Technological innovations in asthma patient monitoring and care Michael Glykas a, * , Panagiotis Chytas b a Department of Financial and Management Engineering, University of Aegean, 31, Fostini Street, Chios 82 100, Greece b Department of Business Administration, University of Aegean, 8, Michalon Street, Chios 82 100, Greece Abstract Recent studies have shown that long-term monitoring of asthma severity can reduce asthma exacerbations, optimise drug therapy and decrease the cost of asthma management [National Heart, Lung and Blood Institute, 1997]. The management of a chronic patient is a collective and cooperative enterprise that may exploit Information Technologies (IT) to improve the overall quality of care [Int. J. Med. Informatics 55 (1999) 87]. The aim of this paper is to present a web based asthma tool that significantly enhances public information and awareness to support illness prevention, patients independent living through user profiling and personalisation and collaborative work between health professionals, therapists, caregivers and patients through Tele-Care and Tele-Consultation. The system has been tested through a preliminary survey that took place in UK and Greece. q 2003 Elsevier Ltd. All rights reserved. Keywords: Telemedicine; Asthma; Asthma management; Asthma monitoring; e-Health; Homecare 1. Introduction More than 150 million people worldwide live with the burden of asthma (WHO, 2000a), with almost half experiencing symptoms that disrupt their everyday lives (Rabe, 2000). In addition, prevalence is rapidly increasing on a global basis, particularly in children and young adults (Lundback, 1998). Shockingly, asthma still claims 180,000 lives each year (WHO, 2000b). Asthma is a chronic lung condition that can develop at any age. It is most common in childhood and occurs in approximately 7–10% of the paediatric population. Asthma is the most common chronic respiratory disease of children; it accounts for 1/4 of school absenteeism. It affects twice as many boys as girls in childhood; more girls than boys develop asthma as teenagers, and in adulthood, the ratio becomes 1:1 males to females. Asthma affects children in varying degrees, from very mild (only during vigorous exercise) to very severe. Children with severe asthma may have symptoms every day that may cause some lifestyle restriction; in these children symptoms occur more easily and more frequently. Effective management of chronic illness requires a close partnership between the patient and all healthcare providers (Lorig, Bodenheimer, Holman, & Grumbach, 2002). Since asthma is a chronic disease it requires continuous care. Recent studies have shown that long-term monitoring of asthma severity can reduce asthma exacerbations, optimise drug therapy and decrease the cost of asthma management (National Heart, Lung and Blood Institute, 1997). The management of a chronic patient is a collective and cooperative enterprise that may exploit Information Tech- nologies (IT) to improve the overall quality of care (Berg, 1999). Most consideration among them is paid on Internet technologies and decision support technologies (Ba, Lang, & Whinston, 1997; Brooks, 1999; Detmer & Shortliffe, 1997; Hersch, Brown, Donohow, Cambell, & Horacek, 1996; Inmon & Hackathorn, 1994; Raghupathi & Tan, 1999; Silver, 1991). Emerging at the beginning of the last decade, the World-Wide Web (WWW) rapidly imposed itself as a new medium for interconnecting people throughout the world. Overstepping the initial publishing purpose, Web appli- cations currently evolve towards the setting-up of virtual working and communication spaces, intending to be used by specific communities of users (Vanoirbeek et al., 2000). The use of the Web for telemedicine applications seems nowadays a compulsory solution: the Web has become a standardized infrastructure for giving access to sophis- ticated telemedicine applications from virtually any machine and operating system. Such standardized com- munication platform guarantees accessibility and usability 0957-4174/$ - see front matter q 2003 Elsevier Ltd. All rights reserved. doi:10.1016/j.eswa.2003.12.007 Expert Systems with Applications 27 (2004) 121–131 www.elsevier.com/locate/eswa * Corresponding author. Address: Department of Financial and Management Engineering, University of the Aegean, 23 Pretenteri Street, Athens 11145, Greece. Tel.: þ30-9774-83370; fax: þ30-2103-894122. E-mail address: mglikas@aegean.gr (M. Glykas).