Digital plaster for personalized healthcare

An Ultra Low Power Intelligent Sensor Interface and Transceiver Platform has been developed by Toumaz. The BAN platform has a variety of sensors embedded in a plaster facilitating a wireless infrastructure
for intelligent, non-intrusive continuous monitoring,
to deliver a new wave
of lifestyle-compatible, personalised care applications – with
the potential to transform the treatment and management
of chronic diseases for millions of people.

By providing the complete infrastructure for an end-to-end telemedicine
system, this new integrated platform has the potential to revolutionise
the architecture of healthcare information systems, providing a unique
platform for analysis and decision-making based on real-time data.

Google Earth for the body

IBM has published this interesting application in their pressroom. This type of application with a graphical representation of the patients' body migt turn out as a very useful interface to EPR's not only for physicans. Especially interesting would be to give patients access to their own avatar and use this system in a Personal Health Record application.

ZURICH, SWITZERLAND 26 Sep 2007: IBM researchers today unveiled a prototype visualization software that allows doctors to interact with medical data the same way they interact with their patients: by looking at the human body.
Created at IBM's Zurich Research Lab, the technology uses an avatar -- a 3D representation of the human body -- to allow doctors to visualize patient medical records in an entirely new way. Called the Anatomic and Symbolic Mapper Engine (ASME), this innovative visualization method allows a doctor to click with the computer mouse on a particular part of the avatar "body" to trigger a search of
medical records to retrieve relevant information.
"It's like Google Earth for the body," said IBM Researcher Andre Elisseeff, who leads the healthcare projects at IBM's Zurich lab. "In hopes of speeding the move toward electronic healthcare records, we've tried to make information easily accessible for healthcare providers by combining medical data with visual representation, making it as simple as possible to interact with data that can improve patient care."

Sophisticated Web 2.0 application 2

A scenario in the uHealth setting might be the connection of the individual's wireless sensor data with knowledgebases and medical expert applications for clinical decision support. The Visual Medical Dictionary is an online dictionary. It goes beyond regular dictionaries by displaying an ontology context tree (MeSH based) and interactive network graph of related drugs, diseases and therapies. For example: a search for "psoriasis" will show a strong relationship with "Cyclosporine" and "Phototherapy" among other drugs and therapies. The providers of the service, Cure Hunter, also offer a Medline based Research Interface. The CureHunter Discovery Engine is the world's only fully unified and integrated numeric index of all known drugs, biologically active agents, diseases and empirical statements of all effective clinical outcomes published in the United States National Library of Medicine.

Sophisticated Web 2.0 application 1

PubGene  represents a new generation of fabulous applications developed to extrapolate information from the overwhelming amount of information pertaining to genomics and proteomics. Althoug currently not related to uHealth directly, this type of applications might at some point be related to data from the individual and utilized to provide information for research and further development of clinical decsision support in an uHealth setting?

The company webpage provides the following information:
PubGene is a new public service that  includes advanced biosearch tools, and a easy to use entry point to search for qualified PubGene gene and protein knowledge using Google and PubMed. Some of the features includes Sequence Homology - PARALIGN to perform Smith-Waterman accuracy sequence searches at BLAST speed, relating your biological sequences to their literature associations. A Network Browser - connecting genes to each other and to relevant keywords -including the functionality to query across 21 genomes combined.
PubGene provides up to date information on gene and protein relationships from the literature. It finds gene and protein relationships from your gene expression experiments. the application map mutations to genes, proteins, diseases, or processes, It integrates your confidential gene expression data and text databases. The user can design better array chips with up-to-date genetic information. The user can get pointers to pathway information and other metadata for your gene and protein clusters. The user can build sequence homology networks and relate them to literature, and more than 25,000 000 associations mapped to date.

Swarm Intelligence and Swarm Robotics in uHealth?

Swarm Intelligence (SI) is defined as "-the property of a system whereby the collective behaviours of (unsophisticated) agents interacting locally with their environment cause coherent functional global patterns to emerge. SI provides a basis with which it is possible to explore collective (or distributed) problem solving without centralized control or the provision of a global model. (ref;http://staff.washington.edu/paymana/swarm/)". The Wikipedia definition is: "Swarm intelligence (SI) is an artificial intelligence technique based around the study of collective behavior in decentralized, self-organized systems.
A relevant link here goes to Swarm robotics defined in Wikipedia as "- a new approach to the coordination of multirobot systems which consist of large numbers of relatively simple physical robots. The goal of this approach is to study the design of robots (both their physical body and their controlling behaviors) such that a desired collective behavior emerges from the inter-robot interactions and the interactions of the robots with the environment, inspired but not limited by the emergent behavior observed in social insects, called swarm intelligence. It has been discovered that a set of relatively primitive individual behaviors enhanced with communication will produce a large set of complex swarm behaviors."
The Wikipedia article on swarm robotics continues;
"Unlike distributed robotic systems in general, swarm robotics emphasizes a large number of robots, and promotes scalability, for instance, by using only local communication. Local communication is usually achieved by wireless transmission systems, using radio frequency or infrared communication.
Potential application for swarm robotics include tasks that demand for extreme miniaturization (nanorobotics, microbotics), on the one hand, as for instance distributed sensing tasks in micromachinery or the human body."
Swarm intelligence and swarm robotics  represents an interesting perspective to large scale ubiquitous/uHealth sensor networks applied in healthcare. The need for some kind of swarm intelligence is obvious with use of large numbers of sensors (ambient of BAN-type) and the need for systems for valuable data extraction from distributed sensors like motes or Sun Spots. Some level of problem solving capabilities are likely to be needed for handling of data streams. Both Tmote Sky motes and Sun SPOTS can be manually programmed "on the fly", passing updates from unit to unit in an epidemic manner. 

Sun SPOT- networked tiny computational systems on Sun's platform

Sun SPOT is a networked tiny computational system running on the IEEE 802.15.4.  2.4 GHz ISM radio frequency. The Sun SPOT technology operates on Java platform top to bottom. It provides the ability to run wireless transducer applications "on the metal"(directly on the CPU), saving overhead and improving performance. "SPOTworld" simplifies development by providing a single tool for programming, configuring, managing and monitoring Sun SPOT devices without any OS (operating system). The system handles strong security and has large scalability potential .
A jaw-droppingly cool "migratable application" functionality enables applications (with their complete state information) to be dragged from one Sun SPOT device to another while they're still running.
Sun SPOT is currently commercially available in the US only.
It will be interesting to follow developments of future healtcare applications based on the Sun SPOT platform. Read a Sun SPOT fact sheet.

Ubiquitous? pervasive? spime? - what's in a word?

What's the difference between 'ubiquitous computing' and 'pervasive computing'? Is there a difference? Does it matter?

I was reading an article on 'Effects of Pervasive Computing on Sustainable Development' ( >>> ) that began with the words 'Since pervasive computing is expected to become ubiquitous in the coming years ...' It set me off thinking about previous discussions of the differences between the terms, so I did a bit of Googling and Wikipedia'ing and came up with:

"Pervasive Computing" is: Shorthand for the strongly emerging trend toward:
* Numerous, casually accessible, often invisible computing devices
* Frequently mobile or imbedded in the environment
* Connected to an increasingly ubiquitous network structure
The aim is for easier computing, more available everywhere it's needed
(NIST Pervasive Computing Conference 2000 - http://www.nist.gov/pc2000/)

"Ubiquitous computing is a post-desktop model of human-computer interaction in which information processing has been thoroughly integrated into everyday objects and activities ... someone "using" ubiquitous computing engages many computational devices and systems simultaneously, in the course of ordinary activities, and may not necessarily even be aware that they are doing so.
(Wikipedia entry for 'Pervasive Computing' - http://en.wikipedia.org/wiki/Pervasive_Computing)

Dictionary definitions are not much more help:
ubiquitous - adj : being present everywhere at once;
pervasive - adj : spread throughout;

And finally - the IEEE Pervasive Computing Journal (www.computer.org/portal/site/pervasive//) describes itself as 'A catalyst for advancing research and practice in mobile and ubiquitous computing' (sic).

So, they seem to be somewhat interchangeable.

And 'spime'? - that's a word made up by writer Bruce Sterling for a "currently-theoretical object that can be tracked through space and time throughout the lifetime of the object ... spimes as coming through the convergence of six emerging technologies, related to both the manufacturing process for consumer goods, and through identification and location technologies.

These six facets of spimes are:
1. Small, inexpensive means of remotely and uniquely identifying objects over short ranges; in other words, radio-frequency identification.
2. A mechanism to precisely locate something on Earth, such as a global-positioning system.
3. A way to mine large amounts of data for things that match some given criteria, like internet search engines.
4. Tools to virtually construct nearly any kind of object; computer-aided design.
5. Ways to rapidly prototype virtual objects into real ones. Sophisticated, automated fabrication of a specification for an object, through “three-dimensional printers.”
6. “Cradle-to-cradle” life-spans for objects. Cheap, effective recycling.
(http://en.wikipedia.org/wiki/Spime)

Ubiquitous (or pervasive?) computing could be a way for spimes to be developed and used - it would be interesting to think about potential health applications.

Low-cost wireless vital sign monitoring project

A post on the SINI2007 blog ( >>> ) reports a project to develop low-cost wireless vital sign monitors that operate on TinyOS and mote platforms. The issue to note is that this is project being done by graduate and high school students!! - they are using physical parameter monitors and a wireless ad-hoc mesh network. They have already done some trials and are seeking clinical trial partners for additional pilots.

Assistive technology projects report

According to a recent report in 'E-health Insider Primary Care', almost '100 research projects on assistive technology including telecare and telehealth schemes were funded by the [UK] government or the European Union in 2006/7, according to a report from the Department of Health (DH). ( >>> )

The full Department of Health report is available ( >>> [820kb pdf file] ) Among projects mentioned are AMUSE (Autonomic management of Ubiquitous e-Health systems), which uses body sensors and wireless.

Wibree Forum Merges with Bluetooth SIG

Announcement from Bluetooth.com;
The Bluetooth SIG, together with Nokia, announced that the Wibree Forum, the group specifying the Nokia-developed ultra low power wireless technology, will be merged with the Bluetooth SIG.
The merger will create an ultra low power Bluetooth specification and strengthen the technology’s ability to provide wireless connectivity for devices with very low battery capacity.
Healthcare;
Monitoring equipment and sensors can send vital health-related data such as blood pressure and glucose level to a mobile phone or a PC. The data can be stored and processed and alerts can be sent to the mobile phones of patients and caretakers.

Workshop on ubiquitous healthcare

A workshop on ubiquitous healthcare, sponsored by HealthAgents, an EU funded project, will take place on 12 November in Busan, South Korea. The event coincides with the Sixth International Semantic Web Conference.

Participants will discuss using semantic web technologies for the creation of ubiquitous healthcare - an emerging paradigm that is gradually reshaping the old 'patient-seeing-doctor' scenario into one in which health services and information become just 'one-click' away.

For more information, please visit: http://www.healthagents.net/

Technology wonder 2: Pearl-the NurseBot-a very impressive young woman

Carnegie Mellon News: brings the following update from the Medical Robotics and Information Technology Center (MERIT):
"Medical robotics combines what humans do well with what machines do well",
" Pearl the Nursebot, an interactive mobile robot that assists the elderly."
Pearl was developed by a team led by Sebastian Thrun of Carnegie Mellon's Center for Automated Learning and Discovery.
"Pearl is a very impressive young woman" Specter said.
"What she can do is remarkable"
"What is being done here is enormously impressive" Specter said.
"This is a community on the move, and high technology is a big factor. I like what I see. I pledge my support for your future achievements"
DiGioia said "these "tools" will reduce medical errors and improve patient outcomes"

Are we a little bit optimistic and slightly jumping to conclusions here? -says UHealth Blog. And what is next from these gentlemen, -a handsome DocBot?

Technology wonder 1: SecNurse

The Dutch company Secumatic claims that "the WeSpot SecNurse is the first sensor for care applications that offers comfort to the staff and more privacy to the patient."
Is this "care" device replacing observations from healthcare professionals, and does it have anything to do with nursing? What about patient integrity and confidentiality? Would I like to put this device in my bedroom when I get old myself- to have someone rushing into my room if I spend a little more time out of bed on something than planned?

Anyway, the SecNurse is an example of an ambient sensor implementation- placed in the patient's surroundings. To me this seems more like a straight forward surveillance system with very limited value. Is it smart enough to be a killer application? Is technology in itself valued too much in this case?

What is uHealth?

What is uHealth (or u-health)? - well, if you try to look around the web, it doesn't seem to exist. There is not much on search engines (apart from this blog climbing rapidly to the top of a Google search) and it does not have a page in Wikipedia.

A wider search including 'ubiquitous health' or healthcare starts to throw up a few more hits, but many lead to dead links. So, it seems to be a term that people have started to use, but haven't taken things much further than that.

It was mentioned in 2006 in the Opening Keynote speech at the NI2006 Congress (see our blog post at http://differance-engine.net/ni2006blog/?p=22) and generated quite a lot of discussion at the conference and the subsequent Post Congress Conference (proceedings forthcoming).

Dr. Unna Huh, President of the Information and Communications University, Korea spoke on "U-Korea: ubiquitous technology and health care" and covered 4 areas - the changing world of knowledge and IT; e-Korea; u-Korea; and u-health. The Korean Government, it was said, has instituted the u-health (ubiquitous health) services project to provide healthcare services to rural areas through electronic networks.

So, what is uHealth? - we will post here some ideas taken from the NI2006 Post Congress Conference discussions as a start to discussing the ideas more widely.

Blog Carnivals season is closing up

Health Informatics 2.0 is an experiment in blog carnivals around health informatics, Web 2.0, and anything related.here in July 2007. It will be available on 22 July - submission deadline to be considered for inclusion is noon UK time on Saturday 21 July.

Please send all submissions via the blogcarnival.com website at: http://blogcarnival.com/bc/submit_1960.html - or if having problems, to hi.blogs[at]gmail.com

CHIRAD Blog

The CHIRAD blog is a blog for and about CHIRAD (Centre for Health Informatics Research and Development).

SINI2007

Peter Murray has created Blogging SINI2007, at University of Maryland, Baltimore - July 2007. A blog developed by Peter Murray and other members of the hi-blogs.info team, to provide interactive discussion of, and participation in, SINI2007, the Summer Institute in Nursing Informatics from the University of Maryland Baltimore School of Nursing.

Informaticopia

Rod Ward from UK hosts Informaticopia-and describes the Blog like this: "Eclectic news and views on health informatics and elearning, by Rod Ward & colleagues. UK bias but worldwide coverage. If you want to join the membership so that you can post comments - just let me know" rod@rodspace.co.uk

DeltaDigital's new uHealth Blog operational

uHealth is becoming more and more important and is changing from a buzzword to a real concept. The u stands for ubiquitous, defined in Wikipedia as "...Omnipresence is the ability to be present in every place at any, and/or every, time; unbounded or universal presence. It is related to the concept of ubiquity, the ability to be everywhere at a certain point in time".
But what is it all about related to clinical practice?

More information to come here about research on clinical use of sensors in body area network scrutinizing the IEEE 802.15.4 standard.
Other actual radio standards are Bluetooth, WiBree (when available), ZigBee stack radios and UWB-IR.
An example of ongoing research can be found at bwsn.net

My approach to uHealth is to look at not only the technological aspects, but how uHealth tools can be implemented in clinical settings to improve care and include the perspective of nurses, physicians and patients.
Karl
DeltaDigital