Author: Yeh-Liang Hsu, Che-Chang Yang (2005-11-05);
recommended: Yeh-Liang Hsu (2006-01-25).
Note: This paper is presented at 2005 International Symposium on
Gerontechnology and Care Service, Nantou,
November 22-24, 2005.
Design of a Portable Tele-homecare
Monitoring System for the Elderly
presents an on-going project of a Portable Tele-homecare Monitoring System
(PTMS) for the elderly developed in Gerontechnology
Yuan Ze University. Instead of using a centralized database structure that
gathers data from many households, in PTMS a household is the fundamental unit
for data transmission, storage, and analysis. Equipped with different sensors,
PTMS can be used for long-term personal health data management of the elderly
in a home environment. PTMS also provides care-givers with convenient access to
the health data of the elderly, and real time event-driven messages in urgent
situations. Several PTMS applications are demonstrated, including environment
and daily behavior monitoring, an RFID-based entrance guard system, sleep
quality monitoring, vital sign monitoring, and a tele-presence robot.
Key words: Gerontechnology, tele-homecare, telepresence.
According to UN’s
definition, a society in which more than 7 percent of the total population is
aged 65 or over is referred to as an aging society. Taiwan has become an aging society
since 1993. Currently the population aged 65 or older is over 2 million. The
needs of health care and management for the elderly has become an important
needs for elderly care cannot be solved by increasing the number of care-givers.
To respond to the question, “How can technology be best used to support the
needs of aging society?” the interdisciplinary research field “Gerontechnology”
was introduced in the early 1990. Gerontechnology includes the research and
development of techniques and technological products, based on the knowledge of
aging processes, for the benefit of a preferred living and working environment
and adapted medical care for the elderly. Gerontechnology Research Center
(GRC) of Yuan Ze University (YZU) was established in January, 2003. Currently
the major research area in GRC is on tele-homecare.
can be defined as the use of information and communication technologies to
enable effective delivery and management of health services at a patient’s
residence. Home has become the centerpiece of health delivery system today,
and significant activity is underway in the development of the tele-homecare
equipment. Commercial systems are available in Europe, North America, and Japan. Most
systems provide vital signs sensing in the home environment for monitoring
chronically ill patients. Figure 1 shows the number of US patents in tele-homecare
in the past 30 years. Clearly, tele-homecare is a rapidly growing area.
Figure 1. The number of US patents in tele-homecare
tele-homecare systems adopt the following sequence: sensing of various vital
signs è data transmission è data storage and analysis è
medical actions. Figure 2 shows a typical example of a tele-homecare system, “SUKOYAKA
Net-i” from NEC “SUKOYAKA Family 21 Plan”. Users use the terminals at home or
public places to measure their vital signs, such as blood pressure, heart rate,
ECG, weight, body temperature, etc., and the data is sent to the health welfare
center through the Internet. Medical institutions can access the health data
and take necessary actions.
Figure 2. Infrastructural diagram of SUKOYAKA Net-i
database is often used in this structure for data storage and analysis, and the
“health welfare center” partnering with a medical institution plays the major
role. Users subscribe to a service from the health welfare center, instead of buying
a product. Telephone line and the Internet, which are readily available in most
homes, are commonly used for transmission of data. To “mobilize” the measuring
devices, wireless communication technologies have been implemented into the
technologies required are readily available, there has not been a successful
commercial tele-homecare system in Taiwan yet. In 2002, a company
called “Asia Pacific Telehealth Technologies” introduced a tele-health service
system from MEDCAN Health Management Inc., which provided FDA-approved vital
sign measuring devices, personal health data management service, and on-line consultation
and diagnosis. However, this system was not well accepted and has been
terminated. In our observation, the cost of such tele-homecare service is too
high, and this cost is not covered by medical health insurance, seem to be the
describes a Portable Tele-homecare Monitoring System (PTMS) developed by GRC,
YZU. Instead of using the centralized database structure that gathers data from
many households, in PTMS a household is the fundamental unit for data
transmission, storage, and analysis. In this distributed structure, PTMS is a
product-oriented system instead of a service-oriented system. The word “portable”
means all devices of PTMS are designed to be modular and portable, and PTMS can
be easily customized and installed in a home environment. Equipped with
different sensors, PTMS can be used for long-term personal health data
management of the elderly in a home environment. PTMS also provides care-givers
with convenient access to the health data of the elderly, and real time
event-driven messages in urgent situations. PTMS also has possible home
security and smart house applications.
Section 2 of
this paper describes the structure of PTMS, and Section 3 presents the
applications already developed in YZU GRC. Section 4 describes an extension of
PTMS, the “Telepresence Robot” developed in YZU GRC. Finally Section 5 outlines
the possible future developments.
The Structure of PTMS and the
Distributed Data Server
Figure 3 shows
the structure of PTMS. Sensing signals from sensors embedded in the home
environment are transmitted to the distributed data server (DDS), which is the
core component of PTMS. Sensing signals are then processed and stored in the
DDS. Remote users can request data from the DDS using an IE browser (through an
application server) or a VB program. Event driven messages, cell phone messages
or emails can be sent to specified care givers when urgent situation is
Figure 3. The structure of PTMS
Figure 4 shows a
picture of DDS, which is consist of a PIC server mounted on an application
board. The PIC server contains a PIC microcontroller and a networking IC. It
provides networking capability and can be used as a web server. Most peripheral
functions of DDS are built on the application board. The application board (as
well as the program in the PIC microcontroller) can be easily customized to
adapt to different sensors and applications.
Figure 4. Distributed Data Server
serial interface (RS-232) are the primary communication interfaces of DDS with
client PCs and other devices. DDS also receives external signals (e.g., sensor
signals) through specific analogue or digital I/O ports. DDS also provides I2C (Inter-Integrated Circuit) communications
to allow connections with external modules. For example, In addition, a GSM
short message service module can be optionally connected to the DDS via I2C, which makes it possible to send text
messages from DDS to specified care givers when urgent situation is detected.
DDS can also connect to a wireless LAN card and becomes a wireless device
Long term health
monitoring data are processed stored in an MMC card in DDS. Remote users can
request for historical health monitoring data through an application program or
an IE browser. Further data analysis or processing (such as authorization
management, creating graphical displays, tables, etc.) can be built in application
programs or an application server. Comparing with using a PC as a home server,
DDS is low-cost, has smaller package, consumes lower energy (thus can be
powered by batteries), is not affected by virus, and is safer and more
several advantages of the PTMS structure over the traditional centralized-
(1) The scale of PTMS is much smaller. A single household can be a
running unit of PTMS. The infrastructure required is minimal too. PTMS can be
easily adapted and implemented in a home environment with very low cost.
(2) Instead of sending the health monitoring data to a centralized
database in an ISP, health monitoring data is stored within the household. Only
authorized caregivers can access the data. Privacy is better protected.
(3) The route from the sensor to server is much shorter. Data
transmission is easier and more reliable. Communication bandwidth will not be
occupied by meaningless sensing data continuously transmitted from sensors to
the centralized database. Data integrity will be better preserved.
(4) This distributed structure can be adapted if a centralized database
is needed. As shown in Figure 3, instead of passively waiting for data, the
centralized database can actively request for data from DDSs in many households
in a batch mode.
different sensors, various PTMS applications have been developed, as described
Environment Monitoring System
sensors such as temperature sensor and humidity sensor, environment monitoring is
the most typical application of PTMS. Figure 5 shows the VB interface developed
for the Grand Palace Museum
for temperature and humidity monitoring. On the left side of the screen, real
time data from temperature and humidity sensors mounted on 4 different DDS can
be monitored simultaneously. The user can also download historical data, and
perform analyses such as calculating average temperature of the day, plot the
temperature tendency of the week, etc.
Figure 5. VB interface of environmental monitoring
Daily Behavior Monitoring
In the daily
behavior monitoring system, we hope to be able to monitor the transition of a
senior from a healthy, independent state into a state of incapacity and
dependency, to recognize the change in pattern of daily activities, and to
remind the caregivers to take early actions. Special-designed sensors detect
activities such as eating, bathing, using the toilet, lying in bed, watching TV,
etc. In this system, all sensors are embedded in the home environment. The
subjects may not be aware of the sensing actions taking place. Sensor signals
are transmitted to the DDS through a battery-powered RF transmitter (Figure
6(a)). Besides the sensors fixed in the environment, a wearable accelerometer
(Figure 6(b)) is under developed to recognize postural movements of the
subjects when walking, sitting and standing or in postural transitions.
Caregivers can use an interface similar to Figure 5 to read real-time sensor
data, down load historical data, perform various analyses, or set up event
driven messages (GSM short message or email messages) once a sensor is
Figure 6. (a) an RF transmitter and (b) a wearable
Figure 7 shows
the structure of an entrance guard system designed for kindergartens. RFID
(Radio Frequency IDentification) readers combined with optical switches are
used as the sensors in the PTMS. The DDS is also connected to a SMS Module for
Data Transmission (SMDT). When a child with an RFID tag passes through the entrance,
DDS will identify the ID, and whether the child is entering or leaving, log the
event in the DDS, and send an email or a GSM short message to notify the
Figure 7. Structure of an entrance guard system
Sleep Quality Monitoring System
Figure 8 shows
the structure of a sleep quality monitoring system. Spcial designed sensors are
connected to the DDS to evaluate sleep quality from the subject’s external
behaviors. The sleep quality sensors are designed in an unrestrained, non-conscious
way, so that we can do long-term sleep quality monitoring in a home environment
– on the subject’s own bed. From the external behavior signals (body
temperature, body movement, breath, and snoring) instead of vital signs (e.g.
brain waves), we can determine sleep quality indices such as the time in bed,
sleeping time, latent period, times of awakening.
Figure 8. The structure of a sleep quality
Other vital sign sensors
Other vital sign
sensors can be connected to the DDS. Figure 9 shows an ECG holter, which can
measure and record ECG data in a small portable package. Real-time ECG data can
be transmitted and displayed on a remote client PC through the Internet (Figure
Figure 9. Portable ECG holter
Figure 10. Real-time ECG data transmitted and
displayed on a remote client
means visual, kinesthetic, tactile or other sensor feedback from the
teleoperator to the human operator that is sufficient and properly displayed
such that the human feels that he is present at the remote site, and that the
teleoperator is an extension of his own body. Figure 11 shows “Dr.Robot”
developed by InTouch Health Inc, which is a good application example of a
telepresence robot. The doctor can “drive this telepresence robot to patrol and
check up on patients.
Figure 11. Dr.Robot
associated with an increased risk for isolation. We also designed a telepresence
robot (Figure 12) to provide a new way of communication. Basically, it is a “mobile
DDS”, which integrates various sensors, a network IP camera with audio module,
a wireless LAN AP, actuators, and batteries, altogether inside a vehicle. Users
can control the telepresence robot from a remote client PC to move around.
Two-audio and one-way video communication can be transmitted through the
Internet. Any PTMS-related function can be carried out as well.
also has the ability to perform fundamental autonomous behaviors while not
being controlled, such as following a given track, detecting obstacles, and
auto-charge at low battery capacity.
Fig 12. Tele-presence robot
Future Work of PTMS
presents an on-going project of a Portable Tele-homecare Monitoring System developed
in GRC, YZU. Several PTMS applications are also demonstrated. Some of these
applications have been tested in practical uses, proven to be complete, stable,
and reliable in performance. Currently we are testing the existing
applications, and expanding the applications. We are also applying for patents,
Figure 13 shows the patent portfolio of PTM, and we are looking forward to
collaborating with industries for commercialization of PTMS.
Figure 12. Patens Portfolio of PTMS
Graafmans, J.A.M. and Bouma, H., 1993, “Gerontechnology, fitting task and
environment to the elderly,” Proceedings
of the Human Factors and Ergonomics Society, v 1, p 182-186.
“International Activities in
Tele-homecare”, Office of Health and Information
Sheridan, T.B., “Human supervisory control of robot system,” in Proc IEEE
Int. Conf. Robotics Automation. San
Francisco. CA. pp.808-812, 1986.
“Dr.Robot Tested at Hopkins”, press releases
from John Hopkins Medicine, August 5, 2003.