Mobile Personal Health Systems for Patient Self-management: On Pervasive Information Logging and Sharing within Social Networks

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Presentation given within the 2nd International Symposium on Ambient Intelligence ISAmI 2011, April 6-8 2011 for the paper entitled "Mobile Personal Health Systems for Patient Self-management: On …

Presentation given within the 2nd International Symposium on Ambient Intelligence ISAmI 2011, April 6-8 2011 for the paper entitled "Mobile Personal Health Systems for Patient Self-management: On Pervasive Information Logging and Sharing within Social Networks". The paper is published in AMBIENT INTELLIGENCE -SOFTWARE AND APPLICATIONS, Advances in Intelligent and Soft Computing, Springer 2011, Volume 92/2011, 141-148, DOI: 10.1007/978-3-642-19937-0_18 and was given the conference BEST PAPER AWARD.

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Abstract: Patient self-management is often considered as an important prerequisite towards effective healthcare. This viewpoint has recently been demonstrated
by the introduction and adoption of approaches and tools, such as the Personal Health Record (PHR). In the current work, the design of a mobile personal health system for logging information corresponding to the patient status and sharing it within social networks is presented. By utilizing event-driven patterns, the pervasive sharing of the recorded information is enabled, under conditions specified by the mobile user. This “anytime-anywhere” information sharing may be valuable to
senders (i.e. patients) and receivers (e.g. relatives, healthcare professionals, similar patients, etc.) in terms of emotional support, mutual understanding, sharing of experiences, seeking of advice and improved self-tracking. A prototype is implemented
on a mobile device illustrating the feasibility and applicability of the presented work by adopting unobtrusive health monitoring with a wearable multisensing device, a Service Oriented Architecture (SOA) for handling communication issues, and popular micro-blogging services.

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  • 1. Mobile Personal Health Systems for PatientSelf-management: On Pervasive InformationLogging and Sharing within Social Networks A.K. Triantafyllidis, V.G. Koutkias, I. Chouvarda, and N. Maglaveras Lab of Medical Informatics Faculty of Medicine, Aristotle University of Thessaloniki Thessaloniki, Greece atriant@med.auth.gr
  • 2. Presentation Outline • Background: – Personal Health Systems – Patient Self-management – Social Networks – Pervasive Monitoring Systems • Scope of the Current Work • Proposed System: – Information Dimensions & Sharing – System Architecture – Micro-blogging Services • Results: – Prototype Implementation - Technical Feasibility • Discussion and Future Work 2Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 3. Personal Health Systems • Personal Health Information Management towards Wellness • Pervasive Health Monitoring: Anytime, Anywhere, Unobtrusive Pervasive Health Monitoring Instruments & Situations Activity Respiration Posture ECG Temperature 3Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 4. Patient Self-management: Rationale Rationale (K.R. Lorig, 2003#): “Whether one is engaging in a health promoting activity such as exercise or is living with a chronic disease such as asthma, he or she is responsible for day-to-day management.” #K.R. Lorig and H.R. Holman, “Self-management education: History, definition, outcomes, and mechanisms”, Ann Behav Med., vol. 26, no. 1, pp. 1-7, 2003. 4Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 5. Patient Self-management : Benefits Enhancement of communication with doctors Focus on treatment plan, adherence Self-efficacy Confidence to carry out a behavior/lifestyle necessary to reach a desired goal Well-being better management 5Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 6. Patient Social Networks – Quantitative self-tracking – Sharing of health information – Purpose: emotional support, exchange of experiences and ideas, education, improved self-tracking – Example Patient Online Community: PatientsLikeME Critical Requirement: Patient Willingness to Share Health Data 6Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 7. Pervasive Monitoring Environments Problems encountered in Health Information Management by patients – Integration with health monitoring infrastructures still in its infancy – Variable Context (Time – Location – Activity – Situation) – Limited patient involvement and user-to-system interactions with respect to generation and pervasive sharing of information about health status 7Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 8. Approach: An environment for logging and event-driven sharing of health information towardseffective (in terms of “anytime-anywhere”) andcollaborative disease management 8
  • 9. Target Users & Functionality • Mobile Personal Health Management System targeted at Chronic Patients who: – Use Portable Health Monitoring Systems – Are highly aware of their disease – Wish to engage more actively in their disease management • Functional Attributes: – Acquisition of sensor data and alert reporting – Patient self-reporting – Event-driven sharing of health status with networked community according to patient needs and preferences 9Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 10. Personal Health Information: Dimensions & Sharing • Vital Sign Measurements & Alerts – Heart rate, respiratory rate, skin temperature, activity, etc – Event-driven alerts/recommendations according to the configuration of personalized monitoring schemas • Health Problems/Symptoms – Dizziness, chest pain, shortness of breath, stress, etc • Patient Situation – Shopping, driving, working, exercising, resting, etc • Time and Location 10Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 11. Personal Health Information: Dimensions & Sharing Subjective information Objective information (i.e. patient provided ) (i.e. patient sensor measurements ) Detailed view of patient health status Visualization Capabilities Sharing Capabilities – Discovery of – Manual patterns – Event-driven – Self-tracking 1. Configuration of health dimensions according to preferences/needs 2. Selection of receivers 3. Instant & Continuous mode of information dissemination 11Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 12. System Architecture 12Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 13. Micro-blogging Services • Typical functionality: Free text messages of small size are sent to selected receivers – Example Micro-blogging platform: Twitter • Size of message 140 characters • URLS used as links to additional information • Use of labels (# before a word) to ease the message discovery – Message Sharing • Dynamic construction of messages according to conditional patterns defined by the patient • Currently applied in the form of if-then-else rules • Use of special characters (e.g. *) character, in order to distinguish the terms provided within system 13Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 14. Examples of Use View of the recorded health Conditions which trigger conditions in the user’s status sharing mobile PHR 14Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 15. Examples of Use Message (sent from user Selected recipients of the “spapageo”) shown to the recipient shared status (via a twitter client application) 15Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 16. Prototype Implementation MBU System Back-end • J2ME-CLDC (Java 2 Micro Edition- • Apache Tomcat Connected Limited Device – Web application container Configuration) – Open platform for mobile applications • Apache Axis2 – Underlying SOAP engine • JSR-172 Web Services (Java Specifications Request) – API for Web Service clients • Twitter API – Based on REST – Security: HTTP Basic Authentication 16Personal Health Systems for Patient Self-management:Integration in Pervasive Monitoring Environments
  • 17. Prototype Implementation Zephyr BioHarness BT • Physiological monitoring system incorporating sensors into a strap – can be worn virtually in any environment • Heart Rate, ECG, Breathing Rate, Skin Temperature, Activity & Posture measurements • Bluetooth communication – SDK available – API based on request-response messages – Support of streaming, periodical, or threshold data 17
  • 18. Discussion: Future Work • Extensive Evaluation: – Patient acceptance – Medical perspective – Privacy policies • Elaborate on a generic methodology integrating: – Patient preferences and observations – Handling of context parameters, e.g. location, activity, etc. – Behavioral monitoring based on user-to-system interactions – Collaborative filtering of information – Pattern discovery 18Mobile Personal Health Systems for Patient Self-management: OnPervasive Information Logging and Sharing within Social Networks
  • 19. Thank you!!! Mobile Personal Health Systems for Patient Self-management: On Pervasive Information Logging and Sharing within Social NetworksThe research leading to these results has received funding from the Ambient AssistedLiving (AAL) Joint Programme under Grant Agreement n° AAL-2008-1-147 – theREMOTE project (http://www.remote-project.eu/). A.K. Triantafyllidis, V.G. Koutkias, I. Chouvarda, and N. Maglaveras Lab of Medical Informatics Faculty of Medicine, Aristotle University of Thessaloniki Thessaloniki, Greece atriant@med.auth.gr