Elena Tamburini

The next generation of mobile medication management solutions

In this paper, we describe the development of an internet-based system and a novel mobile home based device for the management of medication. We extend these concepts through the descriptions of an enhanced service with the use of mobile phone technology and home based digital TV services.

HomeTL: A visual formalism, based on temporal logic, for the design of home based care

The demands of introducing a more practical means of managing and monitoring technology within the home environment to support independent living are increasing. Efforts have been made recently to address these concerns, however, they may be considered to be lacking in mathematical rigour or have not benefited from incorporating the needs and expectations of the healthcare professionals. In this paper, we present a prototype solution, referred to as HomeTL, which allows healthcare professionals to establish the conditions/rules within which technology in the home should operate. The HomeTL concept is based on previous work in the area of visual notation and linear temporal logic. A visual editor for HomeTL has been developed and is presented in this paper. Following a description of the methodology and the prototype developed, results from a usability study, conducted on three computer scientists specializing in the area of healthcare management, are presented. The initial results based on this survey are positive and show that the topic deserves further investigation.

A visual editor to support the use of temporal logic for ADL monitoring

The use of technology within the home environment has been established as an acceptable means to support independent living for elderly and disabled people. An area of particular interest within this domain relates to monitoring of Activities of Daily Living for those persons with a form of cognitive decline. In this area, specific tasks undertaken by the persons in the context of their normal day-to-day lives reveal a wealth of information to be used to customize their environment to improve their living experience. In our current work we investigate the development of models which can be used to represent, classify and monitor basic human behaviors and support observation and control of activities of daily living. In particular, in this paper we focus on the problem of automated recognition of sequences of events that may indicate critical conditions and unexpected behaviors requiring intervention and attention from caregivers. Our work is based on a formal framework developed with temporal logic used for the specification of critical sequences of patterns and a behavior checking engine for automated recognition. In addition we have also developed an approach to provide a means of interaction with user. A visual formalism for the specification of Linear Temporal Logic expressions reduces the barrier of technical complexity enabling the involvement of experts in the domain of healthcare services to interact with the system.

Fall Detection Through Thermal Vision Sensing

Accidental falls can cause serious injury to at risk individuals. This is especially true in the elderly community where falls are the leading cause of hospitalization, injury-related deaths and loss of independence. Detecting and rapidly responding to falls has shown to reduce the long-term impact of and risks associated with falls. A number of real time fall detection solutions exist, however, these have some deficiencies relating to privacy, maintenance, and correct usage. This study introduces a novel fall detection approach that aims to address some of these deficiencies through use of computer vision processes and ceiling mounted thermal vision sensors. A preliminary evaluation has been performed on this process showing promising results, with an accuracy of 68 %, however, highlighting a number of issues related to false positives. Future work will improve this approach and provide extended evaluation.

NFC based dataset annotation within a behavioral alerting platform

Pervasive and ubiquitous computing increasingly relies on data-driven models learnt from large datasets. This learning process requires annotations in conjunction with datasets to prepare training data. Ambient Assistive Living (AAL) is one application of pervasive and ubiquitous computing that focuses on providing support for individuals. A subset of AAL solutions exist which model and recognize activities/behaviors to provide assistive services. This paper introduces an annotation mechanism for an AAL platform that can recognize, and provide alerts for, generic activities/behaviors. Previous annotation approaches have several limitations that make them unsuited for use in this platform. To address these deficiencies, an annotation solution relying on environmental NFC tags and smartphones has been devised. This paper details this annotation mechanism, its incorporation into the AAL platform and presents an evaluation focused on the efficacy of annotations produced. In this evaluation, the annotation mechanism was shown to offer reliable, low effort, secure and accurate annotations that are appropriate for learning user behaviors from datasets produced by this platform. Some weaknesses of this annotation approach were identified with solutions proposed within future work.

Advanced Medical Expert Support Tool (A-MEST): EHR-Based Integration of Multiple Risk Assessment Solutions for Congestive Heart Failure Patients

More and more the continuum of care is replacing the traditional way of treating the subjects of care putting people in the centre of the healthcare process. Currently clinicians start treatment after a problem occurs due to the low adoption of Clinical Decision Support Systems (CDSS) integrated with standardised Electronic Health Record (EHR) systems; The volume to value revolution in the healthcare (from stakeholder-centric to patient-centric) will allow doctors to follow the evolution of the individual before a medical episode happens, treating the patient based on statistical trends to forecast the future. The CDSS techniques applied on tele-monitoring tools permit the doctors to predict forthcoming events, improve the diagnosis and avoid continuous visits to the hospital, therefore saving costs. Advanced Medical Expert Support Tool is a step towards achieving the patient-centric approach by incorporating the health information into the EHR using European standards (ISO/EN 13606) to provide semantic interoperability by means of the dual model approach (reference model and archetypes). Three different CDSS modules have been implemented and contextualised publications are provided to the cardiologist to facilitate their daily work. A person-centric Graphical User Interface (GUI) facilitates the visualization of the health status of the patients providing meaningful information to the cardiologists. The use of archetypes allows scalability, transparency and efficiency to the hospital environment.

Medical expert support tool (MEST): a person-centric approach for healthcare management

The Medical Expert Support Tool (MEST) is aimed at helping the clinician in recognizing risk factors in the patient status by offering a multiparametric overview, and by highlighting the individual situation using meaningful colors (green, yellow and red) in order to compare the person physiological parameters with the computed profile. The medical professionals configure the conditions (relevant parameters, thresholds, rules and alerts) setting the values to the decision support modules and receiving the risk assessment results. Finally, interventions should be done depending on the evaluation of the patient. The tool has been designed along with the clinician involved in the project and it will be fully tested and evaluated during the observational study (100 patients) starting on June 2012.

PHealth Service Deployment Methodology: A Case Study

It has been proved that information and communication technology (ICT) solutions for personalized health (PHealth) and ambient assisted living (AAL) can support people in their daily life activities. Several solutions have been demonstrated to empower different levels of services through seamless data acquisition and specific users’ interaction modalities. Usually services usability and accessibility are handled in the design process and are validated with small users’ groups. Moreover, while service design and systems development have been extensively described in literature, service deployment methodologies are not properly addressed and documented. Proper reference guidelines are also missing. The most common methodologies like unified process (UP) or ICONX can cover only the design and the development of PHealth services without a clear description on the following phases such as deployment, service provision and maintenance. These phases present several risks to be taken into account right from the beginning of the implementation of PHealth or AAL services. This paper focuses on the description of a structured methodology to deploy PHealth services and how this process can be supported by integrated software routines and adapting the UP framework in particular the “Transition phase.”