OPENING VIGNETTE: ELITE CARE SUPPORTED BY INTELLIGENT SYSTEMS

15.1 OPENING VIGNETTE: ELITE CARE SUPPORTED BY INTELLIGENT SYSTEMS

D e l i v e r i n g health services to the elderly is b e c o m i n g a m a j o r societal p r o b l e m in m a n y countries, e s p e c i a l l y i n c o u n t r i e s w h e r e t h e r e are r e l a t i v e l y f e w e r and f e w e r y o u n g p e o p l e to t a k e care of m o r e and m o r e elderly. T h e p r o b l e m is already acute in Japan, and it is e x p e c t e d to be very serious in 1 0 - 1 5 years in several E u r o p e a n countries and in China. T h e specific delivery d e p e n d s on t h e h e a l t h status of t h e individual, and it is p r o v i d e d i n different facilities ranging f r o m h o m e care t o nursing h o m e s .

M a n a g i n g and delivering such care i n v o l v e s large n u m b e r of diversified decisions, ranging f r o m allocation o f resources t o d e t e r m i n i n g w h a t t r e a t m e n t t o p r o v i d e t o e a c h patient at e a c h g i v e n time.

Elderly residents in assisted-living facilities require different levels of care. S o m e residents n e e d m i n i m a l assistance, others h a v e short-term m e m o r y problems, and y e t others h a v e m o r e s e v e r e p r o b l e m s like A l z h e i m e r ' s disease, and s o require m o r e super- vision and help. At E l i t e Care's E s t a t e s Cluster R e s i d e n t i a l Care Facility in M i l w a u k e e , Wisconsin, pervasive c o m p u t i n g and intelligent s y s t e m s are b e i n g u s e d to increase t h e

a u t o n o m y and care level of all of the residents, regardless of their individual needs.

E l i t e Care is a f a m i l y - o w n e d business (elite-care.com), built f r o m t h e g r o u n d up to p r o v i d e " h i g h - t e c h , h i g h - t o u c h " p r o g r a m s . Its a d v i s o r y c o m m i t t e e , w h i c h i n c l u d e ,

a m o n g others, r e p r e s e n t a t i v e s f r o m t h e M a y o Clinic, H a r v a r d U n i v e r s i t y , t h e University of Michigan, t h e University of Wisconsin, and S a n d i a N a t i o n a l Laboratory, has contributed a n u m b e r of i d e a s that h a v e b e e n put i n t o practice.

T h e entire facility is w i r e d with a 30-mile n e t w o r k (wireline and wireless) of u n o b - trusive sensors and other devices, including:

• B i o s e n s o r s (e.g., w e i g h t sensors) attached to e a c h resident's bed. • M o v e m e n t sensors e m b e d d e d in b a d g e s w o r n by t h e residents and staff (wear-

able c o m p u t e r s ) . • Panic buttons used to call f o r help. • Internet access accessible via t o u c h screens in e a c h r o o m . • V i d e o c o n f e r e n c i n g using W e b c a m s . • Climate control, lights, and other r e g u l a t e d appliances.

T h e results c o l l e c t e d by t h e m o n i t o r i n g d e v i c e s are interpreted by intelligent sys- tems, allowing t h e staff to determine:

• Patient location; indicating whether t h e resident is in an e x p e c t e d area of the facility. • Weight loss; indicating c o n d i t i o n s like i m p e n d i n g c o n g e s t i v e heart failure. • R e s t l e s s n e s s at night; indicating c o n d i t i o n s like insufficient p a i n m e d i c a t i o n . • F r e q u e n c y of trips to the b a t h r o o m ; indicating m e d i c a l p r o b l e m s like infection. • L e n g t h of a b s e n c e f r o m bed; indicating that t h e patient m a y h a v e f a l l e n or b e e n

P A R T V IMPLEMENTING M S S IN THE E-BUSINESS ERA

Close monitoring of conditions also allows for giving m e d i c i n e and/or other treat- m e n t s as needed, rather than at a p r e d e t e r m i n e d time. This e n a b l e s true o n e - t o - o n e care, which is both m o r e effective and less expensive.

O n e of the initial concerns with the monitors was that the privacy of the residents w o u l d be unnecessarily invaded. To alleviate these concerns, residents and their fami- lies are given the choice of participating or not. M o s t of t h e m c h o o s e to participate because the families b e l i e v e that the monitors provide better tracking and care. The monitors also increase the a u t o n o m y of the patients, since they lessen the n e e d for staff to constantly monitor residents in person, especially those with m o r e acute care needs.

A l l of the sensors and intelligent systems are c o n n e c t e d through a high-speed eth- ernet. The data produced by t h e e sensors and systems is stored in an S Q L database and can be used to alert the staff in real-time if necessary. The data are analyzed to deter- m i n e patients' health status and to d e v e l o p individualized care programs. The s a m e

d a t a b a s e is also u s e d for administrative purposes, such as m o n i t o r i n g staff perfor- m a n c e in timely delivery.

A similar concept is used in Swan Village of Care in Bentley, Australia. At the pre- sent t i m e such projects are e x p e r i m e n t a l and e x p e n s i v e , but s o m e d a y they will be affordable to many.

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