In the era of data-driven science, corpus-based language technology is an essential part of cyber physical systems. In this chapter, the authors describe the design and the development of an extensible domain-specific web corpus to be used in a distributed social application for the care of the elderly at home. The domain of interest is the medical field of chronic diseases. The corpus is conceived as a flexible and extensible textual resource, where additional documents and additional languages will be appended over time. The main purpose of the corpus is to be used for building and training language technology applications for the “layfication” of the specialized medical jargon. “Layfication” refers to the automatic identification of more intuitive linguistic expressions that can help laypeople (e.g., patients, family caregivers, and home care aides) understand medical terms, which often appear opaque. Exploratory experiments are presented and discussed.

RSP-QL was developed by the W3C RDF Stream Processing (RSP) community group as a common way to express and query RDF streams. However, RSP-QL does not provide any way of annotating data on the statement level, for example, to express the uncertainty that is often associated with streaming information. Instead, the only way to provide such information has been to use RDF reification, which adds additional complexity to query processing, and is syntactically verbose. In this paper, we define an extension of RSP-QL, called RSP-QL*, that provides an intuitive way for supporting statement-level annotations in RSP. The approach leverages the concepts previously described for RDF* and SPARQL*. We illustrate the proposed approach based on a scenario from a research project in e-health. An open-source implementation of the proposal is provided and compared to the baseline approach of using RDF reification. The results show that this way of dealing with statement-level annotations offers advantages with respect to both data transfer bandwidth and query execution performance.

Background: Populations of elderly patients with chronic obstructive pulmonary disease (COPD) or heart failure (HF) are growing. To prevent exacerbations leading to inpatient care, a 4 year (2013-2017) telehealth intervention non-randomized single-centre clinical study was performed. We hypothesized that the patients, grouped by advanced COPD or HF, would exhibit decreased need of hospital admissions.

Objective: To study hospital admissions in patients with COPD or HF using a telemonitoring system, the Health Diary.

Methods: A telemonitoring system, the Health Diary, based on digital pen technology, was employed. Patients with COPD or HF treated at the University Hospital in Linköping were included if they had at least 2 hospital admissions the previous year. Data on hospital admissions was obtained from the administrative healthcare database. Expected number of hospital admissions for the study year was calculated using 5-year data for a group of patients with matching diagnosis and history of hospital admissions and was compared to the actual value in the intervention group using Poisson regression.

Results: Together with the included patients, 159 HF and 136 COPD non-intervention patients was used to calculate the expected values for hospital admissions. For the 58 included HF patients, the average number of hospital admissions of 0.81 was 32.8 percent (p=0.04) lower than expected. For the 36 included COPD patients, the average number of hospital admissions of 1.44 was 37.0 percent (p=0.02) lower than expected.

Conclusions: Use of the telemonitoring system, the Health Diary, decreases hospital admissions in elderly with COPD and HF.

Background: Populations of elderly patients with advanced stages of chronic obstructive pulmonary disease (COPD) or heart failure (HF) are growing, urging the need for specialized health care in the patients’ home. A 4 year (2013-2017) telehealth intervention single-centre clinical study has been completed. We hypothesized that the two groups of patients, advanced COPD or HF, would exhibit differences regarding exacerbations and the need of health care.

Objective: To study exacerbations of COPD or HF, and patients’ need of health care.

Methods: A telemonitoring system, the Health Diary, which is based on digital pen technology, was employed. Patients with at least 2 hospital admissions the previous year were included. Responsible nurses and physicians at a specialized home care unit at a university hospital checked all daily patient reports. Physicians identified exacerbations using information provided through the telemonitoring system and patient contacts. Consumed health care was assessed as the number of patient contacts (home visits or telephone consultations).

Results: Totally, 94 patients with advanced disease were enrolled (36 COPD and 58 HF patients) of which 53 patients (19 COPD and 34 HF patients) completed the 1-yr study period. The major reason for not completing the study was death (13 COPD, 15 HF patients). Average numbers of exacerbations were 3.1 and 0.8 and patient contacts were 94 and 67 per COPD and HF patient, respectively.

Conclusions: Compared to HF patients, COPD patients exhibit exacerbations more frequently and demand much more home health care. This difference of health care consumption is mainly due to disease characteristics.

This paper presents the motivation and challenges to developing semantic interoperability for an internet of things network that is used in the context of home based care. The paper describes a research environment which examines these challenges and illustrates the motivation through a scenario whereby a network of devices in the home is used to provide high-level information about elderly patients by leveraging from techniques in context awareness, automated reasoning, and configuration planning.

Background: Growing populations of elderly patients with advanced stages of COPD or heart failure (HF) urge the need for specialized health care in the patients' home. A telemonitoring study has been initiated including patients using digital pens. Health care was provided by the specialized home care unit at a university hospital. Through an IT system the staff checked all daily patient reports. We hypothesized that the two groups of patients, advanced COPD or HF, would exhibit differences regarding exacerbations and the need of health care.

Objective: To study exacerbations of COPD or HF, and patient health care consumption.

Methods: A tele-monitoring system, the Health diary, which is based on digital pen technology, was employed. Exacerbations were identified using information provided through the telemonitoring system. Consumed health care was assessed as the number of patient contacts (home visits or telephone consultations).

Results: Presently, 33 patients with advanced disease are enrolled (13 COPD and 20 HF patients) of which 11 patients (6 COPD and 5 HF patients) have completed the 1-yr study period or have died during the study period (2 COPD and 4 HF patients). Exacerbations were 2.8 and 0.8 and patient contacts were 96 and 42 per COPD and HF patient, respectively. While HF patients were significantly older than COPD patients, the two groups demonstrated no difference regarding gender distribution and comorbidity.

Conclusions: COPD patients exhibit exacerbations more frequently and demand much more home health care than patients with HF do. It seems that this difference of health care consumption is mainly due to disease characteristics.

Telehealth solutions should be available also for elderly patients with nointerest in using, or capacity to use, computers and smartphones. Fourteen elderly,severely ill heart failure patients in home care participated in a telehealth study andused digital pens for daily reporting of their health state—a technology never usedbefore by this patient group. After the study seven patients and two spouses wereinterviewed face-to-face. A qualitative content analysis of the interview materialwas performed. The informants had no experience of computers or the Internet andno interest in learning. Still, patients found the digital pen and the health diaryform easy to use, thus effortlessly adopting to changes in care provision. Theyexperienced an improved contact with the caregivers and had a sense of increasedsecurity despite a multimorbid state. Our study shows that, given that technologiesare tailored to specific patient groups, even “the digital illiterate” may use theInternet.

Considering that a majority of elderlies are non-users of computers and Internet we developed a telemonitoring system for elderly heart failure (HF) home care patients based on digital pen technology - a technology never used before by this patient group. We implemented the system in clinical use in a 13 months long study. Fourteen patients (mean/median age 84 years) with severe HF participated. They accepted the technology and performed daily reports of their health state using the digital pen and a Health Diary form. Via the system the clinicians detected all HF-related deteriorations at an early stage and thereby prevented hospital re-admissions for all patients during the study, implying improved symptom control and large cost savings.