Solución integral para mejorar la colaboración y el awareness en entornos healthcare ubicuos y sensibles al contexto

• Autores: Juan Enrique Garrido Navarro
• Directores de la Tesis: Víctor Manuel Ruiz Penichet (dir. tes.) , María Dolores Lozano Pérez (codir. tes.)
• Lectura: En la Universidad de Castilla-La Mancha ( España ) en 2014
• Idioma: español
• Tribunal Calificador de la Tesis: José Antonio Gallud Lázaro (presid.) , Silvia Mara Abrahao Gonzales (secret.) , Miguel Ángel Nacenta Sánchez (voc.)
• Enlaces
  • Tesis en acceso abierto en: TESEO
• Resumen
  • español

    SOLUCIÓN INTEGRAL PARA MEJORAR LA COLABORACIÓN Y AWARENESS EN ENTORNOS HEALTHCARE UBICUOS Y SENSIBLES AL CONTEXTO Resumen En la actualidad, la sociedad está experimentando un continuo crecimiento en edad, cuyas consecuencias e implicaciones conllevan el aumento constante del número de personas que requieren cuidados. Este hecho incrementa, aún más si cabe, el interés por mejorar la gestión de entornos Healthcare convirtiéndose en un importante campo de investigación.

    El trabajo de investigación realizado en esta tesis ha comenzando centrando sus esfuerzos en identificar aquellos aspectos a mejorar sobre las complicadas atmósferas de trabajo generadas en centros sanitarios. Como resultado se ha obtenido un amplio abanico de situaciones a afrontar debido a la variedad de campos existentes en Healthcare. Del mismo modo, se han estudiado gran cantidad de propuestas existentes, lo que ha permitido profundizar en problemas no resueltos.

    Debido a la variedad de aspectos involucrados en entornos Healthcare, no resulta viable tratar de abordarlos todos bajo un único sistema que cubra todos ellos, por lo que se ha considerado más adecuado seleccionar el conjunto de aspectos más representativos de estos entornos. En concreto, se ha marcado como primer objetivo abordar la gestión de tareas mejorando el trabajo de los empleados así como la notificación y detección de acontecimientos. Por otra parte, el segundo dominio de actuación se ha centrado en la mejora del proceso de rehabilitación desde el punto de vista de la monitorización y gestión por parte de los especialistas así como de la completitud de terapias por parte de los pacientes. Ubi4Health es el sistema desarrollado en esta tesis para aportar una solución global en estos campos.

    El análisis, diseño y desarrollo del entorno adecuado sobre el que desplegar la solución obtenida, ha supuesto el siguiente paso en el trabajo de investigación. La colaboración, sensibilidad al contexto y la ubicuidad son considerados como fundamentos clave de un entorno healthcare. Su combinación facilita el trabajo colaborativo independientemente del lugar y circunstancia, adaptando funcionalidad e información en base a las necesidades de los usuarios. Bajo estos fundamentos, se ha generado un entorno adecuado sobre el que se despliega la solución integral, la cual se ha desarrollado por medio de un conjunto de componentes interconectados que permite distribuir su funcionalidad así como aportar flexibilidad de cara a posibles ampliaciones y adaptaciones a nuevas situaciones.

    El primer dominio abordado por la solución se centra en la generación de un sistema adecuado para la gestión del día a día de un centro sanitario. El sistema aporta la incorporación de nuevos dispositivos y mecanismos para la mejora de la colaboración, awareness y las interacciones implicadas. Como factores clave se han considerado la capacidad de manejar gran cantidad de información necesaria para completar tareas, así como la detección de emergencias de manera automática. El manejo de mucha información puede suponer pasar por alto ciertos acontecimientos, por lo que la solución incorpora un mecanismo de notificación de cambios en la información ofrecida basado en la mirada del usuario. Asimismo, la continua aparición de tareas y la importancia de respetar la planificación definida, ha conllevado la necesidad de aportar un sistema automático de gestión y asignación de tareas sensible al contexto. Finalmente, el sistema incorpora la capacidad de detectar situaciones anómalas en pacientes o residentes, analizando localizaciones donde no es posible asegurar que en todo momento un empleado visualice lo ocurrido.

    La rehabilitación compone el segundo dominio abordado. Ubi4Health elimina la necesidad de los pacientes de realizar desplazamiento a centros sanitarios, solucionando un problema que conlleva en muchas ocasiones, abandonos de terapias. Sin la intención de sustituir al rehabilitador, el sistema es ofrecido como un asistente siempre bajo la adecuada supervisión. A la vez, el sistema permite al personal de rehabilitación gestionar en la distancia procesos asociados así como poder definir y personalizar terapias de rehabilitación tanto genéricas como específicas.

  • English

    INTRODUCTION COMPREHENSIVE SOLUTION TO IMPROVE COLLABORATIVE AND AWARENESS FEATURES IN UBIQUITOUS AND CONTEXT-AWARE HEALTHCARE ENVIRONMENTS Abstract Nowadays our society is undergoing a rapid ageing of the population whose consequences and implications involve a constant increase of the number of people needing continuing care. This fact increases even more the interest to improve management schemes in healthcare environments, thus becoming a relevant field for research.

    The research work carried out in this thesis started focusing on the identification of those aspects which could be improved within the complex working atmosphere generated in healthcare settings. As a result of this effort, a wide range of situations needing responses were identified, due to the great number of different fields existing in healthcare scenarios. In addition to this, a large number of the existing proposals have been studied, thus resulting in a deeper understanding of unresolved issues.

    Because of the broad variety of aspects involved in Healthcare environments, it is not feasible to deal with all of them with a single system which includes them all, reason for which it was considered more appropriate to select the most representative group of aspects in these environments. More specifically, our first aim was to deal with task management by improving the employee¿s performance as well as events detection and reporting. Furthermore, the second action domain focused on the improvement of the rehabilitation process from the perspective of monitoring and management by therapists and concerning therapy completion on the part of the patient. Ubi4Heath is the system developed in this thesis offering a comprehensive solution in these fields.

    The analysis, design and development of the environment required to display the solution obtained was the next step in our research work. Collaboration, context-awareness and ubiquity are considered as key elements in a healthcare environment. Their combination facilitates collaborative work independently from the place and circumstance, adapting functionality and information based on the user¿s needs. Supporting on these concepts, the adequate environment was generated to display the integral solution, developed by means of a set of interconnected components which allows to distribute its functionality while providing flexibility for future extensions and adaptations to new situations.

    The first domain covered by the solution is focused on the generation an adequate system for daily management of a healthcare center. The system provides the incorporation of new devices and mechanisms to improve collaboration, awareness and the implied interactions.

    The key elements considered were the capability to handle the large amount of information required to complete tasks and automatic detection of emergencies. Handling a large amount of information may imply that certain events are ignored, reason for which the solution incorporates a change reporting mechanism of the information offered based on the user¿s gaze. Furthermore, the continuing emergence of new tasks and the importance to keep the established schedule have implied the need to provide an automatic context aware management and task assignment system. Finally the system incorporates the capability to detect anomalous situations of patients or residents by analyzing locations where it is not possible that a worker visualize the event at any time.

    Rehabilitation is the second domain covered. Ubi4Health prevents the need for patients to attend the Healthcare center, thus eliminating an implicit problem which in many occasions causes noncompliance of the therapy. The system is not meant to replace the therapist but is offered as an assistant, always under adequate supervision. At the same time it offers the rehabilitation professionals the capability to distantly manage some associated processes while enabling to define and customize rehabilitation therapies, whether general or specific.

    CONTRIBUTIONS With the aim to clearly and concisely show the contributions made by this thesis as well as the foundations on which Ub4Health is based, a summary is next presented with the newest aspects of the research work performed: Contributions to Information Management in Healthcare Environments A relevant aspect of the comprehensive solution presented is the novel mechanism developed to report any change occurred in the information that a worker needs to perform management tasks for the proper operation of a healthcare center. Due to the great amount of information involved, a multi-display interface setting is adequate in order to distribute the information depending on the domains implied. However, while the worker is viewing a specific screen, the rest are unattended. In this situation it is possible that changes occurred in the other screens, because of the information contained, are not perceived when looking back again. This is the reason why a new mechanism has been included based on the user¿s gaze with the aim of showing changes in unattended screens by means of different levels of subtlety.

    In the course of the research carried out for the development of the aforementioned mechanism, a new type of awareness based on the user¿s gaze has emerged. The so-called gazed-based awareness is presented as a natural evolution of the traditional concept of awareness. The contribution obtained is defined as the incorporation of the user¿s gaze as the foundation to customize the way through which the user receives reports, with different levels of subtlety, concerning the changes occurred in unattended screens. This gaze-based awareness mechanism has been presented in AVI 2014, one of the most prestigious conferences on this area, being awarded with the ¿Best Full Paper Award¿, in recognition as best long article.

    Contributions to Emergency Detection in Healthcare Environments Another contribution in relation to managing the proper operation of a healthcare center is the mechanism developed for the detection of anomalous situations by means of motion based interaction. The mechanism analyzes the posture of the patient detected and depending on the current and past context, it detects if the current posture implies an emergency.

    This contribution means a solution for healthcare centers facing the impossibility to have visual control of every patient by at least one worker. The main reason for the complexity of the situation is the difference between the number of workers and the number of patients or residents, as well as the dimensions of a great number of healthcare centers.

    Contributions to Completion of Rehabilitation Processes A remarkable contribution is the mechanism provided for certain rehab processes which allows its perfect evolution thanks to the possibility to perform the exercises in the patient¿s home. We have developed a system which allows patients to incorporate the rehab therapy as an element of their daily life, with no need to attend the rehabilitation center. Always under the supervision of qualified personal this novel system allows patients to be guided through the rehab process using motion based interaction in their own home.

    Contributions to Rehabilitation Processes Management The rehabilitation process has been improved from the medical staff¿s perspective thanks to a new contribution. A novel system for specialized therapists has been developed for rehabilitation programs. The system allows management and monitoring tasks of the rehabilitation therapy prescribed to patients to be performed from any distant location. In addition to this, the contribution of the system focuses on the definition mechanism of posture based exercises presented to the professionals. More specifically, a three dimensional designer allows posture generation as part of the rehabilitation exercises thanks to the interaction with a dummy model in which joints and specific body parts can be modified. The mechanism also allows therapists to capture postures by analyzing the body of the therapist himself using motion based interaction.

    CONCLUSION This doctoral thesis presents a comprehensive solution denominated Ubi4Health aimed at improving working conditions and quality of care in healthcare environments. The implementation of the objectives previously set at the start of the thesis allows to draw some conclusions while offering a number of valuable contributions.

    Ubi4Health provides a solution for daily management of healthcare working environments where working conditions and the amount of information involved can generate complex situations causing that some events may be ignored or forgotten. To this regard, our solution presents in the first place the capability to automatically manage task scheduling and also to communicate changes occurred in unattended screens. In the second place, Ubi4Health locates and reports any situation in which the patient or resident acquires an anomalous body posture, being very useful when nobody can see the event.

    This comprehensive solution has been extended in order to incorporate a rehabilitation system which can also help improve the quality of care for the patient or resident. This novel system prevents the patients from actually going to the healthcare facilities to carry out their rehabilitation program since the system has been developed in such a way that the patients can perform the exercises prescribed by the physiotherapist in their own home. In this way, with no obligation to interrupt their daily routine, the patients will do their rehab sessions always under the supervision of the therapist. Far from replacing the therapist, the system requires their supervision and offers them the capability to manage and customize their associated processes independently from the place where they are.

    Taking into account the amount of possible situations that can be improves or solved in healthcare environments which are parallel to those dealt previously, the comprehensive solution has been defined under an ubiquitous collaborative context aware environment whose architecture and modularity allows to offer a valid support for future extensions.

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