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Home health monitoring: A system to assess motor and cognitive funtion
... Home-based assessment affords the opportunity to not only observe change in the person's usual environment but also to more frequently, and in some cases continuously, monitor a subject for salient change. A number of converging computer and sensor technology developments provide the opportunity to assess both functional and cognitive status in an automated manner [18,19]. For example, more accurate assessments of medication management are facilitated by using instrumented pill containers that record when medication is removed [20][21][22]. ...
... An example of a scalable home-based assessment platform and assessment protocol currently developed and deployed by the Oregon Center for Aging and Technology at Oregon Health & Science University [18,24] is shown in Figure 2. In this system, continuous activity data are collected unobtrusively in the home by using passive infrared pyroelectric motion sensors strategically placed in every room at locations oriented to pick up the participant's movements restricted to that room. In addition, magnetic contact sensors placed on each door provide a means to track the flow of visitors and absences from the home. ...
The approach toward treatment of Alzheimer's disease has evolved out of a large body of research, resulting in a common trial paradigm directed toward establishing efficacy and safety of putative treatments for dementia. To achieve the ultimate goal of preventing dementia, the future will build on this model but will need to incorporate new paradigms to more efficiently detect meaningful change over time. Among new innovations needed is the capability for assessing trajectories of change over many years. Intrinsic to this success is the ability to capture increasing variability as well as subject heterogeneity inherent in longitudinal aging cohorts. New methods of ubiquitous embedded home sensing and computing afford the opportunity to assess volunteers not only during long periods of time but with greater frequency and convenience. Clinical studies identifying the optimal ways of using these methods are needed.
... Primary care clinicians may play a key role in monitoring and responding to RMT data. 11 Use of RMTs may reduce care access barriers 12 and enable early detection of disease onset. 13 Various characteristics of rural regions may promote RMT adoption. ...
Remote monitoring technologies (RMTs) may improve the quality of care, reduce access barriers, and help control medical costs. Despite the role of primary care clinicians as potential key users of RMTs, few studies explore their views. This study explores rural primary care clinician interest and the resources necessary to incorporate RMTs into routine practice.
We conducted 15 in-depth interviews with rural primary care clinician members of the Oregon Rural Practice-based Research Network (ORPRN) from November 2011 to April 2012. Our multidisciplinary team used thematic analysis to identify emergent themes and a cross-case comparative analysis to explore variation by participant and practice characteristics.
Clinicians expressed interest in RMTs most relevant to their clinical practice, such as supporting chronic disease management, noting benefits to patients of all ages. They expressed concern about the quantity of data, patient motivation to utilize equipment, and potential changes to the patient-clinician encounter. Direct data transfer into the clinic's electronic health record (EHR), availability in multiple formats, and review by ancillary staff could facilitate implementation. Although participants acknowledged the potential system-level benefits of using RMTs, adoption would be difficult without payment reform.
Adoption of RMTs by rural primary care clinicians may be influenced by equipment purpose and functionality, implementation resources, and payment. Clinician and staff engagement will be critical to actualize RMT use in routine primary care.
... Home monitoring technologies have increasingly been used by individuals in need of medical assistance who in most cases are the frail elderly living on their own [1,17,22,23,25,35,37,38,41]. HAS provides 24-hour personal response monitoring services through the distribution of medical communication devices that allow end users to contact an emergency response center, family or medical professionals if the need arises. ...
Knowledge management (KM) practices of Healthcare Alarm Systems (HAS, pseudo name), a technology company providing medical alarm systems to predominately elderly people living at home alone, are examined to generate insights on if and how this company gains and uses knowledge from elderly users. Data were collected through interviewing HAS employees. Major findings include that HAS had significantly under-utilized elderly users' knowledge, and this major target user group of medical alarm products is relevant to and yet largely absent from product design and development. Despite the lack of systematic approaches to capturing, disseminating, and incorporating elderly users' insights, there were incidents where elderly users had made significant contributions. Drawing from the KM and Science and Technology Studies (STS) literatures, we argue that systematic KM approaches should be in place to capture and use the expertise of these relevant but currently absent and yet knowledgeable elderly users.
In this paper, we describe applications of computing assisted technology to home environments of elderly persons.
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