Development of Elderly-friendly Healthcare Smart Home System

2013/9/3서울대학교병원

김석화, MD, PhD

ISHSH 2013

"This research was supported by a grant(10 High-tech Urban B02) from High-tech Urban Development Program funded by Ministry of Land, Transport and Maritime Affairs of Korean government"

House Call, Origin of U-Health

Pictures of Dr. Mattie B. InGold (missionary) making a house call in Korea (1898)

A ‘house call’ was another type of medical care in Korea till 1960’s

Telemedicine, Beginning of U-Health

An emergency medical service was conducted on a sea through a radio frequency communication (Cover of the the ‘Radio News’ magazine in 1924 )

Telemedicine

:System for diagnosis and treatment of remote patients through telecommunication methods

(e.g. television, telephone and so on).

home healthcare, remote video conference, remote medical imagetransmission system, remote diagnosis, virtual hospital, and so on

Application Scope of Telemedicine

System for providing medical information and special consultation remotely including patient treatment, medical administration, medical education, request and so on

Comprehensive Definition of Telemedicine

U-Healthcare?

U-Healthcare(Ubiquitous Healthcare): Providing health and medical service to the public

Anywhere, Anytime in regards to prevention, diagnosis, cure, aftercare, and etc. using IT infra

weight

Consumer

sensing Collect & transmit

Activity

bp

glucose

cholesterol

patient

gateway

Mobile phone

PC

Analysis & Feedback

Provider

Local hospitalPublic health center

telemedicineAnd healthcare

Generalhospital

Any time

Any where

Unperceivable

For biosignal of patients,

Participation of medical cantors, medical equipment and telecommunication companies is needed

sensing collect transmit analysis feedback

Server

U-Healthcare, expansion of medical Service

U-Healthcare, Demands of the times

Aging of Population

Demand for Chronic Disease Care

Increasing Medical Cost

Demand for convenient medical service

Effective management of chronic disease

Solution for Burden of Elderly Care

치료에서 예방으로 선제적 건강관리로의 패러다임 변화

Delivery Models of advanced Medical IT

U-health Care System for providing ‘Patient centric management’ through reorganizing

traditional medical system

Health examinationClinical Decision

Support

PHR(Personal Health Record)

EHR(Electronic Health Record)

Patient centric Management

Data Repository

DataExchange

DataExchange

Self diagnosis and control

home

Visit care Pharmacy Long-term healthmanagement

General hospital research

Remote diagnosis

Community hospital

Local clinic

Emergency medicine

Beginning of Korean U-Healthcare, SNUH

동일 병원 내 또는 지역적으로 멀리 떨어져 있는 의료기관간에 일반전화회선이나 고속회선, 근거리통신망 등을 이용해 화상정보 및 진단정보를 전송하는 서비스

T1급 전용회선을 연결하여 치매환자 대상으로 상담, 재활교육 및 치매 전문인력 양성 교육 등 실시 (인천 남구, 서울 노원구)

질병의 확인에 해당하는 의료측정은 이를 전문으로 하는 의료기관에서 담당하고,그 다음 내과나 외과 등 또 다른 전문의사에게 치료받을 때 환자의 정보를 신속하고 정확하게 병원에서병원으로 옮겨주는 시스템

U-Healthcare, Growing SNUH

Mobile Healthcare SNUH Gangnam Center: Providing “Health in my Hand” service

Patient centric Application S/W

Healthcare service in my Hand

Checking customer’s EMR in Gangnam center,

SNUH

Customized service according to Exercise,

Nutrition, Stress Management prescriptions

program introduction and reservation

checking recent 3 year medical records

communication with medical staffs

(1:1 consultation, health information bulletin)

1. mobile healthcare

“Health in my Hand (내 손안의 건강)” Service


COPD Portal

Server System

COPD patientsdoctors

Peak Flowmeterstethoscope

Pulse Oximeter

Hospital EMR

1. Equipment Development

Providing related sensors

2. Measurement

Everyday self-check

3. DATA transmission

Storing in portal server

4. EMR Linking

Using treament

2. U-HELATHCARE for COPD

Hospital linkedu-healthcare

Development of u-healthcare service for COPD patients(2008/11~2010/10)


U-health System for COPD Patients

①

“나 같은 숨찬 해소환자가 집에서 병원까지 한 번 가려면 차 몇 번 갈아타고

교통은 불편하고 애로사항이 많은데… 서울대병원에서 우리나라 처음으로

U-헬스케어 라고 매일 관리해 주는 의료 서비스가 있다는 사실 때문에 마음

에 위안이 되고 편하고 좋네요”

->Advantage: Feeling of fearlessness and convenienceA COPD patient(72)

2. U-HELATHCARE for COPD

• Disease centric u-health system• Elder surrounding wired complex and

many appliances• No consideration for residential space of

patient ①

②

③

④

Limitations

12

1차년도 연구단 자체평가

2010/12/23~2013/09/22

Not disease-centric but resident-centric healthcare service based on space properties low-cost and elderly-friendly online & offline healthcare services for community-dwelling

Elderly People with Chronic disease

고령자의 건강 집중모니터링 , 관리

기초 건강 측정 및 관리

서비스 및 콘텐츠 운영

온,오프라인 연계 서비스 관리

고령자 생체정보 측정 및 수집

기존 스마트 홈 연계 시스템

건강관리 feed back 시스템

의료기관 모니터링 연계 시스템

공동 활용 생체정보 측정 및 수집

정신건강 서비스 시스템

커뮤니티형 건강관리 시스템

주거공간, 공용공간, 집중관리 공간간의

연계 모델 구축을 통해 고령자의 종합적인

건강관리가 가능한 스마트 홈 모델을 개발

Goal: Elderly-friendly Healthcare Smart Home Model

14

Subject

• Permanent Rental Apartment Complex in Gangseo-Gu, Seoul, Korea: Gayang 7 Complex (LH공사) + Gayang 4, 5 Complex (SH공사)

Low Educational ‘Basic Livelihood Security Recipients’Elderly

15

Equipment: Elderly-friendly Healthcare System

• The 1st development of end-to-end healthcare system satisfying international standards for interoperability

Interfaces between Sensor Device & Gateway : ISO-IEEE 11073-xxxxx,

Interface between Gateway & Portal Server : IHE PC-01(HL7), W3C-I, SOAP, HTTP

“All sensor Devices are based on wireless communication at home”

16

- Method Cards (IDEO Method Cards, IDEO, Palo Alto, CAL, USA)

A collection of 51 cards representing diverse ways that design teams can understand the

people they are designing for.

They are used to make a number of different methods accessible to all members of a design

team, to explain how and when the methods are best used, and to demonstrate how they

have been applied to real design projects

Inspired by playing cards, the cards are classified as four suits—Ask, Watch, Learn, Try—that

define the types of activities involved in using each method.

System Design

17

-Visual properties - Hearing property

System Design

Aspect Youth Elderly

Background Video games, complex interactive environment TV & radio, relatively non-interactive appliances

Attitude towards digital“Digital native,” grew up with interactive toys and to

ols.Fearless, willing to experiment

Inexperienced, unsure of “rules” or expectations. Afraid to break it

Fear related to this technology

Not having the latest and coolest device Overload with seemingly unnecessary features

Speed and stimulation

The more the better, seeks multi modal stimuli with lots of sights, sounds & choices.

Enjoys immediacy, quick reactions, like to bounce around between items

Prefers steady level of input and output. Clear number of choices/paths.

More time to process

Distractibility Will often seek other pulls while doing tasks Prefers to stay focused and concentrate on task

-Consideration of Physical properties of elderly

18

Application of Design Methods

• Extracted Design Concept & Realization Elderly-friendly Graphic User Interface (GUI)

<Examples of Activities according to the selected methods cards>

19

Application of Design Methods

• Extracted Design Concept & Realization Elderly-friendly Clinical Decision Support System (CDSS): Based on traffic light

biosignal data

feedback

Red

Yellow

Gateway-Sensing & collection of biosignal-Guides about measurement methods and times-Showing feedback contents

Server-Analysis of biosignal data-Staging for feedback

Visiting Hospital-confirm of doctors-Treatment-Changing treat methods

Life Habit Correction-Exercise-Nutrition-Medication

20

-BP monitoring (Home)

CDSS Developed Healthcare Smart Home System

21

-BP monitoring (Community space)


22

-Glucose monitoring (Home)


•

23

-Glucose monitoring (Community space)


24

-Pulmonary Function Monitoring


25

- Cardiovascular Function Monitoring


26

- Home: Picture Selection

Gateway-User Login Developed Healthcare Smart Home System

- Community Space: Barcode Reading

27

- Blood Pressure Monitoring

Gateway-Biosignal Measurement Developed Healthcare Smart Home System

28

- Glucose Monitoring

Developed Healthcare Smart Home SystemGateway-Biosignal Measurement

29

- Weight


30

- ECG


31

- Stethoscope


32

- Pulse Oximeter


33

- Spirometer


34

- Body composition analyzer (Community space)


35

- Patient Monitor (Intensive care space)


36

Gateway- Educational Animation Developed Healthcare Smart Home System

37

Gateway-Video Conferencing Developed Healthcare Smart Home System

38

Gateway-Health Record Chart Developed Healthcare Smart Home System

39

Gateway-TV Developed Healthcare Smart Home System

40

Gateway-Weather Broadcasting Developed Healthcare Smart Home System

41

Gateway-Calendar & Notice Board Developed Healthcare Smart Home System

42

Usability of Gateway Developed Healthcare Smart Home System

43

• Start Window for Start-up to-do list

Current reservation of consultation

Users without measurements for 3 days

Intensive care space Users

Portal Server Developed Healthcare Smart Home System

• User Management

demographic information

Health information

Biosignal information

Consultation history

44

-User health monitoring based on Status board


45 http://www.privacybydesign.ca/


-Application of Privacy by design (PbD) Concept

http://www.privacybydesign.ca/

46

1. Start 2. BP

2. Glucose

3. Pulse Oximeter

4. Weight

IEEE 11073-10417 - Glucose meterIEEE 11073-10407 - Blood pressure monitorIEEE 11073-10415 - Weighing scaleIEEE 11073-104045 – Pulse Oximeter

Additional Development: Android version gateway

Over Android v4.0

47

Wireless activity monitor

Wireless activity monitor Android App

Additional Development: Activity Monitor and Android App

48

Healthcare Smart Home Ecosystem & Expected Effect

Elderly-friendly Healthcare Smart Home Ecosystem for effective Expansion

• Sustainability• Cost-effective• Sociality• Public benefit• Business value

Public health center & its branch (o)

Exercise program of National Health

Insurance Corp. (o)

Visiting nursing service

Community Boucher service

Local home care program

Voluntary healthcare programs (o)

And so on……

ElderlyFriendly

HealthcareSmart Home

49

Thank You

Development of Elderly-friendly Healthcare Smart Home System

Health & Medicine