2010 IEEE 16th International Symposium for Design and Technology in Electronic Packaging (SIITME)
Interactive Communication System for Patients with Disabilities – The Software Component Vlad Cehan, Radu Gabriel Bozomitu, Constantin Barabaşa Faculty of Electronics, Telecommunications and Information Technology “Gh. Asachi” Technical University Iaşi, Romania
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where it is used (home/hospital). In the case of a care center the following are used: a laptop for the patient, a Personal Digital Assistant (PDA) or mobile phone (MPhone) for the caretaker and a computer (usually a desktop computer) for the dispatcher; the configuration is displayed in Figure 1. In his case the patient caretaker communication is entirely made through the dispatcher’s computer. The home care configuration includes only a laptop for the patient and a PDA/MPhone for the caretaker – Figure 2. The patient communicates directly with the caretaker. Communication is accomplished using ‘key words’, based on the principles widely described in [1] and [2]. On the patient’s screen ‘key words’ accompanied by suggestive images are successively displayed; the same words are played on the laptop speakers. The patient selects the desired word by the press of a button. That word is sent to the dispatcher or directly to the caretaker who ensures an adequate response.
Abstract: In the last few years an increasing interest for the improvement of communication with people with disabilities for therapeutic purposes as well as educative, has been observed. For this purpose, a complex communication system (ASISTSYS), based on key-word transmission from the patient and vocal and/or key word reply from the caretaker has been proposed. The system insures radio communication between patient and caretaker: (a) in case of treatment within a care center/hospital through a dispatch or (b) in case of in-house treatment. The hardware component has been presented in previous papers. This paper presents the software component of the system, divided into three modules: patient, caretaker and dispatcher. Keywords - radio, communications, disability.
I. INTRODUCTION From a hardware point of view, the ASISTSYS system is composed of two or three subsystems [x1], [x2], according to
Figure 1. The structure of ASISTSYS: care center configuration and some keywords with images
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2010 IEEE 16th International Symposium for Design and Technology in Electronic Packaging (SIITME)
Figure 2. The structure of ASISTSYS: home configuration
II. THE SOFTWARE SYSTEM
III. ASISTSYS PATIENT SOFTWARE
The software system allows patients with neuro-locomotor disabilities to be assisted and is made of several modules:
AsistsysPatient software assists the patient in communicating/ transmitting/notifying directly to the caretaker or through the dispatcher physiological states/desires.
a) AsistsysPatient – program that assists the patient in transmitting a request to the dispatch. It runs on a laptop and interacts with the patient by a screen and a switch (for example left and/or right mouse button);
Key words are grouped in three levels: • Level 1, the lowest level, with only two words, (YES/NO), used in the first stage of patient training;
b) AsistsysServer – a server that communicates with ASISTSYSPatient and ASISTSYSNurse relaying the requests/replies from the patient to the caretaker and viceversa;
• Level 2, with 10 – 12 words, of key interest (such as ‘it hurts’, ‘can’t breathe’, ...), used in the second training phase; the database containing these words can be edited according to the particularity of each patient (condition, abilities);
c) AsistsysNurse – a program that runs on a PDA used by a medical nurse/caretaker allowing notification to be received and replies to be sent.
• Level 3, with 50 – 100 words, grouped on categories, usable for complex communications by patients with good comprehension skills; this database is also editable and can be modified according to particular needs.
The basic function of the system (Figure 3) is the following: the patient initiates a request (physiological needs, desires, etc) assisted by AsistsysPatient. This request is received and processed by AsistsysServer and transmitted to the nurse/caretaker responsible for the patient. The nurse/caretaker will respond by pressing a Yes/No button. The reply is sent back to AsistsysServer and if affirmative to the patient. In case of a negative answer another nurse/caretaker will be notified, as well as in the case when a connection cannot be established with the PDA or the nurse is nonresponsive. All communication is logged.
Figure 4 shows the working diagram of AsistsysPatient with all levels included. Patients must be familiarized with the use of the icons. Icon placement on screen has been studied. For that the mobility and physical abilities of several patients was evaluated, in order to indicate the most accessible icon position.
Patient acts – sweeping starts KW: want PEE want PEE want PEE Time: 0 3 6
The „startup screen” has two slides that are displayed in succession. Each of them is marked in the background by a color – red or green, a graphical representation and a keyword referring to the category of concepts. The two slides alternate at a slow rate until one of them is selected. The graphical representation has the role of making the choice easier for patients that may have difficulties in reading the keywords. When a slide is selected, the patient hears a voice naming the choice: EMERGENCY or REQUEST. If the patient has made a wrong choice, it can be undone.
It HURTS 10 Patient acts KW: It HURTS It HURTS NURSE NURSE Time: 13 16 20 23 (KW) NURSE is sent On the screen: COMING SOON Figure 3. Succession of operations in ASISTSYS system
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2010 IEEE 16th International Symposium for Design and Technology in Electronic Packaging (SIITME) The EMERGENCY class contains the following subclasses: NECCESITIES, ASSISTANCE, PAIN, SOCIAL. Each of these subclasses is as well represented by a graphical representation, a key-word and an audio recording of the word denoting the subclass.
The NECCESITIES class contains the subclasses: TIME, SPACE, STATUS and SOCIAL. Each of these subclasses is also accompanied by a graphical representation and an audio recording of the key word.
Figure 4. Functional diagram with patient dialog loop (AsistsysPatient)
IV. ASISTSYS NURSE SOFTWARE
The nurse can reply by pressing only the corresponding Yes/No button or by also writing a text message.
AsistsysNurse allows a nurse to be notified about a patient in his/her care. It displays the name of the patient making the request, the room where it is located and their message.
The program also displays the server connection state: connected/disconnected. In figure 5 a typical caretaker application screenshot can be observed.
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2010 IEEE 16th International Symposium for Design and Technology in Electronic Packaging (SIITME) VI. CONCLUSIONS ASISTSYS has been tested at the ‘Spitalul Clinic de Recuperare’ hospital in Iaşi, on 31 subjects. The tests have validated the system’s working principles, the correctness of the design, of the implementation and of the permanent adjustment of the interface. Several versions with a decreasing number of necessary commands and key words have been used. During this last research phase we have extensively tested the efficiency of the interface on a significant number of patients, with a wide diversity of neurological deficiencies. Figure 6 shows the training phase of a patient for the use of ASISTSYS.
Figure 5. AsistsysNurse screenshot
The indications on screen are few enough to allow ease of use and understanding.
Figure 6. Patient training for the use of ASISTSYS
The patients have been positively receptive to such a system, some of them even being interested on the date the system would be permanently integrated into hospital use.
V. ASISTSYS SERVER SOFTWARE The main role of ASISTSYSServer is that of relaying messages from patients to nurses. Each client program (ASISTSYSPatient and ASISTSYSNurse) must login after connecting to it, otherwise they will be disconnected. The codes are built so that they offer information about the client. Once the login is successful, the server will “listen” for requests from the patients, record them and assign the request to the proper nurse. So if a patient transmits the message “pain”, it will be recorded in the main log, and in the log corresponding to the respective client. If the nurse does not answer answers negatively or a connection cannot be established with its PDA, another nurse is selected. Still if no available nurse is found a message is displayed on the screen announcing that patient X has transmitted a message that has not been responded to. The administrator of the server (the dispatch) can make the decision of finding a person to attend to the patient and/or send a reply.
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REFERENCES
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[1]
V. Cehan, R. G. Bozomitu, M. Popa, ”Using Radio Communications in a System for Communicating with Severely Neuro-Locomotor Disabled People”, in Proc. of International Symposium for Design and Technology of Electronic Packaging – SIITME 2007, ISSN 1843-5122, pp. 60-64, Baia Mare, Romania, September 20-23, 2007;
[2]
V. Cehan, A. D. Cehan, R. G. Bozomitu, “A New Technology Of Communication With People With Major Neuro-Locomotor Disability”, in Proc. of the 2nd Electronics System-Integration Technology Conference (ESTC-2008), IEEE Catalog Number: CFP08TEM-PRT, ISBN: 978-1-4244-2813-7, pp. 791-795, 1st – 4th September 2008, Greenwich, London, UK;
[3]
Pedrotty Bryant, D., Bryant, B. R., "Assistive Technology for People with Disabilities", Pb. Allyn & Bacon, 2002, ISBN: 020532715X;
[4]
Cook, A. M., Hussey, S. M., "Assistive Technologies: Principles and Practice", Pb. Mosby-Year Book, 2001, ISBN 032300.
23-26 Sep 2010, Pitesti, Romania
