Ambient Intelligence and Healthcare
The development of nano-enabled devices in healthcare and Ambient Intelligence
A current development in healthcare is to move from hospital care to home care (care-at-a-distance). Promises of Ambient Intelligence can contribute to the realization of this future vision of healthcare, namely the realization of: “an environment that is aware of our presence and responsive to individual needs.” (Aarts 2003; Rathenau 2004).
An example of a body-area network (source: human ++ program IMEC):
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The patient wears two sensors on his chest that monitor and collect ECG data. These sensors connect to a small device that is worn on the upper arm. This contains a processor that collects the data and makes real-time analysis. When unusual heart rhythm patterns are registered, an alarm goes off. In order to detect unusual patterns, the ECG patch is adjusted for each patient separately.
ECG Patch for early detection of epileptic seizures
In collaboration with a centre for epilepsy, IMEC, nano-electronics research centre, has developed an ECG patch to give early warnings of impending epileptic seizures, based on heart rhythm. Current methods for detection are based on acoustics or patient motions, but these do not detect some severe seizures which are noiseless and motionless. This is something heart rhythm can detect. This is an example of one of the sensors that is part of the body-area network.
This nano-enabled application raises some questions:
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When the ECG patch sends out an alarm, who should respond? Should this be a role for close friends/family, or a volunteer, or a specialized clinic?
- Is the wearing of an ECG patch 24/7 an invasion of privacy? What should the protocol be if the patient should choose to remove the patch for a short time?
- The ECG patch and its alarming system do not currently meet the criteria for “health care instruments”, so Health Insurance companies do not yet reimburse the costs. What should be suitable criteria for health care instruments? What are the implications for medical tools that do not use typical medical technology, but telecom technology such as Wi-Fi and GPS?
We would like to invite you to articulate your questions, concerns and ideas about the embedding of the ECG patch and body-area-networks in general to stimulate care-at-a-distance. Please leave your message below.
debate ended – 5 comments:
Current debate
Microchip technology and ambient intelligence, using nanotechnology, enable patients to wear ECG patches which give early warning of impending epileptic seizures. What are the implications of this?
Lotte Krabbenborg
Science and Society Group, University of Groningen 
iantheschouten wrote:
I have the following questions: how does the patch recognise the right hart-rytm? For example my heart rytm rytm can also changes when I am nervous. When does the patch know that the rytm is connected with a seisure?
And when is it interesting to use the patch? At the moment I am using medicins, but what can be a reason to use the patch?
Than my answer on the question ‘who should respond on the alarm of the patch?’. In my case this would be close friends or family, because they are the one I trust. And when I feel that a seisure is comming I immediately make contact with the people I trust and who I know very well. On the work in can be a collegae that I trust. A volunteer or specialized clinic won’t be my first choice.
dmstandley wrote:
A few years ago I was playing golf with a retired GP who claimed that diagnostic life would be so
much easier if all babies were chipped. He was obviously anticipating devices like these. Then he added an interesting ethical question. Are the devices active or passive? Could they send diagnostic details?
Could a doctorfind out that we were ill without us knowing it? If so, he went on, howmuch closerto adding a GPSsensor to the chip? Who then might want to know the data?
Ivo wrote:
Who is responsible if the ECG patch cannot send an alarm because communication networks are down?
Ivo wrote:
What happens to the data the ECG patch collects? Is it stored? Are alarms stored. Who has access to the data? What happens if the alarm goes of and my relatives/ friends are abroad/ elsewere/ not in reach of a communication device (not everyone always carries a mobile phone, and if so, what happens at night?)
T. Groot wrote:
For English, see below.
Is er al over nagedacht voor welke vorm van epilepsie de patch geschikt is? In mijn situatie zie ik niet snel de toegevoegde waarde, omdat de epilepsie zich bij mij uit in absences en schokjes, maar ik wel gewoon blijf functioneren. (overigens nu volledig aanvalsvrij met medicijnen) Ik vroeg me af of er ook een mogelijkheid is om zelf gewaarschuwd te worden, dat er een aanval aankomt? In dat geval zou het wel nuttig kunnen zijn, omdat je dan kunt zorgen dat je bijv. rustig gaat zitten, van je fiets afstapt o.i.d. Nu tijdens mijn zwangerschap moet ik extra gecontroleerd worden, omdat de kans groter is dat aanvallen terugkomen ivm wisselende spiegel door hormonen en extra bloedaanmaak. Ook in dit geval zou een dergelijk apparaat nuttig kunnen zijn, mits ik zelf gewaarschuwd word, om te voorkomen dat ik bijvoorbeeld zou komen te vallen.
Translation into English by moderator: Has anyone already given it some thought for which form of epilepsy the patch would be suitable? In my situation, I do not see the added value so clearly, because my epilepsy leads to absences and jerks, but I’ll just keep working (though now completely free of seizures because of medication). I was wondering if there is an opportunity for me to be warned that an attack is imminent? In that case, it would be useful, because you can ensure that you sit quietly for example, step off your bike or something. Now during my pregnancy, I should be closely supervised, because the attacks are more likely to come back, because of varying levels of hormones and additional blood production. Also in this case, such an apparatus might be useful, provided that I am warned by it myself, in order to prevent for example, that I would fall over.