MHealth and thought control.

First came the joystick. Then came the motion-sensing Wii remote. What´s next? Sensors and mobiles are opening up a new world: thought control.

Co-founded by Allan Snyder, a neuroscientist and former University of Cambridge research fellow, Emotiv says its EPOC headset features 16 sensors that push against the player’s scalp to measure electrical activity in the brain – a process known as electro-encephalography. In theory, this allows the player to spin, push, pull, and lift objects on a computer monitor, simply by thinking. “There will be a convergence of gesture-based technology and the brain as a new interface – the Holy Grail is the mind” says Snyder.

Last month the Defence Advanced Research Projects Agency (Darpa), an arm of the US Defence Department, said it had awarded a $6.7 million contract to Northrop Grumman to develop “brainwave binoculars”. The binoculars use scalp-mounted sensors to detect objects the user might have seen but not noticed – in other words, the computer is used as a kind of brain-aid, giving the user superhuman vision.

Explaining the technology, Dr Robert Shin, an assistant professor of neurology and ophthalmology at the University of Maryland School of Medicine, said: “There is a level where the brain can identify things before it ever makes it to the conscious level. Your brain says, ‘it may be something’, but it might not realize that it is something that should rise to the conscious level.”

Another defence contractor, Honeywell, has been working on a similar technology known as “augmented cognition” to help intelligence analysts to operate more effectively. Based on the same principle as the binoculars, it has been shown to make analysts work up to seven times faster. It can also detect when they are getting tired. In other tests, soldiers have been kitted out with headsets that detect “brain overload”, allowing commanders to know if they can process new information under the extreme pressures of the battlefield.

mHealth and Motion capturing.

Motion capture, or Mocap, is a technique for digitally recording movement. Are we playing games her? Originally used as an analysis tool for biomechanics, mocap is now successfully employed in a wide variety of sectors including mHealth related applications.

Movement is captured through the placement of sensors (or markers) on or near each joint of the body. As each joint moves the positions or angles between the markers are recorded. Software records the, angles, velocities, accelerations and impulses, providing an accurate digital representation of the movement.

Realtime data from mocap enables the diagnosis of problems or enhancement of performance in the arenas of biomechanics and sports. It can also assist in the design of products or buildings when applied to the field of engineering or ergonomics. Animazoo distinguishes three types of Mocap´s.

Gyroscopic systems use tiny inertial gyroscopes that are attached to a body. These directly record the rotations of the body parts. The rotational data is transmitted by radio to a receiver unit where it is mapped instantly to a skeleton in order that the data can be visualized in realtime. These systems perform with no lag in realtime, producing incredibly accurate data. The data retains nuance even with fast moves.

Mechanical systems track body joint angles directly and are often referred to as exo-skeleton mocap systems, due to the way the sensors are attached to the body. A person attaches the skeletal-like structure to their body and as they move so do the articulated mechanical parts, measuring the performer’s relative motion. Mechanical motion capture systems are realtime, relatively low-cost and usually wireless. Movement is captured through the placement of sensors (or markers) on or near each joint of the body. As each joint moves the positions or angles between the markers are recorded. Software records the, angles, velocities, accelerations and impulses, providing an accurate digital representation of the movement.

Optical systems triangulate the 3D position of a marker between one, two or more cameras that have been pre-calibrated for distance to provide overlapping projections. Tracking a large number of markers or multiple performers is accomplished by the adding more cameras. These systems can be expensive to buy, require technical expertise to operate and are studio based. They have a relatively small capture area and can suffer from occlusion as well as being complicated to set up. Magnetic and electrical interference makes these systems highly susceptible to error, they also require extensive data cleaning and technical expertise to operate plus they suffer from limited area of use and lag for realtime use.

Magnetic systems calculate position and orientation by measuring the relative magnetic flux of three orthogonal coils on both the transmitter and each receiver. Magnetic systems require only two-thirds the number of markers compared to optical systems. One drawback is that the markers are susceptible to magnetic and electrical interference from metal objects in the environment and electrical sources. Magnetic and electrical interference makes these systems highly susceptible to error, they also require extensive data cleaning and technical expertise to operate plus they suffer from limited area of use and lag for realtime use.

Sensing textiles as part of your Mobile Body Area Network system.

Sensoring your body while doing everything you are used to do. Is this possible? Comfortable smart clothes that monitor the wearer’s heart, breathing and body temperature promise to revolutionise healthcare by allowing patients to lead there normal lives.

Unlike many remote health monitoring systems that rely on sensors strapped to users’ arms or chests connected by wires to bulky equipment, a Greece team from the Sotiria General Chest Diseases Hospital in Athens, has embedded sensing devices directly into textiles, creating garments that are not only smart but also comfortable and practical to wear. Data from the biosignals collected by the clothes is then sent via a mobile connection to caregivers, allowing doctors to check up on their patients and warning if their health deteriorates.

Whereas other remote monitoring systems require different sensors linked to different transmission devices, the HealthWear system collects all the information from the sensors into a single device called a Portable Patient Unit (PPU). The embedded sensors include a six-lead electrocardiograph (ECG), respiration movement, pulse rate and skin temperature monitors, in addition to an external oximeter to measure blood oxygen saturation and a 3D accelerometer inside the PPU to measure body position. The data are then transmitted via a secure GPRS mobile connection to a central server.

“The information is stored on a patient’s electronic health record and can be accessed via a secure TCP/IP internet connection by doctors and caregivers, in either near real-time or off-line mode,” explains Alexis Milsis, a research engineer at the Sotiria e-Health Unit.

Caregivers, meanwhile, can easily access patients’ data, allowing them to visualise the patients’ progress accurately over time and even monitor their data in real time. This feature allows doctors to perform remote checkups by speaking with the patient via a videophone and instructing them to perform different exercises while they monitor their ECG and oximetry readings.

Ten features that make a tablet PC a unique device.

And here they are:

1. Write on the screen and draw figures and diagrams when taking notes. Use different color pens, circle things and draw arrows to indicate relationships and to mock up flow diagrams.
2. The interface is more personable and less intrusive. Comfortably hold the tablet and look at the person in the face.
   
3. Use it when standing, so it provides tremendous flexibility taking notes at the bedside.
4. Get a full keyboard when needed or swivel the screen.
5. While in a meeting, you can easily get away with a tablet.
6. You can be more efficient and faster navigating an electronic health record (EHR) that’s optimized for pen-based computing.
   
7. Using handwriting recognition forces to improve and maintain a certain quality of handwriting clarity.
   
8. Showin g patients diagrams, pictures, etc. to others.
   
9. It’s so natural to use the pen to scroll and “flip” through pages like a book while reading.
   
10. It invaluable on a plane and the person in front of you reclines and diminishes your workspace.

Hope Phones for mHealth in Africa.

FrontlineSMS:Medic is a realy interesting initiative started by post-grad students out of Stanford University. They are the type of entrepreneurial digital natives that buck tradition and do something different, something that actually works. So what do the do? First was a rich text service. Now it’s the introduction of the HopePhone.

That team has built a major campaign, Hope Phones, to gather unused and discarded mobile phone handsets and convert them into funds for use in their mobile health campaigns in Malawi and elsewhere in Africa.

“Hope Phones will make use of the nearly 450,000 cell phones discarded every day in the US. HopePhones.org allows donors to print a free shipping label and send their old phone in to The Wireless Source, a global leader in wireless device recycling. The phone’s value allows FrontlineSMS:Medic to purchase usable, recycled cell phones for healthcare workers.”

This is a fundraising campaign, one put in place to promote a project that already has a track record of working.

Get involved:
1. Visit www.HopePhones.org and donate your old phones.
2. Spread the word:

• Email your friends, family, classmates and coworkers.
• Post on Facebook and become a fan of the Hope Phones page.
• Tell the world on Twitter – use #HopePhones as a tag so we can thank you.
• Let us know if you want the Hope Phones widget for your website or blog.

3. Contact info@hopephones.org if you’d like to help set up a Hope Phones collection center.

Location Based Services in Uganda using SMS.

The Grameen Foundation on Tuesday launched the first application of its Application Laboratory (AppLab) project. It aims to use the proliferation of mobile phones in Africa as a way to get information and services to poor communities in Uganda without Internet access.

The project began 18 months ago. The Grameen Foundation has been operating a village phone service in Uganda, and had almost 50,000 people receiving “pay-by-the-minute mobile phone services. The foundation wanted to broaden into information services and it sought out Google and MTN as potential partners. They did extensive ethnographic studies to see what kinds of services the Ugandan people wanted and did pilot projects in the field to test out early versions of the services. They’re launching with a few services and hope to add more later. Eventually, they hope to branch out to other countries in Africa.

“The new services work through any phone capable of sending or receiving SMS messages”, Joseph Mucheru, Google’s director of sub-Saharan Africa business, said, adding that almost all phones in Uganda will be able to use the services. “The five applications use Google SMS Search technology and MTN’s telecom network. They include

• Farmer’s Friend, a searchable database with agricultural advice and weather forecasts.
• Health Tips with sexual and reproductive health information, paired with
• Clinic Finder, to locate nearby health clinics.
• Google Trader, which matches buyers and sellers of agricultural produce, commodities and other products.

Content is provided by local partners. Marie Stopes Uganda and the Straight Talk Foundation provide health information, while the Busoga Rural Open Source Development Initiative (BRODSI) provides agricultural information created and tested by small-holder farmers.

Guidelines for physicians using mHealth for clients.

Managers of Mobile Workers deal with new ways of working. Are there lessons learned for medics in relation to mHealth-patients? Just look at the lists below. It’s translated from the business-world to healthcare, just changing some roles. Does it make any sense to you?

The benefits of mHealth:

• mHealth brings a broder range of influence for the medics as they can relate to more patients.
• You gain access to a wider range of talents, knowledge and experiences, not only on better informed patients but also with co-workers.
• A vast majority of clients are more motivated in a flexible, mobile care environment than a traditional one.
• mHealth clients continue to shift doctor’s attention from activities to deliverables.
• Time gain can mean acting proactive in stead of reactive.

Possible challanges of mHealth:

• There is a risk of potential decrease in productivity.
• More influence of the client replaces positional power of the doctor.

Strategie-components for integrating and managing mHealth within the physician practice:

• Focus on building relationships.
• Streamline communications.
• Incorporate less didactic forms of communications.
• Spend more time listening.
• Let mHealth patients define communication and reporting practices they want to follow.
• Manage deliverables, not activities.
• Engage in more frequent and informal preformance management activities.
• Give complete trust until given an concrete behavioral reason to do otherwise.
• Use adaptive management styles tailored to individual clients.
• Leverage technology.

Inspiring isn’t it.

The era of m-Health, sensors and social networking.

Citysense aims to let users find the most popular night spots in San Francisco and the most efficient ways to get to them. Does Healthcare has something to do with this similar real-time location data analysis? The next stage of projects/products will be to enable users to social network, using data from sensors as an input. And sensors we have in mHealth.

Citysense is heading in this new direction. With the next release of its product aiming to guide ‘tribes’ of people together using location data. It will soon be able to show not only where anonymous groups of people are in real time, but where people with similar behavior patterns or health conditions to you are. To do this, Citysense will categorize people into “tribes”. So far, 20 tribes have been identified, including “young and edgy,” “business traveler,” “weekend mole,” and “homebody.” It will use not only GPS (location) data from mobile phones and taxis, but also publicly available company address data and demographic data from the U.S. Census Bureau.

Sensors have become much more prevelant in mobile devices. This means that when we talk about sensors, we’re not necessarily talking about the microchip embedded in your fridge door. Increasingly, sensors are attached to a human via their mobile phone.

One application for sensors in social networks is to help people to meet others, using alerts based on their location at a particular time. A recent W3C Workshop paper entitled Integrating Social Networks and Sensor Networks contains two suggestions using sensor-enabled portable devices:

“Social networks and sensor networks can be combined to support independent living and health support for elders. By deriving semantic presence based on context from sensor-enabled social networking devices, we can carry out useful tasks for the elderly. For example for daily living purposes, we can check the status of the friends and find shopping or walking buddies to promote the mobility of elders. By using semantic representations of information from sensors, we can build on the idea of connecting people through shared activities and interests. More importantly, we can send alerts based on abnormal activity patterns. Through sensor readings of body position or health measurements, we can issue requests for attention not just to carers or clinicians but to nearby friends in the elder’s social network.

“More and more portable devices are supporting sensor-based interactions, from peripherals (Nike+iPod) to integrated sensors (the original iPhone made good use of its accelerometer, while the latest iPhone 3G has added various proximity and light sensors). We can make use of the Social Web and Sensor Networks to create collaborative applications for portable devices to encourage exercise, à la the Wii. As an example of how this could be done, we could begin by finding contacts on the social network with similar interests or by GPS location. This social network of friends can then be used to power collaborative applications where progress can be made by the group when a certain level of exercise has been achieved. Then, as a final step, the resulting sensor data is sent to physicians for analysis.”

The conclusion of the W3C paper is that “the integration of sensor networks with social networks leads to applications that can sense the context of a user in much better ways and thus provides more personalized and detailed solutions.”

MHealth sector most promising for M2M datadelivery.

The number of mobile network connections used for machine-to-machine (M2M) communications will grow from 37.5 million in 2007 to 186 million in 2012. Vehicle telematics, also known as wireless vehicle communications technology, apps will dominate the M2M cellular market in most parts of the world, accounting for more than half of all network connections by 2012. Has healthcare anything to do with this growth? What’s  the impact?

Mobile healthcare solutions are expected to grow substantially. Similar to other type of large-scale machine-to-machine
solutions, mHealth solutions involves complete dataconnectivity services that require a new approach, new products and
expanded service levels from mobile GSM/GPRS operators.  There are 3 challanges:

• mHealth solutions involve full and automated integration of connectivity solution into different objects, terminals and machines.
• mHealth solutions will be integrated in units (mobile and fixed) indented for an international marketplace in stead of national business approach.
• mHealth solutions include large-scale deployments of machines interacting with the mobile network implying completely new requirements on reliability, security and scalability from a mobile operator perspective.

Last week T-Mobile announced the first-of-its-kind embedded SIM for Machine-to-Machine (M2M) solutions. Nearly the size of a head of a pin, the durable embedded SIM withstands challenging environmental factors such as temperature, humidity and motion to deliver reliable wireless connectivity. The embedded SIM is ideal for telematics and smart grid infrastructure solutions where environmental factors may reduce reliability and increase maintenance costs of removable SIM-based solutions. The embedded SIM differs from today’s SIMs in that it’s built from silicon, not plastic. The embedded SIM is designed to be hard-mounted onto M2M modules, accelerating deployment by allowing customers to go directly from the factory to the field without having to provide and manually insert a SIM card.

The Swedish network provider Telenor said on last Med-e-Tel conference that they creating a clear global approach for the mHealth industry, including key learnings from already deployed M2M solutions on an international level like. “We expect the Healthsector to be the third most promising for M2M mobile devices and datadelivery” said Robert Brunbäck, strategic business manager at Telenor.

The mHealth Value Chain.

Developing a mHealth service comes with some specific characteristics. What about the value chain? A model with knowledge management insights gives perspectives,

The initial investment in a mHealth service is independent of the number of users. Reproduction and possible earnings of the service is controlled by the customers, not by the producer. That’s one of the reasons that production cost greatly exceeds the reproduction cost and most of the spendings are accumulated at the front-end of production.

Building a mHealth service means creative use of components like: databases, statistics, collections, publications, documents, correspondence, photographs, diagrams, presentations, speeches, lectures,recorded experiences, stories, laws, regulations and procedures.

The client engages the service with his own experience and self-learning, influenced by beliefs, perspectives and values.The mHealth user competences are: awareness, skills, mental models, expertise, judgement, wisdom and memory.

The health decision process of users is a combination of mHealth-components, -competences and the interfacing in between.

The value of a mHealth service is very difficult to measure. It’s extracted when the service is used. Sharing increases the value of the service. While judging the value in advance is very hard to do. Value can be added by offering the right service at the right time.

So we can look at the value chain from two perspectives: the user and the service provider.

On basis of his sensing, the user starts a process building up his knowledge about a specific situation to make his decision and adopt new behavior. The service provider develops a picture of his customers in order to deliver his product.

A mHealth service adds value by linking the product of the provider, in a meaningfull way, to one of the chains of the user value chain. A qualitative high mHealth service supports the development of the usercapacity and -process to collect and preserve inputs, sharing and integrating newly created information in order to support learning and adaption of health related competences.