Context-aware real-time assistant architecture for pervasive healthcare

The aging population in many countries brings into focus rising healthcare costs and pressure on conventional healthcare services. Pervasive healthcare has emerged as a viable solution capable of providing a technology-driven approach to alleviate such problems by allowing healthcare to move from the hospital-centred care to self-care, mobile care, and at-home care. The state-of-the-art studies in this field, however, lack a systematic approach for providing comprehensive pervasive healthcare solutions from data collection to data interpretation and from data analysis to data delivery. In this thesis we introduce a Context-aware Real-time Assistant (CARA) architecture that integrates novel approaches with state-of-the-art technology solutions to provide a full-scale pervasive healthcare solution with the emphasis on context awareness to help maintaining the well-being of elderly people. CARA collects information about and around the individual in a home environment, and enables accurately recognition and continuously monitoring activities of daily living. It employs an innovative reasoning engine to provide accurate real-time interpretation of the context and current situation assessment. Being mindful of the use of the system for sensitive personal applications, CARA includes several mechanisms to make the sophisticated intelligent components as transparent and accountable as possible, it also includes a novel cloud-based component for more effective data analysis. To deliver the automated real-time services, CARA supports interactive video and medical sensor based remote consultation. Our proposal has been validated in three application domains that are rich in pervasive contexts and real-time scenarios: (i) Mobile-based Activity Recognition, (ii) Intelligent Healthcare Decision Support Systems and (iii) Home-based Remote Monitoring Systems

Fuzzy Logic-Based Health Monitoring System for COVID’19 Patients

In several countries, the ageing population contour focuses on high healthcare costs and overloaded health care environments. Pervasive health care monitoring system can be a potential alternative, especially in the COVID-19 pandemic situation to help mitigate such problems by encouraging healthcare to transition from hospital-centred services to self-care, mobile care and home care. In this aspect, we propose a pervasive system to monitor the COVID’19 patient’s conditions within the hospital and outside by monitoring their medical and psychological situation. It facilitates better healthcare assistance, especially for COVID’19 patients and quarantined people. It identifies the patient’s medical and psychological condition based on the current context and activities using a fuzzy context-aware reasoning engine based model. Fuzzy reasoning engine makes decisions using linguistic rules based on inference mechanisms that support the patient condition identification. Linguistics rules are framed based on the fuzzy set attributes belong to different context types. The fuzzy semantic rules are used to identify the relationship among the attributes, and the reasoning engine is used to ensure precise real-time context interpretation and current evaluation of the situation. Outcomes are measured using a fuzzy logic-based context reasoning system under simulation. The results indicate the usefulness of monitoring the COVID’19 patients based on the current context

Flexible home care automation adapting to the personal and evolving needs and situations of the patient

Health monitoring and healthcare provisioning at home (i.e., outside the hospital) have received increasingly attention as a possible and partial solution for addressing the problems of an aging population. There are still many technological issues that need to be solved before home healthcare systems can be really cost-effective and efficient. However, in this paper we will highlight another category of issues which we call architectural challenges. Each patient is unique, and each patient has a unique lifestyle, living environment and course of life. Therefore it should be possible to personalize the services provided by home healthcare systems according to the needs and preferences of each individual patient, and it should be possible to make incremental adaptations at later points in time if this is necessary due to, for example, a changing health condition. The architectural challenges and solution directions related to this has been discussed in this paper

Context-aware QoS provisioning for an M-health service platform

Inevitably, healthcare goes mobile. Recently developed mobile healthcare (i.e., m-health) services allow healthcare professionals to monitor mobile patient's vital signs and provide feedback to this patient anywhere at any time. Due to the nature of current supporting mobile service platforms, m-health services are delivered with a best-effort, i.e., there are no guarantees on the delivered Quality of Service (QoS). In this paper, we argue that the use of context information in an m-health service platform improves the delivered QoS. We give a first attempt to merge context information with a QoS-aware mobile service platform in the m-health services domain. We illustrate this with an epilepsy tele-monitoring scenario

Ambient-aware continuous care through semantic context dissemination

Background: The ultimate ambient-intelligent care room contains numerous sensors and devices to monitor the patient, sense and adjust the environment and support the staff. This sensor-based approach results in a large amount of data, which can be processed by current and future applications, e. g., task management and alerting systems. Today, nurses are responsible for coordinating all these applications and supplied information, which reduces the added value and slows down the adoption rate. The aim of the presented research is the design of a pervasive and scalable framework that is able to optimize continuous care processes by intelligently reasoning on the large amount of heterogeneous care data. Methods: The developed Ontology-based Care Platform (OCarePlatform) consists of modular components that perform a specific reasoning task. Consequently, they can easily be replicated and distributed. Complex reasoning is achieved by combining the results of different components. To ensure that the components only receive information, which is of interest to them at that time, they are able to dynamically generate and register filter rules with a Semantic Communication Bus (SCB). This SCB semantically filters all the heterogeneous care data according to the registered rules by using a continuous care ontology. The SCB can be distributed and a cache can be employed to ensure scalability. Results: A prototype implementation is presented consisting of a new-generation nurse call system supported by a localization and a home automation component. The amount of data that is filtered and the performance of the SCB are evaluated by testing the prototype in a living lab. The delay introduced by processing the filter rules is negligible when 10 or fewer rules are registered. Conclusions: The OCarePlatform allows disseminating relevant care data for the different applications and additionally supports composing complex applications from a set of smaller independent components. This way, the platform significantly reduces the amount of information that needs to be processed by the nurses. The delay resulting from processing the filter rules is linear in the amount of rules. Distributed deployment of the SCB and using a cache allows further improvement of these performance results

Multimodal and ubiquitous computing systems: supporting independent-living older users

We document the rationale and design of a multimodal interface to a pervasive/ubiquitous computing system that supports independent living by older people in their own homes. The Millennium Home system involves fitting a resident’s home with sensors – these sensors can be used to trigger sequences of interaction with the resident to warn them about dangerous events, or to check if they need external help. We draw lessons from the design process and conclude the paper with implications for the design of multimodal interfaces to ubiquitous systems developed for the elderly and in healthcare, as well as for more general ubiquitous computing applications

The OCarePlatform : a context-aware system to support independent living

Background: Currently, healthcare services, such as institutional care facilities, are burdened with an increasing number of elderly people and individuals with chronic illnesses and a decreasing number of competent caregivers. Objectives: To relieve the burden on healthcare services, independent living at home could be facilitated, by offering individuals and their (in)formal caregivers support in their daily care and needs. With the rise of pervasive healthcare, new information technology solutions can assist elderly people ("residents") and their caregivers to allow residents to live independently for as long as possible. Methods: To this end, the OCarePlatform system was designed. This semantic, data-driven and cloud based back-end system facilitates independent living by offering information and knowledge-based services to the resident and his/her (in)formal caregivers. Data and context information are gathered to realize context-aware and personalized services and to support residents in meeting their daily needs. This body of data, originating from heterogeneous data and information sources, is sent to personalized services, where is fused, thus creating an overview of the resident's current situation. Results: The architecture of the OCarePlatform is proposed, which is based on a service-oriented approach, together with its different components and their interactions. The implementation details are presented, together with a running example. A scalability and performance study of the OCarePlatform was performed. The results indicate that the OCarePlatform is able to support a realistic working environment and respond to a trigger in less than 5 seconds. The system is highly dependent on the allocated memory. Conclusion: The data-driven character of the OCarePlatform facilitates easy plug-in of new functionality, enabling the design of personalized, context-aware services. The OCarePlatform leads to better support for elderly people and individuals with chronic illnesses, who live independently. (C) 2016 Elsevier Ireland Ltd. All rights reserved

Fine-tuning a context-aware system application by using user-centred design methods

Context-Aware Systems in the home environment can provide an effective solution for supporting wellbeing and autonomy for the elderly. The definition and implementation of the system architecture for a particular assisted living healthcare application entail both technological and usability challenges. If issues regarding users’ concerns and desires are taken into account in the early stages of the system development users can benefit substantially more from this technology. In this paper, we describe our initial experiences with different user-centred design methods, as they are applied in the process of fine-tuning a context-aware system architecture to improve quality of life for elderly THR patients (Total Hip Replacement). The insights resulting from this approach result in a clearer functional specification towards a better fit with the user needs regarding information need of the patient as well as the physiotherapist. Important system requirements as timing and content of the feedback are much more fruitful in an earlier phase of the development process. User-centred design methods help to better understand the needed functional features of a context-aware system, thereby saving time and helping developers to improve adoption of the system by the users

Personalised mobile services supporting the implementation of clinical guidelines

Telemonitoring is emerging as a compelling application of Body Area Networks (BANs). We describe two health BAN systems developed respectively by a European team and an Australian team and discuss some issues encountered relating to formalization of clinical knowledge to support real-time analysis and interpretation of BAN data. Our example application is an evidence-based telemonitoring and teletreatment application for home-based rehabilitation. The application is intended to support implementation of a clinical guideline for cardiac rehabilitation following myocardial infarction. In addition to this the proposal is to establish the patient’s individual baseline risk profile and, by real-time analysis of BAN data, continually re-assess the current risk level in order to give timely personalised feedback. Static and dynamic risk factors are derived from literature. Many sources express evidence probabilistically, suggesting a requirement for reasoning with uncertainty; elsewhere evidence requires qualitative reasoning: both familiar modes of reasoning in KBSs. However even at this knowledge acquisition stage some issues arise concerning how best to apply the clinical evidence. Furthermore, in cases where insufficient clinical evidence is currently available, telemonitoring can yield large collections of clinical data with the potential for data mining in order to furnish more statistically powerful and accurate clinical evidence