary teaching material To learn reading the food labels
  • Table 4 generally shows a structure of such books, without explaining its contents in detail. Typical contents of the book will now be shown by way of example with references to Figures 2, 3, 4, 11 and 15. Similar contents may be prepared for other diseases or health problems .
  • Fig 2 shows such an overview map according to the present invention.
  • health indicators which represent personal objective information of the individual.
  • such indicators may be an high level of Fibrinogen, high APO B, hypertension, high TG, LDL, LPa or a low level of HDL which acts e.g. on accumulation of cholesterol, macrophage and collagen.
  • C-reactive proteins, free radicals or LPA may also have an effect on injury of the arterial wall or fatty streaks.
  • High insulin or high homocysteine may have an influence on thrombosis.
  • the individual starts to understand that these health indicators are in direct context with the health problems or potential health risks.
  • the individual starts to understand and is taught a sequence of health problems or health risks which may at the end lead to severe health problems such as stroke.
  • the text book includes another overview map of the stress etiology and progress of heart disease and stroke and their relationship with risk factors (functional deficiency) and lifestyle and behaviour. This overview is revealed to the individual again.
  • Fig 3 shows such an overview map according to the present invention.
  • the individual is taught how specific behaviour or lifestyle has an effect on health indicators or a pathology or functional deficiency.
  • the effects of an inadequate diet, smoking, stress or lack of exercise and specific vitamin on the health indicators or on the pathology of functional deficiency is explained to the individual.
  • the individual Based on the representation of figure 3 or based on parts taken out thereof, the individual starts to understand why lifestyle has to be changed in order to reduce health risks or health problems.
  • Pathological situations and functional deficiencies are shown in the rectangular part in the centre of figure 3.
  • Health indicators are surrounding the rectangular boxes and are shown in circles which represent risk factors caused by functional deficiency in molecular, cell or tissue level.
  • Specific behaviour, lifestyle but also external factors which influence the pathology or functional deficiency are surrounding the health indicators and are displayed as clouds.
  • Health indicators are provided by a health status-check-up, in particular done individually by the individual. Such indicators may be a pathological indicator. Typically, such indicators indicate existing diseases based on symptoms which are visible in the past or at present. Such "lag" indicators indicate an existing disease and may show that there is a requirement for immediate relief.
  • Functional deficiency indicators may be leading indicators, e.g. indicating that certain health problems exist, which have not yet led to symptoms perceived by the individual or by a clinical protocol.
  • leading indicators e.g. may be an increased blood pressure close to a pathological limit but not yet above such limit .
  • genetic predisposition indicators may be analysed.
  • genetic information may indicate a higher risk of a certain person to suffer from diseases some day, although there are no actual symptoms .
  • FIGs. 2 and 3 show exemplary contents of the book in view of cardiovascular diseases. Similar figures will be provided in view of other types of diseases or health problems .
  • Chronic diseases based on modern lifestyle are increasing nowadays.
  • many chronic diseases may be based on mental pressure or on stress.
  • Such diseases may be a disorder of the immune system such as cancer, allergies, collagen diseases or ulcer due to mucosal disease.
  • cardiovascular diseases such as arteriosclerosis and obstruction, thrombosis, cerebrovascular diseases, arrhythmia or ventricular fibrillation may also be due to pressure.
  • Diseases relating to brain function such as brain cell death leading to memory loss, damaged connection of nerves in the hypocampus leading to memory loss or disturbed neurotransmitter functions leading to emotional disorder may be based on stress.
  • stress may influence the metabolic system or the digestive system.
  • Typical solutions to stress induced diseases may be stress management by controlling the pressure source, by developing anti-stress supporting systems or also be learning to relief the stress.
  • the autonomic nerve or the impulse parasympathetic nerve may be adjusted by acupuncture, by bathing, healthier food, massage or guasha. Body-mind balance exercises such as yoga may also help to relief pressure or stress.
  • a second source for diseases may be wrong or bad food.
  • Such disease may be typically diabetes or the x-syndrom or cerebral- cardiovascular diseases, but also saturated fat or hoard induced obstruction, sclerosis or overweight.
  • Typical solutions may be the selection of integrated food and supplements which fit a metabolic type of the individual (e.g. determined by item 6 in table 1) .
  • elimination and avoidance of ingestion of heavy metals may be a solution to this type of problems.
  • a third type of chronic lifestyle illness may be caused by improper posture and lack of exercise. Typical symptoms may be backache, headache or irritation. Solutions may be reconstruction of the vertebra function by back intensification exercises, physical fitness exercises, improvement of a living environment and of posture but also relief and release of physical pressure (see also Fig. 15.
  • Figure 4 shows a map which will be shown and explained to the individual in view of understanding the processes in context with the function and root causes of hypertension.
  • the left and the right hand side branch of figure 4 show pathways leading to hypertension which are based on influences from the brain to the sympathetic nervous system (left branch) and to the adrenal gland (right branch) . Where and how medication such as alpha blockers, beta blockers or Ca channel blockers intervene in this pathway is indicated.
  • Hypertension as a result of these pathways has its roots mainly in psycho stress, hidden stress or physical stress. Such hypertension is rather brain driven. A wrong diet and obesity may furthermore influence these pathways .
  • the middle branch of figure 4 shows a kidney driven pathway which influences hypertension, e.g. by intake of too high amounts of salt.
  • the genetic effect of e.g. AGT, ACE or AGTRl or Renin on production or conversion of angiotensin I and II and aldosterone is shown.
  • Counter measures by medication such as ACE inhibitors or AGTII blockers are shown and may be explained to the individual on the basis of this map.
  • item 24 in Table 1 shows whether in the autonomic nervous system, the sympathetic or the parasympathetic nervous system is more active. Individuals having a more active sympathetic nervous system rather suffer from brain driven hypertension. The cause for hypertension of individuals having a more active parasympathetic nervous system is rather kidney driven. Depending on the result of item 24, the reason or risk for the individual to suffer from hypertension based on the brain driven pathways (right and left branch in figure 4) or based on the kidney driven pathway can be explained and appropriate medication (e.g. alpha blocker, beta blocker or Ca channel blockers for brain driven hypertension or ACE inhibitors, AGTII blockers, diretic or beta blockers for kidney driven hypertension) may be prescribed.
  • appropriate medication e.g. alpha blocker, beta blocker or Ca channel blockers for brain driven hypertension or ACE inhibitors, AGTII blockers, diretic or beta blockers for kidney driven hypertension
  • Typical food supplements may be products such as Foshu anti hypertension food sold by Ameal S, or Katsuobushi (dried bonito) Oligopeptie sold by Nippon Supplement, Inc.
  • Figure 5 shows a flow chart of the general process carried out if an individual wants to participate in a method for changing lifestyle and improper health behaviour according to the present invention. After reception and an initial visit, an overall assessment is made. This is done after an overall questionnaire is answered and medical information are obtained from the individual .
  • This step is followed by a basic blood and urine test and basic functional deficiency test. After this overall assessment it is decided whether further examination is necessary.
  • This consultation of an integral professional team or optionally of a medical doctor or physician assistant leads to a certain prescription.
  • treatments of the individual may need to be taken (see also figure 9) .
  • Individuals with a complex chronic condition should be treated immediately in a facility specialized for this condition.
  • a complementary alternative therapy may be integrated with the conventional medicine to start a holistic therapy in view of improving the individual's healing power but also to quickly relief an uncomfortable complaint. If no immediate reaction is required, a program is selected for the individual and the individual follows said program.
  • a program may also be prescribed directly to the individual based on the basic test result and on overall assessment.
  • Figure 6 shows in more detail the process shown in figure 5.
  • the individual and consumers are interviewed by a receptionist.
  • basic tests are proposed to the individual, registration and payments are made.
  • the individual's basic information in view of choosing a program to which the individual shall attend is acquired.
  • health or body parameters such as height, weight, body construction, blood pressure are taken or health care questions are answered.
  • a schedule is made with the individual.
  • classrooms are held in view of the chosen program. During classroom periods entry tests are done, knowledge is transferred to the individual and the learning and practicing process is verified. Classrooms may be accompanied by consultation of doctors or other experts. Classes are made on the basis of teaching means such as books.
  • the success of the program is analysed and the experiences between participants are shared. It is furthermore possible to follow or coach the individual after the end of the program, e.g. by remote monitoring health parameters or the like.
  • the program may also be carried out on the basis of teaching means such as an electronic book as shown by way of example in Fig 7.
  • the electronic book comprises a main body 500, 501 is a main LCD display to display a text, e.g. as described in Table 2 and Table 3.
  • 502 is also one part of the LCD display but equipped with a touch screen for entering the data and information.
  • 504 to 509 are keys set for operating the electronic book.
  • 510 is a another data port that could be a socket for wire connection or a wireless port like Bluetooth or IRDA to receive the objective information transmitted from a measuring device 600.
  • this is a blood pressure monitor.
  • the 511 is a socket to plug in a memory card to upload the contents of the program to which the individual attends to the electronic book.
  • the memory card may also be used to receive and store the gathered information of the individual.
  • a personal plug-in memory may be used for several purposes . It may be used to upload to the book the contents of the program to which the individual attends. The contents of the program may also be uploaded online through a communication network such as the internet.
  • the plug- in memory may also be used for storage of data of the individual, e.g. information gathered during attendance to the program. From time to time the individual may upload data from the card to the individual database.
  • This electronic book can be installed in an unmovable manner in a table in a classroom. It can also be a portable unit purchased or leased and carried home by the individual in between the courses of the program or after the end of the program.
  • the electronic book may be connected to a communication device such as a mobile phone through another data port 512that could be a socket for wire connection or a wireless port like Bluetooth or IRDA.
  • a communication device such as a mobile phone
  • another data port 512 that could be a socket for wire connection or a wireless port like Bluetooth or IRDA.
  • all of the knowledge which the individual has to learn including the information mentioned in the above text book, the guiding instructions including gathering and entering the objective information, check lists in view of reading, practicing and understanding the contents of the book and the information related to trial behaviour and skill development and the check and practice manual can be integrated in the electronic book.
  • This can be supported also by multimedia, including text, audio and video.
  • the embodiment will make this kind of learning and class become a very convenient and knowledgeable tool .
  • FIG 8 shows a block diagram of the electronic book as schematically shown in Figure 7.
  • the electronic book comprises a central processing unit CPU.
  • the book is provided with a plurality of communication interfaces such as a modem connection, a RS 232, IrDa, USA or LAN interface.
  • a LCD display and touch panel with appropriate controllers is also provided.
  • the book further includes an audio unit with an amplifier and a speaker, memories such as flash memories or RAM controlled by a memory controller. It can also be provided with external expanded memory.
  • a matrix of buttons may be provided for operation of the book.
  • Figure 9 shows an overview of a system for delivering health care.
  • This system basically consists of three facilities which are designed for different types of treatment.
  • a school for a healthier life is provided.
  • This school is especially running a program as shown or explained in Figure 1 to 6 and tables 3 to 4 herein above.
  • an individual is taught how to change his/her lifestyle or behaviour.
  • the school may have different subjects which are taught.
  • One classroom is directed to environmental medicine. The individual learns how the environment may influence health. Another classroom is directed to genetic aspects. Individuals learn to know whether they are at a genetic risk to suffer from certain diseases and how to take counter measures.
  • a third classroom is directed to food intake and metabolism. During courses, the individual learns to understand the effect of different nutrition on the body and health and how to correctly purchase, cook and eat food and nutrient supplements in order to meet the individual's need and to provide a positive effect on the health.
  • a fourth class is directed to biophysical aspects, e.g. to issues in relation with joints, muscles, bones or the skeleton.
  • the posture or bearing of a person may be analysed and improved (see also figure 15) . This may relate to posture during sleep, during work and/or during walking.
  • class room is used in this context in view of different topics which are taught. Of course different class rooms requiring similar equipment may be located at the same physical location or in the same physical room.
  • this system may also provide actions or tools in view of improving the patient's or in the individual's health. This may be in particular done through association with external partners such as healthy food stores, fitness clubs, wellness resorts, sports centres but also tools for improving the environmental situation such as water cleaners and the like.
  • the school for healthy life may be in interaction with laboratories allowing to make low cost tests and also with a healing clinic in case improvement of a chronic pathological situation will be necessary.
  • a second facility according to the present invention is a healing clinic in view of improving chronic problems.
  • This healing clinic typically offers a holistic and optimal treatment which may include energy therapies, mental healing, biology based therapies, manipulative, body based therapies or other complementary and alternative therapies integrated with conventional medicine to provide the patient with an optimal solution based on the clinical condition of the patient.
  • Such a healing clinic is especially used for individuals with a chronic precondition or with less severe health problems.
  • a third facility of the system according to the invention is a centre of excellence for specific complex chronic diseases for individuals with a complex chronic condition.
  • Such hospitals are especially necessary in view of immediate relief from severe health problems .
  • the individual may be referred to the healing clinic. This may also be accompanied by a remote health monitoring service after the hospital discharge.
  • Figure 10 shows different health status. Depending on the status, individuals are classified into different categories and are treated in one of the facilities shown in figure 9. Healthy- persons will attend classrooms in a school for healthy life. They start to know their body and to have a proper life style.
  • Persons with a "sub-healthy" status may join the school for healthy life or also a healing clinic in view of eliminating latent disease factors or reversing the disease state.
  • An acute problem caused by a complex chronic condition is treated by medicine or surgery in a centre of excellence to control or restore the damage or the function of the organism followed by a holistic treatment in the healing clinic to improve the inner healing power.
  • the long term health can be maintained and promoted by a daily life strategy such as nutrition, proper diet, exercise or change of improper lifestyle and management of stress .
  • the specific facility is helping to progress the health.
  • the system shown in figure 9 may further be based on the finding that diseases can be categorised according to a process by which they primarily may be caused. In particular, they may be caused by an inadequate lifestyle or behaviour which interacts with the environment and eventually disturbs, effects and degrades the functions of the cells, tissues or organ which belong to this physiological process. It has been found that if the human organism is considered to have a nutrition/food intake and metabolism process, a Psycho-Neuro-Immuno process and a biophysical or muscle skeleton process as shown in Fig. 11, the root cause of a large number of known diseases can be easily found and appropriately treated.
  • Fig. 11 shows in the left hand side a food intake and metabolism process.
  • a neuro-immuno or mind-body process In the middle branch there is shown a neuro-immuno or mind-body process. In the right branch a biophysical or bone-muscle-skeleton process is shown. Fig. 11 typically may be part of the book as mentioned above for explaining the individual the function and effects of these different processes.
  • chronic diseases related to the food centric metabolic process may be cardiovascular diseases, diabetes or obesity.
  • Chronic diseases related to the mind-body or the so-called Psy- cho-Neuro-Immuno process may be immune diseases, alzheimer, cancer, auto-immune diseases, allergies or asthma.
  • Chronic diseases related to the biophysical process may be broken bones, reduced joint flexibility, muscle tone or poor fitness .
  • Fig. 11 thus shows a new approach to view and understand the human organism from the point of view of an ordinary individual. Instead of viewing the human organism as a plurality of systems defined by functionalism, e.g. the circulation system, respiration system as it is done in standard medicine, this new approach provides an overall picture for the human organism with a simpler and easier explanation to understand the operation of the organism based on physiological processes. Health issues caused by the determining factors for health which interact with these processes can be basically controlled and addressed by empowering and educating the consumer to change the lifestyle and build up correct knowledge and healthy behaviour. This approach is further based on the finding that a whole process will be generally inefficient if there are problems at one point which belongs to that process.
  • functionalism e.g. the circulation system
  • respiration system as it is done in standard medicine
  • FIG 11 also helps to explain to the individual that the processes are in interaction and are influenced by genes, life style and living environment.
  • Figure 12 schematically shows a reward program for providing an incentive to the individual.
  • a reward program for providing an incentive to the individual.
  • the due date typically could be after six months or a year.
  • a quantitative goal could be a lower pulse rate per minute, a certain body fat, weight, or total cholesterol.
  • Un-redeemed rewards could be accumulated to a next period of agreement. For those who choose not to redeem the reward in case of an achieved goal after each agreement period, a reward can be accumulated to renew the agreement and to repeat the reward program for a certain period.
  • Figure 13 shows an IT platform used in context with a system or method according to the invention.
  • An organisation or individual 1 operating a system according to the invention uses a web server to operate a web site.
  • Programmable code of the web site is stored on said web application server.
  • the platform includes program database 2 which contains learning programs and trial behaviour items used in a teaching and learning program as explained hereinabove.
  • a professional coach 3 uses a web server to operate another web site, for him to manage and guide an individual database 8.
  • the system will request data of a program 4 from the Program database 2.
  • a result 5 will be fed back to the web related to the individual database.
  • the individual uses an electronic book 9 to enrol into or order a program.
  • the status of the individual will first be checked by a certification server 7, then be passed to the individual database 8.
  • Data for starting a program will be downloaded to the E- book first. Then a request for downloading an individual teaching and guiding program will be made.
  • the individual database 8 includes data such as the SOAP notes of the individual (gathered objective information) , personal profiles relating to lifestyle or health parameters (so called lifeware data) , personal behaviour records or data relating to the program.
  • a mobile phone 10 with a camera may be used e.g. to capture photos or videos of a special posture or image. Such image or video may be transmitted to the E-Book.
  • the phone or camera may be used for many different purposes. The individual may e.g. use the phone to look up information when purchasing food in a supermarket in order to check whether a specific food is suitable in context with the lifestyle change program.
  • the personal life assistant 9 is a personal central device allowing the individual to store information, gather new information, learn and communicate. It typically includes a specifically designed operation system onto which appropriate application can be run.
  • Other objective information 11 of an individual may be collected by another equipment such as measuring devices . These data can be input into the E-Book.
  • the individual may learn with paper textbooks.
  • the learning model When he or she is familiar with the learning model, he or she may switch to learn with the Electronic Book for a next program.
  • the E-Book may be rented or shared between users .
  • Figure 14 shows a remote monitoring or follow up system.
  • Customer service representatives 16 work with a call center system to create individual accounts for individuals who joined a follow-up program.
  • the representatives 16 are qualified with nursing background and trained to personalize items for the individual who subscribed the program. Every day the representative 16 remotely monitors the follow-up records of a large number of individuals' daily health status or medication compliance.
  • the representative 16 delivers appropriate responses or actions to the individual, e.g. by direct phone calls, informing medical professionals. Responses and actions are kept as part of the follow-up records .
  • the follow-up program database for Remote Monitoring 12 is an extension of the Program database 2 and individual database 8.
  • the Remote monitoring system further may be a mass storage system of all the follow-up records .
  • the Program database 2 replicates its data portion for follow-up purposes, whereas the individual database 8 replicates its data to the follow-up program database 12.
  • An individual 13 who joins a follow-up program may use a web- browser to deal with daily monitored follow-up items .
  • Such an item typically may be the measurement of a medical parameter or compliance with a medication schedule.
  • the individual 13 may choose to use a simple home terminal 14 instead or in addition.
  • This Terminal 14 has a LCD panel to display questions in text mode. Answers may be provided by pressing one of the few buttons, like “1", “2", “3", “4" or “Yes'V'No”.
  • 130 is displayed on the panel by default. E.g. by pressing the ">” key the value is increased by “1”, by pressing the "»” key the value is quickly increased by "5".
  • the terminal 14 may also comprise a vocal mode where questions are given in spoken language. Answers may be given by pressing a specific button, e.g. representing "yes” or “no". This is especially convenient for blind or elderly individuals.
  • a similar operation sequence can also be carried out on a Java or 3G mobile cellular phone 15.
  • a follow-up program has to be downloaded into the terminal or the mobile phone.
  • In- dividual' s answers are uploaded automatically to the database.
  • a PC, the terminal or the mobile phone further may be equipped with a receiving port to transmit data from home monitors such as blood pressure meters.
  • Fig. 15 shows by way of example a guiding tool for teaching the individual in view of a correct posture in context with the body basic process.
  • Correct and incorrect posture is shown by way of pictures, e.g. printed in a text book, displayed in an electronic book or shown in a class room. The pictures may also be animated in case of an electronic book.

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  • Health & Medical Sciences (AREA)
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Abstract

L'invention concerne une méthode et un système d'orientation devant amener un individu à modifier son mode de vie, par l'adoption d'un comportement sain ou plus sain. Cette méthode comprend les étapes consistant à effectuer une évaluation de base de l'individu et à définir au moins un programme que l'individu doit suivre en fonction de cette évaluation. Ce programme consiste au moins à fournir un enseignement à cet individu, à le guider et à l'impliquer activement dans le programme, ainsi qu'à rassembler individuellement des informations objectives personnelles représentées par au moins un indicateur de santé. L'enseignement fourni à l'individu suit les lignes du programme d'apprentissage spécifique destiné à comprendre la relation existant entre les informations objectives et un phénomène ou un symptôme provoqué par une déficience pathologique ou fonctionnelle. Cet individu reçoit également un autre enseignement et est guidé pour comprendre l'effet d'un comportement spécifique et d'un mode de vie spécifique sur sa défaillance pathologique ou fonctionnelle. Enfin, on identifie des mesures à mettre en oeuvre pour changer le mode de vie de l'individu et pour créer un comportement plus sain, afin de réduire les problèmes ou les risques de santé de cet individu.
PCT/EP2006/064129 2005-08-23 2006-07-12 Methode et systeme pour fournir un enseignement a un individu et pour guider cet individu afin qu'il modifie son mode de vie et un comportement malsain, methode et systeme pour traiter un tel individu WO2007023027A2 (fr)

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