ePerion

The e-perion project aims to develop and market a comprehensive solution based on intelligent technology to assist in-home nursing care for the elderly, disabled, or otherwise fragile individuals. The project proposes an open solution allowing for the processing and integration ofdata obtained from various actimetric and medical sensors available on the market, in order to offer appropriate services within a comprehensive integrated telemetry system. E-perion will comprise a central system allowing for the collection of data from different devices, a platform that processes modelled medical knowledge and services, in association with a Call centre, a telealarm, as well as services to the person.This solution is composed of different parts:A material part, requiring the implementation of a central system allowing for data acquisition from a wide variety of sources, such as actimetric sensors and medical systems, as well as data transfer to a service platform. Data may also be transmitted by a mobile device.A software part, along with the development of a platform designed to exploit modelled medical data within structured operational semantics. This semantics will define the manner in which knowledge will be used to develop rational thinking and lead to automatic enrichment.Telecare services with a call centre, Personal Emergency Response System, as well as care giving services. The system may be accessed 24 hours a day, seven days a week, and is made up of qualified administrative personnel, who have been properly trained to fully meet the customer’s needs (setting off alarms, coordinating emergency interventions, and processing requests for home care services).The e-perion project is designed to propose a unique and evolving solution, encompassing a full set of domestic and medical devices, which are either fixed or mobile, along with the analysis and interpretation of integrated actimetric and medical data.

Figure 1: System schema
To develop and commercialise a comprehensive solution (material, software, and services) aimed at enabling the elderly, handicapped, or disabled (suffering from chronic conditions such as heart failure, chronic obstructive bronchopneumopathy, diabetes, etc.) to continue to live independently at their homes, e-perion proposes an open solution capable of processing and integrating data from the various actimetric and medical sensors available on the market, using different technologies. The system adjusts depending on the patient’s condition at a given time, thereby permitting individualised monitoring, depending on the patient’s health status.For instance, when caring for a patient in the postoperative period, the system will be able to take into account the different parameters that need to be controlled, adjusting to this new situation. The system’s tracking model allows for data to be stored, thereby leading to the constitution of a unique medical database, associated with the defining of each patient’s medical history along with an improved understanding of the medical history of each condition. A new transmission platform including all of the new technologies capable of tracking the different sensors (bluetooth wifi and radio) is scheduled to be integrated with a range of telephone terminals specifically designed to meet the needs of the elderly. This transmission platform will be operated using existing networks (RTC, Web, and GPRS) to forward real-time data ranging from very simple (telealarm) to highly complex signals (patient vital parameters). We distinguish two different types of sensors, notably environmental sensors able to detect the patient’s activities at home and medical sensors. Using a simple and interactive graphic interface, the medical module is able to take into account the full range of medical wireless sensors (oximeter, glucometer, blood pressure monitor, ECG, spirometer, stethoscope, etc.) depending on the patient’s medical conditions (COBP, diabetes, hypertension, etc.). This model allows for remote and comprehensive monitoring of patients suffering from chronic conditions or following hospitalisation. All functions of the medical module may also be loaded on a mobile device. The information will be transferred in real-time to a processing centre where data is analyzed by a software solution. Patient data will be hosted within a secure server farm, and the application of actimetric and medical data processing will be based on semantic web technologies. Knowledge will be modelled and formalised (patient profiles, recovery of sensors, contexts and pathologies). Based on these ontologies, it will be possible to reason and identify risky situations, using an inference motor. Call centre agents will receive the appropriate information. Data will be collected and stored in a unique database. Useful information is scheduled to be made available to authorised individuals, without breaking doctor-patient confidentiality, and in line with legal requirements. This will allow us to develop a model of heuristic reasoning capable of improving diagnostic accuracy. This data collected during a given time period is likely to be highly valuable, enabling physicians to optimise their diagnostic approach. Moreover, this database will be a rich source of epidemiological and behavioural data, essential to basic and clinical research. The collected data will make it possible to define the medical history of each condition or disorder, particularly for clinical conditions affecting the elderly. The entire database (patient identification, healthcare personnel, etc.) will be secured, as will the entire application system.Integration and storage of sensor data as well as data analysis by the training software based on scenarios that have already been established by physicians to allow for the following: Appropriate prevention of different medical conditions or risks, as well as early detection of certain risk situations.Remote monitoring and follow-up of chronic diseases using a web interface accessible to physicians and family members.Appropriate medical management in case of emergency.Implementation of a database, enabling patient follow-up and serving as a rich source of epidemiological and clinical data for physicians.Automated management for many patients. Marketing studies show that all the solutions that are based on proprietary protocols that do not permit any inter-operability. They respond to a person’s needs at a given time, but do not evolvewith her/his health status and medical conditions. Current medical telemonitoring solutions are based on software platforms which allow physiological parameters to be collected, but do not make any predictions. Numerous research projects focused on independent assisted living and telemedicine have been developed, but few have managed to obtain financial support. This may be accounted for by multiple causes, including the high cost of access and the difficulty of adapting these new technologies. Currently, there is no comprehensive and fully integrated solution available on the market. Some of these solutions are aimed at equipping old residencies. The majority of these projects, however, are adapted to new and specialised nursing homes or residences for the elderly. This is the case for the MEDeTIC project, which requires extensive equipment in order to be implemented. Indeed, a medical seat allowing for health data collection is only possible in facilities with a common area. Other solutions have been developed with the sole aim of dealing with a specific health issue. This is the case of the Hera project, which has been specifically designed for Alzheimer disease patients. This project does not include medical sensors; rather it only uses standard domotic sensors so as to check social activity and behaviour, with no medical parameters being monitored. This is also the case for projects such as Prosafe or Ger’Home. Lastly, none of the market actors propose a federative solution including the entire set of domotic and medical applications aimed at enhancing the lives of the elderly who are living at home.Given these considerations, our solution aims to provide a simple and evolving answer that is accessible by everyone, regardless of health status, degree of autonomy, or income. The electronic pre-treatment of risky situations (environmental or medical) enables us to propose a product price for our solution that is 30% to 40% inferior to that of our competitors. Our software is able to cover disease detection as well as identification of risky situations; this duplicity allows us to position our product in two highly promising sectors, telecare and home and mobile telemedicine. Our solution is adaptable to all types of housing, whether old or new, as well as nursing homes and care centres, with the goal of facilitating surveillance. Our solution will allow for adaptation to the patient’s physiological condition or any health issues he or she may have (using domotic andmedical sensors depending on the patient’s condition/health issues, and his or her specific healthrelated needs). The technology needed to develop our solution already exists. As a result, the system only requires a small amount of material development. Additionally, the system is based on an open solution rather than a proprietary solution. Lastly, the validation of our system will be performed in appropriate structures using diseased (Internal medicine department of the Strasbourg University hospitals) and elderly (Geriatric department of the Strasbourg University hospitals) individuals.