Presentation given by Sukwha Kim at ISHSH 2013

1. 2013/9/3
서울대학교병원
김석화, MD, PhD
ISHSH 2013
"This research was supported by a grant(10 High-tech Urban B02) from High-tech Urban Development Program funded by Ministry of Land, Transport and Maritime Affairs of Korean government"

2. House Call, Origin of U-Health
Pictures of Dr. Mattie B. InGold (missionary) making a house call in Korea (1898)
A ‘house call’ was another type of medical care in Korea till 1960’s

3. Telemedicine, Beginning of U-Health
An emergency medical service was conducted on a sea through a
radio frequency communication
(Cover of the the ‘Radio News’ magazine in 1924 )
Telemedicine
:System for diagnosis and treatment of remote patients through telecommunication methods
(e.g. television, telephone and so on).
home healthcare, remote video conference, remote medical image
transmission system, remote diagnosis, virtual hospital, and so on
Application Scope of Telemedicine
System for providing medical information and special consultation
remotely including patient treatment, medical administration,
medical education, request and so on
Comprehensive Definition of Telemedicine

4. U-Healthcare?
U-Healthcare(Ubiquitous Healthcare): Providing health and medical service to the public
Anywhere, Anytime in regards to prevention, diagnosis, cure, aftercare, and etc. using IT infra
weight
Consumer
sensing Collect & transmit
Activity
bp
glucose
cholesterol
patient
gateway
Mobile phone
PC
Analysis & Feedback
Provider
Local hospitalPublic health center
telemedicine
And healthcare
General
hospital
Any time
Any where
Unperceivable
For biosignal of patients,
Participation of medical cantors, medical equipment and telecommunication companies is needed
sensing collect transmit analysis feedback
Server

5. U-Healthcare, expansion of medical Service

6. U-Healthcare, Demands of the times
Aging of Population
Demand for Chronic Disease Care
Increasing Medical Cost
Demand for convenient medical service
Effective management of chronic disease
Solution for Burden of Elderly Care
치료에서 예방으로 선제적 건강관리로의 패러다임 변화

7. Delivery Models of advanced Medical IT
U-health Care System for providing ‘Patient centric management’ through reorganizing
traditional medical system
Health examination
Clinical Decision
Support
PHR(Personal Health Record)
EHR(Electronic Health Record)
Patient centric Management
Data Repository
Data
Exchange
Data
Exchange
Self diagnosis
and control
home
Visit care Pharmacy
Long-term health
management
General hospital research
Remote diagnosis
Community hospital
Local clinic
Emergency medicine

8. Beginning of Korean U-Healthcare, SNUH
동일 병원 내 또는 지역적으로 멀리 떨어져 있는 의료기관간에 일반전화회선이나 고속회선, 근거리
통신망 등을 이용해 화상정보 및 진단정보를 전송하는 서비스
T1급 전용회선을 연결하여 치매환자 대상으로 상담, 재활교육 및 치매 전문인력 양성 교육 등 실시 (인천 남구, 서울 노원구)
질병의 확인에 해당하는 의료측정은 이를 전문으로 하는 의료기관에서 담당하고,
그 다음 내과나 외과 등 또 다른 전문의사에게 치료받을 때 환자의 정보를 신속하고 정확하게 병원에서
병원으로 옮겨주는 시스템

9. U-Healthcare, Growing SNUH
Mobile Healthcare SNUH Gangnam Center: Providing “Health in my Hand” service
Patient centric Application S/W
Healthcare service in my Hand
 Checking customer’s EMR in Gangnam center,
SNUH
 Customized service according to Exercise,
Nutrition, Stress Management prescriptions
 program introduction and reservation
 checking recent 3 year medical records
 communication with medical staffs
(1:1 consultation, health information bulletin)
1. mobile healthcare
“Health in my Hand (내 손안의 건강)” Service

10. U-Healthcare, Growing SNUH
COPD Portal
Server System
COPD patients
doctors
Peak Flowmeter
stethoscope
Pulse
Oximeter
Hospital EMR
1. Equipment Development
Providing related sensors
2. Measurement
Everyday self-check
3. DATA transmission
Storing in portal server
4. EMR Linking
Using treament
2. U-HELATHCARE for COPD
Hospital linked
u-healthcare
Development of u-healthcare service for COPD patients
(2008/11~2010/10)

11. U-Healthcare, Growing SNUH
U-health System for COPD Patients
①
“나 같은 숨찬 해소환자가 집에서 병원까지 한 번 가려면 차 몇 번 갈아타고
교통은 불편하고 애로사항이 많은데… 서울대병원에서 우리나라 처음으로
U-헬스케어 라고 매일 관리해 주는 의료 서비스가 있다는 사실 때문에 마음
에 위안이 되고 편하고 좋네요”
->Advantage: Feeling of fearlessness and convenience
A COPD patient(72)
2. U-HELATHCARE for COPD
• Disease centric u-health system
• Elder surrounding wired complex and
many appliances
• No consideration for residential space of
patient ①
②
③
④
Limitations

12. 12
1차년도 연구단 자체평가
2010/12/23~2013/09/22

13.  Not disease-centric but resident-centric healthcare service based on space properties
 low-cost and elderly-friendly online & offline healthcare services for community-dwelling
Elderly People with Chronic disease
고령자의 건강 집중모니터링 , 관리
기초 건강 측정 및 관리
서비스 및 콘텐츠 운영
온,오프라인 연계 서비스 관리
고령자 생체정보 측정 및 수집
기존 스마트 홈 연계 시스템
건강관리 feed back 시스템
의료기관 모니터링 연계 시스템
공동 활용 생체정보 측정 및 수집
정신건강 서비스 시스템
커뮤니티형 건강관리 시스템
주거공간, 공용공간, 집중관리 공간간의
연계 모델 구축을 통해 고령자의 종합적인
건강관리가 가능한 스마트 홈 모델을 개발
Goal: Elderly-friendly Healthcare Smart Home Model

14. 14
Subject
• Permanent Rental Apartment Complex in Gangseo-Gu, Seoul, Korea
: Gayang 7 Complex (LH공사) + Gayang 4, 5 Complex (SH공사)
Low Educational ‘Basic Livelihood Security Recipients’Elderly

15. 15
Equipment: Elderly-friendly Healthcare System
• The 1st development of end-to-end healthcare system satisfying international standards for interoperability
 Interfaces between Sensor Device & Gateway : ISO-IEEE 11073-xxxxx,
 Interface between Gateway & Portal Server : IHE PC-01(HL7), W3C-I, SOAP, HTTP
“All sensor Devices are based on
wireless communication at home”

16. 16
- Method Cards (IDEO Method Cards, IDEO, Palo Alto, CAL, USA)
 A collection of 51 cards representing diverse ways that design teams can understand the
people they are designing for.
 They are used to make a number of different methods accessible to all members of a design
team, to explain how and when the methods are best used, and to demonstrate how they
have been applied to real design projects
 Inspired by playing cards, the cards are classified as four suits—Ask, Watch, Learn, Try—that
define the types of activities involved in using each method.
System Design

17. 17
-Visual properties - Hearing property
System Design
Aspect Youth Elderly
Background Video games, complex interactive environment TV & radio, relatively non-interactive appliances
Attitude towards digital
“Digital native,” grew up with interactive toys and to
ols.
Fearless, willing to experiment
Inexperienced, unsure of “rules” or expectations.
Afraid to break it
Fear related to this technolog
y
Not having the latest and coolest device Overload with seemingly unnecessary features
Speed and stimulation
The more the better, seeks multi modal stimuli with l
ots of sights, sounds & choices.
Enjoys immediacy, quick reactions, like to bounce
around between items
Prefers steady level of input and output.
Clear number of choices/paths.
More time to process
Distractibility Will often seek other pulls while doing tasks Prefers to stay focused and concentrate on task
-Consideration of Physical properties of elderly

18. 18
Application of Design Methods
• Extracted Design Concept & Realization
 Elderly-friendly Graphic User Interface (GUI)
<Examples of Activities according to
the selected methods cards>

19. 19
Application of Design Methods
• Extracted Design Concept & Realization
 Elderly-friendly Clinical Decision Support System (CDSS): Based on traffic light
biosignal data
feedback
Red
Yellow
Gateway
-Sensing &
collection of
biosignal
-Guides about
measurement
methods and
times
-Showing
feedback contents
Server
-Analysis of
biosignal data
-Staging for
feedback
Visiting Hospital
-confirm of doctors
-Treatment
-Changing treat
methods
Life Habit
Correction
-Exercise
-Nutrition
-Medication

20. 20
-BP monitoring (Home)
CDSS Developed Healthcare Smart Home System

21. 21
-BP monitoring (Community space)
CDSS Developed Healthcare Smart Home System

22. 22
-Glucose monitoring (Home)
CDSS Developed Healthcare Smart Home System
•

23. 23
-Glucose monitoring (Community space)
CDSS Developed Healthcare Smart Home System

24. 24
-Pulmonary Function Monitoring
CDSS Developed Healthcare Smart Home System

25. 25
- Cardiovascular Function Monitoring
CDSS Developed Healthcare Smart Home System

26. 26
- Home: Picture Selection
Gateway-User Login Developed Healthcare Smart Home System
- Community Space: Barcode Reading

27. 27
- Blood Pressure Monitoring
Gateway-Biosignal Measurement Developed Healthcare Smart Home System

28. 28
- Glucose Monitoring
Developed Healthcare Smart Home System
Gateway-Biosignal Measurement

29. 29
- Weight
Developed Healthcare Smart Home System
Gateway-Biosignal Measurement

30. 30
- ECG
Developed Healthcare Smart Home System
Gateway-Biosignal Measurement

31. 31
- Stethoscope
Developed Healthcare Smart Home System
Gateway-Biosignal Measurement

32. 32
- Pulse Oximeter
Developed Healthcare Smart Home System
Gateway-Biosignal Measurement

33. 33
- Spirometer
Developed Healthcare Smart Home System
Gateway-Biosignal Measurement

34. 34
- Body composition analyzer (Community space)
Developed Healthcare Smart Home System
Gateway-Biosignal Measurement

35. 35
- Patient Monitor (Intensive care space)
Developed Healthcare Smart Home System
Gateway-Biosignal Measurement

36. 36
Gateway- Educational Animation Developed Healthcare Smart Home System

37. 37
Gateway-Video Conferencing Developed Healthcare Smart Home System

38. 38
Gateway-Health Record Chart Developed Healthcare Smart Home System

39. 39
Gateway-TV Developed Healthcare Smart Home System

40. 40
Gateway-Weather Broadcasting Developed Healthcare Smart Home System

41. 41
Gateway-Calendar & Notice Board Developed Healthcare Smart Home System

42. 42
Usability of Gateway Developed Healthcare Smart Home System

43. 43
• Start Window for Start-up to-do list
 Current reservation of consultation
 Users without measurements for 3 days
 Intensive care space Users
Portal Server Developed Healthcare Smart Home System
• User Management
 demographic information
 Health information
 Biosignal information
 Consultation history

44. 44
-User health monitoring based on Status board
Portal Server Developed Healthcare Smart Home System

45. 45 http://www.privacybydesign.ca/
Portal Server Developed Healthcare Smart Home System
-Application of Privacy by design (PbD) Concept

46. 46
1. Start 2. BP
2. Glucose
3. Pulse Oximeter
4. Weight
IEEE 11073-10417 - Glucose meter
IEEE 11073-10407 - Blood pressure monitor
IEEE 11073-10415 - Weighing scale
IEEE 11073-104045 – Pulse Oximeter
Additional Development: Android version gateway
Over Android v4.0

47. 47
Wireless activity monitor
Wireless activity monitor Android App
Additional Development: Activity Monitor and Android App

48. 48
Healthcare Smart Home Ecosystem & Expected Effect
Elderly-friendly Healthcare Smart Home Ecosystem for effective Expansion
• Sustainability
• Cost-effective
• Sociality
• Public benefit
• Business value
Public health center & its branch (o)
Exercise program of National Health
Insurance Corp. (o)
Visiting nursing service
Community Boucher service
Local home care program
Voluntary healthcare programs (o)
And so on……
Elderly
Friendly
Healthcare
Smart Home

49. 49
Thank You