H2020 EU Research & Innovation Program Boost the Transfer of Technological Breakthroughs, Enable New Solutions for Personalised Health and Impact the Industry and Healthcare Systems.

Our Healthcare systems worldwide are facing grand challenges that can be addressed by intelligent, miniaturized and interconnected devices. Many of today's pharmaceutical drugs create bigger problems than solutions, as drugs help only 40% of the patients and kill, in the USA alone, over 100,000 people per year. The widespread use of antibiotics has led to new strands of bacteria that defy all known antibiotics and kill well over 100,000 people yearly in the world. Outbreaks of infections by new viruses and anti-resistant bacteria are expected with even more grave consequences. The quality of food around the world is steadily deteriorating, as the soils are becoming depleted of essential nutrients and contain increasing amounts of pesticides, herbicides and fungicides. Our environment is burdened with 2.5 billion tonnes of chemicals per year that accumulate in the soil, groundwater, rivers and seas, and eventually end up in our food and our drinking water. As a consequence, there is a strong increase in the incidence of diseases hardly known fifty years ago. In parallel, an increasing number of people are taking the responsibility for their health and well-being in their own hands and are looking for mobile and in-obtrusive ways to objectively monitor their health status. The development of intelligent, miniaturized systems, by the heterogeneous integration of technologies such as micro- and nano-electronics, photonics, biotechnology, materials and information & communication, addresses these issues and has received intensive public support in the EU over the past two decades in the FP6 and FP7 programs. Proven concepts and functional prototypes exist with the potential to create new opportunities to improve our healthcare systems, in particular personalized or precision medicine. These device concepts offer unique abilities to sense, detect, analyze, communicate, respond, and monitor phenomena from the macro (e.g. body, tissues) to the nano scale (e.g. molecules, genes) on the spot, with short response times. For the majority of the projects, the planning for the next phase of prototype validation, through product design, supply chain setup, user targeting, clinical validation and commercial roll-out is now taking full attention. However, significant hurdles exist in the successful translation of the new technology to new products. As these technologies are new-to-the-world the resulting products carry a high risk, often necessitating the creation of new companies. Therefore the EU has developed the Horizon 2020 program as a framework for technology development and new business creation. Horizon 2020 is focusing on support for technology transfer, and on building ecosystems and value chains to ensure shorter times-to-market, thus enabling a higher impact of knowledge-based technologies. This paper will argue the necessity of developing these new class of devices, discuss its state-of-the-art, and the challenges for the implementation of Horizon 2020 and the new opportunities in intelligent miniaturized systems for pHealth.

Smart systems and personalized health: the real challenge of bridging the innovation gap.

Smart miniaturized systems, emerging from the integration of heterogeneous technologies like micro- and nano electronics, photonics, biotechnology, materials and information & communication technologies are considered today, after two decades of intensive public support, proven concepts and functional prototypes, as key enablers opening up new opportunities for healthcare and in particular personalized health. They offer an enhanced ability to sense, detect, analyze, communicate, respond, and monitor phenomena from macro (e.g. body, tissues) to nano scale (e.g. molecules, genes). For the majority of these projects, planning for the next phase of prototype validation, product design, supply chain, user targeting, clinical validation and commercial roll-out are now taking full attention. The new EU Framework Program for Research and Innovation, Horizon 2020, is focusing on technology transfer support and building ecosystems and value chains to ensure better time to market and higher impact of knowledge-based technologies. The state-of-the-art and upcoming challenges for the implementation of H2020 and new opportunities in smart systems for pHealth are discussed in the paper.

Wearable and micro and nano technologies for pHealth: R&D achievements to enable future innovation.

The fast developments in information and communication technology as well as R&D work on micro and nano systems in biology and biomedical engineering are stimulating the explosive growth in life sciences, which is leading to an ever increasing understanding of life at sub-cellular and molecular level and so revolutionizing and personalizing diagnosis and therapy. By bringing these parallel developments to biomedicine and health, ultrafast and sensitive systems can be developed to prevention & lifestyle support, to early diagnose or treat diseases with high accuracy and less invasiveness, and to support body functions or to replace lost functionality. Such pHealth systems will enable the delivery of individualized health services with better access & outcomes at lower costs than previously deemed possible, making a substantial contribution to bring healthcare expenditures under control and increase its productivity.

R&D in micro-nano-bio systems and contribution to pHealth.

The capacity to research, develop and manufacture systems that employ components based on nano- and microstructures with biological functionality, and are capable to share, ubiquitously, information is at the forefront of worldwide competition. A new generation of advanced materials, processes and emerging technologies is building up enabling highly integrated, miniaturized and smart micro-nano-bio-systems to be engineered. These fast technology developments are also stimulating the explosive growth in life sciences, which is leading to an ever increasing understanding of life at the sub-cellular and molecular level. By bringing these parallel developments to biomedicine and health, ultrafast and sensitive systems can be developed to prevent illness, to support lifestyle, to make early diagnosis or treat diseases with high accuracy and less invasiveness, and to support body functions or to replace lost functionality. Such systems will enable the delivery of individualized health services with better access and outcomes at lower costs than previously deemed possible, making a substantial contribution to bringing healthcare expenditures under control and increase its productivity. The MNBS (Micro-Nano-Bio Systems) group of EU funded projects aims at speeding up the convergence of micro- and nanotechnology with the life sciences and accelerating the development of highly integrated diagnostic, monitoring and therapeutics devices. This paper presents R&D activities supported through the MNBS group that are relevant to pHealth and discusses directions to be taken in order to overcome the current problems. Finally, it addresses future challenges to build highly integrated and reliable systems including innovation and usability issues.

Micro-nano-biosystems: An overview of European research.

New developments in science, technologies and applications are blurring the boundaries between information and communications technology (ICT), micro-nano systems and life sciences, e.g. through miniaturisation and the ability to manipulate matter at the atomic scale and to interface live and man-made systems. Interdisciplinary research towards integrated systems and their applications based on emerging convergence of information & communication technologies, micro-nano and bio technologies is expected to have a direct influence on healthcare, ageing population and well being. Micro-Nano-Bio Systems (MNBS) research and development activities under the European Union's R&D Programs, Information & Communication Technologies priority address miniaturised, smart and integrated systems for in-vitro testing e.g. lab-on-chips and systems interacting with the human e.g. autonomous implants, endoscopic capsules and robotics for minimally invasive surgery. The MNBS group involves hundreds of key public and private international organisations working on system development and validation in diverse applications such as cancer detection and therapy follow-up, minimally invasive surgery, capsular endocsopy, wearable biochemical monitoring and repairing of vital functions with active implant devices. The paper presents MNBS rationale and activities, discusses key research and innovation challenges and proposes R&D directions to achieve the expected impact on healthcare and quality of life.

Current and future R&D activities of the EC-IST programme in eHealth.

The EU support to R&D in eHealth over the last few years has addressed citizens, patients and health professionals needs in their activities. The societal challenges based on the principle of citizen-centred care have found solutions in the many projects financed through the IST programme. Major paradigm shifts have emerged e.g. from "hospital centred healthcare" to "patient/citizen centred health" and from "treatment" to "prevention". Information technologies became one of the major driving forces for healthcare evolution, receiving acceptance by an increasing number of health professionals. In addition, a new industrial sector was clearly identified; the "Health Telematics Industry". This paper present the main research and development activities carried out in eHealth during the 5th R&D Framework Programme and the future research and development activities in the 6th R&D Framework Programme.

Research and development of smart wearable health applications: the challenge ahead.

Continuous monitoring of physiological and physical parameters is necessary for the assessment and management of personal health status. It can significantly contribute to the reduction of healthcare cost by avoiding unnecessary hospitalisations and ensuring that those who need urgent care get it sooner. In conjunction with cost-effective telemedicine platforms, ubiquitous health monitoring can significantly contribute to the enhancement of disease prevention and early diagnosis, disease management, treatment and home rehabilitation. Latest developments in the area of micro and nanotechnologies, information processing and wireless communication offer, today, the possibility for minimally (or non) invasive biomedical measurement but also wearable sensing, processing and data communication. Although the systems are being developed to satisfy specific user needs, a number of common critical issues have to be tackled to achieve reliable and acceptable smart health wearable applications e.g. biomedical sensors, user interface, clinical validation, data security and confidentiality, scenarios of use, decision support, user acceptance and business models. Major technological achievements have been realised the last few years. Cutting edge development combining functional clothing and integrated electronics open a new research area and possibilities for body sensing and communicating health parameters. This paper reviews the current status of research and development on smart wearable health systems and applications and discusses the outstanding issues and future challenges.

European Commission activities in eHealth.

Health-care is an information-intensive and knowledge-demanding sector, which is why eHealth solutions are so important in this field. The European Commission (EC) has been initiating and funding research and development activities regarding Information and Communication Technologies (ICT) for health, or "eHealth", since 1988. These programmes covered priority topics like electronic health-care records, regional and national health networks, telemedicine in homecare and care-at-the-point-of-need to support continuity of care concepts, systems to support people to stay healthy, and systems and tools to support health professionals to work more efficiently and safely on patients. During the 15-year span of the programmes, the European Union (EU) has contributed about 500 million Euro to approximately 400 R&D projects, support activities, best practice and studies covering technical, clinical, ethical, legal, organisational and market issues. eHealth has shown proven benefits in application fields like improved access to care, care at the point-of-need, citizen-centred care, improved quality and cost containment. Such applications were on show at the EU High Level eHealth Conferences in Brussels, Belgium, in 2003, and in Cork, Ireland, in 2004. eHealth is now on the governmental agenda of EU Member States to be implemented on a broader scale. In line with this development, the Commission has taken a number of policy initiatives. A European Union Action Plan for a European eHealth Area was published by the Commission in April 2004 and endorsed by the EU health ministers in June 2004. This means that, for the first time, Europe has a coherent agenda for the implementation of eHealth. This report will concentrate on eHealth activities initiated by the Information Society Directorate-General of the European Commission.

Intelligent biomedical clothing for personal health and disease management: state of the art and future vision.

Telemedicine has been introduced to overcome distance in order to get prompt access to medical knowledge and appropriate health care. More recently, work in telemedicine has aimed at developing solutions to support the management of chronic diseases such as diabetes, and lung and heart diseases, as well as to provide support for home care services. Telemedicine is also entering the fields of health promotion/prevention disease, life style management, and well-being. The evolution and broadening of telemedicine gives birth to a nomenclature that includes "e-health," "telehealth," and "telecare." The latest developments in microsystems and nanotechnologies as well as in information processing and communication technologies allow miniaturization and non-invasive smart monitoring of physiological and physical data. Ongoing cutting-edge multidisciplinary research in textile fibers, biomedical sensors, and wireless and mobile telecommunications integrated with telemedicine, aims at developing intelligent biomedical clothing (IBC) that could pave the way to support personalized management of health and diseases at the point of need and at any time. In this study, we aim to describe the current status of multidisciplinary research and development of IBC, based on bibliographic research and reports from seminars, workshops, conferences, and working groups. A further aim is to inform the developers, the decision makers, and users in the health and healthcare sector regarding future solutions to support personalized health care and disease management. Both the textile sector and healthcare sector are looking with great interest at the innovative products and applications that could result from the integration of microsystems, nanotechnologies, biomedical sensors, textiles, and mobile telecommunications. For health monitoring, disease prevention and management, rehabilitation, and sport medicine, IBC may offer, in the mid-term future, a unique, wearable non-obtrusive telemedicine platform for individualized services that is readily accessible and of good quality.