Affordable Location Based Services - Med-e-Tel

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levels. ISMB has more than 150 researchers involved in the following domains e-Health: • Telecare and telemedicine ser
Affordable Location Based  Services (LBS) to assist Services (LBS) to assist  Alzheimer’ss Disease Patients Alzheimer Disease Patients G.Bestente1, A.Frisiello1, F.Scullino1, G.Isaia2, D.Vesco3, M.Massaia4 1Istituto Superiore Mario Boella (ISMB), e‐Health Dpt, Turin, Italy  (bestente@ismb it frisiello@ismb it scullino@ismb it) ([email protected][email protected][email protected]) 2San Luigi Hospital of Turin, Geriatric Dpt, Turin, Italy ([email protected][email protected]) 3 University of Turin, Graduated in Medicine, Turin, Italy  ( [email protected] ) 4San Giovanni Battista Hospital of Turin, Geriatric Dpt, Turin, Italy ([email protected])

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Istituto Superiore Mario Boella (ISMB) ISMB (www.ismb.it) is a non-profit organization founded in 2000 by Compagnia di San Paolo and Politecnico di Torino. ISMB in an applied research centre that operates in the ICT field and its main objective is to innovate at both technology and process levels. ISMB has more than 150 researchers involved in the following domains

e-Health Health:: • Telecare and telemedicine services • Biomedical images processing • Optimisation of health processes

Sustainable Mobility and Logistics: Logistics: •embedded systems; vehicular communication •process process control and applications •localization systems and services

Environment and Energy: Energy: •monitoring and control through pervasive technologies •data management and process innovation [email protected]

The Problem • Patients with dementia (AD or vascular dementia) already from the early stage of the illness may be subject to episodes of confusion and space-time disorientation. This often happens in unpredictable ways, with consequences that sometimes can be very serious. • With the progress of the disease, the escape and wandering can become symptomatic and recurrent events. • Currently, the problem lies completely on the families, which without other solutions, often get to drastic measures, reducing patient’s freedom When this is not possible, freedom. possible they live in a state of continuous stress whenever their relative moves away. Æ • Location Based Services (LBS) can probably provide an useful help at an affordable cost .

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Methodology • Both Technology and Human Factors have been the main drivers of this work. • User Centered Approach: users have been involved in the design process, since the early stages -> problem setting and the users’ requirements collection byy means of interviews and meetings g with g geriatricians, p patients and caregivers. g •

Scouting about on-the shelf technologies and services solutions



Laboratory test and field trial with potential users



Developments of innovative components

• Usability and acceptance tests with final users (more than 100 people involved) •

Field trial of the innovative components with real users



Dissemination technology and service model transfer Dissemination, [email protected]

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Location Based Service Components • a tracker  for the Patient: mobile  phone/personal tracker. (dimension and  weight, battery autonomy, GPS  sensitivity, reliability, cost) • a terminal device (mobile or fixed) for  the Caregiver (preferably a device  already used and known) • A Server Application to store and  manage location and user data •An Operations Center 7x24 available

These items make possible to provide different Service Models: self-managed, mediated by a Service Center or provided with a mixed approach. . [email protected]

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Innovative Components  After the laboratory tests and a short users trial we have decided to develop some new components: •“Sono Qui” (“Here I Am”), An application based on the Qt Library for Symbian, d developed l d for f the th Patient’s P ti t’ Device

A simplified touch screen interface: it provides main contact pictures larger than usual and includes a soft SOS key key.

We have also customised a Commercial Tracker in order to make it more acceptable.

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“SONO QUI” The “Sono Sono Qui Qui” ((“Here Here I Am Am”)) application enables: • location on-demand • tracking • geo-fencing “Sono Qui” automatically starts when the phone is switched on and it works in background. To locate the patient, the caregiver has to send a SMS from his own mobile phone (no application is required) to the patient’s patient s mobile phone phone. Here, when the SMS has been received, the “Sono Qui” automatically performs a fix (by means of Assisted-GPS); it carries out reverse geocoding to provide the corresponding address, and finally replies all the informations via SMS to the caregiver phone and via GPRS to a server. The message contains the hyperlink to a Map Server, the fix accuracy expressed in meters, the fix timing and the patient’s phone battery level. Moreover “Sono Moreover, Sono Qui Qui” enables the continuous tracking (activated via SMS as well) useful in case of the patient’s loss, for the final rescue operations. “Sono Qui” could be proposed to the patients at the early phase of the disease, when they still use a mobile phone. Since the application does not require any active action by the patients, it keeps be useful also with the disease evolution. Patients must only carry the smart-phone with them as usual. usual

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SMS with location data

Location on a map, activated by the link

Usability and Acceptance Tests y p Usability and acceptance of the evaluated terminals and developed solutions have been tested with end-users, end-users in a geriatric day hospital, hospital involving a sample of 109 end users (57 patients, 52 caregivers).

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Patients and Caregivers profile  Patients (57):     38 females,   19males (57): 38 females 19males Caregivers (52): 39 females,13 males (52): 39 females 13 males Average age:  79 Dementia level ((MMSE)) Group 1: 33 patients: mild stage (19‐25) Group 2: 19 patients: moderate stage (10‐19) Group 3: 5 patients: severe stage (