An Overview of Wearable Applications for Health Care: Requirements and Challenges
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Slides presented at the Atelier for Smart Garments and Accessories for Health Care in September 18th, 2015 UbiComp 2015
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An Overview of Wearable Applications for Health Care: Requirements and Challenges
- 1. An Overview of Wearable Applica2ons for Healthcare: Requirements and Challenges Vivian Genaro MoB Kelly Caine School of Compu2ng Clemson University Atelier for Smart Garments and Accessories ISWC / UbiComp 2015 Osaka, September 8th, 2015
- 4. Wearable Health Google Trends -‐ 2010 to 2015
- 5. • Domains: cardiology, pediatrics, obstetrics, neonatology, oncology, neurology, psychiatry • Stages: preven<on, diagnose, treatment, rehabilita<on • Beneficiaries: babies, kids, teens, adults, older adults, pa<ents, medical prac<<oners and caregivers Wearable Health Landscape
- 6. Domains Medical Prac<<oners Caregivers
- 7. Stages Preven<on: UV ring
- 8. Beneficiaries Older Adults in Ambient Assisted Living Baby – monitoring of vital signs: Owlet socks [Source: Kunze et al., 2014]
- 9. Wearable Health Landscape • Alcoholism • Pregnancy Monitoring • Emergency Response • Cancer • Obesity and Overweight • Stress Management • Smoking Cessa<on • Obsessive Compulsive Behaviors (OCB) • Bipolar disorder • Au<sm spectrum • Depression • Diabetes • Alzheimer • Epilepsy • Parkinson • Crohn’s disease • Blindness • Color-‐blindness • Hearing impairments • Motor impairments Assis<ve Technology Chronic Diseases Medical Condi<ons Mental Health
- 11. Chronic Diseases • Diabetes • Alzheimer • Parkinson • Epilepsy • Chron’s
- 12. Mental Health Moodnote App h[p://www.wired.com/2015/08/moodnotes-‐app-‐like-‐personal-‐trainer-‐for-‐mental-‐health/
- 13. Medical Condi2ons [Tempdrop] [Lumo]
- 14. Wearable Health Sensors Form Factors Healthcare Stages Medical Domains
- 16. Preven2on • UV ring
- 17. Diagnose • Trauma<c Brain Injuries [Source: Ning, K. Smart underwear and female health, 2013]
- 18. Monitoring [Source: Poh et al. Cardiovascular Monitoring Using Earphones and a Mobile Device, 2012] [OM Signal] [Moodnotes]
- 19. Treatment Glucometer + Insuline pump
- 20. Rehabilita2on [Source: Edgar, S. et al.Wearable shoe-‐ based device for rehabilita<on of stroke pa<ents, 2010]
- 21. Behavior Change • Large poten<al for lifestyle changes – Improving posture – Monitoring stress levels – Smoking cessa<on – Increasing ac<vity levels – Improving ea<ng habits
- 23. Smoking Cessa2on Stop Smoking!! For Wear h[ps://play.google.com/store/apps/details?id=org.chrjs.wearsmoking
- 24. Moves App
- 25. Humana’s Cue App • Drink water • Stretch • Breath • Straighten up • Go outside
- 26. Common Requirements • Data collec2on – Accurate, flawlessly, con<nuous • Data processing – Interpreta<on, es<ma<on, filtering • Data visualiza2on – Progress along <me, among peers, easy to access, lightweight solu<on • Interven2on
- 27. Benefits
- 28. Key Challenges • Interfaces and Interac<on – Transient requirements, context changes, limited resources • Self-‐diagnose – Shik health care to a pa<ent-‐centric paradigm • Valida<on – Precision, personaliza<on, calibra<on, error • Risks – Es<ma<on, assump<on
- 29. Accuracy [Source: Yang Bai, et al., Comparison of Consumer and Research Monitors under Semistructured Semngs, 2015]
- 30. Risks
- 31. Risks
- 32. Opportuni2es • Behavior change – Monitoring, visualizing, assis<ng • Data analysis • Epidemiological trends • Peer health • Precision medicine
- 34. Conclusion • While wearable health has a promising poten<al for promo<ng and improving medical care, current solu<ons are s<ll in their infancy, and further efforts are needed un<l wearable technologies become accessible, safe, and popular
- 35. Acknowledgments This material is based upon work supported by the Na<onal Science Founda<on under Grant No. 1314342. Any opinions, findings, and conclusions or recommenda<ons expressed in this material are those of the author(s) and do not necessarily reflect the views of the Na<onal Science Founda<on.
- 38. References • Yang Bai, Gregory J. Welk, Yoon Ho Nam, Joey A. Lee, Jung-‐Min Lee, Youngwon Kim, Nathan F Meier, Philip M. Dixon. Comparison of Consumer and Research Monitors under Semistructured Semngs. Medicine & Science in Sports & Exercise, 2015; 1 DOI: 10.1249/MSS. 0000000000000727 • Boujarwah F. A et al. 2010. Understanding the Challenges and Opportuni<es for Richer Descrip<ons of Stereotypical Behaviors of Children with ASD A Concept Explora<on and Valida<on. ASSETS’10, 2010, • Carrington, P., Hurst, A., Kane, S. Wearables and Chairables: Inclusive Design of Mobile Input and Output Techniques for Power Wheelchair Users. CHI´14, (2014), 3103–3112. • Dong, Y., Hoover, A., Scisco, J., & Muth, E. 2012. A new method for measuring meal intake in humans via automated wrist mo<on tracking. Applied Psychophysiology and Biofeedback, 37(3), 205– 215. doi:10.1007/ s10484-‐012-‐9194-‐1 • Fujiki, Y., Kazakos, K., Puri, C., Buddharaju, P., Pavlidis, I. 2008. NEAT-‐o-‐ Games : Blending Physical Ac<vity and Fun in the Daily Rou<ne, 6(2). • Grönvall E, Verdezoto N (2013) Beyond selfmonitoring: understanding non-‐func<onal aspects of home-‐based healthcare technology. Proceedings of the UbiComp’13, 587–596.
Editor's Notes
- Wearable health has been showing a growing interest in Google searches for the past 5 years (Graphic generated via Google Trends for wearable health from January 2010 to July 2015). www.google.com/trends/explore#q=wearable%20health&date=1%2F2010%2067m&cmpt=q&tz=Etc%2FGMT%2B4
- Thinking about potential applications, we realize that several specific domains can benefit from wearable devices. We also notice that such devices can be used by different populations and that a wearable app can help patients throughout different phases of a medical condition Wearables have already been successfully applied in the healthcare domain for many different purposes and for a long period. Wearable devices can be employed as assistive technologies to augment human senses [8], [25], as prosthetics to replace or support human organs or limbs [20], or even as medical devices to monitor specific medical conditions [5]. Despite such a large potential, some wearable applications for healthcare are more popular. Those stand out thanks to their specific requirements, broader impacts, lower costs and risks, besides other benefits involved. The first eyeglass mention for instance dates from 1268. Source: www.media.mit.edu/wearables/lizzy/timeline.html .
- Kai Kunze, Niels Henze, and Koichi Kise. 2014. Wearable computing for older adults: initial insights into head-mounted display usage. In Proceedings of the 2014 ACM International Joint Conference on Pervasive and Ubiquitous Computing: Adjunct Publication (UbiComp '14 Adjunct). ACM, New York, NY, USA, 83-86. DOI=10.1145/2638728.2638747 http://doi.acm.org/ 10.1145/2638728.2638747
- Wearable technologies have potential to address problems in various application domains, including: interactive systems, safety critical settings and entertainment [16]. Among these domains, healthcare stands out. This occurs because wearable devices are versatile and therefore able to accommodate heterogeneous system requirements. Besides this, users wear these devices continuously in closer contact with their bodies, thus individual data can be constantly collected and prompt notifications and responses are practical. Finally, wearable applications center the healthcare on the patient, so its delivery can be personalized and tailored timely according to actual patient needs. Chronic Diseases The application of wearable solutions for chronic health problems includes the usage of glucometers and insulin pumps for diabetic patients [5], [20], the application of accelerometers [18] or Glass [14] to detect gait in Parkinson’s patients, and the monitoring of physiological data to support the diagnosis of Crohn’s disease [22]. Mental Health To support mental health, wearables have been explored to monitor the behavior of Autistic children [14], and to manage stress (including detection and intervention phases) [11], [17]. Assistive Technologies As assistive technologies, wearable solutions facilitate the navigation of blind users [8], enhance colors’ contrast for color-blind users [25], augment auditory feedback for users with hearing impairments [22], and enable navigation of users with motor impairments [2]. Medical Conditions Specific medical conditions that have also been supported by wearable applications include: detection of drinking behaviors of alcoholic patients [9], monitoring of diabetes during pregnancy [5], early diagnosis of breast Cancer [11], monitoring of eating habits of overweight patients [19], as well as their physical activity levels and lifestyles [1].
- http://www.entrepreneur.com/article/249411 http://fingerson.strikingly.com/ https://youtu.be/zmpl81WmFSo
- The advances and popularization of applications in wearable health enables us to analyze it from multiple perspectives
- http://med.miami.edu/news/nfl-grant-awarded-to-study-novel-diagnostic-device-for-concussions 1.
- 1. Poh, M.-Z., Kim, K., Goessling, A., Swenson, N., and Picard, R.Cardiovascular Monitoring Using Earphones and a Mobile Device. IEEE Pervasive Computing 11, 4 (2012), 18–26.
- Edgar, S., Swyka, T., Fulk, G., and Sazonov, E.S.Wearable shoe-based device for rehabilitation of stroke patients. Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 2010, (2010), 3772–3775.
- http://www.macrumors.com/2015/07/28/apple-watch-healthy-lifestyle-changes-wristly/ https://medium.com/@bdesarnauts/wristly-apple-watch-insider-s-report-13-a61eb7ce9a89
- http://wearabletechwatch.net/living-with-apple-watch/ Supporting behavior changes is one of the most promising applications for wearable devices [24]. While existing applications already explored diverse scenarios, they often include three core tasks: (i) the monitoring of users’ behavior, (ii) the visualization of the data collected, and (iii) the assistance in behavior changes. Monitoring Eating and drinking behaviors have been monitored by means of wearables, for instance to quantify the meal intake using a wrist worn device [1], eating behaviors using a body worn sensor [19], [9] (e.g., earpiece, masks and belts), and drinking behaviors using transdermal sensors embedded in bracelets or anklets [9]. The patient behavior, i.e. the level of physical activities, has also been monitored [1], for instance by using a wearable camera embedded in a lanyard [5]. Visualizing The visualization of the data collected through diverse wearables (e.g., HMD, back-, chest-mounted, handheld, bracelet) has been investigated, focusing particularly on behavioral patterns [21]. Assisting Besides data collection, analysis, and visualization, wearables have also been employed to: (i) encourage behavior change, for instance by promoting stress management [11], through accelerometers worn in different body placements (foot, leg, arm, waist) [4]; (ii) support social interactions between human users through wearables [11]; and (iii) support the navigation of blind users according to their behaviors [8].
- Humana’s Cue app goes one step further. In the name of a healthier lifestyle, it advises users to “do small things known to result in better health”. This results in frequent reminders to drink water, stretch, breathe, straighten up and even go outside. It wouldn’t surprise us if the next version nags users to stop smoking and drinking. Users are urged to “download Cue today to start building healthy habits”. Its privacy policy states that “we limit who can see your information to only those who need to see it”, without saying who those who “need to see it” might be. It also states that information gathered may be used “for compliance programs”, or “avert a serious and imminent threat to your health”, both of which sound ominous.
- Despite the heterogeneous nature of the medical applications presented above, they share common underlying requirements that must be supported by the application regardless of its use case scenario. Common Requirements Common features that are available in wearable solutions for healthcare and behavior change include: Continuous data collection: during specific periods of time, in pre-determined frequencies, often without or with low tolerance for interruptions; Unobtrusive design of form factors: ergonomic solutions that are comfortable to be worn frequently and in close contact with the human body, respecting its anatomical dimensions, temperature and skin sensitivity, without disturbing or blocking regular activities and movements of human users; Easy data access and interaction: interactive solutions that enable quick and accessible interaction, and responsive notifications, specially in case of medical emergencies; Reliability: data collection that respects acceptable thresholds in terms of accuracy and precision, with low or no fault tolerance.
- http://www.macrumors.com/2015/07/28/apple-watch-healthy-lifestyle-changes-wristly/ https://medium.com/@bdesarnauts/wristly-apple-watch-insider-s-report-13-a61eb7ce9a89
- Along with the emergence of wearable solutions in healthcare and their many benefits, several challenges emerged. They involve ensuring high accuracy and continuity in the process of data collection, providing efficient interactive solutions in limited physical surfaces with limited resources, understanding the privacy concerns involved and effectively providing respective control mechanisms for end users, besides preventing any potential safety risk caused mainly by the long-term and continuous usage of a device in close contact with the human body To ensure continuous data collection, power solutions for wearable devices need to work flawlessly, without interruption. To ensure reliability, data collected requires high accuracy levels (within acceptable, predefined thresholds). Open challenges in the wearable health domain include: User interfaces that are intuitive, accessible, simple and easy to use, considering, not only the limitations in technological resources and physical dimensions of the device, but also the transient requirements of dynamic contexts of use. Micro-interactions, that enable task completion in less than 3 seconds, are often recommended. Privacy controls that are easy and intuitive for users to understand and use, enabling a comprehensive, fine-grained control also suitable for non-expert users. Devices that are customizable in terms of interfaces (software aspects that are sensitive to the users’ context, e.g., in case of situational impairments) and fit (hardware designs that accommodate heterogeneous users’ profiles, considering ergonomics and anatomical constraints).
- http://medcitynews.com/2015/07/topol-apple-watch-helps-colleagues-patient-self-diagnose-heart-condition/ Accuracy Precision reliability
- Unnecessary services Under over diagnoses
- Exploratory phase Sustained engagement fails
- http://spectrum.ieee.org/robotics/medical-robots/medical-microbots-take-a-fantastic-voyage-into-reality
- Trends: activity levels tracking and improvements, mobile apps, periodic analysis