The Technology Enabled Home: Applications and Bandwidth

Posted on September 20, 2012 by lkeyes70 — Leave a comment

I found myself building list of the applications that we would expect to be running in our rural senior housing sites, for both residents (The Technology Enabled Home) and the housing and health-care staff that are onsite. This should give us some ball-park ideas of what we might want for bandwidth to the building, and what we would expect to deliver to each apartment.

Infrastructure for Rural Housing Sites:
* Symmetrical bandwidth
* Office internet service for VoIP, Internet ,Videoconferencing for up to two simultaneous employees
* A minimum of two fixed IP addresses for the location.
* Wireless internet service in resident common areas
* Individual wired resident internet service in apartments for SASH (health care apps)
* Individual resident internet service for education, eMail, and consumer applications.
* Ubiquitous wireless throughout each building for iPad access (healthcare), and “casual” resident and guest service.

Applications for SASH and Property Management Staff
* H.323 videoconferencing (512Kb symmetrical)
* VoIP for office lines
* VPN routing
* Property Management Database; (Boston Post)
* “Active” web applications (GoToMeeting, Skype, Skype Video, BaseCamp)
* EMR system (DocSite) requires continuous solid web connection)
* Streaming Video, (Vimeo, YouTube)
* The usual web surfing, eMail
* Cloud-based storage (DropBox, Amazon S3)

* Vital sign sensor data (relatively low bandwidth)

* SmartGrid

* HVAC sensors and management

* Video monitoring / surveillance

Applications for Residents

* Web surfing, eMail

* Social Media: FaceBook, Twitter

* Skype, Skype Video, FaceTime

* Video apps: YouTube, iTunes, Vimeo, Hulu

* Real-time networked gaming applications

* Tablet apps, iPad, Kindle, etc.

* Tele-work applications

Tagged with: bandwidth requirement, Hardware, Skype, Tablet, technology, videoconferencing
Posted in Electronic Health Record, Sensors, Skype, Technology, Technology-Enabled Home, Telemedicine, Videoconferencing, Wireless

Quick Notes: Tele-Yoga, GrandCare Home Monitoring, H.323 video for Macintosh

Posted on August 7, 2012 by lkeyes70 — Leave a comment

1. We have begun a “soft opening”… with our Tele-Yoga for COPD/CHF patients, transmitting to 3 patients in their homes in California, which have been equipped with DocBoxes. Originating from our “studio” (the community exercise room) in one of Cathedral Square’s housing facilities; we’re using a Polycom VSX 7000 for our transmission hardware. The program, developed by faculty researchers at the University of California Dsypnea Laboratory, is being delivered to patients who otherwise would have difficulty traveling to a clinic or gym facility. The DocBox allows them to partake in a supervised exercise program while at home. We’re hoping to add additional participants in the coming week.

2. One of the most interesting and comprehensive suite of in-home monitoring technology comes from GrandCare. It works on lots of different hardware, and integrates a lot of external hardware as well.

3. After suffering for years with the open source XMeeting application for Mac OSX, the Logitech LifeSize Softphone appears to be a stable H.323 and SIP client for Mac videoconferencing. Digging a little deeper on the website, and exploring their other offerings, it looks like this was formerly the Muriel software that was purchased and re-branded by Logitech. Logitech also has a fancier version of the Logitech Orbit AF camera, the Conferencecam. We have had great luck with the AF, which we supply with the DocBox. Both the Softphone software and the camera appear to have list prices of $199….which means that the days of $1500-$3500 dedicated desktop videoconferencing systems may be numbered.

Tagged with: CHF, congestive heart failure, COPD, videoconferencing, yoga program
Posted in Personal Technology, Sensors, Skype, Technology, Technology-Enabled Home, Telemedicine, Videoconferencing

Tele-Health in the ICU

Posted on August 7, 2012 by lkeyes70 — Leave a comment

Can Hospital Chains Improve the Medical Industry?
http://www.newyorker.com/reporting/2012/08/13/120813fa_fact_gawande?currentPage=all

Posted in Uncategorized

And they didn’t say “eh”

Posted on July 16, 2012 by lkeyes70 — Leave a comment

I’ve spent the last four days on a trip to Vancouver B.C. for a meeting of our fledging research network.

Several colleagues from the U.S. independently mentioned how well things worked in Canada, how multicultural the society is, and how courteous and friendly the people are. I’m typing this at the end of the concourse in Vancouver’s gleaming airport, watching the sunset over the Canadian Rockies. I’m plugged into a convenient outlet and connected with free wireless, available throughout the airport. I’m in a spot with a better view, and more quiet than the airline club, albeit without the free drinks and food buffet.

Vancouver looks as if it is trying to figure out how to promote a less intensive energy expenditure. About 90% of the taxis are Priuses.. The rest are a mix of mostly other Toyota models. The city has gone a long way to promote and accommodate bicycles, with easy rentals, storage lockers, dedicated bike lanes, etc. My hotel, the Fairmont Hotel Vancouver offers two hour bike rentals for free, with helmet and bike lock included.

For all this, the city is expensive.. more than Washington D.C. Eight dollars for a beer!

I have the nagging feeling that the U.S. used to be a lot more like this… and, in many respects, I wish we could be more like Canada., with it’s examples of beautiful new public infrastructure, socialized healthcare, and a more equitable society all around.

Posted in Uncategorized

How to cancel your iPad AT&T Data Plan

Posted on June 29, 2012 by lkeyes70 — 2 Comments

We have been deploying iPads for our health-care application, and I transferred my iPad from a person credit account to a corporate account. In the process I though it was understood that my credit card would no longer be charged, but I kept seeing charges come up on my card. Now after paying an extra $75.00 or so, I’ve managed to cancel the credit card account; I’m hoping that I haven’t borked the corporate account, but we’ll see what happens at the beginning of next month.

Two reasons we chose AT&T over Verizon for our application:

AT&T seems to have better coverage. As part of a settlement when Fairpoint acquired Verizon land-lines, AT&T acquired Unicel; they took over the Unicel towers, and they had better penetration in the backwoods of New England.
AT&T offers a lower-cost iPad data plan at $14.99 /mo. for 250 megabytes, which we’re hoping is sufficient for our application. The next step for is $30.00 / mo. for 3 gigabytes.

So, anyway, here are the steps I took to cancel my personal plan.

1. Go to http://www.att.com/ipad

2. On the right there is a link: “Add more prepaid data”.

3. Once you get there, you need to log in using the eMail address that you set up for the ATT account. (I know this address, because ATT sends me an eMail each month saying that I successfully updated my data plan.)

4. Click on Add/Edit domestic plan

5. There will be an option to Cancel Plan.

Once you choose that cancel option, you’l be presented with two options;

Cancel plan and cancel your account
Cancel plan and retain your account for sixty days

If you just want to “turn off” your account for a couple months, choose the second option. You can then relog in during the sixty day period and restart the plan.

This whole process seems actually pretty civilized (if it works). It allows you to turn it on or off as needed. It gives you the 3G option for when you are traveling, say, but then allows you to go for a couple months without a charge.

The $30.00 / 3 gig plan has been changed from my earlier personal plan of $25.00 / 2 gigs. I have to say, 2 gigs seemed to be more than sufficient while traveling. The nice thing too is that if there is an ATT hotspot present, the iPad will automatically default to that, so you can avoid daily or hourly charges to those. And of course, the iPad defaults to wireless in the presence of any valid hotspot, to keep your 3G usage lower.

Tagged with: Mobile, Tablet, Wireless
Posted in Personal Technology, Wireless

Parallax / Polar Heart Rate Sensor

Posted on June 28, 2012 by lkeyes70 — Leave a comment

Parallax has added a Polar heart-rate sensor with chest strap to its line of sensors, as well as a receiver. Both are around $30.00 each.

Polar Heart Rate Monitor strap

Found in the super wonderful Nuts and Volts magazine.

Tagged with: Hardware, Sensors
Posted in Sensors, Technology, Technology-Enabled Home

Medical Advocacy Blog A Mashup of Art, Outrage and Patient Advocacy

Posted on June 26, 2012 by lkeyes70 — Leave a comment

The Medical Advocacy Blog chronicles one women’s attempt to participate and advocate in the care of her terminally ill husband, and the wider implications of the Electronic Health Record.

I now sit in meetings for hours and watch power point lectures about electronic medical records. I listen to people dissect HIPPA regulations and incentive time tables. I hear arguments comparing ICD-9 code to ICD-10. And sadly, I hear many people tell me that patients should never see the entire medical record. I think they have no concept of the word meaning in “Meaningful Use.” For too long the medical record has been considered a billing document or a legal document: property of the physician or institution, instead of what it is, the story of the patient. “Meaningful Use” is not just a government buzz word or an unrealistic timetable of obligation, it is that childhood question: “What is the moral of this story?”

Tagged with: Advocacy, Healthcare Reform, Other Voices
Posted in Electronic Health Record, Healthcare Reform, Technology

FitBit Aria WiFi Weight Scale

Posted on June 24, 2012 by lkeyes70 — 1 Comment

Times and technology change. My previous wireless scale from Tanita cost $350.00 and used BlueTooth to communicate to a computer. The FitBit Aria wifi scale works on a conventional wifi network. It will automatically register your weight and percentage body fat, and upload the results to the same personal FitBit web site that stores results from the regular FitBit personal tracker.

FitBit Aria WiFi Weight Scale.

Setup was a little finicky. There are a couple ways to do it, either using a web browser or your smart phone. After several attempts with the web browser I fired up the iPad and managed to get it configured using the smartphone app.

not my feet…or, sadly, my weight either.

Standing on the scale each morning, the scale first displays your weight, (in pounds, kg, or stone), then your percentage of body fat. It then displays your initials, so that you know who the measurements are for. The scale is smart enough to figure out the different average weights from multiple users. Once completed, it uploads the data to the FitBit web site, where you can see it displayed on your account. (Click on the graph to enlarge).

The price of the Aria is $129.00. This is a great addition to the TFHHC toolkit, not only for us schlubs who want to track our weight, but also possibly for those with congestive heart failure. A three-pound weight gain within 24 hours can suggest a dangerous accumulation of fluid; more on CHF and weight gain is available here.

Tagged with: congestive heart failure, healthy-living, technology
Posted in Personal Technology, Technology, Technology-Enabled Home, Telemedicine

FitBit Personal Tracker

Posted on May 19, 2012 by lkeyes70 — Leave a comment

I’ve had a FitBit pedometer for over a year now. Actually I’m on my second one, as I lost the first one. They are so darn unobtrusive that you hardly know they are missing. At $99.00 a pop, though, it it is worthwhile keeping track of your tracker.

The FitBit is a pedometer on steroids. It counts your steps each day, and automatically uploads them to your account on the FitBit web site. The FitBit will also track changes in height; so if you climb five flights of stairs, it will record that effort, and incorporate the altitude change in its calculations of expended effort. The web site encourages goal setting, and allows you to plot changes over time.

The FitBit will also plot sleep time by determining when you go to sleep, and the level of activity or restlessness that you show during your sleeping hours. The unit comes with a wrist band to fasten itself to your wrist. For counting steps, you can wear the FitBit clipped to a belt, or left loose in a pocket.

Setup can be a bit finicky, especially for Mac users. Once you have established an account at the FitBit web site, you plug in the docking station via USB to your computer, and then place the FitBit into the dock. In theory there is a step-by-step set of instructions on screen. Despite any difficulties, once it is set up it works reliably, and requires little in the way of maintenance. If the docking station is plugged in, and the computer is turned on, the FitBit will wirelessly transmit the current readings every 15 minutes or so. These will then be available instantly on the web site for viewing and comparisons.

Using FitBit

The FitBit is rediculously easy to use; Step 1. Put in pocket, Step 2. Walk. I carry it around most days, and, every once in awhile, check to see how the steps are going. On an average work day, despite my attempts to get up and walk around at least once an hour, I get up to maybe 3500 steps, which is pathetic, of course. It just goes to show how a suburban, car-dependent lifestyle sucks away opportunities for walking. So far, my best day has been 18,000 steps which reflects a 45 minute walk first thing in the morning, and then mowing both of my front and back lawn with my tiny electric push mower.

Weekends, I’ve had more time to enter data into the web site, by tracking my food intake. This is a useful exercise which provides lots of interesting information and more than a few surprises. (Yes there is sodium in yogurt.) All-in-all, a very handy gadget for those of us trying to crank up our activity, and keep track of our weight.

Tagged with: fitness, health, pedometer
Posted in Technology, Technology-Enabled Home, Telemedicine