1. Directions for ICT Research in Disease Prevention
FP7-ICT-2009.5.1 – Support Action
Prevention of diseases
WHY, WHAT and HOW
Niilo Saranummi
niilo.saranummi@vtt.fi
This project is partially funded under the 7th Framework Programme by the European Commission

2. Prevention of diseases
WHY
www.preve-eu.org

3. The well-known health system challenges
• Health expenditure vs.
Healthy
value At risk
© Juha Teperi, STM
– What is produced with €’s Ill Under
– Quality & Access concerns treated
Difficult to
– Expectations & Awareness treat Crisis
• And the drivers
– Ageing & Care ratio
– Life styles
– Science, Technology and
”Defense lines”
Innovation Burden of disease
www.preve-eu.org

4. Prevention is the best strategy
• The best strategy for prevention is to lead a healthy
lifestyle.
– According to WHO, 77% of the disease burden in Europe is
accounted for by disorders related to lifestyles. Furthermore, 70%
of stroke and colon cancer, 80% of coronary heart disease, and
90% of type II diabetes could be prevented by maintaining healthy
lifestyles.
• Although we are constantly “bombarded” with health
promotion information that we should exercise regularly,
eat healthy, control our weight, sleep enough, manage
stress, not smoke and use alcohol only moderately etc. as
a population we are not doing a good job in acting
according to this advice.
www.preve-eu.org

5. But people need assistance
• Based on this it should be clear that we as individuals
need assistance in primary prevention.
• The questions are
– What kind of assistance and
– How the assistance should be made available / offered and
– How to ensure that the assistance provides effective help to the
individual in changing and maintaining her lifestyle.
www.preve-eu.org

6. Prevention of diseases
WHAT
www.preve-eu.org

7. PREVE – in brief
A Support Action, under the 4th FP7 ICT Call
• Objective
– Focused on how the citizen can be empowered by ICT solutions
and services in disease prevention and the preservation of health
• What PREVE delivers
– A White Paper* identifying ICT research directions in disease
prevention for the empowerment of citizens highlighting the need
to approach this topic from multiple complementary viewpoints.
www.preve-eu.org

8. PREVE workflow – 3 phases
Workshops
Barcelona Milan
16.3.2010 8.11.2010
Belfast
14.6.2010
31.11.2010
1.12.2009
Select the User White paper
Business ICT Research
diseases & segments &
models and Directions in
best Personal
validation Primary
practices profiles Prevention
(T3.1 – 3)
(T2.1) (T2.2 – 4) (T3.4)
www.preve-eu.org

9. PREVE partners
Valtion teknillinen tutkimuskeskus, VTT
Aarhus University
Fondazione Centro San Raffaele del
Monte Tabor
Universidad Politécnica de Valencia
www.preve-eu.org

10. Prevention of diseases
HOW
PREVENTABLE DISEASES – RISK FACTORS
www.preve-eu.org

11. Associations between Risk Factors and Conditions
Diseases and Disorders Risk Factors
Type 2-diabetes Tobacco smoking
Preventable cancer Alcohol consumption
Cardiovascular disease Diet
Osteoporosis Physical activity
Musculoskeletal disorders Obesity
Hypersensitivity disorders Accidents
Mental disorders Working environment
Chronic obstructive pulmonary disease Environmental factors
www.preve-eu.org

12. Health behaviors
Diseases and Disorders Risk Factors
Type 2-diabetes Tobacco smoking
Preventable cancer Alcohol consumption
• Diet
Cardiovascular disease • Physical Activity Diet
• Alcohol consumption
Osteoporosis
• Smoking Physical activity
• Stress
Musculoskeletal disorders Obesity
• Sleep
Hypersensitivity disorders ( + Family history) Accidents
Mental disorders Working environment
Chronic obstructive pulmonary disease Environmental factors
www.preve-eu.org

13. Prevention of diseases
HOW
PROFILING – SEGMENTING / PERSONALIZING
www.preve-eu.org

14. Determinants of health behavior
Values, personality
Social Ability
influences
Reasoned
Awareness Self-efficacy Intention
behavior
Outcome
expectations Barriers
Automatic
behaviors
Environmental contexts
www.preve-eu.org

15. The environment – Choice architectures
• Physical and social
Society
environments: the context for Policies, laws, regulations
Barriers / Incentives
behavioral decisions and
habitual behaviors Community
Attributes, resources, and norms
– The available options in the in community
(e.g. markets, jogging paths)
environment
– The way the choices are Organizational
Civic, religious, social, political,
presented and related organizations
• The choice architecture of the (e.g. schools, workplaces)
decision context Interpersonal
– supports or discourages a Beliefs and actions of
friends, family, coworkers,
behavior and other referents
– guides the formation of habits Individual
A person’s
• The choice architectures of knowledge,
attitudes, and
environments are built by skills
actors from multiple levels
www.preve-eu.org

16. Periodic reassessment
Current Health behavior?
Diet
Physical Activity Support
OK, no critical need
Alcohol consumption for improvements behavior/
Smoking maintenance
Stress
Sleep
Improvements needed
Intention per Strong Lack of external Yes
Strengthen
behavior? intention resources? resources
High-level Reassessment
Weak or no intention No
intervention Strengthen social
Aware of risks Discouraging social
choice logic and benefits?
Yes
environment?
Yes independence /
increase support
No
Not aware/Misconceptions
Improve self-
Weak self-efficacy? Yes
efficacy and skills
No
Educate
Unfavourable outcome Yes
Improve outcome
expectations? expectations
www.preve-eu.org

17. Prevention of diseases
HOW
NEEDS – SOLUTIONS – BUSINESS CASES
www.preve-eu.org

18. Persons at risk of developing an illness…
JENNI, 31 YEARS SONJA, 20 YEARS
AT RISK AT RISK
ROBERTO, 48 YEARS Value CARLO, 10 YEARS
AT RISK AT RISK
COMMON
GOAL:
STAY HEALTHY
Do all personas share a common goal
of wanting to stay healthy?
www.preve-eu.org

19. All have their own mental model
SERVICE
CUSTOMER
PROVIDER
NEED OFFER
VALUE
VALUE IN USE
PROPOSITION
What does this mean?
www.preve-eu.org

20. Value propositions will be different
JENNI, 31 YEARS . SONJA, 20 YEARS
AT RISK AT RISK
Value Value
. 1) UNIQUE PERCEPTION OF WHAT
. ROBERTO, 48 YEARS
Value VALUE IS PER INDIVIDUAL Value . CARLO, 10 YEARS
2) VALUE PERCEPTION NOT
AT RISK HEALTH RELATED AT RISK
. 1) LONG TERM HEALTH RELATED VALUE HIDDEN COMMON
BEHIND OTHER PERSONAL VALUE PERCEPTIONS GOAL:
STAY HEALTHY
www.preve-eu.org

21. Objects of care will assume a new role as
Co-producers of health and care
Proactive Individuals as
co-producers of
Connected Health
Health & Care
Traditional Co-Producer Model
choices
Model
Illness  Management of health and
care
Patients as
”Outsourced”  ”Insourced” Reactive passive objects
Reactive  Proactive
Episodic  Continuous Health & Care Citizen-
Professionals Dependency Patient
www.preve-eu.org

22. Co-producers of health
www.preve-eu.org

23. The environment matters
”Preloading” to create favourable conditions
Policies
Society Barriers +
Incentives
Education
Individual Health promotion
Awareness
www.preve-eu.org

24. Prevention of diseases
CURRENT STATUS
AND OPEN ISSUES
www.preve-eu.org

25. Current Version
Health management project
Where is
the ICT? ”Recommendation
engines”
DIY ”App store”
Profiler Set goals and broker an
integrated set of
Create a personal interventions
profile of • based on what behaviors
• health behaviours, risk need modifying and
factors , motivators, personal preferences
resources and values
Analyze Plan
Trigger
event
Evaluate Execute
Carry out the plan with
Assess progress the co-creator network
towards the set goals
PHS ”Persuasive
technologies” PGS
www.preve-eu.org

26. The Dilemma of Primary Prevention
Closer integration to healthcare changes institutional framework for
services
At risk, low Difficult accessability
motivation, low must be offset by
education etc public sector subsidies
Value is spread to
Need for healthcare integration increases
healthcare system
Higher benefit providers = number of
from system stakeholder increases
perspective

Need for evidence-
Need for evidence increases
based models
Societal benefits increase
Accessability decreases
increases to justify
subsidies 
BM must be subsidized
to offset risk from
companies perspective
”Consumerism”
Out-of-pocket
Healthy, Value distributed to
technologically one stakeholder 
advanced BM follows
www.preve-eu.org

27. The engine room?
Political, social, economic
Co- Choice
producers architectures
HealthGPS
(digital avatar)
Platform services (security, ID)
PHR
www.preve-eu.org

28. Where are we today?
Workshops
Barcelona Milan
16.3.2010 8.11.2010
Belfast
14.6.2010
31.11.2010
1.12.2009
Select the User White paper
Business ICT Research
diseases & segments &
models and Directions in
best Personal
validation Primary
practices profiles Prevention
(T3.1 – 3)
(T2.1) (T2.2 – 4) (T3.4)
www.preve-eu.org

29. Prevention of diseases
CLOSING
FROM COMPLIANCE 
RESPONSIBILITY 
RESPONSE ABILITY
© Ilias Iakovidis
www.preve-eu.org