The advances in information, communication and micro — technologies are leading to the introduction of new devices that can transform our living environment. One of the most promising fields of applications for domotics is the home of elderly citizens, whose aim is to live independently. The challenge today is to integrate different domotic technologies into a service framework that is really useful and is sustainable in terms of financing: this article sets out to discuss a possible pathway to independent living.
Domotics is attracting a lot of attention, thanks to the presentation of new hardware and software applications that promise to change out relationship with our homes. New gadgets, smart appliances and widespread sensors aim to make life easier and more comfortable. In order to discuss domotics we can start from a definition, quoting wikipedia:
“Home automation (also called domotics) is a field within building automation, specializing in the specific automation requirements of private homes and in the application of automation techniques for the comfort and security of its residents. Although many techniques used in building automation (such as light and climate control, control of doors and window shutters, security and surveillance systems, etc.) are also used in home automation, additional functions in home automation include the control of multi-media home entertainment systems, automatic plant watering and pet feeding, and automatic scenes for dinners and parties.”
Attractive scenarios are created in order to allow us to visualise the possible impact of domotics on our everyday lives. We can start with a scenario exercise, based on technologies that are currently under development, in order to look at our future, discussing what we may call ‘the bathroom centered health management system’. We can imagine entering our very advanced bathroom in the morning, where a micro mass spectrometer could make a complete analysis of our breath, we could place our hand on the wall and get a full blood screening using either non invasive spectrometry measurement or a collection of blood samples through microneedles and our toothbrush could include an analysis system to check our saliva. The complete set of information would then be used to set up our diet for the day, programming the smart appliances in the kitchen to mix drug components in our food, preparing the diet for the day, booking the gym for the necessary physical activity, and organising a visit with our GP in order to look more closely at some more serious problem. While the scenario is fascinating, integrating prevention, diagnosis and therapy seamlessly in our everyday life, it opens up a set of questions that are already valid today when we discuss domotics.
Some of these questions are:
1. Who is going to pay for the technologies and the consumables: a public healthcare service, a private insurance or is it an out-of-pocket expense for the citizen?
2. Who is going to ‘maintain’ the protocols used in the data analysis and is going to make sure that the most effective choices are made?
3. Who is liable if the systems are not successful and result in health damage of some sort?
2. The Technology Background
The needs of the ageing population are one of the main drivers behind the development of domotics: the decrease in physical and mental abilities and the need to prevent and manage chronic ailments pose new questions concerning the living environment.
The goals are:
• Ageing independently: elderly citizens want to continue to live safely and with an appropriate standard of quality in their own homes;
• Control care costs: the burden of care often falls back on the family, creating explicit and implicit costs that add to those generated by the social and health services. Controlling these costs means also reaching efficiency and efficacy targets.
• Create an ICT network that supports citizens, families and caregivers.
• Avoid isolation and promote socialization.
• Develop ‘usable’ technologies.
Figure 1: The ICT network for social and health care services
The complexity of care organization and of the ICT services are depicted in fig. 1: the need to communicate, store data and organise processes poses challenges in terms of innovation in work practices and technology infrastructures.
This infrastructure is the back office for every implementations of domotics: a key role in the organization is represented by the Multimedia E-Health center, that supports all information exchange and is the human factor behind the continuity of the care process. The e-health center maintains all communications channels, as depicted in Figure 2.
Figure 2: The E-Health center managing the content of the communication channels
The multimedia E-Health center acts as the receiving node also for all information generated by the domotic systems installed at home.
The personal and environmental alarms let the citizen manage unexpected crisis events, using devices like:
1. The personal alarm system, a panic button plus microphone in order to send an alarm and communicate from every room in the house
2. A fall detection system, plus audio system, that identifies situations where sudden accelerations have been taking place.
3. Flood, fire and gas sensors, detecting anomalies in the environment.
4. Motion detectors that can indicate that particular rooms in the house are not being used, such as the bathroom and the kitchen, suggesting a situation of inability to fulfil the most basic needs.
5. Door opening sensors, indicating that the person is leaving.
6. Anti burglary devices and alarms, that can be implements in helping to avoid unfriendly intrusions when the person is at home.
The Multimedia E-health center can filter these alarms, activating the proper response.
In addition to the alarm systems, there are systems that support people with reduced physical abilities, such as electromechanic blinds, motorized beds and armchairs, air conditioning and so on. These devices are moving from a ‘non-networked’ situation to a ‘networked’ status: in this case the E-Health centre will also collect information from these devices, increasing the alarm detection capability.
Nicola Pangher: PhD, Director, Business Development and E-Health, ITALTBS SpA, Padriciano 99, 34012 Trieste, Italy.
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Tags: domotics, managing chronic diseases