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

Copyright  2008 by CEBT Contents  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 2

Copyright  2008 by CEBT Introduction  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 3

Copyright  2008 by CEBT 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” 4

Copyright  2008 by CEBT 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 5

Copyright  2008 by CEBT What is context-awareness 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?  Some problems to be addressed especially in the medical domain Equipment – Networks, captors, artifacts, mobile communication Security – Identification, authentication, availability, integrity, confidentiality 6

Copyright  2008 by CEBT The “research context” 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 7

Copyright  2008 by CEBT Researches in health care domain 8

Copyright  2008 by CEBT The “research context” 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 9

Copyright  2008 by CEBT Hospital-based projects  M : model, P: prototype, A: application, S: scenario  Pi: presentation of information, ES: Execution of services, SI: Storage of contextual info. 10

Copyright  2008 by CEBT 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 11

Copyright  2008 by CEBT 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. 12

Copyright  2008 by CEBT Discussion  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 13

Copyright  2008 by CEBT Conclusion  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. 14