Towards Patient-Centric Telehealth: a Journey into ICT Infrastructures and User Modeling

Daniel Bjerring Jørgensen

Research output: ThesisPh.D. thesis


Problem setting: The problem setting for this thesis is the telehealth domain. Telehealth is addressed from two perspectives: ICT infrastructures and personalized telehealth. ICT infrastructures are addressed on both the local level concerning the systems that are deployed in patients’ homes, and on the national level concerning the transmission of data in end-to-end infrastructural scenarios. Personalized telehealth concerns the design of telehealth systems that are able to fit the everyday life of their patients.

Problem and Research questions: The problem setting was formalized in a principal research question: “How can an ICT infrastructure for the local level of telehealth facilitate flexible sensor and application networks, while enhancing the applications abilities to understand the telehealth patients and their activities of daily living?” The principal question led to three sub-questions, which guided the thesis’s work:
• Which paradigms and techniques can be applied to satisfy the infrastructural requirements set forth by the Patient@home project?
• How to model telehealth patients in an ICT infrastructure for the home setting?
• How to understand and learn a telehealth patient’s everyday behavior?

Results: A draft of an ICT infrastructure, intended as a research platform for telehealth applications, has been implemented. Integration to the ICT infrastructure is easily achieved through an ontological framework, provided by an agent-based façade library. User modeling is employed to store and process data sent to the ICT infrastructure by relevant applications. The user model contains two activities of daily living reasoners. They can identify the patient’s behavioral patterns and predict the patient’s next activity. Regarding the national ICT infrastructural level, a survey to identify the state of the art was conducted. Discussions are provided of the advantages and disadvantages of the Continua framework (the foundation of the ongoing national initiatives) and how context information can be used and included on the national level.

Conclusions: The agent, ontology and user modeling paradigms were applied to successfully implement a flexible and open ICT infrastructure where telehealth applications can be tested. One such application is the prediction algorithm whose prediction ability is ~70% of a smart home resident’s next activity making it the state of the art in predicting ADL events in the CASAS datasets. New ideas for research directions have been spawned by the ICT infrastructure: tools to strengthen and supporting telehealth patients’ motivation and identification of patterns, if such exist, indicating correlations between changes to a telehealth patient’s behavioral patterns and deterioration to the patient’s health.
Original languageEnglish
Publication statusPublished - 29. Aug 2017

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