Wolfram Ludwig

Health-enabling technologies for the elderly - An overview of services based on a literature review

BACKGROUND Services for the elderly based on health-enabling technologies promise to contribute significantly to the efficiency and effectiveness of future health care. Due to this promise, over the last years the scientific community has designed a complex variety of these valuable innovations. A systematic overview of the developed services would help to better understand their opportunities and limitations. OBJECTIVE To obtain a systematic overview of services for the elderly based on health-enabling technologies and to identify archetypical service categories. METHODS We conducted a literature review using PubMed and retrieved 1447 publications. We stepwise reduced this list to 27 key publications that describe typical service archetypes. RESULTS We present six archetypical service categories, namely handling adverse conditions, assessing state of health, consultation and education, motivation and feedback, service ordering and social inclusion and describe their implementation in current research projects.

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 Home Monitoring of Elderly People--First Results from the LASS Study

Monitoring elderly or disabled people in smart home environments is a major area of research because it allows for controlling chronic diseases and promises cost reduction. Context recognition and in particular activity recognition is of key importance as it facilitates the interpretation of data from medical monitoring devices. In our study with five elderly or disabled people we used data from multi-sensor wearable devices to generate intra- and interindividual machine-learned classifier models to determine activity patterns. Furthermore we computed the relative relevance of each parameter measured, and assessed the acceptance of computerized questionnaires in computer- illiterate people. The mean classification accuracy was 91.4% for the intraindividual classifiers and 53.7% for the interindividual ones. The most relevant parameters for activity classifications were those derived from accelerometric data, the least relevant one was galvanic skin response. Both the sensor device and the computerized questionnaires were well-received by the study participants. Individually-trained machine-learned classifiers used on data from a wearable device are an adequate means to determine context in elderly or disabled people.

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.

Health information systems for home telehealth services – a nomenclature for sensor-enhanced transinstitutional information system architectures

Home telehealth services for elderly people promise to contribute to a more efficient health care in the future. Though isolated services at a patients home might make sense for some applications, the full potential of home telehealth only arises through its integration into existing health information systems (HIS) and care processes. We know about traditional HIS architectures. However, so far no models exist, helping us to understand and describe the upcoming sensor-enhanced transinstitutional information system architectures for home telehealth services. To develop a nomenclature for sensor-enhanced transinstitutional health information system architectures. We conducted two systematic literature reviews, assessing typical services and users of home telehealth and key characteristics of transinstitutional health information system architectures. The information retrieved from both reviews was integrated to build the nomenclature sought after. We present a nomenclature of information and communication technology (ICT) architectures for home telehealth services. The developed dimensions provide an overview on typical users, services, operating organisations, information flow, geographical reach and architectural paradigms of sensor-enhanced transinstitutional health information systems. The developed nomenclature helps us to better understand the upcoming ICT architectures. However, we are still in need of further experiences with their application.

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.