A Complete Ambient Assisted Living eXperiment (CAALYX) in Second Life® Maged N. Kamel Boulos, MBBCh, MSc, PhD, SMIEEE Athanasios Anastasiou, MRes Faculty of Health and Social Work, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, UK

Introduction Second Life® (SL — an online 3-D virtual world, offers excellent opportunities to create multi-user, interactive medical simulations for various purposes, thanks to its inbuilt physics, programmability and collaborative features. CAALYX ( an EU-funded FP6 eHealth project, aims at developing a Wearable Light Device (WLD) to measure specific vital signs of the elderly, detect falls, and communicate automatically in real time via a mobile computer-phone (Nokia N95) with his/her caregiver in case of an emergency, wherever the person happens to be, at home or outside. The emergency information includes the geographic position alongside the health information of the elderly to enable the caretaker or emergency service to direct an appropriate response in a timely manner.

Objectives To develop an initial simulation of the workings of CAALYX in the virtual world, as another novel means of disseminating and showcasing the project’s concepts to wider audiences. There are also other long-term objectives and possibilities described in detail at

Current CAALYX Presence in SL

Methods and Results - 1 Using SL’s Linden Scripting Language (LSL — the following scripts have been produced in-world: ECG (Electrocardiogram), Respiratory Rate and GPS (Global Positioning System) Sensors; and WLD (Data Logger). They are freely available to anyone as a ‘CAALYX Simulation (pre-alpha concept release)’ package in SL (see

Methods and Results - 2 Currently, the user communicates with the WLD via the text chat channel and output is returned to the same channel.

Methods and Results - 3 Users are able to see how Sensors and WLD pair and unpair (corresponding to Bluetooth pairing that happens in the real system), how Sensor readings change with the user’s avatar in-world activity level (heart and respiratory rate readings) and location (GPS Sensor returns the avatar’s X,Y,Z SL location coordinates), and how alarms can be easily set and triggered when the corresponding conditions are fulfilled, e.g., when heart rate goes above a certain threshold value.

Discussion - 1 This is a very early version that can be developed further in due course, time and resources permitting, to serve more advanced purposes: 1.More sophisticated modelling of the real system to better understand and showcase the full range and sorts of communications taking place between the different components of CAALYX; 2.Demonstrating CAALYX functionality interactively to wider audiences (novel dissemination) anywhere around the world (with a broadband connection) and with negligible demonstration setup/preparations (the free basic membership of SL is enough for this purpose);

Discussion Testing/rehearsing various patient scenarios and interactive induction and training of CAALYX personnel, maybe also using a more standardised ‘Medbiquitous Virtual Patient’ approach ( working_groups/virtual_patient/ ), in addition to graphical colour HUDs (Heads-Up Displays) to reproduce the caretaker’s application screens and the Nokia N95 interface in SL, and display on them the observations and communications taking place, as well as use them to receive user’s input, instead of relying on the text channel for the display of Sensor readings and the input of user’s commands. working_groups/virtual_patient/

Discussion - 3 Graphical HUDs have the potential of making the whole system friendlier and more understandable by someone not familiar with CAALYX and/or the corresponding simulation in SL; and 4.Modelling and investigating the real system’s bottlenecks and scalability. * Screenshots of HUDs used in the Emergency/Nursing Education Simulator (NESIM) in SL. NESIM was developed by John Miller and colleagues at Tacoma Community College, WA, USA.

Conclusions - 1 The current version is still at what is technically known as ‘modelling just for the joy of it’, and has not yet fulfilled the advanced objectives we have just described, so the user is cautioned not to expect much from it or judge the whole concept and approach or the real CAALYX system based on it. Other simulation stages are: modelling for better understanding of complex systems/education and training; for planning; for spotting and solving problems; etc.

Conclusions - 2 However, if the current version has managed to raise the curiosity of the user to further explore the real system and its documentation, which we believe it did from the informal user feedback we have so far received, then at least it has been successful at this very initial stage in disseminating some of the concepts involved in the real CAALYX prototype, which meets our initial objective. We encourage colleagues to consider the potential of Second Life as a readily available multi-purpose platform in developing relatively affordable and high reach, multi-user simulations.

Related Projects in SL Modeling Healthcare Logistics In Virtual Worlds (University of Arkansas) - Nursing Education Simulator (NESIM) — PREVIEW project (Problem-based Learning in Virtual Interactive Educational Worlds) — oJ8http:// oJ8 Game-based learning for Virtual Patients in Second Life (Faculty of Medicine at Imperial College London) — IBM Virtual Healthcare Island — (see also: ‘Interactive Environment Displays IBM’s Vision for Consumer-Driven Healthcare’ — For more pointers, please see ‘3-D Web/Second Life® in Medicine and Health’ (MN Kamel Boulos) —

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