Towards Personalized Services In The Healthcare Domain

Published Date: 02 Nov 2017

Personalized services is a customized expression of main service to user's needs and preferences [George Dubus]

The feature of personalization in healthcare is relied on the assumption that each patient is a unique entity with each needs and preferences with respect to monitoring and support functions and all these features differentiate from other individuals [flexible healthcare. Personalization is the key factor enabling the healthcare service to be tailored to groups of patients and to each individual patient, as well.

Personalized healthcare provides medical services which are actually tailored to the patient. This ensures that healthcare services provisioned to any individual are customized to his/her prevailing healthcare needs and preferences.

Notice that the adoption of personalization by eHealth system is crucial for their success issue, because via the services that they provide are addressed to a wide range of users with quite different needs and preferences. An effective eHealth system provides a different service to each individual user.

Healthcare is one of the domains that are redesigned under the perspective of personalization.

Personalization is about building customer's loyalty by building a meaningful one-to-one relationship; by understanding the needs of each individual and helping satisfy a goal of efficiently and knowledgeably addresses each individual's need in a given context.

Personalization may consists of two steps; user modeling / profiling and content / service recommendation according to user profile. Rule and filtering -based methods as well as methods of classifiers and clustering are considered as recommendation techniques.

Personalized healthcare represents a system delivering personalized healthcare according to every patient's special requirements.

Healthcare services, such as health monitoring, medical consultation, need to be personalized based on context.

To achieve healthcare personalization, without considering phenotypic and genotypic patient data, factors susch as individula's lifestyle, surrounding situations, device capabilities, event of happenong etc should be taken into account. Such personalized factors are known as context whixh refers to any information tat can be used to characterize the situation of an entity and the interaction between them. [] As a result a personalized healthcare system is context-aware-provisioning healthcare information based on the user's changing context so that the right information can be delivered to the right person, at the right time, ath the right place using the right way.

A number of technologies, such as profile management systems, recommendation systems, content adaptation technologies, service discovery systems etc, are developed, enabling as both capture and expression of personalization. Services being personalized, provide a level of Quality of Experience (QoE) and Quality of Service (QoS) far beyond user already experienced. That enhanced user experience is due not only to the fact that user is provided by a level of QoS tailored to his needs and preference, but also is context-aware and therefore adaptable to range of situation. It is personalization that makes systems flexible because it enables them to understand user's current needs and can be tailored to each user separately. In that way systems' effectiveness is increased and errors are reduced, while the acceptance of new products is improved thanks to maximization of commonality of their experience [PIAPs]. The great achievement is the interaction between user and technology is facilitated, as technology is simpler and more user-friendly. In that way groups of user that were unfamiliar with technology can use it. Personalization, also the re-usage of common information that have been modified under that perspective. The control of security and privacy is much more easier, when the notion of personalization is taken into account. []

Modern research focuses on integrating the feature of personalization into modern communication for creating novel services, applications and products tailoring on each user separately. [as referred in]. From the technological perspective, i.e. decision making techniques, information display and triggering of action personalization can be classified as implicit and explicit [].In the former, user configures his communication with increased attendance, facilitating fast orientation and usage. Implicit personalization is characterized as an important service achievement. The latter is constructed on learning schemes that enable the set of information to be adapted on user. Obviously this classification is based on different technologies regarding decision making techniques, information display and trigger of actions. Concerning this criterion, personalization, from a technological point of view can be classified on three categories; implicit, explicit and hybrid.[] The first one is a user-oriented rule based approach. The second one is a self-adaptive system implementing a self-learning mechanism enhanced by an explicit feedback. The third one is an hybrid version taking advantages of both methods, mentioned above, as it enhance self-adaptive system's operation by gratifying its potential user arguments.

Modern researcher also focuses on materialization of personalization and the infusion of, in already existing technologies. The key element for the representation of personalization constitutes profiles. Profiles is the cornerstone of personalization.

As mentioned above, domains that have adopted the feature of personalization radically changed. Healthcare is one of the domains that are redesigned under the perspective of personalization. That procedure was so depth and radical that resulted to a paradigm shifting from the doctor-centric to the patient centric one.

2. Personalization in Healthcare

2.1. Patient-centric paradigm

Personalization in e-Health has been a focus of research for a number of years, both from a User Modeling perspective and from a medical perspective. Research in personalization for e-Health was originally mostly focused on the provision of information to consumers of health care (Lewis et al. 2005). This was largely in response to a significant change in how people looked for information about their health and their involvement in their own health care. While, in the past, the almost exclusive source of information was the medical staff directly concerned with the provision of care, the Internet and the World Wide Web provided new opportunities for a new generation of users, the "health information consumers". These are people who seek information on various aspects related to health and well being, like health promotion, disease prevention, management of long term conditions, and so on. But as the amount of information available on the Web continues to grow, it is recognised that there is a need to design and develop intelligent systems capable of tailoring information for health care consumers (Hawkins et al. 2008), whereby only providing appropriate, timely and relevant information and exploiting this great potential to enhance health information and education through web (or mobile) delivery (Cawsey et al. 2007).

Initially, healthcare domain was called eHealth composed by telemedicine systems providing services that enable healthcare providers in general, to exert Medicine by far.

Objective of patient-centric paradigm is the enablement of patients to live a normal and productive life. The accomplishment of that goal assumes that patient should be enabled to be de-hospitalized. Thus, a healthcare domain should be designed in way where user can change environments and in case of emergency be provided with the appropriate healthcare.

So, t is important that patient should feel safe, i.e. patient should have the feeling that, whenever he/she is, in any case of emergency he/she get the appropriate healthcare, immediately. Therefore healthcare should be provided anytime and anywhere and anyone who needs it. Healthcare services, in order to achieve that goal should ubiquitous, i.e. to be provided to anyone without limitations on place and time []. Ubiquitous healthcare services are supported by the already existed pervasive network infrastructure. However, because healthcare in order to be efficient and effective should take account of the different needs of each individual patient. The adoption of personalization in healthcare domain is key factor for its success. The patient-centric approach naturally implies that personalization plays an important role to achieve the e-Health vision—indeed, to provide relevant, timely and appropriate information or sophisticated intelligent support, a system ought to use personalization techniques.[ Floriana Grasso and Cécile Paris, "Preface to the special issue on personalization for e-health", User Model User-Adap Inter (2011), Springer]. Inevitably healthcare domain in order to be consistent with the patient-centric model should be ubiquitous and personalized.

Within the context of patient-centric paradigm modern eHealth systems include health monitoring systems which enable healthcare to be close to patient and assist patient to included dynamically in the self-care process.

The patient-centric paradigm represents a personalized and ubiquitous healthcare environment. In that context, healthcare properly provided to right persons [Kun-Lung] without spatial and temporal limitations []. Healthcare environment needs to be ubiquitous because healthcare needs to be delivered to every possible place where patient can be, either home or aboard, or even in locations within the healthcare system or in his work.

Personalization is the key factor enabling the healthcare service to be tailored to groups of patients and to each individual patient, as well. The feature of personalization in healthcare is relied on the assumption that each patient is a unique entity with each needs and preferences with respect to monitoring and support functions and all these features differentiate it from other individuals. [flexible home care].

Objective of doctor-centric: The emphasis was on storage of data in a electronic medium which allowing the exploitation of this data at a later point of time. Most IT application in healthcare were designed to support for retrospective information retriaval needs and, in some cases, to analyze the decision undretaken. This has changed healthcare institutions' perspectives towards the concept of utility of data. Clinical data that was traditionally used in a supportive capacity for historical purposes has today beacome an oppurtinity that allows healthcare stakeholders to tackle problems before they arise.

Objective of patient-centric paradigm is the enablement of patients to live a normal and productive life. The accomplishment of that goal assumes that patient should be enabled to be de-hospitalized. Thus, a healthcare domain should be designed in way where user can change environments and in case of emergency be provided with the appropriate healthcare.

Personalized healthcare in ubiquitous computing environments can be provisioned at anytime, anywhere with the support of the infrastructure.

Traditional healthcare environment is in compliance with the doctor-centric paradigm. The doctor-centric paradigm enables healthcare providers (doctors) to deploy conventional services such as access to patients' medical examination and other medical information. The doctor-centric model aims to facilitate healthcare providers regarding the assessment of patient's health condition.

However, in the recent years, it has been observed a shift from the doctor-centric paradigm to the patient-centric paradigm. The emerging modern healthcare environment enables patients' de-hospitalization, i.e. patients live normally and productively, thanks to provided health proactive and consulting services that enhance the prevention and management of diseases. The implementation of patient-centric paradigm requires the deployment of new type of services instead of the conventional ones. The healthcare services, that are oriented on patient-centric paradigm, are provided to any patient without spatial and temporal restrictions, while at the same time meeting his/her current needs and preferences. In other words, ubiquity and personalization are the two features that healthcare services should incorporate in order to be in agreement with the patient-centric paradigm. The required ubiquity of healthcare environment is supported by the already existing mobile network infrastructure and even more by the upcoming heterogeneous network infrastructure

2.2. Personalized healthcare services

The emergence of ubiquitous computing na dcontinuous progress in medical devices and diagnosis methodology, however, enabling personalized healthcare services to be delivered to individuals at any place and any time. Personalized healthcare provides medical services which are trully effective "for me". This ensures that healthcare services provisioned to any individual are customized to his/her prevailing healthcare needs. With personalized healthcare we can have further achieve an early health system where disease is addressed and prevented at the earliest possible moment rather than a late disease model where the emphasis is mainly on diagnosis and teratment.

The adoption of personalization into healthcare solves a fundamental problem. eHealth systems, via the services that they provide, are addressed to a wide range of users with quite different needs and preferences. For being effective and consistent with patient-centric paradigm, eHealth system should provide a different service for each individual user. Obviously, it is impossible and not feasible. Therefore, personalized services were introduced as solution of that problem. Personalized services constitute an extension of non-personalized services [], permitting internal modifications. As referred in [George Dubus], personalized service is a customized expression of main service with respect to user's needs and preferences.

Even though, it is imperative for healthcare service to be, apart from ubiquitous, and personalized, few of them express that feature. Even if some healthcare service have adopted that feature, they express it slightly. It is difficult for services to achieve the goal of being actually personalized.

Useful personalization is reflected in three sub-themes: targeted health information; selecting a physician; and seamless information

The personalized healthcare adviser service provides health-related advice to the user in the right manner and at the right time.

The plethora of already existing and future healthcare can be classified into five following categories; medical consultation, emergency response, remote body check-up, insurance and billing. These services are supposed to adapt to the changing context of service recipients.

Upcoming ubiquitous personal healthcare services imply continuous location-independent access to personalized healthcare information, assistance, support and intervention enabling applications such as continuous monitoring of personal health status, or health - status - related stepwise activation of hierarchically cooperating service and functions. Implementing such an escalation strategy can help avoiding inefficient and adequate use of resources.

Healthcare services are provided by remote healthcare service providers there is a need to interoperate these heterogeneous services for service management, delivery and composition.

Personalized Healthcare adviser is an example of personalized healthcare service. The personalized healthcare adviser service provides health-related advice to the user in right manner and right time.

2.3. Related work in personalized healthcare systems

3. Personalization and profiles in Patient-centric paradigm

3.1. Profiles in Healthcare

3.2. Profile management system in Healthcare

3.3. A Group Profile Management System in Healthcare

4. Conclusions and Future Directions