Wilfried Thoben

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.

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.

Multimodal activity monitoring for home rehabilitation of geriatric fracture patients--feasibility and acceptance of sensor systems in the GAL-NATARS study.

Background: Demographic change will lead to a diminishing care workforce faced with rising numbers of older persons in need of care, suggesting meaningful use of health-enabling technologies, and home monitoring in particular, to contribute to supporting both the carers and the persons in need. Objectives: We present and discuss the GAL-NATARS study design along with first results regarding technical feasibility of long-term home monitoring and acceptance of different sensor modalities. Methods: Fourteen geriatric participants with mobility-impairing fractures were recruited in three geriatric clinics. Following inpatient geriatric rehabilitation, their homes were equipped with ambient sensor components for three months. Additionally, a wearable accelerometer was employed. Technical feasibility was assessed by system and component downtimes, technology acceptance by face-to-face interviews. Results: The overall system downtime was 6%, effected by two single events, but not by software failures. Technology acceptance was rated very high by all participants at the end of the monitoring periods, and no interference with their social lives was reported. Discussion and conclusions: Home-monitoring technologies were well-accepted by our participants. The information content of the data still needs to be evaluated with regard to clinical outcome parameters as well as the effect on the quality of life before recommending large-scale implementations.

Record Linkage of Anonymous Data by Control Numbers

The processing of personal data in information systems is of decisive importance in regard to data protection. Several applications exist where the personal identifying data make no difference but are needed for the record linkage with other data sets. This paper describes a concept which enables to compare anonymous data and to fulfil the complex requirements of data protection in the processing.

Ein unscharfes Bewertungskonzept für die Bedrohungs- und Risikoanalyse Workflow-basierter Anwendungen

Im Rahmen dieser Arbeit wird ein auf Fuzzy-Logik basierendes Bewertungskonzept entwickelt, das es erlaubt, sowohl kardinale als auch ordinale Bewertungen im Rahmen einer Bedrohungs- und Risikoanalyse Workflow-basierter Anwendungen zu verwenden. Innerhalb eines System-Metamodells werden dabei linguistische Variablen zur Beschreibung der Systemelementeigenschaften eingesetzt. Das konkrete Analyseverfahren auf Basis eines definierten Risikomodells wird in Form eines Fuzzy-Reglers realisiert, wobei spezifische Regelbasen genutzt und zur Prasentation der Analyseergebnisse eine Interpretationshilfe angeboten werden.

Einbettung assistierender Technologien in Gesundheitsnetzwerke – von der Wohnung zum Arzt

Die Bedeutung Informationstechnik(IT)-gestutzter Dienstleistungen fur die Sicherstellung bzw. Verbesserung von Qualitat und Effizienz der Gesundheitsversorgung ist langst weltweit erkannt. In ihrer eHealth-Resolution mahnt die World Health Organization bereits 2005 ihre Mitgliedsstaaten, entsprechende Programme systematisch umzusetzen (WHO Executive Board 2005). In reicheren Landern mit gut umfassender Versorgungsstruktur liegt das Potenzial in der Uberwindung okonomischer, wissenschaftlicher und, sozialer und operativer Barrieren. Im Fokus steht dabei die Unterstutzung eines „citizen-preventioneducation-home based“ (Healy 2007) Versorgungsparadigmas.

Sicherheitsanforderungen im Rahmen der Bedrohungs— und Risikoanalyse von IT-Systemen

Sicherheitsanforderungen stellen ein zentrales Element bei der Entwicklung sicherer IT-Systeme dar. Im Rahmen dieser Arbeit wird ein Konzept zur Modellierung und Analyse von Sicherheitsanforderungen prasentiert, das sich speziell an seiner Verwendung zur Bedrohungs- und Risikoanalyse orientiert.

Verschlüsselung personenbezogener und Abgleich anonymisierter Daten durch Kontrollnummern

Diese Arbeit stellt Ausschnitte von Konzept und Realisierung des sich im Aufbau befindlichen Niedersachsischen Krebsregisters vor, dessen Ziel es ist, Meldungen von Krebspatienten zu einem bevolkerungsbezogenen Krebsregister zu verdichten und somit der epidemiologischen Forschung zur Verfugung zu stellen. Um datenschutzrechtlichen Aspekten in einem solchen System gerecht zu werden, findet zunachst eine Anonymisierung der Meldungen statt. Da ein Patient haufig mehrfach uber Jahre hinweg von oft unterschiedlichen Meldestellen (Arzte, Pathologen, Kliniken, Gesundheitsamter etc.) an ein Krebsregister gemeldet wird, mus jeweils ein Abgleich mit dem bereits vorhandenen anonymisierten Datenbestand durchgefuhrt werden. Hierzu wird das Konzept der Kontrollnummern (Einwegverschlusselte Kombinationen aus Teilen personenidentifizierender Variablen) eingefuhrt. Empirische Untersuchungen auf Basis verschiedener Datenquellen dienen dazu, Kontrollnummern bzw. Kombinationen von Kontrollnummern zu definieren, die eine moglichst fehlerfreie Zusammenfuhrung der Datensatze gewahrleisten, so das auch fehlerhafte Meldungen (z.B. mit falschen oder unvollstandigen Angaben) korrekt zugeordnet werden.

Konzeption einer wissensbasierten Bedrohungs- und Risikoanalyse

In diesem Kapitel — dem Kern des Buches — wird ein neuartiges Konzept fur eine wissensbasierte Bedrohungs— und Risikoanalyse Workflow—basierter Anwendungen entwickelt. Es tragt den Namen TRAW (Knowledge Based Threat and Risk Analysis of Workflow-Based Applications) und verknupft die zwei Forschungsgebiete des Risiko—Managements und der Entwicklung Workflow—basierter Anwendungen miteinander.

Konzeption und Realisierung von TRAW

In diesem Kapitel wird das Softwarewerkzeug TRAW ⊤ beschrieben, mit dem das in Kapitel 3 entwickelte Konzept fur eine wissensbasierte Bedrohungs— und Risikoanalyse Workflow—basierter Anwendungen (TRAW) realisiert, und somit eine in Abschnitt 1.3 formulierte Anforderung erfullt wird.