Ambient Assistive Health and Wellness Management in the Heart of the City

An increasingly aging population fuels the need for appropriate care and services for the elderly and disabled. Age related diseases such as Parkinson’s Disease (PD), require close monitoring and assessment. A home-based assessment tool, which collects information on people’s hand and finger movements, has been developed. It is intended that movement difficulties such as bradykinesia and rigidity can be identified through the use of this tool. Remote monitoring of this home based tool has the potential to decrease the number of clinic/hospital visits a person with PD requires. Two groups of 10 people took part in an evaluation of this system. One group were persons with PD and the other were without PD. Results showed that 70% of the control group completed the tool within 30 seconds compared to only 30% in the PD group. The tool endeavours to make the assessment of PD more objective.

This work proposes an assistive computerized system using the Arabic language for children with intellectual and learning disabilities (ILD) who are resident at Shafallah Center in Doha, Qatar. The system is flexible and can be used by parents, children and teachers, where they can employ the materials according to specific needs. The contents are developed with the help of special education instructors. The tutorials cover a range of topics on basic concepts of living including simple mathematics and sciences. The animated images used in the tutorials are taken from the children’s environment, so they can feel more comfortable when using the system. After studying the tutorials, children can solve puzzles based on the topics they learned. A simple intelligent greedy algorithm is used to guide children to a solution. Concept analysis are used to extract the main ideas of electronic texts and dialogues, link them with images, sounds and clips, and present them to the children with ILD.

Mobile devices can be used to provide assistance to people with cognitive impairments wherever they go and increase their independence. Due to the limited capacities of the target users and the constraints related to mobile devices, special care must be used when developing software. In this paper, guidelines are proposed to help in designing mobile assistive technologies for people suffering from cognitive disabilities. Examples of these guidelines application are given in the context of MOBUS: a system providing cognitive assistance and tele-monitoring of daily activities.

Assistive technology is becoming increasingly prevalent within today’s ageing society to help improve mobility, communication and learning capabilities for persons who have disabilities, chronic diseases and age related impairments. The effect of using such technology promotes a level of independence in addition to improving social awareness and interactions [1]. As trends in life expectancy increase, the number of age related impairments and chronic disease within the elderly population will also rise. While for some of these conditions there is no cure, with the help of assistive technology, diseases such as Alzheimer’s for example may be effectively managed. Assistive technology within this domain can be used to support activities such as medication reminders, picture dialing phones and clocks to support day/night orientation. This paper presents an overview of the challenges associated with those suffering from chronic disease, in particular Alzheimer’s disease and defines the methodology of how current advances in mobile phone technology and their associated services may be used to alleviate some of the issues experienced by chronic disease patients.

This paper discusses the trial results of a personalised Cardiac Rhythm Management (CRM) system using a smart phone (PDA) and a wireless ECG sensor. The system is used in a trial to record and diagnose abnormal cardiac arrhythmias. This novel approach uses standard mobile phones, off-the-shelf ECG sensors and personalised feedback to the patient when compared to a conventional clinical Holter and event monitor systems. The preliminary results are discussed of an ongoing trial conducted with the Royal North Shore Hospital in Sydney Australia. The results indicate the viability of the system for commercial purposes.

Advancements in telehealth technologies offer health care providers and medical practitioners ever expanding solutions to improve the quality and timeliness of care. As the use of technology increases, corresponding attention needs to be given to bringing care providers closer to their patients. Extended networks of family, friends and healthcare professionals are integral to a successful care plan. Service oriented architectures and Web 2.0 technologies offer an effective approach to integrating telehealth solutions with social networks to create a new and innovative approach for offering patient centric care. These combined solutions offer the patient and the people who form their primary and extended care networks, a means to communicate, interact and adapt as needs and situations change. Enabling new and creative applications will improve the ability for medical professionals to deliver quality care by combining clinical data with a patient’s own "network effect".

The QSHI (Queensland Smart Home Initiative) consortium was established in Queensland Australia in 2006 for the purpose of promoting a model of health care based on ambient living and wellness management. This model was based on the adoption of smart home and intelligent assistive technologies. A technology research and development program was also established to promote independent living, improved quality of life and reduced unnecessary hospital admissions for the frail elderly, chronic illness sufferers and people with disabilities.

The consortium joined the technology industry, care providers, government and researchers to a collaborative Research & Development program to assist people and their families. The first Phase has been completed and on-going streams of research have been established. These included the establishment of a demonstrator Smart Home in a residential retirement and aged care complex in a metropolitan setting in Queensland, Australia.

This paper reports on the development of the model and outlines the project scope and experiences, the outcomes and learnings achieved, and details the planning considerations for future developments.

An Ambient Assisted Living (AAL) environment is an integration of stand-alone assistive technologies, with elements of smart homes, and telehealth services. Successful development of this emerging technology will promote the ability for older people to live independently and age in place. This paper focuses on the socio-technical challenges associated with implementing the AAL market with specific reference to Canada. The strategy used to gather information was a case study design. Market facilitators include the vast Canadian geography, the number of older people living in rural communities, and the development of several provincial initiatives aimed at enabling seniors to remain independent. The principle of universality in Canada’s healthcare system bodes well for these technologies, as AAL has the potential to assist in equalizing services to these communities. Barriers include fragmentation of the market, where in Canada more than 100 different health authorities serve individuals across ten provinces and three territories.

Home care systems need to be personalised to meet individual needs, and must be easily adjusted as the user’s symptoms develop. Care policies (i.e. Event-Condition-Action rules) can be used to specify care services, facilitating changes in the behaviour of a home care system. Context modelling allows a user to specify the trigger and conditions of a care policy, using high-level context rather than raw sensor data. The actions of a care policy are, however, still dependent on the implementations details of actuators. We propose a framework that allows the actions of a care policy to be specified abstractly using human-understandable concepts. The framework takes care of discovering and using specific actuators, hiding the low-level home networking details from ordinary users. It therefore makes personalisation and modification of home care systems more accessible to ordinary users, requiring very little technical knowledge.

The nowadays smart homes run predefined rules, but the user’s desired behaviour for a smart home varies, as his/her needs change over time. To edit the initial rules is a difficult task for a usual user. We propose a control mechanism that allows the system to learn the new behaviour preferences without editing the rules, but responding emotionally to the system’s decisions. In order to capture the emotion reaction we use FaceReader, a tool for facial analyses, adapting it to read three valence levels that work as positive, negative or neutral feedback. The results in training a MLP neural network to learn the preferred behaviour from the user’s emotional reaction are discussed. Ontology is used in order to describe the context.

This paper deals with the problem of personal localization and guidance in indoor environments. The authors analyze different technologies which can be applied to this task. The goal is to provide users with the most accurate and reliable technology depending on users’ profile. Indoor location technologies are analyzed and compared from different point of views. Relevant parameters which drive the overall system performance are highlighted. In particular, the indoor technologies studied are Bluetooth, WiFi, RFID, UWB and ultrasounds. With the aim to cover outdoor environments authors analyze technologies such as WiMAX and GPS. Finally, the indoor location system will be integrated with a GPS based outdoor localization system to provide global coverage. Based on this goal, integration issues are described and analyzed. All these investigations are within the framework of the project ELISA- Intelligent Location Environment for Assisted Services- www.elisapse.es.

Information derived from wearable sensors, such as illness/fall alarms, can be enhanced with context information to provide advanced health care and assisted living applications. In this paper we describe an architecture that combines sensor and context data into a telecommunication service to detect emergency situations and generate alarm calls according to user’s preferences and contacts geographic proximity.

This paper presents the design of the deictic functionalities for the navigation of a semi-autonomous powered wheelchair driven by a person with disability. Such functionalities, primarily based on a command by vision and a control by laser, offer an ergonomic mode of control to the user. The first functionality implemented is an automatic passing through narrow passages. The user must point the objective to be passed through, on an interface presenting an image of the environment. Then, the wheelchair moves in autonomous mode. Firstly, we describe the controlling mode for the wheelchair, the perception of the environment, the user interface and the means of path following. Then, we present and comment the results obtained during the experimental tests.

This paper discuss the ability to obtain a reliable pervasive information at home from a network of localizing sensors allowing to follow the different locations at which a dependent (elderly or handicapped) person can be detected. The data recorded can be treated as the sequence of color coding numbers of balls (symbolizing activity-stations) taken in a Polya’s urn, in which the persistence of the presence in an activity-station is taken into account by adding a number of balls of the same color as the ball just drawn. We discuss the pertinency of such a procedure to early detect sudden or chronic changes in the parameters values of the random process made of the succession of ball numbers and we use it to trigger alarms.

Today’s societies are very different from those of the past. The proportion of elderly people is growing steadily and has reached highs never reached before. Cases of dementia have also risen as the population gets older. Family members often live far apart and it is not unusual for them to be scattered in more than one country or continent. Memory loss associated with ageing (and amplified in cases of dementia) as well as a general feeling of isolation caused by distance can often lead elderly people to depression. We believe that, if used properly, technology could provide elders with powerful memory aids and social interaction tools that could improve their quality of life. In this article, we propose the use of a special interactive calendar with enhanced functionalities that can help manage a schedule, keep in touch with family members living far away, and reminisce about past events.

Smart home environments often need personalized requirements based on existing service products. Requirements under the environment may change at any time, even while services are correctly provided, since both caregivers and residents eventually diversify their intentions. In this paper, a situation-theoretic framework to infer human intentions is presented through a smart-home demonstration aimed at supporting independent living of elderly people. By analyzing experimental sensor data collected from a real-life smart home, differences and similarities between three detected intentions were intensely discussed.

The motivation of this paper is that the previous ambient display systems are focused on photo display or special purpose such as senior care. It is difficult to customize these systems for other purpose. We present multi-purpose ambient display system. The proposed system supports various display hardware, accepts various media objects (images, videos, agents, voices, sounds, and scripts), and uses simple and powerful Scene Description Language (SDL). The proposed system is composed of three parts; first, a scene renderer parses a SDL and renders 3D image on the screen. Second, a display mediator distributes display request to adequate scene renderer. Third, a mobile messenger is communication tool. We evaluate the proposed system in our Activities Daily Living (ADL) monitoring system and medication alert system.

Smart Home is a hot research area that has gained a lot of attention in recent years. Smart home applications should focus on the inhabitant’s goal or task in diverse situations, rather than the various complex devices and services. One of the important issues for Smart Home design is to perceive the environment and assess occurring situations, thus allowing systems to behave intelligently. This paper proposes a context-dependent task approach to manage the pervasive services, the case based reasoning (CBR) method has been adopted and implemented to recognize tasks, enabling task-oriented system design in smart home environments.

We are developing a novel home network system based upon the integration of information and energy. The system aims to analyze user behavior with a power-sensing network and provide various life-support services to manage power and electric appliances according to user behavior and preferences. This paper describes an electric appliance recognition method using power-sensing data measured by

CECU

(

C

ommunication and

E

nergy

C

are

U

nit) which is an intelligent outlet with voltage and current sensors to integrate legacy appliances (which are incompatible with a communications network) with the home network. Furthermore, we demonstrate a prototype home energy management system and examples of services based upon appliance recognition.

Research on structural health monitoring (SHM) is gaining importance recently due to increase in industrial accidents at construction sites. Wireless sensor networks (WSN) are considered as the promising advanced SHM technology to provide real time site applications using SHM. In this paper, we propose the WIVA (WSN Monitoring Framework based on 3D Visualization and Augmented Reality in Mobile Devices) architecture. The proposed architecture applies 3D visualization and AR technology to camera enabled mobile devices in order to provide real time information to users. Moreover, we performed an experiment to validate the effectiveness of 3D and AR mode based WIVA architecture in IEEE 802.15.4-based WSN. In a real implementation scenario, we demonstrated a fire detection test in a 3-story building miniature.

Maintaining user privacy is a well-known challenge and obstacle to the acceptance of pervasive computing. Privacy has been researched from various perspectives by social science, legislative, and technological communities resulting in an

information-centric

approach that regulates of the collection and use of personal information. However, through the actuation of devices and objects in the user’s physical environment, pervasive computing also introduces other significant challenges to a user’s physical privacy. Our research introduces an

environment-centric

approach to modeling user privacy and regulating intrusions to physical privacy. We introduce four principles to guide the construction of physical privacy policies and demonstrate how existing information privacy models can be extended to address these aspects of physical privacy.

Smart homes can assist their inhabitants with mental and physical tasks, and monitor their safety and health. However, the systems that empower such homes use sensitive information that could be misused by external systems resulting in violations of the inhabitants’ privacy. In this paper, we introduce a Web services-centric solution to handle privacy concerns. Web services provide the functionalities that allow users remotely interact with the systems empowering the smart homes. In addition the solution uses policies to control how Web services handle privacy concerns and penalize those Web services that do not bind to these policies. Moreover the solution uses trust and reputation to select the most trustworthy Web services.

A video monitoring system is presented which aims to detect falls and other critical situations of people living single. Seniors are particularly likely to experience high-risk situations. If, for example, an elderly person falls and cannot call for help independently, it often takes hours or even days until the emergency is noticed and assistance will be provided. The presented video monitoring system is to mitigate situations of this kind. If an emergency is detected, an automatic alarm will be raised. One of the main aspects of the developed assistance system is to be as unobtrusive as possible to achieve a high acceptance among the users. Moreover, the system needs to work very robustly in individual home environments. The fall detection system is part of an extensive real-life Ambient Assisted Living (AAL) concept with many other extended support functions.

Sleep disorders are common in the elderly, can be distressing to both the elderly and their carers, and often contribute to institutionalisation when the disruptive night behaviour of the older person exerts its toll on the carer. The main way of determining Sleep Activity Pattern (SAP) and aberrant changes in the normal sleep/wake cycle is through verbal reports of the patient and his/her carer, information that can be subjective, incomplete and unreliable. An emerging modality for SAP monitoring is actigraphy, involving the use of wearable sensors commonly based on accelerometers. To bring actigraphy to the next level in order to reap its benefit for the elderly population at large, one must consider its deployment in realistic settings such as nursing homes and in the homes of the subjects. In this paper we provide a brief account of the trial deployment of our SAP monitoring system in a nursing home, where data was collected from fifteen elderly residents for a period of two weeks each. Besides providing an objective basis for obtaining sleep related information from patients who are often unable to remember clearly how well they have slept, our system benefits staff and doctors by providing more accurate information as a supplement to the sleep diary, and hopefully even eliminate the need for the latter. Preliminary results are reported herein.

Smart homes generally differ from other pervasive environments such as office environments. Homes are lack of system administrators to fix faulty services on the spot. Nevertheless, services in smart homes can be critical especially when they involve health and wellness services, since faulty services can lead to unexpected/undesirable consequences. Therefore, robustness and availability are two fundamental requirements for service management protocols or middleware at homes. In this paper, we propose an efficient and adaptive failure detection and recovery mechanism, namely, the Rotating Roll-Call-based Protocol (RRCP), for home environments. Failures of software components are detected efficiently with a roll-call-based algorithm in which the roll-caller is elected periodically. Adaptive techniques and reliable UDP are adopted to maintain home network stability. Experimental results show that the proposed protocol is robust even under elevated failure rates.

Fall detection has been an active research problem as fall detection technology is critical for the ageing-at-home of the elderly and it can enhance life safety of the elderly and boost their confidence of ageing-at-home by immediately alerting fall occurrence to care givers. This paper presents an algorithm of fall detection for the ageing-at-home of the elderly. This algorithm detects fall events by identifying (human) shape state change pattern reflecting a fall incident from video recorded by a single fixed camera. The novelty of the algorithm is multiple. First, it detects fall occurrence by identifying the state change pattern. Second, it uses the camera projection matrix in its computing. Thus, it eliminates camera setting-related learning. Lastly, it adds constraints to state change pattern to reduce false alarms. Experiments show that the proposed algorithm has a promising performance.

This paper deals with Activities of Daily Living (ADL) Monitoring System. The proposed system takes into account deploying in real home. The important issue in deployment is the noninvasiveness. That is, the user should not feel inconvenience. Therefore, our system has been developed by making use of FSR sensors and an optional small body-activity sensor. In particular, FSR sensor is a typical noninvasive sensor since it has a shape of film. In order to make a light-weight monitoring system, we use as small number of sensors as possible. And we adopt rule-based ADL inferring algorithms to avoid inconvenience in collecting training data for supervised learning. For the purpose of improving the accuracy of occupation/usage detection, we make FSR sensors into FSR array sensors. We evaluate the proposed system in laboratory and real home environment.

In this paper we propose an efficient and incremental plan recognition method for cognitive assistance. We design our unique method based on graph matching and heuristic chaining rules in order to deal with interleaved and sequential activities. The finding of this research work is to be applied to predict abnormal behavior of the users, and optimize assistance for them. We have studied a use case of kitchen environment during lunch time that we will discuss in this paper and targeted Dementia patients. We will present implementation details as well as our evaluation plan.

Research in the area of developing home based self-management systems aim to provide a means whereby a patient suffering from a chronic condition can maintain a better quality of life while achieving their desired life goal. The use of everyday technologies to facilitate the self-management of three chronic conditions has been proposed. In this paper we outline the methodology by which we have acquired the functional requirements for healthcare professionals and patients in relation to three chronic diseases (Stroke, Congestive Heart Failure and Chronic pain), and describe how these requirements have been mapped onto a technological solution.

SOPRANO (Service-oriented programmable smart environments for Older Europeans) is a EU-funded project to develop an ambient assisted living (AAL) system to enhance the lives of frail and disabled older people. SOPRANO uses pervasive technologies such as sensors, actuators, smart interfaces, and artificial intelligence to create a more supportive home environment. SOPRANO provides additional safety and security, supporting independent living and social participation and improving quality of life. The paper describes the user-driven approach to research and development within the SOPRANO project and presents results that have emerged from this iterative process. The paper concludes by discussing benefits of the user-driven approach and future plans for system demonstration and large-scale field trials.

This paper presents an advanced healthcare support system in ubiquitous computing environment. By utilizing knowledge about healthcare and various information including vital sign, physical location, and video data of a user under observation from real space, the system provides useful information regarding health condition effectively and in user-oriented manner. In this paper, we describe a user-oriented healthcare support system focusing on design and implementation of the system with multi-agent technology.

This paper presents a ubiquitous computing platform over which services are hosted and operated for users in a transparent fashion. To that end, the platform draws on mobile agents that act as surrogates to their user, following him within his environment by migrating to the system’s nearest access point and operating the latter’s services for him in a personalized and automated way. The goal of this system is to better support the mobility of people with special needs, by providing them with assistive services that require minimal effort and investment from their part.

eHealth services is a continuously growing sector, driving the need for advances in both the network characteristics and infrastructure, as well as in the available mobile devices used. The same need requires the development of quality software applications to facilitate and service eHealth activities. On these grounds, this paper proposes a novel evaluation methodology that takes into consideration the peculiarities of sensor/actuator related services. It further focuses on aspects of software quality for eHealth services and applications, and identifies a set of quality characteristics and attributes to take into consideration. These quality characteristics are integrated into our proposed evaluation methodology during the analysis and engineering phases, which is a revised version of the spiral software process used in web engineering. The efficacy of the proposed approach in a real scenario is discussed.

Individual effort toward wellness is the most important factor to prevent and manage health risks. Though physiological sensing devices and self-care applications support that, sensing devices of most existing mobile healthcare systems are very expensive and the service only provides basic notification about a patient’s condition. In this paper we propose a mobile self-care system using voice and facial images. The system consists of a health monitoring module and a symptom checking module. In the system emotion, age and gender information are acquired automatically by using distributed computing-based server-side multimodal emotion, age, and gender recognition system using voice and facial images. The user is then able to use their own voice and face effectively for wellness self-management.

In this paper we propose a new model for tele-rehabilitation based on the Service Oriented Architecture (SOA) approach. SOA can be defined as a group of services that communicate with each other to provide a design framework with a view to realizing rapid and low-cost system development and to improving total system-quality. This approach has proved its efficiency in domains like e-Business and e-Learning. Our approach is so to develop an integrated information system for remote rehabilitations based on a Service Oriented Architecture (SOA).

Ageing population is increasing compared to general population. Related to this, a group of social-healthcare services, known as Ambient Assisted Living (AAL) services, are appearing to promote health and wellness in elderly people. IP Multimedia Subsystem (IMS) technology can help to face this challenge providing networks convergence and a fast and solid service implementation. IMS offers a group of common services which can be reused in different applications, and enable the running of the same application over any device, anywhere and anytime. We propose a conceptual implementation of AAL services through generic IMS services (service enablers), We also show the benefits they can offer in order to support a healthy and independent life on elderly people.

Service Oriented Architectures offer an incomparable setting for the management and reuse of services, mixing different factors like software and services. The ability to choose between the services available often gets blurry, because of the difficulty when trying to find the best service that fits better the actual needs, or even because its invocation process gets excessively complex. This work presents a horizontal layer that enhances service capabilities in OSGi by adding semantic information for intelligent and advanced management in SOA-compliant smart architectures, and more specifically in a Multi-Residential Environment.

The Smart Home is a house equipped with technology to assist especially the elderly and persons with special needs. Smart Homes rely on Service-Oriented technology usually OSGi. Web Services (WS) receives little emphasis on Smart Homes, but they can be very useful for some applications. That is the case of management of medication as this task can become very difficult and involve different, remote parties. Several solutions have been proposed for applications like medications management but their lack of interoperability limits them. This paper presents a solution that integrates current systems and provides interoperability by using WS. The secure transfer of sensitive data among subsystems is achieved by using secure WS for communication purposes as shown by our prototyped implementation.

Smart Homes are pervasive systems that interact with the user using a service offer paradigm to provide fully automated daily repetitive tasks. When services are augmented with semantic relationships, one can build adaptive services and systems. In this paper we deal with service failures and propose a recovering method, which we call service reconfiguration, to ensure service availability in smart homes. Both off-line and on-line reconfigurations are considered. This method has been implemented in the DANAH assistive system.

Smart home is about the application of automation techniques for the comfort and security of residents’ privately owned homes. In a smart home environment, different and independent embedded devices provide services that can be freely used by others, in the sense of service invocation. This paper presents our idea of using Model Driven Development (MDD) for the composition of existing services, by which we aim at demonstrating how new smart home services will be promoted.

Recent literature reports on high adverse events rate, especially among elderly people, due to bad self-administration of their drug therapy. They make errors taking wrong drugs, or taking drugs with incorrect dosage and frequency. These “

therapy errors

”, in the USA, cause about 3,000,000 hospital admissions each year. Within the medical informatics community, different research groups are developing computer-based support systems addressing this problem. This paper presents a novel approach in this area, and describes a device to make home drug therapy as safe as possible. The system designed took into account the whole process, starting from drug prescription by the general practitioner, to the drug acquisition to the chemist and, finally, to drug assumption at home.

Research about applicability of robots in the healthcare sector is constantly increasing. IWARD is a EU 6

th

framework project to directly support staff in hospitals by a self-organizing swarm system that will provide an efficient way to order specific tasks without worrying about the details of their execution. The IWARD swarm will be able to perform delivery, guidance, cleaning, monitoring and surveillance tasks. In order to develop a swarm that works for hospital staff, User Centered Design (UCD) was chosen, as this approach provides the developers with a better way to identify with end users when trying to develop a design for them. Keeping this perspective in mind, the following paper describes the process and methods of gathering information about heath care staff attitudes and expertise towards technology and robots, and how these features may facilitate or interfere with the subsequent inclusion of IWARD technology in hospital environments.

In Korea, Research Institute of the National Rehabilitation Center is recently built up to improve the quality of life for the disabled. We shortly review rehabilitative and assistive robots with their core technologies. Then, the research and development pathway for those is described.

The present paper focuses on the experimental set up of a Health Smart Home (HSH) “or HIS in French” with presence infrared sensors (PIR) to detect and report data on the daily activities of fragile person in hospital suite. To study the data, predictive analyses are used to find the most pertinent parameters and indicators of these activities. A relationship is established between the activities of night (nocturnal) and day (diurnal).

In current Smart Home implementations pressure sensors within the environment are normally deployed in a uniform pattern. Nevertheless, in order to create an optimised pressure sensor deployment paradigm it is necessary to correlate the positions of sensors with the high frequency movement behaviours of the inhabitant. The locations of furniture and other objects in the environment should also be taken into consideration. To create a paradigm for optimised sensor deployment, data pertaining to inhabitant movement behaviour first needs to be collected. This paper outlines the evaluation of two movement behaviour capture methods and assesses them for practical issues such as ease of installation and feasibility of use.

An Electronic Health Record (EHR) is internationally recognised as the primary digital format to communicate and store patient clinical information. The vast majority of patient vital sign monitoring solutions provide limited if any opportunities to seamlessly integrate

real-time

patient vital sign readings e.g. ECG in a coherent or unified approach. In this paper, we highlight the data quality benefits of integrating remote patient monitoring solutions i.e. a Body Area Network (BAN) datasets within patient EHR solutions. The presented Data Management System-Tripartite Ontology Medical Reasoning Model (TOMRM) solution demonstrates how patient care may be improved through the reduction of false alarm generations.

In telemedicine, patient data have to be shared among mobile and geographically dispersed caregivers. The execution environment of telemedicine applications is characterized by hardware and software heterogeneity and can suffer from important variations in resource availability. The data replication can be used to provide significant benefits in terms of data availability and query latency. Moreover, the replication system has to be adaptable to changes of context for a high quality of service. We establish two architectural models, one for distributed replication systems and the other for distributed adaptation systems. We are currently implementing them as two frameworks that can be customized to build an adaptive replication system for a telemedicine application.