Resolving and Mediating Ambiguous Contexts in Pervasive Environments

Pervasive computing applications envision sensor rich computing and networking environments that can capture various types of contexts of inhabitants of the environment, such as their locations, activities, vital signs, and environmental measures. Such context information is useful in a variety of applications, for example to manage health information to promote independent living in “aging-in-place” scenarios. In reality, both sensed and interpreted contexts are often ambiguous, leading to potentially dangerous decisions if not properly handled. Thus, a significant challenge facing the development of realistic and deployable context-aware services for pervasive computing applications is the ability to deal with these ambiguous contexts. In this chapter, the authors discuss a resource optimized quality assured ontology-driven context mediation framework for resource constrained sensor networks based on efficient context-aware data fusion and information theoretic sensor parameter selection for optimal state estimation. It has the ability to represent contexts according to the applications’ ontology and easily composable ontological rules to mediate ambiguous contexts.

A Highly-Interactive and User-Friendly PHR Application for the Provision of Homecare Services

Homecare is an important component of the continuum of care as it provides the potential to improve quality of life and quality of healthcare delivery while containing costs. Personal Health Record (PHR) systems constitute a technological infrastructure that can support greater flexibility for healthcare professionals and patients, thus allowing for more effective homecare services. In particular, PHRs are intended to reach patients outside of care settings, influence their behaviors and satisfy their demand for greater information and access. Moreover, PHRs can facilitate access to comprehensive real-time patient data for healthcare professionals thus enabling them to identify problems quickly (e.g. prior to scheduled appointments) and steer patients to appropriate facilities when needed. To this ends, PHR technology needs to evolve well beyond providing a consolidated patient record, in ways that make it more widely applicable and valuable to health systems. The development of applications and tools on top of PHR systems can allow the PHR to function as a platform for both patients and healthcare professionals to exchange information and interact with the health system (e.g., scheduling appointments electronically). This chapter presents a prototype PHR-based system that aims at supporting chronic disease management. In particular, it assists healthcare professionals in assessing an individual’s condition and in forming the appropriate treatment plan for him/her while it provides individuals with a user-friendly application for step-to-step guidance to their treatment plans. The system has been developed on the grounds of a service-oriented architecture where healthcare process automation is realized by means of dynamic, patient-related workflows.

Next Generation Body Area Networks and Smart Environments for Healthcare

The evolution of wireless network protocols such as Bluetooth and ZigBee, and the reducing size, cost (and power consumption) of small scale sensor devices means that new approaches to healthcare monitoring and provision are now possible. From the technological side, new wireless devices can be envisaged that can monitor patients both externally (in terms of movement, flexibility and mobility) and even internally (in terms of embedded devices). From the health and social care side, such wireless devices can allow home monitoring of patients. This can allow more efficient and effective use of health and social care professionals, and also allow patients in remote areas to potentially receive as much healthcare monitoring as patients in urban environments. However, it is important that any use of such new technologies is carefully piloted and integrated with traditional health and social care approaches, especially in terms of the reliability and security of patient data. In this chapter, the authors provide a discussion on the state-of-the-art research initiatives that are trying to address these challenges. A discussion is presented on some of the more recent background work and a view of what future body area networks and smart environments might look like. Throughout the discussion the authors present the challenges faced by many research communities and the likely trends that will emerge given such challenges.

Wireless Networking Credibility, Device Interoperability & Other Important Issues to Take Into Consideration for the Deployment of a Homecare Service Provision Model

The proposed chapter aims to provide a discussion on the issue of the utilization of wireless technologies, for the deployment of monitoring wireless personal area sensor networks for the unobtrusive monitoring of patients. The chapter aims to answer some of the fundamental questions raised by this, including which is the most appropriate technology for such a networking architecture, what is the best topology for home monitoring wireless sensor network solutions, and what is the performance of the wireless networking technologies. In addition, it aims to initiate some brainstorming as regards how many interoperability protocols we actually need, presenting the strong and weak points of most of the current interoperability standards utilized in the field of homecare, with emphasis on the encoding and formatting of ElectroCardioGram (ECG) waveforms. Last but not least it aims to pinpoint other important issues in the field of homecare, such as legal and safety issues which are worth of consideration.

Interactivating Rehabilitation through Active Multimodal Feedback and Guidance

This chapter outlines a Human-Computer Interaction inspired approach to rehabilitation of neurological damage (e.g. spinal cord injury) that employs novel, computer guided multimodal feedback in the form of video games or generation of musical content. The authors report an initial exploratory phase of a project aimed at gaining insight into the development of spinal cord injury (SCI) rehabilitation tools. This exploration included observation of a number of patient interactions in their current rehabilitation routines; the development of initial prototype proposals; and finally through to the development of rapid prototypes which can be used in rehabilitation settings. This initial phase has yielded an understanding of the issues surrounding the development of novel technologies for rehabilitation that will direct further research in the area of rehabilitation engineering. Through the integration of novel methods, in particular the use of interactive physical devices, to the rehabilitation of SCI patients, larger scale research into efficacy of the devices we are developing can be undertaken. These developments may eventually beneficially impact upon the instruments used, the training methods applied and the rehabilitation routines undertaken for individuals living with neurological damage.

Smart Lifelogging Technology for Episodic Memory Support

Recent episodic memory impairment (EMI) affects over 26 million individuals with Alzheimer’s disease. Smart lifelogging technologies can capture a log of the user’s personal experience using wearable or embedded recording devices and present elements of that log as cues that can support memory recollection for people with EMI. In this chapter, the authors describe their design process for developing and evaluating a smart lifelogging system specifically designed to help people with mild EMI remember their experiences better and reduce the burden on their caregivers. The authors’ design process includes two formative field studies to understand both what lifelogging data is most effective for supporting memory and how to present these data. The authors found that their self-guided approach was more effective at supporting people’s ability to retain a detailed memory of their experiences, to feel more confident about their memory abilities, and to reduce the additional burden placed on the caregiver than a caregiver-guided approach.

A Home-Based System to support Delivery of Health and Social Care

The world-wide problem of an ageing population is introduced. This will require older people to be looked after for longer in their own homes. A brief overview is given of care delivery in the home, focusing on computer-based home care as a likely component of future solutions. The challenges faced by home care technology are discussed. It is explained how the Match project (Mobilising Advanced Technologies for Care at Home) is addressing these issues. The philosophy, architecture and approach of this project are discussed.

Sensor Networks in Pervasive Healthcare Computing

Advances in wireless sensor networking (WSN) have opened up new opportunities in distributed informatics. Pervasive healthcare, based on WSN, is an emerging technology area with great potential of future applicability. Small size devices capable of sensing, computing and communicating, enable pervasive platforms; while opening up the large number of technical, medical, social and ethical questions and challenges. Though mostly focused on technical issues, this chapter also addresses some non-technical aspects implied by the technology implementation in medicine. It presents the general philosophy of the pervasive computing and technical design space of wireless sensor networks, mostly highlighting: the energy conservation, communication aspects, security, and software implementation. The state of the art in ubiquitous healthcare, challenges, open questions, as well as the non-technical aspects of the systems implementation are also presented here. As such, this chapter intends to give an insight on most important WSN-based pervasive computing issues, the multidisciplinary application-driven design of these systems, and their position in healthcare pervasive computing.

Restoring Balance

Bilateral vestibular loss (BVL) is a disorder of the balance sensory organs in the inner ear; it can cause falls which may have grave consequences, particularly among elderly. This chapter presents the iterative user-centered design of a vibrotactile feedback mechanism for substituting the balance sense. Six wearable prototypes were created to compare the suitability of different body parts (foot, ankle, knee, waist, shoulder, upper arm) for perceiving this type of feedback and to compare different encoding mechanisms (number, intensity, and rhythm of vibrations). In a second iteration, two of these wearable devices (for the ankle and the waist), in two feedback encoding mechanisms (directional and non-directional) were improved and evaluated. Based on the combined studies and interviews conducted with patients and specialists, it is argued that vibrotactile non-directional balance feedback should be applied to ankles, and that such devices should be integrated in training systems.

Mapping Input Technology to Ability

Accessibility is a critical aspect of health care system design, particularly E-health systems. Ability to access services may change as ones abilities vary, by situation as in the use of a cell phone while driving, by condition, as during an illness or as a result of an accident and in the process of aging. As the European population becomes increasingly skewed towards elders, the ability to communicate with and via computers will become more and more important. Communication consists of two processes: presenting information in an accessible manner and receiving input from the user in a mode that fits the users skills and needs. This chapter describes the design process in providing an alternative to a keyboard for input by persons with motoric disabilities.