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On Location-based Services for Patient Empowerment, Guidance and Safety

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Presentation given in the 2nd International Conference on Wireless Mobile Communication and Healthcare, Kos Island, Greece, October 2011 …

Presentation given in the 2nd International Conference on Wireless Mobile Communication and Healthcare, Kos Island, Greece, October 2011

Paper available at: WIRELESS MOBILE COMMUNICATION AND HEALTHCARE
Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering, 2012, Volume 83, Part 12, 416-422

The importance of patients’ active participation in healthcare delivery and disease management has been highlighted in various studies, especially for chronic patients. Overall, patient empowerment, guidance and safety constitute concrete goals in modern healthcare systems. To this end, mobile computing technologies can enable to realize such services in a pervasive manner, tailored to each patient’s specific needs. The current work elaborates on the utilization of outdoor location information to deliver personalized services to patients, discriminating among reactive and proactive services according to their initiator and nature. In this regard, we present various use cases and relevant applications that have been developed by our group, exploiting this way the virtue and applicability introduced via the adoption of location-based services. The ultimate goal of this work is the development and establishment of an integrated framework for providing location-based healthcare information services targeting patient safety, empowerment and guidance.

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  • 1. On Location-based Services for Patient Empowerment, Guidance and Safety A.K. Triantafyllidis, V.G. Koutkias, I. Moulos, and N. Maglaveras Lab of Medical Informatics Faculty of Medicine, Aristotle University of Thessaloniki Institute of Biomedical and Biomolecular Research, Center for Research and Technology Thessaloniki, Greece atriant@med.auth.gr
  • 2. Presentation Outline • Background: – Mobile Personal Health Systems – Location-Based Services • Scope of the Current Work • Proposed System: – Conceptual Framework – Reactive Services – Proactive Services • Results: – Prototypes Implementation - Technical Feasibility • Discussion and Future WorkOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 3. Mobile Personal Health Systems • Mobile-based Health Services towards Patient Empowerment, Guidance & Safety • Location Identification: Anytime & Anywhere – Social Networks – Combined with other Contextual Information • User Profile/Medical History • Monitored Health Parameters (Heart Rate, Activity, Blood Pressure, etc) Emergencies Patient Independent LivingOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 4. Scope of Work • Demonstration of various use cases illustrating the adoption of Outdoor Location Information as an important attribute in the design of Pervasive Health SystemsOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 5. Conceptual Framework • Reactive Services – Initiated by the Users – Require Constant Interaction – Suitable for Patient Self-management & Empowerment • Proactive Services – Initiated by the System/Patient’s Family or Caregiver – Executed in an event-driven manner – Suitable for Patient Guidance & SafetyOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 6. 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.On Location-based Services for Patient Empowerment,Guidance and Safety
  • 7. 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 Critical Requirement: Patient Willingness to Actively Engage in Health Management ProcessesOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 8. Patient Guidance & Safety System provision of guidance processes to help the patient to self-manage Alerts/feedback delivery to Caregivers/Family Alert delivery to the Medical Center in case of emergency  Rapid actions  Better emergency managementOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 9. Conceptual FrameworkOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 10. Reactive Service: Location-based Symptom Tracking Functionality & Goals • Recording of subjective elements of health information – e.g. symptoms on a mobile device – Chest pain – Dizziness – Shortness of breath • Association of location with health status • Fine-tuning of patients’ treatment and exercise plans by Caregivers after the reception of generated reportsOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 11. Reactive Service: Social Networking Platform for Activity Sharing Functionality & Goals • Recording and sharing of activities within an online community – e.g. walking, running, shopping etc • Association of location with networked activities • Targeting emotional support & self-confidence increase towards achieving personal goalsOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 12. Proactive Service: Tracking the Location of a Person with Alzheimer’s disease Functionality & Goals • Patient tracking boundaries definition by caregiver/relative: ROI (Region Of Interest) determined by center point & a radius • Alerts sent via SMS if patient enters or leaves the specified ROI • Patient guidance to return at home • Targeting safety via required actionsOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 13. Proactive Service: Health Status Monitoring & Triggering of Location-Based Services Functionality & Goals • Constant health status monitoring via wearable sensing devices: Heart Rate, Blood Pressure, Activity, Breathing Rate • Location determination in case of emergency (as defined by threshold configuration) • Discovery of the nearest hospitals and/or pharmacies • Targeting rapid actions in case of an emergencyOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 14. Prototype Implementation MBU System Back-end• J2ME-CLDC (Java 2 Micro Edition- • Apache Tomcat Connected Limited Device – Web application container Configuration) & Android – Open platforms for mobile applications • Apache Axis2 – Underlying SOAP engine• Location APIs – JSR-179 Location API • Drupal Platform – Nutiteq Mobile Maps – Open source CMS – OpenStreetMap Tested On• SOA adoption Sony Ericsson C905 – SOAP & WSDL – JSR – 172 Web Service API Nokia N86 Android MilestoneOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 15. 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 dataOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 16. Discussion: Future Work • Extensive Evaluation: – Patient acceptance – Medical perspective – Privacy policies • Elaborate on the establishment of an integrated framework: – Handling of context parameters, e.g. location, activity, etc – Patient preferences and observations – Behavioral monitoring based on user-to-system interactionsOn Location-based Services for Patient Empowerment,Guidance and Safety
  • 17. Thank you!!! On Location-based Services for Patient Empowerment, Guidance and SafetyThe 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. Moulos, and N. Maglaveras Lab of Medical Informatics Faculty of Medicine, Aristotle University of Thessaloniki Institute of Biomedical and Biomolecular Research, Center for Research and Technology Thessaloniki, Greece atriant@med.auth.gr