People-centered innovation driving the next generation of telehealth - Q&A with Alan Boucher, Director of Software Architecture and Engineer

May 1, 2012 OpenSystems Media

3Intel Corporation and GE Healthcare came together in 2011 to form a new company that is transforming the world of technology-enabled health care by rethinking the role of the patient in telehealth system design. Alan describes how Care Innovations is creating a new space for embedded computing technologies in virtual care coordination applications.

BOUCHER: Intel-GE Care Innovations creates technology-based solutions that give people confidence to live independently, wherever they are. We are a unique joint venture between Intel Corporation and GE that was formed last year, combining assets and expertise from Intel’s Digital Health Group and GE Healthcare’s Home Health division.

Both Intel and GE Healthcare have a long history of driving innovation, solving hard problems, and creating new markets, with a massive body of research and expertise to back that up. GE’s health care expertise covers medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, biopharmaceutical manufacturing technologies, and performance improvement/solutions services.

Intel also has a deep understanding of the health care industry. Since Intel began investigating health care in 1999, ethnographic researchers have observed and interacted with more than 1,000 households and 150 hospitals and clinics in 20 countries. Intel also initiated collaborative research projects with the Technology Research for Independent Living Centre, the Center for Aging Services Technologies, and many other organizations.

Today, Care Innovations can cull from this deep body of research in product development and prototypes. Our Care Innovations Connect and Care Innovations Guide products were developed directly out of this research. Current prototypes under investigation are also heavily informed by these extensive studies.

ECD: What telehealth products are you currently pushing to market, and how do embedded technologies enable and enhance these products?

BOUCHER: The Care Innovations Guide (Figure 1) is a next-generation telehealth solution that combines traditional vital signs capture with advanced videoconferencing and customizable multimedia education. It strengthens the connection between health care professionals and patients, and helps make virtual care coordination possible. We also offer Care Innovations QuietCare (Figure 2), a wireless monitoring technology that keeps caregivers informed about resident activity levels, which can help improve (patient) safety and security while allowing for proactive care.

21
Figure 1: The Care Innovations Guide strengthens the connection between health care professionals and patients by enabling vital signs capture and videoconferencing capabilities.

22
Figure 2: Care Innovations QuietCare utilizes ZigBee network technology to monitor resident activity levels for facilitating independent living.

In these products, embedded technologies such as wireless platform interfaces, ZigBee sensor networks, wireless medical peripherals, and software are designed for both wired and wireless patient use, allowing patients to integrate our products into their lifestyles without imposing restrictions or requiring significant changes. Platforms utilizing untethered devices, radio-based sensors, sensor networks, and a variety of transport media offer patients choices in how they can better manage their health care from a personal preference and lifestyle perspective.

Significant advancements in the Continua Health Alliance Bluetooth specifications, low-power Wi-Fi, Bluetooth profiles, and High-Speed Alternate MAC/PHY (AMP) offer us connectivity options and the ability to make design choices across a variety of radio platforms. However, we still face all the challenges around device integration, data acquisition, data integrity, quality, safety, and design assurance with either commercial or embedded platforms and Operating Systems (OSs). Even with the abundance of Bluetooth medical devices available today versus 3-5 years ago, many of the design challenges persist in medical systems development.

ECD: Why does Care Innovations emphasize the need to deliver “human-centered” products and services? What other important technical considerations drive the design of a telehealth device/system?

BOUCHER: At Care Innovations, perhaps surprisingly, we don’t start with technology. Instead, we start with the people who use our products, which makes all of our solutions profoundly human-centered. We’ve spent nearly 12 years living with, studying, observing, and listening to people at all levels of health care and independent living. And we’re including them as active participants in the systems we deliver. From our UX/UI formative modeling to our early design formative testing through to validation testing, we are committed to our patients and institutional customers who use and continue to influence our product design. External focus, quality, and discipline are the cornerstones of our products.

We look closely at user lifestyles when designing our products. For instance, chronically ill patients are not always tethered to their homes. Many of our patients live a more active lifestyle and need to take their devices out of their homes to remain adherent to care protocols and clinical instructions. This requires us to think differently from the core platform out to edge devices, device interactions, data acquisition, and data privacy and security. Concurrently, our clinical customers want to help their patients manage their disease states, which means effectively responding to measurement data while proactively managing patients’ needs, regardless of their location.

These are all inputs to our UX/UI and systems engineering use cases and resulting product requirements. One size, model, or type rarely fits all, and that’s certainly the case with the products that we build for our patients, clinicians, and independent living institutional customers.

ECD: What embedded technology advancements are needed to meet future goals of providing a unified technology platform with interoperable components?

BOUCHER: Building blocks simply need to be better coordinated. With embedded platforms, OS vendors like Wind River have done a good job of building the requisite core software subsystem capabilities to enable innovative embedded medical device development. To a somewhat lesser degree, we’ve seen this emerge with Android, iOS, and Windows Mobile as well. However, it’s still a complex undertaking. Companies like Care Innovations build systems that inevitably land on both embedded and commercial platforms, which patients interact with directly.

Regardless, the demands on resources, platform usage analysis, mobile/embedded platform roadmaps, and design/development trade-offs remain a complex puzzle for platforms built on embedded OSs and more commercially available operating platforms. Trying to navigate primary OS vendor core capabilities, feature/API exposure, embedded radio, and sensor and network interface availability can be the difference between success and failure in the marketplace. Bluetooth radio testing and qualification, device driver and I/O integration with platform middleware, design assurance, and data acquisition and integrity all play a role and are significant factors in development decisions.

Challenges can still arise with radio firmware, radio interface testing, API implementation/granularity, OS support for drivers, radio shims, profile implementations, and protocol and middleware integration at a platform level. Additionally, medical device development teams have compounded responsibilities in the areas of intended use validation, design assurance, quality, system test, verification, and data integrity that are expected of them according to product and medical regulations. Completing missing building blocks for platform developers, fully implementing profiles, reducing integration complexity, and improving design assurance will give medical device vendors an opportunity to focus on new capabilities and design advancements instead of solving other vendors’ core OS, I/O, and subsystem challenges.

Alan Boucher is director of software architecture and engineering at Intel-GE Care Innovations.

Intel-GE Care Innovations www.careinnovations.com

Follow Twitter Facebook Google+ LinkedIn YouTube

Special Interview
Previous Article
Model-based approaches close the gap between development and testing
Model-based approaches close the gap between development and testing

To bring testing on par with design, development teams are turning to model-based testing approaches for in...

Next Article
Comparing linear versus nonlinear filters in image processing
Comparing linear versus nonlinear filters in image processing

Whether for noise removal or feature abstraction, selecting correctly between a linear or nonlinear filter ...