SIEMENS

So, that’s it,” says Sigrid Gorn, 83, who’s sitting in a chair in her living room looking at the display of a blood-pressure reader on her wrist. On her TV set she can see the smiling face of Malte Cornils, a computer scientist at the Telemedicine Center in Berlin’s Charité Hospital (TMCC), who is in touch with her through a video link. “Everything’s OK,” Cornils says. “I’ve received your blood pressure and pulse readings.”

Gorn is one of 35 senior citizens in Potsdam who participated in a field test of assistance systems for the elderly. The technologies that were tested in the roughly 50-day trial are part of the “Ambient Assisted Living” program (AAL), a part of the SmartSenior@home project funded by Germany’s Federal Ministry of Education and Research.

The project has 28 participating partners from industry, research institutes, and medium-sized businesses. “There’s never before been an AAL project on this scale and with so many partners in Germany,” says Michael Balasch, the coordinator of the SmartSenior project and Research & Innovation Director for Health at Telekom Innovation Laboratories (T-Labs). “The project’s overriding goal has been to move away from isolated solutions and develop a standardized AAL platform. Another key target is to ensure affordable AAL and telemedicine solutions for seniors through a system of open standards.”

The “SmartSenior@home” project was carried out under the direction of Dr. Mehmet Gövercin, Head of the Technology and Aging working group at Charité Hospital. Gövercin was responsible for presenting the project plan to an ethics commission; once the clinical study was approved, work was able to begin. After passing the final product inspection phase, the project’s technologies were installed in 35 apartments and the participating seniors were taught how to use them.

One of the devices tested in the project was a wristwatch developed by Dr. Asa MacWilliams and his team at Siemens Corporate Technology (CT). The watch notifies users if, for instance, they have left the apartment and forgotten to shut a window or turn off the lights. The test subjects were even able to use the watch to shut off lights in their apartments as long as they were located within the range of their home WLAN system. The watch did this by sending a command to an AAL Home Gateway provided by T-Labs that was placed behind the TV in each participant’s apartment. The signal was then forwarded to the home systems control unit.

Also tested were two gas sensors from CT that measure volatile organic compounds in the air. These sensors were installed in Gorn’s bedroom and study. The goal of this test was to determine whether gas sensors can provide information on activities occurring in the apartment — e.g. whether a senior is cooking, or if rooms are occupied when visitors have arrived. Such information can be useful for ensuring energy-efficient ventilation and climate control systems, for example. Special software in the AAL Home Gateway collected and analyzed the sensor data in the test. “If seniors are to accept the system, the sensor data should normally stay in the apartment,” says MacWilliams. In other words, an ambulance should be called only in potentially dangerous situations or if the user’s behavior changes.

Although the sensors in the apartment were so well hidden as to be practically unnoticeable, the test subjects’ living rooms were packed with technology. Behind Gorn’s TV, for example, were four different data transmission and communication boxes; the camera for video transmission was placed to the right of the TV. Also installed was a special service portal that allowed users to access various applications. Gorn used the “Health” and “At Home” features most frequently. The “Health” function enabled her to transmit blood pressure, weight, and ECG readings directly to the TMCC, view the information herself on a display, and videoconference with TMCC staff.

“At Home” gave her a direct link to her building management company if she needed to do things like get a light bulb changed, order food, or make purchases that were then delivered. The “At Home” function also displayed sensor data and information about energy and water use. Participants in the test could choose between a conventional remote control or a small Web pad with a touchscreen to access the portal and use its features. Gorn clearly liked the touchpad best. “I only use the remote control to adjust the volume on the TV,” she says. “I like the pad because it’s small and easy to read.”

A blood pressure reader and a scale were also put in Gorn’s living room, and the first ten test subjects were issued a mobile ECG device about the size of a smartphone. All of these devices sent their data via a wireless Bluetooth connection to the “Med-I-Box,” which then forwarded it to the TMCC using a new standard for telemedical transmission of vital data (ISO 11073). The TMCC stored the medical data in electronic patient files.

The purpose of all this was not to derive medical treatments from the data but instead to see if the measuring and transmission devices would operate smoothly.

Home Dialysis. Other SmartSenior studies that ran parallel to “SmartSenior@home” did focus on treatment. For example, Telemedically-Assisted Peritoneal Dialysis (TAPD), for example, uses a specially developed system that helps dialysis patients clean their blood at home. Many such patients have to go to a dialysis center several times a week and get hooked up to an artificial kidney by clinic personnel for several hours in order to clean their blood. Peritoneal dialysis (PD) offers an alternative by enabling the patient’s peritoneum, which is located in the abdomen and has good blood circulation, to be used as a blood filter. Patients who utilize PD systems connect themselves every day via a catheter to a type of circulating pump known as a “cycler.” The pump moves a sterile rinsing fluid back and forth from a small bag to the peritoneum. The advantage here is that the dialysis process can be carried out comfortably overnight and patients only have to visit a kidney specialist for monitoring once every six weeks.

“PD is the ideal method for older immobile patients who would prefer to be cared for in their own homes,” says Dr. In-Hee Shin, a nephrologist associated with the Vivantes Clinic in Berlin. “The problem is that many seniors are wary about carrying out PD at home because the systems lack any software to guide them and explain how to use it.”

With this in mind, Corporate Technology in Munich developed a PD assistant for smartphones in a project directed by Evelyn Pfeuffer. TAPD has now been tested with the PD assistant for the first time with a patient in Berlin. On the morning after the PD is conducted, the software guides the patient through the measurements of vital signs such as blood pressure, blood sugar content, and weight. After that, the patient answers questions about his or her physical state on a multiple-choice questionnaire, describes the color tone of the exchanged cleansing fluid, and describes the condition of his or her artificial opening. The patient then sends all of the data via the Internet in encrypted form to the TMCC and the dialysis center at the Vivantes Clinic, where it’s automatically checked against stored emergency values for plausibility. “I look at the readings once a day and can make quick treatment decisions should that become necessary,” Dr. Shin explains.

Gorn is doing so well that she does not need dialysis. Nonetheless, she might soon experience trouble walking, because she has two artificial knee joints. That’s why she’s taking part in a SmartSenior study that addresses stroke rehabilitation and measures for preventing falls. Technicians have placed a Kinect sensor in front of Gorn’s television. Her screen now shows a “virtual trainer” who guides her through various exercises that are important for her well-being. The Kinect sensor and a video camera monitor her as she does the exercises — and the screen shows her immediately whether she’s doing them right. All of Gorn’s movements are transmitted to the Hospital as well. Her caregiver there not only sees whether she’s doing her exercises regularly but also how much progress she’s making.

“That was fun,” says Gorn. “If I can find the time, I’d like to keep doing it even after the project is over.” In her opinion, participating in the project was an interesting experience. “But I don’t need this technology yet,” this busy 83-year-old also points out. She’s got a lot to do, because 180 members of the local tax assistance organization are waiting to receive her advice — and there’s also the garden to tend to and grandchildren to see, among many other activities.