Smart technologies toward sleep monitoring at home

With progress in sensors and communication technologies, the range of sleep monitoring is extending from professional clinics into our usual home environments. Information from conventional overnight polysomnographic recordings can be derived from much simpler devices and methods. The gold standard of sleep monitoring is laboratory polysomnography, which classifi es brain states based mainly on EEGs. Single-channel EEGs have been used for sleep stage scoring with accuracies of 84.9%. Actigraphy can estimate sleep effi ciency with an accuracy of 86.0%. Sleep scoring based on respiratory dynamics provides accuracies of 89.2% and 70.9% for identifying sleep stages and sleep effi ciency, respectively, and a correlation coeffi cient of 0.94 for apnea–hypopnea detection. Modulation of autonomic balance during the sleep stages are well recognized and widely used for simpler sleep scoring and sleep parameter estimation. This modulation can be recorded by several types of cardiovascular measurements, including ECG, PPG, BCG, and PAT, and the results showed accuracies up to 96.5% and 92.5% for sleep effi ciency and OSA severity detection, respectively. Instead of using recordings for the entire night, less than 5 min ECG recordings have used for sleep effi ciency and AHI estimation and resulted in high correlations of 0.94 and 0.99, respectively. These methods are based on their own models that relate sleep dynamics with a limited number of biological signals. Parameters representing sleep quality and disturbed breathing are estimated with high accuracies that are close to the results obtained by polysomnography. These unconstrained technologies, making sleep monitoring easier and simpler, will enhance qualities of life by expanding the range of ubiquitous healthcare.

Effects of Nutrition Education Using a Ubiquitous Healthcare (u-Health) Service on Metabolic Syndrome in Male Workers

The objective of this study was to investigate the effects of nutrition education based on ubiquitous healthcare (u-health) service on changes in dietary habits, nutrition intake, and risk factors for metabolic syndrome in male workers. In total, 72 male office workers with at least three risk factors of the National Cholesterol Education Program-Adult Treatment Panel III were recruited as subjects. Anthropometric measurements and biochemical analyses were conducted on all subjects. Dietary habits and nutrient intake were determined by a questionnaire using the 24-hour dietary recall method before and after nutrition education. Subjects measured their body composition, blood pressure, and physical activity more than once per week during the 12 weeks using the u-health care equipment and sent these data to a central database system using a personal computer. Individual nutrition counseling was provided four times on the first, fourth, eight, and twelfth weeks. The results showed significant decreases in abdominal circumference, body fat (%), diastolic blood pressure, serum triglycerides, and serum total cholesterol during the 12 weeks. Subjects with more than 12 measurements showed significant reductions in abdominal circumference, body fat (%), serum triglyceride, and serum total cholesterol. Mean intake of dietary fiber, animal calcium, potassium, vitamin C, and folic acid after nutrition education were higher than those before nutrition education. Participants showed significant increases in the frequencies of consuming protein foods (meat, fish, eggs, beans, tofu, etc.) and vegetables. In conclusion, nutrition education through the u-health service resulted in positive effects on the risk factors for metabolic syndrome, nutrient intake, and dietary habits.

Review of Semantically Interoperable Electronic Health Records for Ubiquitous Healthcare / 대한의료정보학회지

In order to provide more effective and personalized healthcare services to patients and healthcare professionals, intelligent active knowledge management and reasoning systems with semantic interoperability are needed. Technological developments have changed ubiquitous healthcare making it more semantically interoperable and individual patient-based; however, there are also limitations to these methodologies. Based upon an extensive review of international literature, this paper describes two technological approaches to semantically interoperable electronic health records for ubiquitous healthcare data management: the ontology-based model and the information, or openEHR archetype model, and the link to standard terminologies such as SNOMED-CT.

Development of u-House Gateway for u-Healthcare / 대한의료정보학회지

OBJECTIVE: Ubiquitous healthcare (u-Healthcare) is an emerging paradigm in the healthcare environment. One of the most promising applications for u-Healthcare is the ubiquitous home health monitoring system. This paper addresses two significant challenges in the successful application of the ubiquitous home health monitoring system: the uniform integration of measured biosignal data and easy access to monitored biosignal data. METHODS: We used the Medical waveform description Format Encoding Rule (MFER) standard to encode biosignal data. A web-based MFER upload ActiveX control was designed and implemented to transfer MFER files to the central repository server in a near real-time basis. All of the integrated biosignal data were then accessed and managed through the central repository server. RESULTS: We developed a u-House server that can serve as a uniform data transferer to integrate measured biosignal data from u-House homes into the remote central repository server. We developed user-friendly web services that allow users to easily search and view monitored biosignal data. CONCLUSION: The results of this study suggest that the MFER standard can be easily adapted to u-Healthcare systems and that a web-based ubiquitous home health monitoring system has advantages of ubiquitous access and scalability.

Application of u-Health Under Special Situations

u-Health is a good alternative in providing health care service under special situations where access to health care is limited. With the expansion of life space and the increase of travel, people are being put in danger across various situations on the sea, in the sky, disasters, and so on. It is not easy to provide health care in those situations, while people may still have high expectation to heath care. This gap can be narrowed by using u-Health, which is based on advanced information and communication technologies. The special situation for u-Health is where normal health care cannot be performed because of physical limitation and danger, which can be further broken down to five situations. The first is a situation on means of transportation such as ship and airplane. The second situation is when medical facilities are far away from life space, in places like backwoods. The third situation occurs on the place where it is difficult for patients to receive treatment due to restrained freedom, for example, a prison. The forth is the situation where the medical team is unable to approach easily, such as war zone and disaster area. The last special situation is the extreme environments like polar region. In order to make the u-health system more helpful for patients under special situations, there is a need for a research development and investment on sensors to measure accurate bio-signals, the network to transmit the data, and the technologies to analyze the data and to provide feedback. Therefore, institutional supports for technology development are required for further development of u-Health for people in great needs.

Implementation of Device Independent ECG Reporting System Using Web Development Framework / 대한의료정보학회지

OBJECTIVE: We developed a Cocoon framework-based device independent electrocardiogram(ECG) Reporting System in order to support such various web devices as desktop Personal Computer(PC), Personal Digital Assistants(PDA) and SmartPhone. METHODS: ECG Reporting System, built in the Cocoon framework, consists of modules of ECG Report Module and ECG Image Module. Two modules publish the applied ECG Report to each different templates according to the requesting device. The method of framework-based development in this paper features a reduction of development costs and the robust stability of system. RESULTS: The medical staff may require patient ECG information in ubiquitous healthcare environment, ECG Reporting System supports their correct judgment and expeditious response by servicing ECG report of the patient according to the requesting device. CONCLUSION: The proposed system and concept in this paper may be a good solution for developing the point of care service system supporting various mobile devices.

A PDA-Based Wireless ECG Monitoring System for u-Healthcare / 대한의료정보학회지

OBJECTIVE: The purpose of this study is to design a portable ECG monitoring system, which integrates up-to-date PDA and RF communication technology, and to acquire the subject's biomedical signal without any constraint. METHODS: The developed system is composed of a transmitter and a receiver. The transmitter has a MCU (microcontroller), three-axial acceleration sensor, ECG amplifier and Zigbee communication controller. It has two types of transmission mode, which are total signal transmission mode and HR (heart rate)/SC (step count) transmission mode. The receiver has a MCU, Serial Communication IC, and Zigbee communication controller. It forwards the received data to PDA, where the data can be stored and displayed. RESULTS: In total signal transmission mode, it can send data 60 packets per second whose transmission speed corresponds to 300 ECG samples and 60 acceleration samples. In HR/SC transmission mode, it can calculate heart rate from ECG data with 216 samples per second and step count from acceleration data and send a packet every cardiac cycle. CONCLUSION: Using this device, a new method of remote monitoring both vital sign and activity is realized. A PDA-based wireless ECG system enables patients to be monitored during their daily living, without any constraints. Also, this method will reduce medical costs in the aged society.