The Agenda of Wearable Healthcare

Driven by cost and quality issues, the health system in the developed countries will undergo a fundamental change in this decade, from a physician-operated and hospital centred health system to consumer operated personal prevention, early risk detection and wellness system. This paper sketches the vision of a ‘Personal Health Assistant’ PHA, opening up new vistas in patient centred healthcare. The PHA comprises a wearable sensing and communicating system, seamlessly embedded in our daily outfit. Several onbody sensors identify the biometric and contextual status of the wearer continuously. The embedded computer generates the ‘Life Balance Factor’ LBF as an individual feedback to the user and to the surroundings affording an effective prevention, disease management and rehabilitation also in telemedicine. The state-of-the-art enabling technologies – mainly miniaturization of electronics and sensors combined with wireless communication and recent developments in wearable and pervasive computing are presented and assessed concerning multiparameter health monitoring.

 

Scroll to top

 

 

Scroll to top

• References

• 1 Health Care Costs, publ. by US Agency for Healthcare Research and Quality. Available from: URL: http:// www.ahcpr.gov Sept. 2002
• 2 Schlender B. Intel’s Andy Grove: The Next Battles in Technology. Fortune May 2003; 12: 80-1.
• 3 Alzheimer Association US. Alzheimer’s Disease: The Costs to U.S. Businesses in 2002. Available from: URL: http://www.alz.org/ June 2002
• 4 Dishman E. Inventing Wellness Systems for Aging in Place. Computer May 2004; 37 (05) 34-41.
• 5 Committee on Quality Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century — Executive Summary. Washington: National Academy Press; y2001.;
• 6 Lymberis A. Smart Wearables for Remote Health Monitoring, from Prevention to Rehabilitation:Current R&D, Future Challenges. Proceedings of the 4th Annual IEEE Conference on Information Technology Applications in Biomedicine. 2002. UK: IEEE. 2002: 272-5.
• 7 Pentland A. Healthwear: Medical Technology Becomes Wearable. IEEE Computer. 2004; 37 (05) 42-9.
• 8 Rhodes B. Brief History of Wearable Computing. Available from: URL: http://www.media.mit.edu/wearables/lizzy/ timeline.html
• 9 Smailagic A, Siewiorek D. The Vu-Man2 Wearable Computer. IEEE Design & Test of Computers. 1993; 10 (03) 56-67.
• 10 Lisetti C, Nasoz F, LeRouge C, Ozyer O, Alvarez K. Developing multimodal intelligent affective interfaces for tele-home health care. Int J Hum Comput Stud 2003; 59: 245-55.
• 11 Pentland A. Wearable Intelligence. Sci Am Fall. 1998 09. 04
• 12 Mann S. On the Bandwagon or Beyond Wearable Computing. Personal Technologies. 1997; 01 (04) 203-7.
• 13 Narayanaswami C, Kamijoh N, Raghunath M, Inoue T, Cipolla T, Sanford J. et al. The Challenge of Miniaturization. IEEE Computer. 2002; 35 (01) 33-41.
• 14 Rantanen J, Alfthan N, Impiö J, Karinsalo T, Malmivaara M, Matala R. et al. Smart Clothing for the Arctic Environment. Proc. ISWC 2000; 15-23.
• 15 Lukowicz P, Kirstein T, Tröster G. Wearable Systems for Health Care Applications, Methods Inf Med. 2004; 43 (03) 232-8.
• 16 Park S, Jayaraman S. Textile and Computing: Background and Opportunities for Convergence. CASES’01, Atlanta, Georgia, USA. November 2001
• 17 Kuhn HH, Child AD. Electrically Conducting Textiles. In: Skotheim TA, Elsenbaum RL, Reynolds JR. editors. Handbook of Conducting Polymers. 1998: 993-1013.
• 18 Cottet D, Grzyb J, Kirstein T, Tröster G. Electrical Characterization of Textile Transmission Lines. IEEE Transactions on Advanced Packaging. 2003; 26 (02) 182-90.
• 19 Mackenzie K, Hudson E, Maule D, Jayaraman S, Park S. A Prototype Network Embedded in Textile Fabric. CASES’01, Atlanta, Georgia, USA. November 2001
• 20 Hum AP. Fabric area network: a new wireless communications infrastructure to enable ubiquitous networking and sensing on intelligent clothing. Computer Networks 2001; 35: 391-9.
• 21 Kallmayer C, Pisarek R, Cichos S, Gimpe S. New Assembly Technologies for Textile Transponder Systems. Proc. ECTC May. 2003
• 22 Klemm M, Locher I, Tröster G. A Novel Circularly Polarized Textile Antenna for Wearable Applications. European Microwave Conference, Amsterdam. October 2004
• 23 Scilingo EP, Lorussi F, Mazzoldi A, De Rossi D. Strain-Sensing Fabrics for Wearable Kinaesthetic-Like Systems. IEEE Sensors Journal. 2003; 03 (04) 460-7.
• 24 Edmison J, Jones M, Nakad Z, Martin T. Using Piezoelectric Materials for Wearable Electronic Textiles. Proc. ISWC 2002; 41-8.
• 25 Paradiso R. Wearable Health Care System for Vital Signs Monitoring. Proc of the 4th Annual IEEE Conf on Information Technology Applications in Biomedicine, UK 2003; 283-6.
• 26 Sergio M, Manaresi N, Campi F, Canegallo R, Tartagni M, Guerrieri R. A Dynamically Reconfigurable Monolithic CMOS Pressure Sensor for Smart Fabric. IEEE J Solid-State Circuit. 2003; 38 (06) 966-75.
• 27 Swallow SS, Thompson AP. Sensory Fabric for Ubiquitous Interfaces. International Journal of Human-Computer Interaction. 2001; 13 (02) 147-59.
• 28 Leftly S, Jones D. SOFTswitch Technology: The Future of Textile Electronics. Proc Avantex. 2002
• 29 Lumelsky VJ, Shur S, Wagner S. Sensitive Skin, IEEE Sensors Journal. 2001; 01 (01) 41-51.
• 30 Bar-Cohen Y. Electroactive Polymers as Artificial Muscles – Reality and Challenges. Proc.. 42nd AIAA Structures, Structural Dynamics, and Materials Conference (SDM) April 16-19 2001; 1-10.
• 31 Jezernik S, Wassink RG, Keller T. Sliding mode closed-loop control of FES: controlling the shank movement. IEEE Trans Biomed Eng 2004; Feb; 51 (02) 263-72.
• 32 Lukowic P, Junker H, Stäger M, von Büren T G, Tröster G. WearNET: A Distributed Multi-Sensor System for Context Aware Wearables. Proc. of the UbiComp2002. New York: Springer; 2002: 361-70.
• 33 Starner T. Human-powered wearable computing. IBM Systems Journal 1996; 35 (3&4): 618-29.
• 34 von Büren T, Lukowicz P, Tröster G. Kinetic energy powered computing an experimental feasibility study. Proc. ISWC 2003; 224.
• 35 Bharatula NB, Ossevoort S, Stäger M, Tröster G. Towards Wearable Autonomous Microsystems. Pervasive 2004. New York: Springer; 2004: 225-37.
• 36 Microviosion Company Products. Available from: URL: http://www.mvis.com/ products.html
• 37 von Waldkirch M, Lukowicz P, Tröster G. Spectacle-Based Design of Wearable SeeThrough Display for AccommodationFree Viewing. Pervasive 2004. New York: Springer; 2004: 106-23.
• 38 Fujikakea H, Satoa H, Murashigeb T. Polymer-stabilized ferroelectric liquid crystal for flexible displays. Displays 2004; 25: 3-8.
• 39 De Rossi D, Della ASanta, Mazzoldi AA. Dressware: wearable hardware. Materials Science and Engineering C7 1999; 31-5.
• 40 Starner T, Auxier J, Ashbrook D, Gandy M. The Gesture Pendant: A Self-illuminating, Wearable, Infrared Computer Vision System for Home Automation Control and Medical Monitoring. Proc. ISWC 2000; 87-94.
• 41 de la PHamette, Lukowicz P, Tröster G, Svoboda T. Finger mouse: A Wearable Hand Tracking System. Adjunct Proceedings 4th Int. Conf. Ubiquitous Computing September 2002; 15-6.
• 42 Wheeler KR, Jorgensen CC. Gestures as Input: Neuroelectric Joysticks and Keyboards. IEEE Pervasive Computing. 2003; 02 (02) 56-61.
• 43 Agarabi M, Bonato P, De Luca CJ. A sEMG-based Method for Assessing the Design of Computer Mice. Proc. 26th Conf. of the IEEE EMBS San Francisco. 2004: 2450-3.
• 44 Amft O, Lauffer M, Ossevoort S, Macaluso F, Lukowicz P, Tröster G. Design of the QBIC wearable computing platform. Proceedings 15th IEEE Int. Conf. on Application-specific Systems, Architectures and Processors, ASAP. 2004
• 45 Abowd D, Dey A, Orr R, Brotherton J. Context-Awareness in Wearable and Ubiquitous Computing. Virtual Reality 1998; 03: 200-11.
• 46 Duda RO, Hart PE, Stork DG. Pattern Classification. 2nd ed.. John Wiley; 2001
• 47 Doucet A, de Freitas N, Gordon N. Sequential Monte Carlo Methods in Practice. New York: Springer; 2000
• 48 Weiser M. The Computer for the 21stCentury. SciAm 1991; Sept; 265 (03) 94-104 Available from : URL: http:// www.ubiq.com/hypertext/weiser/ SciAmDraft3.html
• 49 Mattern F. Ubiquitous Computing: Scenarios for an informatized world. ETH Zürich. 2004 Available from: URL: http://www.vs.inf.ethz.ch/publ/papers/ ECCMatternUbicompEng.pdf
• 50 Gouaux F, Simon-Chautemps Fayn J, Arzi M, Assanelli D. et al. Ambient Intelligence and Pervasive Computing for the Monitoring of Citizens at Cardiac Risk: New Solutions form the EPI-MEDICS Project. Comput Cardiol 2002; 29: 289-92.
• 51 Korhonen I, Pärkkä J, van Gils M. Health Monitoring in the Home of the Future. IEEE Eng Med Biol Mag 2003; 22 (03) 66-73.
• 52 Stanford V. Biosignals Offer Potential for Direct Interfaces and Health Monitoring. IEEE Pervasive Computing. 2004; 03 (01) 99-103.
• 53 Mühlsteff J, Such O, Schmidt R, Perkuh M, Reiter H, Lauter J. et al. Wearable approach for continuous ECG and Activity Patient-Monitoring. Proc. 26thConf. of the IEEE EMBS San Francisco 2004; 2184-7.
• 54 Azevado S, McEwan TE. Micropower Impulse Radar. Science & Technology Review January/February 1996; 16-29.
• 55 Droitcour AD, Boric-Lubecke O, Lubecke VM, Lin J, Kovacs GT. Range Correlation and I/Q Performance Benefits in SingleChip Silicon Doppler Radars for Noncontact Cardiopulmonary Monitoring. IEEE Trans Microwave Theory & Techniques 2004; 52: 838-48.
• 56 Malmivuo J, Plonse R. Bioelectromagnetism : principles and applications of bioelectric and biomagnetic fields. Oxford University Press; 1995. Available also from: URL: http://butler.cc.tut.fi/∼malmivuo/bem/bembook/25/25.htm
• 57 Brusco M, Nazeran H. Digital Phonocardiography: A PDA-based Approach. Proc. 26th Conf. of the IEEE EMBS San Francisco 2004; 2299-302.
• 58 Tanaka S, Matsumoto Y, Wakimoto K. Unconstrained and non-invasive measurement of heart-beat and respiration periods using a phonocardiographic sensor. Med Biol Eng Comput. 2002; 40 (02) 246-52.
• 59 Bonato P. Recent Advancements in the Analysis of Dynamic EMG Data. IEEE Eng Med Biol Mag. 2001; 20 (06) 30-2.
• 60 Shaltis P, Reisner A, Asada H. A hydrostatic pressure approach to cuffless blood pressure monitoring. Proc. 26th Conf. of the IEEE EMBS San Francisco 2004; 2173-6.
• 61 Hung K, Zhang YT, Tai B. Wearable Medical Devices for Tele-Home Healthcare. Proc. 26th Conf. of the IEEE EMBS San Francisco 2004; 5384-7.
• 62 Asada H, Shaltis P, Reisner A, Rhee S, Hutchinson RC. Mobile Monitoring with Wearable Photoplethysmographic Biosensors. IEEE Eng Med Biol Mag. 2003; 22 (03) 28-40.
• 63 Analog Devices TMP3/5/6/7 Low voltage temperature sensors data sheet. Rev C. 2002
• 64 AVX TPC Thermistors NTC. S-TNTC-10M698-N.
• 65 Healey JA. Wearable and Automotive Systems for Affect Recognition from Physiology. [PhD Thesis] MIT. 2000
• 66 Lisettia C, Nasoza F, LeRougeb C, Ozyera O, Alvarezc K. Developing multimodal intelligent affective interfaces fortele-home health care. Int J Hum Comput Stud 2003; 59: 245-55.
• 67 Lumelsky VL, Fellow Shur MS, Fellow Wagner S. Fellow Sensitive Skin. IEEE Sensors Journal 2001; 01: 41-51.
• 68 Mayagoitiaa RE, Neneb AV, Veltinkc PH. Accelerometer and rate gyroscope measurement of kinematics: an inexpensive alternative to optical motion analysis systems. J Biomech 2002; 35: 537-42.
• 69 Akay M, Tamura T, Higashi Y, Fujimoto T. Unconstrained Monitoring of Body Motion During Walking. IEEE Eng Med Biol Mag 2003; 22 (03) 104-9.
• 70 Lemke MR, Koethe NH, Schleidt M. Timing of movements in depressed patients and healthy controls. J Affect Disord 1999; 56: 209-14.
• 71 Brashear H, Starner T, Lukowicz P, Junker H. Using Multiple Sensors for Mobile Sign Language Recognition. Proc. ISWC 2003; 45-52.
• 72 Piccard RW. Affective Computing. MIT Press; 1997
• 73 Picard RW, Vyzas E, Healey J. Toward Machine Emotional Intelligence: Analysis of Affective Physiological State. IEEE Trans Pattern Anal Mach Intell 2001; 32: 1175-91.
• 74 France DJ, Shiavi RG, Silverman S, Silverman M, Wilkes DM. Acoustical Properties of Speech as Indicators of Depression and Suicidal Risk. IEEE Trans Biomed Eng 2000; 47: 829-37.
• 75 Choudhury T, Pentland A. Sensing and Modeling Human Networks using the Sociometer. Proc. ISWC 2003; 216-22.
• 76 Keijsers NL, Horstink MW, Gielen SC. Online Monitoring of Dyskinesia in Patients with Parkinson’s Disease. IEEE Eng Med Biol Mag 2003; 22 (03) 96-103.
• 77 MyHeart: Fighting cardio-vascular diseases by preventive lifestyle & early diagnosis. Available from: URL: http:// www.extra.research.philips.com/ euprojects/myheart/..
• 78 Stein J. Wearable Sensor Technology for Functional Assessment After Stroke. IEEE Eng Med Biol Mag 2003; 22 (03) 26-7.
• 79 Winters JM, Wang Y, Winters JM. Wearable Sensors and Telerehabilitation. Med Biol Mag. 2003 May/June: 56-65.
• 80 Proda M, Reina-Tosina J, Roa L. Distributed intelligent architecture for falling detection and physically analysis in the elderly. Proc. 2nd EMBS/BMES Conf Oct 2003; 1910-1.
• 81 Stefanov DH, Bien Z, Bang WC. The Smart House for Older Persons and Persons With Physical Disabilities: Structure, Technology Arrangements, and Perspectives. IEEE Trans Neural Syst Rehabil Eng 2004; 12: 228-50.