• Project Dates: From December 2005 to May 2010
• Project Leader: Calum McNeil
• Staff: Simon Woods, (Ethics work package leader)
• Sponsors: European Union Framework Programme 6

The SmartHEALTH project aimed to develop intelligent diagnostic technology to provide earlier and more accurate medical diagnosis and be compatible with existing healthcare systems.

The technology holds the potential for wider application outside of healthcare, though this project focussed on cervical cancer screening at GPs and breast and colorectal cancer monitoring in hospitals, GP surgeries, and in the home.

SmartHEALTH aimed to go beyond current “lab on a chip” and “point of care” technologies to create a versatile technology that also included wireless communication links between different healthcare locations to enable, for example, GPs to access electronic medical records and specialist knowledge in hospitals.

As each European country has different health provisions, regulations and moral climates, the ethical framework associated with the SmartHEALTH project had to be evaluated. The project involved 25 European partners and, alongside the clinical and technological components, PEALS explored the ethical, legal and social issues (ELSI) of these converging technologies.

Updates

May 2010

The project is now drawing to a close. Health professionals have recognised a number of benefits from the technology, such as the earlier detection of recurrence and reducing the pressure on primary care. However, the early detection of recurrence would only be a benefit if this was translated into improved quality and length of life, so the global effectiveness depends on the effectiveness of other technologies and services.

In collaboration with Italian colleagues from the University of Trento the team conducted a small scoping study of 20 patients’ views on the potential for home monitoring. The benefits they emphasised included the convenience of home testing, avoiding the need to travel to hospital and see multiple healthcare personnel.

But some respondents also expressed a fear of or lack of confidence in technology, and anxiety that the device would be a poor substitute for direct contact with a health professional. Should the technology be developed for home application then a more rigorous and detailed evaluation of the social and ethical aspects will be needed.

June 2009

The findings from the user group sessions were discussed at an international symposium in May 2009 on the potential ELSIs arising from SmartHEALTH.

The symposium (organised by PEALS and Trento University in Italy) brought together an international group of commentators, including SmartHEALTH partners and others outside the project with a “critical” interest in this emerging technology. Symposium and research findings will be disseminated via our website, academic papers, and a collected essay volume.

December 2006

In the first phase of the project, we carried out a literature review of the known ELSIs associated with cancer screening, diagnosis and monitoring. During in-depth interviews, we discussed the findings with our clinical and technical partners and, together, identified the main issues that could arise from the introduction of SmartHEALTH into existing health care systems.

Our research explored these issues with two of the technologies’ user groups.

Small groups of women will be invited to participate in workshops to explore the cervical cancer screening potential of SmartHEALTH. Based on their own experiences, participants will discuss and record their views on what the technology could offer current screening practices

Relevant health professionals will be invited to explore their perceptions of moving current breast and colorectal cancer monitoring from hospitals outpatients to GP surgeries and the potential impact on their everyday working lives.