1. PhD Thesis Defence
Pedro Valente
(prnv@mmmi.sdu.dk)
The Maersk Mc-Kinney Moller Institute
Advisor: Kasper Hallenborg Co-Advisor: Luis Paulo Reis
Associate Professor Associate Professor
The Maersk Mc-Kinney Moller Institute DSI/School of Engineering
University of Southern Denmark University of Minho, Portugal
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2. Outline
3
What we
Learned!
2
What we • Summary
• Contribution
Construct! • Future Work
• Social Aspects:
Intelligent
1 Request
What we System
Know today!
• Danish Nursing
homes
•Elder Care + AAL + IntelliCare
•Motivation + Objectives
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3. Research What we What we What we
definition Know! Construct! Learned!
Ageing challenges
Number of Elders vs. Fertility Rate vs. Work force
Demographic factors:
Working age population (15-64 years) shrink: 5% by 2040
15% of Danes is 65+ (2007)
Earlier retirement (60-64 years): 60% is retired
Life expectancy at birth (2010-2015): 81.4(females) 76.7(males)
Social factors:
Workforce/retired persons ratio will pass in next 30 years from 4:1 to 2:1
3.8% of population received personal and practical help (2007)
Elderly: 80% live at home and 20% in nursing home
Goal: Create non-institutional supportive living arrangements, with different
levels of assistance
Sources:
The Long-Term Care System in Denmark, Schulz, E., 2010
Strategic Intelligence Monitor on Personal Health Systems phase 2 - Country Study Denmark, Nielsen, F. Claus et al., 2012
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Ambient Assisted Living
Empowered the development of ICT-based solutions for the process of
ageing well at home, community and at work
Earlier Age Older Age
End-User Goals:
•
•
Quality of life
Autonomy ≈
• Social engagement User capabilities capabilities ICT
• Skills and employability support
Stakeholders Goals: Chronic
• Reduce health costs and social care Conditions
• Potentiate ICT R&D
• Improve conditions for a shared European framework
• Explore market segments, use cases and target groups Daily Life Social
Activities Interaction
• Address wishes and needs of end-users
AAL JP
Exploration fields: Topics
• ICT integration problem – Fragmentation
• ICT solutions replication
• End-Users commitment to presented solutions Self-serve
Mobility
Society
• Home Care vs. Institution Care
• Care Staff support solutions
source: http://www.aal-europe.eu/
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IntelliCare Project
IntelliCare is a research project consortium supported by the Danish
Ministry of Science, since 2008.
• Different branches co-operating on several
The consortium technological development projects
consists of 12 partners • Cross-disciplinary research projects Partners
• Develop technological solutions
Purpose: • Create a common technological platform
• citizen’s freedom/mobility
• sharing of knowledge
Focus: • information amongst the carers
• scarce resources
T1: IntelliCare platform T2: Monitoring of activities T3: Collaboration and
• The objective is to build a middleware and modeling of behaviors coordination mechanisms
platform, which will integrate the • To meet the individuality of the users. • Some appliances, but primarily aid and
technologies and appliances of the care robots, need planning and
care environment. coordination mechanisms, because
they act autonomously in the care
environment.
source: http://www.intellicare.dk/
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Problem Formulation
Able to work on high abstraction Context-aware Provide services to cope with
level • User interaction with environment artefacts user profile and status along
• User interaction among users (e.g. Staff (e.g. ADL activities) time and space
and Residents) • Quality of care vs. quality of life
• User interacts with the environment as a • Interfaces and interoperability between
whole
systems and appliances
• Collaborative decision making • Services and devices need to behave
autonomously
• Quality-improvement processes
Platform End-User
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Objectives
Focus on activity context coordination Focus on activity coordination
System platform view: End-user view:
• Show pros/cons by using assistive
• Identify System stakeholders technologies
• Define orientations towards how System
• Define System stakeholders participation services interact with end-users
• View platform not only the sum of the parts, • Map users interactions, supported by user
profile (Staff, Residents)
but more than
Individual Social
aspects aspects
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Considerations
• Layout ICT opportunities
• Elderly + Care Staff
• Activities
PART 1 – WHAT WE KNOW TODAY!
...presents Danish nursing home environment with a close view from resident
and care staff behaviours/testimonial, characterizing the person, activities and
social relationships. ICT opportunities also highlighted!
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Layout considerations
Residents are
“A typical flat has one or
accommodated in “Flats lead on to the
two-rooms with
small groups, and communal kitchen and
bathroom and toilet in
each one live in a two- dinning room”
suite”
room flat
“Flat design privileged
function and was “Residents are
dominated by encouraged to decorate
considerations of their flat, bathroom
access and safety exception”
issues”
*Gurli-Vibeke nursing home map
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Elderly considerations
Need to be more than “Elderly people had their
“They are very
65 years old, and own standards in the
emotional and sensitive
suffer from mental or home, which they
to everything”
bodily impairment wanted to preserve”
“They are in constant
“Most of them have
fear of falling, as they
reduced motor abilities
are unstable on their
and limited senses”
feet”
*Copenhagen nursing home staff team organization example
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Care Staff considerations
Nurses, a physician and
Constituted by an a physiotherapist, “Each staff member has
“The heavy workload
highly interdisciplinary service and kitchen one or more residents to
occurs at certain periods
team of healthcare staff, volunteers, whom they are their
of the day”
professionals secretary, caretaker and contact persons”
nursing home director
“They expect from
“Providing care to nursing
residents that they also “Staff members don’t
home residents is
are understandable and spend much time talking
physically demanding
show empathy with their with elder persons”
work”
work”
*Copenhagen nursing home staff team organization example
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Activities considerations
Cleaning, providing
medicine, delivering
“Assistance call from the “Assistance call examples:
laundry, help residents into
Residents. (Random toilet, insufficient light,
bed and with their toilet,
occurrence)” object lost and thirstiness”
providing meals - ADL
activities
“Nursing homes provides
“Although activities are “For resident perspective,
also special programs that
target to individual, they are activities can be associated
encompass a wide range of
arranged in group” with meal schedule”
activities and services”
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ICT Opportunities
Tracking is a Translate informal
Institutions push Staff/Resident
common concern knowledge to
resident to: communication
for staff care formal
Maintain their active life,
providing privacy Resident preferences and
wishes
Residents
Ways to extend their
capabilities
Alarm buttons don’t provide
Help new staff members to
sufficient contextual
information about call nature retain environment routines
Transmit that they have a role
in the environment.
Assets
Activities are prepared to fulfil Identify new Resident
each individual, but are behaviour patterns
organized to maximize social
interactions
*Information collected via interviews and observation
at Kastanjehusene (Copenhagen) and Gurli-Vibeke nursing home (Odense)
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Request System System
workflow Overview evaluation
process • Architecture • Quality of
Problem Solution • Sorting tasks • System A solution Service (QoS) Solution
Ontology Experiment • Quality of
Statement Design • Staff utility scenario Experience
Overview
function
• Allocating tasks (QoE)
• Task
commitment
PART 2 – WHAT WE CONSTRUCT!
... experiment conducted in a nursing home, representing a task request system.
User interfaces were designed along with activity process workflow to guide
requested tasks proposed by residents, to be delivered by care staff, optimizing
resource allocation, via pre-established policies. Focus on design evaluation and
user evaluation.
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Problem statement
Assistance calls are a recurrent Issues with current assistance
action in nursing homes daily systems:
life. • Internal phones, alarm buttons or shouting
• Between staff members and with residents are common methods for residents alert
staff about their requests.
• Alarm buttons - Their simple interface and
design don’t provide contextual information
regarding type of request
• Each call is treated as an emergency!
It is imperative for the residents Elderly people are the
to receive a feedback from staff demographic group with less
member, to acknowledge their skills for ICT
request. • Search for devices compatible with their
• Without feedback, residents will continue ICT comprehension
to repeat same request action,
jeopardizing social balance
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Solution Design
User Experience within HCI
• Improve User Quality of Experience(QoE)
• User interface and device feedback aim for “natural” and
“intuitive” interfaces, if compared with ordinary objects, i.e.
TV remote control
• Based on the work of Turkle et al.(2006), Savensted et
al.(2006), about ICT impact on elderly inside institutions
Action Process Workflow
• Establish individual action plans, based on historical data,
statistics user info and contextual data
• Improve Quality of Service (QoS)
• Based on Medina-Mora et al.(1992) business action-
based workflow
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Request Workflow Process
Proposal:
• resident request
Agreement:
• mutual agreement on the
condition of satisfaction
Performance:
• staff declares the action is
complete
Satisfaction:
• resident declares action
satisfactory
Based on Action Workflow loop diagram, Medina-Mora et al. (1992)
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Sorting Tasks
Resident use
Staff Institution use
System a 5 point
members System locks scale priority 3 point scale
personalize priority fine- priority – 1 Priority scale
tuning, based High priority – 1 (High)
Resident task level request (High) and 3 will height on
on individual and 5 (Low): Utility
priority task from (Low): gives
Residents gives more function
request, changing pragmatic
Occurrences preference
based on ICP expression selection
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Staff Utility Function
Utility Function
•Priority request level 1 search for – staff
availability, proximity, as it as main role and
higher number of occurrences
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Allocating tasks
Manager
Staff member interface example:
Proposal Message format:
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Task commitment
Activity plan state diagram
Staff member use desktop interface to assist him during
task preparation
Resident history Resident
Institution Task
Task resources Resident profile log about that preferences and
procedures
request impairments
Reduce time to understand Resident wishes and preferences
Can be used by newer Staff members
Increase level of proximity between caregiver and care receiver
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Architecture Overview
• Collect the request task from RFID agent
Patient- • Prioritize it with current pending requests
• Manage repetitive requests from patient
Agent • Send the request to Manager Agent
• Delivery feedback message to interface
agent
• Receive patient’s request
• Choose best staff solution for each request
Manager- • Manage system policies
Agent • Organize auctions
• Choose staff members to perform task
• Send feedback to patient
• Receive from manager agent, CFP for task
Staff- • Send task request info to interface agent
• Compute bid (max time to delivery) (Staff
Agent member via interface agent)
• Send bid to manager agent Based on previous experiment Agent based Architecture
conduct during AAL Forum 2010 – Information Extraction
• Schedule tasks to delivery System
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System Ontology overview
Logical information Physical information
Room Position Activity
• Represent a location in • Expresse coordinates • Represent an activity
which a user can be which is used to define taking place can be
present, or where the boundaries of areas describe via ADL or
activities take place IADL classification
Schedule User
• Represent the overall • Represent users of
time schedule for all Request System, with
active request task and profile associated (ICP)
formal activities
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A solution Scenario
The system is based on: Each resident will have
Staff members with
• RFID technology cards representing Resident put a specific
best profile to execute
request tag inside
• RTLS indoor location requests plastic container
task are inform, with
message on Badge tag
• Plug Computer • Pictures will represent the action
• Touch-Screen Pc
• Single-board computer
Each staff member
accepts/declines Staff member with
request, providing shorter delivery time is
Each resident will wear a Each Staff will wear a estimate time to assign to task
location tag location tag execute it.
• Wristband tag • Badge tag with two-way
communication
Resident is inform Staff member delivery
about who and When is request based on User
delivery request. profile
Kiosk (information
RFID readers will be
points) will be
hidden inside plastic
strategically installed on
container and be sorted Staff member report
common areas for staff on system any change
Staff close request
inside apartments ticker.
inquiry on that request
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Experiment
Define 6 task
Use two residents
request
Use two staff Both share same
members nursing home floor
5 days experiment Observational
• First 2 days: Assist Staff analysis based on
• Last day: Interview staff • Resident behaviour
and residents • Location
• Required assistance
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System evaluation - QoS
QoS - Concerns about system service quality
to maintain process workflow tide and
conflict-
conflict-free
System flexible to be extended
• Based on Agent-based architecture
• Common ontology
Location is a very important asset
• Understand social relationships among end-users
• Creates a temporal-spatial pattern
Capable of DSS with user representation
• Staff selection
QoS defined by contract between:
• Care Staff – Resident
Expressed via task request
• Staff task experience
• Resident feedback •*Staff 1 wins CFP
•30 second location frequency – 10 poses (5min)
Request system coexist with others
activities •Process efficiency relies on Staff reply capacity
• Can interfere on task execution
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System evaluation - QoE
QoE - Concerns about end-user expectation and
end-
satisfaction against actions performed by the
Request System Expected time vs. Real time/Task – Resident 1
Request system coexist with
others activities
• Can interfere on task execution
Understanding behaviour from
both end-users help establish
quality metrics
• Delay times vs. Resident satisfaction
Request tasks are correlated and *Resident 1 uses request system as medication
engaged simultaneous (i.e. reminder/confirmation [2p.m. – 3:30p.m.]
4 times miscall detected by staff.
Medication and glass of water)
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System evaluation – QoE(1)
Updates are
Tend to stabilize
registered in trial-
with time
error based
Task procedure update– Resident 1
Extend Staff
Allow keep an
perception
updated activity
towards resident
report
needs
Can express: Resident feels
•“What Resident intend” being taken in
•“What they consideration
have/receive” from all Staff
members
Resident
Delivery time is
satisfaction
reduced
increased
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Overview
End-User
Preferences Acceptance
(user intention) (user expectation)
Context situation Assistance
(income) (outcome)
Platform
Proposed a solution to By structuring request
Update standard task Induce Resource User interfaces and
assist resident task process, staff reduce
requests uncertainty regarding procedures towards optimization Interaction allowed
Creating a request
workflow between Resident Reduce user
residents and Resident wishes Assets
preferences adaptation curve
staff members
Keep pattern
Resident Balance user
activity history Staff
(journaling) capabilities expectation
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Summary Contributions Future Work
PART 4 – WHAT WE LEARNED!
... Reviews important issues discussed during the presentation, focusing on
research contribution to Research and nursing home environments. A proposed
platform component services are introduced as sum up of all work done,
enhancing possibilities for the future, as a logical continuation of this work.
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Summary
Residents and Care staff Intelligent assistive When assistive
share same dynamic technologies are more technologies cannot
environment •Mature balance user disabilities
•Staff provides institutional services •Pervasive (blend with current home •Senior citizens move to a care
•Staff provide assistance for common layout) institution
tasks of daily-living •Normally all services are •Provide assistance services 24/7
•Resources are limited personalized to only one individual
Contextual information
Custom devices and ICT
need to be represented in
solutions need to be blend
different granularities for
with institutions ones (i.e.
services cope with different
Healthcare oriented)
users/situations
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Contributions
Contributions Limitations
• Research work: • ICT solutions cannot be part of the
• Context problem, but part of the solutions:
• Environment • Understanding their role in care institution
• Users • Cooperation with care staff
• Relate several disciplines: • Cooperation with Service providers
• Health care • Residents with irrational behaviours
• Sociology (dementia)
• Usability • Nursing home Privacy and bureaucracy
• Interface design
• Software engineering
• IT
• Provide a statement what end-users can expect from
intelligent assistive solutions
• Define contextual model considerations:
• Technical
• social
• Define policies and process workflow for the request
task
• Contextualize Ambient Intelligent domain, from end-
users perspective
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Future Work
Assistive platform for multiple activities
support with different types of - Components to explore
inputs/outputs
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34. Pedro Valente
(prnv@mmmi.sdu.dk)
The Maersk Mc-Kinney Moller Institute
Ack.:The presented work has been conducted under (Download Presentation slides)
IntelliCare project, which is supported by the Ministry of
Science, Technology and Innovation in Denmark
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35. Presentation Contents
•1- PhD research definition •3 - Social aspects: intelligent request system
• Overall Domain • Problem Statement
•Ageing Challenges • Solution Design
•AAL • Request workflow process
•Intellicare •Sorting tasks
• Problem Formulation •Staff utility function
• Objectives •Allocating tasks
•2 - Danish nursing homes •Task commitment
• Considerations • System Overview
•Layout •Architecture
•Elderly •System Ontology
•Care Staff • A solution scenario
•Activities • Experiment
• ICT opportunities • System evaluation
•Quality of Service (QoS)
•Quality of Experience (QoE)
• Solution Overview
•4 - Enclosures
• Summary
• Contributions
• Future work
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36. Parallel
Publications Presentations
Experiments
ADDITIONAL MATERIAL
(NOT PART OF PRESENTATION)
PRESENTATION)
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