EHEALTH SMART HOME ENVIRONMENT SERVICE

PLATFORM

Enabling Remote Monitoring and Service Composition through Social Media

Yohanes Baptista Dafferianto Trinugroho, Frank Reichert and Rune Fensli

ICT Department, Faculty of Engineering and Science, University of Agder, Grimstad, Norway

Keywords: eHealth, Social media, Remote home monitoring, Interoperability, Service platform, SOA.

Abstract: Demographic changes with the growth of elderly populations implies a need of developing efficient

technology tools in order for the patients to stay in their own home for as long time as possible feeling safe

and secured, and where the medical follow up can be achieved by remote home monitoring equipment. The

lack of actual international standards has the consequence of proprietary solutions being used by vendors,

making interoperability difficult. On the other hand, social media has become an integral part of modern

society and has changed the way people interact with one another. It can potentially be extended to support

well-being at home as well. In this paper we argue that social media have the potential to play an important

role in remote home monitoring and remote service composition for provisioning health-care-related

services in the future. An overview of a proposed platform based on Service-Oriented Architecture (SOA)

paradigm for interoperability between different devices is also presented.

1 INTRODUCTION

Demographic changes in population with increased

number of elderly people is a huge challenge for

future health care services. The new generation

elderly people are supposed to give new

requirements to those services compared to the

elderly generation today. In Norway, a public report

used Mick Jagger as an icon representing the new

generation elderly (Teknologirådet, 2009). This

generation is supposed to bring new challenging

requirements to the future health care services

mainly because they opposed the existing authorities

in their younger days and are still a generation with

an active lifestyle.

In order for this new generation elderly to be

able to continue an independent living with high

degree of self-care and self-management, new

technology developments will compensate for their

needs in daily living activities. This generation is

known as the digital immigrants, compared to

younger generations as digital natives, described by

Prensky (2001). However, during their active

working life, they have been trained and got used to

new information and communications technology

(ICT) solutions such as the Internet, email,

Facebook, and smartphones. In their elderly days, it

is reasonable to expect them to require updated

technology solutions both for ambient assisted living

purposes and for their electronic collaboration with

healthcare service providers.

Their needs of new technologies for an active

and independent lifestyle will give a future private

market for technology solutions. However, in many

countries the social welfare services will support the

elderly person with actual need of assistive

technologies. This paradox will have tremendous

consequences to interoperable solutions for future

eHealth solutions, in order for the elderly to have

home-care installations being able to communicate

with public healthcare services.

Today, there is a lack of common standards for

Tele-home-care technology; those challenges are

focused in the European project HITCH (2011), still

having a long way ahead trying to have acceptance

for the use of international standards. Alternatively,

the use of open standards and open source solutions

can contribute to rapid development of inter-

operability in the home healthcare solutions. In this

paper, we will highlight how open standards can be

developed as a fundamental platform for future

development. With the rapid growth of social media

users around the globe (Backstrom et al., 2006),

434

Baptista Dafferianto Trinugroho Y., Reichert F. and Fensli R..

EHEALTH SMART HOME ENVIRONMENT SERVICE PLATFORM - Enabling Remote Monitoring and Service Composition through Social Media.

DOI: 10.5220/0003847304340438

In Proceedings of the International Conference on Health Informatics (HEALTHINF-2012), pages 434-438

ISBN: 978-989-8425-88-1

 2012 SCITEPRESS (Science and Technology Publications, Lda.)

social media becomes a promising tool to be

integrated into Tele-home-care services.

2 MOTIVATION

eHealth is defined as the use of ICT to access health

and lifestyle information, to give support and

improved health care services (European-

Commission, 2011). Tele-home-care is a specific

instance of telehealth that focuses on providing

remote healthcare services to patients in their homes.

Healthcare personnel can use remote communication

mechanisms either in consulting and cooperating

with their colleagues or in advising and guiding their

patients at home. Patients at home may need to

interact with measurement devices which in turn will

generate clinical information that can be analysed by

healthcare personnel remotely. Several examples of

measurements that can be acquired include heart

rate, blood pressure, oxygen saturation, and weight.

In addition, monitoring of activities of daily living

(ADL) can be provided as well by making use of

various different devices installed within the home

environment (Le et al., 2008). These devices

combined by the computer system being deployed

transform the home environment to smart home.

Besides the elderly population growth and the

decreasing number of healthcare workers, other

important driving force for adopting Tele-home-care

is cost (Menkens and Kurschl, 2010). Tele-home-

care services are expected to reduce the cost of

healthcare services in general, enabling a

personalised treatment based on long-term personal

records with final goal of improving quality of

medical treatments. By employing Tele-home-care

solutions, patients can reduce hospitalisation

periods, reduce energy and carbon emissions

generated by transportation means, as well as

decrease the number of necessary hospital facilities.

However, new devices are needed to be installed

within the home environment to support the

provisioning of Tele-home-care services. In

addition, Internet connectivity and other backup

communications channels (e.g. telephone network)

are needed to be provisioned as well. These

additional requirements may need a huge amount of

initial set-up cost if everything is owned and

managed by the inhabitants at home. To tackle this

issue, different business models can be used by

healthcare service providers, such as bundling the

devices and services in a monthly subscription

manner, so that the patients at home do not need to

buy the devices. From this standpoint, different

healthcare service providers can provide different

types of healthcare services to the patients at home.

Various different devices available in a home

environment, including medical devices, may not be

utilised to their full potential without combining

their capabilities with one another. For example, a

smart carpet detects a falling patient. After five

minutes if no movement is detected by motion

sensors in that particular room, then the patient's

private doctor, nurses, and relatives should be

informed by means of text messaging and email. In

addition, the main door of the house will be

unlocked to enable first aid personnel to come in. To

deploy this scenario, capabilities from several

different devices should be combined (i.e. smart

carpet for fall detection, motion sensors for

movement detection, clock for timing, mobile phone

for sending text messages, personal computer for

sending emails, door actuator for locking and

unlocking a door). In order to achieve this,

capabilities from different devices should be

exposed by means of standardised application

programming interfaces (APIs) which form basic

services in a home environment. These services will

then act as building blocks for composite services

(Trinugroho et al., 2011b).

Social interactions in Tele-home-care should not

be limited to interactions between healthcare service

providers and patients. Involvement of relatives and

colleagues is crucial as well for encouragement of

better lifestyle at home (Abdullah and Zakaria,

2010). However, direct physical interactions may

not always be possible due to location and timing

constraints. Collaboration tools are needed to fulfil

this requirement, and as the Internet plays a crucial

role as a communications backbone in a smart home

environment, social media is expected to contribute

as a collaboration platform for virtual meetings

(Thygesen et al., 2011). Figure 1 shows an overview

of social media’s role in Tele-home-care.

Figure 1: Social Media and Tele-home-care.

EHEALTH SMART HOME ENVIRONMENT SERVICE PLATFORM - Enabling Remote Monitoring and Service

Composition through Social Media

435

3 SOCIAL MEDIA SERVICES IN

TELE-HOME-CARE

Social media services can play different roles in

Tele-home-care scenarios. Table 1 shows a

classification of possible Internet-based social media

services for home health care.

Table 1: Classification of Internet-based social media

services for home health care (Dale et al., 2010).

Internet-based

social media

services

Cognitive

support systems

Memo planner system

Clock/calendar

functions

Time-dependent

reminders

Remote control systems

Secured

communities

Home healthcare

information exchange

Family and friends

social care and

information exchange

Virtual meeting places

for social activities

Voluntary social

services

Web-based

services

Internet communities

Internet information

Entertainment

Music & films/videos

News and channels

Table 1 classifies Internet-based social media

services into three main categories: cognitive

support systems, secured communities, and web-

based services. All these three categories can be

used in Tele-home-care systems, although the

secured communities category may be used more

often than the others. What may be missing in this

classification is the usage of social media services to

remotely compose services in the smart home

environment. Taking the previous example of patient

fall detection service that involves capabilities from

different devices, what if the waiting period is to be

changed from five minutes to ten minutes? Or what

if the personnel being alarmed should be changed?

What if a new device should be involved in the

sequence such as turn on every single light in the

house when the accident happened at night?

A home automation system should provide the

possibility to be remotely administered. This can be

accomplished by making use of the Internet, by

providing a web-based home management system to

remotely compose services from available devices

installed in the corresponding home. This web-based

tool can then also be used to remotely monitor the

patient’s conditions. This will enable healthcare

personnel (e.g. a doctor) to remotely monitor patient

as well as compose services from existing devices at

home to fit best with the patient’s situation and

condition. However, this tool should be accessible

not only by healthcare workers, but also relatives

and colleagues of the patient. This will turn the web-

based tool to a social media, where different users

can monitor the patient’s condition, communicate

with one another, as well as review any change in

deployed services at home. A web-based role-based

access control (RBAC) is needed to be implemented

in the system (Chungen et al., 2001) so that not

everyone can alter services being provisioned at

home.

However, if the deployed web-based remote

home monitoring and management system is a

standalone dedicated application, colleagues and

relatives of the patient may not access it frequently.

In this case, it is beneficial if the web-based tool is

integrated with available social media services such

as Facebook. Instead of deploying the tool as a

standalone system, a dedicated Facebook application

can be developed for this purpose. When integrating

the use of unsecured social media in remote home

care services, this implies security and juridical

issues not clearly defined (Williams and Weber-

Jahnke, 2010).

In order to incorporate the remote access, a

service platform for integrating capabilities of

various devices at home is needed to be deployed in

the smart home environment. In the next section we

will discuss about such platform.

4 HOME EHEALTH SERVICE

PLATFORM SOLUTION

Healthcare service providers can collocate different

devices in a smart home environment to provide

specific health-related services. These devices’

capabilities, combined with one another, can provide

various composite services, which can lead to better

personalised services to the patient at home.

However, different vendors being chosen for these

devices may raise incompatibility issues between

them. To avoid building services from scratch each

time a new service is needed, service-oriented

architecture (SOA) paradigm is promising to be

adopted for a home eHealth service platform, as it

promotes interoperability, modularity, and

reusability of service components.

To further reduce the involvement of the patient

in accomplishing a service’s aim, a context-aware

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home automation system is also needed. A context-

aware home automation system should be able to

gather the patient’s information and the surrounding

environment, then adjust the environment setting to

suit the patient’s needs and preferences. Such

context-aware home integration platform was

proposed in authors’ previous work (Trinugroho et

al., 2011a), shown in Figure 2.

Figure 2: Home eHealth Service Platform.

The proposed platform exposes each device’s

capabilities as reusable services, termed as service

enablers, that can be used to compose more complex

services.

In order for a home automation system to be able

to adapt the surrounding environment, a knowledge

base should exist within the home environment,

storing knowledge about different entities’ situation,

including the patient’s. Reasoning can then take

place on top of the knowledge base. Pure automated

reasoning may not be desirable for Tele-home-care

services as the system may infer false condition of

the patient. On the other hand, healthcare specialist

may know better what is best for the patient. Thus, a

static rule-based reasoning mechanism may fit well,

where the rules can be updated remotely by qualified

personnel.

The proposed platform in Figure 2 is quite

generic in the sense that it may accommodate

different technologies. Since the application for

remote home monitoring and management system is

web-based, standardised Web Services technology

will suit best for implementation purpose. This

means that the capabilities of each device are

exposed as Web Services end-points. Then web-

based client application (e.g. dedicated Facebook

application) can be developed for remote monitoring

and management. Figure 3 shows the high-level

overview of the proposed system.

Figure 3: Remote home monitoring and management

through social media applications.

By deploying this idea, social media applications

can act as a web-based remote home monitoring and

management tool, with three main functions:

1. Remote monitoring of patient’s condition as well

as the surrounding environment.

2. Remote service composition for new services to

meet patient’s needs. This action should be

conducted by healthcare specialists.

3. Remote rule creation for automated reasoning on

the knowledge base. This action should also be

conducted by healthcare personnel.

Authentication, authorisation, and accounting

(AAA) agent is required to be present in the smart

home environment especially for security measure.

Only authorised external applications (e.g. Facebook

application) and authorised users may access the

service creation environment within the smart home

environment. And since all data are transmitted

through the Internet, Hyper Text Transfer Protocol

Secure (HTTPS) protocol is suggested to be used for

secure transmission.

A crucial issue needed to be taken into account

during the development of the web-based social

media application is the user-friendliness of the

graphical user interface (GUI). Icons or puzzles

being used to represent the capabilities of devices

should be clear enough for regular users. Message

flow of a service should also be easily visible, and

should be easily modified.

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Composition through Social Media

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5 CONCLUSIONS

Social media’s user base growth is intriguing, as a

direct consequence of fast penetration of Internet

usage in modern society. This trend can be seen as a

positive reality as it enables remote collaboration

between individuals, breaking time and space

barriers. In this paper we argue that social media

applications can be further pushed to provide remote

home monitoring and management services,

including remote service composition, for patients

living at home. Security measure is suggested to

include current best-practice approaches using AAA

agent at home and HTTPS transmission protocol.

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