Dheergayu

दीर्घायू 1.0

Tele healing solution for the
elderly

IN 614 SOFT PROTOTYPING

Conducted by
Prof. Pramod Khambete

Deerghayu 1.0 tele medicine concept
Presented by
Chinmay Aniruddha Bhave
Ramprasad S
Roopa Narayan Sahoo

4/6/2013 Deerghayu 1.0 Industrial Design Centre IITB 2

Repertoire
• Understanding the user group
• Problem scenarios “Societies do not
• Need identification evolve because their
• Solution approach members grow old,
• Deerghayu 1.0 system design  but rather because
outlining the form, function, network & their mutual relations
human resource are transformed” –
• Solution scenarios Ilya Prigogine
• Limitations
• References

4/6/2013 Deerghayu 1.0 Industrial Design Centre IITB
3

UNDERSTANDING THE USER GROUP
Exploring health & healing for the elderly


Target Audience
• Age : 50 and above
• Location : Urban & rural
• Income : SEC A to D
• We are looking at elderly who are
living away from their relationship
network and have limited mobility. We
are looking at contrastingly different
strata of socioeconomic groups with
differing technology access in order
to create a comprehensive solution.

5

Problems- Mobility
“I am not comfortable “The nearest dispensary
driving … using public from our house is 30 km
transport gets very away in the district town
difficult” … only one bus everyday
to go”
“I am not able to cross
the road … its “After paralytic stroke I
impossible!” have been wheelchair
bound … going out is a
“I find it extremely difficult big big task … I have to
to climb stairs, there is no beg people to help”
lift either”
6

Problems- Emotional
“I am all alone … my kids “I was always a very obidient
are abroad … the only son … but this generation has
person who touches my no respect for us”
in months altogether is
my family doctor” “we were so frugal in our living
… these kids spend so much on
“I want to play with my hotelling and malls”
grand kids … share my
“I have always been
feelings with my son …
independent … I hope I don‟t
but they have no time for
have to live at mercy”
me”

7

Problems- Technological access
“my kids have taught me “they say everything will
only to use skype but I go online … which
want to explore means I will have to learn
everything” how to make online
transactions but one has
“I use my cell just to to avoid frauds”
make calls!”
“I can use computers but
“I cant use computer its difficult to remember
easily … no one teaches things like backup and
me step by step” data transfer etc!”
8

Problems – Senses & Reaction
“I cant see properly … “sometimes I am not able
even with my reading to keep my balance … I
glasses on … I think I feel giddy when tired”
need to get operated for
cataract but who will look
after me!” “we are old … we cannot
react to things fast like
“I am not able to hear when a car comes
properly on the phone … speeding we get frozen”
person on the line has to
keep shouting
9

Problems – Memory
“My grand kids make fun “My husband retired as a
of me … I don‟t senior scientist from a
remember things easily reputed research group
… if I write them on … can you believe he
paper I don‟t remember totally forgot about his
when I kept it.” name, identity and
reached Kalyan … we
“I don‟t think I am alert could not trace him for a
now … one thug conned week almost”
me recently in market …
I cant believe I fell pray”

10

NEEDS IDENTIFICATION
Creating design ethos for the system


Emerging needs
• Loneliness – distanced from their “They say old age is
physical world as well as emotional like second childhood
world … but that doesn‟t
mean we want to be
• Vulnerability – smallest of problems pampered … it is just
can easily escalate into emergency that we need some
situations. warmth … support ..
• Dependable help and support without Some mature head to
compromise to self respect. handle us if we are
cranky”
• Affordable healthcare solutions for day
to day as well as emergency situations

12

Current coping mechanisms
• Loneliness – peer network … going to pensioner clubs,
spiritual groups, spending time with grand kids if possible,
festivals, religious occasions

• Vulnerability – supporting relationships that are time tested

• Affordable healthcare – schemes offered by public sector,
job related treatment plans, community hospitals etc.

13

SOLUTION APPROACH
Think – Feel – Ideate - Design


Thinking journey
Empathize

Decode

Create

Test

Refine

15

Solution approach
• Design a system and not just a device
• Telemedicine exists already; it is also
being implemented under „National
Rural Health Mission – So look at a
different aspect
• This system should be culturally rooted
and have a humane side to it.
• Healing for us is not just about
medicines and treatments … warmth of
relationships is important

16

A few questions
• Can it provide timely diagnosis and “our system will be
medical treatment? meaningful only if it
seamlessly becomes
• Will the system be user friendly? Will it a part of their routine
be dependable? and positions itself as
• Can it make the process less taxing a caregiver they can
and perhaps make it pleasant? depend on with
• Can it instill confidence that I am not complete confidence!”
alone and I can live long and healthy
life?

17

Institutions
Urban Hub Rural Hub
Central Control

Primary
Suburban
healthcare Advanced Pathology
dispensary
centre

Mobile Mobile Diagnostics
Deerghayu Deerghayu
Van Van
Patient Relations
Medical
Medical
Social
social worker
Worker

18

Diagnostic Devices
Patient Medical facility

Wearable Sensors Hub level console

Portable Units High end devices

Emergency alarms Mobile ICU monitor

19

Interactive platforms
SMS &
IVRS

Patient Tablet for
profile doctors

Remote Emergency
operations Response

20

Human Resource
Specialists

MBBS

Trainee Doctors

Medical Social Workers /
Midwifes

21

आऩल्मा शक्काचा डॉक्टय!
जेव्हघ जोशी कघकघांनघ दीर्घायू १ .० ची मदत ममळते तेव्हघ कघय होते
ते पघहूयघ!


शे आशे त आऩरे जोळी काका ! भुक्काभ वलक्रभगड ... तारुका
जव्शाय ... माांचा भुरगा आशे अभेरयकत आणण भुरगी ऩुण्मारा ...
े
ऩत्नीचे ऩाच लऴााऩूली ननधन झारे.

गेल्मा चाय ददलवाांऩावून त्माांची तब्बब्बमेत ठीक नाशी!

कणकण आणण खोकल्माचा त्राव कभी शोत नाशी

क्रोसवन घेऊन वांऩरी ऩण उऩमोग काशीशी नाशी ... आता काम
कयाले ...

खोकरा लाढू रागरा आशे .... घवेदखी ऩण लाढत आशे
ु

आज तय खूऩच अवह्म त्राव शोतो आशे ...

इतकी डोकदखी ... प्रकयण वाध्मा वदी ताऩाचे लाटत नाशीमे
े ु

काम करू? भुरीरा फोरालून घेऊ का? नको नको ... नातलाची
ऩयीषा वुरु आशे

आज फशुदा दलाखान्मात डॉक्टय आशे त ... ऩाशूमा काम म्शणत
आशे त

काकाांना चचांता आशे की काशी भोठे आजायऩण अवू नमे ....

शे आशे वलक्रभगड चे प्राथसभक आयोग्म कद्र
ें

डॉक्टय आत मेऊ का? ताऩ-डोकदखी खोकल्माने शै याण झारोम!
े ु

अशो वध्मा ताऩाची वाथ वुरु आशे ... ऩण भरा गांबीय फ्रू ची
ळांका लाटत आशे – डॉक्टय भाने म्शणतात

ददैलाने आऩल्मा कडे tami-flu ची गोऱी नाशी ... आणण भी
ु
फाशे यगाली जातो आशे ... भी तुभचा नांफय फपयत्मा दलाखान्मारा
दे तो ... त्माांची इथे पयी शोईर रलकयच ...
े

आता काम करू? ठाण्मारा नाशीतय भुफई रा जाले रागेर ... ऩण
ां
त्राण नाशी

एकट्मा म्शाताऱ्माचे आमुष्म अवेच!

ळशय तवे पाय दय नाशी ... ऩण उन्शात रार एवटीने जाणे कवे
ू
झेऩणाय मा लमात

शौव आणण गालाचे प्रेभ म्शणून इथे याशतोम खया ... ऩण जीलालय
फेतामरा नको!

थोडालेऱ ऩेऩय लाचत फवतो .... त्राव कभी शोईर कदाचचत

आता कोणाचा एवएभएव आरा? नुवत्मा जादशयाती मेत अवतात
ददलवबय!

अये गणू शा फपयता दलाखाना कधी वुरु झारा .... भरा त्माांचा
ऐवेभेव आरा तुभची तब्बफेत ऩाशामरा वामांकाऱी ऩोचत आशोत
... आऩरा ऩत्ता वाांगा!

चरा .... काढा घेतराम एक डुरकी काढाली

दरांग दरांग .... जोळी काका ... डॉक्टय आकाळ फोरत आशे ...
आम्शी अध्माा तावात ऩोचू!

शा आशे आऩरा फपयता दलाखाना .... ऩांचक्रोळीतीर गालाांना
आठलड्मारा दोनदा तयी बेट दे णे शे माचे उदिष्ट आशे .... रे नी
डॉक्टय आकाळ वध्मा इथे तैनात अवतो!

मा तुभचीच लाट ऩाशत शोतो ....

अये फाऩ ये !! एकदभ पाईल
स्टाय प्रकयण आशे शे !
ऩयलडणाय का आऩल्मारा!

मा काका .... कवे आशात ... भीच डॉक्टय आकाळ ...
शा फपयता दलाखाना वयकायने शल्रीच वुरु करा आशे
े
...

डॉक्टय भाने म्शणारे की H1N1 ची ळक्मता आशे
... फवा आऩण कईएभ च्मा डॉक्टय वफनीवाांचा
े
वल्रा घेऊमा!

जोळी काका चचांता करू नका ... आऩण वगळ्मा तऩावण्मा कयतो
आशोत कायण आऩल्मारा उगाच धोका ऩत्कयामचा नाशी ...
वयवकट tami-flu ददल्माने दष्ऩरयणाभ शोतात .... डॉक्टय
ु
आकाळ तुभच्मा यक्ताचे नभुने घेतीर ... तोलय काशी औऴधे घ्मा
आऩण दोन ददलवात ऩुन्शा फोरूच!

अशो इथे वगऱी औऴधे सभऱत नाशीत!

Antiobiotics आशे त आऩल्मा कडे .... योज तीनदा घ्मा ... वोफत
शे गुराफी सवयऩ ऩण .... आणण शो ... रयकाम्मा ऩोटी नको .... काशी
औऴधाांचा त्राव लगैये? तुभची ऩदशरी लेऱ अवल्माने वगऱी भादशती
घ्माली रागेर

दोन ददलवाांनतय !
ां


जोळी काका ... तुम्शारा viral infection
आशे ... ऩण गांबीय काशी नाशी ...

श्लवन भागाात वूज
आरी की त्राव जास्त
शोतो ... सळलाम तुभचे
लम ऩाशता शे
स्लाबावलक आशे ...
काशी ददलव उन्शात
आणण फागेत काभ
नको ... धूऱ ऩयागकण
त्राव दे ऊ ळकतात ...
गोळ्मा घेत यशा एक
आठलडाबय!

अये ला! आता
गोळ्मा
वलवयामची
ळक्मता कभी !
जोळी काका
म्शणारे

वलवयार कवे ...
तुम्शारा योज
पोन मेईर
आठलण कयामरा
– डॉ. आकाळ

शे एकदभ छान ...
गालातच तज्ज्स
डॉक्टयाांचा वल्रा
आणण औऴधेशी ... पी
ऩयलडण्माजोगी आणण
कोणाची भदतशी
घ्मामरा नको ...
वलजूरा वाांचगतरे
ऩादशजे ... तुभच्मा
अभेरयकवायखे आशे
े
एकदभ!

गोळ्मा वांऩत आल्मा आशे त ... फपयता
दलाखाना कधी मेणाय आशे आता? भी
आकाळ चा नांफय घ्मामरा ऩादशजे शोता

तुभचे औऴध
उद्मा वांऩेर
...उद्मा वकाऱी
तऩावणी शोईर
... नक्की
कयण्मावाठी
एक दाफा ...
त्राव वुरूच
अवेर तय पोन
लयीर
चौकळीवाठी
दोन दाफा ...

फपयता
दलाखाना
गालात मेतो

जोळी काका :अये फाऱा! तब्बफेत उत्तभ आशे आता!
डॉ. आकाळ : छान ... एकदा डॉ. वफनीव ना ऩाशूदे त! भग भरा
तीनचाय रुग्ण ऩाशामचे आशे त ...

SOLUTION JOURNEYS
Observe and refine


Accident at L.B.S. road

ALARM
DOCTORS
GETS CONTROL IDENTIFIED
ACTIVATED CENTRE MOBILE AND SENT
FROM THE SEES FOR THE
LOCATION ICU SENT
PARAMETE ATTENDING
OF
RS THE CASE
ACCIDENT

70

Gajabhau suffers stroke

PASSERBY PASSERBY CENTRE DOCTORS
SEES AN THEN EXPLAINS IDENTIFIED
OLD MAN HIM CPR AND SENT
CALLS THE FOR THE
WITH CONTROL PROCEDU
CHEST PAIN ATTENDING
CENTRE RE THE CASE

71

Kamala gears up for her first baby

primary
Her
Servant health care
landlady
maid has centre gives
helps her Dai is taught
had expert
contact the some
miscarriage advice and exercise
primary
and is really asks to
health care
worried. consult mid
centre
wife

72

A few soothing words!
• Patient with problem approaches
physiotherapist

• Physiotherapist finds that patient has neuro
problems and recommends another doctor

• Patient assumes he can be cured with
physiotherapy and refuses other treatment.

Patient sent for
counseling and helped Patient undergoes
to understand his neuro treatment and is
problems cured.

73

DHE
Distributed
Healthcare
Management
Environment Administration
Confederation of
Materials Cooperating units, Ambulatories
Supported by systems Wards
individually optimised Diagnostics/
and mutually interacting Laboratories


About DHE:

DHE is a confederation of autonomous
systems/agencies, individually optimised according
to the specific characteristics of the involved units .
In the same time the individual system/unit act
mutually to provide an effective support collectively
towards the whole system‟s goal.


Goal of DHE:

The ultimate goal of such a System is to build a
network of complementary centres ( Hospitals,
Laboratories, Ambulatories, Co-ordination centres,
Primary health centres etc.)Spread over the
territory, to meet healthcare needs in the area.


The network of DHE typically a heterogeneous
environment . It adopts Network Independent
Communication Environment – NICE

NICE- It allows different modules or layers to
interact according to a client server approach ,
regardless of their mutual location over the network


Nursing/Consulting …. Diagnostics ……. Administration

Applications- Responsible for supporting the users activities in the various units

DHE
Authority Management Patient Identification

Network Independent Communication
Environment

Geographical
network
Computer network Mobile network

DHE Placeholders and
Functionality:


Endoscopy
DHE: ECG
Archive of clinical MRI
Diagnostics/ Wards records City Scan Managerial
Laboratories Radiology Support

Admission, Administration
Discharging Communication
Application
Network
Material Monitoring/ Identity
controlling Content- Health
Supply
care record –
Chain aggregation of
Computer Storage
server distributed
authorisation patient data
and security Dispatcher
Routing of Ambulatories
Nursing/ messages
Consulting

LIMITATIONS
Evaluate and evolve


What could go wrong?
• Network connectivity
• Failures would bring down efficacy of
emergency response system.
• Effective training of trainee doctors and
medical social workers is necessary
• It is aimed to improve the reach of the
medical service and not to replace
existing system.
• We should avoid top down approach 
two way information channel needed

82

REFERENCES


• Bill Buxton : Sketching user
experiences
• Living with complexity : Donald
Norman
• Mobile Telemedicine : Xiao Yang
• Design meets disability : Graham Pullin
• Interviews – Dr. Hiren Doshi,
Paediatrics, Dr Balabhai Nanavati
Hospital NRHM centre

84

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