1. 1 SmartSpaghetti: Use of Smart Devices to Solve Health Care Problems Mostafa Uddin,A. Gupta, T. Nadeem, K. Maly Sandip Godambe, Arno Zaritsky BIBM/BIH Shanghai Dec. 18 - 21, 2013

2. 2 Contents Mobile technology opportunities in medical field LEAN : spaghetti problem Smart Spaghetti System Prototype & Experiments Future Work BIBM/BIH Shanghai Dec. 18 - 21, 2013

3. 3 Opportunities* Role of Smart Devices The amount of research in the use of the smartphone in medicine is rapidly growing. Smartphones have a very bright future in the world of medicine, while doctors, engineers, and others alike continue to contribute more ingenuity to this dynamic field. Given the numerous ways in which the smartphone can be used in healthcare, smartphones will be recognized as a diagnostic and therapeutic tool that is as irreplaceable as the stethoscope has been in the practice of medicine. * Ozdalga E, Ozdalga A, Ahuja N, “The Smartphone in Medicine: A Review of Current and Potential Use Among Physicians and Students”, J Med Internet Res 2012;14(5):e128 BIBM/BIH Shanghai Dec. 18 - 21, 2013

4. 4 Vision Create collaborative systems for specific niches such as childhood obesity that: For individuals Collect streams of sensor data continuously Integrate with information in electronic health records Enable interactions from stakeholders Provide action lists for patients, caretakers and doctors Track costs associated with data collection and actions For researchers Create anonymous database of disease patterns Create models and explore hypotheses Develop cost/benefit models BIBM/BIH Shanghai Dec. 18 - 21, 2013

5. 5 Approach Given that: User-Friendly Remote Patient Monitoring Availability of new inexpensive gadgets that monitor your health and fitness ranging from heart monitors to biosensors that read body temperature and motion More than 100 million wearable health-related devices sales annually by 2016 (ABI Research). Projected to reach 80 million wearable sports and fitness- related monitoring devices sales by 2016. Will build: Flexible optimized system integrating smartphones, gadgets, patients, doctors and EHR *. *EHR: Electronic Health Records BIBM/BIH Shanghai Dec. 18 - 21, 2013

6. 6 Lean Lean Healthcare is the application of concepts, tools and management prescriptions aimed at furthering the organizational mission by strengthening operating processes. Characteristics of a Lean Healthcare organization More Efficient (operationally & capital-wise) Faster & more reliable Delivers higher quality More Responsive Performs way above the rest with more satisfaction Plenty of room for improvement! Sandip Godambe, MD, PhD, MBA; Quality Improvement and Safety Team (QuIST) BIBM/BIH Shanghai Dec. 18 - 21, 2013

7. 7 Spaghetti Problem BIBM/BIH Shanghai Dec. 18 - 21, 2013 Findings: Layout not visual control friendly Many isolated islands Workstation layout not standardized

8. 8 Smartphone Approach Obtain room layout, targets, feasible paths Use smartphone with accelerometer, gyroscope sensors For a starting point have individual walk to a target Obtain raw data from sensors Extract information such as strides, directions, and pauses Compute final path BIBM/BIH Shanghai Dec. 18 - 21, 2013

9. 9 Basic Scheme Human movement path can be segmented into units of strides and turns. Stride length Turn BIBM/BIH Shanghai Dec. 18 - 21, 2013

10. 10 Basic Scheme We use the sensors (Accelerometer+Gyroscope) reading to count the stride. Detected Stride Gyroscope Reading BIBM/BIH Shanghai Dec. 18 - 21, 2013

11. 11 Basic Scheme We use the orientation and magnetic field sensor to detect the turns. Stride Orientation sensor reading Turn/ change of angle BIBM/BIH Shanghai Dec. 18 - 21, 2013

12. 12 Basic Scheme Movement information from raw sensors data. BIBM/BIH Shanghai Dec. 18 - 21, 2013

13. 13 Tracking User Movement Path – Basic Approach Step1: Collecting sensor reading using user's smartphone Start application; select start location; walk & collect data; end walk phase; send data to backend Step2: Offline process on the sensor reading to estimate user's movement Smooth data Model parameters Stride – average length of an individual’s steps Turn angles – a step function of angles approximating the angle of a turn between two adjacent segments BIBM/BIH Shanghai Dec. 18 - 21, 2013

14. 14 Collecting Sensor Data How we have collected the data BIBM/BIH Shanghai Dec. 18 - 21, 2013

15. 15 System Architecture Offline Process BIBM/BIH Shanghai Dec. 18 - 21, 2013

16. 16 Preliminary Scheme & Experiments BIBM/BIH Shanghai Dec. 18 - 21, 2013

17. 17  Experiment #1 (at ODU) BIBM/BIH Shanghai Dec. 18 - 21, 2013

18. 18  Experiment #2 (at ODU) BIBM/BIH Shanghai Dec. 18 - 21, 2013

19. 19 Experiments (at CHKD) Part of Map of CHKD First Floor BIBM/BIH Shanghai Dec. 18 - 21, 2013

20. 20 Experiment #3 (at CHKD) BIBM/BIH Shanghai Dec. 18 - 21, 2013

21. 21 Experiment #4 (at CHKD) BIBM/BIH Shanghai Dec. 18 - 21, 2013

22. 22 Conclusions & Challenges Smartphones can be used in an automated, non-intrusive manner to generate spaghetti diagrams but needs: User/Device - independent Orientation/position -independent Error correction schemes Ideal paths: Select the best path among all possible paths. Location confirmation: Fusing with other technologies WiFi, sound, Bluetooth WiFi MSE CISCO infrastructure Use of anchor point Enhanced machine learning scheme for estimating location Obstacle Target 1 Target 2 Start point BIBM/BIH Shanghai Dec. 18 - 21, 2013