1. Integrated Approach to Monitoring Paediatric Cases at Home Malcolm Clarke - Brunel Alex Jones – Gt Ormond St Russell Jones - Chorleywood

2. Case Study – Single Heart Vessel Congenital abnormality of single heart vessel Rare problem Balance pulmonary and systemic blood flow Prone to infection Rapid deterioration Small number specialist centres Large distance to travel for review and management Occupy valuable bed Separation of family Greater survival rate and longevity

3. Case Study – Single Heart Vessel Desire to release from hospital but need safe environment at home Frequent checks –Nurse calls –Time consuming –Lack of objective information for management –Can be delay in recognising deterioration –Not pro-active

4. Approach Single platform –Extensible – add sensors for changing conditions and issues –Platform “grows” with child – change the sensor with age Inexpensive –Based on ubiquitous platform not bespoke –Deploy on wide scale – large number of conditions not specialist –Advantage of scale for cost and experience of use Simple to use –Not all families familiar with technology –Don’t add to complications of the family –Do not burden busy family –Optional aspects that “add value”

5. Telecare Semantic interoperability Functional interoperability TelehealthHome controls Protocol interoperability Physical co-existence Inter-related standards

6. Approach Base on standards - IEEE 11073 Apply guidelines – e.g. Continua Alliance Support interoperability beyond immediate environment (in home, out of the home, in the healthcare enterprise)

7. Continua Architecture 7

8. Integrated platform Simple home use Home sensors Clinician view Family view

9. System investigated SECA Model 336 –Inexpensive base model –Internal connection for modules –Can be supplied with wireless USB and SECA proprietary protocol –Modified to take IEEE 11073 module using -10415 Standard Weighing Scale Nonin SpO 2 Module and paediatric probe (not compatible with adult) –IEEE 11073-10404 (Also investigate TaiDoc TD8201 Hand Held with paediatric probe)

10. Progress Proof of concept meetings with staff Internal validation of sensors

11. What benefits 1.Extensible range of devices 2.Single system for all patients 3.Protect investment – devices compatible and re-usable – lower cost

12. 4.Modularise the system (common interfaces) a)Niche sensors b)Specialist providers of system components c)Extend range of devices available d)Improved system functionality e)Competition from different device manufacturers f)Lower cost

13. 5.Increased scale a)Can be used on patients with more prevalent diseases b)System cost spread over more users c)Lower cost

14. Innovative applications 1.Cardiac patients 2.Many types of patients 3.Extension to other centres

15. 4.Instant install (by the patient) -Early discharge -Reduce cost 5.System grows with need -Can support mother and child -E.g. Pre-eclampsia (device can be mapped to patient) Innovative applications

16. Malcolm Clarke Department of Computer Science Brunel University malcolm.clarke@brunel.ac.uk Thank You