Based on studies of medical work it is evident that conventional computer technology designed for office use is inadequate for use in a hospital setting. Clinical work is characterized as being hectic, nomadic, collaborative, ad hoc, and interrupted – attributes that are in strong contrast to normal office work. In a hospital setting such a basic thing for desktop computers as a desk and a chair does simply not exist. Hence, there is a need for creating fundamental new concepts for creating computer systems in a hospital environment.

We have created the ABC framework – ABC standing for Activity Based Computing. The basic computational unit is no longer the file (a document) or the application (MS Word) but the work activity of a user. Users can simply carry with them the various work activities in which they are engaged within the hospital and seamlessly transfer these from one computer to another. Actually, we no longer talk about ‘computers’ anymore but about ‘public displays’. These public displays are embedded in floors, walls, medicine cabinets, beds, etc.

Project website: http://www.daimi.au.dk/~bardram/abc

Because of the nomadic nature of medical work, the use of PDAs and TabletPCs are increasing in hospitals. There are however a number of technical challenges of creating a smooth integration between a fixed Electronic Patient Record system and more mobile devices. Issues of software architecture, integration, user-interface, interaction, and the degree of functionality on a mobile device versus on desktop PCs are non-trivial questions.

This project seeks to investigate how to design a flexible software architecture for mobile EPR solutions, which automatically adapts itself to its execution environment – both concerning what device the user is currently using and in what working context the user is situated. Hence, the architecture enables the user to change device easily, ranging from small PDAs to desktop computers with large displays, without any interruption in the user session and no need for any kind of user authentication on the devices used. We call this concept ‘application roaming’ between devices. Furthermore, the software architecture enables the user-interface on a mobile device to adapt itself to the usage context of the user. For example when a nurse is entering a ward room, a list of the patients located in this room is listed for easy access, and when she approaches a patient, the device automatically brings up this patient’s medical record. We call this concept ‘context-aware displaying’.

The demographic development shows a growing percentage of elders in Denmark and in other Western countries. Assisted living denotes technologies designed to assist elders and help them to stay in their own home for a longer time and manage better. The ElderTech project involves an ethnographic study of newly developed technology offering assistance for the elder to handle medication, monitoring of blood pressure and weight, and easy communication and coordination of the care of the elders. The study particularly pays attention to the relation between the elder, the medication and the physical setting and the technology’s role in this. These studies form the basis for the design of new innovative technologies for assisted living based on pervasive computing technology.

In this project we work with at IT-support for pregnant, diabetic women - how to develop such IT support, the nature of such support and concrete prototypes. Among the novel techniques under development are workshops conducted in waiting rooms at hospitals in order to involve pregnant women living far apart without too much extra effort. The prototypes under development include an electronic diary that integrates health-related information and is used for communication and information sharing between the pregnant women's private sphere, e.g. husband and friends, and the healthcare sphere, e.g. doctors and midwives and the EPR systems of the different hospitals. A second it prototype is the virtual ambulatory which supports tele-consultations between specialized hospitals at the one end and homes/workplaces/general practitioners/non-specialized hospitals at the other. An important part of the set-up is different kinds of bio-sensors. The use of the e-diary and the simultaneous involvement of more than one home/workplace/... are also important aspects of the concept and prototypes. Download report here

Context-awareness covers the idea of computers reacting upon, and adapting to the user’s context, e.g. location, time of day, the specific task the user is engaged in, etc. Context is sensed by tracking location of persons and objects, through sensors in the environment, and by trying to understand what the user is doing, by e.g. looking in his or her calendar.

As a basic infrastructure for enabling context-awareness in hospitals we have created the Java Context-Awareness Framework (JCAF). This framework is used as a basic service in many of the other projects, including the Activity-Based Computing framework, the AWARE architecture, and in the creating of the proximity-based user authentication mechanisms.

Furthermore, in our attempt to embed computational power into the everyday devices of clinical personnel we have created a prototype of a context-aware hospital bed. The bed has an integrated (small) computer and a touch sensitive display. Furthermore, the bed is equipped with various sensors that can identify the patient lying in the bed, the clinician standing beside the bed, and other items in its vicinity. In this way, the computer can adapt the computer screen to the users – be it a nurse or the patient. For example, the video and internet browsing preferences of a patient is loaded into the computer when a patient is using the bed.

Project website: http://www.daimi.au.dk/~bardram/jcaf/

The project partners wish to investigate whether it is realistic within two to three years to create an entirely new type of personalized guiding for people going to a hospital for examination, treatment or hospitalization and visitors to hospitals; as an alternative to the signage which is used today.

In the new system the visitor/patient (the user) will be equipped with a small, inexpensive, robust device which is equipped with wireless communication. The destination of the user must be programmed into the device to "know" where the user should be guided to.

Using the infrastructure at the hospital, the user will be assisted in finding his way through the hospital - even if the user comes astray and must be helped back on track, just as the car's GPS, which can dynamically calculate a new route.

Studies show, that there is a large savings potential by staff, not spending their time guiding people and help lost people around in the buildings.

The Lodestar project is funded by The Central Denmark Region and EU via Caretech Innovation.

Surgical simulation presents a virtual environment where surgeons can train surgical procedures. Our research has focused on the development of faster calculation of deformation and visualization. We seek to simulate very complex morphology in real-time. The project has two clinical applications; congenital cardiac diseases and cranio facial deformations.

Current standards in magnetic resonance imaging of congenital heart disease are based mostly on anisotropic protocols to image both morphology and function. Operator-dependent acquisition planning is typically needed to obtain the desired images. We propose to instead use operator-independent, three-dimensional, isotropic imaging protocols to acquire both morphology and function (cine, flow) of the entire heart in a few standardized acquisitions. Then, due to the isotropic property of the data, any desired imaging plane can be 'imaged' offline by interactive planar reformatting and used for qualitative and quantitative diagnostic evaluation.

Project website: http://www.daimi.au.dk/~mosegard/medVisSim/
Additional website: http://www.cavi.dk/projects/medicalvisualization.php

Emergency situations demand fast, effective collaboration between diverse actors: victims, personnel on the scene of an accident, in emergency vehicles, dispatch centres, and hospitals, sometimes the media and public authorities need to be involved, too. Communication is crucial, but often difficult under immense time-pressure, in extremely complex and often dangerous settings. A range of technologies is used to obtain and record information, construct an overview of (ongoing) events, for communication and synchronous as well as asynchronous collaboration (including radio, mobile phones, biometric monitoring, live maps, etc.). We observe and collaborate with workers in several different settings: Aarhus Hospital, Aarhus Police Force, Aarhus Firestation and Falck in Aarhus. Our work so far have points at the need for better support for:

• overview, including use of peripheral awareness
• communication, including both co-located and distributed people and the generation of, and collaborative interaction with, information, including maps and graphic representation of biomedical, sensor-based information.

Most pregnant women engage with a range of different healthcare providers as well as family, friends and informal discussion and exercise groups – and many different technologies are involved (ultrasound, electronic patient records, personal computers, paper, mobile phones, alarms, biometric monitoring, etc.). Observations and participatory workshops are carried out with healthcare providers from Skejby Hospital and the City of Aarhus, and pregnant women. Focus in the project is to uncover new possibilities for ict-support and develop concepts and application prototypes based on  palpable computing that can support the pregnant woman and their families as well as the health care providers she meets during and after her pregnancy. Our work so far points at two sets of issues:

• improving communication among the pregnant woman and all the healthcare professionals and
• improving support for the pregnant woman (and her partner) in handling information.

The use of usernames and password in hospitals is a source of much frustration amongst clinicians. The result is that proper user authentication is often circumvented by sharing passwords, creating easy-to-remember passwords, and by leaving computers open for all to use. We have though out the concept of Proximity-Based User Authentication, as a usability-wise ideal for UbiComp systems – a user simply walks up to a device and is automatically authenticated without doing anything.

Our current implementation of proximity-based user authentication runs a context-aware user authentication protocol, which (1) uses a JavaCard for identification and cryptographic calculations, (2) uses a context-awareness system for verifying the user's location, and (3) implements a security fall-back strategy. This protocol is less secure than the correct use of e.g. usernames and passwords, but is much more secure than the existing work-around often found in hospitals.

This project is a longitudinal ethnographic investigation of the development and implementation of an Electronic Patient Record (EPR) in a large county in Denmark. The study is carried out over a 2-year period. The aim of the project is to study the consequences of introducing EPR systems in a Danish hospital. The project studies 4 main things: (1) The process of developing the EPR system, which is done in close cooperation with numerous clinicians from different specialities and hospitals. (2) The work of the clinicians before the computer system is introduced. (3) The challenges of implementing the EPR system, and (4) the consequences to the clinical work of implementing the system after a period of initial usage.

Home treatment for diabetics with foot ulcers

Persons who have suffered from diabetes for a longer period of time are in high risk of developing severe foot ulcers due to decreased blood supply to the tissue and damage to the nerve system. A diabetes-related ulcer heals slowly, and even though high caution is put into caring the ulcer, infections can arise, eventually requiring the foot to be amputated. This project looks into organizing the treatment of foot ulcers in a new way. A large part of the treatment is moved from the hospital to the home, and the expert is able to control the treatment despite the physical distance through the use of new technology (pervasive computing).

On the technical side the project seeks to establish a communication platform with the possibility of sharing digital pictures/film of the ulcer. A direct (synchronous) dialogue is necessary for the expert and home care nurse to reach a commond ground in the cooperation, however also asynchronous communication must be supported, for instance via a shared online medical patient record.

Maintaining social awareness of the working context of fellow co-workers is crucial to successful cooperation. For mobile, non co-located workers, however, this social awareness is hard to maintain. In this project we work with the concept of Context-Mediated Social Awareness to denote how context-aware computing can be used to facilitate social awareness. Based on extensive studies of cooperative work in hospitals, we have developed the AWARE architecture, which is a generic platform for supporting context-mediated social awareness. The AWARE platform is running as the infrastructure for the AwarePhone which is a small application running on Symbian phones and provide the user with a constant social awareness about his fellow workers.

Project website: http://www.daimi.au.dk/~thomasr/interaction/AWARE.htm

This project is creating a distributed software infrastructure for creating Composite Devices. A ‘composite device’ is one device made up of a composition of several separate devices, working together in concert. For example, take two or more laptops, put the together on a desktop, and start using them as one computer, with one big screen with several keyboards and mice. The laptops are simply merged into one virtual desktop computer and users can share documents and applications, while using their own input devices. Other devices, like PDAs or wall-sized displays can participate in the composition as it may fit the work situation.  We have created the ComPUTE software architecture for composite devices on a Windows XP platform.

Project website: http://www.clemen.dk/sc/CompUTE

The Interactive Hospital is a research project between Medical Insight, the Hospital of Horsens, the Department of Computer Science at the University of Aarhus, and the Aarhus School of Architecture.

The main focus of the project is to investigate how pervasive computing technology can be designed to help clinicians interact with medical data in relations to surgery. Special focus is on supporting the surgeon to access medical images from PACS systems while preparing for a surgical procedure and while operating in the operating room. A secondary focus is to support the cooperation between the operating surgeon, the rest of the surgical team, and clinical experts situated outside the operating room. The research questions addressed are /multi-modal interaction/ with large display surfaces, /context-awareness/ during surgical operations, and enabling /social awareness/ amongst co-located and distributed clinicians.

Project website in Danish: www.ihospital.dk
Project website in English: www.pervasive-interaction.org

• www.alexandra.dk/dk/projekter/Sider/The-Visible-Ear-Simulator.aspx
• www.alexandra.dk/ves/

Telemedical measurement of blood pressure vs. conventional measurement.

20-30% of the Danish population suffer from hypertension (high blood pressure), which causes increased mortality due to complications in brain, heart and kidneys. Effective diagnosis and monitoring of the disease is a condition for lowering the number of complications. There are, however, a number of problems associated with the conventional methods for measuring hypertension. For instance, measuring blood pressure in the consultation at the general practitioner causes a 20-40% of false positives - the socalled "white coat hypertension".

The project's hypothesis is, that a more efficient measurement of hypertension can be obtained by letting the patients perform the measuring themselves at home. This is achieved by providing the patient with blood measurement equipment, that is connected to a central server over the Internet, where the patient and general practioner can access the data. The hypothesis is tested statistically by means of about 400 patients, divided in 4 groups: Diabetics, non-diabetics and control groups. The included patients are found at general practitioners in Holstebro and Holstebro Central Hospital. The project is driven by commercial partners (B&O Medicom, Kolle IT-ingeniørfirma and CIM Electronics), medical partners (Holstebro Central Hospital) and educational partners (Herning Institute of Business Administration and Technology) and Centre for Pervasive Healthcare.