User-tailored E-health services

This thesis describes a method to offer personalised healthcare. It is motivated\ud by a desire for more efficient healthcare, as population ages and care demand and costs increase. Developing and testing individually tailored health services using ICT fits in this motivation, as it leads to more adequate information provided to care receivers and caregivers, a shift in tasks from caregiver to care receiver, and most of all: health services that empower as they are personalised towards individual needs.\ud \ud In this research, a platform is realised and tested to provide user-tailored\ud e-health services. Tailored means client-specific, i.e different care receivers can consume varying care services of different vendors from the same platform. E-health services are electronic health services, or recurring health applications involving communication, mediated by ICT to bridge time and/or distance. The services in the platform apply to care situations like alarming, reminding, taking vital sign measurements, and medication management. Moreover, activity management and interaction between (in)formal caregivers and care receivers are supported. The personalisation of these services can be performed\ud by end users themselves. Hence, the e-health services are user-tailored.\ud \ud \ud To realise this platform, requirements have been elicited involving interviews\ud with end users. Desires and needs have been translated into scenarios and scenario visualisations to discuss refinement. The technical design based on this requirements engineering process, has been implemented. Then it was tested in a nursing home. Finally we researched how, given such a system in use, data can be analysed and leveraged to monitor patients over longer time, to offer decision support and to provide insight into patient behaviour.\ud \ud Results show that is possible to create a platform that enables patientspecific\ud care. The platform provides useful applications in care. These applications\ud can save time for caregivers, and increase self-management in patients. However, it requires investment in the learning process.\ud \ud In sum, the work shows that this platform successfully integrates and tailors\ud heterogeneous sensors, actuators and services from different vendor and technological origins. Moreover, the research shows how collected data can be\ud leveraged for analysis and decision support. Adequate personalisation of selected e-health services saves time, increases health situation awareness, supports interaction and furthers patient empowerment

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

User-centered design of a dynamic-autonomy remote interaction concept for manipulation-capable robots to assist elderly people in the home

In this article, we describe the development of a human-robot interaction concept for service robots to assist elderly people in the home with physical tasks. Our approach is based on the insight that robots are not yet able to handle all tasks autonomously with sufficient reliability in the complex and heterogeneous environments of private homes. We therefore employ remote human operators to assist on tasks a robot cannot handle completely autonomously. Our development methodology was user-centric and iterative, with six user studies carried out at various stages involving a total of 241 participants. The concept is under implementation on the Care-O-bot 3 robotic platform. The main contributions of this article are (1) the results of a survey in form of a ranking of the demands of elderly people and informal caregivers for a range of 25 robot services, (2) the results of an ethnography investigating the suitability of emergency teleassistance and telemedical centers for incorporating robotic teleassistance, and (3) a user-validated human-robot interaction concept with three user roles and corresponding three user interfaces designed as a solution to the problem of engineering reliable service robots for home environments

Internet of robotic things : converging sensing/actuating, hypoconnectivity, artificial intelligence and IoT Platforms

The Internet of Things (IoT) concept is evolving rapidly and influencing newdevelopments in various application domains, such as the Internet of MobileThings (IoMT), Autonomous Internet of Things (A-IoT), Autonomous Systemof Things (ASoT), Internet of Autonomous Things (IoAT), Internetof Things Clouds (IoT-C) and the Internet of Robotic Things (IoRT) etc.that are progressing/advancing by using IoT technology. The IoT influencerepresents new development and deployment challenges in different areassuch as seamless platform integration, context based cognitive network integration,new mobile sensor/actuator network paradigms, things identification(addressing, naming in IoT) and dynamic things discoverability and manyothers. The IoRT represents new convergence challenges and their need to be addressed, in one side the programmability and the communication ofmultiple heterogeneous mobile/autonomous/robotic things for cooperating,their coordination, configuration, exchange of information, security, safetyand protection. Developments in IoT heterogeneous parallel processing/communication and dynamic systems based on parallelism and concurrencyrequire new ideas for integrating the intelligent “devices”, collaborativerobots (COBOTS), into IoT applications. Dynamic maintainability, selfhealing,self-repair of resources, changing resource state, (re-) configurationand context based IoT systems for service implementation and integrationwith IoT network service composition are of paramount importance whennew “cognitive devices” are becoming active participants in IoT applications.This chapter aims to be an overview of the IoRT concept, technologies,architectures and applications and to provide a comprehensive coverage offuture challenges, developments and applications

The OCareCloudS project: toward organizing care through trusted cloud services

The increasing elderly population and the shift from acute to chronic illness makes it difficult to care for people in hospitals and rest homes. Moreover, elderly people, if given a choice, want to stay at home as long as possible. In this article, the methodologies to develop a cloud-based semantic system, offering valuable information and knowledge-based services, are presented. The information and services are related to the different personal living hemispheres of the patient, namely the daily care-related needs, the social needs and the daily life assistance. Ontologies are used to facilitate the integration, analysis, aggregation and efficient use of all the available data in the cloud. By using an interdisciplinary research approach, where user researchers, (ontology) engineers, researchers and domain stakeholders are at the forefront, a platform can be developed of great added value for the patients that want to grow old in their own home and for their caregivers

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