context awareness in health care: a review nathalie bricon-souf, conrad r. newman centre d’etude...

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Context awareness in health care: A Context awareness in health care: A review review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International Journal of Medical Informatics, 76, 2-12, 2007 International Journal of Medical Informatics, 76, 2-12, 2007 2008. 09. 22. Summarized by Jaehui Park, IDS Lab., Seoul National University Presented by Jaehui Park, IDS Lab., Seoul National University

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Page 1: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Context awareness in health care: A reviewContext awareness in health care: A review

Nathalie Bricon-Souf, Conrad R. NewMan

Centre d’Etude et de Recherche en Informatique Medicale, France

International Journal of Medical Informatics, 76, 2-12, 2007International Journal of Medical Informatics, 76, 2-12, 2007

2008. 09. 22.

Summarized by Jaehui Park, IDS Lab., Seoul National University

Presented by Jaehui Park, IDS Lab., Seoul National University

Page 2: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

ContentsContents

Introduction

What is context?

What is context-awareness computing?

The “research context” of “context-awareness computing in health care”

What are the challenges?

Discussion

Conclusion

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Page 3: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

IntroductionIntroduction

New technologies:

context awareness

– help health care professionals to manage their tasks

– increase the quality of patient care

Aim of this paper

Survey of the existing literature

Outline difficulties and possible solutions

in context awareness computing in health care

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Page 4: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

What is context? (1/2)What is context? (1/2)

Definitions

Dey et al.

– “Any information that can be used to characterize the situation of entities that are considered relevant to the interaction between a user and an application, including the user and the application themselves.”

Dourish

– Incompatibility between two views of context Positivist theory

Context can be described independently of the actions done.

Phenomenological theory Context emerges from the activity and cannot be described independently.

Winograd

– “Something is context because of the way it is used in interpretation.”

Sato

– “A pattern of behavior or relations among variables that are outside of the subjects of design manipulation and potentially affect user behavior and system performance”

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Page 5: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

What is context? (2/2)What is context? (2/2)

[Purpose] What context is used for? (Dey’s)

Presentation of information and services to a user

Execution of a service

Tagging of context to information for later retrieval

What are the context items of information?

three main classes

– people, environment, activities

Organization of context features

Hierarchical : from general to local aspect of context

Dimensions of concept : internal aspect or external

Focus of current activity

Current usefulness : manifesting aspect or latent

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Page 6: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

What is context-awareness What is context-awareness computing?computing?

J. Kjeldskov et al. “An application’s ability to adapt to changing circumstances and respond

according to the context of use”

Satyanarayanan Issues in context awareness system implementing

1. How is context represented internally?

2. How frequently does context information have to be consulted?

3. What are the minimal services an environment needs to provide to make context awareness feasible?

4. What are the relative merits of different location-sensing technologies?

5. ...

Some problems to be addressed especially in the medical domain Equipment

– Networks, captors, artifacts, mobile communication

Security– Identification, authentication, availability, integrity, confidentiality

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Page 7: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

The “research context” The “research context” of “context-awareness computing in health care”of “context-awareness computing in health care”

Context-aware medical applications Vocera communication system (St.Vincent hospital, USA)

– Communicator badge system for mobile user Push-to-call button, small text screen, voice dialing, hand-free conversation

Biometrically secured with speaker verification

Hospital-based prototypes Hospital of the future (Centre for Pervasive Healthcare, Denmark)

– Hospital bed with a built-in display Bed “knows” who is using it, and what and who is near it

– A context-aware pill container that is “aware of the patient”

– A context-aware Electronic Patient Record Medication scheme or patient record

Intelligent hospital software (University of Cambridge, UK)– Scenarios of use

Remote consultation, tracking of patients and equipment, notification of awareness and patient data

– Implementing a prototype QoS DREAM : middleware platform

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Page 8: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

Researches in health care domainResearches in health care domain

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Page 9: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

The “research context” The “research context” of “context-awareness computing in health care”of “context-awareness computing in health care”

Hospital-based prototypes (cont’d) Context-aware mobile communication (CICESE, Mexico)

– Mobile devices to recognize the context in which hospital workers perform their tasks. Instance messaging with context such as circumstances

Location, delivery timing, role reliance, an so on

MobileWARD (Mobile Electronic Patient Record, Denmark)

– Supporting morning procedure tasks in a hospital ward Information and functionalities according to the location of the nurse and the time

Other prototypes medication consumption, distant monitoring and new assistants

Scenario Representation of context for a hospital information system that uses

PDAs to deliver patient information to doctors (Institute of Design, Chicago)

– How context could be described by combining contextual information from the environment, person and activity

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Page 10: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

Hospital-based projectsHospital-based projects

M : model, P: prototype, A: application, S: scenario

Pi: presentation of information, ES: Execution of services, SI: Storage of contextual info.

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Page 11: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

What are the challenges?What are the challenges?

1. We did not find any recommendations about the functional needs of the context.

Difficult to know “why” such context setting have been chosen

2. The gap which still exists between fundamental researches on context representation and actual context-awareness prototypes.

No organization of context is used even if recommended in the studies.

3. The difficulties in building efficient computerized systems for a mediation of human perspectives

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Page 12: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

What are the challenges?What are the challenges?

Difficulties linked with human perspectives

The system must remain intelligible.

– Inferring human intent

– Mediating between people

People invent new conventions through new tools.

– Correct behavior using context is incredibly complex.

– People use technology to communicate context to users

The purpose of the tool could be deviated.

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Page 13: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

DiscussionDiscussion

Yet to be explored to a sufficient level of granularity

The importance of location as an important attribute in context-awareness system

– In a health care setting, the location may not be important.

It is apparent to the authors that

developing context-aware applications is not a problem of access to technologies (sensors, networks, etc.) as these exist.

A small number of of actual systems development and implementation in this area.

Gap between the requirements express in the literature and the prototypes

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Page 14: Context awareness in health care: A review Nathalie Bricon-Souf, Conrad R. NewMan Centre d’Etude et de Recherche en Informatique Medicale, France International

Copyright 2008 by CEBT

ConclusionConclusion

Overview of the context awareness in health care

Existing systems for health care

Features of context actually used

Gap between actual context-awareness prototypes and the modeling of contextual application in the literature

No preferred contextual needs emerge yet.

A greater understanding of which aspects of context are most important in the health care.

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