A pair of USF professors from seemingly disparate disciplines are helping to further develop and refine a new medical alert system with state-of-the-art potential.
“We were approached by a company that’s developing technology to monitor seniors at home,” said Dr. Carla VandeWeerd, assistant professor in the Department of Community and Family Health at the USF College of Public Health. “What’s a little bit different about the technology that they’re developing compared to what’s already on the market is that, instead of having a system that responds to a person pushing a button to indicate there’s a problem, multiple sensors will be in the house providing information about the person’s wellbeing around the clock.
“Additionally,” she said, “the system includes comprehensive case management that uses information collected by the home sensors to improve care coordination between patients and health care providers.”
VandeWeerd’s co-principal investigator is Dr. Ali Yalcin, who will evaluate the wireless monitoring system. Yalcin is an associate professor in the USF College of Engineering, Department of Industrial and Management Systems Engineering.He co-authored the Design for Industrial Information Systems textbook, which won the 2007 IIE/Joint Publishers Book-of-the-Year Award.
The project is jointly funded by a grant from the Florida High-Tech Corridor and corporate sponsor Always Near Inc. VandeWeerd noted its broad interdisciplinary nature as a natural by-product of its universal human appeal.
“We have students from the College of Public Health, the College of Engineering and the Department of Anthropology who are working with us on a health problem that almost all of us are going to have to face at some point,” she said, “because almost all of us have parents and grandparents or at some point will be older adults ourselves. And even though we don’t really like to think about that, figuring how we can age in place successfully will be very important for most of us.”
“Taking care of the older population – it touches everybody,” Yalcin concurred.
“Another one of the benefits of this type of project is the emphasis it places on student education and training,” VandeWeerd added, “which not only fosters interdisciplinary collaboration and student learning, but also helps to further develop the workforce for high-tech industries in the region.
“Ultimately,” Yalcin said, “technology like this offers the potential to positively influence health and wellness in powerful ways, and the better prepared we are to harness it, the better off many seniors may be.”
The sensors are set up to monitor the person’s activity and automatically send out alerts as necessary. For example, if a monitored person has gotten out of bed but not shown up in another part of the house, the sensors will send an alert that he or she may have fallen.
Some of the various sensors at work in the project’s living lab: bathroom sensors, door sensors (above), kitchen sensors (including motion sensor left of coffee maker), motion sensor in shower (below).
The included case management feature tailors the system to the individual’s health conditions and expectations. No alert is sent, for example, if a person expected to spend 12 hours a day in bed has been in bed for 10 hours, while one will be sent after 10 hours for a client expected to spend eight hours in bed.
A local man believes the system saved his elderly father’s life in October. Ron Bartley received an alert about his father, Ray, who is 80 and has suffered from idiopathic neuropathy for 35 years. Walking is a challenge for the elder Bartley, who has little sensation below his knees.
Ron Bartley already had been visiting his father more often in the preceding weeks, because the system had told him of a dramatic increase in the time he was spending in bed, from 13-14 hours to more than 20 hours a day. One day, while checking his father’s activity, Bartley noticed that it had taken him an unusually long time to make it back to bed from the kitchen.
“I also noticed,” Bartley wrote, “that the display of the bed sensor was different in that it was an intermittent signal with several gaps of no signal, which indicated to me that either he wasn’t in bed all the way or was moving around much more than normal.”
That prompted a call and the subsequent discovery that Ray Bartley had fallen in his kitchen and had crawled back to bed, which explained the long interval. Unable to get back into bed, he instead was hanging onto the side of the bed, which caused the intermittent signal from the bed sensors.
Ron Bartley called for an ambulance that rushed his father to a hospital, where tests revealed severe dehydration and other conditions that suggested he may not have survived more than another few hours without medical help.
The system is slated for a larger community-based trial this spring in The Villages, Florida’s largest planned senior community, after more extensive testing in the research group’s living lab near the USF Tampa campus. Preliminary limited test runs have proven successful and beneficial, and in the Bartley case, possibly lifesaving.
“We have a living lab set up in and donated by the John Knox Village for the project,” VandeWeerd said, “so we actually have put all the sensors into an apartment to make sure that they work the way they should and that the alerts are working the way they should before we put them in more homes for community-based testing. We anticipate putting them in the homes of 60 older adults in the spring.”
Yalcin compared the system’s technology with a home equipped to turn lights and heating or cooling on and off automatically by anticipating its owner’s needs and preferences.
“It’s the difference between having to tell the environment what you want vs. the environment learning and knowing what you want,” he said.
“It’s supposed to learn your patterns of behavior and be able to pick up when there are changes that should be brought to someone’s attention,” VandeWeerd said, “and alerts are designed to be automatic instead of relying on users to notify supports that they are experiencing a challenge. For people who have, for example, dementia, being able to remember to push a button to let someone know that they have a problem can be difficult.
“The great thing about this kind of technology,” she continued, “is that it’s designed to send alerts for certain conditions. So if you’ve had a fall and there’s no movement – you were recently in a chair but now there’s no movement in the house – it will send an alert right away.
“If you’re getting up more to go to the bathroom, that might be an indication of a bladder infection. It notices those things right away and notifies caregivers and case managers, so instead of ending up in a hospital with a kidney infection, you can be treated as an outpatient for a simple bladder infection.”
While “He may have fallen and can’t get up” sounds expensive compared with “I’ve fallen and can’t get up,” VandeWeerd said cost projections are reasonable. She also emphasized the potential health care savings, reiterating her example of early home treatment vs. hospitalization.
Yalcin said that the cost also is affected, interestingly enough, by privacy issues.
“To circumvent that,” he said, “this whole system is using basic, inexpensive sensors that have been around since automation in factories – contact sensors, proximity sensors, motion sensors.
“So from that perspective, the hardware part isn’t prohibitively expensive, but a lot of the sensors that could be used to capture these data you’re carrying with yourself now – your cell phone,” he said. “It would be next to nothing if people would just let us use their cell phones so that we can monitor everything, but most people aren’t comfortable with that. The real value in the cost of the service is the intelligence software, the brains of it.”
“It has a user interface that’s available online,” VandeWeerd added, “so if you live in Idaho and your mom lives in Florida, and you’re wondering how your mom’s doing – if she’s showering, if she’s getting out, if her therapist is really coming to the house three days a week to work with her – you can easily look at the system and actually see the activities that have occurred. It’s not invading her privacy the way that video cameras might or that RFID, that constantly tracks where she is at every second, might. Older adults have clearly expressed that they’re comfortable with it.”
VandeWeerd and Yalcin both expressed enthusiasm for the project for its potential for humanity, as well as its place in the university’s and their respective colleges’ missions.
“With the looming aging and health care crisis on the horizon, this type of technology may be crucial in finding solutions that cut costs and improve health and well-being for seniors,” Yalcin said.
“In terms of how we do research that fundamentally has the power to really change people’s lives, and to do it in a way that’s quickly translational and that’s highly applied and interdisciplinary, this is a really good example,” VandeWeerd said, “and it’s a fabulous learning opportunity for our students.”
Story by David Brothers, College of Public Health. Photos courtesy of Dr. Carla VandeWeerd.