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E-raamat: Digital Patient: Advancing Healthcare, Research, and Education

Edited by (Eastern Virginia Medical School), Edited by (Old Dominion University), Edited by (Old Dominion University)
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Medical modeling and simulation technology is interdisciplinary and combines life and physical sciences, engineering, and medical expertise, and since it is being executed at various levels for various purposes at research and development institutions throughout the world, there exists the foremost challenge of conjoining these independent, yet complementary efforts to exploit their full potential. This is especially true with regard to the virtual human wherein there is the necessity to assimilate both the developed and developing components of the human physiome and diseaseome to advance patient care, medical practice, research and development, and education and training. This book advances personalized patient care using the virtual human and its ability to represent the human physiome (how the body functions) and diseaseome (disruptions to the body's functions). In order to achieve a holistic analysis of the body, this book provides an integrated, interoperable,i.e., complex and dynamic, examination of human biology with physiological and behavioral components of the overall patient experience. The future of healthcare is proving to be an overwhelming challenge globally, and changing practice to provide holistic, personalized care in an expanding (longer-lived and growing population) and demanding (multiple pathologies and needs per individual patient) environment requires optimizing research, technology, and training. Clinicians must exploit new generation capabilities in diagnostic and therapeutic patient care for the burden of patient needs to be met. Medical technology is very near to providing safe and effective personalized patient care through the use of virtual human technology, and via simulation, clinicians receive a virtual patient in real-time and conclude a more timely and precise treatment action. With contributions from international experts, the book presents the state-of-the-art in the development of the virtual human physiome in three areas: anatomical; physiological; and behavioral. This is followed by a discussion of current applications in: practice-personalized care; research; and education. With this two-fold research agenda aimed at assimilating the various resources needed to complete the virtual human, the book extends the integrated, interoperable capabilities to further research and development, augment education and training, and advance patient care.
List of Contributors
xiii
Preface xvii
PART 1 The Vision: The Digital Patient---Improving Research, Development, Education, and Healthcare Practice
1(48)
1 The Digital Patient
3(12)
C. Donald Combs
Health, The Goal
4(1)
Personalized Medicine
4(1)
The Best Outcomes
5(1)
The Emergence of the Digital Patient
5(1)
The Human Physiome
6(2)
Enabling the Digital Patient
8(3)
P4 Medicine
11(1)
Conclusion
11(1)
References
12(3)
2 Reflecting on Discipulus and Remaining Challenges
15(12)
Vanessa Diaz-Zuccarini
Mona Alimohammadi
Cesar Pichardo-Almarza
Introduction
15(1)
A Brief Contextual Background and a Call for Integration: Personalized Medicine is Holistic
16(2)
The Many Versions of the Digital Patient: On the Road to Medical Avatars
18(1)
Discipulus: The Digital Patient Technological Challenges and Main Conclusions
19(5)
The Remaining Challenges and Big Data
24(1)
Conclusion
25(1)
References
26(1)
3 Advancing the Digital Patient
27(6)
Catherine M. Banks
Introduction
27(1)
The Digital Patient: Its Early Start
28(2)
Engaging the Digital Patient
30(1)
Conclusion
31(2)
4 The Significance of Modeling and Visualization
33(16)
John A. Sokolowski
Hector M. Garcia
Introduction
33(1)
Modeling a Complex System: Human Physiology
34(1)
Medical Modeling, Simulation, and Visualization
35(5)
Modes and Types of Visualization
40(3)
Visualization for Patient-Specific Usefulness
43(1)
Conclusion
43(2)
References
45(4)
PART 2 State of the Art: Systems Biology, the Physiome, and Personalized Health
49(158)
5 The Visible Human: A Graphical Interface for Holistic Modeling and Simulation
51(12)
Victor M. Spitzer
Introduction
51(2)
Education
53(2)
Modeling
55(1)
Virtual Reality Trainers and Simulators
56(2)
Conclusion
58(1)
References
59(4)
6 The Quantifiable Self: Petabyte by Petabyte
63(10)
C. Donald Combs
Scarlett R. Barham
Introduction
63(1)
Smarr's Quantified Self
64(3)
Extending Smarr's Research
67(2)
The Quantified Self-Vision, Simplified
69(1)
Criticism
69(2)
Conclusion
71(1)
References
72(1)
7 Systems Biology and Health Systems Complexity: Implications for the Digital Patient
73(12)
C. Donald Combs
Scarlett R. Barham
Peter M. A. Shot
Introduction
73(2)
Systems Biology
75(1)
The Institute for Systems Biology
76(2)
The Complexity Institute
78(3)
The Potential of Systems Biology
81(1)
Criticism
82(1)
Conclusion
83(1)
References
83(2)
8 Personalized Computational Modeling for the Treatment of Cardiac Arrhythmias
85(16)
Seth H. Weinberg
Introduction
85(1)
Basics of Cardiac Electrophysiology
86(3)
Cardiac Modeling Advancements
89(1)
Regulation of Intracellular Calcium
90(1)
From Cells to Cables to Sheets to Tissue to the Heart
91(4)
Where Can we go from Here? What is the Cardiac Model in the Digital Patient?
95(1)
References
96(5)
9 The Physiome Project, openEHR Archetypes, and the Digital Patient
101(26)
David P. Nickerson
Koray Atalag
Bernard de Bono
Peter J. Hunter
Introduction
101(1)
Multiscale Physiological Processes
102(1)
Physiome Project Standards, Repositories, and Tools
103(9)
Archetype Specialization
112(1)
Archetype Definition Language
113(1)
Linking Archetypes to External Knowledge Sources (Terminology and Biomedical Ontologies)
114(1)
Archetype Annotations
114(1)
OpenEHR Model Repository and Governance
115(1)
Fast Healthcare Interoperability Resources
115(1)
A Disease Scenario
116(5)
Summary and Conclusions
121(1)
References
122(5)
10 Physics-Based Modeling for the Physiome
127(22)
William A. Pruett
Robert L. Hester
Introduction
127(1)
Modeling Schemes
128(14)
Future Challenges
142(1)
Conclusion
142(1)
Acknowledgments
143(1)
References
143(6)
11 Modeling and Understanding the Human Body with SwarmScript
149(22)
Sebastian von Mammen
Stefan Schellmoser
Christian Jacob
Jorg Hahner
Introduction
149(1)
Related Work
150(2)
Multiagent Organization
152(1)
Designing Interactive Agents
152(1)
Speaking SwarmScript
153(1)
Answering Demand: The Design of SwarmScript
153(1)
Graph-Based Rule Representation
153(1)
The Source--Action--Target
154(1)
SwarmScript INT03D
154(1)
A SwarmScript Dialogue
155(9)
Discussion
164(2)
Summary
166(1)
References
166(5)
12 Using Avatars and Agents to Promote Real-World Health Behavior Changes
171(10)
Sun Joo (Grace) Ahn
Introduction
171(1)
Avatars and Agents
172(1)
Using Agents and Avatars to Promote Health Behavior Changes
173(5)
Conclusion
178(1)
References
178(3)
13 Virtual Reality and Eating, Diabetes, and Obesity
181(18)
Jessica E. Cornick
Jim Blascovich
Introduction
181(1)
Virtual Reality
181(5)
Obesity and Weight Stigma
186(1)
Virtual Reality as a Tool for Combatting Health Issues
187(4)
Conclusion
191(1)
References
191(8)
14 Immersive Virtual Reality to Model Physical: Social Interaction and Self-Representation
199(8)
Eric B. Bauman
Introduction
199(1)
Theory for Immersive Virtual Learning Spaces
199(5)
Conclusion
204(1)
References
205(2)
PART 3 Challenges: Assimilating the Comprehensive Digital Patient
207(48)
15 A Roadmap for Building a Digital Patient System
209(16)
Saikou Y. Diallo
Christopher J. Lynch
Introduction
209(3)
Approach
212(1)
Building the Digital Patient Through Interoperability
213(9)
Conclusion
222(1)
Acknowledgments
223(1)
References
223(2)
16 Multidisciplinary, Interdisciplinary, and Transdisciplinary Research: Contextualization and Reliability of the Composite
225(16)
Andreas Tolk
Introduction
225(1)
Interdisciplinarity and Interdisciplinary Research
226(2)
Data Engineering to Support Interdisciplinarity and Interoperability
228(5)
Base Object Models to Support Transdisciplinarity and Composability
233(2)
Open Challenges on Reliability
235(2)
Summary and Conclusion
237(2)
References
239(2)
17 Bayes Net Modeling: The Means to Craft the Digital Patient
241(14)
Joseph A. Tatman
Barry C. Ezell
Introduction
241(5)
Other Interesting Applications
246(5)
Conclusion
251(2)
References
253(2)
PART 4 Potential Impact: Engaging The Digital Patient
255(50)
18 Virtual Reality Standardized Patients for Clinical Training
257(16)
Albert Rizzo
Thomas Talbot
Introduction
257(1)
The Rationale for Virtual Standardized Patients
258(1)
Conversational Virtual Human Agents
259(1)
Usc Efforts to Create Virtual Standardized Patients
260(9)
Conclusion
269(1)
References
270(3)
19 The Digital Patient: Changing the Paradigm of Healthcare and Impacting Medical Research and Education
273(16)
V. Andrea Parodi
Introduction
273(2)
Overview Digital Medicine Projects
275(4)
Personalized Patient Care Clinical Use
279(2)
Recommended Education and Training for VPH Project Participation
281(3)
From Flexner to the 2010 Carnegie Report
284(2)
Summary Statements
286(1)
References
287(2)
20 The Digital Patient: A Vision for Revolutionizing the Electronic Medical Record and Future Healthcare
289(10)
Richard M. Satava
Introduction
289(2)
Applications of the Digital Patient as the EMR
291(5)
Discussion
296(1)
Conclusion
297(1)
References
297(2)
21 Realizing the Digital Patient
299(6)
C. Donald Combs
John A. Sokolowski
Index 305
C. Donald Combs, PhD, is Vice President and Dean of the School of Health Professions at Eastern Virginia Medical School and is also a senior faculty member in the Department of Modeling, Simulation, and Visualization Engineering at Old Dominion University.  

John A. Sokolowski, PhD, is Associate Professor and Executive Director of the Virginia Modeling, Analysis, and Simulation Center at Old Dominion University.  

Catherine M. Banks, PhD, is Research Associate Professor at the Virginia Modeling, Analysis, and Simulation Center at Old Dominion University.