Service-Oriented Architecture for Patient-Centric eHealth Solutions

The world is in shortage of about 7.2 million healthcare workers in 2013, and the figure is estimated to grow to 12.9 million by 2035, according to the World Health Organization (WHO). On the other hand, the median age of the world’s population was predicted to increase from 26.6 years in 2000 to 37.3 years in 2050, and then to 45.6 years in 2100. Thus further escalating the need for new and efficient healthcare solutions. Telehealth, telecare, and Ambient Assisted Living (AAL) solutions promise to make healthcare services more sustainable, and to enable patients to live more independently and with a higher quality of life at their homes. Smart homes will host intelligent, connected devices that integrate with the Internet of Things (IoT) to form the basis of new and advanced healthcare systems. However, a number of challenges needs to be addressed before this vision can be actualised. These challenges include flexible integration, rapid service development and deployment, mobility, unified abstraction, scalability and high availability, security and privacy. This thesis presents an integration architecture based on Service-Oriented Architecture (SOA) that enables novel healthcare services to be developed rapidly by utilising capabilities of various devices in the patients’ surroundings. Special attention is given to a service broker component, the Information Integration Platform (IIP), that has been developed to bridge communications between everyday objects and Internet-based services following the Enterprise Service Bus (ESB) principles. It exposes its functionalities through a set of RESTfulWeb services, and maintains a unified information model which enables various applications to access in a uniform way. The IIP breaks the traditional vertical “silo” approach of integration, and handles information dissemination task between information providers and consumers by adopting a publish/subscribe messaging pattern. The feasibility of the IIP solution is evaluated both through prototyping and testing the platform’s representative healthcare services, e.g., remote health monitoring and emergency alarms. Experiments conducted on the IIP reveal how performance aspects are affected by needs for security, privacy, high availability, and scalability

Usability of a telehealth solution based on TV interaction for the elderly: the VITASENIOR-MT case study

Remote monitoring of biometric data in the elderly population is an important asset for improving the quality of life and level of independence of elderly people living alone. However, the design and implementation of health technological solutions often disregard the elderly physiological and psychological abilities, leading to low adoption of these technologies. We evaluate the usability of a remote patient monitoring solution, VITASENIOR-MT, which is based on the interaction with a television set. Twenty senior participants (over 64 years) and a control group of 20 participants underwent systematic tests with the health platform and assessed its usability through several questionnaires. Elderly participants scored high on the usability of the platform, very close to the evaluation of the control group. Sensory, motor and cognitive limitations were the issues that most contributed to the difference in usability assessment between the elderly group and the control group. The solution showed high usability and acceptance regardless of age, digital literacy, education and impairments (sensory, motor and cognitive), which shows its effective viability for use and implementation as a consumer product in the senior market.This work has been financially supported by the Portuguese foundation for science and technology (FCT) and European funds through Project VITASENIOR-MT with grant CENTRO-01-0145-FEDER-023659.info:eu-repo/semantics/publishedVersio

Holistic System Design for Distributed National eHealth Services

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Acceptance of ambient assisted living (AAL) technologies among older Australians : a review of barriers in user experience

One of the great challenges facing Australian society is that of an ageing population. Amongst the issues involved in this drastic demographic change, the most significant aspect is the demand for older Australians to live independently at home. The development of Ambient Assisted Living (AAL) technologies aims to address this issue. The advancement of AAL applications have been done to support the users with their daily-life activities and health concerns by providing increased mobility, security, safety in emergencies, health-monitoring, improved lifestyle, and fall-detection through the use of sensors. However, the optimum uptake of these technologies among the end-users (the elderly Australians) still remains a big concern. Thus, there is an elevated need to understand the needs and preferences of the seniors in order to improve the acceptance of AAL applications. The aim of this study is to investigate the barriers and perceptions in the use of AAL applications amongst older Australians. Focus groups and quantitative surveys have been conducted to provide a detailed analysis of these impediments. The results show that there are different factors that restrict the use of these technologies along with the fact that elderly people have certain preferences when using them. An understanding of these factors has been gained and suggestions have been made to increase the acceptance of AAL devices. This work gives useful insights towards the design of AAL solutions according to user needs

A Telerehabilitation System for the Selection, Evaluation and Remote Management of Therapies

Telerehabilitation systems that support physical therapy sessions anywhere can help save healthcare costs while also improving the quality of life of the users that need rehabilitation. The main contribution of this paper is to present, as a whole, all the features supported by the innovative Kinect-based Telerehabilitation System (KiReS). In addition to the functionalities provided by current systems, it handles two new ones that could be incorporated into them, in order to give a step forward towards a new generation of telerehabilitation systems. The knowledge extraction functionality handles knowledge about the physical therapy record of patients and treatment protocols described in an ontology, named TRHONT, to select the adequate exercises for the rehabilitation of patients. The teleimmersion functionality provides a convenient, effective and user-friendly experience when performing the telerehabilitation, through a two-way real-time multimedia communication. The ontology contains about 2300 classes and 100 properties, and the system allows a reliable transmission of Kinect video depth, audio and skeleton data, being able to adapt to various network conditions. Moreover, the system has been tested with patients who suffered from shoulder disorders or total hip replacement.This research was funded by the Spanish Ministry of Economy and Competitiveness grant number FEDER/TIN2016-78011-C4-2R

Improving personalized elderly care: an approach using cognitive agents to better assist elderly people

Tesis por compendio de publicaciones[ES]El envejecimiento de la población a nivel global es una constante cada vez más presente en el día a día y las consecuencias derivadas de este problema son cada vez más impactantes para el correcto funcionamiento y estructuración de la sociedad. En este contexto, hablamos de consecuencias a nivel de crecimiento económico, estilos de vida (y jubilación), relaciones familiares, recursos disponibles por el gobierno a la franja etaria más anciana e inevitablemente la prevalencia de enfermedades crónicas. Es ante esta realidad que surge la necesidad de desarrollo y promoción de estrategias eficaces en el acompañamiento, prevención y estímulo al envejecimiento activo y saludable de la población para garantizar que las personas ancianas continúen teniendo un papel relevante en la sociedad en lugar de someterse al aislamiento y fácil deterioro de las capacidades físicas, cognitivas, emocionales y sociales. De esta forma, tiene todo el sentido aprovechar todos los desarrollos tecnológicos verificados en los últimos años, principalmente en lo que se refiere a avances en las áreas de dispositivos móviles, inteligencia artificial y sistemas de monitoreo y crear soluciones capaces de brindar apoyo diariamente al recopilar datos e indicadores del estado de salud y, en respuesta, proporcionar diversas acciones personalizadas que motiven la adopción de mejores hábitos de salud y medios para lograr este envejecimiento activo y saludable. El desafío consiste en motivar a esta población a conciliar su día a día con el interés y la voluntad de utilizar aplicaciones y sistemas que brinden este apoyo personalizado. Algunas de las abordajes recientemente explorados en la literatura con este objetivo y que han alcanzado resultados prometedores se basan en la utilización de técnicas de gamificación e incentivo al cumplimiento de desafíos a nivel de salud (como si la persona estuviera jugando un juego) y la utilización de interacciones personalizadas con objetos (ya sean físicos como robots o virtuales como avatares) capaces de brindar feedback más personal, creando así una conexión más cercana entre ambas entidades. El trabajo aquí presentado combina estas ideas y resulta en un enfoque inteligente para la promoción del bienestar de la población anciana a través de un sistema de cuidados de salud personalizado. Este sistema incorpora diversas técnicas de gamificación para la promoción de mejores hábitos y comportamientos, y la utilización de un asistente virtual cognitivo capaz de entender las necesidades e intereses del usuario para posibilitar un feedback e interacción personalizados con el fin de ayudar y motivar al cumplimiento de los diferentes desafíos y objetivos que se identifiquen. El enfoque propuesto fue validado a través de un estudio con 12 usuarios ancianos y se lograron resultados significativos en términos de usabilidad, aceptación y efectos de salud. Específicamente, los resultados obtenidos permiten respaldar la importancia y el efecto positivo de combinar técnicas de gamificación e interacción con un asistente virtual cognitivo que traduzca el progreso del estado de salud del usuario, ya que se lograron mejoras significativas en los resultados de salud después de la intervención. Además, los resultados de usabilidad obtenidos mediante la cumplimentación de un cuestionario de usabilidad confirmaron la buena adhesión a el enfoque presentado. Estos resultados validan la hipótesis de la investigación estudiada en el desarrollo de esta disertación

Connectivity for Healthcare and Well-Being Management: Examples from Six European Projects

Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general) an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the research efforts of six projects (that the authors are currently, or have recently been, involved in), CAALYX, eCAALYX, COGKNOW, EasyLine+, I2HOME, and SHARE-it, all funded by the European Commission towards a future where citizens can take an active role into managing their own healthcare. Most importantly, sensitive groups of citizens, such as the elderly, chronically ill and those suffering from various physical and cognitive disabilities, will be able to maintain vital and feature-rich connections with their families, friends and healthcare providers, who can then respond to, and prevent, the development of adverse health conditions in those they care for in a timely manner, wherever the carers and the people cared for happen to be

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