PERVASIVE HEALTHCARE Technologies for the Healthcare of the Future. Jakob E. Bardram, PhD

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1 PERVASIVE HEALTHCARE Technologies for the Healthcare of the Future Jakob E. Bardram, PhD

2 About the IT University of Copenhagen IT University of Copenhagen 10 years focusing on cross-disciplinary IT research ~50 faculty, 552 STÅ, active stud., 39 PhD 296 candidates 2007 Out of total DK ~ IT masters, ITU ~1500 Master Degree in Healthcare IT 4 large projects within healthcare Activity-Based Computing TrustCare Usable EHR Pacemaker treatment at home 2

3 Professor in Computer Science Research areas pervasive computing human-computer interaction software architecture computer supported cooperative work Focus on healthcare hospitals pervasive healthcare technologies Methods detailed studies of work in hospitals About me designing and implementing technologies together with users and patients 3

4 Agenda Motivation the Age Tsunami the lack of healthcare professionals Pervasive Healthcare in Hospitals managing complex work organizations managing time & life critical work managing coordination & communication Pervasive Healthcare at Home managing the new increasing demand managing patients while not hospitalized preventive and persuasive technologies 4

5 Motivation 5

6 6

7 The Age Tsunami US Demand/Supply of Nurses 7

8 Pervasive Computing Ubiquitous Mobile PC Internet Mini Mainframe 8

9 9

10 10 Source: Eric Dishman. Inventing wellness systems for aging in place, IEEE Computer 37:5 (May 2004),

11 Changing the Centralized Model of Healthcare Acute Continuous Hospitalization Home & out-patient Reactive Pro-active & Preventive IT Assistive Technology Centralized Pervasive Sampling Monitoring Doctor-centric Patient-centric Source: Jakob E. Bardram. Pervasive Healthcare as a Scientific Discipline. Methods of Information in Medicine, 3(47): ,

12 Pervasive Healthcare Application of pervasive computing, ubiquitous computing, proactive computing, ambient intelligence technologies for healthcare, health, and wellness management. Second, it is about making healthcare pervasively available everywhere, anytime, and to anyone. In essence, pervasive healthcare addresses a set of related technologies and concepts that help integrate healthcare more seamlessly to our everyday lives, regardless of space and time. Source: Korhonen, Ilkka, and Bardram, Jakob B. Guest editorial introduction to the special section on pervasive healthcare, IEEE Transactions on Information Technology in Biomedicine 8:3, 2004,

13 Pervasive Healthcare in Hospitals 13

14 Increasing demand more (elderly) patients rising expectations (the baby boomers / 68 s) more diseases can be treated Limited resources lack of clinical staff (nurses & doctors) money! public & private Lack of technologies designed for hospitals a hospital is very different from an office mobility collaboration interruptions time and life critical work... Challenges 14

15 15

16 16

17 Pervasive Healthcare Technologies Technologies for Hospitals Location Tracking Context-aware information retrieval and use Mobile computing Embedded computers (tables, walls, floors,...) Collaboration Technologies co-located remote Communication and Coordination technology Smart sensor technology Patient identification Self-aware monitoring technology... 17

18 Pervasive Healthcare Technologies Technologies for Hospitals Location Tracking Context-aware information retrieval and use Mobile computing Embedded computers (tables, walls, floors,...) Collaboration Technologies co-located remote Communication and Coordination technology Smart sensor technology Patient identification Self-aware monitoring technology... 18

19 State-of-the-Art Coordination

20

21 The Interactive Hospital ihospital AwareMedia The embedded OR Schedule AwarePhone The mobile OR schedule ActiveTheatre The interactive operating room Context-awareness Location tracking Status tracking 21

22 Deployment Site OR Ward, Bed Ward, Recovery / PACU Supports 3 ORs, people pr. day Technology Coordination central : 2 large interactive displays 3 OR / Wards : 20 touch screens Web cams Location tracking based on Bluetooth Tag Mobile phones ~20 AwarePhones Deployed during 12 months 22

23 Horsens Hospital 23

24 Operating Ward 24

25

26

27

28

29

30

31 Qualitative research Questionnaires, observations, interviews Passive and active use Results Increased productivity Increased quality in treatment Reduced stress Reduction of interruptions Reduction in disturbing phone calls Increased hygiene Increased patient satisfaction Passive / Active use ~ 50:50 Clinical Evidence Hansen, T.R., and Bardram, J.E. Applying Mobile and Pervasive Computer Technology to Enhance Coordina;on of Work in a Surgical Ward. Paper presented at MedInfo 2007.

32 Spin-out Cetrea A/S Base technologies location tracking large interactive displays mobile technology unified communication Products Cetrea Surgical ~ Peri-operative coordination & communication Cetrea Emergency ~ Pre-hospital and acute coordination Cetrea Safety ~ Patient identification and safety Integration Ascom communication platform BookPlan ~ booking system in Region Midt AmPHI ~ ambulance medical record from Judex Elektronisk Medicin Profil (EMP) 32

33 Pervasive Healthcare for Hospitals Summary Challenges increasing demands lack of resources, clinical staff, and technology Technology is crucial if we want to handle these challenges Example of technology for coordination and communication life and time critical activities (acute chain) designed for hospitals and clinical use (not office use) available as products now When building new hospitals plan for technology from the very start 33

34 Pervasive Healthcare in the Home 34

35 Home Treatment & Home Care Home of the Patient Hospital Diagnose Prescription Consultation Treatment Rehabilitation 35

36 Monitoring Pervasive Healthcare Research Themes Assistive Technologies Preventive and pro-active health systems Self-care & Self-treatment Medication support and compliance Capture and Access, Training Clinical Support Systems Software Architecture Sensor and Network Design Field Studies Persuasive technologies for better health 36

37 Technology Pervasive Healthcare Characteristics Sensor technology and networks Embedded and mobile devices Context-aware adaptation Capture & Access Clinical approach Pro-active and preventive Patient-focused Monitoring rather that sampling Assistive Technology rather than Information Technology Research Multi-disciplinary from field studies to hardware design Proof-of-Concept rather than evidence-based medicine 37

38 Blood pressure Hypertension Blood sugar Diabetes Lung function Examples - Montoring Chronic obstructive pulmonary disease (COPD) Heart rate, O2, ECG,... Heart diseases Activities of Daily Living Dementia Cognitive Decline Depression... 38

39 Monitoring Blood Pressure 39

40 Pervasive Monitoring Mobile Monitoring Bodyworn Monitors Wireless Monitors Body Sensor Network MyHeart Project 40

41 Philips Patient Tele-monitoring 41

42 Sensors in the Home 42

43 Examples Persuasive Technologies Persuasive Technologies technologies for behavioral change quit smoking, stay active, socialize,... Stay active use stair instead of lift or escalator peer-game for running UbiFit self-monitor their physical activity and incorporate regular and varied activity into everyday life Capture and Access KidCam: Toward an Effective Technology for the Capture of Children's Moments of Interest Baby Steps: Evaluation of a System to Support Record- Keeping for Parents of Young Children 43

44 Pervasive Healthcare for the Home - Summary Challenges increasing demand for mobile/private based services treatment of chronic rather than acute diseases technology is still in its infant Lessons learned new technology is crucial clinical benefit easy to use integrated w. existing healthcare system & technology does it technically integrate? does it scale? adoption is hard conflict between who pays and who gets the benefit 44

45 Wrapping up... 45

46 Summary Motivation the Age Tsunami the lack of healthcare professionals Pervasive Healthcare in Hospitals managing complex work organizations managing time & life critical work managing coordination & communication Pervasive Healthcare at Home managing the new increasing demand managing patients while not hospitalized preventive and persuasive technologies 46

47 47

48 Questions? 48

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