The Nexus of Forces in Action – Use-Case 9: Augmented Patient Care Sensor Feedback
Summary
The remote monitoring of patient health life signs and safety.
Primary Industry Sectors
Healthcare
Business Value
Improved quality of life for patient, lower cost of palliative care, lower cost of healthcare
Key Business Functions
Portable bio sensors, low-cost integration with commercial devices such as android phone or iPhone and apps, web-based access to dashboard, events and emergency alerts, automatic call to emergency services, policy and rules engine management
Primary Actors
Patient
Secondary Actors
Medical care staff, research monitoring analyst
Machine Actors
Wearable body sensor (accelerometer, heart rate, heart electrical activity, brain electrical activity, blood pressure, blood chemistry), GPS, patient and medical data aggregation and analytics, NFC, wireless, 3G, 4G, 5G
Key Technologies
Medical remote sensor device, Bluetooth, Zigbee wireless standards, Wi-Fi connectivity, mobile cell phone technology, RFID, Internet, cloud connectivity
Main Scenario
Personal Ambient Management (PAM) is a technique in which sensors are used to monitor and manage the behavior and movement of a patient. The sensors collect data on movement, sleep patterns, body function, and noise levels of communication. These can be analyzed to determine repetitive and anomalous behavior that can indicate self-harm or other conditions of the patient.
Location and movement monitoring can create “geofencing” features that can detect that the patient has left a designated safe area, or the level of contact and interaction.
Measures can be put in place from analysis of the data to improve patient care and quality of life as well as potential value for money and cost efficiencies in use of improved precision care interventions, and use of lower-cost automatic monitoring systems not requiring human support for all processes.
Key Data
Master Data
Patient condition record, patient treatment information, monitoring rules
Current Observations Data
Patient current status, location
Historical Data
Patient past medical history, patient movement, and condition changes
Query Data
Current medical condition of patient, whether patient condition alert required.
Action Taken Data
Action alert to responder on patient condition, alert patient remotely, self-condition alert
Real Business Examples
Geofence Assisted Living Safety Technology
Geofences protect elderly, dementia, and alzheimer's patients who wander, and offer many other useful applications. They are virtual perimeters set around geographic areas that utilize GPS tracking technology to trigger alerts if those designated areas are breached via entrance or exit. This technology has tremendous promise for telecare users and people using assisted living technologies. Particularly useful for dementia and Alzheimer's suffers, the technology alerts carers should the user wander outside of or into certain areas. Geofences enable remote protection of a wide range of vulnerable people and can be effectively used to assist in the care of individuals with many other disabilities. (See the Geonovo product website.)
Ekahau at Napa State Hospital
“Ekahau RTLS (RFID-over-Wi-Fi™) ensures staff safety with location-aware alerting at Napa State Hospital. Reston, VA — July 16, 2013”
“Ekahau Inc., the high-performance leader in RTLS (RFID-over-Wi-Fi) announced today the deployment of its location-aware safety alert solution at Napa State Hospital (NSH), which serves 1,362 psychiatric patients annually. By giving hospital police real-time visibility into staff and guest locations during emergencies, NSH expects to prevent injuries and reduce response times on its 138 acre campus.”
“Installed by Ekahau partners AT&T and NetXperts, Ekahau RTLS uses NSH’s Cisco Wireless LAN to enable 2,000 wearable Ekahau active RFID badges which instantly alert NSH police of staff duress emergencies and indicate the location and nature of the emergency, indoors and outdoors, throughout the sprawling campus. NSH employees in distress simply pull down on Ekahau badges worn on break-away lanyards, and their location appears on security monitors, web-based virtual floor plans and on Ekahau badges worn by the police and other staff members who are closest to the emergency. All business partners also receive Ekahau safety badges upon check-in at the main guard station, ensuring safety and visibility at all times.”
“Having real-time location visibility along with two-way alerting during an emergency is essential to safety at NSH. Ekahau’s safety solution not only makes employees and guests feel safer, it helps us prevent tragedies by reducing emergency response times on campus. There are no maps to pull out or people to call. All employees are notified of the incident and simply know where to go, instantly,” says Dolly Matteucci, Executive Director of NSH.
(See the Ekahau Case Study.)
Diabetes Therapy Management
An IoT–based personal device for diabetes therapy management in ambient assisted living. (See the article by Antonio J. Jara, Miguel A. Zamora, and Antonio F. G. Skarmeta.)
9Solutions IPCS
9Solutions IPCS is a wireless Bluetooth and SaaS-based RTLS and application platform that enables real-time tracking of people and equipment. The 9Solutions system, which works with cellphones, can be used to protect “lone employees” – medical and other personnel who might need assistance while doing their jobs. (See the 9Solutions website.)
Wearable Health Devices
See the Information Week article on Wearable Health Devices.
Other Examples
Preventice BodyGuardian Remote Monitoring System, Imec, AiQ smart clothing, Metria, BodyTel, Danfoss PolyPower A/S, Moticon, Nuubo, TmG-BMC
Additional Considerations
Existing Interoperability Standards
Bluetooth, Wi-Fi (see Wi-Fi in Wikipedia), ISO/IEEE 11073 (see Wikipedia), Health Informatics, Zigbee
Comments on Context
Residential or managed care setting may have ethical issues of using telecare. (See the Social Care Institute for Excellence report.)
Preconditions
- Clinician approval and support organization to maintain and monitor patients
- Ethics of recording patient data
- Data security of remote collection and use of patient condition and data