1. Reprogrammable Hardware used in future Patient-Centric eHealth Tools Authors: Årsand E a, Hartvigsen G a, b a Norwegian Centre for Telemedicine, University hospital of North Norway b Department of Computer Science, University of Tromsø, Tromsø, Norway

2. Agenda Reprogrammable Hardware used in future Patient-Centric eHealth Tools Reprogrammable Hardware used in Future Patient-Centric eHealth Tools Motivation Disease case Patient-centric Reprogrammable hardware Challenges Alternatives

3. Need for eHealth tools Safety Adjusting unhealthy parameters Health information Motivation Support In form of a wearable buddy? Reprogrammable Hardware used in future Patient-Centric eHealth Tools

4. E.g. people with diabetes 200 mill. people, epidemic Avoiding unhealthy blood glucose values Serious complications Vulnerable groups of people –Especially children and elderly Need help to self-help –Blood glucose, nutrition, physical activity and medicine –Also on distance Reprogrammable Hardware used in future Patient-Centric eHealth Tools

5. Main principle forming a ICT Self-help tool sensors+ Mobile/wearable terminal Reprogrammable Hardware used in future Patient-Centric eHealth Tools

6. Patient-centric, demands Mobile or wearable Primarily for the patient Easy and motivating to use Self-adjustable Self-reconfigurable Context sensitive Reprogrammable Hardware used in future Patient-Centric eHealth Tools

7. eHealth tool / buddy Main components (reconfigurable) –Sensors –Wireless communication –Power –Logic (hardware) –Intelligence (software) –Memory –Supporting electronics Reprogrammable Hardware used in future Patient-Centric eHealth Tools

8. Reprogrammable components PLDs – Programmable Logic Devices pSOCs – programmable System On Chips FPGAs – Field Programmable Gate Arrays ASICs - Application Specific Integrated Circuits hybrids with CPUs - Central Processing Units integrated with some of the above + : dynamic, cheap, small, low power - : specific competence needed Xilinx FPGA 16x16x1.2 mm

9. Example setup Reprogrammable Hardware used in future Patient-Centric eHealth Tools

10. Technology - PLDs Programmable Logic Devices – hardware changed at real-time Self-configured (software) and self- adjustable based on sensor input Example: Per with T2D is very inactive, walking just 700 steps each day. Then he is getting motivated by the eTool, beginning to walk 3000 additional steps each day…) Reprogrammable Hardware used in future Patient-Centric eHealth Tools

11. The eTool senses this increase in activity and changes hardware (AD-converter and electronics) to receive data from a different kind of step-sensor. During Per’s weekly blood pressure measurement, the eTool prepare itself (physically) to receive this data. Per is motivated to increase the blood glucose tests from 1 to 3 tests a day. Thus, the eTool reconfigure (software) itself to present a daily overview at the evening, in addition to the weekly graph. All data is transferred wirelessly (Bluetooth). The eTool is constantly sensing for changes in Per’s habits and consequently adjusts itself, i.e. self-adjustable (hardware and software).

15. Challenges Power Labs and expertise Size Speech recognition / easy interface Usability –i.e. aiming for functionalities that use a “no-touch” principle Reprogrammable Hardware used in future Patient-Centric eHealth Tools

16. Alternatively Using existing mobile terminals; Smartphones / PCs A good alternative if the “Bluetooth Medical Device Profile” is realized Reprogrammable Hardware used in future Patient-Centric eHealth Tools

17. Example Programmed mobile phone (Bluetooth enabled) Sensor Short-range comm. adapter Long-range transfer EHR, PC, mobile phone, etc. Reprogrammable Hardware used in future Patient-Centric eHealth Tools

18. Close to 100% propagation Follows the patient almost everywhere No extra device Cheap terminal (compared to PC) Verbal communication channel in the same unit Advantages of using the patient’s mobile phone Reprogrammable Hardware used in future Patient-Centric eHealth Tools

19. Physically reprogrammable, i.e. more flexible, more functions on less space Self-adjustable, both software and hardware Small size Cheaper per unit Low power consume Advantages of using reprogrammable hardware

20. Reprogrammable Hardware used in future Patient-Centric eHealth Tools

21. Self-help through a mobile ICT tool Supporting lifestyle changes for preventing secondary diseases for people with Type 2 diabetes using a digital diabetes diary Eirik.Arsand@telemed.no +47 992 43 592 For more information: currently working with the PhD project: Reprogrammable Hardware used in future Patient-Centric eHealth Tools