A systematic literature review of published sources that discuss radio frequency identification technology, ubiquitous health care, and dosage measurement was performed. The results were then critiqued. Methods of storing data and using Radio Frequency Identification (RFID) were studied. These results were used as an aid for developing a prototype system for monitoring medication dosages in a home health care environment. The combination of an RFID technology – the Intel Wireless Sensor Platform (WISPs) and the construction of a specific pill dispensing container in this prototype demonstrated that it is possible to use RFID technology to effectively and ubiquitously monitor and track drug taking compliance. With further refinements on the dispensing unit and optimization of the software this product could be manufactured and released to home care patients to help increase compliance and reduce health related issues. This could form the heart of a modular telecare data collection system. RFID-based devices that can store data in standardized formats may allow incremental development of home telecare systems in an economical fashion.
TopIntroduction
Increasing health demands require investment in telecare. The “smart home” can support this but infrastructure issues and the rapid rate of change of technology act to make integrated comprehensive systems unaffordable. In order to be proven clinically, particular applications need to be developed and deployed. Integrated telecare systems are complex and currently unaffordable and not scalable. Data storage and transmission also remain a major issue. However there are many conditions that need monitoring and assessment in the patient’s own homes, over long periods. In particular a high level of non-compliance relating to taking of medication can lead to compromised health benefits and wasted money. Improving patient compliance has the potential for improving issues related to Cardiovascular Disorder (CVD) and many other diseases. Current solutions either lack needed functionality or are much too costly to be used in a home care environment.
As the population of the western world ages, increased health costs and increasingly complicated drug regimes are becoming greater problems. In order to reduce health costs, or at least reduce the size of health cost increases, a large number of initiatives are taking place around the world in order to improve care in the home. To give a scale for the potential size of the problem, United Nations figures indicate that the number of people over 60 will triple over the next 50 years, with 2 Billion people over 60 by 2050(Population Division United Nations, 2002). Such large numbers of people with potential for chronic disease along with frailty may not want to be cared for in institutions, and care will shift increasingly to the home, supported by telecare technologies (UK Department of Health, 2005).
However, home telecare poses special challenges. The cost and intrusiveness of the infrastructure and technology needed to support it should be minimized. Each patient requires different care, so the monitoring and measurement toolset must be flexible, extensible and efficient. The equipment needs to be reliable and not impact on the lifestyle of the patient or other members of the household. Data management and storage remains one of the major challenges facing telecare, and the use of distributed data sources may form one answer to these problems.
The chapter will explain why WISP-based devices may offer a safe, secure and low-cost method of measuring compliance and may be incorporated into reminder systems as part of a home telecare node. The objective of this chapter is to outline the issues associated with the development and use of a home telecare node, the need to have common data standards and identify potential architectures based around WISP/wireless sensor devices and other RFID devices.
The example of a WISP-based drug compliance monitor (Montefiore, Parry, & Philpott, 2010) will be used as a guide to some of the potential problems and advantages of this approach.