OHMS allows physicians to perform continuous monitoring of elderly patients through a distributed system of personalized and synchronized XML profiles. This solution ensures that information accessed by both elderly and physician clients is always up-to-date by validating updates through a communication channel using web services and OSGi architecture. The health profile contains medical history, medications, sensor measurements, and protocols to manage this information based on a user's health conditions. OHMS was tested in European pilots to assess its ability to monitor users and react appropriately to emergency situations or medication changes based on profile information.

1. Distributed and synchronized users’ profile
management for Ambient Assisted Living
A. Esteban#1, V. Jimenez-Mixco#2, M.F. Cabrera-Umpiérrez#3, M.T. Arredondo#4
#
Life-Supporting Technologies, UPM
C/Ciudad Universitaria s/n
ETSI Telecomunicación
28040 Madrid-SPAIN
1
aesteban@lst.tfo.upm.es
2
vjimenez@lst.tfo.upm.es
3
chiqui@lst.tfo.upm.es
4
mta@lst.tfo.upm.es
Abstract—This paper presents the Oasis Health Monitoring OHMS allows physicians to perform continuous
System (OHMS), developed within the EU FP7 funded project monitoring of the elderly, through a distributed system of
OASIS, as a new approach for the next generation of monitoring personalized and synchronized XML profiles. This solution
systems. ensures that the accessed information is updated and validated
OHMS allows physicians to perform continuous
monitoring of the elderly patient, through a distributed system of
in both sides of the communication channel, the elderly and
synchronized XML profiles. This solution ensures that the physician clients, through the use of Web Service technology
accessed information is updated and validated in both sides of and OSGi architecture [4]. Thus, the information is always up-
the communication, the elderly and physician clients, through the to-date in order ensure the well-being of the elderly.
use of Web Service technology and OSGi architecture. The health profile is the main element used to personalise
The OHMS will be tested within OASIS pilots in the OHMS. This profile is generated for every user, allowing
several European countries, where the system functionalities will the system to be more effective and to personalize the services
be assessed in a semi-controlled environment. The outcomes of offered to the elderly [5][6][7]. In addition, the elderly safety
these tests will help to validate the OHMS model and objectives. increase as the OHMS knows in advance possible risky
I. INTRODUCTION situations alerting relatives and caregivers. Each profile stores
valuable information of the elderly, such as the general
Due to improvements occurring within health care medical history, medication schedule and the measurements
systems, longevity has increased and the age distribution of taken with several biomedical off the shelf sensors with
the population in industrialized countries has shifted towards Bluetooth capabilities. Moreover, the health profile contains a
older age groups. This noticeable aging will continue over the pre-defined protocol in order to manage this information.
next decades. Depending on the specific health condition of the user, the
Moreover, European Union elderly people dependency protocol defines a set of vital signs and activity signals that
ratio is expected to increase substantially from its current should be regularly measured and controlled, and also the
levels of 25.4% to 53.5% in 2060[1]. As a result, a large ranges of these parameters in order to set the urgency of
number of older people will require attention on a daily bases, response in case of emergency, thus the OHMS reacts
however they would prefer to continue living independently accordingly depending on the situation [6]. If the physician
instead of moving to residences or relative`s home. Elderly decides to change the user medication, the OHMS is able to
people feel safer about their mobility if they can get help in notify users the medication changes and generate reminders at
critical situations. So, the elderly’s quality of life will heavily the right time [3].
depend on the efficiency, comfort and safety of their home’s The next section explains in details the materials and
health care systems [2][3][4]. methods used in this project to obtain the results.
In order to keep the elderly’s health in an optimal status it
is essential the development of effective monitoring systems.
This paper presents the Oasis Health Monitoring System II. MATERIALS AND METHODS
(OHMS), developed within the EU FP7 funded project OASIS, The project life cycle was divided in three iterative phases
as a new approach for the next generation of health (conceptualization, implementation and deployment),
monitoring systems. involving medical experts and patients at all the stages,
Nowadays, most of the remote monitoring healthcare evaluating the system in the different phases.
solutions operate in a non continuous way, allowing the
physician to monitor the patient’s conditions periodically,
sending the measurements by asynchronous methods.
Moreover, these solutions are not personalised.

2. A. Profile description B. Biomedical sensors
The user’s profile is an essential part of the OHMS. Every Several biomedical off the shelf sensors with Bluetooth are
profile stores valuable information of the elderly. According used to perform continuous monitoring of the elderly. These
to this information, the system personalizes its behavior sensors measure blood pressure, heart rate, blood glucose,
[5][6][7]. The information is classified as shown in Table 1. weight, activity, electrocardiogram and oxygen saturation.
Blood pressure and ECG sensors are shown in figure 1.
1) General information: contains information about the
user like name, age, affiliation, phone, relative’s
name, relative’s phone, reference doctor, reference
hospital and other demographic information [5]. This
information is entered by the elderly and the
physician.
TABLE I
USER PROFILE PROPERTIES CLASSIFICATION
Properties group Write Launch Helps taking Fig. 1 Blood pressure and ECG sensors
Permission Alerts decisions
General Physician NO NO Blood pressure, weight and blood glucose sensors send the
Information and elderly values to the user’s personal computer after the measurements
General Health Physician NO YES
are taken, while electrocardiogram, oxygen saturation and
Information
activity sensors send the values during the acquisition process.
Treatment, Physician YES YES
recommendations, and system The oxygen saturation sensor is a special case. While the
measurements others get a new value every one or two seconds, this one gets
more or less one hundred measurements per second. This
2) General health information: contains information enormous amount of information is handled carefully, to
about the user’s health. The most important field is avoid the lost of out of range measurements that could
the health condition that describes the diseases generate a risk situation.
suffered by the elderly. This property allows the C. Vital signs classification
system to select the adequate measurements to be
taken by the biomedical sensors and the values of the The vital signs measurements need to be real time treated to
thresholds that will trigger the alerts. This control risk situations and ensure the well-being of the elderly.
information is inserted by the physician. The vital signs classification allows the system to know
3) Treatments, recommendations and measurements: which decision is the right one. This is the reason why it is
contains information about the treatments [3], necessary to set up different thresholds in order to manage the
recommendations and measurements values. This properties changes. The physician can choose the ranges
group of properties is the most important. Table 2 among four categories:
shows the fields and the decisions taken according to
the stored values. 1) NORMAL: safe situation. The measurement is correct
and between the limits.
TABLE II 2) TO BE CONTROLLED: possible risky situation. The
TREATMENTS, RECOMMENDATIONS AND MEASUREMENTS
measurement is correct, but the user should know his
Properties group Description Decision health status.
Medication Describes the Reminds the user 3) URGENT: risky situation. The measurement is above
medication the user to take the or below the threshold and the user needs immediate
takes. medication. attention by a medical doctor.
Biomedical Biomedical sensors Triggers the 4) EMERGENCY: emergency situation. The
parameters values of the last control of changes
measurement is completely out of and the elderly
measurement taken by that sends the
the user. alerts needs imminent attention by a medical doctor.
Recommended Measurements the Decides what kind D. Profile management
measurements user should monitor. of alert should be
Also stores for each sent. The creation of an individual, dynamic and personalized
biomedical parameter user’s profile requires the collection of information explicitly
the ranges of values or implicitly, through direct patient or physician intervention
that classify the or through sensors that monitor the users’ vital signs [5].
measurement.
The method applied to handle the profile information
ensures two main objectives: the adequate reading and writing

3. and the real time assessment of the changes in the properties. field also allow the system to trigger the listener when new
The controlled reading and writing prevents simultaneous values are received (see table 4).
writing in one profile property, avoiding inconsistencies TABLE IV
within the information. The real time assessment enables to SINGLE PROPERTY STRUCTURE
control properties changes: if a critical property is modified
(e.g. the elderly vital signs) the system takes the appropriate Field Description
decisions according to the established protocol. Entry Property name
Time Timestamp of the last change
E. Profiles network communication Type Type of value stored
The Web Services are the selected tool for network Value Property value
communications [8][9]. Through this technology the
application ensures the communication security and also the B. Profile Web Service
synchronization between the local profile in the user’s device
and the remote one in the Profile Web service. The system’s core is the Profile Web Service [8][9]. It is
located in the server where the user’s XML profiles are stored.
III. RESULTS This web service is accessed through the “Profile Manager”
OSGi bundle and the Profile Web Service stub [4]. This part
The OHMS system model has three different components:
Profile Web Service, Profile Manager bundle and Web of the system controls the reading and writing. Thus, the
Service stub. All of them interact with each other, having a Profile Web Service ensures properties to always be up-to-
date and valid.
local copy of the XML Profile, as shown in Fig. 2.
C. Profile Manager Bundle
Fig. 2 OHMS system model The Profile Manager is a OSGi bundle [4]. This
component is located in the patient personal computer. This
bundle allows reading and writing properties of the user
profile, and also listening changes in the profile. The Profile
Manager listener follows an actuation protocol. This protocol
controls information changes in order to inform the user, give
him advices or ensure his well-being [5]. The protocol is
depicted in Fig. 3. First of all, the protocol checks if the value
of the property is different from the stored one. If the value
does not change no action is taken. Then, the protocol checks
the type of the property (the group it belongs to). Once the
system knows the property and its value, one of the next steps
is followed:
1) Change recommended measurements properties: if the
health condition changes, which involve changes in the
diseases the elderly suffers, other properties need to be
A. Profile XML changed as well (e.g. which measurements the user
needs to take).
The profile XML has been implemented following the 2) Send alert: if a vital sign is out of range the system
profile description described previously. In order to validate sends an alert.
the XML files created, an XML Schema has been 3) Send notification: changes in the profile properties
implemented. The fields structure of the Schema is shown in should be notified to the elderly.
Table 3.
TABLE III Values coming from the oxygen saturation sensor receive a
SCHEMA SINGLE PROPERTY STRUCTURE special treatment: all the values are controlled but only
Field Description relevant changes are stored in the profile (e.g. values out of
Key Property name to validate range).
Default Default value of the property
Type Type of value stored
D. Profile Web Service stub
Description Description of the property
The Profile Web Service stub allows reading and writing
The profile XML field structure allows ensuring the main properties of the user profile. This component is located in the
objectives of the system. First, the Time field controls the physician personal computer. Using this web service, the
writing and reading, avoiding inconsistencies. The values physician can: notify changes in the medication,
received with an old time stamp are rejected. Second, this

4. Fig. 3 Profile Manager Actuation protocol
change the recommended measurements and receive alerts [4] Novais, P., Costa, R., Carneiro, D., Machado, J., Lima, L., Neves, J.,
from the vital signs measurements of the elderly [8]. 2008, in IFIP International Federation for Information Processing,
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[5] S. Gauch1, M. Speretta1, A. Chandramouli1, A. Micarelli, User
This paper has presented the user’s profile management Profiles for Personalized Information Access, Lecture Notes in
approach applied in the development of the OHMS, that is a Computer Science, Berlin, Germany: Springer, 2007, vol. 4.
solid tool for controlling the health status of the elderly.
This solution for managing the user’s health profile [6] P. Moraitis1, N. Spanoudakis, “Agent Architecture for Providing
implements a distributed system of XML profiles, focusing on Accessibility Content and Services in an Ambient Intelligence
Context” in ASK-IT International Conference ,October 2006
personalization, data security and synchronization, and thus [7] I. Zinnikus, K. Fischer, J. Alexandersson, “Bringing the elderly into the
ensuring that the stored information is always valid and up-to- mainstream of e-society: the vital project” in IADIS International
date in the elderly or physician clients. Conference e-Society, 2009
Network congestion and other problems that may arise [8] J. Mykkänen, A. Riekkinen, M. Sormunen, H. Karhunen, P. Laitinen,
causing reception errors have been solved through “Designing web services in health information systems: From process
to application level”, international journal of medical informatics, vol.
synchronized time fields within the user’s profile, providing 20, pp. 89–95, 2007.
an adequate reading and writing, and real time assessment of [9] A. Tablado, A. Illarramendi, M. Bagüés, J. Bermúdez, A. Goñi,
properties changes. “AINGERU: An Innovative System for Tele-assistance of Elderly
The OHMS will be tested within OASIS pilots in several People”, The Journal on Information in Healthcare”., vol. 2, pp. 205-
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European countries, where the system functionalities will be
assessed in a semi-controlled environment. The outcomes of
these tests will help to validate the OHMS model and
objectives.
ACKNOWLEDGMENT
This work has been carried out as part of the OASIS
project co-funded by the European Commission under the
Seventh Framework Programme. Authors would like to thank
the OASIS consortium for their valuable contribution to this
work.
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