3. Use cases and scenarios for remote support of the elderly to live autonomously alone


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Use cases and scenarios for remote support of the elderly to live autonomously alone

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3. Use cases and scenarios for remote support of the elderly to live autonomously alone

  1. 1. Use cases and scenarios for remote support of the elderly to live autonomously alone Dr. Evangelos Bekiaris Hellenic Institute of Transport Greece
  2. 2. Facts for the elderly care <ul><li>The elderly care taking services are very different among European countries and regions. </li></ul><ul><ul><li>E.g. in Germany 68% of the care taking service is ambulatory, whereas 47% is performed by the family and 21% by a professional service at home </li></ul></ul><ul><ul><li>The above service types are indirect relation to the way elderly live, i.e. roughly 30% of them live at home with professional service (nursing service), 30% at home with the assistance of children or other relatives, 10.8% at a senior/nursing home/geriatric, etc. </li></ul></ul><ul><ul><li>Many of them have chronic conditions, which require ongoing adjustments by the affected person and long lasting interactions with the health care system. </li></ul></ul><ul><li>With their number being projected to increase by 2030 by more than 1% per year (chronically ill population of 171 million), several challenges arise with regards to modern healthcare systems </li></ul>
  3. 3. A few words about REMOTE project <ul><li>Co-funded by the EC, under the 7th FP </li></ul><ul><li>Aim: to define and establish a multidisciplinary and integrated approach to R&D of ICT for addressing identified needs of frail elderly, especially of citizens at risk due to geographic and social isolation in combination with: </li></ul><ul><ul><li>chronic conditions (hypertension, arthritis, asthma, stroke, Alzheimer’s disease, and Parkinson’s disease) </li></ul></ul><ul><ul><li>the coexistence of lifestyle risk factors (obesity, blood pressure, smoking, alcohol abuse, poor eating / drinking habits, stress, and low levels of physical activity) </li></ul></ul><ul><li>The project enhances the elderly’s personal environment with audio-visual, sensor / motoric monitoring, and automation abilities for tracing vital signs, activity, behaviour and health condition, and detecting risks as well as providing effective and efficient support at home </li></ul>
  4. 4. REMOTE & Use Cases <ul><li>The Use Cases definition is the initial working step in any project. </li></ul><ul><li>The UCs act as reference guide for the upcoming developments within the project and provide a basic input to the design of the devices, defining the system functionality, involved actors, scenarios of use, restrictions, etc. </li></ul><ul><li>A UC as a description of an actor’s interaction with the system to be designed, is both a description of the system’s user interface and an indirect description of the function that the system will provide </li></ul><ul><li>The UC is a powerful description to preview and analyze the functionality of a system and to satisfy the user needs. </li></ul>
  5. 5. Methodology for the extraction of the use cases <ul><li>Work started with a technological benchmarking on the user needs and health monitoring solutions for isolated elderly </li></ul><ul><ul><li>It aimed at classifying the user needs with regards to various chronic conditions, as well as with regards to co-morbidity and establishing the starting point on current applications and services dealing with elderly health monitoring and management </li></ul></ul><ul><li>F ace-to-face interviews were realised in 5 countries (30 carers and 125 elderly users) </li></ul><ul><li>A thorough literature and market survey has been performed in the area of services for the everyday support of elderly people </li></ul><ul><ul><li>Issues considered are related to technological aids, systems and services for remote health monitoring and systems to support the elderly in pre-trip and on-trip info, etc. </li></ul></ul><ul><ul><li>A utonomous living applications and services are included, such as health monitoring, home automation, memory enhancement, physical activity management, etc. </li></ul></ul>
  6. 6. UCs template <ul><li>Priority level (essential, secondary or supportive) </li></ul><ul><li>Brief description on the user goal to be satisfied </li></ul><ul><li>Primary actor (type of chronic problem of the elderly, like arthritis, stroke, diabetes, etc.) </li></ul><ul><li>Secondary actor i.e. family members, formal and informal care givers, health care and emergency support service providers, national or local regional authorities, etc.). </li></ul><ul><li>Tertiary actors (i.e. insurances, industry, scientific community, etc.) </li></ul><ul><li>Application scenarios describing the use case </li></ul><ul><li>System output </li></ul><ul><li>Resources required to perform the use case </li></ul><ul><li>Relevant devices (PC, PDA, mobile, etc.) and restrictions for each </li></ul><ul><li>Environmental restrictions (i.e. indoors, outdoors) </li></ul><ul><li>Quality of service indicators </li></ul><ul><li>Personalisation level (i.e. based upon chronic conditions, medical profile, user implicit preferences, etc.) </li></ul><ul><li>Interaction steps to realise the use case </li></ul><ul><li>Other connected use cases </li></ul><ul><li>Background info and reason on use case selection and priority level assignment. </li></ul>
  7. 7. List of 40 UCs in REMOTE <ul><li>Category 1: Nutritional Advisor </li></ul><ul><ul><li>Nutritional advisor (related to health and activity) </li></ul></ul><ul><ul><li>Monitoring of user compliance to nutritional plans </li></ul></ul><ul><ul><li>Patient nutrition monitoring </li></ul></ul><ul><li>Category 2: Activity Coach </li></ul><ul><ul><li>User activity recognition and characterization </li></ul></ul><ul><ul><li>Monitoring of user compliance to activity plans </li></ul></ul><ul><ul><li>Activity advisor (related to health and nutrition) </li></ul></ul><ul><ul><li>Patient activity monitoring </li></ul></ul><ul><li>Category 3: Brain and skills trainer </li></ul><ul><ul><li>Brain and skills trainer for memory support </li></ul></ul><ul><ul><li>Brain and skills trainer for memory assessment </li></ul></ul><ul><ul><li>Cooperative brain and skills trainer </li></ul></ul><ul><ul><li>Cognitive problem prognosis </li></ul></ul>
  8. 8. List of 40 UCs in REMOTE <ul><li>Category 4: Social Communities platform </li></ul><ul><ul><li>Social gaming </li></ul></ul><ul><ul><li>Social networking </li></ul></ul><ul><li>Category 5: Health monitoring </li></ul><ul><ul><li>Vital signs monitoring </li></ul></ul><ul><ul><li>Medical advisor (related to activity and nutrition) </li></ul></ul><ul><ul><li>Monitoring of user compliance to medical treatment </li></ul></ul><ul><ul><li>Patient records monitoring </li></ul></ul><ul><li>Category 6: Environmental Control </li></ul><ul><ul><li>Health based trip advisor </li></ul></ul><ul><ul><li>Environmental control at home </li></ul></ul><ul><ul><li>In home user localization </li></ul></ul><ul><ul><li>Fall protection </li></ul></ul><ul><ul><li>Home gateway for services </li></ul></ul><ul><ul><li>Guarding angel </li></ul></ul><ul><ul><li>On the move health care </li></ul></ul><ul><ul><li>Virtual trip assistant </li></ul></ul>
  9. 9. List of 40 UCs in REMOTE <ul><li>Category 7: Administration </li></ul><ul><ul><li>User profile building </li></ul></ul><ul><ul><li>Personal calendar construction and maintenance </li></ul></ul><ul><ul><li>Decision support tool for patient and treatment administration </li></ul></ul><ul><ul><li>Treatment planning assistant </li></ul></ul><ul><ul><li>MD – patient dialogue support </li></ul></ul><ul><ul><li>Informal assisstant – patient dialogue support </li></ul></ul><ul><ul><li>Care planning assisstant </li></ul></ul><ul><ul><li>Automated alerts and periodic health status reporting </li></ul></ul><ul><ul><li>Medical Center Administration tool </li></ul></ul><ul><ul><li>Emergency management service </li></ul></ul><ul><ul><li>System Administration </li></ul></ul><ul><ul><li>Patient subscription </li></ul></ul><ul><ul><li>Professional carer subscription </li></ul></ul><ul><ul><li>Informal carer subscription </li></ul></ul><ul><ul><li>Statistical and help tools </li></ul></ul>
  10. 10. Example: Vital signs monitoring UC analysis <ul><li>The primary actors are elderly with hypertension, diabetes, stroke, asthma and c-morbidity issues </li></ul><ul><li>There are also secondary actors expected to be affected, i.e. formal care givers, service centre, health care and emergency support service providers and telematic service providers </li></ul><ul><li>One of the specific scenarios of this UC is when the medical doctor wishes the user to take some measurements for monitoring his/her health status through vital signs measurement; these are different per user group: </li></ul><ul><ul><li>In case of an elderly patient with hypertension the user has to check his/her blood pressure </li></ul></ul><ul><ul><li>In case of an elderly patient with diabetes the user has to control his/her glucose with a glucose meter </li></ul></ul><ul><ul><li>In case of an elderly patient with asthma the user has to check his/her respiration rate </li></ul></ul>
  11. 11. Vital signs monitoring UC analysis (cont.) <ul><li>Another scenario would be the system to be able to measure some of the vital signals of the user by itself (i.e. temperature, ECG, EMG, heart rate, etc.) by sensors embedded on wearable multisensorial platforms </li></ul><ul><li>Thus, the system output is first to inform the user on the medical doctor request for vital signs measurement and then to present the key medical signals to the doctor </li></ul><ul><li>The required equipment for the UC to function can be a heart rate meter, a blood pressure meter, a glucose meter, a respiration monitoring device and a health condition tracking system </li></ul><ul><li>In addition, it can be realised through a PC connection, but even a PDA or a mobile phone (by Bluetooth gateway) in case the patient is out. There are several indicators determined for the quality of service definition, i.e.: </li></ul><ul><ul><li>User’s compliance with the system </li></ul></ul><ul><ul><li>Efficiency and accuracy of data acquisition </li></ul></ul><ul><ul><li>Privacy and security in data transmission </li></ul></ul><ul><ul><li>Reliability, in terms of decisions made about the needed measurements to be taken </li></ul></ul><ul><ul><li>Emergency recognition </li></ul></ul>
  12. 12. Business cases <ul><li>REMOTE promotes a modular business approach, with 3 product versions, all controlled by a Common Architecture and ontologies; thus allowing for easy upgrades : </li></ul><ul><ul><li>a light version, based on portable devices and supposed to be self-purchased and funded </li></ul></ul><ul><ul><li>a core version, requiring home installation, that can be offered at a competitive price by a local SME </li></ul></ul><ul><ul><li>a full version, that requires typically the connection to a public or private health services actor and might need also social funding to achieve wide market penetration </li></ul></ul>
  13. 13. Business cases (cont.) <ul><li>In order to perform a proof of concept of its business scenarios, REMOTE: </li></ul><ul><ul><li>Sets up Pilots in six different countries, representing the different European health care models, to prove that REMOTE solutions can be adapted and integrated into different service types </li></ul></ul><ul><ul><li>Caters for adapted UI‘s, using as much as possible icons/earcons based and language independent elements, but also translated in each Pilot language </li></ul></ul><ul><ul><li>Caters for device independent and alternative designs repository, to allow the service to operate with what the user has at hand in each case (with varying quality of service, functionality and usability) </li></ul></ul>
  14. 14. Business cases (cont.) <ul><li>Its wireless sensors networks and the rest telematic transmission channels and carriers follows in parallel several architectures and standards, to be adaptable to the local conditions </li></ul><ul><li>For local communication between sensors, both Zigbee and Bluetooth are used, whereas the connection to the Medical Center is based upon Internet, but also supports (in case of absence of GPRS/UMTS or stable internet connection) GSM – based (i.e. by SMS or MMS) communications </li></ul>
  15. 15. Conclusion <ul><li>The REMOTE use cases (UC) and scenarios of use have been defined based upon literature review, on-site interviews, technological benchmarking and iterative consensus building among key stakeholders. In total 41 UCs have been drafted </li></ul><ul><li>REMOTE provides solutions that can be easily adapted to fit different legal, institutional, socioeconomic and cultural backgrounds, taking into consideration the wide difference in IT infrastructure around Europe and beyond </li></ul><ul><li>The wide range of UCs supported, the multitude of means to achieve them (including automated, semi-automated and user-triggered actions), the various telematic carers considered and its modular architecture, guarantee that REMOTE is a system for today and tomorrow, that can be applied optimally in IT advance countries, whereas in can also match the rapidly emerging needs of countries under development </li></ul>
  16. 16. Conclusion (cont.) <ul><li>As the UCs form an immediate reflection of user needs and relevant gaps in the area of services for the daily support of the elderly population who suffer from chronic conditions, they constitute the starting point of work for the definition of the user-computer interaction platform and properties, being: </li></ul><ul><ul><li>the easy customisation and system reconfiguration (e.g. through assisted dialogues) </li></ul></ul><ul><ul><li>personalisation to the individual need and preferences of the users, </li></ul></ul><ul><ul><li>self-adaptivity of content presentation according to environmental constraints </li></ul></ul><ul><ul><li>devices restrictions </li></ul></ul><ul><ul><li>cultural characteristics </li></ul></ul><ul><ul><li>multi-services interconnection </li></ul></ul><ul><ul><li>etc. </li></ul></ul>