Paper Alberto Esteban - Distributed and synchronized users’ profile management for Ambient Assisted Living services
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 email@example.com 2 firstname.lastname@example.org 3 email@example.com 4 firstname.lastname@example.orgAbstract—This paper presents the Oasis Health Monitoring OHMS allows physicians to perform continuousSystem (OHMS), developed within the EU FP7 funded project monitoring of the elderly, through a distributed system ofOASIS, as a new approach for the next generation of monitoring personalized and synchronized XML profiles. This solutionsystems. ensures that the accessed information is updated and validated OHMS allows physicians to perform continuousmonitoring of the elderly patient, through a distributed system of in both sides of the communication channel, the elderly andsynchronized XML profiles. This solution ensures that the physician clients, through the use of Web Service technologyaccessed information is updated and validated in both sides of and OSGi architecture . 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, allowingseveral European countries, where the system functionalities will the system to be more effective and to personalize the servicesbe assessed in a semi-controlled environment. The outcomes of offered to the elderly . In addition, the elderly safetythese 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 measurementssystems, longevity has increased and the age distribution of taken with several biomedical off the shelf sensors withthe population in industrialized countries has shifted towards Bluetooth capabilities. Moreover, the health profile contains aolder 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 thatratio is expected to increase substantially from its current should be regularly measured and controlled, and also thelevels of 25.4% to 53.5% in 2060. As a result, a large ranges of these parameters in order to set the urgency ofnumber of older people will require attention on a daily bases, response in case of emergency, thus the OHMS reactshowever they would prefer to continue living independently accordingly depending on the situation . If the physicianinstead of moving to residences or relative`s home. Elderly decides to change the user medication, the OHMS is able topeople feel safer about their mobility if they can get help in notify users the medication changes and generate reminders atcritical situations. So, the elderly’s quality of life will heavily the right time .depend on the efficiency, comfort and safety of their home’s The next section explains in details the materials andhealth care systems . methods used in this project to obtain the results. In order to keep the elderly’s health in an optimal status itis 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 phasesas 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 thephysician to monitor the patient’s conditions periodically,sending the measurements by asynchronous methods.Moreover, these solutions are not personalised.
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 areprofile stores valuable information of the elderly. According used to perform continuous monitoring of the elderly. Theseto this information, the system personalizes its behavior sensors measure blood pressure, heart rate, blood glucose,. 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 . 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 , 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 . measurement. The method applied to handle the profile information ensures two main objectives: the adequate reading and writing
and the real time assessment of the changes in the properties. field also allow the system to trigger the listener when newThe controlled reading and writing prevents simultaneous values are received (see table 4).writing in one profile property, avoiding inconsistencies TABLE IVwithin the information. The real time assessment enables to SINGLE PROPERTY STRUCTUREcontrol properties changes: if a critical property is modified(e.g. the elderly vital signs) the system takes the appropriate Field Descriptiondecisions according to the established protocol. Entry Property name Time Timestamp of the last changeE. Profiles network communication Type Type of value stored The Web Services are the selected tool for network Value Property valuecommunications . Through this technology theapplication ensures the communication security and also the B. Profile Web Servicesynchronization between the local profile in the user’s deviceand the remote one in the Profile Web service. The system’s core is the Profile Web Service . 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 . 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, theService 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 . 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 . 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 beA. 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 systemprofile 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 propertiesimplemented. 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 theobjectives of the system. First, the Time field controls the physician personal computer. Using this web service, thewriting and reading, avoiding inconsistencies. The values physician can: notify changes in the medication,received with an old time stamp are rejected. Second, this
Fig. 3 Profile Manager Actuation protocolchange the recommended measurements and receive alerts  Novais, P., Costa, R., Carneiro, D., Machado, J., Lima, L., Neves, J.,from the vital signs measurements of the elderly . 2008, in IFIP International Federation for Information Processing, Volume 286; Towards Sustainable Society on Ubiquitous Networks, IV. CONCLUSIONS eds. Oya, M., Uda, R., Yasunobu, C., (Boston: Springer), pp. 353–362.  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 inapproach 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  P. Moraitis1, N. Spanoudakis, “Agent Architecture for Providingimplements a distributed system of XML profiles, focusing on Accessibility Content and Services in an Ambient Intelligence Context” in ASK-IT International Conference ,October 2006personalization, data security and synchronization, and thus  I. Zinnikus, K. Fischer, J. Alexandersson, “Bringing the elderly into theensuring that the stored information is always valid and up-to- mainstream of e-society: the vital project” in IADIS Internationaldate in the elderly or physician clients. Conference e-Society, 2009 Network congestion and other problems that may arise  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  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- 214, 2004.European countries, where the system functionalities will beassessed in a semi-controlled environment. The outcomes ofthese tests will help to validate the OHMS model andobjectives. ACKNOWLEDGMENT This work has been carried out as part of the OASISproject co-funded by the European Commission under theSeventh Framework Programme. Authors would like to thankthe OASIS consortium for their valuable contribution to thiswork. REFERENCES K. Giannakouris, Ageing characterises the demographic perspectives of the European societies, Eurostat, 2008. H. Steg, Dr. H. Strese, C. Loroff, J. Hull, S. Schmidt, Europe Is Facing a Demographic Challenge Ambient Assisted Living Offers Solutions, VDI/VDE-IT, Berlin, Germany, European Overview. Rep. March 2006. J.M. Aguilar, J. Cantos, G. Expósito, P.J. Gómez, “Tele-assistance Services to Imporve the Quality of Life for Eldely Patients and their Relatives: The Tele-CARE aproach,” The Journal on Information in Healthcar., vol. 2, pp. 109-117, 2004.