Presentation given within the 2nd International Symposium on Ambient Intelligence ISAmI 2011, April 6-8 2011 for the paper entitled "Mobile Personal Health Systems for Patient Self-management: On Pervasive Information Logging and Sharing within Social Networks". The paper is published in AMBIENT INTELLIGENCE -SOFTWARE AND APPLICATIONS, Advances in Intelligent and Soft Computing, Springer 2011, Volume 92/2011, 141-148, DOI: 10.1007/978-3-642-19937-0_18 and was given the conference BEST PAPER AWARD. ---------------------------------------------------------------------- Abstract: Patient self-management is often considered as an important prerequisite towards effective healthcare. This viewpoint has recently been demonstrated by the introduction and adoption of approaches and tools, such as the Personal Health Record (PHR). In the current work, the design of a mobile personal health system for logging information corresponding to the patient status and sharing it within social networks is presented. By utilizing event-driven patterns, the pervasive sharing of the recorded information is enabled, under conditions specified by the mobile user. This “anytime-anywhere” information sharing may be valuable to senders (i.e. patients) and receivers (e.g. relatives, healthcare professionals, similar patients, etc.) in terms of emotional support, mutual understanding, sharing of experiences, seeking of advice and improved self-tracking. A prototype is implemented on a mobile device illustrating the feasibility and applicability of the presented work by adopting unobtrusive health monitoring with a wearable multisensing device, a Service Oriented Architecture (SOA) for handling communication issues, and popular micro-blogging services.

1. Mobile Personal Health Systems for Patient
Self-management: On Pervasive Information
Logging and Sharing within Social Networks
A.K. Triantafyllidis, V.G. Koutkias, I. Chouvarda, and
N. Maglaveras
Lab of Medical Informatics
Faculty of Medicine, Aristotle University of Thessaloniki
Thessaloniki, Greece
atriant@med.auth.gr

2. Presentation Outline
• Background:
– Personal Health Systems
– Patient Self-management
– Social Networks
– Pervasive Monitoring Systems
• Scope of the Current Work
• Proposed System:
– Information Dimensions & Sharing
– System Architecture
– Micro-blogging Services
• Results:
– Prototype Implementation - Technical Feasibility
• Discussion and Future Work
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

3. Personal Health Systems
• Personal Health Information Management towards Wellness
• Pervasive Health Monitoring: Anytime, Anywhere, Unobtrusive
Pervasive Health Monitoring
Instruments & Situations
Activity Respiration
Posture ECG Temperature
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

4. Patient Self-management: Rationale
Rationale (K.R. Lorig, 2003#): “Whether one is engaging in
a health promoting activity such as exercise or is living
with a chronic disease such as asthma, he or she is
responsible for day-to-day management.”
#K.R. Lorig and H.R. Holman, “Self-management education: History, definition, outcomes,
and mechanisms”, Ann Behav Med., vol. 26, no. 1, pp. 1-7, 2003.
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

5. Patient Self-management : Benefits
Enhancement of communication with doctors
Focus on treatment plan, adherence
Self-efficacy
Confidence to carry out a behavior/lifestyle necessary to
reach a desired goal
Well-being better management
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

6. Patient Social Networks
– Quantitative self-tracking
– Sharing of health information
– Purpose: emotional support, exchange of experiences
and ideas, education, improved self-tracking
– Example Patient Online Community: PatientsLikeME
Critical Requirement: Patient Willingness to Share
Health Data
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

7. Pervasive Monitoring Environments
Problems encountered in Health Information
Management by patients
– Integration with health monitoring infrastructures still in
its infancy
– Variable Context (Time – Location – Activity –
Situation)
– Limited patient involvement and user-to-system
interactions with respect to generation and pervasive
sharing of information about health status
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

8. Approach: An environment for logging and event-
driven sharing of health information towards
effective (in terms of “anytime-anywhere”) and
collaborative disease management
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9. Target Users & Functionality
• Mobile Personal Health Management System targeted
at Chronic Patients who:
– Use Portable Health Monitoring Systems
– Are highly aware of their disease
– Wish to engage more actively in their disease management
• Functional Attributes:
– Acquisition of sensor data and alert reporting
– Patient self-reporting
– Event-driven sharing of health status with networked
community according to patient needs and preferences
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

10. Personal Health Information: Dimensions &
Sharing
• Vital Sign Measurements & Alerts
– Heart rate, respiratory rate, skin temperature, activity, etc
– Event-driven alerts/recommendations according to the
configuration of personalized monitoring schemas
• Health Problems/Symptoms
– Dizziness, chest pain, shortness of breath, stress, etc
• Patient Situation
– Shopping, driving, working, exercising, resting, etc
• Time and Location
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

11. Personal Health Information: Dimensions &
Sharing
Subjective information Objective information
(i.e. patient provided ) (i.e. patient sensor measurements )
Detailed view of patient health status
Visualization Capabilities Sharing Capabilities
– Discovery of – Manual
patterns – Event-driven
– Self-tracking 1. Configuration of health
dimensions according to
preferences/needs
2. Selection of receivers
3. Instant & Continuous mode of
information dissemination
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

12. System Architecture
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

13. Micro-blogging Services
• Typical functionality: Free text messages of small size
are sent to selected receivers
– Example Micro-blogging platform: Twitter
• Size of message 140 characters
• URLS used as links to additional information
• Use of labels (# before a word) to ease the message discovery
– Message Sharing
• Dynamic construction of messages according to conditional
patterns defined by the patient
• Currently applied in the form of if-then-else rules
• Use of special characters (e.g. *) character, in order to
distinguish the terms provided within system
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

14. Examples of Use
View of the recorded health
Conditions which trigger
conditions in the user’s
status sharing
mobile PHR
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

15. Examples of Use
Message (sent from user
Selected recipients of the “spapageo”) shown to the recipient
shared status (via a twitter client application)
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

16. Prototype Implementation
MBU System Back-end
• J2ME-CLDC (Java 2 Micro Edition- • Apache Tomcat
Connected Limited Device – Web application container
Configuration)
– Open platform for mobile applications
• Apache Axis2
– Underlying SOAP engine
• JSR-172 Web Services (Java
Specifications Request)
– API for Web Service clients
• Twitter API
– Based on REST
– Security: HTTP Basic Authentication
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Personal Health Systems for Patient Self-management:
Integration in Pervasive Monitoring Environments

17. Prototype Implementation
Zephyr BioHarness BT
• Physiological monitoring system
incorporating sensors into a strap
– can be worn virtually in any environment
• Heart Rate, ECG, Breathing Rate,
Skin Temperature, Activity & Posture
measurements
• Bluetooth communication
– SDK available
– API based on request-response
messages
– Support of streaming, periodical, or
threshold data
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18. Discussion: Future Work
• Extensive Evaluation:
– Patient acceptance
– Medical perspective
– Privacy policies
• Elaborate on a generic methodology integrating:
– Patient preferences and observations
– Handling of context parameters, e.g. location, activity, etc.
– Behavioral monitoring based on user-to-system interactions
– Collaborative filtering of information
– Pattern discovery
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Mobile Personal Health Systems for Patient Self-management: On
Pervasive Information Logging and Sharing within Social Networks

19. Thank you!!!
Mobile Personal Health Systems for Patient
Self-management: On Pervasive Information
Logging and Sharing within Social Networks
The research leading to these results has received funding from the Ambient Assisted
Living (AAL) Joint Programme under Grant Agreement n° AAL-2008-1-147 – the
REMOTE project (http://www.remote-project.eu/).
A.K. Triantafyllidis, V.G. Koutkias, I. Chouvarda, and
N. Maglaveras
Lab of Medical Informatics
Faculty of Medicine, Aristotle University of Thessaloniki
Thessaloniki, Greece
atriant@med.auth.gr