The Smart Condo Project

Most would agree that older adults want affordable, high-quality healthcare that enables them to live independently longer and in their own homes. To this end, ambient assisted living environments have been developed that are able to non-intrusively monitor the health of people at-home and to provide them with improved care. The authors have designed an environment, the Smart Condo, to support seniors and rehabilitating patients. They have embedded a wireless sensor network into a model living space, which incorporates universal design principles. Information from the sensor network is archived in a server, which supports a range of views via APIs. One such view is a virtual world, which is realistic and intuitive, while remaining non-intrusive. This chapter examines computing technologies for smart healthcare-related environments and the needs of elderly patients. It discusses the Smart Condo architecture, reviews key research challenges, and presents the lessons learned through the project.

Integrating Telehealth into the Organization’s Work System

With increased use of telehealth to provide healthcare services, bringing telehealth technology out of experimental settings into real life settings, it is imperative to gain a deeper understanding of mechanisms underlying the assimilation of teleheath systems. Yet, there is little understanding of how information systems are assimilated by organizations, more work is then warranted to understand how telehealth can be integrated into administrative and clinical practices and to identify factors that may impinge onto telehealth integration. Borrowing from institutional, structural and organizational learning theories, the authors develop a multilevel model for understanding assimilation of telehealth systems. Their study addresses limitations of past work and will be helpful for guiding research and managerial actions while integrating telehealth in the workplace.

A Multi-Disciplinary Approach to Ambient Assisted Living

This chapter illustrates the different disciplinary design challenges of smart healthcare systems and presents an interdisciplinary approach toward the development of an integrative Ambient Assisted Living environment. Within the last years a variety of new healthcare concepts for supporting and assisting users in technology-enhanced environments emerged. While such smart healthcare systems can help to minimize hospital stays and in so doing enable patients an independent life in a domestic environment, the complexity of such systems raises fundamental questions of behavior, communication and technology acceptance. The first part of the chapter describes the research challenges encountered in the fields of medical engineering, computer science, psychology, communication science, and architecture as well as their consequences for the design, use and acceptance of smart healthcare systems. The second part of the chapter shows how these disciplinary challenges were addressed within the eHealth project, an interdisciplinary research project at RWTH Aachen University.

Iterative User Involvement in Ambient Assisted Living Research and Development Processes

The example chosen to best demonstrate how the character and detail of user ideas changed in the different stages of the R&D process is the development of an exercise support system applying an avatar showing the exercises on the TV in the home of an older person.

Foundations of Trust for E-Health

Trust has always been an important element of healthcare. As healthcare evolves into ehealth, a question arises: What will the nature of trust be in ehealth? In this chapter the authors provide the reader with a foundation for considering this question from a research perspective. The authors focus on one ehealth domain: online websites. The chapter begins with a high-level overview of the body of offline trust research. Next, findings related to online trust are presented, along with a working definition. Trust research in the context of online health care is then examined, although this body of work is in its infancy. A detailed discussion of our research in the area of online trust is then presented. Finally, with this background, we take the reader through some possible research questions that are interesting candidates for future research on the nature of trust in ehealth.

Privacy and Security in e-Health Applications

The introduction of e-Health and extramural applications in the personal healthcare domain has raised serious concerns about security and privacy of health data. Novel digital technologies require other security approaches in addition to the traditional “purely physical” approach. Furthermore, privacy is becoming an increasing concern in domains that deal with sensitive information such as healthcare, which cannot absorb the costs of security abuses in the system. Once sensitive information about an individual’s health is uncovered and social damage is done, there is no way to revoke the information or to restitute the individual. Therefore, in addition to legal means, it is very important to provide and enforce privacy and security in healthcare by technological means. In this chapter, the authors analyze privacy and security requirements in healthcare, explain their importance and review both classical and novel security technologies that could fulfill these requirements.

Patient Centered Medicine and Technology Adaptation

In many locations throughout the world, the optimal process is non-existent or has broken down; the United States is no exception as explained from a national, (Sarfaty, 2010) as well as an international perspective by Zwar (2010). The situation has become inefficient because of poorly coordinated, acute-focused, episodic care. The solution lies in the most basic role of the healthcare continuum; primary care. However, to achieve maximum effectiveness and efficiency, adoption of various technologies need to be embraced. While it is referenced by different terms, the concept is often termed patient centered medicine.

Security in E-Health Applications

Wireless sensor networks (WSNs) in e-health applications are acquiring an increasing importance due to the widespread diffusion of wearable vital sign sensors and location tags which can track both healthcare personnel and patient status location continuously in real-time mode. Despite the increased range of potential application frameworks the security breach between existing sensor network characteristics and the requirements of medical applications remains unresolved. Devising a sensor network architecture which complies with the security mechanisms is not a trivial task since the WSN devices are extremely limited in terms of power, computation and communication. This chapter presents an analysis of various WSN security techniques from the perspective of healthcare applications, and takes into consideration the significance of security to the efficient distribution of ubiquitous computing solutions.

Med-on-@ix

The aim of the project Med-on-@ix is to increase the quality of care for emergency patients by the operationalisation of rescue processes. The currently available technologies will be integrated into a new emergency telemedical service system. The aim is to capture all the necessary information comprising electrocardiogram, vital signs, clinical findings, images and necessary personal data of a patient at the emergency scene and transmit this data in real time to a centre of competence. This would enable a “virtual presence” on site of an Emergency Medical Services physician (EMS-physician, the German Notarzt). Thus, we can raise the quality of EMS in total and counter the growing problem of EMS-physician shortage by exploiting the existing medical resources. In addition, this system offers EMS-physicians and paramedics consultation from a centre of competence. Thereby referring to evidence-based medicine and ensuring the earliest possible information of the hospital.

Acceptance of Ambient Assisted Living Solutions in Everyday Life

The aim of “Ambient Assisted Living” -devices is to increase comfort and safety and to provide support for elderly people in their homes. In a housing estate in Kaiserslautern, Germany, a touch screen tablet-PC called PAUL (Personal Assistive Unit for Living), numerous sensors and an EIB/KNX-Bus were installed in 20 apartments. Within the framework of the project “Assisted Living”, Urban Sociologists from the University of Kaiserslautern analyzed the elderly people’s experiences and acceptance of the implemented home automation devices, especially of the tablet-PC over a period of two years of usage. Besides technical aspects social issues like community building are focused in the project. The main results of the project will be presented in the chapter.