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Interactive Multi-Site Tele-Science and Tele-Rehab

Interactive Multi-Site Tele-Science and Tele-Rehab. Jack Winters, Ph.D. John P. Raynor Distinguished Chair Department of Biomedical Engineering & Jill Winters, Ph.D., R.N. Associate Professor College of Nursing. Motivation. Internet2 Initiatives

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Interactive Multi-Site Tele-Science and Tele-Rehab

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  1. Interactive Multi-Site Tele-Science and Tele-Rehab Jack Winters, Ph.D. John P. Raynor Distinguished Chair Department of Biomedical Engineering & Jill Winters, Ph.D., R.N. Associate Professor College of Nursing

  2. Motivation • Internet2 Initiatives • Internet2 Commons: “Through Internet2 Commons videoconferencing, you can connect to your peers, independent of endpoint brands and through your existing Internet2 network connection.” • Health Sciences Initiative: supports and facilitates the use of advanced networking applications in clinical practice, medical and related biological research, education, and health awareness.

  3. Overview • This presentation will describe several ongoing projects that involve interactive exchange of voice, video and data. • Focus on 3 labs: • Telerehabilitation & Performance Assessment Lab • Medical Device Accessibility & Usability Lab (RERC-AMI) • Falk Neurorehab Reseach Lab • For each, discussion of possible roles for Internet2

  4. Telerehabilitation & Performance Assessment Lab: • Capabilities • 4 + 1 ISDN lines (+ 4 in Conf Rm), Videophones • Focus onProcess • Human-technology interfaces • Different goals require different solutions

  5. Videoconferencing/Multimedia • H.320 Videoconferencing • ISDN, 128K to 512Kb/s • H.324 Videophones • Dial in modems ~31Kb/s • Internet (IP) Conferencing • H.323 (IP/LAN) – voice over IP, [data, video] • SIP Standard - Smarts in computer “terminals” • Messenger Programs – some H.323, some SIP • Streaming Multimedia • Mpeg, Windows Media, Real, …

  6. Modes for Tele-Interaction • Voice (Audio) Issues: • Frequency, Volume • Speech patterns • Codecs (G.xxx) • VideoIssues: • Image quality • pixel (CIF 352x288) • Refresh (2-30 fps) • Codecs (H.xxx) • Shared Data • White Board, mouse • Applications (EHRs) • time-based signals • Files, email • Tactile/Manipulation • Single-user modes • e.g., force, FV • Bi-Lateral Mapping • Force-velocity • Time Delays? E m e r g i n g … Telecom

  7. MU Example:Remote Telerehab Assessment Anna Adenine Stanislaus

  8. Local Telerehab Research Also VAMC, UWM, Clinics, Homes

  9. Internet2 & Telehealth • Internet2 & Quality of Service (QOS) • Will enable new research questions, integration of video, audio and computer/sensor data • Internet2 and Off-Campus Collaboration • Technology into Community for Research Studies? • Collaborative MU-MCW-VAMC Research? • Telehealth Hub at MU? • Clinic? Home? • Opportunities for Internal Collaborations? • Telenursing, teledentistry, telerehab • Software development?

  10. RERC on Accessible Medical Instrumentation Labs • At MU: Medical Device Accessibility and Usability Lab • At UC Berkeley/UCSF: Ergonomics Lab • Collaborative Projects • National Student Design Competition coordinated through our U Conn partners

  11. Rehab Engng Res. Center on Accessible Medical Instrum: “This center must research, develop and evaluate methods and technologies to increase the usability and accessibility of diagnostic, therapeutic, and procedural healthcare equipment for people (e.g., patients, providers) with disabilities.” Marquette University Western University, CA UCSF/Berkeley Ergonomics Lab UW-Milwaukee, U Conn

  12. D1 / Tools for Accessibility Analysis: MU Lab • Approach: • Assemble known human factors, usability lab, universal design tools and methods • Integrate with accessibility requirements • Hardware selection and integration • Video, audio, sensors, wireless • Software development: • Assessment instrument • Mobile lab system use protocol • Platform: ASP.Net & C#

  13. D1: Interaction Between RERC Labs • IP Videoconferencing every 1-2 weeks • 6-8 persons in each meeting • Plan for Cooperative Data Analysis • Interactive analysis of shared video and sensor data • During a videoconference • Using multiple monitor screens

  14. D3: Emerging & Accessible Healthcare Technologies • Coordinator: Jack Winters • Approach: • Participate in the development process of: • Telehealth interfaces • Cross-product integration • Modality translation • Develop and evaluate prototypes aimed at • Consumer-centered access to medical instrumentation • Use of more modern mass-market standards

  15. Impact of Internet2 for RERC • Better MU Lab Collaboration with UCSF/UCB • Better QOS for videoconferencing • Ability to data-share (e.g., video) at same time

  16. Falk Neurorehab Research Lab • Considerable Ongoing Neurorehab Research • Jack Winters (and Jill Winters) • Remote assessment for neurorehab • Motivating therapy for stroke • Intelligent mobile rehab assistant • Jerry Harris – cerebral palsy & movement, stroke-botox • Bob Scheidt – arm movements, including stroke • Brian Schmit – SCI, stroke & spasticity • Michelle Johnson – stroke & rehab robotics • Falk Lab – Available to team

  17. UniTherapy Development • Software for Web-Based Computer-Assisted Motivating Therapy • Designed to Support both Therapy & Assessment • Existing Support for: • Force-Reflecting Joysticks • TheraJoy Devices • Mouse (any form) • TheraDrive wheels • PocketPC Touchscreens (wireless) • Telecommunication over Web • Two Types of Interfaces • Telepractitioner Interface (TI) • Consumer/Patient Interface

  18. TheraJoy • Shown: Horizontal version • Chris Ellsworth • Also: Vertical Extension • Andy Dick, Laura Johnson

  19. UniTherapy Infrastructure

  20. Systems Perspective on Clinical Rehab Process

  21. Interactive Telecoached Therapy H e a l t h c a r e: Possibilities • Motivation • Home Exercise Programs … • Motivating Therapy • Telesupport, telecoaching, tele-assessment • Ex: Constraint-Induced Therapy for Stroke • Technologies: • Virtual Reality/Haptic interfaces • Gaming Interfaces & Software • Interfaces: Mouse, Joystick, Force-reflecting

  22. Figure 1. Telecoach / Supportive Telecare Info (Web) H e a l t h c a r e: Possibilities Tele-Nurse Physician, Therapist Intervention Electronic Healthcare Record Periodic Sampling Data Quality Alarm Tech

  23. Impact of Internet2 for Neurorehab • Web-Based R&D Demo Projects • Possible Interaction with Strategic Colleagues • Northwestern, UC Irvine, MIT/Spaulding Rehab, Sr. Kenney Rehab, Palo Alto VA • Local R&D and Tele-supported Neurorehab? • Cardiopulmonary rehab

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