1. Department of Signals and Systems Disease Management System for CHF Patients Bengt Arne Sjöqvist, Adj. Professor, Chalmers University of Technology Kaj Lindecrantz, Professor, Borås University College, Borås, Sweden Inger Ekman, Associate Professor, Sahlgrenska Akademin, Gothenburg University Care @ Distance Anna Gund PhD Student, Chalmers University of Technology Gothenburg, Sweden

2. Department of Signals and Systems Overview Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

3. Department of Signals and Systems Introduction Congestive Heart Failure –2% of western population –Most over 60 years of age –Chronic health disorder Amount of elderly increasing Growing expenses Shrinking resources Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

4. Department of Signals and Systems Purpose of IT-based Home Care Improved care: –Improved treatment compliance –Better basic data for health related decision- making –Faster detection of deteriorating health –Easier to see effects of new/changed medication –Patient can stay home for longer periods of time Cost Efficient: –Fewer/shorter hospital visits –Fewer acute situations Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

5. Department of Signals and Systems Database Network Care giver Patient Patient’s Family Patient Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

6. Department of Signals and Systems System Overview Home client –Placed at patient’s home –Computer with installed software –Physiological sensor equipment Web portal –For care givers as well as patient with family –Accessible through internet browser Infrastructure –Broadband connection (UMTS) –(Bluetooth between sensor and home client) Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

7. Department of Signals and Systems Home Client Home equipment –Easy to use –Small intrusion on daily life Measurements –Once or several times per day –Body weight –Blood pressure –Pulse –(Electric Bio-Impedance) Subjective questions –Fatigue –Dyspnoea Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

8. Department of Signals and Systems Web Portal Accessible via web browser Examine patient data Administrate: –Patient data –Equipment –Questionnaires Create measurement schedules Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

9. Department of Signals and Systems Pre-trial Performed at Östra Hospital, Gothenburg Sweden, spring 2007 Two parts: evaluation of home client and web portal Home Client –Objective: evaluation of usability and design –10 patients, ages 62-87, 4 female 6 male, none to average computer experience –Tried system once in connection with appointment –Evaluation through observations and questionnaire Web portal –Objective: re-design of web portal –Paper prototype –3 nurses at Östra Hospital –Evaluated through interviews Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

10. Department of Signals and Systems Results Home client –8 out of 10 (80%) found the system easy or very easy to use, 2 out of 10 (20%) found the system hard to use –6 out of 10 (60%) had difficulties pressing the touch sensitive screen –5 out of 10 (50%) had some difficulties with numeric keyboard –Most problems can most likely be solved with better instructions –All patients could consider using the system on a daily basis –Larger and longer trials necessary Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

11. Department of Signals and Systems Results cont’ Web portal –2 out of 3 found the system intuitively easy to use, the third thought if would take some time getting used to –Many comments of details of the pages, such as names on buttons and which information should be entered –Greatest concern not of usability of system, but of amount of information to be handled –More tests needed to evaluate over longer periods of time Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

12. Department of Signals and Systems Current Work System verification –“De-bugging” using healthy volunteers Preparations for longer trials in home environment –~3 patients –1-3 months Improvements on current home client –Web based system, master thesis recently started Development of new Web Portal Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

13. Department of Signals and Systems Future Plans Apply EBI (Electric Bio-Impedance) –ECG –Oedema –Respiration –Etc. Develop new sensor techniques –Necessary in order to use EBI in home care applications –User friendly –Non-invasive, pain free –Wearable electronics / Smart textiles More tests and improvements Introduction Purpose of IT-based home care System overview Pre-trial Current work Future plans

14. Department of Signals and Systems Thank you!