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Quality of Life – Independent Living Panel facilitator: Eleni Stroulia • Lili Liu “Technologies to support home care services and community living” • Gary Faulkner “Rehabilitation prosthetics”
Research on smart homes Literature review of non-obtrusive technologies to enhance the quality of life and safety of older adults living at home, congregate housing, and assisted living settings.
• Bob Aloisio “Always connected, safe and secure”
Technologies to Support Home Care Services and Community Living Lili Liu, PhD Professor & Chair Department of Occupational Therapy Analytics, Big Data and the Cloud
Funded by Alberta Addiction & Mental Health Research Partnership Program
Computing Science: Eleni Stroulia, Yannis Nikolaidis, Nick Boers, Koosha Golmohamaddi Industrial Design: Robert Lederer, Greig Rasmussen Occupational Therapy: Angela Sekulic, Katie Woo, Ran Ran Zhang Pharmacy: Cheryl Sadowski, Lisa Guirguis Shepherd’s Care Fdn: Corinne Schalm, Suzanne Maisey, Beth Wilkey HSERC: Sharla King Library: Linda Seale Alberta Health Services: Angela Sekulic, Katie Woo Alberta Seniors: Carmen Grabusic
April 23-25, 2012, Edmonton, AB
Outline
1.What research has been done on technologies to support community living (smart homes)? 2.What is the Smart Condo™ project at the University of Alberta? 3.How can technologies support home-care services and community living? (HCA-T Project)
SCOPUS, CINAHL, IEEE Smart home and health; gero(n)technology; telesurveillance or telemonitoring; technology for older adults
Inclusion ≥2000; English, addressing the physical, cognitive, social, or mental health needs of older adults in home or supported living settings
4.Health Care on the Cloud
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Tag clouds of top 200 words in 188 papers selected for review
Target users
Number of papers published each year
Conditions & topics
Articles published/year 2000
4
Dementia Care/Management
2001 2002
2003
2004
40
0 Other Chronic Disease Management
6 3
39
Detecting deviations in health status or activity levels (including fall detection)
36
8
2005
10
2006
10
2007
Vital signs monitoring
20
User perceptions and acceptance of technologies
20
24 Diabetes Management
2008
8
41 Other (privacy and ethical issues, best technologies for aging, design considerations)
2009
2010 (until May)
5
54 13
Environments technologies were designed for
Country of Publication
Main players USA
Great Britain France
18
Canada
13 12
Netherlands
8
Sweden
7
China
6
Finland Germany
3
Greece
3
Japan
3
Singapore
3
Australia
2
Ireland
2
Italy
2
Korea
2
Other
58
21
10
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Type of Research Design
6
28 Pilot and Case Studies
23
RCT Experimental Design Non-RCT Experimental Design Qualitative Mixed Methodology
Play & Connect Rest & Sleep Bathing & Grooming Cooking & Eating
3 20
Summary
Smart Condo™
Technologies can support older adults with complex chronic conditions (arthritis, hypertension, heart disease, cognitive impairment) to stay at home. However challenges need to be addressed: Adaptation Accessibility Usability Privacy Accuracy Unobtrusiveness Social & ethical implications
Smart designs Smart technologies Living lab
Smart Condo™ Project at the U of A • • • • •
2008: mock design of a condo in Telus Centre 2012: Edmonton Clinic Health Academy 30 to 50 students annually (ID, OT, CS & Pharm) Universal Design, visitability Sensors, Test medical devices, e-health software, health management applications, prototype designs
Lili Liu
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How can technologies support home care services and community living?
(Our) Smart Condo technology
Tracks patient in precise, non-intrusive way o
• Sensors to monitor activities, critical incidents (Glenrose ILS) • Medication adherence • Technologies to support health care aides in home care (HCA-T Project)
Why monitor with sensors?
Community care
◦ Clients with chronic conditions staying at home longer ◦ Transition from hospital to rehab to home
Valid assessment of function ◦ Frequent visits are misleading ◦ Cameras are intrusive
Courage Centre (GRH)
Visualizes patient’s activities o
Wireless sensor networks
Virtual world client
Flexible, inexpensive, and effective
Wireless sensors Consist of multiple components: • Sensors (e.g., acceleration, passive-infrared motion, switches, tactile pressure) • Wireless module • Microcontroller (e.g., MSP430: 8 MHz, 2 KB RAM, 48 KB flash) • Radio transceiver (e.g., TR8100: 916.50 MHz, 9.6 kbit/s) • Energy source (e.g., 9 V battery)
Wireless sensor network
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Screenshot (overhead)
Glenrose Independent Living Suite
Other possible views
Medical Assistance Technologies
Alerts Reports/graphs
(Katie Woo)
1. What is the current level of awareness of MATs among older adult’s care providers? 2. Are MATs designed for older adult use?
MATS (active monitoring, feedback)
Virtual world client
Virtual representation of condo space Avatar represents patient Avatar directed by control mechanism to move between co-ordinates in virtual condo ◦ Path planning algorithm used to avoid obstacles
Other smart objects embedded in virtual space, manipulated by similar control mechanism
Major Findings Survey Study • Medication adherence issues common • over 50% encounter issues frequently • Patient or caregiver self-report most frequently used • Blister packs most recommended • MATs awareness (25%) and usage (6%) low • No significant relationships found in demographics • High interest or belief MATs could be useful (82%)
3 0
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Methods
Katie Woo
Client Trials (June – October 2011)
Technology Acceptance Model: Participant #1 and MATs
• MATs product trial with in-patients • 2 day trials, Independent Living Suite • Commercially available product • Observations, interviews, product data and evaluations Results • 2 participants • 4 team surveys completed, 2 interviews, investigator observations, 2 sets of product data
3 1
Adapted from “The Technology Acceptance Model: its past and its future in healthcare by R.J. Holden and B.T. Karsh, 2010, Journal of Biomedical Informatics, 43,1, p. 161.
3 4
Medical Adherence MedSignals®
Technology Acceptance Model: Participant #2 and MATs
Adapted from “The Technology Acceptance Model: its past and its future in healthcare by R.J. Holden and B.T. Karsh, 2010, Journal of Biomedical Informatics, 43,1, p. 161.
3 5
Systems approach
Katie Woo Technology Acceptance Model: Health care providers and MATs
Adapted from “The Technology Acceptance Model: its past and its future in healthcare by R.J. Holden and B.T. Karsh, 2010, Journal of Biomedical Informatics, 43,1, p. 161.
3 3
3 6
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Health Care Aides & Technology • Alberta Health & Wellness • Five Home Care Zones • Apps for multiplatform mobile devices • Recruitment, Retention & Recognition
HCA-T Project • • • • • •
Workflow Safety (GPS) (e.g., SafeTracks) Communication Documentation Remote authorization Etc.
Summary 1. Research on technologies - home care, assistive living and continuing care; users are clients, family and caregivers; applied to chronic conditions – dementia, diabetes, activities monitoring.
Summary 2. Examples such as the U of A’s Smart Condo™ Project emphasize the importance of interdisciplinary training, research and industrial partnerships.
Summary 3. A systems approach is needed to introduce and sustain technologies targeted at clients, families and home care or community service providers.
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Health Care – the killer app on the Cloud
To support patients to live independently longer
To enable care givers to make more informed decisions about client care We need To collect data; to fuse data from different sources; to decide on actions This is what we hope cloud to do for us
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