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Quality of Life – Independent LivingPanel facilitator: Eleni Stroulia

• Lili Liu“Technologies to support home care services

and community living”

• Gary Faulkner“Rehabilitation prosthetics”

• Bob Aloisio“Always connected, safe and secure”

Technologies to SupportHome Care Services and

Community LivingLili Liu, PhD

Professor & ChairDepartment of Occupational Therapy

Analytics, Big Data and the CloudApril 23-25, 2012, Edmonton, AB

Outline1.What research has been done on technologies

to support community living (smart homes)?

2.What is the Smart Condo™ project at the University of Alberta?

3.How can technologies support home-care services and community living? (HCA-T Project)

4.Health Care on the Cloud

Research on smart homes

Literature review of non-obtrusive technologies to enhance the quality of life and safety of older adults living at home, congregate housing, and assisted living settings.

Funded by Alberta Addiction & Mental HealthResearch Partnership Program

Computing Science:Eleni Stroulia, Yannis Nikolaidis, Nick Boers, Koosha GolmohamaddiIndustrial Design: Robert Lederer, Greig RasmussenOccupational Therapy: Angela Sekulic, Katie Woo, Ran Ran ZhangPharmacy: Cheryl Sadowski, Lisa GuirguisShepherd’s Care Fdn: Corinne Schalm, Suzanne Maisey, Beth WilkeyHSERC: Sharla KingLibrary: Linda SealeAlberta Health Services: Angela Sekulic, Katie WooAlberta Seniors: Carmen Grabusic

SCOPUS, CINAHL, IEEESmart home and health; gero(n)technology;

telesurveillance or telemonitoring; technology for older adults

Inclusion ≥2000; English, addressing the physical, cognitive, social,

or mental health needs of older adults in home or supported living settings

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Tag clouds of top 200 words in 188 papers selected for review

Articles published/yearNumber of papers published each year

13

54

41

24

10

10

8

3

6

0

4

2010 (until May)

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

Environments technologieswere designed for

Target users

40

39

36

20

20

8

5

Dementia Care/Management

Other Chronic Disease Management

Detecting deviations in health status or activity levels (including fall detection)

Vital signs monitoring

User perceptions and acceptance of technologies

Diabetes Management

Other (privacy and ethical issues, best technologies for aging, design considerations)

Conditions & topics

Main playersCountry of Publication

58

21

18

13

12

8

7

6

3

3

3

3

2

2

2

2

10

USA

Great Britain

France

Canada

Netherlands

Sweden

China

Finland

Germany

Greece

Japan

Singapore

Australia

Ireland

Italy

Korea

Other

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28

3

20

23

6

Type of Research Design

Pilot and Case Studies

RCT Experimental Design

Non-RCT Experimental Design

Qualitative

Mixed Methodology

Technologies can support older adults with complex chronic conditions (arthritis, hypertension, heart disease, cognitive impairment) to stay at home. However challenges need to be addressed:

AdaptationAccessibilityUsabilityPrivacyAccuracyUnobtrusivenessSocial & ethical implications

Summary

Smart Condo™ Project at the U of A• 2008: mock design of a condo in Telus Centre• 2012: Edmonton Clinic Health Academy• 30 to 50 students annually (ID, OT, CS & Pharm)• Universal Design, visitability• Sensors, Test medical devices, e-health

software, health management applications, prototype designs

Lili Liu

Play & Connect Rest & Sleep Bathing & Grooming Cooking & Eating

Smart Condo™

Smart designsSmart technologiesLiving lab

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How can technologies support home care services and community living?

• Sensors to monitor activities, critical incidents (Glenrose ILS)

• Medication adherence• Technologies to support health care aides in

home care (HCA-T Project)

Why monitor with sensors? Community care◦ Clients with chronic conditions staying at home

longer◦ Transition from hospital to rehab to home

Valid assessment of function◦ Frequent visits are misleading◦ Cameras are intrusive

Courage Centre (GRH)

Tracks patient in precise, non-intrusive wayo Wireless sensor networks

Visualizes patient’s activitieso Virtual world client

Flexible, inexpensive, and effective

(Our) Smart Condo technology

Wireless sensorsConsist of multiple components:• Sensors

(e.g., acceleration, passive-infrared motion, switches, tactile pressure)

• Wireless module• Microcontroller

(e.g., MSP430: 8 MHz, 2 KB RAM, 48 KB flash)• Radio transceiver

(e.g., TR8100: 916.50 MHz, 9.6 kbit/s)

• Energy source(e.g., 9 V battery)

Wireless sensor network

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Screenshot (overhead)

Alerts Reports/graphs

Other possible views

Virtual representation of condo space Avatar represents patient Avatar directed by control mechanism to

move between co-ordinates in virtual condo◦ Path planning algorithm used to avoid obstacles

Other smart objects embedded in virtual space, manipulated by similar control mechanism

Virtual world client

GlenroseIndependent Living Suite

MATS(active monitoring, feedback)

Medical Assistance Technologies(Katie Woo)

1. What is the current level of awareness of MATs among older adult’s care providers?

2. Are MATs designed for older adult use?

Major Findings

Survey Study

• Medication adherence issues common

• over 50% encounter issues frequently

• Patient or caregiver self-report most frequently used

• Blister packs most recommended

• MATs awareness (25%) and usage (6%) low

• No significant relationships found in demographics

• High interest or belief MATs could be useful (82%)

30

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MethodsClient Trials (June – October 2011)

• MATs product trial with in-patients

• 2 day trials, Independent Living Suite

• Commercially available product

• Observations, interviews, product data and

evaluations

Results

• 2 participants

• 4 team surveys completed, 2 interviews, investigator

observations, 2 sets of product data 31

Medical AdherenceMedSignals®

Katie Woo

Technology Acceptance Model: Health care providers and MATs

Adapted from “The Technology Acceptance Model: its past and its future in healthcare by R.J. Holden and B.T. Karsh, 2010, Journal of Biomedical Informatics, 43,1, p. 161.

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Katie Woo

Technology Acceptance Model: Participant #1 and MATs

Adapted from “The Technology Acceptance Model: its past and its future in healthcare by R.J. Holden and B.T. Karsh, 2010, Journal of Biomedical Informatics, 43,1, p. 161.

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Technology Acceptance Model: Participant #2 and MATs

Adapted from “The Technology Acceptance Model: its past and its future in healthcare by R.J. Holden and B.T. Karsh, 2010, Journal of Biomedical Informatics, 43,1, p. 161.

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Systems approach

36

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Health Care Aides & Technology

• Alberta Health & Wellness

• Five Home Care Zones• Apps for multi-

platform mobile devices

• Recruitment, Retention & Recognition

HCA-T Project• Workflow• Safety (GPS) (e.g., SafeTracks)• Communication• Documentation• Remote authorization• Etc.

Summary1. Research on technologies - home care,

assistive living and continuing care; users are clients, family and caregivers; applied to chronic conditions – dementia, diabetes, activities monitoring.

Summary2. Examples such as the U of A’s Smart

Condo™ Project emphasize the importance of interdisciplinary training, research and industrial partnerships.

Summary3. A systems approach is needed to introduce

and sustain technologies targeted at clients, families and home care or community service providers.

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Health Care –the killer app on the Cloud

To support patients to live independently longerTo enable care givers to make more informed decisions about client care

We needTo collect data; to fuse data from different sources; to decide on actionsThis is what we hope cloud to do for us