Search

Background: Telehealth and home-based care options significantly expanded during the SARS-CoV2 pandemic. Sophisticated, remote monitoring technologies now exist that support at-home care. Advances in the research of smart homes for health monitoring have shown these technologies are capable of recognizing and predicting health changes in near-real time. However, few nurses are familiar enough with this technology to use smart homes for optimizing patient care or expanding their reach into the home between healthcare touch points. Objective: The objective of this work is to explore a partnership between nurses and smart homes for automated remote monitoring and assessing of patient health. We present a series of health event cases to demonstrate how this partnership may be harnessed to effectively detect and report on clinically relevant health events that can be automatically detected by smart homes. Participants: 25 participants with multiple chronic health conditions Methods: Ambient sensors were installed in the homes of 25 participants with multiple chronic health conditions. Motion, light, temperature, and door usage data were continuously collected from participants’ homes. Descriptions of health events and participants’ associated behaviors were captured via weekly nursing telehealth visits with study participants and used to analyze sensor data representing health events. Two cases of participants with congestive heart failure exacerbations, one case of urinary tract infection, two cases of bowel inflammation flares, and four cases of participants with sleep interruption were explored. Results: For each case, clinically relevant health events aligned with changes from baseline in behavior data patterns derived from sensors installed in the participant's home. In some cases, the detected event was precipitated by additional behavior patterns that could be used to predict the event. Conclusions: We found evidence in this case series that continuous sensor-based monitoring of patient behavior in home settings may be used to provide automated detection of health events. Nursing insights into smart home sensor data could be used to initiate preventive strategies and provide timely intervention. Tweetable abstract: Nurses partnered with smart homes could detect exacerbations of health conditions at home leading to early intervention

Advances in machine learning and low-cost, ubiquitous sensors offer a practical method for understanding the predictive relationship between behavior and health. In this study, we analyze this relationship by building a behaviorome, or set of digital behavior markers, from a fusion of data collected from ambient and wearable sensors. We then use the behaviorome to predict clinical scores for a sample of n = 21 participants based on continuous data collected from smart homes and smartwatches and automatically labeled with corresponding activity and location types. To further investigate the relationship between domains, including participant demographics, self-report and external observation-based health scores, and behavior markers, we propose a joint inference technique that improves predictive performance for these types of high-dimensional spaces. For our participant sample, we observe correlations ranging from small to large for the clinical scores. We also observe an improvement in predictive performance when multiple sensor modalities are used and when joint inference is employed.

Wearable sensor-based devices are increasingly applied in free-living and clinical settings to collect fine-grained, objective data about activity and sleep behavior. The manufacturers of these devices provide proprietary software that labels the sensor data at specified time intervals with activity and sleep information. If the device wearer has a health condition affecting their movement, such as a stroke, these labels and their values can vary greatly from manufacturer to manufacturer. Consequently, generating outcome predictions based on data collected from patients attending inpatient rehabilitation wearing different sensor devices can be challenging, which hampers usefulness of these data for patient care decisions. In this article, we present a data-driven approach to combining datasets collected from different device manufacturers. With the ability to combine datasets, we merge data from three different device manufacturers to form a larger dataset of time series data collected from 44 patients receiving inpatient therapy services. To gain insights into the recovery process, we use this dataset to build models that predict a patient's next day physical activity duration and next night sleep duration. Using our data-driven approach and the combined dataset, we obtained a normalized root mean square error prediction of 9.11% for daytime physical activity and 11.18% for nighttime sleep duration. Our sleep result is comparable to the accuracy we achieved using the manufacturer's sleep labels (12.26%). Our device-independent predictions are suitable for both point-of-care and remote monitoring applications to provide information to clinicians for customizing therapy services and potentially decreasing recovery time.

Smart-Home in a Box (SHiB) is a ubiquitous system that intends to improve older adults’ life quality. SHiB requires self-installation before use. Our previous study found that it is not easy for seniors to install SHiB correctly. SHiB CBLE is a computer-based learning environment that is designed to help individuals install a SHiB kit. This article presents an experiment examining how smart home sensor installation was affected by knowledge gained from two methods, SHiB CBLE, and a written document. Results show that participants who were trained by the CBLE took significantly (p<0.05) less time in the installation session than those in the control group. The accuracy rate of SHiB kit installation is 78% for the group trained by the CBLE and 77% for the control group. Participants trained by the CBLE showed significantly (p<0.01) higher confidence in the actual installation than those in the control group. These results suggest that having a training before the actual installation will help installers avoid unnecessary work, shorten the installation time, and increase installers’ confidence.

Digital markers of behavior can be continuously created, in everyday settings, using time series data collected by ambient sensors. The goal of this work was to perform individual- and population-level behavior analysis from such time series sensor data. In this paper, we introduce a novel algorithm—Resident Relative Entropy-Inverse Reinforcement Learning (RRE-IRL)—to perform an analysis of a single smart home resident or a group of residents, using inverse reinforcement learning. By employing this method, we learnt an individual’s behavioral routine preferences. We then analyzed daily routines for an individual and for eight smart home residents grouped by health diagnoses. We observed that the behavioral routine preferences changed over time. Specifically, the probability that the observed behavior was the same at the beginning of data collection as it was at the end (months later) was lower for residents experiencing cognitive decline than for cognitively healthy residents. When comparing aggregated behavior between groups of residents from the two diagnosis groups, the behavioral difference was even greater. Furthermore, the behavior preferences were used by a random forest classifier to predict a resident’s cognitive health diagnosis, with an accuracy of 0.84.

Continuous monitoring of complex activities is valuable for understanding human behavior and providing activity-aware services. At the same time, recognizing these activities requires both movement and location information that can quickly drain batteries on wearable devices. In this paper, we introduce Change Point-based Activity Monitoring (CPAM), an energy-efficient strategy for recognizing and monitoring a range of simple and complex activities in real time. CPAM employs unsupervised change point detection to detect likely activity transition times. By adapting the sampling rate at each change point, CPAM reduces energy consumption by 74.64% while retaining the activity recognition performance of continuous sampling. We validate our approach using smartwatch data collected and labeled by 66 subjects. Results indicate that change point detection techniques can be effective for reducing the energy footprint of sensor-based mobile applications and that automated activity labels can be used to estimate sensor values between sampling periods.

Evaluating patient progress and making discharge decisions regarding inpatient medical rehabilitation rely upon the standard clinical assessments administered by trained clinicians. Wearable inertial sensors can offer more objective measures of patient movement and progress. We undertook a study to investigate the contribution of wearable sensor data to predict discharge functional independence measure (FIM) scores for 20 patients at an inpatient rehabilitation facility. The FIM utilizes a seven-point ordinal scale to measure patient independence while performing several activities of daily living, such as walking, grooming, and bathing. Wearable inertial sensor data were collected from ecological ambulatory tasks at two time points mid-stay during inpatient rehabilitation. Machine learning algorithms were trained with sensor-derived features and clinical information obtained from medical records at admission to the inpatient facility. While models trained only with clinical features predicted discharge scores well, we were able to achieve an even higher level of prediction accuracy when also including the wearable sensor-derived features. Correlations as high as 0.97 for leave-one-out cross validation predicting discharge FIM motor scores are reported.

One of the main challenges of today’s society is the need to fulfill at the same time the two sides of the dichotomy between the growing energy demand and the need to look after the environment. Smart Grids are one of the answers: intelligent energy grids which retrieve data about the environment through extensive sensor networks and react accordingly to optimize resource consumption. In order to do this, the Smart Grids need to understand the existing relationship between energy demand and a set of relevant climatic variables. All smart “systems” (buildings, cities, homes, consumers, etc.) have the potential to employ their intelligence for self-adaptation to climate conditions. After introducing the Smart World, a global framework for the collaboration of these smart systems, this paper presents the relationship found at experimental level between a range of relevant weather variables and electric power demand patterns, presenting a case study using an agent-based system, and emphasizing the need to consider this relationship in certain Smart World (and specifically Smart Grid and microgrid) applications.

In the coming decades, as we experience global population growth and global aging issues, there will be corresponding concerns about the quality of the air we experience inside and outside buildings. Because we can anticipate that there will be behavioral changes that accompany population growth and aging, we examine the relationship between home occupant behavior and indoor air quality. To do this, we collect both sensor-based behavior data and chemical indoor air quality measurements in smart home environments. We introduce a novel machine learning-based approach to quantify the correlation between smart home features and chemical measurements of air quality, and evaluate the approach using two smart homes. The findings may help us understand the types of behavior that measurably impact indoor air quality. This information could help us plan for the future by developing an automated building system that would be used as part of a smart city.

Smart environment technology has matured to the point where it is regularly used in everyday homes as well as research labs. With this maturation of the technology, we can consider using smart homes as a practical mechanism for improving home security. In this paper, we introduce an activity-aware approach to security monitoring and threat detection in smart homes. We describe our approach using the CASAS smart home framework and activity learning algorithms. By monitoring for activity-based anomalies we can detect possible threats and take appropriate action. We evaluate our proposed method using data collected in CASAS smart homes and demonstrate the partnership between activity-aware smart homes and biometric devices in the context of the CASAS on-campus smart apartment testbed.