title: Cybercare 2.0: meeting the challenge of the global burden of disease in 2030.
abstract: In this paper, we propose to advance and transform today's healthcare system using a model of networked health care called Cybercare. Cybercare means "health care in cyberspace" - for example, doctors consulting with patients via videoconferencing across a distributed network; or patients receiving care locally - in neighborhoods, "minute clinics," and homes - using information technologies such as telemedicine, smartphones, and wearable sensors to link to tertiary medical specialists. This model contrasts with traditional health care, in which patients travel (often a great distance) to receive care from providers in a central hospital. The Cybercare model shifts health care provision from hospital to home; from specialist to generalist; and from treatment to prevention. Cybercare employs advanced technology to deliver services efficiently across the distributed network - for example, using telemedicine, wearable sensors and cell phones to link patients to specialists and upload their medical data in near-real time; using information technology (IT) to rapidly detect, track, and contain the spread of a global pandemic; or using cell phones to manage medical care in a disaster situation. Cybercare uses seven "pillars" of technology to provide medical care: genomics; telemedicine; robotics; simulation, including virtual and augmented reality; artificial intelligence (AI), including intelligent agents; the electronic medical record (EMR); and smartphones. All these technologies are evolving and blending. The technologies are integrated functionally because they underlie the Cybercare network, and/or form part of the care for patients using that distributed network. Moving health care provision to a networked, distributed model will save money, improve outcomes, facilitate access, improve security, increase patient and provider satisfaction, and may mitigate the international global burden of disease. In this paper we discuss how Cybercare is being implemented now, and envision its growth by 2030.
authors.affiliation: Geisel School of Medicine, Dartmouth College, Hanover, NH USA ; Plastic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH USA ; Thayer School of Engineering, Dartmouth College, Hanover, NH USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Rosen
authors.affiliation: Global Citizen Safety and Security WG; IEEE Society on Social Implications of Technology (SSIT), Vienna, VA USA.
authors.forename: Luis
authors.initials: L
authors.lastname: Kun
authors.affiliation: Geisel School of Medicine, Dartmouth College, Hanover, NH USA.
authors.forename: Robyn E
authors.initials: RE
authors.lastname: Mosher
authors.affiliation: Anesthesiology and Pain Medicine, University of Washington, Seattle Children's Hospital, Seattle, WA USA.
authors.forename: Elliott
authors.initials: E
authors.lastname: Grigg
authors.affiliation: Virginia Commonwealth University, Mentone, AL USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Merrell
authors.affiliation: Lancaster General Health, Penn Medicine, Lancaster, PA USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Macedonia
authors.affiliation: Geisel School of Medicine, Dartmouth College, Hanover, NH USA ; Thayer School of Engineering, Dartmouth College, Hanover, NH USA.
authors.forename: Julien
authors.initials: J
authors.lastname: Klaudt-Moreau
authors.affiliation: Department of Political Science, Colorado College, Colorado Springs, CO USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Price-Smith
authors.affiliation: Geisel School of Medicine, Dartmouth College, Hanover, NH USA ; Veterans Affairs Medical Center, White River Junction, VT USA.
authors.forename: James
authors.initials: J
authors.lastname: Geiling
keywords: Burden of disease; Cell phones; Cybercare; Global health; Health care cost; IT; Information technology; Telemedicine