DEVELOPMENT OF A PROTOTYPE WELLNESS SUPPORT

SYSTEM FOR ELDERLY PEOPLE

Jun Sasaki, Koki Ito, Manato Saikachi, Masanori Takagi and Keizo Yamada

Faculty of Software and Information Science, Iwate Prefectural University, Takizawa, 020-0193, Iwate, Japan

Keywords: Information system, Healthcare system, Safety monitoring, Life support, IP telephone.

Abstract: An increasingly aging society and higher prevalence of lifestyle-related diseases are significant problems in

advanced countries. There are social requirements of integrated services for medical care, welfare, and

healthcare. In this paper, we propose the concept of a Wellness Support System (WSS), which is an

integrated information system that can be used to prevent the solitary death of elderly people, provide daily

life support services, and improve the health of those at risk for lifestyle-related diseases. The WSS enables

ease of use and a helpful information environment using a newly developed type of IP telephone for elderly

people. This paper introduces the concept and describes the development of a prototype WSS.

1 INTRODUCTION

There are three main areas in human life support,

namely, medical care, welfare and healthcare. Many

systems using information and communication

technology (ICT) have already been introduced in

each area. There are also social requirements for

integrated medical care, welfare, and healthcare

services to reduce management costs and improve

security and serviceability (Sasaki, 2011).

This paper first discusses previous studies on

ICT applications in each of the above fields as well

as issues to be solved. Then, we propose the concept

of a Wellness Support System (WSS) to help solve

these issues. We present the architecture and a

prototype development of the WSS.

2 PREVIOUS STUDIES

2.1 ICT in the Medical Field

The medical field typically has a consistent budget

and can develop new technologies and advanced

equipment such as teleradiology, telepathology,

electronic medical records, and so on. However,

subjected to the effect of an ever-increasing number

of elderly people, economic conditions for medical

services in Japan will become more strained as a

result of the greater need for costly treatments

combined with the weak financial position of retired

people. Particularly in rural areas, government

budgets are too limited to allow optimal

management of public hospitals and medical

facilities. Recently, network-based medicine (i.e.,

cooperation in a regional medical group through

information sharing) and telemedicine (a medical

diagnosis service from a remote site using a

network) have become popular since the need for

high-cost medical facilities is not strictly necessary.

2.2 ICT in the Welfare Field

There is a social problem of increasing solitary

deaths of the elderly. Although many kinds of

sensor-type systems are available to monitor the

health and activities of elderly people (Talab, 2009)

(Eikerling, 2009), these have not been very

successful because the intended users see such

systems as an invasion of their privacy. Previously,

we proposed a self-send-type monitoring system

using an L-mode telephone and reported some

successful experimental results (Yoneda, 2006).

Now, a new self-send-type monitoring system using

normal home telephones has been developed and

tested in Japan (Sasaki, 2010).

2.3 ICT for Healthcare

Daily healthcare is important to prevent lifestyle-

related diseases such as hypertension,

439

Sasaki J., Ito K., Saikachi M., Takagi M. and Yamada K..

DEVELOPMENT OF A PROTOTYPE WELLNESS SUPPORT SYSTEM FOR ELDERLY PEOPLE.

DOI: 10.5220/0003872504390442

In Proceedings of the International Conference on Health Informatics (HEALTHINF-2012), pages 439-442

ISBN: 978-989-8425-88-1

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

hyperlipidemia, and diabetes. Although many

healthcare-related web sites aimed at the general

public are available online, there is no adequate

healthcare system for professional users such as

healthcare workers and physicians. People with

lifestyle-related diseases usually have little

motivation to seek good health promotion, nutrition

management, and physical exercise, and if their

healthcare were to be provided by a medical clinic,

the cost would be high.

3 TARGET OF WSS

3.1 Users and Items in a WSS

The approach adopted for improving the health of

those with lifestyle-related diseases is shown in

Figure 1. The target users of our research are located

midway between wellness users and patients. Vital

signs, including weight, fat ratio, and blood glucose

levels, have to be monitored to improve the health of

these users. Patients are surrounded by a variety of

therapies, including:

- dietetics, which deals with their intake of food

and history of nutritional counseling, among others;

- physical exercise, which deals with calories and

their history of exercise counseling; and

- drugs, which deal with their history of medicine.

As one moves from the bottom to the top of the

pyramid, health conditions improve and the items

dealt with become simpler. As such, the users and

items in a healthcare system can be very complex

and changeable depending on the individual health

condition and situation of the user.

Figure 1: Approach for improving the health of those with

lifestyle-related diseases.

3.2 Current Healthcare Support

Systems

There are many existing healthcare support systems

in Japan, which can be categorized by their services

and target users. However, there is no all-

encompassing main healthcare system in Japan. If

we use multiple systems to cover multiple areas, a

conflict of scope and items occurs. For example,

when the condition of a wellness user changes to

that of a patient, the data must be transferred to a

different system, because the different health

databases are not integrated.

3.3 Conventional Studies on WSS

Previously, the authors proposed the concept of a

Life Support Network (LSN) (Sasaki, 2001).

Currently, using standard non-LSN systems,

personal data of individuals are managed in each

individual field’s system, causing many problems

with regard to information security, management

cost, and serviceability. In the LSN, on the other

hand, personal data are managed in a single local

database and can be shared with high security to

provide optimal service through collaboration in the

medical, welfare, and healthcare fields.

The requirements for the next level of healthcare

system, or WSS, include:

- construction of an integrated healthcare database;

- effective use of any available part of the current

system (to satisfy this requirement, a common

platform for different systems is needed—further,

administration items should be customized);

- adaptability to a variety of terminals and

networks;

- security and user authorization management.

4 WSS PROTOTYPE

We propose a WSS architecture that includes

various terminals and networks. In the architecture,

single-sign-on can be realized by a core system, and

users can control access to their data. The

architecture also realizes an integrated healthcare

database, which can be used by all users, for

example, patients, healthcare administrators, and

specialists.

Figure 2 shows the paradigm shift from the

current model to a new model by means of the WSS.

The server computers are placed at the top level with

users and specialists in the bottom and middle levels,

HEALTHINF 2012 - International Conference on Health Informatics

440

respectively. A characteristic of the new model is to

place the core system between the servers and users.

In the current model, users have to access servers

individually. In the new model, users can use a

service without considering individual servers. An

aim of our research is to construct a WSS platform

and architecture to realize the new healthcare

management model.

Figure 2: Paradigm shift from current model to new model

by means of the WSS.

Figure 3 shows the proposed WSS architecture,

which has the following layers.

Figure 3: Proposed WSS architecture.

Measuring Layer. This layer has a health data

measurement terminal that can be connected to the

presentation layer or the gateway layer. Health data

measurement terminals have a standard wireless

interface such as Bluetooth to connect to the

gateway layer. The available standard interface is

the ISO/IEEE 11073 proposed by the Continua

Health Alliance (Continua, 2010) and is our

recommended interface. In consultation with

medical doctors, we selected various devices for the

daily healthcare of a residential client as shown in

Figure 4. All the devices have a standard wireless

communication network (ISO/IEEE 11073) and

auto-sending function of the measured data to the

gateway device. The gateway device has an IP

network interface to connect to the server via the

Internet.

Urinary salinometer

Weight scale

Pedometer

Sphygmomanometer

Authentication device

Gateway device

Figure 4: Prototype measurement devices.

Presentation Layer. This layer provides a user-

friendly interface for easy input, expression, and

editing to enable users to understand the vital health

data visualized graphically or using other

presentation tools.

Gateway Layer. This layer connects the measuring

layer and presentation layer terminals with the IP

network (Internet- or Cloud-based). The gateway

layer terminal can be used to allow communication

among users including physicians and health

managers. We are developing a new application that

works on the IP telephone shown in Figure 5. The IP

telephone has six touch panel buttons, the top three

of which (representing, I am “fine”, “not so fine”,

“bad”) are used for a self-reporting type safety

monitoring system, while the bottom three are to talk

to a volunteer, a life supporter, or a healthcare

manager. The IP telephone also includes gateway

and presentation functions to connect to the Internet

and to allow for easy operation by the elderly,

respectively.

Figure 5: A new terminal with self-reporting type safety

monitoring, gateway, and presentation functionality.

DEVELOPMENT OF A PROTOTYPE WELLNESS SUPPORT SYSTEM FOR ELDERLY PEOPLE

441

Application Layer. This layer includes many

healthcare applications including vital data

management, nutritional management, and physical

exercise management. Documents exchanged in the

WSS are XML format as this is preferable to realize

flexible adaptation for many applications and a

variety of terminals. Representational State Transfer

(REST) (Fielding, 2000) is a useful technology for

this layer.

Database Layer. All the data used in the WSS are

centralized in the database layer so that the best

combination of optimal quality medical, welfare,

and healthcare services can be provided to users.

The database can be constructed as a virtual

database on the Internet or in a Cloud. There are

certain required functions such as a recognition

(certification) function to access data and data

protection and a back-up function to maintain good

reliability. We propose adopting Open Authorization

(OAuth, 2011) technology for more convenient

certification.

5 SUMMARY

In this paper we proposed the concept of a WSS to

ensure the daily safety of elderly people and to

improve the health conditions of people with

lifestyle-related and pre-lifestyle-related diseases.

The architecture of the WSS allows easy operation

with a flexible information environment supporting

a variety of terminals and applications, as well as

interface adaptability. The following issues should

be considered when constructing an ideal WSS:

- social and system management organization for

continual use of the system;

- the economic effects and a business model of the

system so as to clarify suitable areas and long-term

use; and

- a real-time action system with a decision-making

support function.

The major benefit of a WSS is the integration of

isolated information systems in the medical, welfare,

and healthcare fields on a common platform.

ACKNOWLEDGEMENTS

This research is supported by the Japan Science and

Technology Agency. We would like to thank the

project members at the Hitachi Regional Technical

Support Center, Office M&M Co., Ltd., and Citizen

Systems Japan Co., Ltd., for assistance in

developing the WSS prototype. We also thank

Professor Akiko Ogawa at Iwate Prefectural

University, Dr. Michiru Tanaka at Iwate-shiga Co.,

Ltd., and Mr. Yuji Ichihara at Nihon Information

Co., Ltd., for informative discussions and assistance

in designing the self-reporting type safety

monitoring system.

REFERENCES

Jun Sasaki, Koki Ito, Keizo Yamada and Masanori Takagi,

“Proposal of Wellness Support System”, New Trends

in Software Methodologies, Tools and Techniques

(SoMeT_11), pp.331-343, 2011.

Tarik Taleb, Dario Bottazzi, Nidal Nasser and Hammadi

Nait-Charif, “An Advanced Home Eldercare Service”,

HEALTHINF 2009.

Heinz-Josef Eikerling, Gernot Gräfe, Florian Röhr and

Walter Schneider, “Ambient Healthcare Systems

Using the Hydra Embedded Middleware for

Implementing an Ambient Disease Management

System”, HEALTHINF 2009.

Tae Yoneda, Akiko Ogawa, Jun Sasaki and Yutaka Funyu,

“Development and operation of mimamori network

system for elders in Kawai Village, Iwate Prefecture”,

Personal computer users’ application technology

association, Vol. 16, No. 3, pp.31-38( 2006), in

Japanese.

Jun Sasaki, Keizo Yamada, Masanori Takagi, Michiru

Tanaka and Akiko Ogawa, “Development of a

Monitoring System Using Telephones for the Elderly

Living Alone”, New Trends in Software

Methodologies, Tools and Techniques

(SoMeT_10),pp.467-477,2010.

Jun Sasaki, Takashi Mitsuishi and Yutaka Funyu, “A New

Concept and Configuration Method of Life Zone

Network”, ICOIN-15 2001, pp.381-386, 2001.

Jun Sasaki, Bayme Abaydulla, Keizo Yamada, Michiru

Tanaka and Yutaka Funyu, “An Experiment of the

Life Support Network for Elderly People Living in a

Rural Area”, Proceedings of 7

WSEAS international

conference on applied computer science (ACS’07),

pp.316-321(2007.11).

Continua, http://www.continuaalliance.org/index.html,

2010.

REST: Roy Thomas Fielding, “Architectural Styles and

the Design of Network-based Software Architectures”,

University of California, Ph. D papre,

http://www.ics.uci.edu/~fielding/pubs/dissertation/fiel

ding_dissertation.pdf., 2000.

OAuth: Google’s Internet Identity Research, “OAuth

Practices”,

http://sites.google.com/site/oauthgoog/oauth-practices,

2011.

HEALTHINF 2012 - International Conference on Health Informatics

442