OVERVIEW OF THE OPENCARE PROJECT


The OpenCare Project is divided into four logic tiers. The Home, Central, Public and Mobile-tier. The Home-tier logically belongs at the end-users home, while Central-tier contains the central server and database, as well as various business-logic code. The Public-tier constitutes the facades for the administrative staff and professional caretakers, hospital staff, general practitioners, and home nurses and other caretaking staff. Represented by either a PC, web or mobile solution. Also, the Public-tier is available as distribution services, including as SOA-based web services and other supported heterogenic distribution middleware standards.

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Figure 1: The four tiers of the OpenCare Infrastructure, along with the major components contained within them.

The Home-tier consists of a stationary touch screen unit in the end-users home (but may also be a regular PC or even a headless unit), including a near-zero-configuration framework [37], a reminder framework, a persistency framework and an alert and alert media framework. Also, a symbiotic mobile framework (OpenCare Personal Communication Device) is under development, allowing the user the freedom of leaving his or her home while continuing being monitored – shifting to the Mobile-tier.
It has previously been argued that usability and efficiency are some of the primary success criteria in order to get a pervasive healthcare system successfully deployed in the user’s homes [36]. We cannot expect the relatives or caretaking staff who are installing and handling these systems, or new sensors, to have the necessary technical expertise to handle complicated installation procedures.

Therefore all installation should occur with zero or minimal configuration (near-zero) efforts. To ensure this, an essential part of the system is the near-zero-configuration sensor framework [38], which allows sensors and base stations to configure and pair automatically. This is accomplished through Bluetooth, WiFi and other wireless and wired technologies as discussed in [37]. Minimal required user interaction is one of the most important elements of ubiquitous and pervasive computing, and this is thus a very important aspect of the system, and is widely implemented at current.
As stated earlier, the system today supports a wide range of wireless sensor types from different manufactures, and all of these may be automatically detected, which will lead to automatic driver download and activation in the running system in the users home, without any kind of user interaction. As such the system achieves a kind of zero-configuration, or almost zero-configuration, as the use of a NFC -device-based binding mechanism is necessary, as true zero-configuration has proven not to be practical possible to implement, as discussed in [37]. Minimal required user interaction is one of the most important elements of ubiquitous and pervasive computing, and this is thus a very important aspect of the system, and is widely implemented at current.

In the Central-tier we find the domain model of the system, modelling users, equipment, relations (including who should receive which data, in which formats and on which media). For instance, the users being monitored are found in this database, including personal records, a reminder calendar, the data that has been gathered from sensors and other sources, as well as which caretakers and relatives should receive status information and data from them, including alerts on media such as SMS texts, email, callbacks to surveillance software and more. Also in the Central-tier, we find a service layer, servicing the Home-tier, and thus the software running in the user’s homes. There is also a layer servicing the Public-tier. A range of different heterogenic distribution middleware types are supported here, including web services for maximum openness to different operating system and programming language platforms. In the Central-tier, the hostDriverRepository is also hosted, which contains all known drivers for any sensor devices supported by the system. Usually a device is identified using its MAC-address or its Service signature (which is the case for most Bluetooth-based devices).

New hostdrivers must implement the IHostDriver interface, which must then be compiled to a .NET assembly and deployed on the repository, and the database needs to be updated with its UID. This is all that is needed to add a new hostdriver to a running system, and start deploying software.

The Public-tier is divided into several views providing different functionality for different user groups. One view targets the administrative staff, providing features for creating the data entities: users, sensor types, host drivers etc. This is provided by a web application for easy deployment. However, in order to allow maximum flexibility and openness, all functionality is also supported by a distribution middleware, so that it is easy to integrate the administrative functionality in existing applications, including PC, UNIX, LINUX, Apple or web based, not locking developers to the web platform. Again, as all code is open source, one can easily change the code as preferred, while the modularized design further enhances this

The Public-tier also provides a view for the associated caretaking staff. This includes home nurses, general practitioners, and hospital physicians. Views for relatives are at current rather limited, but does include receiving emails or SMS based text messages.
The system is developed for the .NET platform using the C# programming language for application development and ASP.NET for web development. As such, the system requires a .NET common language runtime virtual machine to run on a given platform This currently limits the system to primarily the Microsoft Windows family of PC and server operating systems, although the Mono project might LIN
UX enable the code with some modifications. This has not yet been tested however.

REFERENCES

  • [1] US Census Bureau, International Database. Accessed via Internet: http://www.census.gov/ipc/www/idb/, November 2008.
  • [2] T. Ezzati-Rice, D. Kashihara and S. Machlin, “Health care expenses in the United States, 2000”, Agency for Helatchare Research and Quality, Report 04.0022, 2004.
  • [3] J.E. Bardram, A. Mihailidis, D. Wan, “Pervasive Computing in Healthcare”, CRC Press, p.6, 2006.
  • [4] “Scaling Mount Proteome to bring down chronic disease”. The Pfizer Journal®, Global Edition Volume 1I, Number 2, 2001, 4-9.R.
  • [5] Centers for Disease Control and Prevention, National Center for Health Statistics, Health United States, “Limittation of acitivity caused by selected chronic health conditions among working-age adults, by age United States, 2004-2005.”, 2007, Figure 16. Data from the National Health Interview Survey. Accessed via Internet: http://www.cdc.gov/nchs/data/hus/hus07.pdf, November 2008.
  • [6] Centers for Disease Control and Prevention, National Center for Health Statistics, Health United States, “Limittation of acitivity caused by selected chronic health conditions among older adults, by age: United States, 2004-2005.”, 2007. Data from the National Health Interview Survey. Accessed via Internet: http://www.cdc.gov/nchs/data/hus/-hus07.pdf, November 2008.
  • [7] J.E. Bardram, A. Mihailidis, D. Wan, “Pervasive Computing in Healthcare”, CRC Press, 2006.
  • [8] S. Candrili, J. Mauskopf, “How much does a hospital day cost?” Presented at: 11th Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes Research May 20-24 2006. Philadelphia. PA
  • [9] L.M Tolstrup, A. Bonne, Dansk Regioner, Note on the Estimated Average Value of 1 Day of Hospitalization in a Danish Public Sector Hospital, data drawn from http://www.sst.dk/-Planlaegning_og_behandling/DRG.aspx , November 2008.
  • [10] R. Bennefield, R. Bonnette, “Structural and occupancy characteristics of housing: 2000”, United States Census Bureau, Report No. C2KBR-32, 2003
  • [11] J. Keye, T. Zitzelberger, “Overview of healthcare, disease, and disability”, in “Pervasive Computing in Healthcare”, CRC Press, p. 3-20, 2006.
  • [12] R. Thractenberg, C. Singer, J. Kaye, “Symptoms of sleep disturbance in persons with Alzheimer’s disease and normal elderly”, Journal of Sleep Research 14, 177-185, 2005
  • [13] M. Weiser, “The computer for the 21st century”. In Scientific American, September, 1991.
  • [14] M. Weiser, “Some computer science issues in ubiquitous computing”. In Communications of the ACM, July 36, vol. 7, 1993.
  • [15] D. A. Norman, “The invisible computer: why good products can fail, the personal computer is so complex, and information appliances are the solution”. The MIT Press, Cambridge, Massachusetts, USA, 1998.
  • [16] H. Kautz, L. Arnstein, G. Borriello, O. Etzioni., D. Fox. “An overview of the assisted cognition project.”, AAAI-2002 Workshop on Automation as Caregiver: The Role of IntelligentTechnology in Elder Care, Edmonton, Alberta, 2002.
  • [17] Seon-Woo Lee, Yong-Joong Kim, Gi-Sup Lee, Byung-Ok Cho, Nam-Ha Lee, “A remote behavioral monitoring system for elders living alone”, Control, Automation and Systems, 2007. ICCAS '07. International Conference on, pages 2725_2730, Oct. 2007.
  • [18] C.Y. Huang and J.L. Su, “A middleware of dicom and web service for home-based elder healthcare information system”. Information Technology Applications in Biomedicine, 2007. ITAB 2007. 6th International Special Topic Conference on, p. 182-185, Nov. 2007.
  • [19] DICOM. Accessed via Internet http://medical.nema.org/ , Nov. 2008
  • [20] NEMA. Accessed via Internet http://www.medicalimaging.org/. November 2008
  • [21] U. Varshney, “Pervasive healthcare and wireless health monitoring”, Mobile Networking Applications, 12(2-3)113-127, 2007
  • [22] A. Bamis, D. Lymberopoulos, T. Teixeira, A. Savvides, “Towards precision monitoring of elders for providing assistive services”. In PETRA '08: Proceedings of the 1st international conference on Pervasive Technologies Related to Assistive Environments, pages 1-8, New York, NY, USA, 2008. ACM.
  • [23] D. Kirovski, N. Oliver, M. Sinclair, D. Tan. “Health-os: a position paper”. In HealthNet '07: Proceedings of the 1st ACM SIGMOBILE international workshop on Systems and networking support for healthcare and assisted living environments, pages 76-78, New York, NY, USA, 2007. ACM.
  • [24] L. Schwiebert, S.K.S. Gupta, and J. Weinmann, “Research challenges in wireless networks of biomedical sensors”. In MobiCom '01: Proceedings of the 7th annual international conference on Mobile computing and networking, pages 151-165, New York, NY, USA, 2001. ACM.
  • [25] M. Rodrig, A. LaMarca. “Oasis: an architecture for simplified data management and disconnected operation”. Personal Ubiquitous Computing, 9(2):108-121, 2005.
  • [26] J. E. Bardram, C. Bossen, A. Thomsen, “Designing for transformations in collaboration: a study of the deployment of homecare technology.” In GROUP '05: Proceedings of the 2005 international ACM SIGGROUP conference on Supporting group work, pages 294-303, New York, NY, USA, 2005. ACM.
  • [27] Telcomed, “About us”, Accessed via Internet: http://www-.telcomed.ie/about_us.html, November 2008
  • [28] Corscience, “Telemedicine”, Accessed via Internet: http://www.corscience.de/en/medical-engineering/products-systems/telemedicine.html , November 2008
  • [29] Tunstall, “Telehealth Monitors”, Accessed via Internet: http://www.tunstallhealthcare.com/Default.aspx?ID=2137, November 2008
  • [30] Intel, “Intel Health Guide Overview“, Accessed via Internet: http://www.intel.com/healthcare/ps/healthguide/index.htm, November 2008
  • [31] Continua Alliance, “Home Page”, Accessed via Internet: http://www.continuaalliance.org, November 2008.
  • [32] Continua Alliance, “Overview”, Accessed via Internet: http://www.continuaalliance.org/about/, November 2008.
  • [33] Continua Alliance, “Delivering on the promise of modern medicine: the need for interopable health & medical devices”, Accessed via Internet: http://www.continuaalliance.org/news_events/news/back-grounder, November 2008.
  • [34] Continua Alliance, “Continua Overview Presentation”, Accessed via Internet: http://www.continuaalliance.org/about/Continua-_Overview_Presentation_v10.1.pdf, November 2008.
  • [35] Linux Information Project Definition. “Vendor lock-in definition”, Accessed via Internet: http://www.linfo.org/vendor_lockin.html, September, 2007. [35]
  • [36] S. Wagner, "Towards an open and easily extendible home care system infrastructure”, Proceedings of the 2nd International Conference on Pervasive Computing Technologies for Healthcare, Tampere, Finland 2008
  • [37] S. Wagner, “Zero-configuration of pervasive healthcare sensor networks” Proceedings of the The Third International Conference on Pervasive Computing and Applications (ICPCA2008), Alexandria, Egypt, 2008.
  • [38] R.A. Soerensen, J.M. Nygaard, “Distributed zero configuration base station”, Proceedings of the 2nd International Conference on Pervasive Computing Technologies for Healthcare, Tampere, Finland (2008).