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PARTS PLAYED BY
US:-
DEEPIKA :: Handled the research Biosensors & various
connecting services like (ZigBee/ IEEE standard 804.15.6,
Bluetooth, WPAN, WLAN) and networks with the main
station.
OSHIN :: Handled the research on various applications and
devices which work as Smart Sensors in healthcare and their
future prospects and firmness in e-health fields.
OBJECTIVE
To deal with various technologies which provide smart
sensing in healthcare and compare them for their
energy usage and battery life and discuss the format of
communication to the database of these devices. To put
forward devices which use smart sensors in advanced
medical check-ups. To discuss the prospects of
upcoming technology called Smart Dust in e-health and
its advantages and effects for better deployment of
trustworthy services in healthcare keeping in mind all
the capabilities of the Smart Sensors.
SENSORS USED IN
HOSPITALS
What do they measure?
•Temperature
•Blood Pressure
•Pulse
•ECG (Heart Rate)
•Respiratory Rate
•Blood Sugar
APPLICATIONS OF E-
HEALTH SENSORS
• Patient Monitoring Blood pressure, blood
sugar etc.
• Environmental Tests Environmental
Pollution
• Diagnosis Patient Monitoring,
Dope Testing,
Cancer or Tumor
analysis.
BIOSENSO
RS
• A biosensor is an analytical device,
used for the detection of an analyte,
that combines a biological component
with a physiochemical detector.
• The sensitive biological element(e.g.
tissue, microorganisms, organelles,
cell receptors, enzymes, antibodies,
nucleic acids, etc.), a biologically
derived material or biomimetic
component that interacts (binds or
recognizes) with the analyte under
study.
The sensor which can
measure heart and brain
activity (ECG, EEG and EMG).
BIOSENSORS-AN
EXAMPLE
• A common example of a commercial biosensor is the blood glucose
biosensor, which uses the enzyme glucose oxidase to break blood
glucose down.
• In doing so it first oxidizes glucose and uses two electrons to reduce
the FAD (a component of the enzyme) to FADH2.
• This in turn is oxidized by the electrode (accepting two electrons from
the electrode) in a number of steps.
• The resulting current is a measure of the concentration of glucose. In
this case, the electrode is the transducer and the enzyme is the
biologically active component.
APPLICATIONS OF
BIOSENSORS
• Glucose monitoring in diabetes ← historical market driver.
• Detection of pathogens.
• Routine analytical measurement of folic acid, vitamin B12 etc
as an alternative to microbiological assay.
• Drug discovery & evaluation of new compound biological
activity.
Smart sensor enhances the following applications:
 Self calibration: Adjust deviation of o/p of sensor from desired value.
 Communication: Broadcast information about its own status.
 Computation: Allows one to obtain the average, variance and standard
deviation for the set of measurements.
 Multisensing: A single smart sensor can measure pressure, temperature,
humidity, gas flow and infrared, chemical reaction surface
acoustic vapour etc.
 Cost effective: less hardware and reduction of repetitive testing make smart
sensor cost effective.
1. Mertia Sensing Device :-
A small sensor is worn on the body and is attached using a
skin-friendly adhesive. The low-profile design makes it
suitable for daily activities like showering and exercise. The
sensor is built to gather a variety of patient information,
from heart rate and respiration to sleep duration and activity
levels.
ZigBee is targeted at applications that
require a low data rate, long battery life,
and secure networking. ZigBee has a
defined rate of 250 kbit/s, best suited for
periodic or intermittent data or a single
signal transmission from a sensor or input
device
ZigBee is a specification for a suite
of high level communication
protocols using small, low-power
digital radios based on an IEEE 802
standard for personal area
networks.
ZigBee is seen as a key technology
for home automation and sensor
networks, but its characteristics
can be extremely valuable in some
healthcare applications as well.
2. ZigBee(IEEE 802.15.4)
3. MEDIC
• Acquire data from patients in real world
• It sends data to the centralized server and the
centralized server forwards data to all the nodes
• It can be configured from the remote server
• Wearable sensors to patients for comfortability
4. Smart dust:- Smart dust is a theoretical concept of a tiny
wireless sensor network, made up of microelectromechanical
sensors (called MEMS), robots, or devices, usually referred to as
motes, that have self-contained sensing, computation,
communication and power.
• Blood pressure sensor, Weight scale.
• Emfi-sensors for exercise equipments/bed.
• Low resolution IR camera.
• Ultrasound radar.
• Capacitive floor sensors.
• ZigBee sensor network.
• Connection to local and remote servers.
• Strong collaborative, and robust clinical research with population
studies is required!
WLAN
(802.11)
Bluetooth-based
WPAN (802.15.1)
ZIGBEE
(802.15.4)
Range 100m ~10-100m ~10m
Cost/complexity >6 1 0.2
Power consumption Medium Low Ultralow
Size Larger smaller smallest
BLUETOOTH VS. ZIGBEE (IEEE
802.15.4)
Bluetooth based WPAN
• Few devices
• Data range is 10m to 100m
• Data rate is nearly 1Mb/s
• Power consumption is a
low.
• Battery life is low.
• Star only.
IEEE 802.15.4 LR-WPAN
• Many devices
• Data range is nearly 10m
• Data rate is 20
kb/s,40kb/s,250kb/s.
• Power consumption is ultra
low.
• Battery lasts years.
• peer to peer, Star.
COMMUNICATION PROTOCOLS :-
AN OVERVIEW OF THE PROCESS OF
MEDICAL SENSING :
• Sensors: various types of wearable biomedical sensors with
integrated radio transceivers (ex: accelerometer in bracelet to
detect hand tremors, mertia)
• Radio signal received by cell phone and transmitted to server
• Analysis of raw data performed via wavelet analysis
• Decision tree or artificial neural network used to decide
appropriate action (data is within normal range, outside
normal range and either does or does not require emergency
action, etc.)
• Data stored in server side database and report is generated to
send to healthcare professional
• As shown in next figure:
ARCHITECTURE OF THE PROCESS OF
MEDICAL SENSING :
VIVOMETRICS(ANOTHER
ADVANCED TECHNOLOGY)
• A wireless pulse oximeter and wireless two-lead EKG(as given in fig. below)
• These devices collect heart rate (HR), oxygen saturation and EKG data .
• It is over a short-range (100m) wireless network to any number of receiving
devices, including PDAs, laptops, ambulance terminals.
• Data is displayed in real time & integrated into the patient care record.
• The sensor devices can be programmed to process the vital sign data, for
example, to raise an alerts when vital signs fall outside of norms .
• These vital sign sensors consist of a low-power microcontroller and low-power
digital spread-spectrum radio .
• Powered by batteries with a lifetime of up to a year.
Pulse Oximeter Wireless two-lead EKG
Accelerometer,
gyroscope, and
electromyogram (EMG)
sensor for stroke patient
monitoringFIG. 1
What is wearable smart shirt?
Wearable smart shirt = Wearable + smart shirt
• smart shirt is an analytical
device used for detection of
analyte.
• e.g.RespirationRate,body
temperature ,heart rate etc.
• Object that can be worn on
body.
• e.g. wrist watches, ring,
shirts etc.
Smart ShirtWearable
•A noninvasive system
•Based on plethysmography (measuring changes in volume within an organ or
whole body usually resulting from fluctuations in the amount of blood or air it
contains)
•Wearable medical system, which provides constant monitoring of ambulatory
patients by measuring and storing respiratory and cardiac parameters.
•Creates health profile during normal daily activities.
•Embedded sensors collect data on cardiopulmonary function.
•Can be combined with optional peripherals and monitor functions such as
electrocardiogram, electro-myografima, leg movement, body temperature,
blood oxygen saturation, blood pressure etc .
WEARABLE CLOTHES:
LIFESHIRT
 Remote Monitor the vital sign.
 Communicate seamlessly with external devices.
 Enhance safety and quality of care for patient through
Telemedicine
 Monitoring of individuals who work with hazardous
condition .
• GTWM that is outfitted with a microphone or GPS may compromise
the wearer's privacy.
• Technology like Bluetooth and WLAN using for data transfer , having
short range 30-300 m.
• The data that is transferred by the "Smart Shirt" could be viewed
and access by unauthorized people.
Advantages
 Continuous monitoring.
 Right Treatment at the right
time
 Easy to wear and takeoff.
 Reduce the work load of
medical assistance.
 Washable
 very fast process.
Disadvantages
 Initial cost is high
 Battery life is less
 Repairing and maintaince
process is tedious.
SOME LATEST COMMERCIAL
SENSORS
Plastic Sensor Fiber
Woven Temperature Sensor
inserted into Textile
Accelerometer data
on smart phone
Wearable sensor a 3-axis
accelerometer
JAWBONE UP
BASIS
Wristband packed with
vibration and motion sensors
to track and analyze exercise,
diet, and sleep data .
Wrist-worn device that measures
the wearer’s heart rate, caloric
burn, sleep patterns .
SOME LATEST COMMERCIAL
SENSORS(CONTD.)
Withings Wi-Fi Body Scale
Sends body measurements
wirelessly to computer or
iPhone, to track gains or losses
over time .
AgaMatrix
Sensor for tracking blood glucose
levels. It also tracks carbs intake
and insulin dose for users with
diabetes.
SOME LATEST COMMERCIAL
SENSORS(CONTD.)
Advantages of biosensors
i.Minimum Interconnecting Cables
i.High Reliability
ii.High Performance
iii.Easy to Design, Use and Maintain
iv.Scalable -Flexible System
v.Minimum Cost
We have various advantages related to access of health related information from
distant areas to the server instantly .This can be very time saving and energy
efficient process. Even very large amount of data can be saved in the database. It
has a promising future.
 The smart sensor consists of both actuators & sensors, so it is
more complexed than other simple sensors.
 The complexity is much higher in the wired smart sensors, as
a consequence the costs are also higher.
ACCEPTANCE OF
BIOSENSORS BY PATIENTS
Especially important for elderly patients:
• Tendency to reject technology
• Must be intuitive and easy to operate
A study in which elderly residents of Sydney participated in an open-ended
discussion found:
• Overall positive view of WSNs due to implications for independence
• Ashamed of visible sensors (design as unobtrusive as possible)
• Adherence issues due to forgetfulness
• Distrust of technology
• Privacy
PLAYERS IN THE FIELD OF E-HEALTH
SMART SENSING:-
REFERENCES:-
 Mobile Wireless Sensor Networks: Healthcare in Hospitals by
balakrishna@research.iiit.ac.in , Garimella Ramamurthy, Sujeeth Nanda in ifth
International Conference on eHealth, Telemedicine, and Social Medicine(eTELEMED
2013)
 ZigBee Wireless Sensor Applications for Health, Wellness and Fitness - March
2009 at www.zigbee.org
 A Health Monitoring System Using Smart Phones and Wearable Sensors Valerie
GAY , Peter LEIJDEKKERS- Faculty of IT, University of Technology Sydney, PO Box
123, Broadway 2007 NSW Australia
 On the Use of Wireless Network Technologies in Healthcare Environments Nicolas
Chevrollier Nada Golmie National Institute of Standards and Technology
Gaithersburg, Maryland 20899,2010
 Application of Wireless Sensor Networks to Healthcare Promotion Paulo Neves,
Michal Stachyra, Joel Rodrigues,2010
 Patient Monitoring Using Personal Area Networks of Wireless Intelligent Sensors
Emil Jovanov, Dejan Raskovic, John Price, John Chapman, Anthony Moore,
Abhishek Krishnamurthy Electrical and Computer Engineering Department,
University of Alabama in Huntsville 301 Sparkman Drive, Huntsville, AL 35899,2009
SMART
DUST
FUTURE IMPLICATIONS:-
•Blood pressure sensor,
weight scale.
•Emfi-sensors for exercise
equipments/bed.
•Low resolution IR camera.
•Ultrasound radar.
•Capacitive floor sensors.
•ZigBee sensor network.
•Connection to local and remote
servers.
Smart dust is a theoretical concept of a tiny wireless sensor network, made up
of microelectromechanical sensors (called MEMS), robots, or devices, usually
referred to as motes, that have self-contained sensing, computation,
communication and power.
FUTURE OF ”SMART DUST” IN HEALTHCARE
–TO LEAP FORWARD
PROMISES:
- THE NEW TECHNOLOGY AND NEW SENSORS
WILL ENABLE US TO BRING NEW SERVICES FOR
HEALTHCARE, EVENTUALLY.
- FOR THE CUSTOMERS NEW TECHNOLOGY
COULD PROVIDE COMPLETELY NEW AVENUES
ENABLING PERSONALIZED DISEASE
PREVENTION, DISEASE MANAGEMENT AS WELL
AS REHABILITATION AND CARE THAT IS NOT
AVAILABLE TODAY.
STRONG COLLABORATIVE, AND ROBUST
CLINICAL RESEARCH WITH POPULATION

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Smart sensor technology in healthcare & protection

  • 1.
  • 2. PARTS PLAYED BY US:- DEEPIKA :: Handled the research Biosensors & various connecting services like (ZigBee/ IEEE standard 804.15.6, Bluetooth, WPAN, WLAN) and networks with the main station. OSHIN :: Handled the research on various applications and devices which work as Smart Sensors in healthcare and their future prospects and firmness in e-health fields.
  • 3. OBJECTIVE To deal with various technologies which provide smart sensing in healthcare and compare them for their energy usage and battery life and discuss the format of communication to the database of these devices. To put forward devices which use smart sensors in advanced medical check-ups. To discuss the prospects of upcoming technology called Smart Dust in e-health and its advantages and effects for better deployment of trustworthy services in healthcare keeping in mind all the capabilities of the Smart Sensors.
  • 4. SENSORS USED IN HOSPITALS What do they measure? •Temperature •Blood Pressure •Pulse •ECG (Heart Rate) •Respiratory Rate •Blood Sugar
  • 5. APPLICATIONS OF E- HEALTH SENSORS • Patient Monitoring Blood pressure, blood sugar etc. • Environmental Tests Environmental Pollution • Diagnosis Patient Monitoring, Dope Testing, Cancer or Tumor analysis.
  • 6. BIOSENSO RS • A biosensor is an analytical device, used for the detection of an analyte, that combines a biological component with a physiochemical detector. • The sensitive biological element(e.g. tissue, microorganisms, organelles, cell receptors, enzymes, antibodies, nucleic acids, etc.), a biologically derived material or biomimetic component that interacts (binds or recognizes) with the analyte under study. The sensor which can measure heart and brain activity (ECG, EEG and EMG).
  • 7. BIOSENSORS-AN EXAMPLE • A common example of a commercial biosensor is the blood glucose biosensor, which uses the enzyme glucose oxidase to break blood glucose down. • In doing so it first oxidizes glucose and uses two electrons to reduce the FAD (a component of the enzyme) to FADH2. • This in turn is oxidized by the electrode (accepting two electrons from the electrode) in a number of steps. • The resulting current is a measure of the concentration of glucose. In this case, the electrode is the transducer and the enzyme is the biologically active component.
  • 8. APPLICATIONS OF BIOSENSORS • Glucose monitoring in diabetes ← historical market driver. • Detection of pathogens. • Routine analytical measurement of folic acid, vitamin B12 etc as an alternative to microbiological assay. • Drug discovery & evaluation of new compound biological activity.
  • 9. Smart sensor enhances the following applications:  Self calibration: Adjust deviation of o/p of sensor from desired value.  Communication: Broadcast information about its own status.  Computation: Allows one to obtain the average, variance and standard deviation for the set of measurements.  Multisensing: A single smart sensor can measure pressure, temperature, humidity, gas flow and infrared, chemical reaction surface acoustic vapour etc.  Cost effective: less hardware and reduction of repetitive testing make smart sensor cost effective.
  • 10. 1. Mertia Sensing Device :- A small sensor is worn on the body and is attached using a skin-friendly adhesive. The low-profile design makes it suitable for daily activities like showering and exercise. The sensor is built to gather a variety of patient information, from heart rate and respiration to sleep duration and activity levels.
  • 11. ZigBee is targeted at applications that require a low data rate, long battery life, and secure networking. ZigBee has a defined rate of 250 kbit/s, best suited for periodic or intermittent data or a single signal transmission from a sensor or input device ZigBee is a specification for a suite of high level communication protocols using small, low-power digital radios based on an IEEE 802 standard for personal area networks. ZigBee is seen as a key technology for home automation and sensor networks, but its characteristics can be extremely valuable in some healthcare applications as well. 2. ZigBee(IEEE 802.15.4)
  • 12. 3. MEDIC • Acquire data from patients in real world • It sends data to the centralized server and the centralized server forwards data to all the nodes • It can be configured from the remote server • Wearable sensors to patients for comfortability
  • 13. 4. Smart dust:- Smart dust is a theoretical concept of a tiny wireless sensor network, made up of microelectromechanical sensors (called MEMS), robots, or devices, usually referred to as motes, that have self-contained sensing, computation, communication and power. • Blood pressure sensor, Weight scale. • Emfi-sensors for exercise equipments/bed. • Low resolution IR camera. • Ultrasound radar. • Capacitive floor sensors. • ZigBee sensor network. • Connection to local and remote servers. • Strong collaborative, and robust clinical research with population studies is required!
  • 14. WLAN (802.11) Bluetooth-based WPAN (802.15.1) ZIGBEE (802.15.4) Range 100m ~10-100m ~10m Cost/complexity >6 1 0.2 Power consumption Medium Low Ultralow Size Larger smaller smallest
  • 15. BLUETOOTH VS. ZIGBEE (IEEE 802.15.4) Bluetooth based WPAN • Few devices • Data range is 10m to 100m • Data rate is nearly 1Mb/s • Power consumption is a low. • Battery life is low. • Star only. IEEE 802.15.4 LR-WPAN • Many devices • Data range is nearly 10m • Data rate is 20 kb/s,40kb/s,250kb/s. • Power consumption is ultra low. • Battery lasts years. • peer to peer, Star. COMMUNICATION PROTOCOLS :-
  • 16. AN OVERVIEW OF THE PROCESS OF MEDICAL SENSING : • Sensors: various types of wearable biomedical sensors with integrated radio transceivers (ex: accelerometer in bracelet to detect hand tremors, mertia) • Radio signal received by cell phone and transmitted to server • Analysis of raw data performed via wavelet analysis • Decision tree or artificial neural network used to decide appropriate action (data is within normal range, outside normal range and either does or does not require emergency action, etc.) • Data stored in server side database and report is generated to send to healthcare professional • As shown in next figure:
  • 17. ARCHITECTURE OF THE PROCESS OF MEDICAL SENSING :
  • 18. VIVOMETRICS(ANOTHER ADVANCED TECHNOLOGY) • A wireless pulse oximeter and wireless two-lead EKG(as given in fig. below) • These devices collect heart rate (HR), oxygen saturation and EKG data . • It is over a short-range (100m) wireless network to any number of receiving devices, including PDAs, laptops, ambulance terminals. • Data is displayed in real time & integrated into the patient care record. • The sensor devices can be programmed to process the vital sign data, for example, to raise an alerts when vital signs fall outside of norms . • These vital sign sensors consist of a low-power microcontroller and low-power digital spread-spectrum radio . • Powered by batteries with a lifetime of up to a year.
  • 19. Pulse Oximeter Wireless two-lead EKG Accelerometer, gyroscope, and electromyogram (EMG) sensor for stroke patient monitoringFIG. 1
  • 20. What is wearable smart shirt? Wearable smart shirt = Wearable + smart shirt • smart shirt is an analytical device used for detection of analyte. • e.g.RespirationRate,body temperature ,heart rate etc. • Object that can be worn on body. • e.g. wrist watches, ring, shirts etc. Smart ShirtWearable
  • 21. •A noninvasive system •Based on plethysmography (measuring changes in volume within an organ or whole body usually resulting from fluctuations in the amount of blood or air it contains) •Wearable medical system, which provides constant monitoring of ambulatory patients by measuring and storing respiratory and cardiac parameters. •Creates health profile during normal daily activities. •Embedded sensors collect data on cardiopulmonary function. •Can be combined with optional peripherals and monitor functions such as electrocardiogram, electro-myografima, leg movement, body temperature, blood oxygen saturation, blood pressure etc . WEARABLE CLOTHES: LIFESHIRT
  • 22.
  • 23.  Remote Monitor the vital sign.  Communicate seamlessly with external devices.  Enhance safety and quality of care for patient through Telemedicine  Monitoring of individuals who work with hazardous condition .
  • 24. • GTWM that is outfitted with a microphone or GPS may compromise the wearer's privacy. • Technology like Bluetooth and WLAN using for data transfer , having short range 30-300 m. • The data that is transferred by the "Smart Shirt" could be viewed and access by unauthorized people.
  • 25. Advantages  Continuous monitoring.  Right Treatment at the right time  Easy to wear and takeoff.  Reduce the work load of medical assistance.  Washable  very fast process. Disadvantages  Initial cost is high  Battery life is less  Repairing and maintaince process is tedious.
  • 26. SOME LATEST COMMERCIAL SENSORS Plastic Sensor Fiber Woven Temperature Sensor inserted into Textile Accelerometer data on smart phone Wearable sensor a 3-axis accelerometer
  • 27. JAWBONE UP BASIS Wristband packed with vibration and motion sensors to track and analyze exercise, diet, and sleep data . Wrist-worn device that measures the wearer’s heart rate, caloric burn, sleep patterns . SOME LATEST COMMERCIAL SENSORS(CONTD.)
  • 28. Withings Wi-Fi Body Scale Sends body measurements wirelessly to computer or iPhone, to track gains or losses over time . AgaMatrix Sensor for tracking blood glucose levels. It also tracks carbs intake and insulin dose for users with diabetes. SOME LATEST COMMERCIAL SENSORS(CONTD.)
  • 29. Advantages of biosensors i.Minimum Interconnecting Cables i.High Reliability ii.High Performance iii.Easy to Design, Use and Maintain iv.Scalable -Flexible System v.Minimum Cost We have various advantages related to access of health related information from distant areas to the server instantly .This can be very time saving and energy efficient process. Even very large amount of data can be saved in the database. It has a promising future.
  • 30.  The smart sensor consists of both actuators & sensors, so it is more complexed than other simple sensors.  The complexity is much higher in the wired smart sensors, as a consequence the costs are also higher.
  • 31. ACCEPTANCE OF BIOSENSORS BY PATIENTS Especially important for elderly patients: • Tendency to reject technology • Must be intuitive and easy to operate A study in which elderly residents of Sydney participated in an open-ended discussion found: • Overall positive view of WSNs due to implications for independence • Ashamed of visible sensors (design as unobtrusive as possible) • Adherence issues due to forgetfulness • Distrust of technology • Privacy
  • 32. PLAYERS IN THE FIELD OF E-HEALTH SMART SENSING:-
  • 33. REFERENCES:-  Mobile Wireless Sensor Networks: Healthcare in Hospitals by balakrishna@research.iiit.ac.in , Garimella Ramamurthy, Sujeeth Nanda in ifth International Conference on eHealth, Telemedicine, and Social Medicine(eTELEMED 2013)  ZigBee Wireless Sensor Applications for Health, Wellness and Fitness - March 2009 at www.zigbee.org  A Health Monitoring System Using Smart Phones and Wearable Sensors Valerie GAY , Peter LEIJDEKKERS- Faculty of IT, University of Technology Sydney, PO Box 123, Broadway 2007 NSW Australia  On the Use of Wireless Network Technologies in Healthcare Environments Nicolas Chevrollier Nada Golmie National Institute of Standards and Technology Gaithersburg, Maryland 20899,2010  Application of Wireless Sensor Networks to Healthcare Promotion Paulo Neves, Michal Stachyra, Joel Rodrigues,2010  Patient Monitoring Using Personal Area Networks of Wireless Intelligent Sensors Emil Jovanov, Dejan Raskovic, John Price, John Chapman, Anthony Moore, Abhishek Krishnamurthy Electrical and Computer Engineering Department, University of Alabama in Huntsville 301 Sparkman Drive, Huntsville, AL 35899,2009
  • 34. SMART DUST FUTURE IMPLICATIONS:- •Blood pressure sensor, weight scale. •Emfi-sensors for exercise equipments/bed. •Low resolution IR camera. •Ultrasound radar. •Capacitive floor sensors. •ZigBee sensor network. •Connection to local and remote servers. Smart dust is a theoretical concept of a tiny wireless sensor network, made up of microelectromechanical sensors (called MEMS), robots, or devices, usually referred to as motes, that have self-contained sensing, computation, communication and power.
  • 35. FUTURE OF ”SMART DUST” IN HEALTHCARE –TO LEAP FORWARD PROMISES: - THE NEW TECHNOLOGY AND NEW SENSORS WILL ENABLE US TO BRING NEW SERVICES FOR HEALTHCARE, EVENTUALLY. - FOR THE CUSTOMERS NEW TECHNOLOGY COULD PROVIDE COMPLETELY NEW AVENUES ENABLING PERSONALIZED DISEASE PREVENTION, DISEASE MANAGEMENT AS WELL AS REHABILITATION AND CARE THAT IS NOT AVAILABLE TODAY. STRONG COLLABORATIVE, AND ROBUST CLINICAL RESEARCH WITH POPULATION