Development and evaluation of assistive technology to improve chronic care

Today we notice a rising life expectancy in the Western countries. Together with an aging population we see an increasing prevalence of age-related diseases such as dementia. This results already in a lack of places in living and care centres. We also notice that the Western population has an unhealthy eating and exercising habit. This can be seen in a significant increasing prevalence of lifestyle diseases such as obesity and cardiovascular diseases. This means that not only the older persons but also the active population is confronted with health problems. Besides the growing number of persons reliant on care, we see that there are fewer (young) professional caregivers available. This meansnbsp;the demographic evolution in the Western countries has made that the current healthcare systems are under enormous pressure. In addition to the demographic evolution, we also experienced anbsp;(r)evolution. In our daily lives, we are becoming more familiar with (mobile) technology and we are approaching a turning point in the healthcare sector where technology will increasingly find its way into healthcare applications. Therefore, this doctoral research is lookingnbsp;opportunities to use technology in the healthcare in order to support in chronic care. Because today there is already a need for technology to support healthcare tasks, we are looking for technology that is immediately usable in real-life conditions. In this work, we focus on three different target groups which are from old to young: demented elderly persons, adults in the prevention and rehabilitation ofnbsp;diseases, and children with epilepsy. For each of these target groups a specific application will be developed. Each ofnbsp;applications also fits into a broader context of current challenges in the healthcare. The challenges being focused upon in this worknbsp;1) an aging population, 2) a rising prevalence of lifestyle diseases, and 3) a shortage of healthcare professionals. Although not explicitly investigated in this work these systems willnbsp;contribute to an increasing quality of life of the target group, offer support to caregivers and have a positive economic impact on the cost of the healthcare. Fornbsp;three target groups the following specific applications will be discussed. First, for demented elderly persons we investigate the ability to automatically detect pain or discomfort based on their facial expressions. Secondly, for adults we will try to predict their physical activities based on knee angle measurements. Thirdly, for children with epilepsy we search for the ability to recognizenbsp;abnormal movement. For each of these applications, a specific system is developed and tested in real-life conditions. During the development of these systems five items get special attention in this work. Firstly, we consider the specific application in itself. From the application point of view, the functional requirements are determined. Based on the functional requirements the measurement system is defined. This is a combination of hardware and software which needs to work in a real environment and with a minimal impact on the user. Next, we look at the raw data, collected by the measurement system, and how it can be processed into usable data. Then we have to make these systems work in real-life conditions. Therefore thenbsp;processing should be performed quickly and accurately in order to meet thenbsp;constraints. Hence, we look for opportunities to execute the (sometimes computationally intensive)nbsp;in real-time. Finally, the added value of these systems is the clinical information and results that can be extracted in a simple and useful way fromnbsp;measurements. Therefore, we also evaluate the usability of these applications in a real-life environment. The ultimate goal of this doctoral research is to describe a methodology that can be used in the development of technological systems in the healthcare sector. Hopefully this thesis can also contribute to a faster integration of technology in the healthcare sector, and improvement of the quality of life of the patient, and support the caregiver (from professional caregiver to informal caregiver) in performing care.status: publishe