Jim Basilakis - Academia.edu (original) (raw)
Papers by Jim Basilakis
This paper describes a personal falls monitoring project using smart phone based tri-axial accele... more This paper describes a personal falls monitoring project using smart phone based tri-axial accelerometry, for surveillance of elderly people with falls risk living independently at home. The project relied on collaboration of three parties to achieve its clinical, research and technology aims. The results of data collection during the six month trial period are presented and analysed here. These results indicate a very high rate of false positives (94.7%) which would need to be addressed in future development of the system. .
Studies in health technology and informatics, 2015
Telehealth pilot projects and trial implementations are numerous but are often not fully evaluate... more Telehealth pilot projects and trial implementations are numerous but are often not fully evaluated, preventing construction of a sound evidence base and so limiting their adoption. We describe the need for a generic Telehealth project evaluation framework, within which evaluation is undertaken based on existing health systems performance indicators, using appropriately chosen measures. We provide two case studies explaining how this approach could be applied, in Australian and Canadian settings. It is argued that this framework type of approach to evaluation offers better potential for incorporating the learnings from resultant evaluations into business decisions by "learning organisations", through alignment with organisational performance considerations.
A clinical trial of a home telecare system (1-5) for the management of chronic disease at home on... more A clinical trial of a home telecare system (1-5) for the management of chronic disease at home on 22 patients with a primary diagnosis of Conges- tive Heart Failure (CHF) and / or Chronic Obstruc- tive Pulmonary Disease (COPD) has demonstrated a high level of patient and doctor satisfaction with respect to usability, functionality and effectiveness. Measurement and medications compliance was high and all patients were able to use the system daily. Although a detailed evaluation of health care out- comes and cost benefits of the clinical trial was be- yond the scope of this project, individual case studies suggest that this home telecare system could have a profound impact on the active management of
The Medical journal of Australia
Information and communications technology (ICT) is increasingly being used in management of chron... more Information and communications technology (ICT) is increasingly being used in management of chronic illness to facilitate shared services (virtual health networks and electronic health records), knowledge management (care rules and protocols, scheduling, information directories), as well as consumer-based health education and evidence-based clinical protocols. Common applications of ICT include home monitoring of vital signs for patients with chronic disease, as well as replacing home visits by nurses in person with telemedicine videophone consultations. A patient-managed Home Telecare System with integrated clinical signs monitoring, automated scheduling and medication reminders, as well as access to health education and daily logs, is presented as an example of ICT use for chronic disease self-management. A clinical case study demonstrates how early identification of adverse trends in clinical signs recorded in the home can either avoid hospital readmission or reduce the length of...
The last 60 years has seen a continual increase of the use of information and communication techn... more The last 60 years has seen a continual increase of the use of information and communication technology (ICT) to support the sustainable delivery of healthcare services. The need for easily implementable and effective ICT interoperability standards in healthcare has been well-demonstrated1. In the last 15 years, technology development and implementers’ concerns2 have resulted in new standards development such as HL7 V3, HL7 Clinical Document Architecture (CDA), openEHR, etc. In August 2011, a proposal was put forward3 from within the HL7 standards development community to explore the creation of the new standard that would constitute a "fresh start" using the most current thinking and technologies. This new standard, initially called Resources for Health ("RFH") and late renamed to Fast Healthcare Interoperability Resources ("FHIR") has progressed very quickly and has been balloted twice. Its main characteristic is the use of standard ICT technologies su...
Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology, 2002
2010 Annual International Conference of the IEEE Engineering in Medicine and Biology, 2010
Fledgling clinical decision support systems (DSSs) are being designed on the false assumption tha... more Fledgling clinical decision support systems (DSSs) are being designed on the false assumption that consistent, good-quality signals are created in the unsupervised telehealth environment, but it has in fact been shown that signal quality is often very poor. Hence, it is important to investigate the detrimental impact of failing to recognize erroneous clinical parameter values. This study combines previous work in this area, related to artifact detection in electrocardiogram (ECG) signals, and piecewise-linear trend detection in longitudinal heart rate parameter records, to investigate the impact of choosing to ignore ECG signal quality prior to trend detection in the heart rate (HR) records. Using an artifact detection algorithm to improve the HR estimates from the ECG signals, when compared to reference HR values derived from human annotated 2453 ECGs from nine patients, resulted in a decrease in the estimation bias from 2.54 BPM (beat per minute) to 0.70 BPM and a decrease in the standard error from 0.47 BPM to 0.17 BPM. The application of the same artifact detection also results in a significant improvement in trend fitting, when compared to a fitting of the reference HR values, by reducing the mean RMSE value of the error in the trend fit from 2.14 BPM to 0.78 BPM and standard error from 0.49 BPM to 0.10 BPM. As trend detection will be a component of future telehealth decision support systems, signal quality measures for unsupervised measurements are of paramount importance.
2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2001
We review the development of an Internetenabled home clinical workstation for the management of c... more We review the development of an Internetenabled home clinical workstation for the management of chronic disease, and the implementation of a clinical trial to test the functionality, usability and effectiveness of the system in both a city and a remote country setting. The Home Telecare System integrates with established primary care services to provide a new paradigm of active disease management through the daily collection of clinical data and assessment of functional health status, and the provision of feedback for patient self-management and education. A novel Medications Management module is also implemented to permit on line variation of prescribed medications.
2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2001
Accelerometers can be used to monitor physical activity in the home over prolonged periods. We de... more Accelerometers can be used to monitor physical activity in the home over prolonged periods. We describe a novel system for objectively and continuously monitoring movement, suitable for patients with chronic diseases including congestive heart failure and chronic obstructive pulmonary disease. The key design criteria were ease of use by, and comfort for, the patient together with the provision of clinically relevant information. The patient's posture, energy expenditure and movement are clinically important parameters that can be measured by accelerometry. A data processing schema in which these parameters are extracted is described.
The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2004
We describe the design and implementation of an intelligent reporting and alerts system that has ... more We describe the design and implementation of an intelligent reporting and alerts system that has been designed with a specific goal to address the needs of managing chronic and complex disease through the use of home telecare technology. Our approach has been to develop these tools using as far as possible, open standards. Clinical measurement data gathered using home telecare and stored in a relational database in XML format is extracted and converted into a Clinical Document Architecture (CDA) as defined by the Health Level 7 (HL7) organization. Data trends are presented to the clinician as simple graphs and summary statistics (means, standard deviations) over time for an individual patient.
IET Irish Signals and Systems Conference (ISSC 2009), 2009
Page 1. ISSC 2009, Dublin, June 10-11 An Investigation of the Impact of Artifact Detection on Hea... more Page 1. ISSC 2009, Dublin, June 10-11 An Investigation of the Impact of Artifact Detection on Heart Rate Determination from Unsupervised Electrocardiogram Recordings Stephen J. Redmondt, Jim Basilakis tt , Branko G. Cellertt and Nigel H. Lovent ...
Public health research & practice, 2015
Increasingly, automated methods are being used to code free-text medication data, but evidence on... more Increasingly, automated methods are being used to code free-text medication data, but evidence on the validity of these methods is limited. To examine the accuracy of automated coding of previously keyed in free-text medication data compared with manual coding of original handwritten free-text responses (the 'gold standard'). A random sample of 500 participants (475 with and 25 without medication data in the free-text box) enrolled in the 45 and Up Study was selected. Manual coding involved medication experts keying in free-text responses and coding using Anatomical Therapeutic Chemical (ATC) codes (i.e. chemical substance 7-digit level; chemical subgroup 5-digit; pharmacological subgroup 4-digit; therapeutic subgroup 3-digit). Using keyed-in free-text responses entered by non-experts, the automated approach coded entries using the Australian Medicines Terminology database and assigned corresponding ATC codes. Based on manual coding, 1377 free-text entries were recorded and,...
Studies in health technology and informatics, 2013
Physical activity recognition has emerged as an active area of research which has drawn increasin... more Physical activity recognition has emerged as an active area of research which has drawn increasing interest from researchers in a variety of fields. It can support many different applications such as safety surveillance, fraud detection, and clinical management. Accelerometers have emerged as the most useful and extensive tool to capture and assess human physical activities in a continuous, unobtrusive and reliable manner. The need for objective physical activity data arises strongly in health related research. With the shift to a sedentary lifestyle, where work and leisure tend to be less physically demanding, research on the health effects of low physical activity has become a necessity. The increased availability of small, inexpensive components has led to the development of mobile devices such as smartphones, providing platforms for new opportunities in healthcare applications. In this study 3 subjects performed directed activity routines wearing a smartphone with a built in tri...
Studies in health technology and informatics, 2012
Our overall aim in this research is to develop a health smart home design that can monitor activi... more Our overall aim in this research is to develop a health smart home design that can monitor activities of its occupants. Our design includes three stages: system physical layers and software, fusion of multi-layered data, and classification of activities of daily living. We review prior work, discuss design and implementation issues, and describe our validation approach.
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2010
In developed countries, chronic disease now accounts for more than 75% of health care expenditure... more In developed countries, chronic disease now accounts for more than 75% of health care expenditure and nearly an equivalent percentage of disease-related deaths [1]. The burden of chronic disease (often, but not exclusively, associated with ageing) includes congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), hypertension and diabetes. Over the past several decades there has been an epidemiological shift in disease burden from acute to chronic diseases that has rendered acute care models of health service delivery inadequate to address population health needs.
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2009
Recently, telecare solutions have been demonstrated as an effective means of monitoring chronic d... more Recently, telecare solutions have been demonstrated as an effective means of monitoring chronic disease at a distance. A clinician may be managing many tens or hundreds of remote patients, prompting the need for a decision support system (DSS) to provide a more automated approach to managing these vast amounts of data. While simple threshold-based alert techniques provide some utility in notifying clinicians of extreme out-of-range parameter values, more incipient changes in a subject's condition may be sooner recognized by identifying trends in the longitudinal parameter data. Here we describe an approach for obtaining a piecewise-linear fit, to longitudinal physiological trend data, comparable with a similar fitting performed by a human observer, using a graphical user interface. The technique has been applied to both simulated and real data, and a comparison performed against the human scoring for each. On simulated data, the method matches or betters the human performance in...
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2007
A major challenge facing designers of telecare systems today is providing decision support to enh... more A major challenge facing designers of telecare systems today is providing decision support to enhance the health carer's review of remotely acquired monitoring data and to support clinical decision-making for the management of chronic and complex disease in this setting. We are implementing a decision support framework to analyze clinical information generated from subjects at their place of residence (home, residential care settings) and from other clinical environments. The telecare information generated from these environments is both substantial and multi-modal (physiological, questionnaire, medication data, etc.). Using the JBoss Application Server, a rules engine is used to analyze these data. The health carer will be alerted to any deterioration in the health status of a patient by way of a Web page that will stratify a clinical data summary into high, medium and low risk groups. In this way, outputs from the decision support system can be used to assist in the efficient ...
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2007
In this paper, we will discuss business models as well as technical specifications, user interfac... more In this paper, we will discuss business models as well as technical specifications, user interfaces, clinical services and knowledge management that we believe to be essential for the mainstreaming of telehealth services as an integral part of healthcare delivery in a modern industrialized society.
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2006
A novel image capture and retrieval system has been developed for use in a range of telehealth ap... more A novel image capture and retrieval system has been developed for use in a range of telehealth applications in the home and in residential care facilities. The system is based around the JPEG 2000 standard and uses the PTP protocol for image capture from any high resolution digital camera and the Kakadu suite of JPEG2000 utilities to serve the collected images via a proxy server over any available communication channel from telephone lines to broadband services. When coupled with an image processing system such as the AMWIS system for pressure wound management, the system provides a high level of clinical functionality suitable for a wide range of telemedicine applications in rural and remote sites.
2010 Annual International Conference of the IEEE Engineering in Medicine and Biology, 2010
The objectives of this paper are to present a guideline-based decision support system (GBDSS) des... more The objectives of this paper are to present a guideline-based decision support system (GBDSS) design for supporting patient telehealth management of chronic disease and to test its performance in correctly making referral recommendations using routinely recorded measurement data from home telehealth recordings. The GBDSS has been developed to manage lung disease patients in a home telehealth environment. The system operates by checking the availability of home telehealth measurement data on a daily basis, interprets these data using a rule-based decision tree classification, and ultimately generates referral recommendations based on these measured data. The system has demonstrated discriminative power when applied in the analysis of retrospective telehealth data, as a surrogate for realtime referral generation. To this end a telehealth dataset comprising 16 chronic obstructive pulmonary disease (COPD) patients monitored over a 12 month period was used. It was shown that GBDSS referral recommendations could help reduce the number of cases that required a carer's urgent attention by 72.1%, with 81.9% accuracy, 80.8% specificity and 90.4% sensitivity.
This paper describes a personal falls monitoring project using smart phone based tri-axial accele... more This paper describes a personal falls monitoring project using smart phone based tri-axial accelerometry, for surveillance of elderly people with falls risk living independently at home. The project relied on collaboration of three parties to achieve its clinical, research and technology aims. The results of data collection during the six month trial period are presented and analysed here. These results indicate a very high rate of false positives (94.7%) which would need to be addressed in future development of the system. .
Studies in health technology and informatics, 2015
Telehealth pilot projects and trial implementations are numerous but are often not fully evaluate... more Telehealth pilot projects and trial implementations are numerous but are often not fully evaluated, preventing construction of a sound evidence base and so limiting their adoption. We describe the need for a generic Telehealth project evaluation framework, within which evaluation is undertaken based on existing health systems performance indicators, using appropriately chosen measures. We provide two case studies explaining how this approach could be applied, in Australian and Canadian settings. It is argued that this framework type of approach to evaluation offers better potential for incorporating the learnings from resultant evaluations into business decisions by "learning organisations", through alignment with organisational performance considerations.
A clinical trial of a home telecare system (1-5) for the management of chronic disease at home on... more A clinical trial of a home telecare system (1-5) for the management of chronic disease at home on 22 patients with a primary diagnosis of Conges- tive Heart Failure (CHF) and / or Chronic Obstruc- tive Pulmonary Disease (COPD) has demonstrated a high level of patient and doctor satisfaction with respect to usability, functionality and effectiveness. Measurement and medications compliance was high and all patients were able to use the system daily. Although a detailed evaluation of health care out- comes and cost benefits of the clinical trial was be- yond the scope of this project, individual case studies suggest that this home telecare system could have a profound impact on the active management of
The Medical journal of Australia
Information and communications technology (ICT) is increasingly being used in management of chron... more Information and communications technology (ICT) is increasingly being used in management of chronic illness to facilitate shared services (virtual health networks and electronic health records), knowledge management (care rules and protocols, scheduling, information directories), as well as consumer-based health education and evidence-based clinical protocols. Common applications of ICT include home monitoring of vital signs for patients with chronic disease, as well as replacing home visits by nurses in person with telemedicine videophone consultations. A patient-managed Home Telecare System with integrated clinical signs monitoring, automated scheduling and medication reminders, as well as access to health education and daily logs, is presented as an example of ICT use for chronic disease self-management. A clinical case study demonstrates how early identification of adverse trends in clinical signs recorded in the home can either avoid hospital readmission or reduce the length of...
The last 60 years has seen a continual increase of the use of information and communication techn... more The last 60 years has seen a continual increase of the use of information and communication technology (ICT) to support the sustainable delivery of healthcare services. The need for easily implementable and effective ICT interoperability standards in healthcare has been well-demonstrated1. In the last 15 years, technology development and implementers’ concerns2 have resulted in new standards development such as HL7 V3, HL7 Clinical Document Architecture (CDA), openEHR, etc. In August 2011, a proposal was put forward3 from within the HL7 standards development community to explore the creation of the new standard that would constitute a "fresh start" using the most current thinking and technologies. This new standard, initially called Resources for Health ("RFH") and late renamed to Fast Healthcare Interoperability Resources ("FHIR") has progressed very quickly and has been balloted twice. Its main characteristic is the use of standard ICT technologies su...
Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology, 2002
2010 Annual International Conference of the IEEE Engineering in Medicine and Biology, 2010
Fledgling clinical decision support systems (DSSs) are being designed on the false assumption tha... more Fledgling clinical decision support systems (DSSs) are being designed on the false assumption that consistent, good-quality signals are created in the unsupervised telehealth environment, but it has in fact been shown that signal quality is often very poor. Hence, it is important to investigate the detrimental impact of failing to recognize erroneous clinical parameter values. This study combines previous work in this area, related to artifact detection in electrocardiogram (ECG) signals, and piecewise-linear trend detection in longitudinal heart rate parameter records, to investigate the impact of choosing to ignore ECG signal quality prior to trend detection in the heart rate (HR) records. Using an artifact detection algorithm to improve the HR estimates from the ECG signals, when compared to reference HR values derived from human annotated 2453 ECGs from nine patients, resulted in a decrease in the estimation bias from 2.54 BPM (beat per minute) to 0.70 BPM and a decrease in the standard error from 0.47 BPM to 0.17 BPM. The application of the same artifact detection also results in a significant improvement in trend fitting, when compared to a fitting of the reference HR values, by reducing the mean RMSE value of the error in the trend fit from 2.14 BPM to 0.78 BPM and standard error from 0.49 BPM to 0.10 BPM. As trend detection will be a component of future telehealth decision support systems, signal quality measures for unsupervised measurements are of paramount importance.
2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2001
We review the development of an Internetenabled home clinical workstation for the management of c... more We review the development of an Internetenabled home clinical workstation for the management of chronic disease, and the implementation of a clinical trial to test the functionality, usability and effectiveness of the system in both a city and a remote country setting. The Home Telecare System integrates with established primary care services to provide a new paradigm of active disease management through the daily collection of clinical data and assessment of functional health status, and the provision of feedback for patient self-management and education. A novel Medications Management module is also implemented to permit on line variation of prescribed medications.
2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2001
Accelerometers can be used to monitor physical activity in the home over prolonged periods. We de... more Accelerometers can be used to monitor physical activity in the home over prolonged periods. We describe a novel system for objectively and continuously monitoring movement, suitable for patients with chronic diseases including congestive heart failure and chronic obstructive pulmonary disease. The key design criteria were ease of use by, and comfort for, the patient together with the provision of clinically relevant information. The patient's posture, energy expenditure and movement are clinically important parameters that can be measured by accelerometry. A data processing schema in which these parameters are extracted is described.
The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2004
We describe the design and implementation of an intelligent reporting and alerts system that has ... more We describe the design and implementation of an intelligent reporting and alerts system that has been designed with a specific goal to address the needs of managing chronic and complex disease through the use of home telecare technology. Our approach has been to develop these tools using as far as possible, open standards. Clinical measurement data gathered using home telecare and stored in a relational database in XML format is extracted and converted into a Clinical Document Architecture (CDA) as defined by the Health Level 7 (HL7) organization. Data trends are presented to the clinician as simple graphs and summary statistics (means, standard deviations) over time for an individual patient.
IET Irish Signals and Systems Conference (ISSC 2009), 2009
Page 1. ISSC 2009, Dublin, June 10-11 An Investigation of the Impact of Artifact Detection on Hea... more Page 1. ISSC 2009, Dublin, June 10-11 An Investigation of the Impact of Artifact Detection on Heart Rate Determination from Unsupervised Electrocardiogram Recordings Stephen J. Redmondt, Jim Basilakis tt , Branko G. Cellertt and Nigel H. Lovent ...
Public health research & practice, 2015
Increasingly, automated methods are being used to code free-text medication data, but evidence on... more Increasingly, automated methods are being used to code free-text medication data, but evidence on the validity of these methods is limited. To examine the accuracy of automated coding of previously keyed in free-text medication data compared with manual coding of original handwritten free-text responses (the 'gold standard'). A random sample of 500 participants (475 with and 25 without medication data in the free-text box) enrolled in the 45 and Up Study was selected. Manual coding involved medication experts keying in free-text responses and coding using Anatomical Therapeutic Chemical (ATC) codes (i.e. chemical substance 7-digit level; chemical subgroup 5-digit; pharmacological subgroup 4-digit; therapeutic subgroup 3-digit). Using keyed-in free-text responses entered by non-experts, the automated approach coded entries using the Australian Medicines Terminology database and assigned corresponding ATC codes. Based on manual coding, 1377 free-text entries were recorded and,...
Studies in health technology and informatics, 2013
Physical activity recognition has emerged as an active area of research which has drawn increasin... more Physical activity recognition has emerged as an active area of research which has drawn increasing interest from researchers in a variety of fields. It can support many different applications such as safety surveillance, fraud detection, and clinical management. Accelerometers have emerged as the most useful and extensive tool to capture and assess human physical activities in a continuous, unobtrusive and reliable manner. The need for objective physical activity data arises strongly in health related research. With the shift to a sedentary lifestyle, where work and leisure tend to be less physically demanding, research on the health effects of low physical activity has become a necessity. The increased availability of small, inexpensive components has led to the development of mobile devices such as smartphones, providing platforms for new opportunities in healthcare applications. In this study 3 subjects performed directed activity routines wearing a smartphone with a built in tri...
Studies in health technology and informatics, 2012
Our overall aim in this research is to develop a health smart home design that can monitor activi... more Our overall aim in this research is to develop a health smart home design that can monitor activities of its occupants. Our design includes three stages: system physical layers and software, fusion of multi-layered data, and classification of activities of daily living. We review prior work, discuss design and implementation issues, and describe our validation approach.
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2010
In developed countries, chronic disease now accounts for more than 75% of health care expenditure... more In developed countries, chronic disease now accounts for more than 75% of health care expenditure and nearly an equivalent percentage of disease-related deaths [1]. The burden of chronic disease (often, but not exclusively, associated with ageing) includes congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), hypertension and diabetes. Over the past several decades there has been an epidemiological shift in disease burden from acute to chronic diseases that has rendered acute care models of health service delivery inadequate to address population health needs.
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2009
Recently, telecare solutions have been demonstrated as an effective means of monitoring chronic d... more Recently, telecare solutions have been demonstrated as an effective means of monitoring chronic disease at a distance. A clinician may be managing many tens or hundreds of remote patients, prompting the need for a decision support system (DSS) to provide a more automated approach to managing these vast amounts of data. While simple threshold-based alert techniques provide some utility in notifying clinicians of extreme out-of-range parameter values, more incipient changes in a subject's condition may be sooner recognized by identifying trends in the longitudinal parameter data. Here we describe an approach for obtaining a piecewise-linear fit, to longitudinal physiological trend data, comparable with a similar fitting performed by a human observer, using a graphical user interface. The technique has been applied to both simulated and real data, and a comparison performed against the human scoring for each. On simulated data, the method matches or betters the human performance in...
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2007
A major challenge facing designers of telecare systems today is providing decision support to enh... more A major challenge facing designers of telecare systems today is providing decision support to enhance the health carer's review of remotely acquired monitoring data and to support clinical decision-making for the management of chronic and complex disease in this setting. We are implementing a decision support framework to analyze clinical information generated from subjects at their place of residence (home, residential care settings) and from other clinical environments. The telecare information generated from these environments is both substantial and multi-modal (physiological, questionnaire, medication data, etc.). Using the JBoss Application Server, a rules engine is used to analyze these data. The health carer will be alerted to any deterioration in the health status of a patient by way of a Web page that will stratify a clinical data summary into high, medium and low risk groups. In this way, outputs from the decision support system can be used to assist in the efficient ...
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2007
In this paper, we will discuss business models as well as technical specifications, user interfac... more In this paper, we will discuss business models as well as technical specifications, user interfaces, clinical services and knowledge management that we believe to be essential for the mainstreaming of telehealth services as an integral part of healthcare delivery in a modern industrialized society.
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2006
A novel image capture and retrieval system has been developed for use in a range of telehealth ap... more A novel image capture and retrieval system has been developed for use in a range of telehealth applications in the home and in residential care facilities. The system is based around the JPEG 2000 standard and uses the PTP protocol for image capture from any high resolution digital camera and the Kakadu suite of JPEG2000 utilities to serve the collected images via a proxy server over any available communication channel from telephone lines to broadband services. When coupled with an image processing system such as the AMWIS system for pressure wound management, the system provides a high level of clinical functionality suitable for a wide range of telemedicine applications in rural and remote sites.
2010 Annual International Conference of the IEEE Engineering in Medicine and Biology, 2010
The objectives of this paper are to present a guideline-based decision support system (GBDSS) des... more The objectives of this paper are to present a guideline-based decision support system (GBDSS) design for supporting patient telehealth management of chronic disease and to test its performance in correctly making referral recommendations using routinely recorded measurement data from home telehealth recordings. The GBDSS has been developed to manage lung disease patients in a home telehealth environment. The system operates by checking the availability of home telehealth measurement data on a daily basis, interprets these data using a rule-based decision tree classification, and ultimately generates referral recommendations based on these measured data. The system has demonstrated discriminative power when applied in the analysis of retrospective telehealth data, as a surrogate for realtime referral generation. To this end a telehealth dataset comprising 16 chronic obstructive pulmonary disease (COPD) patients monitored over a 12 month period was used. It was shown that GBDSS referral recommendations could help reduce the number of cases that required a carer's urgent attention by 72.1%, with 81.9% accuracy, 80.8% specificity and 90.4% sensitivity.