Personalised ambient monitoring (PAM) of the mentally ill

One in ten of the (UK) population will suffer a disabling mental disorder at some stage in their life. Bipolar disorder is one such illness and is characterized by periods of depression or manic activity interspersed with stretches of normality. Some patients are able to manage this condition via their self-awareness that enables them to detect the onset of debilitating episodes and so take effective action. Such self management can be achieved through a paper-based process, although more recently PDAs have been used with success. This presentation will introduce the Personalised Ambient Monitoring (PAM) concept that aims to augment such processes by automatically providing and merging environmental details and information relating to personal activity. Essentially the PAM project is investigating what may be loosely referred to as ‘electronic’ monitoring to automatically record ‘activity signatures’ and subsequently use this data to issue alerts. The types of data that we are considering using includes: location and activity (e.g. via GPS and accelerometers); and environment (e.g. temperature and light levels). Other types of sensor under consideration are passive IR sensors (within the home); and sound processing to log the audio ‘environment’. The use of such monitoring will be agreed between the patient and their health care team and it is anticipated that different patients will be comfortable with different sensor packages, thus personalizing the monitoring. Although such tele-monitoring is now generally common, its use in the treatment of the mentally ill is still in its infancy. This paper will consider the specific problems faced in applying it to this community along with the aims of this project. In addition, the use of modelling to predict the effects of the possible problems of sparse data that is expected, and to predict the effect on the overall patient pathway will be considered

A multi-state model to improve the design of an automated system to monitor the activity patterns of patients with bipolar disorder

This paper describes the role of mathematical modelling in the design and evaluation of an automated system of wearable and environmental sensors called PAM (Personalised Ambient Monitoring) to monitor the activity patterns of patients with bipolar disorder (BD). The modelling work was part of an EPSRC-funded project, also involving biomedical engineers and computer scientists, to develop a prototype PAM system. BD is a chronic, disabling mental illness associated with recurrent severe episodes of mania and depression, interspersed with periods of remission. Early detection of the onset of an acute episode is crucial for effective treatment and control. The aim of PAM is to enable patients with BD to self-manage their condition, by identifying the person's normal ‘activity signature’ and thus automatically detecting tiny changes in behaviour patterns which could herald the possible onset of an acute episode. PAM then alerts the patient to take appropriate action in time to prevent further deterioration and possible hospitalisation. A disease state transition model for BD was developed, using data from the clinical literature, and then used stochastically in a Monte Carlo simulation to test a wide range of monitoring scenarios. The minimum best set of sensors suitable to detect the onset of acute episodes (of both mania and depression) is identified, and the performance of the PAM system evaluated for a range of personalised choices of sensors

Automated mobile health: designing a social reasoning platform for remote health management

With the drastic expansion of mobile technologies, mobile health has become ubiquitous and versatile to revolutionize healthcare for improved health outcomes. This study takes initiatives to investigate a new paradigm of automated mobile health as the process automation of mobile-enabled health interventions. Through the realisation of the paradigm, a novel social reasoning platform with a comprehensive set of design guidelines are proposed for efficient and effective remote health management. The study considerably contributes to the cumulative theoretical development of mobile health and health decision making. It also provides a number of implications for academic bodies, healthcare practitioners, and developers of mobile health