Bianying Song

The Lower Saxony research network design of environments for ageing: towards interdisciplinary research on information and communication technologies in ageing societies

Worldwide, ageing societies are bringing challenges for independent living and healthcare. Health-enabling technologies for pervasive healthcare and sensor-enhanced health information systems offer new opportunities for care. In order to identify, implement and assess such new information and communication technologies (ICT) the ‘Lower Saxony Research Network Design of Environments for Ageing’ (GAL) has been launched in 2008 as interdisciplinary research project. In this publication, we inform about the goals and structure of GAL, including first outcomes, as well as to discuss the potentials and possible barriers of such highly interdisciplinary research projects in the field of health-enabling technologies for pervasive healthcare. Although GALs high interdisciplinarity at the beginning slowed down the speed of research progress, we can now work on problems, which can hardly be solved by one or few disciplines alone. Interdisciplinary research projects on ICT in ageing societies are needed and recommended.

Wearable sensors in healthcare and sensor-enhanced health information systems: all our tomorrows?

Wearable sensor systems which allow for remote or self-monitoring of health-related parameters are regarded as one means to alleviate the consequences of demographic change. This paper aims to summarize current research in wearable sensors as well as in sensor-enhanced health information systems. Wearable sensor technologies are already advanced in terms of their technical capabilities and are frequently used for cardio-vascular monitoring. Epidemiologic predictions suggest that neuropsychiatric diseases will have a growing impact on our health systems and thus should be addressed more intensively. Two current project examples demonstrate the benefit of wearable sensor technologies: long-term, objective measurement under daily-life, unsupervised conditions. Finally, up-to-date approaches for the implementation of sensor-enhanced health information systems are outlined. Wearable sensors are an integral part of future pervasive, ubiquitous and person-centered health care delivery. Future challenges include their integration into sensor-enhanced health information systems and sound evaluation studies involving measures of workload reduction and costs.

Information and communication technologies for promoting and sustaining quality of life, health and self-sufficiency in ageing societies – outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL)

Many societies across the world are confronted with demographic changes, usually related to increased life expectancy and, often, relatively low birth rates. Information and communication technologies (ICT) may contribute to adequately support senior citizens in aging societies with respect to quality of life and quality and efficiency of health care processes. For investigating and for providing answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, the Lower Saxony Research Network Design of Environments for Ageing (GAL) had been established as a five years research project, running from 2008 to 2013. Ambient-assisted living (AAL) technologies in personal and home environments were especially important. In this article we report on the GAL project, and present some of its major outcomes after five years of research. We report on major challenges and lessons learned in running and organizing such a large, inter- and multidisciplinary project and discuss GAL in the context of related research projects. With respect to research outcomes, we have, for example, learned new knowledge about multimodal and speech-based human–machine-interaction mechanisms for persons with functional restrictions, and identified new methods and developed new algorithms for identifying activities of daily life and detecting acute events, particularly falls. A total of 79 apartments of senior citizens had been equipped with specific “GAL technology”, providing new insights into the use of sensor data for smart homes. Major challenges we had to face were to deal constructively with GAL’s highly inter- and multidisciplinary aspects, with respect to research into GAL’s application scenarios, shifting from theory and lab experimentation to field tests, and the complexity of organizing and, in our view, successfully managing such a large project. Overall it can be stated that, from our point of view, the GAL research network has been run successfully and has achieved its major research objectives. Since we now know much more on how and where to use AAL technologies for new environments of living and new forms of care, a future focus for research can now be outlined for systematically planned studies, scientifically exploring the benefits of AAL technologies for senior citizens, in particular with respect to quality of life and the quality and efficiency of health care.

A method to align the coordinate system of accelerometers to the axes of a human body: The depitch algorithm

One of the key problems in accelerometry based gait analyses is that it may not be possible to attach an accelerometer to the lower trunk so that its axes are perfectly aligned to the axes of the subject. In this paper we will present an algorithm that was designed to virtually align the axes of the accelerometer to the axes of the subject during walking sections. This algorithm is based on a physically reasonable approach and built for measurements in unsupervised settings, where the test persons are applying the sensors by themselves. For evaluation purposes we conducted a study with 6 healthy subjects and measured their gait with a manually aligned and a skewed accelerometer attached to the subjects lower trunk. After applying the algorithm the intra-axis correlation of both sensors was on average 0.89±0.1 with a mean absolute error of 0.05g. We concluded that the algorithm was able to adjust the skewed sensor node virtually to the coordinate system of the subject.

A sensor-enhanced health information system to support automatically controlled exercise training of COPD patients

For an improvement of the quality of life for patients suffering from chronic obstructive pulmonary disease (COPD) we developed a concept and prototype of a sensor-enhanced health information system. This system includes a component that is monitoring the rehabilitation training and automatically controls the target load for the exercise on the basis of his or her vital data. The system also detects potentially critical health states and communicates alarms to external users. The component interacts with a personal electronic health record (PHR) that provides additional health related information for the decision making process, as feedback to the user and as an opportunity for physicians to optimize the users exercise plan. The PHR uses current medical informatics standards to store and transmit training data to health care professionals and to provide a maximum of interoperability with their information systems. We have integrated these components in a service oriented platform design that is located in the home environment of the user.

A Collaboration Tool Based on SNOCAP-HET

Health enabling technologies and ambient assisted living are important fields in biomedical informatics. In this context, a huge variety of analysis methods are applied. Neither is a suitable structuring of these methods available, nor is an aid known for selecting appropriate methods for a given set of data specifying a context and a problem. The goal of the present paper is to present a prototype of a semantic collaboration tool which is based on the Systematic Nomenclature for Contexts, Analysis Methods and Problems in Health-Enabling Technologies (SNOCAP-HET). This tool can be seen as a first step towards an assistance system for decision support within SNOCAP-HET. We present aspects of the selection and modeling process of our tool and discuss its benefits and appealing tasks for further research. Moreover we present a number of already planned and some unspecified upcoming steps which should optimize SNOCAP-HET in the future.

A methodological framework for the analysis of highly intensive, multimodal and heterogeneous data in the context of health-enabling technologies and ambient-assisted living

Background: When applying health-enabling technologies (HET), researchers are faced with analyzing highly intensive, multimodal and heterogeneous data sets. Experience has shown that there is a lack of understanding concerning the relationship of analysis methods suitable for such data sets and their appropriate application. Objectives: The objective of this paper is to describe the present situation when analyzing data of HET and the main problems in this context, to present a nomenclature suitable for analysis methods in the context of HET, to present an example dealing with geriatric diseases that highlights the problems and the urgent need for results and to explain some steps for future work. Methods: Nomenclatures as standard tools in information processing are applied. Results: We present an open three-axial mono-hierarchical nomenclature called SNOCAP-HET. Moreover, we explain other ideas to overcome the lack of systematization within the set of analysis methods suitable for HET. Conclusions: Our approach allows for an extension of SNOCAP-HET and will allow for the development and evaluation of different measures for the appropriateness of analysis methods given a certain highly intensive, multimodal and heterogeneous data set in the context of HET. Our final future aim is to obtain better results when analyzing medical data.

A system for the model based emergency detection and communication for the telerehabilitation training of cardiopulmonary patients

Cardiopulmonary diseases affect millions of people and cause high costs in health care systems worldwide. Patients should perform regular endurance exercises to stabilize their health state and prevent further impairment. However, patients are often uncertain about the level of intensity they should exercise in their current condition.