The Anatomy of Home Healthcare System: A Review Tam Van Nguyen and Deokjai Choi Department of Computer Engineering, Chonnam National University Email: [email protected], [email protected] ABSTRACT Home healthcare system is coming under increasing pressure to improve the quality of care delivered to homeowners through effective prevention and post-operative care. The system tracks and monitors the health status daily. There is a legitimate need to curtail growth in health care spending fueled by aging populations, and the prevalence of fatal diseases such as obesity, diabetes, cancer and chronic heart and lung diseases. This paper addresses the anatomy of a home health care system by describing the components along with the latest research works in the field.

Keyword: home healthcare system, ubiquitous computing, mobile computing, elderly healthcare

In smart home which seems to get popular nowadays,

I. INTRODUCTION

home healthcare system is coming under increasing Ubiquitous computing is considered as the next generation of IT technology which has great potential for many applications such as pervasive healthcare, smart automotive, smart home, intelligent education, intelligent work environment, seamless traveler service, pervasive mobile commerce, etc. Its "anytime, anywhere and humancentered" fashion makes it a perfect technology for healthcare

applications.

Along

with

today's

fast

development of network and computer technology as well as the recent work on pervasive computing, Mark Weiser's vision of pervasive/ubiquitous computing [1] is coming true gradually.

pressure to improve the quality of care delivered to homeowners through effective prevention and postoperative care. There have been many studies about home healthcare monitoring and system based on ubiquitous computing technologies. In this study, each device which measured physiological signals was developed and the signals

were

transmitted

to

medical

center

with

communication technologies. The measured signals are transmitted via the home gateway and home server, and finally transmitted to home healthcare center which is managed with the telecommunication service corporation. The specialist in the medical center could monitor through internet and give feedback to home server. However, there

are some devices in home, and they are not located at same

to the progressively reduced degree of autonomy. This

place. For example, if one member at home tends to

paper addresses the anatomy of a home healthcare system

measure his blood pressure, he should go to the location of

by describes the components along with the latest research

blood pressure monitors. Likewise, if he wants to measure

in the field.

the body temperature, he should find the thermometer.

The rest of this paper is as follows. We begin with a

Therefore, it is necessary to develop the integrated module

general introduction to context awareness - what it means,

which can measure many physiological signals. Also, they

what are the design goals and what are the devices and

are hard to operate because there are many buttons and

approaches present in research that can aid this building

complicated. Thus, for ubiquitous home healthcare, it is

process in section II, section III, section IV, respectively.

served the people who are not specialist in medical care.

We present the components’ structures, and an analysis of

Figure 1 shows the overview of the system for ubiquitous

their capabilities and weaknesses. Also, in Section V, we

home healthcare.

mention

the

elderly healthcare

issue.

Finally,

the

conclusion will be given in Section VI.

Ⅱ. CONTEXT AWARE

Context [3] is any information that can be used to characterize the situation of an entity. An environment which has been built or embedded intelligent system is certainly possible to support context-aware computing. Context-aware computing not only encompasses a variety of elements from different disciplines but also is necessary Figure 1. The overview of the home healthcare system

to make assessment in many aspects [4]. Chen et al . [5]

Another issue in home healthcare is the elderly care.

proposed an agent-oriented infrastructure to support

Since the aging problem is becoming an increasingly

pervasive context-aware systems in smart environments.

important social issue as elderly people are taking up an

SOCAM [6] also utilized Ontology technique to build rapid

increasingly high percentage of the world as well as Korean

prototype of context-aware services. There exist various

populations. According to the data provided by Korea

methods which will be described in the later part to obtain

Statistics [2], the nosedive in the birth rate and the rapid

the context from the environment.

growth of the elderly, however, raised Korea's senior

The goal of a context aware framework is to achieve

citizen population from eight percent in 1055 to 55 percent

the autonomous behavior in software using context

in 2007. This group requires special care and vigilance due

information. Context aware convert the raw data collected

from the environment into the query-able data like ontology.

with information from the base station which receives an

The context-aware middleware plays the intermediate layer

alarm. Battery life is the main essential problem in the

between hardware and software. Figure 2 depicts the

sensors. The vendor claim a coin battery can use over seven

operation of one common context-aware system.

years in an active tag, but the duration actually depends on the frequency and data size transmitted. To prolong the battery life, we adopt specific rules that the sensors should be turned on for measurement rather than monitoring continuously. Especially when the elderly is alone, like staying at a restroom, park or garden, where there are no caregivers or other elderly people in the neighborhood, for it would be not easy to know and aid at once to save the elderly. In such circumstances, the sensor will be triggered by the reader to start continuous measuring temp, pulse rate, SpO2, ECG, and monitoring their location.

Figure 2. The common context-aware system

III. HEALTH MONITORING

There exist a large number of devices to obtain the context from the environment and monitor the health. The most common used devices are bio-sensors. A bio-sensor contains electronic sensing devices which output electronic signal, a process unit which partially processes digitalized data and transmits required data, and a communication unit to communicate. Its transmission frequency and distance are major issues related to the battery life limitation. The collected data could be used to detect accidents of an

Figure 3. List of sensors. (a): environmental sensor, (b): a wrist type sensor system, (c): a chest belt type sensor system.

elderly such as a fall or fainting [7] or stored for a period of

In RFID approach [9], to locate a tag in a region, we

time to be analyzed [8]. Each people takes a small and light

could install a number of readers at known locations. The

weight sensor, if a fall occurred in the garden or in a private

whole area is divided into a number of sub-regions, where

zone such as restroom, the system can locate the people

each sub-region can be uniquely identified by the subset of

readers. Given an RFID tag, based on the subset of readers

assessing post-operative care and body reaction to complex

that can detect it, we should be able to associate that tag

therapeutic drug regimes. Ubiquitous healthcare systems

with a known sub-region. Figure 3 shows the list of sensors;

will monitor users as they maintain their normal everyday

consist of environmental sensor and two types of bio-sensor,

activities, in order to warn the patients or healthcare

wrist type and chest belt type.

workers of problems as well as collecting data for trend

The deployment of these devices varies from research

analysis and medical research. The integration of body

groups to the others. MIT developed Environmental

sensors with home environment sensors can also be used

Sensors [10]. Their laboratory, PlaceLab, has set up

for monitoring of the elderly to determine state of well-

currently 125 wireless object movement sensors on objects

being and warn family or social care workers of potential

such as chairs, tables, appliances, brooms, remote controls,

problems related to physical fitness, social activity and

large containers, and other objects people may manipulate.

cognitive engagement.

The installation of the sensors is simple. Just stick the

Similarly, the Smart-Its, a project in the research

sensor to the surface of the object with sticky material

program of The Disappearing Computer Project, envisions

(such as putty) and forget about it. The installation takes

small-scale smart devices - "Smart-Its" - that can be

between 5-60 seconds. The temperature and light sensors

attached to mundane everyday artefacts [12] to augment

have also the same form factor that is a little bigger than an

these with a "digital self". These devices will be as cheap,

American quarter coin. We call these sensors MITes: MIT

as unobtrusive and as generic as state-of-the-art smart

Environmental Sensors. These are a flexible kit of wireless

labels (i.e., RFID tags). In addition these devices will be

sensing devices for pervasive computing research in natural

enabled with perception of their environment, with peer-to-

settings. The sensors have been optimized for ease of use,

peer communication, and with customizable behaviour.

ease of installation, affordability, and robustness to

Collections of such devices will be used to augment and

environmental conditions in complex spaces such as homes.

interconnect entire families of artefacts, such as scattered

The kit includes six environmental sensors: movement,

personal belongings, toys in the playroom, and objects in

movement

collaborative interactive experiences.

tuned

for

object-usage-detection,

light,

temperature, proximity, and current sensing in electric appliances.

IV. COMMUNICATION

Another method used to collecting context is to attach the bio-sensor to the body, which is considered in mobility.

Communication is the very crucial part of a home

Morris Sloman proposed the mechanism [11] with

healthcare system. Without the communication, the system

miniaturized implantable and on-body wireless bio-

is like the oasis with no connection to outside. Whenever

sensorswhich will reshape common practice in clinical

the system detects the anomaly, the homeowner is able to

medicine especially for the prevention of terminal illness,

be warned by the direct warning at home or SMS. In

monitoring the progression of chronic disease, and

addition, the information of home members’ health statuses

is also sent to the family doctor. The diagnostics result

considerably high. In order to further reduce the waste of

from the doctor is transmitted in the reverse way.

medical resources and achieve real-time care service, the

In the last 5 years, the advancement of mobile

concept of tele-care emerges by integrating the information

computing facilitates the information transmission. The

and communication technologies [14], [15]. Therefore, it is

Internet mobile applications can be built in the cellular

an inevitable trend to create an appropriate home healthcare

phone based on the framework such as WAP and WIPI.

service by making use of tele-care.

WIPI (Wireless Internet Platform for Interoperability) [13]

A typical scenario can be described as follows. "An

is a middleware platform that allows mobile phones,

elderly could carry a small, wearable lightweight module

regardless of manufacturer or carrier, to run Internet

which contains three basic sensing functions: pulse rate,

applications. In particular, WIPI is a dominant framework

blood oxygen saturation and temperature. Within the

which is built and used in Korea, one of the most developed

module a process unit partially process bio-signal data and

mobile application countries. The voice and image included

saves them to a flash memory, then an active RFID tag

in the message increase the richness of the information.

identify and transmit them to the nearby base station. The

Integration of patient monitoring and clinical systems to

caregivers carry the passive RFID and could be identified

Wireless Telephone in a hospital or assisted living

and located via specific base stations to reveal their

environment dramatically improves staff efficiency and

locations. RFID readers could be placed indoor such as

home member satisfaction at the same time. Also, the

walls, and be placed outdoor such as lamps in the garden.

versatility of the information expresses in other sort of

Readers in the garden send data to the server through the

messages such as, remind to do health behavior, keep on

802.11b wireless network to the base station located at the

routine, give health info on demand, and so on.

windows outside of the building". Figure 4 depicts the scenario for the elderly care.

V. ELDERLY NURSING

Along with the approaching of aging society, the most important issue is the long-term home healthcare service for senior citizens. The probability that a senior citizen suffers from a chronic disease is relatively high, and due to diseases, a chronic patient may be unable to look after oneself in daily life, or patient’s conditions must be observed for a long term. Under such situations, the required medical care or patient’s condition monitoring must be provided through professional medical personnels so that the consumed manpower and social cost will be

Figure 4. Elderly monitoring

Through the healthcare system, we can record the

VI. CONCLUSION

daily activities of an elderly, such as times to gets up, have meals and go to exercise. In conjunction with calorie intake

This paper describes the structure of the home

and consumption records calculated by restaurant e-order

healthcare system based on the analysis of the components.

menu and exercise e-diary, then we can evaluate the health

A vast number of techniques have been proposed to address

function and nutrition status. By interpretation of the

this problem, and the purpose of this paper is to classify

monitored vital sign, the healthcare professionals can

and review these approaches and to point out promising

prescribe the appropriate activities for the elderly and keep

directions for future research. This paper is the useful initial

on monitoring and evaluating the progress of the elderly.

step for the system which has not been developed into a

On the other hand, via the analysis of the location tracking

real application product yet. We offer our approach to

records, we can also evaluate the social interaction with

analyze the system to help researchers make better choices

others and early detect the abnormal mental condition,

for the techniques they use in building home healthcare

therefore, the whole team of caregivers can figure out best

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