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Preface
7
Contents
8
Digital Homecare – An Introduction
10
References
12
Information Highway to the Home and Back: A Smart Systems Review
14
The Global Village
15
Mobility
15
Identity
16
Data Privacy
16
Interoperability
18
Development Initiatives
20
‘Harvesting’ Professional Knowledge
22
Health Information Systems Interoperability
25
Community Care
25
The Demographic Time-bomb
25
“Creeping” Impairment
27
Self-Care Support & Lifestyle Improvement
28
‘Smart’ Care Support
29
‘Smart Home’ Systems
31
Smart’ Wearables for a ‘Smart’ Environment
32
Help at Hand Anywhere
34
Embracing Change
34
Behavioural Compunetics
35
Process of Change and Change of Process
36
A Whole Systems Approach
37
References
38
Personalizing Care: Integration of Hospital and Homecare
42
Introduction: The concept of personalized medicine
43
Protocols and technologies for personalized medicine
44
Personalization of care decisions
44
Personalization of the interaction with the subject of care
47
Technologies and knowledge at home
50
Main research fields in the homecare context
50
Technologies and infrastructures to solve particular problems
51
The challenges of homecare
52
Future developments in homecare
53
Technologies and knowledge at the hospital
54
The situation
54
Solutions of particular problems
54
Challenges and future developments
55
Architecture for integration
55
Management of technology by healthcare organizations
56
Middleware approach
56
Discussion: benefits of integration
59
References
60
Standards for Digital Homecare
62
Why is standardization of digital homecare important?
63
Scope
65
Goals
65
Client’s goals and needs
66
Client’s control of data
66
Ensuring quality of the services
67
Quality management system
67
Quality indicators
67
Managing information
67
Quality of data
68
Quality of information
68
Managing the supporting systems in the patient's home
68
Quality of patient’s measurements
68
System integration
69
Organizing the services of digital homecare
69
Cooperation
69
Management of processes
70
Standards for medical devices
71
The European Medical Device Directive 93/42/EEC
71
Definition of medical device
71
The essential requirements in the Medical Device Directive
72
Full device-related quality assurance system
72
EN ISO 13485
73
Risk analysis and solutions
73
Clinical evaluation
73
Post-market surveillance
74
Classification
74
Conformity with the (amended) Medical Device Directive
75
Technical documentation
75
Harmonized standards
76
Relation between Directive and EN ISO 13485
77
Relation EN ISO 13485 and EN ISO 9001
77
Software
78
Conclusion for medical devices in digital homecare
79
Implementing a standard
80
Who is responsible for a standard for digital homecare
81
References
82
Model-Based Methodology for the Analysis of e-Health Systems Diffusion: Case Study of a Knowledge-Centered Telehealthcare System Based on a Mixed License
84
Introduction
84
Potential barrier for diffusion: an integrative academic and business model
86
A methodology to analyze the diffusion of e-health systems
92
Description of an innovative e-health system
99
Summary
101
References
102
The Consumerisation of Home Healthcare Technologies
104
Introduction
105
Overview of Digital Homecare
106
Negative Aspects of Digital Homecare
107
Digital Homecare for the Patient’s Support Network
108
Defining Consumerisation in Digital Homecare
109
The need for consumerisation
110
System Benefits of Consumerisation
110
Current State of Digital Homecare
111
Digital Homecare for future consumers
111
The Importance of Collective Intelligence
114
Making Collective Intelligence Accessible
117
Factors That Limit Future Digital Homecare
118
Creating the Step Change
119
New Entrants
119
Telecoms
120
Home Security
120
Home Automation
120
Software Publishers
121
Social Networks
121
Consumer Electronics
122
Other Industry Initiatives
124
Conclusion
125
References
125
Privacy and Digital Homecare
126
Introduction
128
Legal framework
129
Medical regulations
129
Data protection legislation
130
Other relevant legislation
138
Set-up manual for eHomecare projects
140
Primary and secondary data processing
140
Notification
141
Privacy notice for the patient
142
Privacy and security policies
145
Practical recommendations for the start-up of an eHomecare project
146
First stage: before the project kick-off
147
Middle stage: during the project
148
Final stage
154
Conclusion
155
Reference list
156
VirtualECare: Group Support in Collaborative Networks Organizations for Digital Homecare
160
Introduction
161
Motivation
162
Collaborative Networks in Digital Homecare
162
Group Decision Support Systems
163
Group Support Systems
163
Meeting phases
163
Recommendation System
165
Idea Generation
165
Argumentation
167
Quality of Information
168
Applications Scenarios
175
VirtualECare Project
177
Technology Overview
178
Conclusion and Future Work
185
References
186
Standard-Based Homecare Challenge
188
Introduction
190
X73 PoC implementation
192
ISO/IEEE 11073 challenges: evolution from X73-PoC to PHD
196
X73-PHD model
198
X73-PHD protocol stack
199
X73-PHD Finite State Machine
201
Future trends and open points
203
Signal handling: harmonization and enhancements
203
Implementation into medical devices
204
Open points
208
Conclusion
209
References
210
An Automatic Smart Information Sensory Scheme for Discriminating Types of Motion or Metrics of Patients
212
Introduction
213
One dimensional performance study for a static load distribution
215
Two dimensional performance study for a static load distribution
220
Dynamic Loading studies
222
Experimental study
223
Other applications
225
Conclusions
226
References
227
User-Centered Design of Tele-Homecare Products
230
Technology pushed versus care-pull
231
User-centered design: how to involve users
232
Phase 1 - Exploring the needs
233
Human concerns
234
The profile of all human concerns
236
How can quality of life be measured?
237
Adaptive Tasks
238
Personal experiences of patients
239
Tele-homecare products
239
Phase 2: Analysis of a single need
241
Phase 3: Idea generation
243
Phase 4: Optimization of idea
244
Phase 5: Realization of product design
247
Pluralistic Walkthrough
247
User Walkthrough
248
Thinking Aloud
248
Questionnaire method
249
Alternative
249
Discussion
250
References
250
A Multi-disciplinary Approach towards the Design and Development of Value+ eHomeCare Services
252
Get the picture right
254
Making a snapshot
254
Setting the scope
255
Find a good team
255
Look at the contextual mapping
256
Investigate the needs
257
The who’s and what’s
257
Limiting the user group
258
Looking for the known needs fitting in their everyday practices
258
Looking for future needs in interaction with the current everyday practices
259
Match towards market opportunities and business strategies
260
The eHealth market place
260
How to find a solution?
262
Taking a value proposition to the market
262
Assemble the puzzle
263
Personas and scenari
263
Script book – dream or reality?
264
The I-strategy
265
Test and evaluate from the early start
266
Introducing the UCD principle
266
User and task analysis: gathering information on the end user
267
Conceptual model and the transition to a first design
267
Testing the prototype
268
Translation to technical requirements
269
Final product?
271
Do the proof of the pudding
271
Checklists
271
Stage gate process
273
Happy endings?
274
SWOT analyses
274
S for Soul mates!
274
W for We are not perfect
275
O for Other things to do?
275
T for Try to stop us!
275
Reference list
275
Changing Role of Nurses in the Digital Era: Nurses and Telehealth
278
Introduction
279
ICT and nursing
280
Brief history
281
Types of telehealth interaction
282
Telenursing
285
To support the patient in the home
285
To support remote nurses
287
To promote and support self-care
288
To improve medication management and compliance
288
Cost saving
289
Barriers
290
References
291
A Multi-Modal Health and Activity Monitoring Framework for Elderly People at Home
296
Introduction
297
The overall network architecture
298
Health and activity monitoring framework
300
Framework architecture
301
Overview
302
Sensor-network based motion detector
303
Audio monitoring system
304
Health monitoring subsystem
304
Conclusion and future work
306
References
306
Digital Homecare Experiences: Remote Patient Monitoring
308
Introduction
309
Background
310
Remote Patient Monitoring Equipment and Systems
312
Implementation
318
Evaluation
327
Conclusion
330
References
331
A Home-Based Care Model of Cardiac Rehabilitation Using Digital Technology
338
Introduction
339
Components of a Comprehensive Cardiac Rehabilitation/Secondary Prevention Programs
340
Traditional Cardiac Rehabilitation
342
Requirements of CR services
344
Home-Based Cardiac Rehabilitation
345
ICT for Home-based Care
347
Clinically relevant measurements and measures for CR from ambulatory monitoring
348
Communications technology and infrastructure for home based outpatient care
351
Use Cases of using a tele-health system in cardiacrehabilitation
352
Case scenario
354
Issues and Limitations for the uptake of tele-health technologies
357
Summary
357
References
358
Role of Nano- and Microtechnologies in Clinical Point-of-Care Testing
362
Introduction
363
Clinical need for miniaturized devices
363
Reliability of POC tests
364
Micro and nanotechnology
365
Barriers to implementation
366
Technology development
368
Future directions in testing
369
References
370
Author Index
372
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