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ITALH Information Technology for Assisted Living at Home A joint initiative between UC Berkeley, U of Aarhus and Tampere UT M. Kyng, T.R. Hansen, J. Hyttinen, J. Lekkala, J.M. Eklund, J. Sprinkle, R. Bajcsy and S. Sastry. Presentation Outline. Background: Aging and IT

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Italh information technology for assisted living at home

ITALH

Information Technology for Assisted Living at Home

A joint initiative between UC Berkeley, U of Aarhus and Tampere UT

M. Kyng, T.R. Hansen, J. Hyttinen, J. Lekkala, J.M. Eklund, J. Sprinkle, R. Bajcsy and S. Sastry


Presentation outline

Presentation Outline

  • Background:

    • Aging and IT

  • Overall project description:

    • IT for Assisted Living at Home (ITALH)

  • Current Berkeley efforts:

    • The SensorNet sub-project

    • The IVY Fall Detector project


Background aging and it

Background: Aging and IT


Squaring the u s population pyramid 1950 2030

Squaring the U.S. Population Pyramid1950-2030

Age

85+

80-84

75-79

70-74

65-69

60-64

55-59

50-54

45-49

40-44

35-39

30-34

25-29

20-24

15-19

10-14

5-9

0-4

1950

(150,216,000)

1980

(227,658,000)

2000

(267,955,000)

2030

(304,807,000)

Source: U. S. Census


Changing demographics

Changing Demographics

  • Table compiled by the U.S. Administration on Aging based on data from the U.S. Census Bureau.


Italh information technology for assisted living at home

  • Table compiled by the U.S. Administration on Aging based on data from the U.S. Census Bureau.


Worldwide age wave is coming 2002

Worldwide age wave is coming: 2002

2002

Percentage of Population

over 60 years old

Global Average = 10%

SOURCE: United Nations ▪ “Population Aging ▪ 2002”


Worldwide age wave is coming 2050

Worldwide age wave is coming; 2050

2002

2050

Percentage of Population

over 60 years old

Global Average = 21%

SOURCE: United Nations ▪ “Population Aging ▪ 2002”


Opportunities and challenges

Opportunities and Challenges

According to the NSF:

  • Technologies that meet the challenges of aging will be increasingly valuable

  • We must identify collaborative, technology transfer, and technology development and deployment opportunities for government, industry, and academia that help improve the independence, mobility, security, and health of aging U.S. citizens.

  • We must examine potential opportunities and barriers and identify and prioritize recommendations both near and long term, including Grand Challenge class recommendations


But definition of older is evolving

But . . .Definition of “older” is evolving

  • Old doesn’t mean disabled or poor.

  • Old doesn’t mean institutionalized.

    • Only 10% of those 65-85 and 25% of those adults 85+are institutionalized.

  • Gender matters.

    • Most of the elderly are and will be women.


The longevity paradox

The Longevity Paradox

  • At 50, many will have more than half their adult life still ahead, most living on their own.

  • According to the world’s oldest person, “I enjoy longevity because I have my health and can do things.”

  • Enabling older adults to “do things” and assisting those who care for them will become a leading global market--for those who choose to invest in it.


Ageless information and telcom technologies

Ageless Information and Telcom Technologies

  • Technologies that:

    • are usable by all ages

    • address the needs of all ages

    • adjust to the needs, abilities, and preferences of users

    • equally engaging to all ages


What is telemedicine

What is Telemedicine?

  • Telemedicine is a technology-rich alternative to a traditional face-to-face physician consultation.

Physician Station

Patient Station

Courtesy Dr. Richard Re,

Ochsner Clinic

  • Audio/video interaction

  • Data exchange: real-time / store-and-forward

  • Multimedia electronic patient records (EPRs)

  • Medical devices: blood pressure cuff, pulse oximeter, stethoscope, weight scale, temperature probe, ECG leads, ...


Categories of systems

High-End

Mid-Range

Economy

Categories of Systems


Telemedicine key issues

Telemedicine: Key Issues

  • Home health care

    • Reactive/episodic  preventative/predictive

    • Beyond “telemedicine”

  • Medical systems (Component confederacies)

    • Ability: Smart, decision-enabled, and capable

    • Layout: Distributed and dynamic

    • Practicality: Cost-effective & high-surety

  • Information and communication technology: enabling factor


Telemedicine misconception

Telemedicine Misconception

  • “Telemedicine”  real-time communication

    • (replicate traditional patient-physician consultation)

  • Practical remote medicine:

    • sensor-based systems

    • store-and-forward framework

    • monitor/alert systems


Future directions

In person visit  telemedicine  smart sensors

“Virtual” medical systems: distributed, networked devices

Patient-Centric Health Care

&

Internet

EPR’s

Telemedicine

Novel Devices

Future Directions

  • New model for home care

    • Webs of self-aware devices

      • Assess/treat patients

      • Make care decisions

      • Predict health

      • Health Care delivery in pull mode rather than traditional push mode


Future home layout

Future Home Layout


Current devices and systems

Current Devices and Systems

  • E.g., Honeywell HomMed Products

    • http://www.hommed.com

    • Telemedicine applications

Spirometer

PT/INR

Peak Flow/FEV1

ECG

Blood Glucose

Oximeter


Current test systems

Current Test Systems

  • E.g. MIT’s PlaceLab: http://architecture.mit.edu/house_n/placelab.html

    • 100s of sensors

    • Requires massive computing power and storage


Requirements for smart home care systems

Requirements for Smart Home Care Systems

  • Devices: smart, aware

  • Interoperable

  • Collective Intelligence

  • Distributed

  • Dynamically configurable

  • Secure, Private


Technology drivers

Technology Drivers

  • Interoperability Technology

  • Home Networking Standards

  • Network-Enabled Devices

  • Novel Sensors

  • Environmental Sensors


Technology trends bell s law new computer class per 10 years

Number Crunching

Data Storage

productivity

interactive

Technology Trends: Bell’s Law – new computer class per 10 years

log (people per computer)

streaming

information

to/from physical

world

  • Enabled by technological opportunities

  • Smaller, more numerous and more intimately connected

  • Ushers in a new kind of application

  • Ultimately used in many ways not previously imagined

year


Italh information technology for assisted living at home

Wind Response

Of Golden Gate Bridge

Fire Response

Building Comfort,

Smart Alarms

Vineyards

Instrumenting the world

Great Duck Island

Redwoods

Elder Care

Factories

Soil monitoring


Mote evolution

Mote Evolution

Evolution of 3 technology generations


Information technology for assisted living at home italh

Information Technology for Assisted Living at Home - ITALH

University of California Berkeley/CITRIS

Technical University of Tampere/Ragnar Granit Institute

University of Aarhus/Alexandra Institute


Information technology for assisted living at home

ITALH

Finland:

Tampere University of Technology, VTT

Denmark:

Aarhus University

The Alexandra Institute

Bay Area:

CITRIS, UC Berkeley

Information Technology for Assisted Living at Home

Electronic Health Records

Miniaturized wireless

ambulatory

wearable sensors, visual and other stationary sensors

System software, wireless architecture

& user interfaces

Independent living

of elderly

Partner: Finnish American Heritage Association, Sonoma

Projects directly under ITALH

Supportive projects


Technical and commercial rationale

Technical and Commercial Rationale

  • Opportunities

    • Disappearing electronics enable new phase for embedded systems

    • Wireless technologies are about to mature

  • Challenges

    • Real time systems and software face some very unique challenges when they are embedded in the physical world

    • Successful solutions require that technical possibilities and scientific analysis are balanced with usefulness and the development given direction through user needs


Technical and commercial rationale1

Technical and Commercial Rationale

  • Payoff

    • Through participatory design with stakeholders the cluster creates a unique opportunity to develop novel approaches and solutions

    • It will be developed and testing in three international settings

    • It will provide the participant with a competitive advantage in a rapidly growing market


The application elder home tech

The Application: Elder/Home Tech

  • Goals

    • Societal: to improve the potential for better quality of life for elder citizens

    • Technological: to develop and test concepts and prototypes in a diverse set of real life settings

    • Commercial: to create new global market opportunities

  • Project Research Areas

    • Enabling technologies:

      • Embedded software systems and architecture

      • Wireless sensor and other systems

      • Design methods and usability

    • Uses and services

    • Evaluation of societal needs and impact of technology

    • Real applications and test sites


Technology contributions enabling technologies

Technology contributions: Enabling Technologies

  • The new enabling technologies provides ways to develop new smart wireless home services and systems

  • Embedded Software Systems

    • Berkeley and Aarhus

  • Wireless

    • Berkeley and Tampere

  • Sensors

    • Tampere, Aarhus and Berkeley

  • Electronic packaging

    • Tampere and Berkeley

  • Software Infrastructure/Architecture

    • Aarhus and Berkeley

  • User Interfaces

    • Aarhus and Tampere


Technology contributions embedded software systems

Technology contributions: Embedded Software Systems

  • This is an essential part of modern electronics devices of all kinds

    • They generally contain custom software which must be very carefully designed and tested

    • This is a difficult task, particularly to do efficiently, and is an ongoing research issue


Technology contributions wireless technology

Technology contributions: Wireless technology

  • Wireless technology is essential to the project in order to:

    • Reduce installation/retrofit costs

    • Enable mobility and flexibility

    • Reduce the obtrusiveness of the technology

  • The project will carry out advanced research in

    • Wireless security

    • Robustness and mobility

    • Device power requirements


Technology contributions sensors computer vision

Technology contributions: Sensors/Computer Vision

  • Computer vision can provide very efficient and effect methods of remote:

    • Therapy

    • Non-invasive monitoring

    • And even diagnosis

  • The challenge of computer vision is to reduce the enourmous amount of information in images to be:

    • Compact enough that it doesn’t require many system resources

    • Sufficient and clear enough to be useful


Technology contributions sensors

ECG plaster

ECG plaster

ECG implant

HEART

MONITOR

Technology contributions: Sensors

  • Required for

    • home safety

    • reporting of sudden health problems

    • feedback for medication planning

  • The project carries out research in

    • Configuration redesign for new packaging dimensions

    • Power consumption

    • New sensing possibilities

    • Design methods


Technology contributions implantable sensors

Technology contributions: Implantable Sensors

biocompatible material

capsule (hermetic layer)

power

S1

Signal

and data

processing

Wireless

link

Wireless

link

Information

processing

and transfer

RF-

link

Readout

electronics

S2

User interface

S3

sensors

antenna

data

antenna

readout device

implant

skin

body

outside


Technology contributions electronic packaging

Technology contributions: Electronic Packaging

  • Present technology using ASIC circuits in standard packaging on printed circuit boards can not provide necessary integration level especially for continuous health monitoring

  • The project will carry out research in new 3D system in package (SiP) technology

    • All components – including the passive ones – are to be packaged into 3D stacked structure

    • Mass manufacturing of SiPs

    • Biocompability of the sensors for health

System Miniaturization and Integration for 3D Stacked SiP by TUT/ELE


Technology contributions software infrastructure architecture

Technology contributions: Software Infrastructure & Architecture

A new robust software infrastructure is needed to support IT systems for elderly people

The project will carry out research in infrastructure/software architecture

  • Support easy installation and updating of software from remote locations

  • Mobile applications, data & sessions

    • home care people and visiting elderly people should be able to carry this stuff around

  • Robustness, security, privacy, safety, accessibility


Technology contributions user interfaces

Technology contributions:User Interfaces

Current technology is too difficult to install and use

  • Elderly people are often resistant to using it

    The project will focus on developing user interfaces that

  • Make it easy to install devices/equipment

  • Make it easy to identify the cause of a breakdown

  • Are trustworthy for elderly people

    • Allow for varying levels of interaction, e.g. for service provider, relative, users own choice


Supporting elder citizens first elaboration

Supporting elder citizens: first elaboration

  • Self-care and preventative efforts

    • People want to be able to take care of themselves and stay in their own home as long as possible

      • Can we design different kinds of technology, which can help elder citizens take the proper medication?

  • Safety and security at home

    • If elder citizens stay in their own homes for more years, they – and their family and friends – need support in order to rightly feel safe and secure

  • Cooperation and services

    • How can computer technology be designed to improve the communication and coordination in the care and treatment?

    • How can it support the elderly in taking on a more active role?


Evaluation societal needs and impact

Evaluation: Societal Needs and Impact

  • Preparatory and on-going analysis of needs, including:

  • Factors affecting technology adoption

  • The short and long term effects of new technologies

  • The contribution of technology to the integration and coordination of care

  • The market level effects to health plan benefit providers

  • The regulatory policies impacting the adoption and diffusion of these new technologies


Sensornet

SensorNet

UC Berkeley/CITRIS

Thomas Hansen

Mike Eklund

Jon Sprinkle

Shankar Sastry

Ruzena Bajcsy


Sensornet objectives

SensorNet Objectives

  • To provide the wireless infrastructure and remote connectivity for ITALH

  • Use largely COTS components

  • Focus on integration, robustness privacy and functionality

  • Provide early prototypes to enable other aspects of the project


Sensornet overview

SensorNet Overview


Privacy and security

Privacy and Security

  • Privacy must be built into these systems from the start

  • Embedded "smart" sensors will reduce the wireless traffic and increase privacy by only sending alerts

  • Live monitoring or access to stored data will be only accessible by authorized and authenticated users

  • Secure wireless, internet and telephone access


Security and privacy embedding

Security and Privacy: Embedding

  • Fundamental to maintaining privacy in the project is the embedding of data processing in the sensors

  • Information will not be streamed over the Internet nor the local wireless network as a rule

    • This reduces bandwidth requirements

    • And (more importantly) maintains privacy

  • Streamed data can be requested, e.g.:

    • Remote check-in via camera

    • Current signal data such as ECG


Security and privacy wireless

Security and Privacy: Wireless

  • Bluetooth has built in (and evolving) security.

    • There are three modes of security for Bluetooth access between two devices.

      • Security Mode 1: non-secure

      • Security Mode 2: service level enforced security

      • Security Mode 3: link level enforced security

  • ZigBee (802.15.4) security includes methods for

    • key establishment,

    • key transport,

    • frame protection, and

    • device management.


Security and privacy internet

Security and Privacy: Internet

  • Collaboration with VTT and their B2C-MED project (with Jaakko Lähteenmäki)


Use of it for health in the home

Use of IT for health in the home

  • Embedded, intelligent sensors as event monitors:

    • Provide private monitoring and alerting

    • Can also enable telemedicine functions

    • Can be used as

      • A personal system

      • Or integrated with a health care provider system

    • Smart sensors can/will be easy to install and operate

    • Will be modular and upgradeable:

      • Learning and/or assimilation technologies that will customize the devices to individuals.


Functions and applications

ECG plaster

ECG plaster

ECG implant

HEART

MONITOR

Functions and Applications

  • Wearable devices

    • Accelerometer-based fall sensors: IVY Project

    • ECG and other bio-monitors: Tampere

    • Connect to fixed and mobile base stations

  • Fixed place monitors

    • Room monitors, vision systems

    • Environmental monitors

  • Identification of functions and devices are part of the development process

  • System development:

    • Robustness

    • Reliability

    • Low power consumption.

  • All these properties are necessary for wide public acceptance.


Current development setup

Current Development Setup

RS232-Bluetooth “Cable Replacers”

Device being deployed

EECS Network (http)

Laptops for emulation of other sensors

Camera phone – Nokia 6670

Communicator – Nokia 9500

Telos Motes


Wireless network bluetooth

Wireless Network: Bluetooth

  • All mobile phones have Bluetooth and Symbian OS

  • Incremental development for other devices:

    • RS-232 to Laptop to Bluetooth

    • RS-232 to Bluetooth

    • Embedded Bluetooth

      Bluegiga devices:


Wireless network zigbee

Wireless Network: Zigbee

  • Fixed base station at home:

    • Easy to set up wireless sensor network

    • Power is an issue, however:

      • Batteries last a long time with newer motes

      • AC adapters can be used in fixed applications

  • Mobile base station on the road issues:

    • no Zigbee connectivity in mobile phones as yet

    • Phones and motes are USB slave devices

    • New phones no longer support RS-232

  • Telos motes


Wireless network capabilities

Wireless Network: Capabilities

  • E.g., Wireless video consultation

    • Uses local Bluetooth, 802.11 network and/or ethernet

    • Monitor sensors, medical devices, etc.


Existing sensors

Existing Sensors

  • Berkeley Fall Detectors

    • 3-axis accelerometers and GPS

    • RS-232 connection

    • 4 hours recording time

    • Collected data with UCB Judo Club

    • About to start collecting data with senior citizens

  • Tampere ECG monitors

    • External sensors

    • Zigbee enabled

  • Telos motes

    • For network development and testing

    • Home and biometric sensors will be incorporated based on evaluation of needs


First sensors the ivy project fall detectors

First Sensors: the IVY Project Fall Detectors

  • Senior Citizens Community in Bay Area

    • Collecting “normal” activity data from elderly residents

    • Accelerometer data and video cameras for truth data

  • UCB Judo Club

    • Collecting “fall” data

  • Algorithms for fall detection to be developed off-line then embedded in sensors

  • Interviews with volunteers will be used to evaluate usability of these and other devices


Two extremes falling and sitting

Two extremes: falling and sitting

Falling (Trained Judo-ist)

Sitting (Septuagenarian)


But what about in between

But what about in-between?

  • False positives

    • Unnecessary alerts, worries

    • At the least very bothersome

  • False negatives

    • Critical problem

  • Solution must be very robust:

    • Good algorithms and devices

    • User interaction

    • Sensor fusion

    • Reliability


Future sensors

Future Sensors

  • Medical sensors

    • Incorporate COTS sensors

    • Tampere developing implantable sensors

  • Vision sensors

    • To detect motion, falls

  • Others

    • Open (and open source) architecture will allow for integration of many other devices

    • Participatory design process will identify novel devices to include


Project implementation

Project Implementation

  • Field work and participatory analysis

  • Collaborative focussing

  • Concept development and initial design

  • Experimental development of prototypes, including:

    • Initial development

    • Explorative use in workshops

    • Continued development

    • Experimental use in real life settings


Project implementation1

Project Implementation

  • First iteration in process:

    • Building wireless network infrastructure to enable device testing and participatory design

    • Test system:

      • Bluetooth and 802.15.4

      • Mobile phones and laptops

      • Fall sensors with the IVY project

    • Field testing of fall sensors:

      • Gather data on fall detection

      • Test wireless network

      • Learn from test subjects about this application and other potential applications


Open test sites

Open test sites

  • Denmark, Aarhus and Copenhagen

    • Homes for elder citizens, e.g. with the municipalities of Aarhus and Copenhagen

    • Hospitals, e.g. Aarhus University Hospital

    • City areas, e.g. Katrinebjerg and Ørestad

  • Finland, Tampere

    • Homes and hospitals,e.g. Pihlajalinna private hospital and health home service provider, City of Parkano, Pirkanmaa Central Hospital Region

  • Bay area

    • Group homes for elder citizens,e.g. Finnish American Heritage Association, Sonoma California

    • Various Bay Area Hospitals


First deployment

First Deployment

  • Finnish American Heritage Association, Sonoma CA: FAHA Manor

  • Will collect “normal” activity data from elderly residents starting this weekend

    • Fall detectors

    • Video cameras for truth data

  • UCB Judo Club data already collected

  • Algorithms for fall detection to be developd off-line then embedded in sensors

  • Interviews with volunteers will be used to evaluate usability of these and other devices


Participatory design process

Participatory Design Process

  • Early prototyping (e.g. with laptops in network) to enable evaluation and identification of improvements and new applications

  • Iterative design

  • On-going consultation with users

    • Patients

    • Health Care Professionals

    • Others involved


Integration into italh

Integration into ITALH

  • SensorNet will be shared with Aarhus and Tampere

  • Devices, sensors, etc will be shared with all for integration and alpha testing

  • Deployments in all locales will take place for beta testing and evaluation

    • Bay Area

    • Denmark

    • Finland

  • Medium- and large-scale testing will follow


The outcome and the future

The Outcome and the Future

  • Lifestyle related diseases such as diabetes, high blood pressure, and heart diseases or various types of prosthesis is dramatically increasing:

    • The demand for long-term physiological measurements and support systems will be excessive

  • Substantial social impact of technology

    • Empowerment of citizens, for example:

      • Home monitoring and treatment enabling people to stay longer at home

  • Market value

    • Experimental research and realization of home and heath services for elderly in three countries provides excellent footing to develop international business in this area.


Project plans

Project Plans

  • Joint project has been developed by the partners:

    • UC Berkeley

    • Tampere University of Technology

    • Aarhus University

  • Provides:

    • An understanding between the partners

    • A baseline proposal for regional use by the partners, e.g.:

      • TUT is using it for proposals to the Finnish funding agencies (Tekes and FinnWell) at the end of this month


Questions

Questions?


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