CAPSIL - OCG · CAPSIL International Support of a Common Awareness and Knowledge Platform for...

CAPSIL

International Support of a Common Awareness and Knowledge Platform for Studying and E bli I d d t Li i

CAPSILEnabling Independent Living

Support Action (Apr 2008 - Mar 2010) theme FP7-ICT-2007.7.1 €500,000 (budget)

R. Benjamin Knappj ppQueen’s University, Belfast, UKNetwell Centre, Dundalk, [email protected]

www.capsil.org © CAPSIL 7 April 2009

Th EU C t t f R d iThe EU Context for Roadmapping

AALIANCE is providing a framework for stakeholders, led by industry, to define research and development priorities, timeframes and action plans on strategically important issues in the field of ambient assisted living (AAL). CAPSIL is developing a roadmap and Wiki for EU research to achieve effective and sustainable solutions to independent living based on an in-depth analysis of clinical requirements and the ICT scenarios developed or under development in the EU, as well as the US and Japan. SENIOR is providing a systematic assessment of the social, ethical and privacy issues involved in ICT and Ageing, in order to plan strategies for governing technology trends according to EU legal and ethical standards.ePAL is developing a strategic research roadmap focused on inducing new ways towards a balanced active life for retiring and retired professionals while promoting a new notion of g p p gthe silver economy with a wide societal impact.

www.capsil.org © CAPSIL 1 October 2009

Th T lkThe Talk

CAPSIL and Its GoalsCoordination between the EU, US, and JapanThe CAPSIL WikiThe Development of a Roadmap and The Technology Gaps p p gy pin the Road


P j t W b it ilProject Website - www.capsil.org


CAPSIL’ th f d t l bj tiActivities -

CAPSIL’s three fundamental objectives

Website, WorkshopsWiki Input…

A Mechanism forCAPSIL

Consolidated

A Mechanism for Continual Sharing

of InformationCo so da edRoadmap

Wiki

To help li k

www.capsil.org

policy makers in the US, EU, and Japan

coordinate research© CAPSIL 1 October 2009

E l M ti i W hi t D CExample Meeting in Washington, D.C.

Engagement with 60 individuals among program officers ofEngagement with 60 individuals among program officers of US and EU agencies and researchers from the US, EU, and Japan to discuss potential synergisms among EU and USJapan to discuss potential synergisms among EU and US federal agencies and other US Institutions with focus on research on aging and independent livingresearch on aging and independent living(over 20 distinct funding agencies and institutions)


Example MeetingW hi t DCWashington DC

1. Delegation of the European Commission in Washington DC,2 H d f S t ICT & A i I f ti S i t & M di D G2. Head of Sector ICT & Ageing, Information Society & Media D-G,3. Office of Science Policy, National Institutes of Health,4. International Research Activities and Legislative Officer, National Institute on Aging/National Institutes of Health,5. Office of Europe and Eurasia, Office of Global Health Affairs,6. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health,7. Agency for Healthcare Research and Quality, Office of the National Coordinator for HIT (ONC),8. Department of Health and Human Services,Center for Primary Care, Prevention, and Clinical Partnerships,9 Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation Office of9. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of

Disability, Aging, and Long-Term Care Policy,10. Cerebral Palsy International Research Foundation,11. Cerebral Palsy International Research Foundation (CPIRF) Scientific Advisory Council,12 US D t t f V t Aff i12. US Department of Veterans Affairs,13. Center for Aging Services Technologies (CAST),14. American Telemedicine Association,15. President of the European Research Council,16. Office of International Science and Engineering, National Science Foundation,17. Biomedical Engineering Program, National Science Foundation,18. Computer and Network Systems Division, Computer and Information Science and Engineering Directorate, National

Science Foundation

www.capsil.org © CAPSIL 7 April 2009

Science Foundation,19. Integrative, Hybrid and Complex Systems Program, National Science Foundation,20. National Institute on Aging/National Institutes of Health.

AAL Technologies in the USAAL Technologies in the US

Safety TechnologiesFall detectionMobility aidsStove use detectorsSmoke and temperature alarmsSmoke and temperature alarmsDoor locksWander management toolsWander management tools

Health / Wellness TechnologiesHealth coaching disease managementHealth coaching, disease managementTelemedicine, home monitoringMedication management


gCognition

AAL Technologies in the US:Safety Technology Example - Currently Available MonitoringSafety Technology Example - Currently Available Monitoring System

Quiet Care


AAL Technologies in the US:S f t T h l E l R h S tSafety Technology Example – Research System

ORCATECH

Fusion


AAL Technologies in the US:Serious GamingSerious Gaming


AAL in Japan:Changes from Japanese Health Insurance Reform

Environment

Changes from Japanese Health Insurance Reform

(1) Suppression of Increasing Medical Payment by Government(2) Change of major type of disease (lifestyle related diseases)(3) Increase awareness and risk management for companies(3) Increase awareness and risk management for companies(4) Increase health related payment for individuals Japanese Health related Policies(1) Ad ti f N i C I (2000)

Cure to Prevention・Make prevention(1) Adoption of Nursing Care Insurance (2000)

(2) Plans for Prolonging Healthy Life Expectancy(3) Change of Medical Service Payment System (2003)(4) Ch f H it l S t (2002 3)

・Make preventionobligatory

・Start large scale clinical interventions(4) Change of Hospital Systems (2002～3)

(5) Medical insurance & nursing care insurance change (2006)(6) Change of Industrial Safety and Health (2006)(7) Ch f H lth I L (2008)

clinical interventions・ Start discussing medical service paymentof prevention (7) Change of Health Insurance Law (2008)

Overall, the Japanese policies are shifting from “cure” to “prevention and control” However the government has not provided the services with ICT

o p e e o


control . However, the government has not provided the services with ICT. Home care agencies focus on terminal care.

AAL in Japan:Business Example ANZEN Center azbil

Steps

Business Example ANZEN Center azbil

Safety Service CenterCustomer at home

a) Manual or automatic alarm on a pendant or wrist band (emergency false alarm or to chat)

Steps

false alarm, or to chat)

b) Call the customer to confirm alarm, (or call the customer once a month)

a

c) Call a relative or neighbor and ask him/her to check on the customer

d) Visit the customer to check his/her

b

d fg

condition

e) Report the condition and situation

f) Call for emergency dispatchc e h

R l ti i hb

Medical emergency center(Fire station or hospital)

f) Call for emergency dispatch

g) Send an ambulance to the customer


Relative or neighbor Medical care center h) Transport the customer to a medical care center.

AAL i J R b t f lfAAL in Japan: Robots for welfare

PARO AISTMY SPOONSECOM CoSECOM Co.

WAKAMARU RI MAN Riken

PAPERO NEC Co.


HAL Tsukuba Univ.WAKAMARU Mitsubishi Co.

RI-MAN Riken

Differences between the EU, US, and Japan? Differences between the EU, US, and Japan?

Technological – Very FewOpportunity for coordinated strategies, research and data sharingOpportunity to examine best practicespp y p

Social / Support Networks - HeterogeneousC liti i t ithi t i i t l t tCommonalities exist within certain societal structuresOpportunity to look at focused solutions for specific support structures

Reimbursement – Large Differences in Care Delivery and Economic Cost Distribution

Opportunity to examine best practicesOpportunity to examine best practices


R d d Wiki D l t M th d lRoadmap and Wiki Development Methodology

Development includes these four steps:Development includes these four steps:Baseline Analysis (Where are we) Vi i i (Wh d )Visioning (Where do we want to go) Gap analysis (What are we missing)Implementation

Current CAPSIL consolidated roadmap 150 pages


Current CAPSIL consolidated roadmap, 150 pages.

CAPSIL Wiki C tlCAPSIL Wiki - Currently

230 i Wiki230+ main Wiki pages100,000+ words350 pages

www.capsil.org Slide 17

Adopting a hierarchical structureh Wikito the Wiki

Describe the i it ti

Describe the preventative

This naturally leads into the use of enabling technologies and research into these

Scenarios based th

Leading nicely

E bli t h l i p

unique situations that older people

encounter

preventative measures and

interventions that may be taken

technologies and research into these technologies as described in the WPs.

Common themes can be merged and highlighted

on these technologies can then be described

g yinto the

roadmap

Enabling technologies and issues

ase

entio

n

os adm

ap

BodySensor

Networksd di

sea

inte

rve

cena

ri

SIL

Roa

Networks Homeand MobileMonitoringTransportationei

ng a

n

on a

nd Sc

CA

PS

Software(Knowledge,

Fusion)Wel

lbe

Prev

enti

Links back to wellbeing

www.capsil.org

P Links back to wellbeing and disease and

prevention and intervention

An Example StructureAn Example Structure

www.capsil.org

CAPSIL Wiki ( )CAPSIL Wiki (a)


CAPSIL Wiki (b)CAPSIL Wiki (b)


CAPSIL Wiki ( )CAPSIL Wiki (c)


Th Fi t G ( d S l ti )The First Gap (and Solution)

The Knowledge Gap (CAPSILS of knowledge) • Where do you get information on who is doing what, where, when,

and what are the results?


Th S d G Wh t i th P bl ?The Second Gap: What is the Problem?

If everyone:stayed healthycould perform all the activities of daily livingstayed employedy p ymaintained their social network

to the level that they always enjoyed until the day theyto the level that they always enjoyed until the day they died

Then:Then:there is no problem


Healthcare: Extends life – doesn’t save lives

What is the goal?What is the goal?

Staying at Home

Life

y g

ality

of Residential Care

Qua

Acute Care


COST [ $/Day]

The Real AAL Roadmap:C B ith P th l (G )Curvy, Bumpy, with Potholes (Gaps)

Reimbursement

Standards

Life

Larger Deployments

ScalabilityPilot Studies

ality

of

Initial Telehealth /

Qua

Telecare Systems


COST [ $/Day]

What are the Technological Gaps in the R d ?Roadmap?

• Development of Requirements• Some of the Areas:• Some of the Areas:

• Body Sensor NetworksH & M bil M it i S t• Home & Mobile Monitoring Systems

• Software and Interfaces• Intervention Systems


RequirementsR h d D l t GResearch and Development Gaps

Data Quality:•collection of data in uncontrolled (e g home mobile office)

Clinical Requirements•lack of commonality between study reference points, definitions and data sets

(e.g. home, mobile, office) environments

•currently mostly population studies not individual studies

•need for personalisation of measures and individualised therapiesindividualised therapies

Cost / Benefit Analysis•Collection of data on cost savings vs. quality of life

www.capsil.org

Body Sensor Networks Research and Development GapsResearch and Development Gaps

Pilots• More data is needed on home monitoring and pervasive sensing to show clinical

Power Sourcee.g. Solar, Fuel Cells, Power Scavengingand pervasive sensing to show clinical

benefits. Power Scavenging

Ultra‐low power radio

Biocompatibility•Studies on long term effects of sensors on human cells tissue is needed

Ultra low power radio•To prolong the lifetime of the sensors and enable miniaturisation, an ultra‐low power radio is essential for a on human cells tissue is neededWBSN.


Body Sensor Networks Research and Development Gapsesea c a d e e op e t Gaps

Usability and Practicality•Continue research on integrating

Trust, Security and Policy•With the very limited resources on the sensors further research is required to

sensors into garments and other everyday objects.

sensors, further research is required to implement the required security policies for patient data

RF EffectsRF Effects •What are the effects on human exposure to RF fields over long periods (heating etc). No real data

Autonomic Networks•Self Organizing/healing properties. Increasing reliability through smart routing, distributed inferencing and management p ( g )

here.distributed inferencing and management methods.


Home and Mobile Systems Research and Development GapsResearch and Development Gaps

Sensing and Data Collection•Unobtrusiveness•Elder involvement

Clinical Evidence and Benefits•Algorithms for early detection and prognosis

•Adaptability•Robustness, self‐monitoring, self‐organizingS h i ti

prognosis•Understanding dynamics of diseases•Indentify target usage models e.g. CHF and DiabetesEffi ff i d i•Synchronization

•Location and context assessment•Efficacy, effectiveness and economics

Integration to Workflow andData Processing and Inference

•Privacy and security•Standardization•Inference algorithms and Sensor fusion

Integration to Workflow and Usability

•Scalability•Data representation, summarization

•Inference algorithms and Sensor fusion•Detection and recognition of ADLs, IADLs, and unusual events

and visualization•Human Factors Considerations –Stakeholder needs and usability

•Integration with medical and clinical


Integration with medical and clinical data (PHR and EMR)

Home and Mobile Systems Research and Development Gaps

System Design•Scalability•Usability for elders and caregivers•Usability for elders and caregivers•Access: high speed broadband•Reliability and network performance

Engineering Research Data Fusion Techniques •Unsupervised calibration and maintenance•Integration and synchronization•Individual identification, localization

•Information fusion algorithms and statistical estimation techniques

•Statistical pattern recognition, including activities of daily livingactivities of daily living

•Early detection of slow, subtle changes•Environmental and contextual adaptation


Software and Interfaces Research and Development GapsResearch and Development Gaps

Networking•Access to Broadband•High‐Speed 'intelligent' networks

Data: Reduction/Retrieval/Mining

•Round‐trip clinical validation of data•High Speed intelligent networks•Context awareness e.g. Use of 'push‐based' P2P

•Research into ubiquitous/pervasive

Round trip clinical validation of data inference

•Advanced data mining in the face of interpretation of

/ /computing•Research into outdoor/mobile systems

privacy/security/national data constraints

•Standardised data production, consumption and provenanceconsumption and provenance

Interoperability•Need for International standard for

Interfaces•Alternative User Interfaces e g Haptic Need for International standard for

FDA/CE type compliance•standardised service platforms

Alternative User Interfaces e.g. Haptic, Tangible, Ambient, Surface

•Customisation/Personalisation


M t lit d DiMortality and Diseases

The World Health Organization has identified risk factors associated with the main causes of mortality in the World and set goals to address such factors with the


goal of improving life expectancy and quality of life.

Intervention SystemsResearch and Development GapsResearch and Development Gaps

Interoperability and Standards•No appropriate end‐to‐end standard•No defined connectivity between

li bl t d d

Coordinated interventions to address multiple health issues

•Need for systems that deliver a multi‐f l di d i iapplicable standards

•Data connectivity between the home and EHR/PHR required

•workflow to manage multidisciplinary

focal coordinated interventions•Need clinically valid protocols for combining and coordinating care for multiple conditionsg p y

teamsmultiple conditions

Privacy and SecurityUsability

•improved ease of use•common security model that is configurable for access

•show value proposition of sacrificing some degree of privacy (education)

improved ease of use•adaptive interfaces (cognitive, vision, hearing)

•more sophisticated user models for ld l ( h l fsome degree of privacy (education)

•generate trust with users•New intervention protocols for ensuring privacy and security

elderly users (archetypal reference personae)

•tailored views/interfaces for clinicians, caregivers, family, elders


caregivers, family, elders

Intervention SystemsResearch and Development GapsResearch and Development Gaps

Quality of lifeAcceptance/Safety

•improved reliability of robots•need to focus on QOL and physical functionality, cognitive performance and mood

•address depression before trying to change

p y•quality assurance, fault tolerance and failure detection and analysis

•Standards for assisted driving systemsaddress depression before trying to change health behaviours

•more work on developing socialisation interventions: research into robot/human

/interactions/companions, socialisation feedback, video interventions

Clinical Benefits•more large scale pilots needed•identify target usage models•improve ease of use•improve ease of use•abstract technical usage detail from non‐technical users e.g. clinicians


Common Themes: Toward Jumping the Gaps in the RoadmapCommon Themes: Toward Jumping the Gaps in the Roadmap

Common Themes•Person‐centred ergonomic designP i it d•Privacy, security and access•Evidence based research, large scale deployments•Focus on QOL and mood•Development of ontologies knowledge models and algorithms for•Development of ontologies, knowledge models and algorithms for data reduction/retrieval/mining•Inclusion of context awareness including location, emotion, and healthhealth•Business models and the economics of ageing•Evolution of standards and interoperability and lowering of trans‐jurisdictional barriersjurisdictional barriers•Holistic (across all aspects of ageing), but heterogeneous (specific to regions and cultures) approach


CAPSIL C ti M bCAPSIL Consortium Members

U i it C ll D bli H d M di l S h l tUniversity College Dublin, Ireland

Harvard Medical School at Spaulding Rehabilitation

University of Genoa,Italy

Intel Performing Learning Solutions(Intel Digital Healthcare)

Queens University Belfast, UK

Oregon Health (Intel Digital Healthcare)Oregon Health & Science University, USA

Waseda University,Tokyo Japan


Imperial College of Science,Technology and Medicine, London UK

W b it htt // ilWebsite: http://www.capsil.org

www.capsil.org

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