1. Technical Application and Review of Remote Public Health Monitors Project Scope The project is primarily to monitor the health among disaster victims in shelters or quarantine situations. The monitor is a band that can be placed on the wrist, or elsewhere on the body, and provides heart rate and body movement in real time and/or stores data for assessments. While the monitor is currently designed for rehabilitation, an advanced, multi-sensor device can measure body heat and fluids to determine different stages of infections, lifespan status and individuals’ locations. Since the bands remotely monitor the infected and sick, health management can be more effective. If a specialist monitors an affected population to detect possible illness, such as less movement and/or heart rate changes, protocols can determine whether to attach the advanced band to monitor health care more effectively. The mass production of the heart rate and movement band will cost $60 and the advanced band will cost $180. Other costs include equipment such as computers with software designed to view the status of each band and also the trained staff to install and maintain the equipment. Project Scope The project is primarily to monitor the health among disaster victims in shelters or quarantine situations. The monitor is a band that can be placed on the wrist, or elsewhere on the body, and provides heart rate and body movement in real time and/or stores data for assessments. While the monitor is currently designed for rehabilitation, an advanced, multi-sensor device can measure body heat and fluids to determine different stages of infections, lifespan status and individuals’ locations. Since the bands remotely monitor the infected and sick, health management can be more effective. If a specialist monitors an affected population to detect possible illness, such as less movement and/or heart rate changes, protocols can determine whether to attach the advanced band to monitor health care more effectively. The mass production of the heart rate and movement band will cost $60 and the advanced band will cost $180. Other costs include equipment such as computers with software designed to view the status of each band and also the trained staff to install and maintain the equipment. Materials and Methods The Remote Public Health Monitor is composed of two components – a band monitor and feedback to the specialist through software. These components work together to provide the data and insight that enables specialists to deliver true health management and disaster victim safety. Key Metrics Delivered Figure one shows the technology that will be used to determine a individuals current health status in a shelter or quarantine situation. The technology will provide the following: Heart Rate – used to understand basic condition of victim Body Temperature -- used to discover illness or disease Piezoelectric Accelerometer – used to detect movement GPS – used to locate victim in case of emergency Materials and Methods The Remote Public Health Monitor is composed of two components – a band monitor and feedback to the specialist through software. These components work together to provide the data and insight that enables specialists to deliver true health management and disaster victim safety. Key Metrics Delivered Figure one shows the technology that will be used to determine a individuals current health status in a shelter or quarantine situation. The technology will provide the following: Heart Rate – used to understand basic condition of victim Body Temperature -- used to discover illness or disease Piezoelectric Accelerometer – used to detect movement GPS – used to locate victim in case of emergency Design Features and Results A band similar to one shown in figure two will contain all the components needed to monitor an individual’s life signs. It will be worn on the person’s wrist and activate once movement is detected. The data collected by the sensors will be sent to the health monitoring interface computer in which specialists can view in real time the progress of any infections or disease. Implementation The specialist will utilize the health monitors as a therapeutic tool on disaster victims throughout the quarantine situation. The victim's heart rate and life signs will be monitored through the use of sensor technology in order to uphold health management and safety. When an individual is involved in a quarantine situation or enters a shelter, emergency personal will place the health monitor on the individual and monitor their life signs via software. The software will be designed to understand and provide feedback from the data sent by the health monitors by the use of user-friendly graphical user interfaces (GUIs). A solution overview of the components of Remote Public Health Monitors is shown in figure three. In the Health Monitor system, the heart rate sensor, galvanic skin response sensor, and skin temperature sensor are used to determine the user’s life signals and different stages of an infection if present. The sensors are melded to the programmable unit within the band and process data through the CPU. The processed data is then sent to the health monitor interface computer via a Bluetooth transmitter. The sensors and programmable unit will be powered by a rechargeable small battery similar to a watch battery. The health monitoring interface computer will store and use the data received by the band to produce infromative feedback reports of the health status of band users. Design Features and Results A band similar to one shown in figure two will contain all the components needed to monitor an individual’s life signs. It will be worn on the person’s wrist and activate once movement is detected. The data collected by the sensors will be sent to the health monitoring interface computer in which specialists can view in real time the progress of any infections or disease. Implementation The specialist will utilize the health monitors as a therapeutic tool on disaster victims throughout the quarantine situation. The victim's heart rate and life signs will be monitored through the use of sensor technology in order to uphold health management and safety. When an individual is involved in a quarantine situation or enters a shelter, emergency personal will place the health monitor on the individual and monitor their life signs via software. The software will be designed to understand and provide feedback from the data sent by the health monitors by the use of user-friendly graphical user interfaces (GUIs). A solution overview of the components of Remote Public Health Monitors is shown in figure three. In the Health Monitor system, the heart rate sensor, galvanic skin response sensor, and skin temperature sensor are used to determine the user’s life signals and different stages of an infection if present. The sensors are melded to the programmable unit within the band and process data through the CPU. The processed data is then sent to the health monitor interface computer via a Bluetooth transmitter. The sensors and programmable unit will be powered by a rechargeable small battery similar to a watch battery. The health monitoring interface computer will store and use the data received by the band to produce infromative feedback reports of the health status of band users. As shown in figure four, when the user puts on the Health Monitor, it will turn on automatically from detecting movement and begin recording of life signs via the sensors. The CPU on the programmable unit will process the data and send it to the health monitoring interface computer by Bluetooth. The data will be stored in a database and be used to display the current life signals of individuals in real time. The specialist will then decide whether to remove the health monitor from an individual by receiving information from a higher authority that the quarantine is over. If the quarantine is lifted, the health monitors will be removed and be charged through USB ports. Another option instead of recharging the health monitors is to replace the battery. Technical Risk Analysis C1 – User Acceptance is the biggest risk of this project because if the disaster victim believes the health monitor to be violating human rights then the individual will not wear it, making the system incomplete. More information about this risk is provided by Nick Paulson’s study of risk factors of remote health monitors. C2 – Improper utilization of the health monitor interface by specialists and improper use of the health monitors by disaster victims will be mitigated by very specific install instructions. T1 – Hardware and Software Interoperability is the second largest risk for the project and will be mitigated by testing. T2 – Malfunction of the device and software will be mitigated by troubleshooting staff that will support both users and specialists. As shown in figure four, when the user puts on the Health Monitor, it will turn on automatically from detecting movement and begin recording of life signs via the sensors. The CPU on the programmable unit will process the data and send it to the health monitoring interface computer by Bluetooth. The data will be stored in a database and be used to display the current life signals of individuals in real time. The specialist will then decide whether to remove the health monitor from an individual by receiving information from a higher authority that the quarantine is over. If the quarantine is lifted, the health monitors will be removed and be charged through USB ports. Another option instead of recharging the health monitors is to replace the battery. Technical Risk Analysis C1 – User Acceptance is the biggest risk of this project because if the disaster victim believes the health monitor to be violating human rights then the individual will not wear it, making the system incomplete. More information about this risk is provided by Nick Paulson’s study of risk factors of remote health monitors. C2 – Improper utilization of the health monitor interface by specialists and improper use of the health monitors by disaster victims will be mitigated by very specific install instructions. T1 – Hardware and Software Interoperability is the second largest risk for the project and will be mitigated by testing. T2 – Malfunction of the device and software will be mitigated by troubleshooting staff that will support both users and specialists. Conclusion and DHS Relevance This project can primarily be used for emergency response and for emergency preparedness. In the context of emergency response, the health monitors can be implemented at shelters and for quarantines to improve recognition of infections and minimize the spread of disease in confinement. In the context of preparedness, the monitors can be available for emergency services in communities and provide a way that severe infections can be successfully managed and the sick quarantined to improve the protection of the survivors and prevent a disaster. Prototype Design: If funded, a similar device on the market can be purchased and tested to remotely monitor sickness among a target population, such as a business office. If remote protocols are helpful in a test community, the design of an advanced monitor is warranted. The technology transitioning of a product from the company SenseWear can be modified and used as a health monitor prototype. The sample picture of a band in figure two and also the core technology picture in figure one are examples of the Sense Wear product that can be transformed into a health monitor. Also, more research into risk analysis and mitigation, competition, project management, and budgeting staff expenses are needed to make this prototype a success. Conclusion and DHS Relevance This project can primarily be used for emergency response and for emergency preparedness. In the context of emergency response, the health monitors can be implemented at shelters and for quarantines to improve recognition of infections and minimize the spread of disease in confinement. In the context of preparedness, the monitors can be available for emergency services in communities and provide a way that severe infections can be successfully managed and the sick quarantined to improve the protection of the survivors and prevent a disaster. Prototype Design: If funded, a similar device on the market can be purchased and tested to remotely monitor sickness among a target population, such as a business office. If remote protocols are helpful in a test community, the design of an advanced monitor is warranted. The technology transitioning of a product from the company SenseWear can be modified and used as a health monitor prototype. The sample picture of a band in figure two and also the core technology picture in figure one are examples of the Sense Wear product that can be transformed into a health monitor. Also, more research into risk analysis and mitigation, competition, project management, and budgeting staff expenses are needed to make this prototype a success. Literature Cited SenseWear. (2008). Retrieved January 5, 2009, from SenseWear: http://www.sensewear.com/http://www.sensewear.com/ Acknowledgments Dr. Anne Garland - Applied Research in Environmental Sciences NonProft, Inc. (ARIES) “This project was funded through the National Center of Risk and Economic Analysis of Terrorism Events (CREATE) Center of Excellence by a grant from the Department of Homeland Security, Science and Technology Directorate, Office of University Programs.” For Further Information -Contact Spencer Garland at sgarl002@odu.edu A brief description, project management and technical information can be viewed at http://24.241.255.90:84/dotproject/ with Username: “Guest” and Password: “project”, and go to the forum section of the Project labeled “Remote Public Health Monitors”. http://24.241.255.90:84/dotproject/ Literature Cited SenseWear. (2008). Retrieved January 5, 2009, from SenseWear: http://www.sensewear.com/http://www.sensewear.com/ Acknowledgments Dr. Anne Garland - Applied Research in Environmental Sciences NonProft, Inc. (ARIES) “This project was funded through the National Center of Risk and Economic Analysis of Terrorism Events (CREATE) Center of Excellence by a grant from the Department of Homeland Security, Science and Technology Directorate, Office of University Programs.” For Further Information -Contact Spencer Garland at sgarl002@odu.edu A brief description, project management and technical information can be viewed at http://24.241.255.90:84/dotproject/ with Username: “Guest” and Password: “project”, and go to the forum section of the Project labeled “Remote Public Health Monitors”. http://24.241.255.90:84/dotproject/ Spencer Garland, Nick Paulson Working Together For A Safer Tomorrow/National Center of Risk and Economic Analysis of Terrorism Events Old Dominion University, Department of Computer Science Spencer Garland, Nick Paulson Working Together For A Safer Tomorrow/National Center of Risk and Economic Analysis of Terrorism Events Old Dominion University, Department of Computer Science Probability Not LikelyLowModerateHighExpected Impact ExtremeT1 C1 High ModerateT3 T2 Low C2 Negligible ItemTechnical RisksProbabilityImpact T1Hardware and Software Interoperability25 T2Malfunction (Device and Software)23 T3Hardware and Software Accuracy13 ItemCustomer RisksProbabilityImpact C1User Acceptance3 5 C2Proper Utilization12 Fig..1 – Core Technology Fig.3 – Major Functional Component Diagram Fig.2 – Health Monitor Band Fig.4 – Device Process Flow Skin Temperature measures the surface temperature of the body 3-axis Accelerometer measures motion Galvanic Skin Response measures skin impedance which reflects water content of the skin and the constriction or dilation of the Vascular periphery Heat Flux Measures the rate at which heat is dissipating from the body