Phd Seminar Long

8/8/2019 Phd Seminar Long

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PersonalElectronic

Health Devices

A summary of research and applications in personal health including devices based on smartphone, handheld and other small mobile platforms.

A shorter version of this presentation was given in the University of Birmingham Biomedical Seminar series

Dr Sandra I. Woolley

http://www.eee.bham.ac.uk/woolleysi

[email protected]

Electronic, Electrical and Computer Engineering

October 2007

Picture: http://mlearning.edublogs.org/2006/11/20/m-learning-is-vital-for-industry-compatibility/



Followed by an Example Application

³Supporting Childrenwith Anaphylactic

Allergies.´ Luis U. Hernandez Munoz

Picture: http://medfusion.wordpress.com/2006/04/



Personal Health Devices

Mobile computing has come a

long way. Can it help do goodthings for health?

Personal health devices can

± provide information or

± sense and respond,

± or both.

They can provide emergencyor everyday support.

They can interface with wired

or wireless vital sign oractivity sensors to detect andreact to events, for example,sending messages, makingcalls or logging sensed data.

Mobile computing has come a long way.Can it help do good things for health?

http://www.eee.bham.ac.uk/woolleysi/projects/index.htmhttp://www.disetronic-ca.com/dstrnc_ca/rewrite/content/en_CA/3.2:20/article/DC M _general_article_53.htm

http://mlearning.edublogs.org/2006/11/20/m-learning-is-vital-for-industry-compatibility/



TechnologiesAs well as all manner of mobile computing platformswe now have new sensing and communication

technologies.

Sensors

Location via: GPS, GSM cell, wi-fi/ network signal,acoustic, etc.

Proximity: RFID tags

Movement: Accelerometers, tilt switches, gyroscopes

Environmental toxins

Health : Basic vital signs, Glucose, etc.

³Context-awareness´ can be derived from multiplesensors.

³Smart Spaces´ can be created from environmentswith embedded networks of sensors.

Communicating Networks

Local and Personal Area Networks

Wireless wi-fi, bluetooth, Zigbee (Sensor Network)

Berkeley Engineering News Nov 2003,

SM

ALL

PACKAGE:T

he wireless motecommunication chip.

Glucose Biosenor detail

www.strath.ac.uk/bioeng/ pg-info/engd/pics.html



So Aren¶t We ³There´ Yet?

With so much existing technology andresearch activity ...

aren¶t we nearly ³there´? Is it justa technology race?

Or is the cleverness in putting goodtechnologies together?

In«

« connecting cooperatingtechnologies with people and thethings they do.

An example, from ³The Media History

Timeline´ ± 1565 The graphite pencil

± 1770 The eraser

± 1858 Eraser fitted to the end of apencil

A carpenters pencil - the oldest knownpencil found in the roof of a 17th-

century German house.

Photo Sandra Suppa, FABER-CASTELL GmbH & Co.,

Germany



R esearch Questions

System-centred research question

± How can sensors, systems anddata interact and combine orsynergise?

User-centred research question

± How can users manage and interpret all this newinformation?

... more generally

± How can all this newinformation more widely andusefully inform humanknowledge?



R esearch Questions ... for health ...

Can we use new technology tomake more people more well moreof the time ... and maybe with lessmoney?

Can we help people keep well and

take control of their own health?

Can we avoid exposing people toexcessive electromagnetic fields?

Di d you know about the great

med ici nal propert i es of dandel i ons? Can we also reinformourselves with traditional healthwisdom?

http://en.wikipedia.org/wiki/Medicinal_properties_of_dandelion

Picture: http://www.herbs-hands-healing.co.uk/articles/quality.html



Illness ... Wellness

Illness signals a need for change.

Education is a path to wellness.

Personal health devices c anprovide and collect information tosupport education andunderstanding ... and cantherefore potentially support

wellness.

Though ... "It is easier to change aman's religion than to change hisdiet." Cultural anthropologistMargaret Mead

Healing that worked for my family... Understanding and correctingdeficiencies and removing toxins.Treating viral, parasitic andbacterial infections .... andtraditional healthful eating high inraw foods.

http://www.jbpub.com/catalog/9780763752941/http://www.handango.com/SoftwareCatalog.jsp?platformId=2&siteId=1&language=english&N=96806+4294961135

http://classic.pocketgear.com/software_detail.asp?id=11138http://www.mobiletopsoft.com/pocket-pc/download-butterfly-animated-free.html

http://www.answers.com/topic/vegetable-juicehttp://www.skazka.co.nz/product-details.aspx?p=1209&pageno=0&Category=18

http://commons.wikimedia.org/wiki/Image:Glass-of-kvass.jpg

H ealth, herbal and nature-i nspi red P DA software examplesVegetable juic e, and fermented kef i r and kvass dr i nks

Medicine ...derived from the

Latin arsmed ici nameaning the art

of healing.http://en.wikipedia

.org/wiki/Medical



Natives Were Healthy

³These days the jaws are not big

enough for all 32 teeth to erupt andusually there is only room for 28teeth.´

http://www.dentecom.co.uk/patients/pa_wisdomteeth_faq.htm

These days ... we do see morenarrow jaws ... more endocrinedysfunction, immune disorders,degenerative diseases, learning andattention dysfunction.

³Good dental health begins with thediet of both parents. The Samoangirl on the left was born to parentswho ate nutrient-rich native foods.

The Samoan boy on the right wasborn to parents who had abandonedtheir traditional diet. He has crowdeddental arches and will be moresusceptible to dental decay andchronic illness.´

Weston A. PriceNutrition and Degeneration

http://www.westonaprice.org/brochures/wapfbrochure.html

http://www.westonaprice.org/traditional_diets/native_americans.htmlhttp://www.westonaprice.org/brochures/wapfbrochure.html



Pervasive and e-Health

³Perhaps the most important force behind thecurrent and potential use of pervasive health careis the need to reduce, or at least contain, theskyrocketing health care costs that affecteveryone.´

The Case for Pervasive Health Care, Part 1

Luis Taveras and Dadong Wan

http://www.hhnmostwired.com/hhnmostwired_app/jsp/articledisplay.jsp?dcrpath=HHNMOSTWIRED/PubsNews ArticleMostWired/data/07Spring/070808MW_Online_Taveras&domain=HHNMOSTWIRED

³ Consumer health informatics is the branch of med i cal i nformat i c s that analy ses consumer s¶ need s for i nformat i on; stud i es and i mplement s method s of mak i ng i nformat i on accessi ble toconsumer s; and model s and i ntegrates consumer s¶ preferences i nto med i cal i nformat i onsy stems.´ (Eysenbach 2000) http://en.wikipedia.org/wiki/Consumer_Health_Informatics

Pervasive healthcare to save money...

A new market of ³consumers´ too ...

http://www.pervasivehealth.org/



Most Wired and Wireless Hospitals

Preparing for the Worst³I nformat i on technology w i ll play a cr i t i cal part i n pandemi c

read i ness.´ Greg Dworkin, M.D. http://www.hhnmostwired.com/hhnmostwired_app/jsp/articledisplay.jsp?dcrpath=HHNMOSTWIRED/PubsNews ArticleMostWired/data/07Summer/071017MW_online_Dworkin&domain=HHNMOSTWIRED

³Information technology provides a wide range of tools tohelp hospitals improve quality.´http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNM AG/ Article/data/07JUL2007/0707HHN_CoverStory_ Landing&domain=HHNM AG

Most wired and wireless hospital award criteria ± Use of Electronic Bed Boards

± Project Analytics

± Medications Ordered Electronically

± Medication Orders Matched Electronically

± Electronic Surveillance

± Quality Indicator Compliance Alerts

± Digital Clinical Imaging ± Clinical Documentation in the OR

± Primary Data Center Recoveryhttp://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNM AG/ Article/data/07JUL2007/0707HHN_CoverStory_ Landing&domain=HHNM AG

³... 28% of medical schools require students to ownand use a PDA ...´ (April 2006) http://medfusion.wordpress.com/2006/04/

http://medfusion.wordpress.com/2006/04/





My Last Cigarette

PD A and Smartphone application to encouragestopping smoking. ~$10

³Here's another example of mobile persuasiontechnology for health ...´http://software.palminfocenter.com/product.asp?id=168

Nicotine level readout

Expected cravings readout

Daily motivational quote or medical fact. Deaths since you quit readout

Carbon Monoxide level of your blood

Increase in life expectancy readout

Time you have been a non smoker readout

Number of cigarettes NOT smoked readout

Your risk of a heart attack compared to your risk before

Your risk of lung cancer compared to your risk before

Daily picture of what smoking does to your health

Money saved

Expected circulatory improvement

Expected lung function improvement

Readouts updated every second and are based upon your ownpersonal past smoking habits.

Screenshots from My Last Cigarettehttp://software.palminfocenter.com/product.asp?id=168

http://www.pocketnow.com/index.php?a=portal_detail&t=reviews&id=427



Medic Alerts and R ecords

Traditional medic alerts are engraved

bracelets or necklaces bearing simple and(hopefully) recognisable medical icons.

Important life-critical allergy or otherhealth data is engraved on the reverse.

There is a huge growth in this marketwith the increase in allergies and life-threatening anaphylaxis.

Also an increasing desire of patients tohave and carry their own medical recordinformation.

New ideas include USB keyring fobs «and some Birmingham University studentPDA projects.

www.MedicalTags.co.ukwww.MedicAlert.org

Photo: Joshua Lutz

http://www.spectrum.ieee.org/oct06/4589

PATIENT BEWARE: Cheryl Conrad [right] makes sureshe always keeps a copy of husband Tom¶s medical

records on hand, after he experienced an excruciating

delay in getting treated at a local hospital.

Dying for DataRobert N. Charette

IEEE Spectrum

October 2006



Blood Pressure/Pulse Monitors

Automatic large LED blood

pressure systolic / diastolic /pulse readout with fuzzy logic.

Automatic inflation & deflation

48 sets of memory to monitoryour progress plus date / time /average pressure

Requires 2 x AAA batteries.

Tatung http://www.tatung.com/med/product.html



Wearable Insulin Pumps

The catheter at the end of the

insulin pump is inserted through aneedle into the abdominal fat of aperson with diabetes.

Dosage instructions are enteredinto the pump's small computerand the right amount of insulin is

injected in a controlled manner.

[Medline Plus]



AMON - Advanced Telemedical Monitor

A European project from ETH, Zurich

Designed to be worn by cardiacoutpatients, the device allows remotemonitoring of blood pressure, pulse,oxygen saturation, body temperature and2-channel ECG signals.

AMON: A Wearable Medical Computer for

High Risk Patients,P. Lukowicz, U. Anliker, J. Ward, G. Tröster, E.Hirt, C. Neufelt,

ISWC 2002: Proc eed i ngs of the 6thI nternat i onal Symposi um on W earable

C omputers, 7.-10. October 2002, pp 133-34



SensVest C.Baber, A.Schwirtz and J. Knight

The ³Lab of Tomorrow´ EU project(C.Baber @ Birmingham) to enablestudents to capture and analyse ³activity´ sensor data.

Senses temperature Heart rate (ECG) andactivity via accelerometers.

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Time (mins)

H e a r t r a t e ( b p m )

R Body movement



Biofeedback and ³Inner-active´ Games Biofeedback is a process for monitoring a

body function such as breathing, heartrate, blood pressure and altering thatfunction through relaxation or imagery.

³ ANTEN SE®

Bi ofeedbac k ant i -tensi on dev ic e

C ombat stress i n the pr i vac y of your

home´ $160

³I ntroduci ng emW ave Personal StressRel i ever, an entertai ni ng stress rel i ef tec hnology to help you balanc e your emot i ons, mi nd and body.´ $199

³..T he Journey to W i ld Di v i ne, the f i rst i na ser i es of ³I nner- Ac t i ve´ c omputer adventures to c ombi ne the sci enc e of bi ofeedbac k w i th a beaut i ful, enc hant i ngand entertai ni ng mult i med i a exper i enc e.Over 10 hours of game play!´ $187.50

Top left: Antense® Anti-Tension DeviceTop right: http://www.holisticonline.com/Biofeedback.htm

Bottom: http://www.myemwave.org/about_emwave_stress.htmlhttp://www.luxevivant.com/index.asp?Page Action=VIEWPROD&ProdID=166



³Women¶s´ Health

Pregnancy and ovulation tests.

A substantial market potential forpersonal health care, but fraught withconcerns over correct usage andinterpretation ... and the potential forexpensive litigation.

2002 BBC news - new Persona legal cases



The ³Digital Plaster´

A device meant to be embedded in ordinaryplaster that includes sensors for monitoringhealth-related metadata such as bloodpressure, temperature and glucose levels.

The ³digital plaster´ contains a Sensiumsilicon chip, powered by a small battery,which sends data via a cellphone or PDA to a

central computer database.

If the results show any worrisome signs,patients and doctors alike would be notifiedof the change in the data patterns. They alsoplan to add a motion sensor to the device so

it could additionally serve in the role of ³granny monitor´ by detecting things like fallsor complete inactivity.

[The Toumaz Digital Plaster]



A Short Selection of Notes on

Electrosensitivity and

Electrotherapy



Electrosmog? 3G telephone masts, indoor cordless

(DECT) telephones and Wi-Fi

networks are just a few examples of new electromagnetic sources.

Electric blankets, microwave ovens,computers, and bluetooth devicesalso add to our exposure.

University campuses and manypublic spaces are now wirelesslynetworked.

Soon there will be many morewireless devices including PersonalArea Networks or Body Area

Networks WSN (IEEE 802.15.4) andZigbee.

What about the health environmentsof the future? Might we expect alarge amount of EMF?

http://www.electrosmog.org.uk/http://www.sheffielder.com/SH AM/s10.html

³H ospital's phone mast has highest signal in UK´

Feb 19 2003By Susanne Elsworth Daily Post

Staff

³H ospital defiant over phone masts´

27 May 2005

Chartered Inst. EnvironmentalHealth,

Addenbrooke¶s Hospital now has around 30

masts on the roof of its main ward block.Departments in close proximity to the

masts include the maternity and breastunits and the oncology centre. The masts,

or base stations, are used for mobilephones, pagers, and the Tetra police radio

system



Electrosensitivity Electrosensitivity: ³A unhealthy sensitivity

to a particular source of electricity, for

example mobile phones, computers, powerlines or even minor electrical equipment.1´

The Health Protection Agency produced agood summary of the condition in aNovember 2005 report.2

The most high-profile case of electricalhypersensitivity is Gro Harlem Brundtlandthe last Secretary-General of the WorldHealth Organisation, W.H.O, she is amedical doctor and former Prime Minister of Norway.

"It's not the sound, but the waves I react

on. My hypersensitivity has gone so far thatI even react on mobiles closer to me thanabout four metres,³

Translation from Cover story in Norwegian newspaper "Dagbladet " March 9,2002: http://www.dagbladet.no/nyheter/2002/03/09/318013.html © Dagbladethttp://www.electrosensitivity.org.uk/doctorsguidance.htm#Appendix%201

1http://www.electrosensitivity.org/

2http://www.hpa.org.uk/radiation/publications/hpa_rpd_reports/2005/hpa_rpd_010.htm

Left: Gro Harlem BrundtlandRight: http://www.electrosensitivity.org.uk/What%20is%20ES.htm

http://www.electrosensitivity.org/



FDA R eports ³Kinetics of Microbial Inactivation forAlternative Food Processing

TechnologiesOscillating Magnetic Fields´http://vm.cfsan.fda.gov/~comm/ift-omf.html

An FDA publication on the effects of oscillating magnetic fields on pathogens.

³Kinetics of Microbial Inactivation for

Alternative Food ProcessingTechnologiesPulsed Electric Fields´http://vm.cfsan.fda.gov/~comm/ift-pef.html

An FDA publication on the effects of pulsedelectric fields on pathogens.http://www.electroherbalism.com/Bioelectronics/FrequenciesandAnecdotes/CAFL.htm

These reports summarise the researchfindings of these fields on a variety of bacteria, including inactivation of micro-organisms such as E. coli, Streptococcusthermophilus and various strains of yeast.

and more links at http://rifehealth.com/index.html



TE NS Transcutaneous Electrical Nerve Stimulators

TENS machines are used for pain relief,for example, by chronic pain sufferers orfor pain during child birth.

³TEN S mac hi nes del i ver small elec tr ic al pulses to the body v i a elec trodes plac ed on the sk i n. TEN S mac hi nes are thought to affec t the way pai n si gnals are sent to

the brai n. Pai n si gnals reac h the brai n v i anerves and the spi nal c ord. I f pai n si gnalsc an be bloc ked then the brai n w i ll rec ei vefewer si gnals from the sour c e of the pai n.W e may then feel less pai n.´ http://www.patient.co.uk/showdoc/23069069/

F rom N HS Di rec t: ³a pad that admi ni sterssmall amounts of elec tr ic al c urrent,bloc k i ng pai n si gnals and st i mulat i ngendorphi ns´ http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=914

AnNHS

-A

pproved TENS machinehttp://www.maternitytens.com/index.asp?function=DISP LAYPRODUCT&productid=9

http://www3.telus.net/chemelec/Projects/Tens/Tens.htm



³Electrotherapy´ ... from IEEE Spectrum There is slow but increasing interest in various

electrotherapies.

Z ap

Schoenbach, K.H.; Nuccitelli, R.; Beebe, S.J.;

Spectrum, IEEE. Vol 43, Iss 8, Aug. 2006p20-26

A huge voltage for a just billionths of secondskills cancer cells.

³Researchers from different disciplines;electrical engineers, cell biologists andmedical professionals, work side by side at theCenter for Bioelectrics to explore the cellularresponses to nanosecond pulsed electricfields.´ http://www.odu.edu/engr/bioelectrics/biogateway.htm

Z apping away the blues: a pacemaker-like device to treat depression takes a giant step forward Moore, S.K.;Spectrum, IEEE Vol 42, Issue 5, May 2005pp16-17

http://www.odu.edu/engr/bioelectrics/index.htmlhttp://www.ece.odu.edu/nuccitelli.htm

http://www.odu.edu/engr/bioelectrics/biogateway.htm



Personal Mobile Electrotherapy?

NovoCure is currently performing clinicaltrials using 100-200 kHz electric fields,which they call tumour treating fields(TTFields), to stunt the growth of cancercells. Animal and early human trialsappear very promising.

³W hen c ells d i v i de, a molec ular motor

c alled the mic rotubule spi ndle helpssegregate c hromosomes i nto the result i ngdaughter c ells. ... i f a 200-k Hz f i eld i sappl i ed to these mac romolec ules, thespi ndle c an't form properly. As a result,c ells stop d i v i d i ng and eventually d i e.´ http://sciencenow.sciencemag.org/cgi/content/full/2007/530/3

Might these be the personal healthdevices of the future?

Safety cap.A glioblastoma patient wears the NovoTTF-100A.

http://sciencenow.sciencemag.org/cgi/content/full/2007/530/3



Personal Health Devices Mobile computing has come a

long way. Can it help do good

things for health?

... and what about ...

± mobility and usability

± privacy and security

± accountability and ownership

... there are certainly many otherissues we should consider.

There may be challenges ahead,but pervasive health technologyis undoubtedly on its way.

There is certainly great potential.Hopefully these devices w i ll helpin the art of healing.

Thank You Sandra Woolley

[email protected]

Other presentations on-line

http://www.eee.bham.ac.uk/woolleysi/thebodyelectric.ppthttp://www.eee.bham.ac.uk/woolleysi/wearablecomputingreading2005.ppt

and student projectshttp://www.eee.bham.ac.uk/woolleysi/projects/index.htm

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Phd Seminar Long