Basic components for building mHealth devices.

One step beyond the platform is adding other components. What do you create when your motto is “Computing stuff tied to the physical world?”  A tiny, fairly well featured kit with wireless capability. The JeeNode wireless communication platform.

It looks like a fun and cost effective way to get into experimenting with RF communication. By combining an Arduino-compatible processor (ATmega328) with a low-cost HopeRF radio module, Jean-Claude Wippler in a town called Houten, The Netherlands,  creates these building blocks and offering them for sale as a kit, or, since it is an open source hardware design, you can just download the PCB layout and roll your own. You can think of lots of applications (remote candle lighter, interactive cat toy:)) that aren’t worth a full xBee-based solution, where it would be handy to have a development board like this that I could just drop in and use.

Jee Labs also has a weblog with daily news about projects being worked on in the fascinating world of physical computing, wireless comm’s, sensors, lights, switches, motors, robots, WSN’s, Arduino’s, you name it.

Wireless Sensor Networks and mHealth basics 3.

Last theory on Wireless Sensor Networks coming up. What about the software, middleware and programming languages?

Software

Energy is the scarcest resource of WSN nodes, and it determines the lifetime of WSNs. WSNs are meant to be deployed in large numbers in various environments, including remote and hostile regions, with ad-hoc communications as key. For this reason, algorithms and protocols need to address the following issues:

• Lifetime maximization
• Robustness and fault tolerance
• Self-configuration

Middleware

There is considerable research effort currently invested in the design of middleware for WSN’s. In general approaches can be classified into distributed database, mobile agents, and event-based.

Programming languages

Programming the sensor nodes is difficult when compared with normal computer systems. The resource constrained nature of these nodes gives rise to new programming models although most nodes are currently programmed in C.

• c@t (Computation at a point in space (@) Time)
• DCL (Distributed Compositional Language)
• galsC
• LabVIEW
• nesC
• Protothreads
• SNACK
• SNAPpy (Python)
• SQTL
• Java Sun SPOT
• uSWN

MHealth secures hygiene in hospitals.

Experts say nearly 2 million hospital-acquired infections occur each year, resulting in about 5,000 deaths and more than 90,000 illnesses in the US. Research shows that simple hand washing by medical staff could cut the number of infections in half. But what if your rushing to the next patient? There is now a wireless, credit-card-sized sensor that can detect whether health care workers have properly washed their hands upon entering a patient’s room.

The Virginia Commonwealth University Medical Center was chosen as a study site because of its higher-than-average rate of hand hygiene compliance, nearly twice the national average. The sensor is worn like a name badge and is programmed to detect the presence of ethyl alcohol, the most common ingredient in hand cleansing solutions used in hospitals.
When a health care worker enters a patient’s room, a small, wall-mounted sensor sends a signal to the badge to check for the presence of alcohol. The worker places their hands near the badge to obtain a reading. Lights on the badge glow red if no alcohol is present, indicating the need to wash hands. A green light indicates alcohol is present.

“Health care workers don’t deliberately avoid washing their hands; they get distracted or are so busy moving from one thing to the next they don’t remember to do it,” said Mike Edmond, M.D., chief hospital epidemiologist. “Until now, the only way we’ve been able to track hand washing habits is through direct observation. This new system continuously monitors and records data and serves as a constant reminder.”

The hand hygiene program is part of an aggressive environmental and patient safety campaign at the VCU Medical Center called Safety First, Every Day. The goal of the campaign is to make the medical center the safest health care institution in the country with no events of preventable harm to patients, employees and visitors. The device was developed by BioVigil, LLC.

MHealth muscles tests more accurate.

Doctors test the strenght of intrinsic hand muscles by letting the patient pull an push at their hand and fingers. Is this an accurate methode? No, a team of bioengineering students from Rice University developed a device to measure thenar, hypothenar, interosseus and lumbrical muscles.

Graduates Caterina Kaffes, Matthew Miller, Neel Shah and Shuai “Steve” Xu invented PRIME, or Peg Restrained Intrinsic Muscle Evaluator, for their senior project. “Twenty percent of all ER admissions are hand-related. Neuromuscular disorders like spinal cord injuries, Lou Gehrig’s, diabetes, multiple sclerosis-all these diseases affect the intrinsic hand muscles,” said Xu. PRIME, was created to replace the common test. The real goal is to quantify finger/muscle strength for a more accurate diagnosis for carpal tunnel syndrome evaluation and other disorders.

“U.S. surgeons perform over 500,000 procedures for carpal tunnel each year. $2 billion per year is spent treating this disease but up to 20 percent of all surgeries need to be redone. Our invention can be used across the spectrum of care from diagnosis to outcome measurements,” said Xu.

The device has three elements: a pegboard restraint, a force transducer enclosure and a PDA custom-programmed to capture measurements. In a five-minute test, a doctor uses pegs to isolate a patient’s individual fingers. “You wouldn’t think it works as well as it does, but once you are pegged in, you can’t move anything but the finger we want you to,” Miller said. A loop is fitted around the finger, and when the patient moves it, the amount of force generated is measured. “PRIME gets the peak force,” Xu said. “Then the doctor can create a patient-specific file with all your information, time-stamped, and record every single measurement.”

MHealth business models changing.

The business models for wireless based healthcare are fluid. eHealth style services are online but should the system enable the patient to manage their own health on there health portal? The UK NHSDirect has been set up and the Danish healthcare uses Sundhed.dk

Most ehealth services around the world adhere to a version of the model here on the right. Healthcare providers aspire to a more complex ehealth model. One in which all information flows are automated, data is held centrally and surgery, like other procedures that require physical contact with the patient, is carried out in special treatment centres. See the advanced eHealth Model on the left.

The Sundhed portal, as it is based on IBM’s WebSphere platform, could eventually act as a front end for the disease and public health monitoring applications. However the healthcare IT world has changed by the emergence of Google and Microsoft as potential suppliers of personal healthcare record vendors. IBM has itself acknowledged as much and is now, via the Continua Alliance, working with Google.

The idea that Microsoft and Google are merely a pair of disruptive new players in a healthcare market, where the incumbents cannot provide the tools that enable consumers to manage their own health, is a bit too simplistic. The threat to established healthcare providers is far more subtle than a direct and open attack on their business models. At first viewing, the threat appears to be from Google Health and Microsoft’s HealthVault themselves. However it is the ease to connect to there platform, hand out free of charge, to new entrants to the healthcare market that will create an enormous driving force.

As the ehealth developers armed with Google and Microsoft SDKs take healthcare into the clouds next generation healthcare providers will be start to use the disease knowledge-base their users construct to force the pharma industry into deals. In some cases these deals will disadvantage incumbent healthcare providers. This means that when, with the help of Google and Microsoft, cloud based ehealth providers start establishing themselves in the healthcare market the demise of the incumbent providers will be quick.

Mindcontrolling by mHealth-devices.

For some years now researchers at the University of Zaragoza in Spain are working on a wheelchair that would be operated by thought alone. Can we control devices just by thinking? The work in Spain has yielded a prototype model that essentially performs the basic task of getting a person from one place to another.

By first providing options on a laptop screen for where to go, the system then reads EEG waves as the user focuses on the preferred choice and moves the chair accordingly. The chair displays a realtime 3D HUD while the user concentrates on basic functions, such as rotating the chair left or right. That information is read by the chair via EEG waves (the electricity running along your scalp as a byproduct of your brain working). The chair also features laser sensors, allowing it to override a circumstance in which a misreading could drive the user into a wall or an innocent bystander.

The company Ambient introduces a same breakthrough wheelchair called the Audeo. Thought generated control is also in development in recent game controllers. And Adam Wilson, a graduate student at University of Wisconsin-Madison, linked up a “mind-reading” system developed at the Biomedical Engineering department to work with Twitter. By using EEG to record brain wave variations in patients focusing on a flashing letter. People who are locked-in and are not able to voluntarily use their muscles are now able to Tweet just like anyone else.

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.

RFID tags for medicine control at home.

RFID tracking is here. Want to know which medicine, when or what dosis to take? Just start with a home RFID kit for just $50.

Attach the RFID tags to things around your home or office, install the software and you’re good to go. You can use your own programming skills to make your computer do various things when various RFID tags are presented to your reader, or use an application website to link your RFID tags to just about anything on the web.

There are now two products on the market with the same kind of product and service. Mir:ror is an Internet of Things app from the company Violet. As the name suggests, it is literally a mirror – but an Internet-connected one which detects the objects you show it, triggering applications and multimedia content on your computer. It works via RFID stamps. These are colorful adhesive stamps that contain a relay chip. When the user waves a stamped object over the mir:ror, a pre-programmed action occurs. This can also mean reading a message aloud to you.

Second is Touchatag an internet startup from Alcatel-Lucent.  With a Touchatag starter kit and some client software, you can also program your own RFID tags so that they can do anything you want them to do. They can launch an application, deliver you to a URL, and much more. What’s great about Toucha’s tags is that you don’t need a specialized RFID reader in order to scan them. They’re can also be read with a barcodescanner in any enabled mobile phone.

The usage for medicinecontrol are specialy interesting. Reading the stamp you put on the medicinebottle can not only inform the patient with information about his useage, but can also sent data to a medical centre.

The Mir:ror also works with the company’s other internet-connected object: the Nabaztag, a cute robot rabbit that can deliver anything from ambient information through lights and sounds to verbal information.

A lot of telemedicine-stuff can be seen as mHealth.

Today just a nice video about some latest telemedicine equipment.

The mHealth information management system at home.

The confrontation with MHealth-services lies in the homes, office-buildings and even the streets where people go. What do we know about that context? Who’s in charge of health information at work? Who plays the main nursing role in the home? It’s important to learn what livingconditions are, starting with the household.

Patti Brennan, professor at the University of Wisconsin-Madison, spoke on the emerging field of home-health information technology last week. She stressed that, “if we truly want to get the power of healthcare in the hands of people and have them use health information technology, we need to think about people where they are.” It’s essential to know about the home environment.  There are at least five influencing factors to consider: living conditions, social, technological, psychological and health service options. “What tools might be useful to people as they face health care in homes?” asked Brennan. The question is how to help patients with chronic illnesses improve their health by helping them record, understand and act on information they record about their daily lives.

These observations of daily living, or ODLs, are thought to be the key to designing effective health 2.0 tools. People are not apt to keep a daily health journal of habits and behaviors. Focus on creating innovative ways to capture this information. You can’t sell health by just delivering cool tools. There must be an understanding of the daily lives of individuals.

What could these capture tools possibly look like? Brennan described smart clothing that monitor critical health indicators, or carpeting with sensors that will recognize a change in a person’s cadence – an early sign of confusion and cognitive ailment. Air sensors and other environmental tools could monitor for pollen density in homes. Tools can be mobile, such as a portable health diary, a key fob that would encourage exercise, or cell phone application that captures food intake and connects to medical records.

“The popularity of consumer electronic devices such as the iPhone, iPod and even gaming systems like the Wii could provide the so-called “killer ap” said Brennan. “This will drive patient adoption of data-capture devices. Challenges lie in monitoring and reporting the data in stream, and figuring out what the data means”.

The idea behind ODLs is moving consumers to the next level of responsibility for their own choices and their own health. There has to be thought given to the shift in accountability for health care decision-making. Environmental readiness will be a key issue. Future development of healthcare IT in the home is guided by principals that promote dignity, autonomy and well being in communities. Moving beyond industrial services and toward patient activation and engagement. Brennan:”People need to be trained, perhaps starting as early as Kindergarten, to think about taking an active part in their own health.”