Topic: Toward the Harmonization of Health IT Standards: The NIST HealthCare Standards Landscape

Description: The health IT industry has many standards development organizations (SDOs) developing specifications and standards for health IT informatics and information exchange covering a wide spectrum of activities. The many development efforts and large number of health IT standards that exist or are in development, make it very difficult to monitor and track the overall healthcare standards landscape.  This in turn impedes harmonization efforts among SDOs and frustrates efforts by users and organizations to identify understand and adopt needed standards. The NIST HealthCare Standards Landscape (HCSL) is a public web-based repository containing information about health IT standards, the organizations that develop, promote, or use these standards, related health IT standards' information, and links to external resources.  The HCSL information facilitates harmonization, implementation, and use of health IT standards by developers, implementers, and end-user organizations.  NIST researchers will provide an overview of the HCSL and a demonstration.

Description: The HLPR Chair is a patient-assist device to provide independence for wheelchair users such as the elderly, stroke victims, and others who are currently immobile.  HLPR was designed to relieve the heavy burden on insufficient numbers of nurses and other caregivers who lift and position patients and to decrease the 30% rate of back injuries among nurses.  This back injury rate is the highest among all occupations, including construction.  HLPR therefore, can provide independence to current patients who cannot work due to immobility, who cannot reach high shelves from a wheelchair, who cannot rotate their bodies to access target items, etc.  HLPR can lift a patient one meter to reach high shelves, it can mobilize a patient like a powered chair, and it can rotate a person to pick-up or place them onto a chair, bed or toilet.  Intelligence can also be built into the HLPR to perhaps allow even longer independence for Dementia and Alzheimer Disease patients.  As there is no other system like HLPR, NIST will work to advance design and safety standards for intelligent-lift-wheelchairs and provide performance metrics and technology advancements for these future devices.

Topic: Medical Device Communication

Description: In a typical intensive care unit (ICU), a patient may be connected to one or more vital-sign monitors, be receiving other fluids through multiple infusion pumps and be supported by a ventilator. Each of these medical devices has the ability to capture volumes of data, available multiple times per second, on a per patient basis. These devices are implemented as stove-pipe applications, communicating only with the monitor to which it is connected, with no plug-and-play interoperability. The ISO 11073-Point-of-care Medical Device Communication Standards defines a set of standards to enable medical device communication.  NIST collaborates with the IEEE 11073 Working Group, the Integrating the Healthcare Enterprise’s (IHE) Patient Care Device (PCD) domain effort and others in the medical device community by developing conformance tests and tools that will be used by vendors to improve medical device implementations.  NIST researchers will demonstrate IEEE 11073 testing capabilities developed to date.

Topic: HLPR Chair – A patient-Assist Device Toward Independent Mobility

Description: The HLPR Chair is a patient-assist device to provide independence for wheelchair users such as the elderly, stroke victims, and others who are currently immobile.  HLPR was designed to relieve the heavy burden on insufficient numbers of nurses and other caregivers who lift and position patients and to decrease the 30% rate of back injuries among nurses.  This back injury rate is the highest among all occupations, including construction.  HLPR therefore, can provide independence to current patients who cannot work due to immobility, who cannot reach high shelves from a wheelchair, who cannot rotate their bodies to access target items, etc.  HLPR can lift a patient one meter to reach high shelves, it can mobilize a patient like a powered chair, and it can rotate a person to pick-up or place them onto a chair, bed or toilet.  Intelligence can also be built into the HLPR to perhaps allow even longer independence for Dementia and Alzheimer Disease patients.  As there is no other system like HLPR, NIST will work to advance design and safety standards for intelligent-lift-wheelchairs and provide performance metrics and technology advancements for these future devices.

Description: Modeling and Simulation

• Disaster Management
  
• Modeling of bones using 3D laser scanning
• Interoperability issues between healthcare systems and simulation
  
• Facilities improvement through simulation

Topics:

• Healthcare informatics
• Medical device

Descritpion: Healthcare informatics deals with all the processes or “software” of the healthcare enterprise: modeling and simulation, design and production, biosurveillance, manufacturing and its associated supply chains, and information and data management both in clinical practice and biological research. Medical devices deal with all the products or “hardware” of the enterprise: the characterization, design, manufacture, testing, and metrology of medical devices at scales ranging from large equipment to nano-scale drug delivery mechanisms.
The healthcare industry is facing major challenges: increasing costs, unacceptable error rates, and dissatisfied patients and providers. Healthcare costs in the United States were about 14.9% of the GDP - $1.6 trillion - in 2002 , estimated to be 1.9 trillion in 2005  and projected to rise to 3.6 trillion by 2014.1 These costs are also a major concern for U.S. industry, as escalating healthcare costs are impeding our ability to globally compete.  According to a February 11, 2005 issue  of the Washington Post, General Motors spent $5.2 billion on healthcare in 2004 for its employees, retirees and their families. These healthcare expenses added $1,500 to the price of each GM car. Other U.S. automobile manufacturers face similar costs.

Topic: The SAGE NIST ATP Project

• Project objectives
• Accomplishments
• Samples of work 

Suzanne Joyce
Allen Pomerantz
Kevin Machon

suzanne.joyce@techguardsecurity.com
allen.pomerantz@techguardsecurity.com
kevin.machon@techguardsecurity.com

Topic: Secure Trusted Web Portal for Personal Wellness Records

Description: Utilizing technology developed from NIST ATP funded research and secure web portal technology developed for the defense industry a trusted web site to store personal wellness information.  Security first is the basis for such a web portal.  The technology can be applied to web portals that not only used by individuals for storing their personal health records, but can also be used for healthcare providers and research institutions.

Rajeev Sharma
CEO & Founder
Mr. Satish Mummareddy
VP Engineering & CTO
Ingmar Rauschert
Director of Interfaces Research

Topic: Personalized Multimodal Interface Platform (PerMIP) for people with severe communication disabilities

Description: Without access to functional speech, handwriting, and computer technologies, individuals with severe communication disabilities are significantly restricted in all domains of living, namely educational, vocational, personal well being and social interaction. Concerns with the inefficiency of existing access techniques however, led to the identification of new requirements for access technology, which include the ability to distinguish between communicative gestures and non-communicative movements, the ability of the systems to accommodate a wide range of users and postures, and most importantly the ability to be “untethered” (which addresses both usability and social acceptability issues).

This work introduces the concept of a Personalized Multimodal Interface Platform (PerMIP), which enables the use of a variety of body gestures and vocal modalities in a “personalized” manner based on individual preferences and capabilities. The Personalized Multimodal Interface Platform uses a sensor suite that enables a large number of vision and audio processing modules to be implemented. The PerMIP platform addresses challenges in computer vision, audio sensing, multimodal fusion and interface design to enable a multimodal interface that can be personalized for an individual. An overview of currently implemented sensing modalities and different personalization modules is given that can semi-automatically match the needs of individual users.

Topic: Obje™ - A Middleware Framework for Radical Interoperability

Description: The Obje™ software architecture is an interconnection technology that enables digital devices and services to easily interoperate over both wired and wireless networks. It provices a simple "meta standard" for interoperation that enables people to access information and services from anywhere, in a completely hassle-free, ad hoc manner.

Devin Williams
CEO
Holly B. Jimison
Senior Research Scientist
Misha Pavel
Senior Research Scientist

devin@sprylearning.com

Jimisonh@ohsu.edu

pavel@bme.ogi.edu

Topic: Game Technology for Cognitive Monitoring and Remediation

Description: Spry Learning researchers will present their work on developing and testing a set of computer games to both monitor and potentially remediate cognitive performance.  This project involved performing a needs assessment to determine the types of games that elders would enjoy on the computer.  We also performed a cognitive assessment of existing games to determine which activities could best be used to extract cognitive measures that would correspond to standard neuropsychological tests.  Based on this feedback, we developed a suite of 8 adaptive computer games with embedded cognitive assessment algorithms.  At this poster, we will demonstrate the computer games and our tools for analyzing our cognitive metrics.  We currently have 30 subjects enrolled in an evaluation of these games where we will compare our cognitive measures based on these games to the subjects' scores on standard neuropsychological tests.

Bill Reed 
Bill Cote

reed@elitecaretech.com 
bcote@elitecaretech.com

Topic:

1. Active relationship based care through technology
2. e-establishing the adult children’s role as primary caregiver through the use of sensors and connectivity

Description: Elite Care Technologies has taken the knowledge and insights that it has gained from five years of development and created a comprehensive multi layer platform that uses many diverse technologies to create a relationship based network where all of the participants are connected through a common data stream of pertinent information.  This transparency and real-time data allows for a uniform delivery of a common agreed upon plan of action between all stakeholders. Elders stay in their home longer, require less professional services, and traditional non-paid caregivers are given the ability to resume active participation in their love ones care. Additionally, when the elder moves to a facility the longitudinal data stays with them allowing them to only move once.

Topic: Technology Interoperability Demo

Description: This is a demonstration of an elderly person living at home needing health care and monitoring.  One of the goals of Intel’s Digital Health Group is to enable elder adults to live independently for a greater period of time through the use of technology.  By connecting vital sign measurement devices (e.g. weight scale, blood pressure cuff) to technology elements that can process information and notify appropriate individuals (elders, remote family caregivers, health care professionals) of important events, care can become more preventative rather than reactive.  Interoperability of the devices in this emerging ecosystem (medical devices, display devices, computers, cell phones) will be critical if we are to achieve this vision.

Topic: Quality of Life Technology Center (QoLT)

Description: The Quality of Life Technology Engineering Research Center (QoLT ERC) will transform lives in a large and growing segment of the population - people with reduced functional capabilities due to aging or disability. Future compassionate and intelligent QoLT systems that range from individual devices to technology-rich environments will monitor and communicate with people, understand their needs, and provide safe, reliable and welcome assistance by compensating or substituting for diminished natural human capabilities.

Our research will build upon sensing, perception, robotics, machine learning, communications and miniaturization technologies that to date have been applied predominantly in manufacturing, the military, and entertainment. We will combine them with advances in rehabilitation and geriatrics to develop new capabilities to improve lives. Most importantly, we will create a new scientific and engineering knowledge base that enables systematic development of human-centered intelligent systems.

Topic: Research produced by CAST task group volunteers

Description: The Center for Aging Services Technologies (CAST) is leading the national charge to develop and deploy technologies that can improve the aging experience in America. CAST has four focus areas:

1. Driving a national vision of how technologies can improve the quality of life for seniors while reducing healthcare costs
2. Accelerating technology R&D pilots with seniors to fulfill this vision
3. Advocating to remove barriers to the rapid commercialization of proven solutions
4. Promoting national dialogue about standards to ensure interoperability and widespread access to aging services technologies.

Established in 2003, CAST has become a national coalition of more than 400 technology companies, aging services organizations, research universities, and government representatives.

Topic: Ambulatory Monitoring of Older Patients Undergoing Rehabilitation

Description: Chronic diseases and falls are leading causes of hospitalization among the older community aged over 65 years. To investigate the feasibility of ambulatory monitoring for clinical purposes, a clinical trial was conducted in a rehabilitation ward of a major Brisbane hospital, over a period of 14 weeks. Fifteen post-stroke patients were fitted with 2-axis accelerometer devices to monitor movement and falls. Monitored movement and falls data were analyzed to extract activity classification and derive a framework for gait analysis in order to study mobility factors that may contribute to falls. The results of the study have the potential to provide daily activity profile and gait assessment of a patient at various stages of rehabilitation, and also indicate when he or she has fallen. Such information of mobility assessment of patients can be used as indicators of rehabilitation assessment during their stay in hospital and/or community healthcare settings.

Paul Larson
Dina Amento 

Description: "Health Politics with Dr. Mike Magee" is a weekly Internet-based electronic media program that explores complex topics at the intersection of health care and policy. Supported by veteran health leader and media expert Mike Magee, M.D., the program examines the hidden stories and emerging trends that are rapidly reshaping our health care system. As a passionate advocate for patients and their families, Dr. Magee strives to help his viewers understand the big picture of how our health care system works and how it affects their lives – offering, along the way, practical advice on what we need to do to make the system work more effectively for all of us.

Topic: Geoscience Interoperability for Supporting Public Health

Description: The presentation introduces research, development, and applications of utilizing geoscience information to support various public health applications, including air quality, west nile, dust storm, and other applications. Interoperability plays a key role in achieving these activities.

Alan M. Letzt
Executive Vice President

Stephanie Paula Letzt

Alan.Letzt@healthcare.volcollect.com

stephanie.letzt@healthcare.volcollect.com

Description: AccuNurse is a voice activated system that enables nursing staff in long term care organizations to listen to their care plans, document care by voice and communicate effortlessly with each other. Our presentation will demonstrate how AccuNurse enables data to be recorded and transformed to text using advanced speech recognition technology then transferred to a secure AccuNurse web site that includes the minimum data set (MDS). This web site is linked to clinical software that transfers the MDS data to the Centers for Medicare and Medicaid Services (CMS).

Topic: The Caring Home Study – An Evidentiary Study of QuietCare

Description: The Caring Home Study systematically examines the impact on care provision of non-intrusive home telemonitoring in a variety of residential settings. Findings from this initiative have resulted in nine articles/book chapters and over 30 presentations at national and international meetings and conferences. These findings are the key contributors to the refinement of BII’s existing intellectual property, the development of new technologies and its ability to continue to offer meaningful advice to companies that want to remain on the cutting-edge of the informatics revolution.

• Care Providers
• North America
• New York—Selfhelp
• Pennsylvania—Keystone Home Health, Messiah Village
• Minnesota—Ecumen
• Europe
• England—Hyde Housing, Oasis
• the Netherlands
• Germany
• Between 250 and 300 installations/clients
• Study periods ranging from 6 to 12 months
• Started January 2006
• Ending December 2007
• Evaluation of QuietCare as caregiving tool
• Impact on well-being of individual clients
• Role of family members in care provision
• Response to urgent alerts
• Influence of long term trend information
• Use of behavioral records by caregivers
• Examination of effect at organizational level 
• How integrated into care provision model
• Effect on staff efficiencies
• Use as supervisory tool
• Ability to generate new sources of revenue       

Self-help Study of QuietCare: High Tech Help for High Touch Care

• Integration into Care Provision Model
• Additional source of timely information
• No dramatic change in normal routine required
• Fully web-based
• Email alerts
• Ability to access details with click of a mouse
• Alerts Triggering Action
• Emergency response
• Urgent needs addressed
• Hidden problems revealed
• Communication increased
• New information on client needs and attitudes
• Enhanced discussions with clients’ family
• Long term trend
• Ability to examine subtle changes in behavior
• Behavioral records created

Behavioral Informatics Inc: Information Management Periodic Automated Case Summary (imPACS)

• Integrate Information for Caregiving
• Quality Assurance
• Customized for Individual Care/Business Models

Topic: Impact of passive health status monitoring on the cost-of-care

Description: We will present the results of a case-controlled study to assess economic impact of passive health status monitoring technology in an assisted-living facility.  Passive monitoring systems were installed in the assisted-living units of 21 residents to track physiological parameters, the Activities of Daily Living (ADLs) and key alert conditions.  Professional caregivers were provided with access to the wellness status of the monitored residents they serve.  The monitored individuals’ cost of medical care was compared to that of an age, gender and health status matched cohort.  Similarly, efficiency and workloads of professional caregivers providing care to the monitored individuals were compared to those of caregivers providing care to the control cohort in the control site.  Over the three-month period of the study, a comparison between the monitored and control cohorts showed significant reductions in billable interventions, hospital days, and estimated cost of care.  The results demonstrate that monitoring technologies have significantly reduced billable interventions, hospital days and cost-of-care to payers, and had a positive impact on professional caregivers’ efficiency.