Smart homecare system for health tele-monitoring

© 2007 IEEE. An increasing aged population worldwide puts our medical capabilities to the test. Research and commercial groups are investigating novel ways to care for the aged and chronically ill both in their own homes and in care facilities. This paper describes a prototype we have developed for remote healthcare monitoring. This personalized smart homecare system uses smart phones, wireless sensors, web servers and IP webcams. To illustrate the functionality of the prototype we describe a series of typical tele-health monitoring scenarios

Palliative home-based technology from a practitioner's perspective: benefits and disadvantages

This critical review paper explores the concept of palliative home-based technology from a practitioner's perspective. The aim of the critical review was to scope information available from published and unpublished research on the current state of palliative home-based technology, practitioner-focused perspectives, patient-focused perspectives, quality of life, and the implications for clinical practice. Published and unpublished studies were included. An example of one UK patient-centered home-based technology is explored as an exemplar. The evidence suggests that despite the challenges, there are numerous examples of good practice in relation to palliative home-based technology. Improvements in technology mean that telehealth has much to offer people being cared for at home with palliative needs. However, some of the evaluative evidence is limited, and further rigor is needed when evaluating future technology-based solutions innovations

Healthcare PANs: Personal Area Networks for trauma care and home care

The first hour following the trauma is of crucial importance in trauma care. The sooner treatment begins, the better the ultimate outcome for the patient. Generally the initial treatment is handled by paramedical personnel arriving at the site of the accident with an ambulance. There is evidence to show that if the expertise of the on-site paramedic team can be supported by immediate and continuous access to and communication with the expert medical team at the hospital, patient outcomes can be improved. After care also influences the ultimate recovery of the patient. After-treatment follow up often occurs in-hospital in spite of the fact that care at home can offer more advantages and can accelerate recovery. Based on emerging and future wireless communication technologies, in a previous paper [1] we presented an initial vision of two future healthcare settings, supported by applications which we call Virtual Trauma Team and Virtual Homecare Team. The Virtual Trauma Team application involves high quality wireless multimedia communications between ambulance paramedics and the hospital facilitated by paramedic Body Area Networks (BANs) [2] and an ambulance-based Vehicle Area Network (VAN). The VAN supports bi-directional streaming audio and video communication between the ambulance and the hospital even when moving at speed. The clinical motivation for Virtual Trauma Team is to increase survival rates in trauma care. The Virtual Homecare Team application enables homecare coordinated by home nursing services and supported by the patient's PAN which consists of a patient BAN in combination with an ambient intelligent home environment. The homecare PAN provides intelligent monitoring and support functions and the possibility to ad hoc network to the visiting health professionals’ own BANs as well as high quality multimedia communication links to remote members of the virtual team. The motivation for Virtual Homecare Team is to improve quality of life and independence for patients by supporting care at home; the economic motivation is to replace expensive hospital-based care with homecare by virtual teams using wireless technology to support the patient and the carers. In this paper we develop the vision further and focus in particular on the concepts of personal and body area networks

Home telehealth in older patients with heart failure – costs, adherence, and outcomes

Susanna Spinsante Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, Ancona, Italy Abstract: This short review discusses the role of telehealth technologies in the management of older patients with heart failure, from different perspectives. Instead of providing a systematic overview of existing literature in the field, this paper provides evidence for a simple, but effective, paradigm upon which a telehealth system may be built, and highlights how such a model may successfully apply to heart failure management, to improve patients' quality of life after discharge, increase independency, and reduce readmissions and costs for the public health institutions. A few examples are discussed, to show the real applicability of the proposed model and further confirm the effectiveness of telehealth, when properly designed and tailored to users' needs. Keywords: remote health care, workflow, requirement

Algorithms design for improving homecare using Electrocardiogram (ECG) signals and Internet of Things (IoT)

Due to the fast growing of population, a lot of hospitals get crowded from the huge amount of patients visits. Moreover, during COVID-19 a lot of patients prefer staying at home to minimize the spread of the virus. The need for providing care to patients at home is essential. Internet of Things (IoT) is widely known and used by different fields. IoT based homecare will help in reducing the burden upon hospitals. IoT with homecare bring up several benefits such as minimizing human exertions, economical savings and improved efficiency and effectiveness. One of the important requirement on homecare system is the accuracy because those systems are dealing with human health which is sensitive and need high amount of accuracy. Moreover, those systems deal with huge amount of data due to the continues sensing that need to be processed well to provide fast response regarding the diagnosis with minimum cost requirements. Heart is one of the most important organ in the human body that requires high level of caring. Monitoring heart status can diagnose disease from the early stage and find the best medication plan by health experts. Continues monitoring and diagnosis of heart could exhaust caregivers efforts. Having an IoT heart monitoring model at home is the solution to this problem. Electrocardiogram (ECG) signals are used to track heart condition using waves and peaks. Accurate and efficient IoT ECG monitoring at home can detect heart diseases and save human lives. As a consequence, an IoT ECG homecare monitoring model is designed in this thesis for detecting Cardiac Arrhythmia and diagnosing heart diseases. Two databases of ECG signals are used; one online which is old and limited, and another huge, unique and special from real patients in hospital. The raw ECG signal for each patient is passed through the implemented Low Pass filter and Savitzky Golay filter signal processing techniques to remove the noise and any external interference. The clear signal in this model is passed through feature extraction stage to extract number of features based on some metrics and medical information along with feature extraction algorithm to find peaks and waves. Those features are saved in the local database to apply classification on them. For the diagnosis purpose a classification stage is made using three classification ways; threshold values, machine learning and deep learning to increase the accuracy. Threshold values classification technique worked based on medical values and boarder lines. In case any feature goes above or beyond these ranges, a warning message appeared with expected heart disease. The second type of classification is by using machine learning to minimize the human efforts. A Support Vector Machine (SVM) algorithm is proposed by running the algorithm on the features extracted from both databases. The classification accuracy for online and hospital databases was 91.67% and 94% respectively. Due to the non-linearity of the decision boundary, a third way of classification using deep learning is presented. A full Multilayer Perceptron (MLP) Neural Network is implemented to improve the accuracy and reduce the errors. The number of errors reduced to 0.019 and 0.006 using online and hospital databases. While using hospital database which is huge, there is a need for a technique to reduce the amount of data. Furthermore, a novel adaptive amplitude threshold compression algorithm is proposed. This algorithm is able to make diagnosis of heart disease from the reduced size using compressed ECG signals with high level of accuracy and low cost. The extracted features from compressed and original are similar with only slight differences of 1%, 2% and 3% with no effects on machine learning and deep learning classification accuracy without the need for any reconstructions. The throughput is improved by 43% with reduced storage space of 57% when using data compression. Moreover, to achieve fast response, the amount of data should be reduced further to provide fast data transmission. A compressive sensing based cardiac homecare system is presented. It gives the channel between sender and receiver the ability to carry small amount of data. Experiment results reveal that the proposed models are more accurate in the classification of Cardiac Arrhythmia and in the diagnosis of heart diseases. The proposed models ensure fast diagnosis and minimum cost requirements. Based on the experiments on classification accuracy, number of errors and false alarms, the dictionary of the compressive sensing selected to be 900. As a result, this thesis provided three different scenarios that achieved IoT homecare Cardiac monitoring to assist in further research for designing homecare Cardiac monitoring systems. The experiment results reveal that those scenarios produced better results with high level of accuracy in addition to minimizing data and cost requirements

Advances in Telecare over The Past Ten Years

This article reviews advances during the past decade or so in telecare (ie, computer-supported social care at home). The need for telecare is discussed along with how it relates to social and health care. The expected benefits of telecare are also discussed. The evolution of telecare technology is reviewed, covering various system generations. The capabilities of present day telecare are covered, along with its advantages, limitations, and barriers to uptake. Recent evaluations and exemplars of telecare are discussed. The user requirements for telecare are presented, complemented by a discussion of the issues in user and professional acceptance. The article concludes with a summary of past developments in telecare and the prospects for the future

Telephone support and adherence in patients with chronic disease:A qualitative review of reviews

Divya Balasubramanian,1 Joanne Yoong,1–3 Hubertus JM Vrijhoef1,3–6 1Saw Swee Hock School of Public Health, National University Singapore, Singapore; 2Center for Economic and Social Research, University of Southern California, California, USA; 3Center for Health Services and Policy Research, National University Health System, Singapore; 4Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands; 5Department of Patients & Care, Maastricht University Medical Center, Maastricht, The Netherlands; 6Department of Family Medicine and Chronic Care, Vrije Universiteit Brussels, Brussels, Belgium Abstract: Among patients with a chronic disease, low adherence to prescribed treatments is very common, leading to substantial morbidity, mortality, and increase in health care costs. Telephone or mobile phone support is a common form of intervention that can be used to improve their adherence. We reviewed existing systematic and nonsystematic reviews to analyze the effectiveness of telephone interventions to improve treatment adherence in patients with chronic disease. Secondary aims were to evaluate the selected reviews in terms of cost-effectiveness of the intervention and frequency of messages affecting the adherence outcomes. A search for reviews was conducted in three databases, including PubMed, the Cochrane Library, and CINAHL, and three reviews that met the inclusion criteria were selected for final analysis. A qualitative review of the selected reviews was conducted, and reviews were evaluated to extract and summarize the characteristics and outcomes. Two of the selected reviews studied mobile phone text messaging, and one review studied telephone or mobile phone consultation. All three reviews reported an overall improvement in adherence, but the reviews varied in the types of research and the outcome measures. However, none of the reviews reported costs as an outcome. The evidence from reviews to characterize the effectiveness or cost-effectiveness of telephone support as an intervention to improve adherence among people with chronic diseases is fairly small and weak. Telephone support interventions have to be evaluated more systematically in routine practice against a comprehensive set of criteria, including their relative costs and outcomes. Keywords: literature review, compliance, telemedicine, communicable diseases, cost-effectivenes

A Systematic Review of the Economic Evaluation of Telemedicine in Japan.

ObjectivesThere is no systematic review on economic evaluations of telemedicine in Japan, despite over 1000 trials implemented. Our systematic review aims to examine whether Japan's telemedicine is cost-saving or cost-effective, examine the methodological rigorousness of the economic evaluations, and discuss future studies needed to improve telemedicine's financial sustainability.MethodsWe searched five databases, including two Japanese databases, to find peer-reviewed articles published between January 1, 2000 and December 31, 2014 in English and Japanese that performed economic evaluations of Japan's telemedicine programs. The methodological rigorousness of the economic analyses was assessed with a well-established checklist. We calculated the benefit-to-cost ratio (BCR) when a reviewed study reported related data but did not report the BCR. All cost values were adjusted to 2014 US dollars.ResultsAmong the 17 articles identified, six studies reported on settings connecting physicians for specialist consultations, and eleven studies on settings connecting healthcare providers and patients at home. There are three cost-benefit analyses and three cost-minimization analyses. The remaining studies measured the benefit of telemedicine only, using medical expenditure saved or users' willingness-to-pay. There was substantial diversity in the methodological rigorousness. Studies on teledermatology and teleradiology indicated a favorable level of economic efficiency. Studies on telehomecare gave mixed results. One cost-benefit analysis on telehomecare indicated a low economic efficiency, partly due to public subsidy rules, e.g., a too short budget period.ConclusionsOverall, telemedicine programs in Japan were indicated to have a favorable level of economic efficiency. However, the scarcity of the economic literature indicates the need for further rigorous economic evaluation studies

Telecare technologies and isolation : some ethical issues

Telecare technologies involve the remote monitoring of patients who have health, rehabilitation or social needs. These technologies, although deployed unevenly in developed countries, represent a shift in the ways in which care is practiced. Research on the consequences of this shift away from more traditional ‘hands-on’ care has focused primarily on quantitative measurement (for example cost savings) with less attention paid to how recipients themselves experience these new care practices. This paper discusses two aspects of telecare technologies which are under researched; the potential for isolation which may arise as a result of the use of these technologies, and the ethical issues raised by this. The primary locus of the discussion is the United Kingdom, where a major public policy shift towards telecare is under way and where telecare research has been particularly well funded by government. The discussion concludes that isolation raises the potential for loneliness – which is increasingly recognised as a significant factor in overall health and well-being – and is not being sufficiently considered, in part because the ethical frameworks in use do not adequately address the issue of loneliness itself, given their bio-medical, rather than relational focus

Mobihealth: mobile health services based on body area networks

In this chapter we describe the concept of MobiHealth and the approach developed during the MobiHealth project (MobiHealth, 2002). The concept was to bring together the technologies of Body Area Networks (BANs), wireless broadband communications and wearable medical devices to provide mobile healthcare services for patients and health professionals. These technologies enable remote patient care services such as management of chronic conditions and detection of health emergencies. Because the patient is free to move anywhere whilst wearing the MobiHealth BAN, patient mobility is maximised. The vision is that patients can enjoy enhanced freedom and quality of life through avoidance or reduction of hospital stays. For the health services it means that pressure on overstretched hospital services can be alleviated