Wearable Computing and Personal Medical Systems

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Wearable Computing and Personal Medical Systems

• Sandra Woolley
• http//www.eee.bham.ac.uk/woolleysi
• S.I.Woolley_at_bham.ac.uk
• Electronic, Electrical and Computer Engineering

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Wearable Computing

• Wearable, hand-held and portable technologies are
  pervading aspects of our everyday lives. The
  presentation will review wearable and pervasive
  computing research directions, challenges and
  applications, and a look ahead at new potentials
  in personal medical devices.
• Starting with the original ubiquitous computing
  visions of Mark Weisner considering
  applications and their accompanying challenges.
  For example, aesthetics, function, usability,
  and, security and privacy.
• Wearable computing project examples from the
  Pervasive Computing and Human Interface
  Technology Research based at the University of
  Birmingham and elsewhere. Including new personal
  medical devices.

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Contents

• From the beginning personal and wearable
  information technology and what people will
  wear.
• Wearable and ubiquitous computing.
• Design issues and research questions.
• Sensors, communications, context and privacy.
• Example of wearable computing and personal
  medical devices.

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Towards Personal Information Technology
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Personal Portable Information

• Cuneiform - the first form of writing predating
  Egyptian hieroglyphs.
• The first personal and portable information
  technology?
• Legal documents, statements of freedom,
  record-keeping.
• www.cuneiform.net
• A collaborative project, headed by Assyriologist
  Dr Alasdair Livingstone, between The University
  of Birmingham and The British Museum.

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Wearable Information - The Wristwatch

• A wristwatch was a womans jewellery item before
  WW1 made it a useful piece of wearable
  technology.
• Pocket watches were clumsy to carry and thus
  difficult to operate while in combat.
• Soldiers came home wearing trench watches and
  the feminine perception of the wristwatch was
  gone forever.

• Above The WWI Soldiers Kit and WW1 wristwatch
  from Umstead Collection
• Top Righthttp//www.207squadron.rafinfo.org.uk/ww
  1/1918.htm
• Bottom Right Sittingborne http//www.pigstrough.
  co.uk/ww1/

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What Will/Wont People Wear?

• What will people wear?
• What wont people wear?
• Clothes and accessories must be acceptable to the
  society/culture.

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Aesthetics

• Notions of ideal shape and ideal beauty vary
  dramatically over time and between cultures.

Above http//www.uihealthcare.com Top left - A
veiled Iranian woman wears a traditional dress as
she smokes a water pipe Photo Hasan
Sarbakhshian Top right - Jodie Kidd
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Geek Cool?

• Aesthetics of wearing technology?
• Does my RAM look big in this?
• (Eurowearable keynote speech)
• Most people dont want to look silly even we
  didnt want to wear our own prototype in public!
• But is wearing technology a geek thing anymore?

Microsoft Fashion 2000 http//www.microsoft.com/
presspass/features/2000/Dec00/12-11fashion.mspx
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The Geek Age

• The Levi/Philips ICD MP3/Phone Jacket was an
  early TechVest project.
• The ScotteVest is a large range of commercial
  jackets that support the integration of everyday
  portable electronics. Routing for cables, up to
  52 pockets and even models with solar panels.

www.scottevest.com/ www.thinkgeek.com
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Towards Wearable Computing
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Pervasive/Ubiquitous/Wearable/Embedded?

• Pervasive or Ubiquitous computing labels are
  often used interchangeably.
• Wearable computing significantly overlaps with
  these but specifically includes subjects like
  smart textiles, and fashion. The sort of
  computing that might have been called personal
  computing.
• Mobile computing is an essential requirement for
  all the above.
• Embedded systems, being systems (other than
  general purpose computing systems) that have
  added processor intelligence, therefore include
  wearable computing systems.

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Mark Wesier and Ubiquitous Computing

• The father of ubiquitous computing.
• His ideas were summarised in a Scientific
  American article, The Computer for the 21st
  Century.
• He described ubiquitous computers of different
  sizes which he called tabs, pads and boards
• Tabs - post-it scale
• Pads - paper or book scale
• Boards - blackboard scale.
• He suggested that rooms might contain hundreds of
  computers.
• He also thought that mobile devices would need 3
  types of communications, tiny-range wireless,
  long-range wireless and high-speed wired.

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Progress Toward Wearable Computing

• A weight/visibility spectrum of computing
• Decreasing size gtgtgt Increasing mobility gtgtgt
  Decreasing visibility/noticeability
• Room computer desktop luggable portable
  palmtop handheld embedded wearable
  invisible?

Alex Bilstein holding the first "luggable"
computer, the 1981 Osborne 1 photo by Jana
Birchum Flexible screen technology developed by
Universal Display. Toshiba's 0.85 inch hard disk
drive can store 4 GB of data.
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Mobility and Usability

• Computing and communications dont naturally suit
  mobility.
• New physical interfaces beyond the
  keyboard/keypad and mouse are needed.
• And new software interfaces beyond WIMP (Windows,
  Icons, Mouse, pointer) are needed also.
• Keeping users mobile and task-focused presents
  interesting challenges.
• The new motorway signs THINK DON'T PHONE WHILE
  DRIVING are a sign of the time.

Left top TINMITH2 - the mobile research AR
platform developed at the Wearable Computer
Laboratory in the University of South Australia.
Above middle wearcam.org and right Chris Baber
at Birmingham
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Mobile Technology and Solutions

• New, and sometimes simple, ideas can make
  mobility easier.
• And there are some useful new technologies and
  products.
• Wireless communications, e.g., Wi-Fi, bluetooth,
  sensor network
• Smart phones and 3G
• RFID tagging technology
• GPS SATNAV, TomTom GO

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Arent we nearly there?(and what are the
research questions)
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So Arent We There Yet?

• With so much existing technology and research
  activity,
• arent we nearly there? Is it just a
  technology race?
• Is the cleverness in putting good technologies
  together?
• Or better still
• connecting cooperating technologies with
  people and the things they do.
• An example, from The Media History Timeline
• 1565 The graphite pencil
• 1770 The eraser
• 1858 Eraser fitted to the end of a pencil

A carpenters pencil - the oldest known pencil
found in the roof of a 17th-century German
house. Photo Sandra Suppa, FABER-CASTELL GmbH
Co., Germany
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Design Issues
System-Centred Design Networked/wireless
communications Hardware and software
specification Interfacing Performance and
security Power consumption

• User-Centred Design
• Task analysis and user requirements
• User interface design
• User privacy issues
• Usability and formal testing
• Success in action

• Universal-Centred Design
• (Uncentred Design)
• Ways for experts, users and others to make use of
  new and large data sets.
• Expanding human knowledge

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Research Questions

• System-centred research question
• How can sensors, systems and data interact and
  combine or synergise?
• User-centred research question
• How can users manage and interpret all this new
  information?
• Uncentred research question
• How can all this new information more widely and
  usefully inform human knowledge?

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Wearable Systems Functions

• Examples of basic functions of wearable computing
  systems.

• Sensing
• Enabling sensing of environment or people in the
  environment.
• E.g., Activity monitoring, chemical sensing,
  position, vital signs.
• Possibly providing context-awareness or
  ambient-intelligence using combined sense data.
• But what about privacy?

• Informatics
• Local and/or remote display and visualization of
  information.
• Could be locally or remotely sensed, created or
  retrieved.
• Potential to generate vast amounts of data.
• But how can data be made useful and useable to
  users, systems and beyond?

• Information Giving
• Mobile access to a static or dynamic database of
  information.
• Possibly interactive.
• Possibly adaptive.
• Possibly personalizable.
• But what about interfaces?

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Communications, Sensors, Context and Privacy
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Personal Area Networks

• IEEE 802.15 - Wireless PAN (Personal Area
  Network) Standards.
• Wi-Fi (IEEE 802.11b and g) and Bluetooth (IEEE
  802.15.1)
• Sensor area networks (IEEE 802.15.4) and Zigbee
  for low-power short range wireless
  communications.
• Challenges in design and management of
  communications in mobile multi-sensing systems
  interacting with other mobile multi-sensing
  systems and in multi-sensing environments.

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Sensor Examples

• Location via GPS, GSM cell, wi-fi/ network
  signal, acoustic, etc.
• Proximity RFID tags
• Movement Accelerometers, tilt switches,
  gyroscopes
• Environmental toxins
• Health Basic vital signs, Glucose (Biosensor)
• Smart Spaces can be created from environments
  with embeded networks of sensors.
• Smart Dust projects use the smallest sensors
  and computing/communicating chips
• A biosensor uses biological materials to monitor
  the presence of various chemicals in a substance.
  
• The most widespread commercial biosensor is the
  blood glucose biosensor, that uses an enzyme to
  break blood glucose down. In so doing it
  transfers an electron to an electrode and this is
  converted into a measure of blood glucose
  concentration.

Berkeley Engineering News Nov 2003, SMALL
PACKAGE The wireless mote integrates radio
frequency communication onto a sensor processing
chip just five square mm in size.
Glucose Biosenor detail www.strath.ac.uk/bioeng/
pg-info/engd/pics.html
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Context Awareness and Ambient Intelligence

• Connecting sensor data can help determine
  context.
• This can be useful in reducing/avoiding
  task-distracting interfaces.
• But What do we talk about when we talk about
  context?
• (P. Dourish, PUC 2004)
• Sensor information in the environment can create
  ambient intelligence.
• Context Detection with Hidden Markov Model
  Analysis of on-body accelerometer sensor data
  (A.Schwirtz _at_ Birmingham).

Left Emma Maceys One Thousand Suspended
Moments Right Accelerometer Context Detection
(A. Schwirtz)
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Privacy and Security

• Issues of digital and pervasive privacy and
  security are active areas of debate and research.
• Privacy is dead, deal with it, Sun MicroSystems
  CEO, Scott McNealy.
• Excerpts from Privacy The Achilles heel of
  Pervasive Computing M.Satyanarayanan
• (Editorial of IEEE Pervasive Computing Magazine
  on special issue on Security and Privacy, 2003.)
• Privacy and security are already thorny problems
  in distributed computing.
• Inherent conflict between the goal of a
  knowledgeable sensing environment with minimal
  interface requirement and a ubiquitous, shared,
  multi-user space where trust boundaries represent
  seams of discontinuity.
• Unease associated with pervasive computing
  systems might involve location tracking and
  smart spaces monitoring user locations and
  activities on an almost continual basis.
• New pervasive computing infrastructures must
  expect new classes of malicious software.

Top (c) Chuck Painter/Stanford News Service-
Ralph Merkle, Martin Hellman, Whitfield Diffie
(1977) - defined a system of safe key
exchange Middle Adi Shamir, Ronald Rivest und
Leonard Adleman - creators of RSA (used in PGP)
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Examples of Wearable Computing
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Early Wearable Computing Projects

• Early wearable computing work by Boeing to
  provide hands-free support for aircraft
  construction workers.
• Steve Mann and Thad Starner pioneered wearable
  computing at MIT, e.g., MIThril a context-aware
  jacket platform with health applications.
• MITs Affective Computing group also explore
  emotions and computing.
• The Galvactivator is a glove-like wearable device
  that senses the wearer's skin conductivity and
  maps its values to a bright LED display.
  Increases in skin conductivity across the palm
  tend to be good indicators of physiological
  arousal

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Pervasive Imaging - Steve Mann

• Steve Mann _at_ Toronto. Pervasive imaging and
  free-thinking.
• Recommend reading his Leonard paper Existential
  Technology and visiting wearcam.org and
  www.eyetap.org

Wikepedia Sousveillance as a situationist
critique of surveillance. This wearable wireless
webcam imitates surveillance cameras common in
casinos and department stores.
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HIT Pervasive Computing _at_ Birmingham

• Pervasive Computing
• HIT - Human Interface Technology
• Prof Bob Stone, Chris Baber, Theo Arvanitis
• and
• James Cross, Anthony Schwirtz, James Knight, and
  many more

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Pervasive Computing _at_ Birmingham

• Building from an embedded PC104 trial at an
  archaeological dig near Rome.
• This early prototype was just the first in a
  series of systems developed by Dr James
  Cross (right).
• Wearable computing for field archaeology proved a
  very interesting application involving precise
  evidence recording in limited time.
• Another Birmingham project is a forensic scene of
  crime project where wearable/pervaisve computing
  aids crime scene report writing.(P. Smith, C.
  Baber, S.Woolley, J.Hunter)

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3D, VR and Augmented Reality _at_ Birmingham

• Pervasive Computing - computing situated in the
  real world.
• Virtual Reality - ourselves situated in unreal
  world.
• Augmented reality - a bit of both. Mapping
  virtual (context-informed) information onto
  reality.
• Prof Bob Stone - 3D and VR - Serious Games
  Apllication of game engine technology.
• Defence, marine and medical applications.
• E.g., Ship pilot trainer Battlefield surgery
  trainer.

Bob Stone - Professor of the new Human Interface
Technology Group.
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Pervasive Computing _at_ Birmingham

• An increasing range of wearable, pervasive,
  medical, 3D, VR and augmented reality projects.
• Wearable projects in particular focus on best use
  of sensor data to reduce/automate interaction
  yet avoid wearing the Microsoft Clippy
  (C.Baber)
• Wearable Computing Conferences
• IEE Wearable computing symposium, IEE Savoy
  Place, London
• Wearable Computing Workshop, HP, Bristol
• IEE Eurowearable03 _at_ Birmingham

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WEARME _at_ Eurowearable
Example of smart textiles Self-ironing shirt,
Self-cooling jacket, Self-scented dress .

• Puddlejumper Elise Co / MIT Media Lab
• Puddlejumper is a luminescent raincoat that
  glows in the rain. Hand-silkscreened
  electroluminescent lamps on the front of the
  jacket are wired to interior electronics and
  conductive water sensors on the back and left
  sleeve. When water hits one of the sensors, the
  corresponding lamp lights up, creating a
  flickering pattern of illumination that mirrors
  the rhythm of rainfall.

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CyberJacket

• Wearable Computing _at_ Bristol
• CyberJacket
• A heavy duty Hein Gericke jacket for use in the
  field. Equipped with a CardPC, dGPS and GSM
  'phone. User interface is audio (speech
  recognition TTS) and/or a Jornada hand held
  display.
• BlazerJet
• For the busy man (or woman) about town,
  BlazerJet is equipped with CardPC, GPS, GSM
  'phone, a novel Pinger receiver and both the
  audio interface and a Jornada 420 palmtop. 

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Examples of Personal Medical Systems
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SensVest

• C.Baber, A.Schwirtz and J. Knight 
• The Lab of Tomorrow EU project (C.Baber _at_
  Birmingham) to enable students to capture and
  analyse activity sensor data.
• Senses temperature Heart rate (ECG) and activity
  via accelerometers.

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AMON - Advanced Telemedical Monitor

• A European project from ETH, Zurich
• Designed to be worn by cardiac outpatients, the
  device allows remote monitoring of blood
  pressure, pulse, oxygen saturation, body
  temperature and 2-channel ECG signals.
• AMON A Wearable Medical Computer for High Risk
  Patients,
• P. Lukowicz, U. Anliker, J. Ward, G. Tröster, E.
  Hirt, C. Neufelt,
• ISWC 2002 Proceedings of the 6th International
  Symposium on Wearable Computers, 7.-10. October
  2002, pp 133-34   

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WEALTHY

• European-funded Wearable Healthcare System
• Aimed at fulfilling the need to continuously
  monitor the patient's vital signs through a
  ground-breaking woven sensing interface to be
  worn without any discomfort for the user.

http//wealthy-ist.com
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Blood Pressure/Pulse Monitors

• Automatic large LED blood pressure systolic /
  diastolic / pulse readout with fuzzy logic.
• Automatic inflation deflation
• 48 sets of memory to monitor your progress plus
  date / time / average pressure
• Requires 2 x AAA batteries.

Tatung http//www.tatung.com/med/product.html
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Wearable Insulin Pumps

• The catheter at the end of the insulin pump is
  inserted through a needle into the abdominal fat
  of a person with diabetes.
• Dosage instructions are entered into the pump's
  small computer and the right amount of insulin is
  injected in a controlled manner.   

Medline Plus
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The Digital Plaster

• A device meant to be embedded in ordinary plaster
  that includes sensors for monitoring
  health-related metadata such as blood pressure,
  temperature and glucose levels.
• The digital plaster contains a Sensium silicon
  chip, powered by a small battery, which sends
  data via a cellphone or PDA to a central computer
  database.
• If the results show any worrisome signs, patients
  and doctors alike would be notified of the change
  in the data patterns. They also plan to add a
  motion sensor to the device so it could
  additionally serve in the role of granny
  monitor by detecting things like falls or
  complete inactivity.

The Toumaz Digital Plaster
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Womens Health

• Pregnancy and ovulation tests.
• A substantial market potential for personal
  health care, but fraught with concerns over
  correct usage and interpretation, and the
  potential for expensive litigation.

2002 BBC news - new Persona legal cases
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Issues of User Self-Testing

• Need to integrate with existing standards.
• Need to be as reliable as possible yet still
  convey level of confidence.
• Do mail order tests cause more harm than good?
• Regarding cancer screening tests, the BMA
  recently reported that false positive results
  and the lack of counselling with results could
  mean that mail order tests cause more harm than
  good.
• Is ignorance preferable to a little knowledge?

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Medic Alerts

• Traditional medic alerts are engraved bracelets
  or necklaces bearing simple and (hopefully)
  recognisable medical icons.
• Important life-critical allergy or other health
  data is engraved on the reverse.
• There is a huge growth in this market with the
  increase in allergies and life-threatening
  anaphylaxis.
• Also an increasing desire of patients to have and
  carry their own medical record information.
• New ideas include USB keyring fobs and a large
  number of Birmingham University student PDA
  creations.

www.MedicalTags.co.uk
www.MedicAlert.org
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Medic Alerts (A Simple Example of Scope)

• Remembering the pencil and eraser example
• can we better connect cooperating sensing,
  computing and communicating technologies with
  people and the things they do?
• There still seems lots of scope for research, for
  improvement, and for new products in wearable and
  pervasive computing. Particularly, well
  connected cooperating systems.
• And particularly in personal medical devices.

www.MedicalTags.co.uk
www.MedicAlert.org
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Thank You

• Sandra Woolley
• S.I.Woolley_at_bham.ac.uk
• http//www.eee.bham.ac.uk/woolleysi