Download PDF
Methods Inf Med 2009; 48(01): 29-37
DOI: 10.33414/ME9136
Original Articles
Schattauer GmbH

On Health-enabling and Ambient-assistive Technologies

What Has Been Achieved and Where Do We Have to Go?[*]
S. Koch
1   Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden
,
M. Marschollek
2   Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig – Institute of Technology and Hannover Medical School, Germany
,
K. H. Wolf
2   Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig – Institute of Technology and Hannover Medical School, Germany
,
M. Plischke
2   Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig – Institute of Technology and Hannover Medical School, Germany
,
R. Haux
2   Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig – Institute of Technology and Hannover Medical School, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
24 January 2018 (online)

    Permissions and Reprints

Summary

Objectives: To provide an introductory overview on selected areas of health-enabling and ambient-assistive technologies and to suggest relevant fields for future research.

Methods: Summarizing the state of the art for 1) ambient environments and 2) health- related sensor technologies, 3) presenting relevant medical conditions and their relation to health-enabling technologies, and 4) illustrating the application of those technologies for lifestyle management with examples for activity monitoring and prevention of over-weight. The suggestions for future research are based on own research projects in this field.

Results: Health-enabling and ambient-assistive technologies are regarded to have the potential to significantly improve quality of life and efficiency of health care in aging societies. Research on health-enabling and ambient-assistive technologies is highly multidisciplinary.

Conclusions: It still has, to a large extent, to be exploratory. An increasing amount of outcomes research through well-designed evaluation studies that explore technical solutions in a social context and in relation to individual needs will be crucial.

Keywords

Medical informatics - integrated advanced information management systems - information storage and retrieval - home care services - nursing record

* The motivation to write this manuscript were two invited talks, the authors had given on this topic at the Symposium ‘Perspectives of Medical Informatics’ at the University of Heidelberg, Germany. This symposium has been organized on April 5, 2008, on the occasion of the 35th anniversary of the Medical Informatics Program of the Universities of Heidelberg and Heilbronn.


 

  • References

  • 1 Lanzieri G. Long-term population projections at national level. Eurostat Statistics in focus Newsletter 3 2006 (cited 2008, March 28). Available from: http://www.europa.eu.int/comm/eurostat
    PubMedGoogle Scholar
  • 2 UN.. Department of Economic and Social Affairs. World Population Ageing. 2007 (cited 2008, April 25). Available from: http://www.un.org/esa/population/publications/WPA2007/wpp2007.htm
    PubMedGoogle Scholar
  • 3 Haux R, Howe J, Marschollek M, Plischke M, Wolf KH. Health-Enabling Technologies for Pervasive Health Care: On Services and ICT Architecture Paradigms. Informatics for Health and Social Care 2008; 33: (in print).
    PubMedGoogle Scholar
  • 4 Robine JM, Michel JP, Herrmann FR. Who will care for the oldest people?. BMJ 2007; 334: 570-571.
    CrossrefPubMedGoogle Scholar
  • 5 Spillman B, Pezzin L. Potential and active family caregivers: changing networks and the “sandwich generation”. Milbank Q 2000; 78: 347-374.
    CrossrefPubMedGoogle Scholar
  • 6 Marschollek M, Wolf KH, Bott OJ, Howe J, Haux R. Predictions for epidemiologic indicators of age-related diseases and implications for the development of health-enabling technologies. European Conference on Ambient Intelligence (ami-07). Springer; 2008 pp 253-260.
    PubMedGoogle Scholar
  • 7 Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006; 3 (11) e442.
    CrossrefPubMedGoogle Scholar
  • 8 Federal Statistical Office of Germany.. Gesundheit – Ausgaben, Krankheitskosten und Personal 2004 [Health – Spendings, Disease Costs and Personnel 2004]. (cited 2007, March 10). Available from: http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Presse/pk/2006/Gesundheit/Pressebroschuere,property=file.pdf
    PubMedGoogle Scholar
  • 9 Steinhagen-Thiessen E, Borchelt M. Morbidität, Medikation und Funktionalität im Alter (morbidity, medication and functional status in the elderly). Berlin: Akademie Verlag; 1996
    Google Scholar
  • 10 RIC.. Rehabilitation Institute of Chicago 2003 (cited 2008, March 27). Available from: http://www.ric.org/aboutus/mediacenter/press/2003/1210a.aspx
    PubMedGoogle Scholar
  • 11 Bardram JE. Pervasive Healthcare as a Scientific Discipline. Methods Inf Med 2008; 47: 178-185.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Haux R. Individualization, globalization and health – about sustainable information technologies and the aim of medical informatics. Int J Med Inform 2006; 75: 795-808.
    CrossrefPubMedGoogle Scholar
  • 13 Haux R, Kulikowski C. editors. IMIA Yearbook of Medical Informatics: Ubiquitous Health Care Systems. Stuttgart: Schattauer; 2005
    Google Scholar
  • 14 Saranummi N. IT applications for pervasive, personal, and personalized health. IEEE Trans Inf Technol Biomed. 2008; 12: 1-4.
    CrossrefPubMedGoogle Scholar
  • 15 Saranummi N, Wactlar H. Pervasive Healthcare. Selected papers from the Pervasive Healthcare 2008 conference, Tampere, Finland (editorial). Methods Inf Med. 2008; 47: 175-177.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Demiris G. Smart Homes and Ambient Assisted Living in an Aging Society – New Opportunities and Challenges for Biomedical Informatics, editorial. Methods Inf Med 2008; 47: 56-57.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Kidd CD, Orr R, Abowd GD, Atkeson CG, Essa IA, MacIntyre B. et al. The Aware Home: A Living Laboratory for Ubiquitous Computing Research. Proceedings of CoBuild’99, position paper; 1999
    PubMedGoogle Scholar
  • 18 Demiris G, Skubic M, Keller J. Nurse Participation in the Design of User Interfaces for a Smart Home System. Proceedings of the International Conference on Smart Homes and Health Telematics. Belfast, Northern Ireland; 2006
    PubMedGoogle Scholar
  • 19 Cash M. Assistive technology and people with dementia. Reviews in Clinical Gerontology. 2003; 13 (04) 313-319.
    CrossrefPubMedGoogle Scholar
  • 20 Chan M, Bocquet H, Campo E, Val T, Pous J. Alarm communication network to help carers of the elderly for safety purposes: a survey of a project. Int J Rehabil Res 1999; 22: 131-136.
    CrossrefPubMedGoogle Scholar
  • 21 Swedish_Handicap_Institute.. SmartLab – technology that cares. 2002 (cited 2008, April 27). Available from: http://www.hi.se/shopping/ShowItem_598.aspx
    PubMedGoogle Scholar
  • 22 Stauffer HB. Smart enabling systems for home automation. IEEE Trans Cons Electron 1991; 37: 29-35.
    PubMedGoogle Scholar
  • 23 Chan M, Estéve D, Escriba C, Campo E. A review of smart homes – Present state and future challenges. Comp Meth Prog Biomed 2008; in press, doi: 10.1016/j.cmpb.2008.02.001.
    PubMedGoogle Scholar
  • 24 Perry M, Dowdall A, Lines L, Hone K. Multimodal and ubiquitous computing systems: supporting independent-living older users. IEEE Trans Inf Technol Biomed 2004; 8 (03) 258-270.
    CrossrefPubMedGoogle Scholar
  • 25 Intille SS. A new research challenge: persuasive technology to motivate healthy aging. IEEE Trans Inf Technol Biomed 2004; 8 (03) 235-237.
    CrossrefPubMedGoogle Scholar
  • 26 Marsh A, Biniaris C, Vergados D, Eppler A, Kavvadias C, Bigalke O. et al. An assisted-living home architecture with integrated healthcare services for elderly people. Stud Health Technol Inform 2008; 137: 93-103.
    PubMedGoogle Scholar
  • 27 IST_Advisory_Group (ISTAG).. Ambient Intelligence – From Vision to Reality. In: Riva G, Vatalaro F, Davide F, Alcañiz M. editors. Ambient Intelligence. IOS Press; 2005. pp 45-68.
    Google Scholar
  • 28 Barton J, O’Mathúna SC, O’Reilly S, Healy T, O’Flynn B, Bellis S. et al. Micro and nano technology enabling ambient intelligence for P-Health. Stud Health Technol Inform 2005; 117: 89-97.
    PubMedGoogle Scholar
  • 29 Alcañiz M, Rey B. New Technologies for Ambient Intelligence. In: Riva G, Vatalaro F, Davide F, Alcañiz M. editors. Ambient Intelligence. IOS Press; 2005. pp 3-15.
    Google Scholar
  • 30 Riva G. Ambient Intelligence in Health Care. Cyber-Psychology and Behavior 2003; 6 (03) 295-300.
    CrossrefPubMedGoogle Scholar
  • 31 Bushko RG. Future of Health Technology. Amsterdam, The Netherlands: IOS Press; 2002
    Google Scholar
  • 32 Friedewald M. et al. Safeguards in a World of Ambient Intelligence (SWAMI). 2006 (cited 2008, August 28). Available from: http://is.jrc.ec.europa.eu/pages/TFS/documents/Deliverable5-ReportonConference.pdf
    PubMedGoogle Scholar
  • 33 Oberg PA, Togawa T, Spelman FA. Sensors in medicine and health care. Weinheim: Viley-VCH; 2004
    Google Scholar
  • 34 Wolf KH, Marschollek M, Bott OJ, Howe J, Haux R. Sensors for health-related parameters and data fusion approaches. In: Hein A, Thoben W, Appelrath HJ, Jensch P. editors. Proceedings of the European Conference on eHealth ECEH2007 Volume P-118 of Lecture Notes in Informatics (LNI). Bonn: GI; 2007. pp 155-161.
    Google Scholar
  • 35 Demiris G, Hensel BK, Skubic M, Rantz M. Senior residents’ perceived need of and preferences for “smart home” sensor technologies. Int J Technol Assess Health Care 2008; 24 (01) 120-124.
    CrossrefPubMedGoogle Scholar
  • 36 Jansen B, Temmermans G, Deklerck R. 3D human pose recognition for home monitoring of elderly. 29th IEEE EMBS Annual International Conference. Lyon, France; 2007
    PubMedGoogle Scholar
  • 37 Alwan M, Kell S, Dalal S, Turner B, Mack D, Felder R. In-home monitoring system and objective adl assessment: Validation study. International Conference on Independence, Aging and Disability. Washington DC; 2003
    PubMedGoogle Scholar
  • 38 Singh SS, Carlson BW, Hsiao HS. Evaluation of heart rate variability indices using a real-time hand-held remote ECG monitor. Telemed J E Health 2007; 13 (06) 657-662.
    CrossrefPubMedGoogle Scholar
  • 39 Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R. et al. Using Pedometers to increase physical activity and improve health. JAMA 2007; 298: 2296-2304.
    CrossrefPubMedGoogle Scholar
  • 40 Dorminy CA, Choi L, Akohoue SA, Chen KY, Buchowski MS. Validity of a multisensor armband in estimating 24-h energy expenditure in children. Med Sci Sports Exerc 2008; 40 (04) 699-706.
    CrossrefPubMedGoogle Scholar
  • 41 Bott OJ, Hoffmann I, Bergmann J, Kosche P, von Ahn C, Mattfeld DC. et al. Simulation based cost-benefit analysis of a telemedical system for closed-loop insulin pump therapy of diabetes. Stud Health Technol Inform 2006; 124: 435-440.
    PubMedGoogle Scholar
  • 42 Hutten H, Schreier G, Kastner P, Grasser B, Iberer F, Tscheliessnigg KH. Der Herzschrittmacher als Briicke zum kardialen Telemonitoring (Cardiac pacemaker as bridge to cardiac telemonitoring) (Article in German). Biomed Tech (Berl) 1996; 41 (06) 158-165.
    PubMedGoogle Scholar
  • 43 Mata A, Llach J, Bordas JM. Wireless capsule endoscopy World. J Gastroenterol 2008; 14 (13) 1969-1971.
    PubMedGoogle Scholar
  • 44 Valdastri P, Menciassi A, Arena A, Caccamo C, Dario P. An implantable telemetry platform system for in vivo monitoring of physiological parameters. IEEE Trans Inf Technol Biomed 2004; 8 (03) 271-278.
    CrossrefPubMedGoogle Scholar
  • 45 Anliker U, Ward JA, Lukowicz P, Tröster G, Dolveck F, Baer M. et al. AMON: a wearable multiparameter medical monitoring and alert system. IEEE Trans Inf Technol Biomed 2004; 8 (04) 415-427.
    CrossrefPubMedGoogle Scholar
  • 46 Mundt CW, Montgomery KN, Udoh UE, Barker VN, Thonier GC, Tellier AM. et al. A multiparameter wearable physiologic monitoring system for space and terrestrial applications. IEEE Trans Inf Technol Biomed 2005; 9 (03) 382-391.
    CrossrefPubMedGoogle Scholar
  • 47 Lin BS, Lin BS, Chou NK, Chong FC, Chen SJ. RTWPMS: a real-time wireless physiological monitoring system. IEEE Trans Inf Technol Biomed 2006; 10 (04) 647-656.
    CrossrefPubMedGoogle Scholar
  • 48 Paradiso R, Belloc C, Loriga G, Taccini N. Wearable healthcare systems, new frontiers of e-textile. Stud Health Technol Inform 2005; 2005 117 9-16.
    PubMedGoogle Scholar
  • 49 Yao J, Schmitz R, Warren S. A wearable point-of-care system for home use that incorporates plug-and-play and wireless standards. IEEE Trans Inf Technol Biomed 2005; 9 (03) 363-371.
    CrossrefPubMedGoogle Scholar
  • 50 Aziz O, Atallah L, Lo B, Elhelw M, Wang L, Yang GZ. et al. A pervasive body sensor network for measuring postoperative recovery at home. Surg Innov 2007; 14 (02) 83-90.
    CrossrefPubMedGoogle Scholar
  • 51 Lee RG, Chen KC, Hsiao CC, Tseng CL. A mobile care system with alert mechanism. IEEE Trans Inf Technol Biomed 2007; 11 (05) 507-517.
    CrossrefPubMedGoogle Scholar
  • 52 Kharitonov SA, Barnes PJ. Exhaled biomarkers. Chest 2006; 130 (05) 1541-1546.
    CrossrefPubMedGoogle Scholar
  • 53 Steinerman JR, Honig LS. Laboratory biomarkers in Alzheimer’s disease. Curr Neurol Neurosci Rep 2007; 7 (05) 381-387.
    CrossrefPubMedGoogle Scholar
  • 54 Tacconi D, Mayora O, Lukowicz P, Tröster G, Haring C. On the feasibility of using activity recognition and context aware interaction to support early diagnosis of bipolar disorder. Ubiwell (Ubicomp Workshop); 2007 pp 206-209.
    PubMedGoogle Scholar
  • 55 Goldman DP, Shekelle PG, Bhattacharya J, Hurd M, Joyce GF. Health status and medical treatment of the future elderly – final report. RAND Corporation; 2004
    Google Scholar
  • 56 Perry J. Gait analysis – normal and pathological function. Thorofare, NJ: Slack; 1992
    Google Scholar
  • 57 Kamen G, Patten C, Du CD, Sison S. An accelerometry-based system for the assessment of balance and postural sway. Gerontology 1998; 44 (01) 40-45.
    CrossrefPubMedGoogle Scholar
  • 58 Moe-Nilssen R, Helbostad JL. Interstride trunk acceleration variability but not step width variability can differentiate between fit and frail older adults. Gait Posture 2005; 21 (02) 164-170.
    CrossrefPubMedGoogle Scholar
  • 59 Marschollek M, Wolf KH, Gietzelt M, Nemitz G, Schwabedissen HMz, Haux R. Assessing elderly persons’ fall risk using spectral analysis on accelero-metric data – a clinical evaluation study. Conf Proc IEEE Eng Med Biol Soc 2008: 3682-3685.
    PubMedGoogle Scholar
  • 60 Pinhas-Haniel O, Dolan LM, Daniels SR, Standi-ford D, Khoury PR, Zeitler P. Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatrics 1996; 128: 608-615.
    CrossrefPubMedGoogle Scholar
  • 61 Salmon J, Booth ML, Phongsavan P. Promoting Physical Activity Participation among children and adolescents. Epidemiol Rev 2007; 29: 144-159.
    CrossrefPubMedGoogle Scholar
  • 62 Stewart L, Chapple J, Hughes AR, Poustie V, Reilly JJ. The use of behavioural change techniques in the treatment of paediatric obesity: qualitative evaluation of parental perspectives on treatment. J Hum Nutr Diet 2008; epub ahead of print.
    PubMedGoogle Scholar
  • 63 Bonner G, Madden AM, Baker A, Jones JM. The validation of a rating scale to assess dietitians’ use of behaviour change skills. J Hum Nutr Diet 2008; 21 (04) 381.
    PubMedGoogle Scholar
  • 64 Byrne NM, Hills AP, Hunter GR. et al. Metabolic equivalent: one size does not fit all. Journal of Applied Physiology 2005; 99: 1112-1119.
    CrossrefPubMedGoogle Scholar
  • 65 Plischke M. Zur Analyse alltäglicher körperlicher Aktivität von Jugendlichen mittels Assistierender Gesundheitstechnologien (Ph. D. Thesis). Norderstedt: Books on Demand GmbH; 2008
    Google Scholar
  • 66 Plischke M, Marschollek M, Wolf KH, Haux R, Tegtbur U. cyberMarathon – increasing physical activity using health-enabling technologies (in print). MIE2008. Gothenburg, Sweden; 2008
    PubMedGoogle Scholar
  • 67 Korsten-Reck U, Kromeyer-Hauschild K, Wolfarth B, Dickhuth HH, Berg A. Freiburg Intervention Trial for Obese Children (FITOC): results of a clinical observation study. International Journal of Obesity 2005; 29: 356-361.
    CrossrefPubMedGoogle Scholar
  • 68 Jurg MW, Kremers SPJ. A controlled trial of a school-based environmental intervention to improve physical activity in Dutch children: JUMP-in, kids in motion. Health Promotion International 2006; 21 (04) 320-330.
    CrossrefPubMedGoogle Scholar
  • 69 Bott OJ, Marschollek M, Wolf KH, Haux R. Towards New Scopes: Sensor Enhanced Regional Health Information Systems – Part 1: Architectural Challenges. Methods Inf Med 2007; 46 (04) 476-483.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 70 Koch S. Ubiquitous care in aging societies – a social challenge. Stud Health Technol Inform 2008; 134: 89-95.
    PubMedGoogle Scholar
  • 71 Nolan M, Grant G, Keady J. Understanding family care. Buckingham: Open University Press; 1996
    Google Scholar
  • 72 Marschollek M, Wolf KH, Bott OJ, Geisler M, Plischke M, Ludwig W. et al. Sustainable Ubiquitous Home Healthcare – Architectural Considerations and First Practical Experiences. MEDINFO. Brisbane: IOS Press; 2007
    Google Scholar
  • 73 Hägglund M, Scandurra I, Moström D, Koch S. Bridging the Gap – a Virtual Health Record for Integrated Home Care. International Journal of Integrated Care 2007; 7 (27) 1-11. http://www.ijic.org/publish/articles/000289/article.pdf.
    PubMedGoogle Scholar
  • 74 Halamka JD, Mandl KD, Tang PC. Early Experiences with Personal Health Records. J Am Med Inform Assoc 2008; 15 (01) 1-7.
    CrossrefPubMedGoogle Scholar
  • 75 Google Health.. (cited 2008 Sept, 1). Available from: www.google.com/health
    PubMedGoogle Scholar
  • 76 Health Vault.. (cited 2008 Sept, 1). Available from: http://www.healthvault.com
    PubMedGoogle Scholar
  • 77 Continua Health Alliance.. (cited 2008, Sept 1). Available from: http://www.continuaalliance.org/home
    PubMedGoogle Scholar
  • 78 Kaelber DC, Jha AK, Johnston D, Middleton B, Bates DW. A Research Agenda for Personal Health Records (PHRs). J Am Med Inform Assoc 2008; Epub ahead of print.
    PubMedGoogle Scholar
  • 79 Koch S. Facing the challenges – the role of medical informatics in an ageing society. Stud Health Technol Inform 2006; 124: 25-31.
    PubMedGoogle Scholar
  • 80 Konstantas D. An overview of wearable and implantable medical sensors. IMIA Yearbook of Medical Informatics 2007. Methods Inf Med 2007; 46 (01) 61-65.
    PubMedGoogle Scholar
  • 81 Kuhn KA, Giuse DA, Lapao L, Wurst SH. Expanding the scope of health information systems – from hospitals to regional networks, to national infrastructures, and beyond. Methods Inf Med 2007; 46: 500-502.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 82 Shabo A. A global socio-economic-medico-legal model for the sustainability of longitudinal electronic health records. Part 1. Methods Inf Med 2006; 45: 240-245.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 83 Shabo A. A global socio-economic-medico-legal model for the sustainability of longitudinal electronic health records – part 2. Methods Inf Med 2006; 45: 498-505.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 84 Winters JM, Wang Y, Winters JM. Wearable sensors and telerehabilitation. IEEE Eng Med Biol Mag 2003; 22 (03) 56-65.
    CrossrefPubMedGoogle Scholar
  • 85 Rigby M. Ubiquitous Technologies in Health: New Challenges of Opportunity, Expectation, and Responsibility. Stud Health Technol Inform 2006; 124: 65-70.
    PubMedGoogle Scholar
  • 86 Kulikowski CA. Editorial: Introducing Kuhn et al.’s Paper “Informatics and Medicine: From Molecules to Populations” and Invited Papers on this Special Topic. Methods Inf Med 2008; 47: 279-282.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 87 Kuhn KA, Knoll A, Mewes HW, Schwaiger M. et al. Informatics and medicine. From molecules to populations. Methods Inf Med 2008; 47: 283-295.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 88 Altman RB, Balling R, Brinkley JF, Coiera E. et al. Commentaries on “Informatics and Medicine: From Molecules to Populations”. Methods Inf Med 2008; 47: 296-317.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 89 Bemmel JHv.. Medical Informatics Is Interdisciplinary avant la Lettre. Methods Inf Med 2008; 47: 318-321.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 90 Bott OJ, Ammenwerth E, Brigl B, Knaup P. The challenge of ubiquitous computing in health care: technology, concepts and solutions. Methods Inf Med 2005; 44: 473-479.
    Article in Thieme ConnectPubMedGoogle Scholar