Presentation given in the 2nd International Conference on Wireless Mobile Communication and Healthcare, Kos Island, Greece, October 2011 Paper available at: WIRELESS MOBILE COMMUNICATION AND HEALTHCARE Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering, 2012, Volume 83, Part 12, 416-422 The importance of patients’ active participation in healthcare delivery and disease management has been highlighted in various studies, especially for chronic patients. Overall, patient empowerment, guidance and safety constitute concrete goals in modern healthcare systems. To this end, mobile computing technologies can enable to realize such services in a pervasive manner, tailored to each patient’s specific needs. The current work elaborates on the utilization of outdoor location information to deliver personalized services to patients, discriminating among reactive and proactive services according to their initiator and nature. In this regard, we present various use cases and relevant applications that have been developed by our group, exploiting this way the virtue and applicability introduced via the adoption of location-based services. The ultimate goal of this work is the development and establishment of an integrated framework for providing location-based healthcare information services targeting patient safety, empowerment and guidance.

1. On Location-based Services for Patient
Empowerment, Guidance and Safety
A.K. Triantafyllidis, V.G. Koutkias, I. Moulos, and
N. Maglaveras
Lab of Medical Informatics
Faculty of Medicine, Aristotle University of Thessaloniki
Institute of Biomedical and Biomolecular Research, Center for Research and
Technology
Thessaloniki, Greece
atriant@med.auth.gr

2. Presentation Outline
• Background:
– Mobile Personal Health Systems
– Location-Based Services
• Scope of the Current Work
• Proposed System:
– Conceptual Framework
– Reactive Services
– Proactive Services
• Results:
– Prototypes Implementation - Technical Feasibility
• Discussion and Future Work
On Location-based Services for Patient Empowerment,
Guidance and Safety

3. Mobile Personal Health Systems
• Mobile-based Health Services
towards Patient Empowerment,
Guidance & Safety
• Location Identification: Anytime &
Anywhere
– Social Networks
– Combined with other Contextual
Information
• User Profile/Medical History
• Monitored Health Parameters (Heart
Rate, Activity, Blood Pressure, etc)
Emergencies Patient Independent Living
On Location-based Services for Patient Empowerment,
Guidance and Safety

4. Scope of Work
• Demonstration of various use cases illustrating the
adoption of Outdoor Location Information as an
important attribute in the design of Pervasive Health
Systems
On Location-based Services for Patient Empowerment,
Guidance and Safety

5. Conceptual Framework
• Reactive Services
– Initiated by the Users
– Require Constant Interaction
– Suitable for Patient Self-management & Empowerment
• Proactive Services
– Initiated by the System/Patient’s Family or Caregiver
– Executed in an event-driven manner
– Suitable for Patient Guidance & Safety
On Location-based Services for Patient Empowerment,
Guidance and Safety

6. 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.
On Location-based Services for Patient Empowerment,
Guidance and Safety

7. 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
Critical Requirement: Patient Willingness to
Actively Engage in Health Management Processes
On Location-based Services for Patient Empowerment,
Guidance and Safety

8. Patient Guidance & Safety
 System provision of guidance processes to help
the patient to self-manage
 Alerts/feedback delivery to Caregivers/Family
 Alert delivery to the Medical Center in case of
emergency
 Rapid actions
 Better emergency management
On Location-based Services for Patient Empowerment,
Guidance and Safety

9. Conceptual Framework
On Location-based Services for Patient Empowerment,
Guidance and Safety

10. Reactive Service: Location-based Symptom Tracking
Functionality & Goals
• Recording of subjective elements
of health information – e.g.
symptoms on a mobile device
– Chest pain
– Dizziness
– Shortness of breath
• Association of location with
health status
• Fine-tuning of patients’ treatment
and exercise plans by Caregivers
after the reception of generated
reports
On Location-based Services for Patient Empowerment,
Guidance and Safety

11. Reactive Service: Social Networking Platform for
Activity Sharing
Functionality & Goals
• Recording and sharing of
activities within an online
community – e.g. walking,
running, shopping etc
• Association of location with
networked activities
• Targeting emotional support &
self-confidence increase
towards achieving personal
goals
On Location-based Services for Patient Empowerment,
Guidance and Safety

12. Proactive Service: Tracking the Location of a Person
with Alzheimer’s disease
Functionality & Goals
• Patient tracking
boundaries definition by
caregiver/relative: ROI
(Region Of Interest)
determined by center
point & a radius
• Alerts sent via SMS if
patient enters or leaves
the specified ROI
• Patient guidance to return
at home
• Targeting safety via
required actions
On Location-based Services for Patient Empowerment,
Guidance and Safety

13. Proactive Service: Health Status Monitoring &
Triggering of Location-Based Services
Functionality & Goals
• Constant health status
monitoring via wearable
sensing devices: Heart Rate,
Blood Pressure, Activity,
Breathing Rate
• Location determination in case
of emergency (as defined by
threshold configuration)
• Discovery of the nearest
hospitals and/or pharmacies
• Targeting rapid actions in case
of an emergency
On Location-based Services for Patient Empowerment,
Guidance and Safety

14. Prototype Implementation
MBU System Back-end
• J2ME-CLDC (Java 2 Micro Edition- • Apache Tomcat
Connected Limited Device – Web application container
Configuration) & Android
– Open platforms for mobile applications
• Apache Axis2
– Underlying SOAP engine
• Location APIs
– JSR-179 Location API • Drupal Platform
– Nutiteq Mobile Maps – Open source CMS
– OpenStreetMap
Tested On
• SOA adoption Sony Ericsson C905
– SOAP & WSDL
– JSR – 172 Web Service API Nokia N86
Android Milestone
On Location-based Services for Patient Empowerment,
Guidance and Safety

15. 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
On Location-based Services for Patient Empowerment,
Guidance and Safety

16. Discussion: Future Work
• Extensive Evaluation:
– Patient acceptance
– Medical perspective
– Privacy policies
• Elaborate on the establishment of an integrated
framework:
– Handling of context parameters, e.g. location, activity, etc
– Patient preferences and observations
– Behavioral monitoring based on user-to-system interactions
On Location-based Services for Patient Empowerment,
Guidance and Safety

17. Thank you!!!
On Location-based Services for Patient
Empowerment, Guidance and Safety
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. Moulos, and
N. Maglaveras
Lab of Medical Informatics
Faculty of Medicine, Aristotle University of Thessaloniki
Institute of Biomedical and Biomolecular Research, Center for Research and Technology
Thessaloniki, Greece
atriant@med.auth.gr