Using a Mobile Multimedia System to Improve Information Exchange in EMS.

This research uses multiple research methodologies guided by Information Systems Design Theory (ISDT) to design and evaluate a mobile multimedia information system for Emergency Medical Services (EMS). We examined the impact of multimedia information for EMS information exchange and decision-making. A field study was designed and conducted in the Boise, Idaho region for three months to evaluate the system and validate ISDT design propositions. Findings from qualitative analysis illustrated the value of digital images and audio recordings for improving information exchange and augmenting medical decision-making. This paper describes the problem and justification, presents the system design, the pilot test methodology and findings and overall implications and future research directions

Network selection mechanism for telecardiology application in high speed environment

The existing network selection schemes biased either to cost or Quality of Service (QoS) are not efficient enough for telecardiology application in high traveling speed environment. Selection of the candidate network that is fulfilling the telecardiology service requirements as well as user preference is a challenging issue. This is because the preference of telecardiology user might change based on the patient health condition. This research proposed a novel Telecardiology-based Handover Decision Making (THODM) mechanism that consists of three closely integrated algorithms: Adaptive Service Adjustment (ASA), Dwelling Time Prediction (DTP) and Patient Health Condition-based Network Evaluation (PHCNE). The ASA algorithm guarantees the quality of telecardiology service when none of the available networks fulfils the service requirements. The DTP algorithm minimizes the probability of handover failure and unnecessary handover to Wireless Local Area Network (WLAN), while optimizing the connection time with WLAN in high traveling speed environment. The PHCNE algorithm evaluates the quality of available networks and selects the best network based on the telecardiology services requirement and the patient health condition. Simulation results show that the proposed THODM mechanism reduced the number of handover failures and unnecessary handovers up to 80.0% and 97.7%, respectively, compared with existing works. The cost of THODM mechanism is 20% and 85.3% lower than the Speed Threshold-based Handover (STHO) and Bandwidth-based Handover (BWHO) schemes, respectively. In terms of throughput, the proposed scheme is up to 75% higher than the STHO scheme and 370% greater than the BWHO scheme. For telecardiology application in high traveling speed environment, the proposed THODM mechanism has better performance than the existing network selection schemes

Opportunities And Challenges of E-Health and Telemedicine Via Satelite

The introduction of Information and Communication Technology (ICT) in the health scenario is instrumental for the development of sustainable services of direct benefit for the European citizen. The setting up of satellite based applications will enhance rapidly the decentralisation and the enrichment of the European territory driving it towards a homogenous environment for healthcare

EVA: Emergency Vehicle Allocation

Emergency medicine plays a critical role in the development of a community, where the goal is to provide medical assistance in the shortest possible time. Consequently, the systems that support emergency operations need to be robust, efficient, and effective when managing the limited resources at their disposal. To achieve this, operators analyse historical data in search of patterns present in past occurrencesthat could help predict future call volume. This is a time consuming and very complex task that could be solved by the usage of machine learning solutions, which have been performed appropriately in the context of time series forecasting. Only after the future demands are known, the optimization of the distribution of available assets can be done, for the purpose of supporting high-density zones. The current works aim to propose an integrated system capable of supporting decision-making emergency operations in a real-time environment by allocating a set of available units within a service area based on hourly call volume predictions. The suggested system architecture employs a microservices approach along with event-based communications to enable real-time interactions between every component. This dissertation focuses on call volume forecasting and optimizing allocation components. A combination of traditional time series and deep learning models was used to model historical data from Virginal Beach emergency calls between the years 2010 and 2018, combined with several other features such as weather-related information. Deep learning solutions offered better error metrics, with WaveNet having an MAE value of 0.04. Regarding optimizing emergency vehicle location, the proposed solution is based on a Linear Programming problem to minimize the number of vehicles in each station, with a neighbour mechanism, entitled EVALP-NM, to add a buffer to stations near a high-density zone. This solution was also compared against a Genetic Algorithm that performed significantly worse in terms of execution time and outcomes. The performance of EVALP-NM was tested against simulations with different settings like the number of zones, stations, and ambulances.A medicina de emergência desempenha um papel fundamental no desenvolvimento da Sociedade, onde o objetivo é prestar assistência médica no menor tempo possível. Consequentemente, os sistemas que apoiam as operações de emergência precisam de ser robustos, eficientes e eficazes na gestão dos recursos limitados. Para isso, são analisados dados históricos no intuito de encontrar padrões em ocorrências passadas que possam ajudar a prever o volume futuro de chamadas. Esta é uma tarefa demorada e muito complexa que poderia ser resolvida com o uso de soluções de Machine Learning, que têm funcionado adequadamente no contexto da previsão de séries temporais. Só depois de conhecida a demanda futura poderá ser feita a otimização da distribuição dos recursos disponíveis, com o objetivo de suportar zonas de elevada densidade populacional. O presente trabalho tem como objetivo propor um sistema integrado capaz de apoiar a tomada de decisão em operações de emergência num ambiente de tempo real, atribuindo um conjunto de unidades disponíveis dentro de uma área de serviço com base em previsões volume de chamadas a cada hora. A arquitetura de sistema sugerida emprega uma abordagem de microserviços juntamente com comunicações baseadas em eventos para permitir interações em tempo real entre os componentes. Esta dissertação centra se nos componentes de previsão do volume de chamadas e otimização da atribuição. Foram usados modelos de séries temporais tradicionais e Deep Learning para modelar dados históricos de chamadas de emergência de Virginal Beach entre os anos de 2010 e 2018, combinadas com informações relacionadas ao clima. As soluções de Deep Learning ofereceram melhores métricas de erro, com WaveNet a ter um valor MAE de 0,04. No que diz respeito à otimização da localização dos veículos de emergência, a solução proposta baseia-se num problema de Programação Linear para minimizar o número de veículos em cada estação, com um mecanismo de vizinho, denominado EVALP-NM, para adicionar unidades adicionais às estações próximas de uma zona de alta densidade de chamadas. Esta solução foi comparada com um algoritmo genético que teve um desempenho significativamente pior em termos de tempo de execução e resultados. O desempenho do EVALP-NM foi testado em simulações com configurações diferentes, como número de zonas, estações e ambulâncias

An adaptive physiology-aware communication framework for distributed medical cyber physical systems

For emergency medical cyber-physical systems, enhancing the safety and effectiveness of patient care, especially in remote rural areas, is essential. While the doctor to patient ratio in the United States is 30 to 10,000 in large metropolitan areas, it is only 5 to 10,000 in most rural areas; and the highest death rates are often found in the most rural counties. Use of telecommunication technologies can enhance effectiveness and safety of emergency ambulance transport of patients from rural areas to a regional center hospital. It enables remote monitoring of patients by the physician experts at the tertiary center. There are critical times during transport when physician experts can provide vital assistance to the ambulance Emergency Medical Technicians (EMT) to associate best treatments. However, the communication along the roads in rural areas can range irregularly from 4G to low speed 2G links, including some parts of routes with cellular network communication breakage. This unreliable and limited communication bandwidth together with the produced mass of clinical data and the many information exchanges pose a major challenge in real-time supervision of patients. In this study, we define the notion of distributed emergency care, and propose a novel adaptive physiology-aware communication framework which is aware of the patient condition, the underlying network bandwidth, and the criticality of clinical data in the context of the specific diseases. Using the concept of distributed medical CPS models, we study the semantics relation of communication Quality of Service (QoS) with clinical messages, criticality of clinical data, and an ambulance's undertaken route all in a disease-aware manner. Our proposed communication framework is aimed to enhance remote monitoring of acute patients during ambulance transport from a rural hospital to a regional center hospital. We evaluate the components of our framework through various experimentation phases including simulation, instrumentation, real-world profiling, and validation

Supporting Ambulance Crews Electronically through the Provision of ‘On-Demand’ Patient Health Information

The North East Ambulance Service (NEAS) does not have direct access to any information regarding patient health history, current medication, allergies, etc. that might assist an ambulance crew when they are dispatched to an emergency incident. Therefore, an ambulance crew responding to a call-out usually travels to the incident ‘information blind’ regarding the patient’s general health status. What makes the ambulance service in general, and the ambulance crew in particular, unique from other healthcare organizations is the spectrum of exposure to a diversity of health organizations (care homes, GPs, hospitals, etc.), and none-health organizations (police, social services, fire forces,etc.). This thesis describes an investigation into the feasibility of implementing a software Information Broker (IB) prototype, that has the ability to provide ‘on-demand’ electronic health information to ambulance crews while on scene, by accessing a set of autonomous databases containing patient records. This is to support the ambulance crew with reliable patient information in order to assist their decision-making process, therefore, reduce unnecessary patients’ conveyance to the Emergency Department (ED). The thesis also examines the sociotechnical issues surrounding health information transfer between and within the National Health Service (NHS) in the United Kingdom (UK) for patients with epilepsy (PWE), specifically in the North East region of England. A case study approach was employed as an overarching framework for the feasibility study of the IB prototype. This case study was centred upon studying the needs of people with epilepsy (PWE), as this group has been identified by NEAS as frequent users of the ambulance service. In many cases, if the ambulance crew are given adequate information to support their decision-making, they do not need to convey patients to a hospital ED unless necessary. Within the case study, a phenomenological approach was employed for the set of perspectives used for investigating the sociotechnical issues surrounding the IB. The three perspectives were the perceptions of NEAS operational and management staff, those of the JCUH staff and PWE/carers, and finally, the perceptions of the ambulance crew. The prototype IB technology has demonstrated the feasibility of using an information transfer broker to transfer information from autonomous organizations to the ambulance crew on scene. Overcoming technical challenges alone is not sufficient for this success. Stakeholders’ requirements, organization collaboration, compliance with national standards and targets, social and technical aspects, and so forth, are other issues that have been considered. Involvement of potential stakeholders in stages of any Health and Information Technology (HIT) development is an essential element to be included, as much as possible, to satisfy those requirements and needs of end-users. Improving the data availability to the ambulance crews on scene via an IB, means that they can perform better decision-making while on scene with a patient. The demonstration of the IB prototype has shown its potential for transferring patient health information from an autonomous database to ambulance crews. To increase opportunities of success, shared incentives and aims of the intra- and inter-organizational communication and collaboration should facilitate the implementation of HIT. Facilitating incremental improvements of systems and technologies may have an effect on the organization as a whole in terms of robustness of systems and technologies

Cenários comunicacionais baseados em IOT para a promoção do bem-estar físico, psicológico e social dos séniores

The main objective of this research is to design and validate IoT based social hybrid scenario model that has the potential to promote psychological and physical wellbeing among older adults. The main reason to design and validate the model is age growth, older adults face psychological, physical and social well-being problems that increase mild cognitive impairment and frailty among older adults. Thus, to overcome older adults' problems, the study proposes and validates an IoT-based social hybrid scenario model. The model's features contain passive communication in which Drs, caregivers, and family members can monitor older adults' physical data from long distances. The model's features also contained intentional communication in which Older adults can interact online by text, audio, video calls, sharing images, and online activities such as painting, exercises and cooking. Moreover, older adults can do outdoor activities by inviting peers, friends or family members; the activities can be location-based IoT games, city tours, groups gardening and dinners. The outcomes of model validation will indicate how IoT characteristics can promote physical, psychological and social well-being and provide an opportunity for older adults to spend their life independently. The research that embodies this thesis includes 411 senior Portuguese Universities which are located mainland and on the island of Portugal. Using descriptive research methodology, where quantitative results are analysed, the results indicated a holistic scenario of passive and intentional communication in the context of well-being promotion among olderadults. from here, the social hybrid scenario is outlined, a hybrid model that offers passive and intentional communication between olderadults, family and medical doctors in the context of well-being promotion. The design and characteristics of the model are based on the existing knowledg, and needs of older adults, family members and also medical doctors. Such as model is a compound of passive and intentional characteristics that helps to reduce problem-related mental and physical health. The Passive and intentional communication characteristics are capable to create an environment for older adultsto take care of their psychological and physical health without any intervention and also increase their social physical and online activities, these activities help to promote the well-being of olderadults andd improve the daily lifestyle.O principal objetivo desta pesquisa é projetar e validar um modelo de cenário híbrido social baseado em IoT que tenha o potencial de promover o bem-estar psicológico e físico entre os idosos. A principal razão para projetar e validar o modelo é o crescimento da idade, os idosos enfrentam problemas psicológicos, físicos e de bem-estar social que aumentam o comprometimento cognitivo leve e a fragilidade entre os idosos. Assim, para superar os problemas dos idosos, o estudo propõe e valida um modelo de cenário híbrido social baseado em IoT. Os recursos do modelo contêm comunicação passiva na qual médicos, cuidadores e familiares podem monitorar os dados físicos dos idosos a longas distâncias. As características do modelo também contemplam comunicação intencional em que os idosos podem interagir online por meio de texto, áudio, videochamadas, compartilhamento de imagens e atividades online como pintura, exercícios e culinária. Além disso, os idosos podem fazer atividades ao ar livre convidando colegas, amigos ou familiares; as atividades podem ser jogos de IoT baseados em localização, passeios pela cidade, jardinagem em grupo e jantares. Os resultados da validação do modelo indicam como as características da IoT podem promover o bem-estar físico, psicológico e social e fornecer uma oportunidade para os idosos passarem sua vida de forma independente. A investigação que dá corpo a esta tese inclui 411 universidades portuguesas seniores localizadas no continente e na ilha de Portugal. Utilizando metodologia de pesquisa descritiva, onde são analisados resultados quantitativos, os resultados indicaram um cenário holístico de comunicação passiva e intencional no contexto da promoção do bem-estar entre idosos. a partir daqui, delineia-se o cenário social híbrido, um modelo híbrido que oferece comunicação passiva e intencional entre idosos, médicos de família e médicos no contexto da promoção do bem-estar. O desenho e as características do modelo baseiam-se no conhecimento existente e nas necessidades dos idosos, familiares e também médicos. Tal modelo é um composto de características passivas e intencionais que ajuda a reduzir os problemas relacionados com a saúde mental e física. As características de comunicação passiva e intencional são capazes de criar um ambiente para que os idosos cuidem de sua saúde psicológica e física e também aumentem suas atividades sociais físicas e online, essas atividades ajudam a promover o bem-estar dos idosos e melhorar o estilo de vida diário.Programa Doutoral em Informação e Comunicação em Plataformas Digitai

A Context-aware Healthcare Architecture For The Elderly

In order to provide dependable healthcare services for the elderly, it is necessary to have a patient-centric healthcare architecture in which context-aware healthcare services can be provided at any time and anywhere. Such a service automation has the virtues to overcome the disadvantages arising from the disabilities that are inherent in the elderly population, physically challenged, and those who live in remote areas. In order that patients trust the healthcare services provided by the system, the creation of healthcare services must be founded on accurate personalized health model of patients, and must be delivered by experts through dependable medical devices and secure channels. Motivated by this goal, this thesis proposes a layered health model that can be personalized to meet the privacy requirements of a patient, and constructs a context-aware healthcare architecture in which healthcare services for each patient is specialized based on personalized health models, health contexts, and emerging health situations. A prototype implementation of the architecture is validated for Hypertension and Dementia case studies

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios