Extending remote patient monitoring with mobile real time clinical decision support

Large scale implementation of telemedicine services such as telemonitoring and teletreatment will generate huge amounts of clinical data. Even small amounts of data from continuous patient monitoring cannot be scrutinised in real time and round the clock by health professionals. In future huge volumes of such data will have to be routinely screened by intelligent software systems. We investigate how to make m-health systems for ambulatory care more intelligent by applying a Decision Support approach in the analysis and interpretation of biosignal data and to support adherence to evidence-based best practice such as is expressed in treatment protocols and clinical practice guidelines. The resulting Clinical Decision Support Systems must be able to accept and interpret real time streaming biosignals and context data as well as the patient’s (relatively less dynamic) clinical and administrative data. In this position paper we describe the telemonitoring/teletreatment system developed at the University of Twente, based on Body Area Network (BAN) technology, and present our vision of how BAN-based telemedicine services can be enhanced by incorporating mobile real time Clinical Decision Support. We believe that the main innovative aspects of the vision relate to the implementation of decision support on a mobile platform; incorporation of real time input and analysis of streaming\ud biosignals into the inferencing process; implementation of decision support in a distributed system; and the consequent challenges such as maintenance of consistency of knowledge, state and beliefs across a distributed environment

Bells that still can ring: systems thinking in practice

Complexity science has generated significant insight regarding the interrelatedness of factors and actors constituting our real world and emergent effects from such interrelationships. But the translation of such rich insight towards developing appropriate tools for improving real world situations of change and uncertainty provides a further significant challenge. Systems thinking in practice is a heuristic framework based upon ideas of boundary critique for guiding the use and development of tools from different traditions in managing complex realities. By reference to five systems approaches, each embodying more than 30 years of experiential use, three interrelated features of the framework are drawn out – contexts of systemic change, practitioners as change agents, and tools as systems constructs that can themselves change through adaptation. The ‘bells that still can ring’ refer to tools associated with the Systems tradition which have demonstrable capacity to change and adapt by continual iteration with changing context of use and different practitioners using them. It is in the practice of using such tools whilst being aware of significant ‘cracks’ associated with traps in managing complex realities that enables systems thinking in practice to evolve. Complexity tools as examples of systems thinking can inadvertently invite traps of reductionism within contexts, dogmatism amongst practitioners, and fetishism of our tools as conceptual constructs associated with ultimately undeliverable promises towards achieving holism and pluralism. The heuristic provides a guiding framework on monitoring the development of tools from different traditions for improving complex realities and avoiding such traps

An environment for object-oriented real-time system design

A concise object-oriented method for the development of real-time systems has been composed. Hardware components are modelled by (software) base objects; base objects are controlled by a hierarchy of coordinator objects, expressed in an organizational diagram. The behaviour of objects is specified by state transition diagrams. This approach considerably promotes requirements analysis and communication with the customer. A CASE tool has been constructed with diagram editors for graphical specifications of real-time systems. The tool can generate executable code for PLCs from these graphical specifications; reuse of previous results is supported by the repository function of the tool. Experiences attained in practice with method and tool show that time spent in system testing and installation is reduced considerabl

Really Natural Linear Indexed Type Checking

Recent works have shown the power of linear indexed type systems for enforcing complex program properties. These systems combine linear types with a language of type-level indices, allowing more fine-grained analyses. Such systems have been fruitfully applied in diverse domains, including implicit complexity and differential privacy. A natural way to enhance the expressiveness of this approach is by allowing the indices to depend on runtime information, in the spirit of dependent types. This approach is used in DFuzz, a language for differential privacy. The DFuzz type system relies on an index language supporting real and natural number arithmetic over constants and variables. Moreover, DFuzz uses a subtyping mechanism to make types more flexible. By themselves, linearity, dependency, and subtyping each require delicate handling when performing type checking or type inference; their combination increases this challenge substantially, as the features can interact in non-trivial ways. In this paper, we study the type-checking problem for DFuzz. We show how we can reduce type checking for (a simple extension of) DFuzz to constraint solving over a first-order theory of naturals and real numbers which, although undecidable, can often be handled in practice by standard numeric solvers

CENTURION: Incentivizing Multi-Requester Mobile Crowd Sensing

The recent proliferation of increasingly capable mobile devices has given rise to mobile crowd sensing (MCS) systems that outsource the collection of sensory data to a crowd of participating workers that carry various mobile devices. Aware of the paramount importance of effectively incentivizing participation in such systems, the research community has proposed a wide variety of incentive mechanisms. However, different from most of these existing mechanisms which assume the existence of only one data requester, we consider MCS systems with multiple data requesters, which are actually more common in practice. Specifically, our incentive mechanism is based on double auction, and is able to stimulate the participation of both data requesters and workers. In real practice, the incentive mechanism is typically not an isolated module, but interacts with the data aggregation mechanism that aggregates workers' data. For this reason, we propose CENTURION, a novel integrated framework for multi-requester MCS systems, consisting of the aforementioned incentive and data aggregation mechanism. CENTURION's incentive mechanism satisfies truthfulness, individual rationality, computational efficiency, as well as guaranteeing non-negative social welfare, and its data aggregation mechanism generates highly accurate aggregated results. The desirable properties of CENTURION are validated through both theoretical analysis and extensive simulations