Mobile Health Advisor with acronym MOHEAD
1Alabi, Abdullateef.O., 2Lawal,
Mufutau.K.
1,2 Computer Engineering
Technology Department, Federal Polytechnic, Offa
ABSTRACT
A Novel E-health Smartphone Application
that reduces the risk for cardiovascular diseases (CVD) by measuring the stress
level, predicting the evolution of the evolution of the CVD risk and by
promoting a healthier lifestyle with personalized advice. The stress is
computed using no additional hardware, just the smartphone camera, by measuring
the heart rate variability (HRV).
This will require no
additional hardware in addition to the Smartphone.
This will be used for predicting the
possible evolutions of the users of the application and for giving
recommendations related to life-style changes that will help in reducing the
cardio risk and stress
Keywords: Cardiovascular disease (CVD), Mobile
health (m-health), stress reduction
1.0 INTRODUCTION
WHAT: Mobile Health Advisor is a
smartphone application that falls under the umbrella of participatory and
prevention medicine supporting tools, by democratizing the health care process,
allowing the patient a more active role in his/her prevention and treatment.
MOHEAD
will approach two interrelated problems among contemporary citizens:
cardiovascular diseases and stress. By measuring different indicators such as
lifestyle or heart pressure and variability the application builds a custom
profile for each patient and uses the profile to give specialized counsel for a
healthier lifestyle. There are no privacy issues as the data is stored locally,
on the smartphone and is also encrypted.
WHY: The intended product has very good
marketing perspectives by its focus on tackling pressing medical and personal
problems for the contemporary population.
Cardiovascular
diseases are the number one killer in the world. The causes of CVD are diverse
but stress and hypertension are the most common. Nigerians are under serious
pressure ranging from economic, employment, welfare, community, peer pressure,
political and health challenges. The rise in cardiovascular diseases has risen
from 15 percent to 25 percent within a period of 20 years. This applies to
stress as well. In the same period, the use of mobile technology has risen to
above 60 percent. This means that our stress-reducing software application has
a very large potential market, since we aim for the lower-middle income user,
with access to smartphone technology and under considerable stress, both in rural
and urban areas (Karasek R (1990)).
The aim of this
research work is to design and implement a smartphone app which lowers the risk
of cardiovascular diseases by measuring the stress level, predicting the
evolution of the evolution of the CVD risk and by promoting a healthier lifestyle
with personalized advice and to also increase overall health in Nigeria by
tackling the number one killer, cardiovascular diseases, while decreasing the
pressure on the national healthcare system.
In order to make
accurate simulations, the research study will include simulation techniques
such as sensitivity analysis and evolutionary simulations that use a profile of
the user built from relevant input information and that can predict not only
the risk and the stress but the evolution of the risk and stress level over the
lifetime of the patient. This will be done by simulating the variation in time
of the inputs such as weight or blood pressure and also by predicting different
lifestyles choices. The stress will be evaluated by determining heart rate
variability measured through the photoplethy smographic acquisition with the
video camera of a Smartphone.
RELATED WORKS
Healthcare in
Nigeria, while having positive trends in some areas, exhibits some structural
deficiencies, such as differentiated quality based on region, an exodus of
health care providers, thus affecting its capacity for mitigating CVD risks for
most Nigerians. In addition to the
inefficient healthcare provisioning in rural areas, urban areas suffer from environmental
and noise pollution, major factors for CVD. As a consequence, life expectancy
in Nigeria is very low, at 52.62 years. Our solution mitigates CVD risks, by
self-measuring and personalized counsel, decreasing the pressure on the public
healthcare and addressing the most important cause of CVD in Nigeria, stress.
HOW: The final product is a Smartphone
Application consisting of a personalized cardiovascular risk and stress level
detector, simulator and advisor, based on simulations techniques such as
sensitivity analysis and evolutionary simulations that uses a profile of the
user built from relevant input information and that can predict not only the
risk and the stress but the evolution of the risk and stress level over the
lifetime of the patient according to (Cliff Note 2014). The users will be
presented with possible risk evolutions based on his current lifestyle and
possible beneficial changes. In addition, based on the profile and simulator,
MOHEAD will give personalized counsel for the reduction of cardiovascular risk
level; counsel related to how to change the factors that mostly affects the
risk of a given person and other possible corrective actions according to Inner Body 2012. The product’s main
modules (profile, simulator) will be generic allowing them, by extending their
rule base; to be used for simulating other conditions in future products.
ESTIMATED MARKET SIZE AND EXPECTED MARKET
SIZE
MOHEAD
targets the fast growing Smartphone e-health applications (apps) market. The
apps market has been quickly transformed from a niche market to a mainstream
force. According to a Smartphone app –
Global Strategic Business Report from September 2011, from the Research Group,
the global market for applications is expected to reach US $101.2 billion by
the year 2017. This accelerated growth is motivates by several reason (Murphy L
(1995): Mayo Clinic 2013)
Firstly, the advances of IT telecom underlay and support the need of the
applications and the market itself.
Secondly, the
average price of the apps is significantly low ranging between US $0.99 and $25
– price range in which MOHEAD application is also expected to be sold – which
enables customers to download mobile applications even in a frugal economic
environment. Thus, its expected that MOHEAD sales will have a fast growth
according to the existing tendencies and its price range.
By its regular
use, the applications user will be able to have a better understanding of his
lifestyle impact on his health and then will be driven to develop and reinforce
healthy routines and habits. The software used behavioral change model which
allow complex behavioral changes such as a healthy lifestyle which reduces
stressors and CVD risk factors, to be informed gradually, by first identifying
the risk factors, proposing custom action plans and following the feedback on
the commitment to those plans.
3.0 RESEARCH
METHOD
In order to
construct the application, MOHEAD an Agile Software Engineering Development
Method was used with small iterative cycling activities. It will start with a
first cycle (activity) where the functional, nonfunctional and high-level
architecture will be developed. Then in several activity-cycles - initial,
alpha and final prototype - the application will be developed. For the
development itself, a simulation technique was adopted such as sensitivity
analysis and evolutionary simulations that use a profile of the user built from
relevant input information and that can predict not only the risk and the stress
but the evolution of the risk and stress level over the lifetime of the
patient.
MOHEAD
will use an agile software engineering development method with small iterative
cycling activities, simulation techniques by simulating the variation in terms
of the input based on methods such as evolutionary computation with the pilot
testing of the application on selected group of users and dissemination
activities as part of middle and final activity cycle such as Genome,
Epigenome, and environment which usually ripe to subclinical diseases from
caser agent “ cardiovascular risk factors and biomarkers”, this illustration is
shown in Fig 1.
Fig 1:
Circulation: Showing Genomic and Precision Medicine
All the
components of the application will be deployed on Smartphone. Below are the
main components of our applications and their main functionalities:
1.
Application
front –end (AF) uses a graphical interface to gather input data directly from
the patient, such as regular self-assessments of his/her physical exercise activity,
eating habits or any other relevant CVD or stress factor measure.
2.
Personal Profile
(PP) is a personal electronic medical record that stores the relevant medical
situations of the patient and is based on a health state model focused on
storing and interpreting relevant information (health events) for the stress
level and CVD risk.
3.
Simulator (SIM)
uses the information from the personal profile and the developed models and
measurements and based on sensitivity analysis and evolutionary simulations, the
program will predict probable evolutions for specific health related attributes
of the user. The simulations will also take into consideration different
probable lifestyles.
4.
Counselor (CS)
uses information from the simulator and profile in order to promote the most
efficient lifestyle choices for lowering the CVD risk and stress level. The
counsels will be based on notifications which will have a personalized tone and
frequency based on the psychological profile of the patient.
5.
Notification
agent (NA) forwards the counsels prepared by the counselor to the user.
Together with
the development, in each Agile activity cycle, pilot-testing of the application
on selected group of users will be carried out. Dissemination activities will
be part of middle and final activity-cycles.
Fig 2: Mobile Monitoring and Reasoning Methods to Prevent Cardiovascular Diseases
RESEARCH DESIGN
Requirements and high-level architecture: In
this phase, functional and nonfunctional requirements will be gathered. The
requirements will be determined through 1) field interviews with medical
doctors, potential users, ICT professionals and through 2) extensive literature
review. Based on the obtained requirements, the general architecture of the
application will be designed.
Initial Prototype of the application: The
detailed design of the application will be made. An initial prototype of
application will be created, including initial functionality of the application
such as personal profile of the user, cardio and stress calculator. Pilot
testing will also be carried out with selected group of users. Their feedback
will be collected to be incorporated for the later development of the
application.
Prototype alpha of the application: Extra
features are added such as cardio and stress simulations over time through
techniques such as sensitivity analysis and evolutionary simulations that use a
profile of the user built from relevant input information and that can predict
not only the risk and the stress but the evolution of the risk and stress level
over the lifetime of the patient.
Dissemination activities – presentations in academic and general public
events will happen also in this phase. Submission of a first series of articles
(1-3) is also planned.
Final Prototype: The final features of
the applications such as personalized counsels, overall improvements will be
implemented. Final pilot testing will also be part of this activity.
Dissemination activities will have a large role in this phase, including
presentations in selected events, second series of articles (1-3) submission,
and community event.
ANALYSIS OF DATA
Analysis of Data is part of each phase
starting with Initial Prototype phase
till Final Prototype in different
forms.
-
Through Piloting: Starting with the Initial
Prototype phase, Alpha phase and Final Phase piloting activities are part
of each phase: the different prototypes are tested on selected group of users
and the user feedback will be incorporated in the application development in
the next phase. Analysis of Data is part
of piloting activities through the collection and analysis of user feedback
from pilot activities for further improvement of the tool.
-
As part of the MOHEAD application: Cardio, Stress and Life Style data collected from
the user is analyzed by the application; recommendations related to how to
change life-style to reduce the cardio-risk and stress will be displayed on the
Smartphone screen.
Below are
details on the analysis of data: used methods, principle of operation, etc.
Summary Statistics: There are two ways
in which the project will provide summaries:
-
For general public: A registered Domain Name, Web hosting, a database storage, SmarthHealth
application, SMS gateway system, e-mail alert
and initialization query data from clients will be used to present
summaries of medical results, recommended medical diagnostics and other
relevant usages of MOHEAD application through the web-site of the project.
-
For the users of the applications: MOHEAD application will display on the screen of the
Smartphones recommendations related to the life-styles changes needed by the
users to reduce the cardio risks and stress.
Questionnaires: There are several ways
in which questionnaires will be used for the project:
-
While starting to use the application: Initial questionnaire is (see description of Application front–end module, Section 1.4) displayed by the
application for gathered input data directly from the user, such as regular
self-assessments of his physical exercise activity, eating habits or any other
relevant CVD or stress factor measure. It is also used to create the initial
profile.
-
While piloting:
In each phase, for the different prototypes of the MOHEAD application,
questionnaires will be administered to the selected users that are doing the
piloting such that their feedback will
be incorporated in the further development of the system
4.0 Test
Result and proposed feature Analysis
4.1 ACADEMIC
INNOVATION: A smartphone application to feature a generic simulator for CVD
risks and stress level prediction combined with personalized prevention
counseling does not exist currently in the market. At International level,
there are some products such as “cardiac risk calculator” by Tonic Minds using
Framingham Risk score, “Manage CVD Risk in Reduced GFR” by National Kidney
Foundation; “Cardiovascular risk calculation” by Reb Edersalud, implementing
Framingham, Score and RECICOR algorithms; “Stress Test and CBT Self Help” by
Excel at Life; Ithlete etc that touches some of the items of our proposed
application, but none have the combination of features described.
As mentioned
above, none of these applications cover all the proposed features of MOHEAD nor
can they predict the evolution in time. Our approach is a much more
personalized solution and has a distinctive new direction of research as it
applies simulation algorithms for being able to advice corrective actions for
the CVD risk and stress level evolution of the user.
MOHEAD also
integrates the CVD and stress profile with the readings from the HRV detector,
allowing real-time updates to the stress profile.
4.2 MARKET
APPLICATION AND EXPLOITATION:
Novel Mobile
Health advisory is a mobile application program that enable user to integrate
service intervention to medical practice guidelines, health symptoms and
patient health profiles for economic analysis of healthcare service according
to Euro WHO (2013: Tand Fonline (2010)). This depends on defined medical
parameters (fixed and variable) template for efficient treatments and cure
service delivery via a generic template database simulation.
4.3 Evaluation
mechanism: state clearly the evaluation mechanism you will adopt in achieving
the stated objectives.
The research
path is based on a logical and scientifically proved approach, which should be
a good assurance for keeping the research in the expected parameters. However,
in order to limit the unexpected results, the Lead Researcher will maintain the
model as simple as possible, using a modular approach.
The project will
involve end-users and stakeholders throughout the whole lifetime of the
project, using a flexible approach to the feedback. During the course of the
MOHEAD project, the team will organise and manage a number of workshops that
will mainly target end-users in Nigeria. Publications in external conferences
and journals would be used as good means for reaching academics, researchers,
healthcare operators, and the team is committed to make full use of them
(Objective Medical System (2014)). In
addition, internet dissemination (such as the development of a web-site and the
issuing of electronic newsletters and press releases to relevant Nigerian news
channels) will allow a larger community of interested potential users to access
MOHEAD for longer times and to keep them informed about the project’s aims and
progression.
-
5.0 Recommendation
and Conclusion
The proposed
model dissemination strategies: This enables user to indicate the steps to take
just to ensure the query outcomes are brought the attention of health
professionals.
Therefore the target
dissemination activities after full deployment will target industrial and scientific
levels including presentations in conference, seminars, workshops etc.
The research
path is based on a logical and scientifically proved approach, which will
involve the end- users and the stakeholders throughout the whole life time of
the project using a flexible approach to the feedback.
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