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How to Save a Life: Could Real-Time Sensor Data Have Saved Mrs Elle?
AUSTRALIAN E-HEALTH RESEARCH CENTRE
Dana Kai Bradford | Senior Research ScientistMay 2018
Bradford D. and Zhang Q. 2016 How to save a life: could real-time sensor data have saved Mrs Elle? CHI ‘16 Extended Abstracts 910-920.
Why Smart Homes?
• Ageing on the rise• 14% of the population 65+ (~3.34 million) (ABS 2013)
• Number of residential care places ~270,000 (www.AIHW.gov.au)
• Age in place (Menzies Centre 2012)
Home monitoring fosters increased independence, sense of security and lowered frustration
(IBES 2012; Doyle et al. 2009; Wild et al. 2008; Smith et al. 2007
Bradford et al. 2017 Watching over me: Positive, negative and neutral perceptions of in home monitoring held by independent
living elderly residents in an Australian pilot study. Ageing & Society)
How to Save a Life | Dana Kai Bradford
Components of the Smart Home System
How to Save a Life | Dana Kai Bradford
Type Data gathered Place of installation Sensors Motion sensor Motion within 5m Ceiling in all rooms
Power meters Power use of appliances Wall power outletsAcoustic sensor Water flow Kitchen downpipeAmbient sensor Temperature, Humidity Kitchen, bathroomAccelerometer Object movement Bed, chairReed switch Doors open/close Entrance, wardrobe, kitchen cupboard, fridgeCircuit meter Stove use Meter box
Medical devices
Blood pressure monitor
Systolic/diastolic pressure, heart rate
At resident’s discretionWeight scale Body weight Thermometer Body temperatureType Data shown Location
Tablet iPad with SSH app
Health measurements (graphs)Movement dataVideo conferencingDaily and weekly diary
Portable
Family Portal Website Varied depending on level of access
approved URL provided to approved family members
Clinical Portal Website Medical data and ADLs URL provided to approved practitioners
Activities of daily living
How to Save a Life | Dana Kai Bradford
Zhang et al. 2014. Activities of daily living assessment through wireless sensor data. Proceedings of the 36th IEEE Engineering in Medicine and Biology Society Conference (EMBC), Chicago USA.
Single sensor
Activities of daily living
How to Save a Life | Dana Kai Bradford
Zhang et al. 2014. Activities of daily living assessment through wireless sensor data. Proceedings of the 36th IEEE Engineering in Medicine and Biology Society Conference (EMBC), Chicago USA.
Two sensors
Hygiene, Dressing, Transfer
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Dressing
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Hygiene
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Transfer
Scor
es
How to Save a Life | Dana Kai Bradford
Activities of daily living − Meal preparation
How to Save a Life | Dana Kai Bradford
Zhang et al. 2014. Activities of daily living assessment through wireless sensor data. Proceedings of the 36th IEEE Engineering in Medicine and Biology Society Conference (EMBC), Chicago USA.
Multiple sensors
Mon Tue Wed17:52 – 18:49 20:46 – 21:04 11:07 – 12:55
08:40 – 09:13 13:40 – 15:07 20:30 ~ 22:00
High
Low In
fere
nce
Activity Recognition – meal preparation
How to Save a Life | Dana Kai Bradford
0
10
20
30
40
50
60
70
80
90
100
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Mobility Meal Hygiene Dressing Transfer
OADL score representing health status
How to Save a Life | Dana Kai Bradford
Estimated Vs. Self-reported health status
Home A
Home B
OADL estimation ADL estimation Self-reported
How to Save a Life | Dana Kai Bradford
Components of the Smart Home System
How to Save a Life | Dana Kai Bradford
Type Data gathered Place of installation Sensors Motion sensor Motion within 5m Ceiling in all rooms
Power meters Power use of appliances Wall power outletsAcoustic sensor Water flow Kitchen downpipeAmbient sensor Temperature, Humidity Kitchen, BathroomReed switch Doors open/close Entrance, wardrobe, kitchen cupboard,
refrigerator Circuit meter Stove use Meter box
Medical devices
Blood pressure monitor
Systolic/diastolic pressure, heart rate
At resident’s discretionWeight scale Body weight Thermometer Body temperatureType Data shown Location
Tablet iPad with SSH app
Health measurements (graphs)Movement dataVideo conferencingDaily and weekly diary
Portable
Family Portal Website Varied depending on level of access
approved URL provided to approved family members
Clinical Portal Website Medical data and ADLs URL provided to approved practitioners
Components of the Smart Home System
How to Save a Life | Dana Kai Bradford
Type Data gathered Place of installation Sensors Motion sensor Motion within 5m Ceiling in all rooms
Power meters Power use of appliances Wall power outletsAcoustic sensor Water flow Kitchen downpipeAmbient sensor Temperature, Humidity Kitchen, BathroomReed switch Doors open/close Entrance, wardrobe, kitchen cupboard,
refrigerator Circuit meter Stove use Meter box
Medical devices
Blood pressure monitor
Systolic/diastolic pressure, heart rate
At resident’s discretionWeight scale Body weight Thermometer Body temperatureType Data shown Location
Tablet iPad with SSH app
Health measurements (graphs)Movement dataVideo conferencingDaily and weekly diary
Portable
Family Portal Website Varied depending on level of access
approved URL provided to approved family members
Clinical Portal Website Medical data and ADLs URL provided to approved practitioners
Components of the Smart Home System
How to Save a Life | Dana Kai Bradford
Type Data gathered Place of installation Sensors Motion sensor Motion within 5m Ceiling in all rooms
Power meters Power use of appliances Wall power outletsAcoustic sensor Water flow Kitchen downpipeAmbient sensor Temperature, Humidity Kitchen, BathroomReed switch Doors open/close Entrance, wardrobe, kitchen cupboard,
refrigerator Circuit meter Stove use Meter box
Medical devices
Blood pressure monitor
Systolic/diastolic pressure, heart rate
At resident’s discretionWeight scale Body weight Thermometer Body temperatureType Data shown Location
Tablet iPad with SSH app
Health measurements (graphs)Movement dataVideo conferencingDaily and weekly diary
Portable
Family Portal Website Varied depending on level of access
approved URL provided to approved family members
Clinical Portal Website Medical data and ADLs URL provided to approved practitioners
Motion Sensor Firing Ceases
How to Save a Life | Dana Kai Bradford
When the curtains remained closed two days running, the neighbor alerted facility staff and Mrs Elle was found unconscious in bed at around 9.30am on 5 November.
Motion Sensor Firing Ceases
How to Save a Life | Dana Kai Bradford
When the curtains remained closed two days running, the neighbor alerted facility staff and Mrs Elle was found unconscious in bed at around 9.30am on 5 November.
Secrets in the Sensors — Motion
How to Save a Life | Dana Kai Bradford
0
50
100
150
200
250
300
350
400
Bathroom
Laundry
Lounge
Kitchen
Bedroom
Mea
n m
otio
n se
nsor
fire
s
Daily mobility prior to25 Oct
Daily mobility 25 Oct - 4Nov
Room ∆%
Bathroom -26
Laundry -53
Lounge -38
Kitchen -60
Bedroom +26
Secrets in the Sensors — Meal Preparation
How to Save a Life | Dana Kai Bradford
0
20
40
60
80
100
120
15-A
ug17
-Aug
19-A
ug21
-Aug
23-A
ug25
-Aug
27-A
ug29
-Aug
31-A
ug02
-Sep
04-S
ep06
-Sep
08-S
ep10
-Sep
12-S
ep14
-Sep
16-S
ep18
-Sep
20-S
ep22
-Sep
24-S
ep26
-Sep
28-S
ep30
-Sep
02-O
ct04
-Oct
06-O
ct08
-Oct
10-O
ct12
-Oct
14-O
ct16
-Oct
18-O
ct20
-Oct
22-O
ct24
-Oct
26-O
ct28
-Oct
30-O
ct01
-Nov
03-N
ov
Mea
l pre
para
tion
scor
e
Secrets in the Sensors — Hygiene
How to Save a Life | Dana Kai Bradford
0
20
40
60
80
100
120
15-Aug 22-Aug 29-Aug 05-Sep 12-Sep 19-Sep 26-Sep 03-Oct 10-Oct 17-Oct 24-Oct 31-Oct
Hygi
ene
Scor
e
Secrets in the Sensors — Medical data
How to Save a Life | Dana Kai Bradford
• Temperature• M=35.5°C• Fluctuating < 1°C
• Weight• M=73kg• Fluctuations up to 3kg• Overall loss 2kg
• Cardiovascular• Pulse steady decline to <50 bpm• Several systolic readings of >140mmHg• Fluctuations
Fluctuations in blood pressure
How to Save a Life | Dana Kai Bradford
0
20
40
60
80
100
120
140
160
15/08/2013 0:00
17/08/2013 0:00
19/08/2013 0:00
21/08/2013 0:00
23/08/2013 0:00
25/08/2013 0:00
27/08/2013 0:00
29/08/2013 0:00
31/08/2013 0:00
2/09/2013 0:00
4/09/2013 0:00
6/09/2013 0:00
8/09/2013 0:00
10/09/2013 0:00
12/09/2013 0:00
14/09/2013 0:00
16/09/2013 0:00
18/09/2013 0:00
20/09/2013 0:00
22/09/2013 0:00
24/09/2013 0:00
26/09/2013 0:00
28/09/2013 0:00
30/09/2013 0:00
2/10/2013 0:00
4/10/2013 0:00
6/10/2013 0:00
8/10/2013 0:00
10/10/2013 0:00
12/10/2013 0:00
Pre
ssu
re (
mm
Hg
)
Diastolic Systolic
How to Save a Life | Dana Kai Bradford
“But as far as the high blood pressure, I did actually mention to
my doctor and she sort of slightly upped the blood pressure stuff
I was taking. And then I found I had some – I had another
condition (I can’t remember what it’s called now. Means I have
too many red blood cells.) and the specialist said no, you mustn’t
have a diuretic, so she had to go back to the other one. But my
blood pressure is going up and down like a yo-yo, if that thing’s
accurate. … I’ll mention that to the doctor, but this may be due
to the treatment I’m having for this thing that’s wrong. So I’m
not really bothered about that at the moment.”
Summary of physiological and behavioral changes
How to Save a Life | Dana Kai Bradford
• reduced mobility • reduced meal preparation and • reduced attention to hygiene
• high blood pressure • odd fluctuations in blood pressure • low pulse rate • high red blood cell count
• low body temperature • losing weight • missed weekend activities and
intrastate drive
Indicative of fatigue
Recently visited GP with her concerns and had medication changed
Power of Smart Homes
• Harness information available from the sensors and devices to provide a predictive picture far more detailed than the glimpses currently seen by medical professionals. • Allow closer monitoring for people with medical conditions
• Dementia• Huntington’s Disease• Stroke
How to Save a Life | Dana Kai Bradford
Challenge:to channel the accumulated information through a clinical portal to medical professionals to alert them to inform clinical decisions based on every day behaviour.
Conclusion
In-home monitoring is effective for determining activities of daily living and the algorithms are subtle enough to detect potential impending stroke.
But the prevention of such incidents will depend on coordinated action between the monitoring system, the response service and the medical health team.
How to Save a Life | Dana Kai Bradford
Dear Mrs ElleWe would have alerted every specialist
in townHad our system known how to save a life.
Australian e-Health Research CentreDana Kai BradfordSenior Research Scientistt +61 7 3327 4404e [email protected] www.csiro.au
HEALTH AND BIOSECURITY
Thank you
Intervention
AcknowledgementsWe are very grateful to the residents who participated in the smart homes trial and the staff at the residential care facility.
We pay our deepest respects to Mrs Elle and her family.
Bradford D. and Zhang Q. How to save a life: could real-time sensor data have saved Mrs Elle? CHI ‘16 Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (in press).