ITALH Information Technology for Assisted Living at Home

1. ITALH Information Technology for Assisted Living at Home A joint initiative between UC Berkeley, U of Aarhus and Tampere UT M. Kyng, T.R. Hansen, J. Hyttinen, J. Lekkala, J.M. Eklund, J. Sprinkle, R. Bajcsy and S. Sastry

2. Presentation Outline • Background: • Aging and IT • Overall project description: • IT for Assisted Living at Home (ITALH) • Current Berkeley efforts: • The SensorNet sub-project • The IVY Fall Detector project

3. Background: Aging and IT

4. Squaring the U.S. Population Pyramid1950-2030 Age 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 1950 (150,216,000) 1980 (227,658,000) 2000 (267,955,000) 2030 (304,807,000) Source: U. S. Census

5. Changing Demographics • Table compiled by the U.S. Administration on Aging based on data from the U.S. Census Bureau.

6. Table compiled by the U.S. Administration on Aging based on data from the U.S. Census Bureau.

7. Worldwide age wave is coming: 2002 2002 Percentage of Population over 60 years old Global Average = 10% SOURCE: United Nations ▪ “Population Aging ▪ 2002”

8. Worldwide age wave is coming; 2050 2002 2050 Percentage of Population over 60 years old Global Average = 21% SOURCE: United Nations ▪ “Population Aging ▪ 2002”

9. Opportunities and Challenges According to the NSF: • Technologies that meet the challenges of aging will be increasingly valuable • We must identify collaborative, technology transfer, and technology development and deployment opportunities for government, industry, and academia that help improve the independence, mobility, security, and health of aging U.S. citizens. • We must examine potential opportunities and barriers and identify and prioritize recommendations both near and long term, including Grand Challenge class recommendations

10. But . . .Definition of “older” is evolving • Old doesn’t mean disabled or poor. • Old doesn’t mean institutionalized. • Only 10% of those 65-85 and 25% of those adults 85+are institutionalized. • Gender matters. • Most of the elderly are and will be women.

11. The Longevity Paradox • At 50, many will have more than half their adult life still ahead, most living on their own. • According to the world’s oldest person, “I enjoy longevity because I have my health and can do things.” • Enabling older adults to “do things” and assisting those who care for them will become a leading global market--for those who choose to invest in it.

12. Ageless Information and Telcom Technologies • Technologies that: • are usable by all ages • address the needs of all ages • adjust to the needs, abilities, and preferences of users • equally engaging to all ages

13. What is Telemedicine? • Telemedicine is a technology-rich alternative to a traditional face-to-face physician consultation. Physician Station Patient Station Courtesy Dr. Richard Re, Ochsner Clinic • Audio/video interaction • Data exchange: real-time / store-and-forward • Multimedia electronic patient records (EPRs) • Medical devices: blood pressure cuff, pulse oximeter, stethoscope, weight scale, temperature probe, ECG leads, ...

14. High-End Mid-Range Economy Categories of Systems

15. Telemedicine: Key Issues • Home health care • Reactive/episodic  preventative/predictive • Beyond “telemedicine” • Medical systems (Component confederacies) • Ability: Smart, decision-enabled, and capable • Layout: Distributed and dynamic • Practicality: Cost-effective & high-surety • Information and communication technology: enabling factor

16. Telemedicine Misconception • “Telemedicine”  real-time communication • (replicate traditional patient-physician consultation) • Practical remote medicine: • sensor-based systems • store-and-forward framework • monitor/alert systems

17. In person visit  telemedicine  smart sensors “Virtual” medical systems: distributed, networked devices Patient-Centric Health Care & Internet EPR’s Telemedicine Novel Devices Future Directions • New model for home care • Webs of self-aware devices • Assess/treat patients • Make care decisions • Predict health • Health Care delivery in pull mode rather than traditional push mode

18. Future Home Layout

19. Current Devices and Systems • E.g., Honeywell HomMed Products • http://www.hommed.com • Telemedicine applications Spirometer PT/INR Peak Flow/FEV1 ECG Blood Glucose Oximeter

20. Current Test Systems • E.g. MIT’s PlaceLab: http://architecture.mit.edu/house_n/placelab.html • 100s of sensors • Requires massive computing power and storage

21. Requirements for Smart Home Care Systems • Devices: smart, aware • Interoperable • Collective Intelligence • Distributed • Dynamically configurable • Secure, Private

22. Technology Drivers • Interoperability Technology • Home Networking Standards • Network-Enabled Devices • Novel Sensors • Environmental Sensors

23. Number Crunching Data Storage productivity interactive Technology Trends: Bell’s Law – new computer class per 10 years log (people per computer) streaming information to/from physical world • Enabled by technological opportunities • Smaller, more numerous and more intimately connected • Ushers in a new kind of application • Ultimately used in many ways not previously imagined year

24. Wind Response Of Golden Gate Bridge Fire Response Building Comfort, Smart Alarms Vineyards Instrumenting the world Great Duck Island Redwoods Elder Care Factories Soil monitoring

25. Mote Evolution Evolution of 3 technology generations

26. Information Technology for Assisted Living at Home - ITALH University of California Berkeley/CITRIS Technical University of Tampere/Ragnar Granit Institute University of Aarhus/Alexandra Institute

27. ITALH Finland: Tampere University of Technology, VTT Denmark: Aarhus University The Alexandra Institute Bay Area: CITRIS, UC Berkeley Information Technology for Assisted Living at Home Electronic Health Records Miniaturized wireless ambulatory wearable sensors, visual and other stationary sensors System software, wireless architecture & user interfaces Independent living of elderly Partner: Finnish American Heritage Association, Sonoma Projects directly under ITALH Supportive projects

28. Technical and Commercial Rationale • Opportunities • Disappearing electronics enable new phase for embedded systems • Wireless technologies are about to mature • Challenges • Real time systems and software face some very unique challenges when they are embedded in the physical world • Successful solutions require that technical possibilities and scientific analysis are balanced with usefulness and the development given direction through user needs

29. Technical and Commercial Rationale • Payoff • Through participatory design with stakeholders the cluster creates a unique opportunity to develop novel approaches and solutions • It will be developed and testing in three international settings • It will provide the participant with a competitive advantage in a rapidly growing market

30. The Application: Elder/Home Tech • Goals • Societal: to improve the potential for better quality of life for elder citizens • Technological: to develop and test concepts and prototypes in a diverse set of real life settings • Commercial: to create new global market opportunities • Project Research Areas • Enabling technologies: • Embedded software systems and architecture • Wireless sensor and other systems • Design methods and usability • Uses and services • Evaluation of societal needs and impact of technology • Real applications and test sites

31. Technology contributions: Enabling Technologies • The new enabling technologies provides ways to develop new smart wireless home services and systems • Embedded Software Systems • Berkeley and Aarhus • Wireless • Berkeley and Tampere • Sensors • Tampere, Aarhus and Berkeley • Electronic packaging • Tampere and Berkeley • Software Infrastructure/Architecture • Aarhus and Berkeley • User Interfaces • Aarhus and Tampere

32. Technology contributions: Embedded Software Systems • This is an essential part of modern electronics devices of all kinds • They generally contain custom software which must be very carefully designed and tested • This is a difficult task, particularly to do efficiently, and is an ongoing research issue

33. Technology contributions: Wireless technology • Wireless technology is essential to the project in order to: • Reduce installation/retrofit costs • Enable mobility and flexibility • Reduce the obtrusiveness of the technology • The project will carry out advanced research in • Wireless security • Robustness and mobility • Device power requirements

34. Technology contributions: Sensors/Computer Vision • Computer vision can provide very efficient and effect methods of remote: • Therapy • Non-invasive monitoring • And even diagnosis • The challenge of computer vision is to reduce the enourmous amount of information in images to be: • Compact enough that it doesn’t require many system resources • Sufficient and clear enough to be useful

35. ECG plaster ECG plaster ECG implant HEART MONITOR Technology contributions: Sensors • Required for • home safety • reporting of sudden health problems • feedback for medication planning • The project carries out research in • Configuration redesign for new packaging dimensions • Power consumption • New sensing possibilities • Design methods

36. Technology contributions: Implantable Sensors biocompatible material capsule (hermetic layer) power S1 Signal and data processing Wireless link Wireless link Information processing and transfer RF- link Readout electronics S2 User interface S3 sensors antenna data antenna readout device implant skin body outside

37. Technology contributions: Electronic Packaging • Present technology using ASIC circuits in standard packaging on printed circuit boards can not provide necessary integration level especially for continuous health monitoring • The project will carry out research in new 3D system in package (SiP) technology • All components – including the passive ones – are to be packaged into 3D stacked structure • Mass manufacturing of SiPs • Biocompability of the sensors for health System Miniaturization and Integration for 3D Stacked SiP by TUT/ELE

38. Technology contributions: Software Infrastructure & Architecture A new robust software infrastructure is needed to support IT systems for elderly people The project will carry out research in infrastructure/software architecture • Support easy installation and updating of software from remote locations • Mobile applications, data & sessions • home care people and visiting elderly people should be able to carry this stuff around • Robustness, security, privacy, safety, accessibility

39. Technology contributions:User Interfaces Current technology is too difficult to install and use • Elderly people are often resistant to using it The project will focus on developing user interfaces that • Make it easy to install devices/equipment • Make it easy to identify the cause of a breakdown • Are trustworthy for elderly people • Allow for varying levels of interaction, e.g. for service provider, relative, users own choice

40. Supporting elder citizens: first elaboration • Self-care and preventative efforts • People want to be able to take care of themselves and stay in their own home as long as possible • Can we design different kinds of technology, which can help elder citizens take the proper medication? • Safety and security at home • If elder citizens stay in their own homes for more years, they – and their family and friends – need support in order to rightly feel safe and secure • Cooperation and services • How can computer technology be designed to improve the communication and coordination in the care and treatment? • How can it support the elderly in taking on a more active role?

41. Evaluation: Societal Needs and Impact • Preparatory and on-going analysis of needs, including: • Factors affecting technology adoption • The short and long term effects of new technologies • The contribution of technology to the integration and coordination of care • The market level effects to health plan benefit providers • The regulatory policies impacting the adoption and diffusion of these new technologies

42. SensorNet UC Berkeley/CITRIS Thomas Hansen Mike Eklund Jon Sprinkle Shankar Sastry Ruzena Bajcsy

43. SensorNet Objectives • To provide the wireless infrastructure and remote connectivity for ITALH • Use largely COTS components • Focus on integration, robustness privacy and functionality • Provide early prototypes to enable other aspects of the project

44. SensorNet Overview

45. Privacy and Security • Privacy must be built into these systems from the start • Embedded "smart" sensors will reduce the wireless traffic and increase privacy by only sending alerts • Live monitoring or access to stored data will be only accessible by authorized and authenticated users • Secure wireless, internet and telephone access

46. Security and Privacy: Embedding • Fundamental to maintaining privacy in the project is the embedding of data processing in the sensors • Information will not be streamed over the Internet nor the local wireless network as a rule • This reduces bandwidth requirements • And (more importantly) maintains privacy • Streamed data can be requested, e.g.: • Remote check-in via camera • Current signal data such as ECG

47. Security and Privacy: Wireless • Bluetooth has built in (and evolving) security. • There are three modes of security for Bluetooth access between two devices. • Security Mode 1: non-secure • Security Mode 2: service level enforced security • Security Mode 3: link level enforced security • ZigBee (802.15.4) security includes methods for • key establishment, • key transport, • frame protection, and • device management.

48. Security and Privacy: Internet • Collaboration with VTT and their B2C-MED project (with Jaakko Lähteenmäki)

49. Use of IT for health in the home • Embedded, intelligent sensors as event monitors: • Provide private monitoring and alerting • Can also enable telemedicine functions • Can be used as • A personal system • Or integrated with a health care provider system • Smart sensors can/will be easy to install and operate • Will be modular and upgradeable: • Learning and/or assimilation technologies that will customize the devices to individuals.

50. ECG plaster ECG plaster ECG implant HEART MONITOR Functions and Applications • Wearable devices • Accelerometer-based fall sensors: IVY Project • ECG and other bio-monitors: Tampere • Connect to fixed and mobile base stations • Fixed place monitors • Room monitors, vision systems • Environmental monitors • Identification of functions and devices are part of the development process • System development: • Robustness • Reliability • Low power consumption. • All these properties are necessary for wide public acceptance.