PRE2016 3 Groep14

This is the project page of group 14. Initially, this group was mostly focussed on developing smart home technology for elderly people, while keeping the needs and wished of these people in mind. Because this subject was very broad, it evolved into smart technology for just monitoring people's health by measuring their heartbeat. The group wants to ask elderly people for their preferences and then develop a simple prototype of this smart monitoring system.

Group members

• Jeffrey Baijens
• Margot Emke
• Jari van Ewijk
• Marjolijn Kleijer
• Bram Lustenhouwer
• Wouter Wolthuis

Introduction

According to the Global Health and Aging report, by the World Health Organization (WHO), the world population is growing and the age composition of the world population is changing over the years. This causes an increase in the amount of elderly, which can be seen in Figure 1. The increase is mainly caused by the “baby boom” between the years 1946 and 1964 in combination with the rising life expectancy within the older population itself.

With the population ageing, there are expected challenges to our health care system. Future shortages of healthcare workers and lack of the diversity of their professions is likely. To be able to manage the increasing demand for healthcare, new models of care will be required. One of the possible solutions is to implement medical equipment in a smart home. This medical equipment can be for example a "smart heart", which constantly checks the condition of the heart.

Our goal

The goal of our project to build an interface for the application of a smart heart inside a smart home. First, it is important to determine what the needs the elderly and care givers are.To determine what the elderly and care givers want, a literature search will be done and a questionnaire will be taken. After the questionnaire, the results will be processed and discussed, where after decisions can be made about the design of the user interface.

What is a smart home?

A smart home, or house, is a home in which the appliances and other systems in the house can be monitored and controlled from anywhere in the world. [1] Via the use of a phone, or other means of connection to the internet, the functions available to a home can be controlled. One could with a specific app, for example, control the lighting, temperature, doors and windows, security systems, manipulate other devices, such as turning off TVs, and more. One could monitor the energy consumption of the house and reduce it by closing windows, shutting off appliances, stop warm water circulation and so on. [2]

Even the exact location of the residents inside or their belongings can be kept track of. This can be used to simplify searching for specific items, as well as monitoring activity to allow the system to notice when accidents might have occurred, for example, if an elderly person fell. Smart Homes are designed with the idea to make life easier and more comfortable and improve energy management and thereby reducing the costs of living.

There are a number of concepts that are important to the idea of a Smart Home: [2] Simplicity is one such an important concept. In general, these Smart Homes experience a lot of different end-users and therefore must be useable by all kinds of people with different technical skills. Our focus lies in Smart Homes for the elderly, to improve on their independence and comfort. For these users, it is important to keep the controls simple, such that these technologies do not have a high barrier to entry for less technically experienced users.

However, with the use of different levels of abstraction, simple systems could be used by more capable individuals to adjust these houses to their needs and preferences. As mentioned before, these homes will experience a variety of users. Therefore, mobility is another aspect of Smart Homes important to consider. What this entails, is multiple types and brands of devices should be applicable to and detectable by the Smart Home. For example, it should not be necessary to buy certain devices to operate the house with or that the house is capable of controlling. The controlling app should be runnable on different types of devices, whatever suits the desires of the users.

Furthermore, especially nowadays, security and privacy are important matters. More so when your entire home would be connected to the internet. These issues must be carefully considered and implemented in the design, to prevent homes from being hacked and for such fears to result in a higher barrier of entry to the technologies. Information of and access to the system should not be except for a specifically designated group of people. For this, good authentication and authorization processes are needed. Additionally, possible malfunctions of devices and how the system responds to those must be contemplated upon as well.

Heart problems [1]

Heart attack

With a heart attack, there is accute danger of life. Especially, lack of oxygen to the brains is causing problems. After only 4 to 6 minutes, brain cells become irreversibly damaged. After that, the other organs can get damaged too. A heart attack can immediately be recognised on an Electrocardiography (ECG), by a deviation in the ST-segment of the ECG. During a heart attack, this segment is higher than normally.

Cardiac arrythmia

A cardiac arrhytmia is a deviation in the cardiac conduction system, a small electric network that controls the pinch of the heart muscle. There exist a lot of different kinds of a cardiac arrythmia. They can affect the pumping force of the heart, but they are fairly harmless. An example of a cardiac arrhytmia is a heart block.

Pain on chest

Pain on the chest can be caused by heart failures.

USE aspects

The USE-aspects of a smart home for elderly are discussed here:

• With medical equipment in a smart home, elderly can live a longer independent life.
• Because of a smart home, care givers can focus their time on tasks which are not performed as well by robots as by humans.
• When care givers get more time, they are able to care more elderly. Therefore, family and friends do not have to take care of the elderly anymore, which is an advantage for the society.
• Through the smart home for elderly a new market in home automation is created, which focusses on monitoring devices, etc. Thereby, new jobs and companies can be developed.

User needs

(?) --> can be adjusted after the results of the questionary

Primary users:

The elderly:

• Should be able to press an alarm button themselves. (?)
• Need a display of their ECG themsleves. (?)

Secondary users:

The care givers:

• Need to be alarmed, within ..... seconds, when there is a cardiac arrythmia.
• Need to be able to alarm people, within ... seconds, in the neighbourhood of the elderly, who are qualified to reanimate.
• Need a screen, which constantly shows the ECG of the elderly or which shows the ECG only when there is a cardiac arrythmia. (?)

The family and friends of the elderly:

• Need to be alarmed, when...........

Tertiary users:

Heart specialists:

Advantages and disadvantages

With smart home technology, there are a lot of advantages and disadvantages. underneath, the most important advantaged and disadvantages are mentioned.

advantages:

• The whole system inside your house can be managed from one place. This can be your phone or a tablet. This has a advantage for elderly who are not able to run certain task by individually, but are now able to run everything through an app on their phone. [2] [3]

• Smart home technologies will increase the security of a household. The app can alert the owner when there is a burglary, can call the police immediately or the fire department when there is a fire. Also, it can unlock doors and light a path with the shortest escape route when the residents need to leave the house as soon as possible. [1]

• There is an increase in energy efficiency. A smart home can shut down appliances that are running but not needed at that time. For example, it can shut off light in a room where nobody is in. Also heating costs will decrease, as the owner can control the heating system when at work. Research has shown that the energy bills are decreased with 30%. [1] [2] [4]

• For elderly, smart home technologies will improve the quality of life. A smart home can remind the owner when to take his medicine or can remind the owner where some stuff is stored when it is lost. All of this can be run with voice command, so that the owner can do everything himself inside his house. most importantly, a smart home system can alert family members and the hospital when the health of the owner is at stake. This can for example hold when the owner fell and cannot get up, or the heart rate of the owner is decreasing.[1] [2] [3]

Disadvantages:

• It is difficult to find a audience for this system, as smart home technologies require some acknowledgement in technology. Especially for the elderly, this can be one of the most important reasons not to implement smart home technologies in their houses. [5] [6]
• Smart home technologies are really expansive. This means that this technology will only be able for the higher class of society. [5] [7]
• When everything in a house is connected to the internet, the privacy of the owner will decrease. Also the system can be hacked by a thief in which it is easier to perform a robbery. People will be skeptic about this fact and therefore will not buy the smart home technology. [5] [6]

What do elderly want in technology [8]

according to a survey held to elderly aged 65-100 in 2011, not many elderly are interested In technology. In that survey, only 10% was interested in technology like cell phone, (wireless) internet, laptop, eReader etc. In contrast to that, 61% does own a cell phone, or 41% does own a PC. But elderly also see the benefits of communication technologies. 66% said that with technology they want to connect with their family and friends. Also 53% want to use technology for sending E-mails and 44% for news.

With current technologies on the market for elderly, safety and security plays a big role. 35% owns a medical pendant alarm, and 15% has a home alarm system. In contrast to that, only 2% has home activity monitoring, which is rather low with the fact that it can approve the health of the elderly. Also, only 1% has an automatic stove shutoff, which can cause severe burnings.

Of course, health and wellness is an important aspect of the elderly life. Research has shown that 59% of the elderly in the USA have high blood pressure, and 27% has diabetes. Only 40% of the elderly above 65 own a blood pressure cuff, almost 20% lower than the number of high blood pressure patients. Next to that, only 17% has a diabetes monitor and 2% has the electronic pill box.

With these numbers it can be said that elderly are not interested in technology, otherwise they would have had more technical appliances. In this research it is also shown that 21% is not interested in learning about new technology. A quarter of the people, only want technology for news, family or friends. On the upper side, 41% is interested in learning new technologies from their doctor or health provider. In that way it can be said that elderly will be more open for new technologies that can improve their health and their quality of living.

Now another hesitation point for the elderly is money. Those with lower incomes are not willing to pay for the technology. If the income is less the $25K, 71% does not want to pay anything on new technology, and only 1% is willing to pay over $100. And with an income greater than $75K, 42% does not want to spend any money to technology.

“I marked on Tablet & Laptop with Camera, “not interested” because I can’t afford them however, it sounds very interesting to be able to keep up with new technology. This survey reminds me of the implication of being close to adolescence I’ve become since I taught school some years ago. Computerized grade books are used now instead of paper ledger. I’m a life-long-learner and still realize that language determines the way we perceive the world and I’m lost on all the new technology that exists today because I haven’t been able to keep up...finances make a difference in one’s life. Many of these questions have to be marked “not interested” because financially it’s not possible to obtain it! My TV is an old Magnavox that’s hanging on just for me! I enjoyed the survey!”

“I think technology is great especially for younger people; the elderly need someone to teach us personally, I feel more safe & secure with my phone and connected to my older family members out of town."

“I am legally blind but I can hear very well!! Most of these devices require sight.”

Opportunities for stakeholders

Doctors and other health providers - recognize trust; introduce technology.

Doctors see social isolation as one of the biggest threats for the healthcare for elderly. They believe that if they can have more contact with friends and family via technology, that their social life will improve a lot. Yet, doctors do not offer any technology to help the elderly.

Senior Housing executives - upon move-in, engage seniors with technology they can use.

survey

In order to gain proper information in what elderly think of the heart sensor, a survey is held under elderly and care takers. The survey can be found underneath (the survey is in dutch, as it is held under dutch citizens):

1. Bent u verzorger of oudere?

Verzorger

Oudere

2. Wat is uw geslacht?

Man

Vrouw

3. Wat is uw leeftijd?

Deze enquete gaat over een slimme hartslagmeter. Deze hartslagmeter kan in uw kleding zitten, pacemaker (als u die heeft) of in uw horloge. De komende vragen hebben betrekking op functies die kunnen worden geïmplementeerd in de hartslagmater. Bent u een verzorger, ga dan door naar vraag 16.

4. Heeft u last van hartklachten, of heeft u een pacemaker?

5. Bent u geïnteresseerd in het meten en zien van uw eigen hartslag en waarom?

6. Hoe zou u het vinden als er een hartslagmeter continu uw hartslag in de gaten kan houden?

7. Zou u het fijner vinden als deze hartslagmeter gelijk hulp belt wanneer er geconstateerd wordt dat dit nodig is?

8. Wilt u ook een functie hebben op de hartslagmeter om hulp op te roepen wanneer u zich niet lekker voelt?

9. Zou u langer thuis blijven wonen of hebben gewoond als u een slimme hartslagmeter zou hebben?

10. Zou u eerder alleen uit huis gaan wanneer u een slimme hartslagmeter om zou hebben (om bijvoorbeeld boodschappen te doen of om een wandeling te maken)?

11. Zal u zich veiliger voelen wanneer er met een hartslagmeter continu uw hartslag in de gaten wordt gehouden?

12. Zal u het toestaan voor uw verzorger, thuiszorghulp of familie om van een afstand uw gezondheid in de gaten te houden?

13. Zou u zich er fijner bij voelen wanneer uw verzorger, thuishulp of familie alleen een signaal binnen krijgt wanneer er een afwijking is in uw hartslag, in plaats van een signaal wat ze altijd binnen krijgen?

14. Wanneer er onregelmatigheden plaats vinden in uw hartslag, vindt u het dan fijn als uw familie automatisch gealarmeerd wordt of niet?

15. Heeft U nog overige opmerkingen of ideeën? De komende vragen zijn alleen voor verzorgers. Bent U een oudere, dan kunt U hier stoppen met deze enquete.

16. Wat vindt u van de technologie dat ouderen met een slimme hartmeter rondlopen?

17. Denkt u dat met deze technologie ouderen langer zelfstandig thuis kunnen blijven wonen?

18. Denkt u dat deze technologie een bijdrage heeft aan de veiligheid van de ouderen?

19. Met deze hartslagmeter is het ook mogelijk dat u de hartslag kunt checken. Heeft u dan de voorkeur om deze constant te kunnen bekijken of alleen wanneer er afwijkingen ontstaan in de hartslag?

20. Via welke apparaten wilt u de hartslag kunnen meten?

21. Denkt u dat deze technologie uw werkdruk verlaagd?

22. Gaat u deze technologie aanraden wanneer het eenmaal op de markt is verschenen?

23. Heeft u nog overige opmerkingen of ideeën?

Logbook

The logbook uses the following abbreviations for the names of the groupmembers:

• JB: Jeffrey Baijens
• ME: Margot Emke
• JE: Jari van Ewijk
• MK: Marjolijn Kleijer
• BL: Bram Lustenhouwer
• WW: Wouter Wolthuis

Note: The logbook is currently incomplete. Individual tasks from the first weeks still have to be added in.

Member(s)	Description of the activity	Date	Time
JB, ME, JE, MK, BL, WW	Introduction of the project. Formation of the group. Brainstorming about possible ideas. Determining the initial goal to work on a smart home with focus on easy use (for the elderly) and privacy.	06-02-2017	8:45 - 12:30
???	???	???	??? - ???
ME, JE, MK, BL, WW	Further brainstorming about the idea. Discussing gathered background information.	09-02-2017	13:45 - 15:30
???	???	???	??? - ???
JB, ME, JE, MK, BL, WW	Presentation	16-02-2017	13:45 - 17:30
???	???	???	??? - ???
JB, ME, JE, MK, BL, WW	Presentation	23-02-2017	13:45 - 17:30
???	???	???	??? - ???
JE	Preparing a Raspberry Pi as the "control unit" of the prototype. It will receive the inputs from the measuring device, process them and take the appropriate action. Reminder: This still needs to be documented on the wiki!	11-03-2017	13:00 - 17:00
MK	Determining user needs, literature search about heart problems and putting this with the goal on wiki	12-03-2017	16:00 - 19:00
MK	Literature search about heart problems	13-03-2017	11:00 - 13:00
JE	Giving feedback on survey questions	14-03-2017	17:00 - 18:00
JE	Small updates to the wiki	15-03-2017	19:30 - 19:45