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作者:劉育瑋 (2014-07-17);推薦:徐業良(2015-12-11)


Chapter 6. Conclusion and future work

6.1    Conclusion

In this thesis, the development of a Bed-Centered Telehealth System (BCTS) based on the commercialized motion-sensing mattress WhizPAD is described. WhizPAD is a textile-based sensor suited for long term monitoring in home and nursing home environment. Working with a bedding manufacturer, WhizPAD with motion sensing capability using the same material and fabrication process of the bedding manufacturer, so that the mattress is comfortable, inexpensive, and is closer to being a commercial product. Figure 5-1 shows the commercialized version of WhizPAD.

Figure 5-1. Commercialized version of WhizPAD

Based on the decentralized home telehealth system structure, WhizPAD is the center of health data collection of telehealth systems. WhizPAD collects signals of physical activities in bed, which can be classified into events such as on/off bed, sleep posture and movement counts. The respiration rate detection and sleep quality assessment of WhizPAD has also been developed for further applications. Integrated with information and communication systems, the BCTS can provide home telehealth functions including real-time monitoring (on/off bed status, sleep posture, body movements, respiration rate, and sleep quality), service reminder, and historical data record. So that caregivers can maintain awareness of older adults’ daily activities and needs by using their mobile devices to access the WhizPAD and further provide the necessary care for them.

In the home application, the BCTS have been tested for commercialization for four months. Now WhizPAD is a commercial product in department store of Taiwan. Without the special setting, the BCTS of WhizPAD is plug and play in home environment. By connects the BCTS with internet, it could facilitate the tele-monitoring of the basic bed-related information of the older adults.

In the nursing home application, the care management system of BCTS has been implemented in Yi-De Nursing Home for 30 beds for six months. For the sensing aspect, the WhizPAD was found to be able to detect the body movements correctly. Besides, the ZigBee wireless network and remote server also worked well for data transmission and storage. After implementing the care management system based on WhizPAD, the nursing staff expressed that the abnormal leaving bed event could be easily found, and bedsore event becomes to zero. Finally, the nursing staff was satisfied with the benefits it brought about. In summary of the nursing home applications, the proposed care management system integrated with WhizPAD has the potential for the practical use in nursing homes toward a high-quality healthcare.

For extending the BCTS applications, two sensors of activities daily of living have also been added in this study, including the ADL sensor and WhizCarpet. The ADL sensor facilitates the monitoring of environment parameters, appliance usage and mobility at home. WhizCarpet is used to detect the mobility at home and fall event. All sensing devices communicate with the BCTS through Zigbee wireless data transmission, and sensing data are stored in BCTS for data management. By integrating these key sensors with the BCTS, more important information about the living of older adults could be delivered to the remote caregivers.

In this research, the bed is not only a comfortable zone for rest and sleep, but also becomes a telehealth center for healthcare service. Tablets and mobile phones are the main communication devices of the BCTS platform. The family members and caregivers can keep aware of the needs of the older adults for emergency and urgent care, as well as providing life and health management for them.

6.2    Future work

Centered around the bed, the BCTS has the potential to be extended for broader applications. The following tasks are being developed:

(1)   Applications of light therapy based WhizPAD

The quality, timing and length of sleep are dependent upon an interaction of our brain. Our body clock drives daily patterns called circadian rhythms, while a sleep monitor, called the sleep homeostat, acts like a timer, tracking how long we are awake. Particular groups of cells in the brain are involved in maintaining a wake state, whilst others induce sleep. When these sleep homeostat get out of sync, it might cause insomnia, sleep phase disorders and other problems like waking too early or poor quality sleep.

Light is able to synchronize the body clock and stimulate the brain cells to produce sleep or wakefulness hormones at the right time. In addition, all body clocks have a dimming sunset that promotes production of the sleep hormone melatonin to help you unwind naturally, ready for bed.

Ÿ   Sleep improvement with light therapy

Based on the application of sleep quality assessment of WhizPAD, the light can be integrated with WhizPAD. The time and light intensity of light for therapy can be adjusted according to the sleep report of WhizPAD for home users. The local application helps the home users to have better sleep performance.

Ÿ   Wake up with light therapy

In this sleep awake application, a wake-up App connects to the WhizPAD and light for. When the wake-up time is almost up, the intensity of light will increase gradually, like the sunrise. The local application helps the home users to wake up easily and energetically.

(2)   Shaping a perfect sleep environment

Sleep can be affected by the immediate environment, including lighting, noise, and temperature. KNX is the worldwide standard communication protocol for all applications in home and building control (ISO/IEC 14543-3) […]. A centralized BCTS could be integrated with KNX to form a building automation application that could control appliances according to sleep status detected by the BCTS. For example, dim the light and raise the temperature of the air conditioner if the BCTS detects that the user has fallen asleep.

(3)   The commercialization of ADL sensor and WhizCarpet

In this study, the integration of ADL sensor and WhizCarpet with BCTS for broader telehealth application is proposed. Working with the SEDA company, a series of related-bedding products cabable of telehealth functions are ready to being products, including the ADL sensor and WhizCarpet.