title: Chronobioengineering toward a cost-effective quality health care.
abstract: The current disease-cure-oriented health care system does too little too late for too few. Engineering for concomitantly resolving the external conditions and the internal schedules, chronoengineering in the broad sense, could change this status quo into a system that recognizes environmental and organismic risk early, blows a whistle as a minimum and acts automatically, as an optimum. The chronobioengineering feature (of the broader chronoengineering for external as well as internal monitoring and decision helping) would gain new individualized information from the resolution of predictable variations that occur within the physiologic range, the chronomes, genetically anchored multifrequency rhythms and trends. Their resolution by chronobiometry provides a more precise and more accurate mean value (than the arithmetic mean) along with new dynamic endpoints for improved screening, diagnosis, prognosis, and timely and timed treatment. Trends are those with growth, development, maturation and aging, and also those with risk elevation or disease and treatment. Risk elevation may change amplitude or timing, but not necessarily the mean. The implementation of engineering for concomitantly resolving the external and internal schedules depends on telecommunications and telehygiene as well as telemedicine for (i) universal chronobiologic education (to assume self-responsibility and self-help in health care), (ii) physiologic monitoring (complemented as a sine qua non by chronobiologic data analysis and interpretation of the results) and (iii) the monitoring of pertinent environmental conditions. Thus, the number of cases of catastrophic diseases could be reduced and quality (since preventive) health care made available to all.
authors.affiliation: Chronobiology Laboratories, University of Minnesota, Minneapolis 55455.
authors.forename: F
authors.initials: F
authors.lastname: Halberg
authors.forename: K
authors.initials: K
authors.lastname: Tamura
authors.forename: G
authors.initials: G
authors.lastname: Cornélissen
mesh_terms: D000328:Adult; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy; D001698:Biomedical Engineering / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology; D002304:Cardiac Pacing, Artificial; D002309:Cardiology / Q000295:instrumentation / Q000379:methods; D002909:Chronobiology Phenomena; D002940:Circadian Rhythm / Q000502:physiology; D003362:Cost-Benefit Analysis; D015716:Electrocardiography, Ambulatory; D005260:Female; D006331:Heart Diseases / Q000191:economics / Q000401:mortality / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation; D009017:Morbidity; D011787:Quality of Health Care / Q000191:economics*; D051381:Rats; D016019:Survival Analysis