The digital patient: advancing healthcare, research, and education (Wiley Series in Modeling and Simulation)

**A modern guide to computational models and constructive simulation for personalized patient care using the Digital Patient** The healthcare industry’s emphasis is shifting from merely reacting to disease to preventing disease and promoting wellness. Addressing one of the more hopeful Big Data undertakings, __The Digital Patient: Advancing Healthcare, Research, and Education__ presents a timely resource on the construction and deployment of the Digital Patient and its effects on healthcare, research, and education. The Digital Patient will not be constructed based solely on new information from all the “omics” fields; it also includes systems analysis, Big Data, and the various efforts to model the human physiome and represent it virtually. The Digital Patient will be realized through the purposeful collaboration of patients as well as scientific, clinical, and policy researchers. __The Digital Patient: Advancing Healthcare, Research, and Education__ addresses the international research efforts that are leading to the development of the Digital Patient, the wealth of ongoing research in systems biology and multiscale simulation, and the imminent applications within the domain of personalized healthcare. Chapter coverage includes: * The visible human * The physiological human * The virtual human * Research in systems biology * Multi-scale modeling * Personalized medicine * Self-quantification * Visualization * Computational modeling * Interdisciplinary collaboration __The Digital Patient: Advancing Healthcare, Research, and Education__ is a useful reference for simulation professionals such as clinicians, medical directors, managers, simulation technologists, faculty members, and educators involved in research and development in the life sciences, physical sciences, and engineering. The book is also an ideal supplement for graduate-level courses related to human modeling, simulation, and visualization. TITLE PAGE 5 COPYRIGHT PAGE 6 CONTENTS 9 LIST OF CONTRIBUTORS 15 PREFACE 19 PART 1 THE VISION:: THE DIGITAL PATIENT—IMPROVING RESEARCH, DEVELOPMENT, EDUCATION, AND HEALTHCARE PRACTICE 23 CHAPTER 1 THE DIGITAL PATIENT 25 HEALTH, THE GOAL 26 PERSONALIZED MEDICINE 26 THE BEST OUTCOMES 27 THE EMERGENCE OF THE DIGITAL PATIENT 27 THE HUMAN PHYSIOME 28 ENABLING THE DIGITAL PATIENT 30 P4 MEDICINE 33 CONCLUSION 33 REFERENCES 34 CHAPTER 2 REFLECTING ON DISCIPULUS AND REMAINING CHALLENGES 37 INTRODUCTION 37 A BRIEF CONTEXTUAL BACKGROUND AND A CALL FOR INTEGRATION : PERSONALIZED MEDICINE IS HOLISTIC 38 THE MANY VERSIONS OF THE DIGITAL PATIENT: ON THE ROAD TO MEDICAL AVATARS 40 DISCIPULUS : THE DIGITAL PATIENT TECHNOLOGICAL CHALLENGES AND MAIN CONCLUSIONS 41 THE REMAINING CHALLENGES AND BIG DATA 46 CONCLUSION 47 REFERENCES 48 CHAPTER 3 ADVANCING THE DIGITAL PATIENT 49 INTRODUCTION 49 THE DIGITAL PATIENT: ITS EARLY START 50 ENGAGING THE DIGITAL PATIENT 52 CONCLUSION 53 CHAPTER 4 THE SIGNIFICANCE OF MODELING AND VISUALIZATION 55 INTRODUCTION 55 MODELING A COMPLEX SYSTEM: HUMAN PHYSIOLOGY 56 MEDICAL MODELING, SIMULATION, AND VISUALIZATION 57 MODES AND TYPES OF VISUALIZATION 62 VISUALIZATION FOR PATIENT-SPECIFIC USEFULNESS 65 CONCLUSION 65 REFERENCES 67 PART 2 STATE OF THE ART: : SYSTEMS BIOLOGY, THE PHYSIOME, AND PERSONALIZED HEALTH 71 CHAPTER 5 THE VISIBLE HUMAN: A GRAPHICAL INTERFACE FOR HOLISTIC MODELING AND SIMULATION 73 INTRODUCTION 73 EDUCATION 75 MODELING 77 VIRTUAL REALITY TRAINERS AND SIMULATORS 78 CONCLUSION 80 REFERENCES 81 CHAPTER 6 THE QUANTIFIABLE SELF: PETABYTE BY PETABYTE 85 INTRODUCTION 85 SMARR’S QUANTIFIED SELF 86 EXTENDING SMARR’S RESEARCH 89 THE QUANTIFIED SELF-VISION, SIMPLIFIED 91 CRITICISM 91 CONCLUSION 93 REFERENCES 94 CHAPTER 7 SYSTEMS BIOLOGY AND HEALTH SYSTEMS COMPLEXITY: IMPLICATIONS FOR THE DIGITAL PATIENT 95 INTRODUCTION 95 SYSTEMS BIOLOGY 97 THE INSTITUTE FOR SYSTEMS BIOLOGY 98 THE COMPLEXITY INSTITUTE 100 THE POTENTIAL OF SYSTEMS BIOLOGY 103 CRITICISM 104 CONCLUSION 105 REFERENCES 105 CHAPTER 8 PERSONALIZED COMPUTATIONAL MODELING FOR THE TREATMENT OF CARDIAC ARRHYTHMIAS 107 INTRODUCTION 107 BASICS OF CARDIAC ELECTROPHYSIOLOGY 108 CARDIAC MODELING ADVANCEMENTS 111 REGULATION OF INTRACELLULAR CALCIUM 112 FROM CELLS TO CABLES TO SHEETS TO TISSUE TO THE HEART 113 WHERE CAN WE GO FROM HERE? WHAT IS THE CARDIAC MODEL IN THE DIGITAL PATIENT? 117 REFERENCES 118 CHAPTER 9 THE PHYSIOME PROJECT, OPENEHR ARCHETYPES, AND THE DIGITAL PATIENT 123 INTRODUCTION 123 MULTISCALE PHYSIOLOGICAL PROCESSES 124 PHYSIOME PROJECT STANDARDS, REPOSITORIES, AND TOOLS 125 ARCHETYPE SPECIALIZATION 134 ARCHETYPE DEFINITION LANGUAGE 135 LINKING ARCHETYPES TO EXTERNAL KNOWLEDGE SOURCES (TERMINOLOGY AND BIOMEDICAL ONTOLOGIES) 136 ARCHETYPE ANNOTATIONS 136 OPENEHR MODEL REPOSITORY AND GOVERNANCE 137 FAST HEALTHCARE INTEROPERABILITY RESOURCES 137 A DISEASE SCENARIO 138 SUMMARY AND CONCLUSIONS 143 REFERENCES 144 CHAPTER 10 PHYSICS-BASED MODELING FOR THE PHYSIOME 149 INTRODUCTION 149 MODELING SCHEMES 150 FUTURE CHALLENGES 164 CONCLUSION 164 ACKNOWLEDGMENTS 165 REFERENCES 165 CHAPTER 11 MODELING AND UNDERSTANDING THE HUMAN BODY WITH SWARMSCRIPT 171 INTRODUCTION 171 RELATED WORK 172 MULTIAGENT ORGANIZATION 174 DESIGNING INTERACTIVE AGENTS 174 SPEAKING SWARMSCRIPT 175 ANSWERING DEMAND: THE DESIGN OF SWARMSCRIPT 175 GRAPH-BASED RULE REPRESENTATION 175 THE SOURCE–ACTION–TARGET 176 SWARMSCRIPT INTO3D 176 A SWARMSCRIPT DIALOGUE 177 DISCUSSION 186 SUMMARY 188 REFERENCES 188 CHAPTER 12 USING AVATARS AND AGENTS TO PROMOTE REAL-WORLD HEALTH BEHAVIOR CHANGES 193 INTRODUCTION 193 AVATARS AND AGENTS 194 USING AGENTS AND AVATARS TO PROMOTE HEALTH BEHAVIOR CHANGES 195 CONCLUSION 200 REFERENCES 200 CHAPTER 13 VIRTUAL REALITY AND EATING, DIABETES, AND OBESITY 203 INTRODUCTION 203 VIRTUAL REALITY 203 OBESITY AND WEIGHT STIGMA 208 VIRTUAL REALITY AS A TOOL FOR COMBATTING HEALTH ISSUES 209 CONCLUSION 213 REFERENCES 213 CHAPTER 14 IMMERSIVE VIRTUAL REALITY TO MODEL PHYSICAL: SOCIAL INTERACTION AND SELF-REPRESENTATION 221 INTRODUCTION 221 THEORY FOR IMMERSIVE VIRTUAL LEARNING SPACES 221 CONCLUSION 226 REFERENCES 227 PART 3 CHALLENGES: : ASSIMILATING THE COMPREHENSIVE DIGITAL PATIENT 229 CHAPTER 15 A ROADMAP FOR BUILDING A DIGITAL PATIENT SYSTEM 231 INTRODUCTION 231 APPROACH 234 BUILDING THE DIGITAL PATIENT THROUGH INTEROPERABILITY 235 CONCLUSION 244 ACKNOWLEDGMENT 245 REFERENCES 245 CHAPTER 16 MULTIDISCIPLINARY, INTERDISCIPLINARY, AND TRANSDISCIPLINARY RESEARCH: CONTEXTUALIZATION AND RELIABILITY OF THE COMPOSITE 247 INTRODUCTION 247 INTERDISCIPLINARITY AND INTERDISCIPLINARY RESEARCH 248 DATA ENGINERING TO SUPORT INTERDISCIPLINARITY AND INTEROPERABILITY 250 BASE OBJECT MODELS TO SUPPORT TRANSDISCIPLINARITY AND COMPOSABILITY 255 OPEN CHALLENGES ON RELIABILITY 257 SUMMARY AND CONCLUSION 259 REFERENCES 261 CHAPTER 17 BAYES NET MODELING: THE MEANS TO CRAFT THE DIGITAL PATIENT 263 INTRODUCTION 263 OTHER INTERESTING APPLICATIONS 268 CONCLUSION 273 REFERENCES 275 PART 4 POTENTIAL IMPACT: ENGAGING THE DIGITAL PATIENT 277 CHAPTER 18 VIRTUAL REALITY STANDARDIZED PATIENTS FOR CLINICAL TRAINING 279 INTRODUCTION 279 THE RATIONALE FOR VIRTUAL STANDARDIZED PATIENTS 280 CONVERSATIONAL VIRTUAL HUMAN AGENTS 281 USC EFFORTS TO CREATE VIRTUAL STANDARDIZED PATIENTS 282 CONCLUSION 291 REFERENCES 292 CHAPTER 19 THE DIGITAL PATIENT: CHANGING THE PARADIGM OF HEALTHCARE AND IMPACTING MEDICAL RESEARCH AND EDUCATION 295 INTRODUCTION 295 OVERVIEW DIGITAL MEDICINE PROJECTS 297 PERSONALIZED PATIENT CARE CLINICAL USE 301 RECOMMENDED EDUCATION AND TRAINING FOR VPH PROJECT PARTICIPATION 303 FROM FLEXNER TO THE 2010 CARNEGIE REPORT 306 SUMMARY STATEMENTS 308 REFERENCES 309 CHAPTER 20 THE DIGITAL PATIENT: A VISION FOR REVOLUTIONIZING THE ELECTRONIC MEDICAL RECORD AND FUTURE HEALTHCARE 311 INTRODUCTION 311 APPLICATIONS OF THE DIGITAL PATIENT AS THE EMR 313 DISCUSSION 318 CONCLUSION 319 REFERENCES 319 CHAPTER 21 REALIZING THE DIGITAL PATIENT 321 INDEX 327 WILEY SERIES IN MODELING AND SIMULATION 330 EULA 331 "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"--Provided by publisher.

A modern guide to computational models and constructive simulation for personalized patient care using the Digital Patient

The healthcare industry's emphasis is shifting from merely reacting to disease to preventing disease and promoting wellness. Addressing one of the more hopeful Big Data undertakings, The Digital Patient: Advancing Healthcare, Research, and Education presents a timely resource on the construction and deployment of the Digital Patient and its effects on healthcare, research, and education. The Digital Patient will not be constructed based solely on new information from all the "omics" fields; it also includes systems analysis, Big Data, and the various efforts to model the human physiome and represent it virtually. The Digital Patient will be realized through the purposeful collaboration of patients as well as scientific, clinical, and policy researchers.

The Digital Patient: Advancing Healthcare, Research, and Education addresses the international research efforts that are leading to the development of the Digital Patient, the wealth of ongoing research in systems biology and multiscale simulation, and the imminent applications within the domain of personalized healthcare. Chapter coverage includes:

• The visible human
• The physiological human
• The virtual human
• Research in systems biology
• Multi-scale modeling
• Personalized medicine
• Self-quantification
• Visualization
• Computational modeling
• Interdisciplinary collaboration

The Digital Patient: Advancing Healthcare, Research, and Education is a useful reference for simulation professionals such as clinicians, medical directors, managers, simulation technologists, faculty members, and educators involved in research and development in the life sciences, physical sciences, and engineering. The book is also an ideal supplement for graduate-level courses related to human modeling, simulation, and visualization.