Biomedical Engineering Reference
In-Depth Information
systems to become context aware (see Aarts and Roovers 2003). This means
that advances in technology will enable the information infrastructure of
the BAN device to recognize and react to the real-world context of the user/
patient, including the identity of the user, its physical location, and if nec-
essary also the activities that are being undertaken by the user. As these
monitoring devices become more responsive, more responsibilities are del-
egated and incorporated to the technology. All forms of remote care involve
the replacement of clinical and nursing observations by sensor-generated
readings and wireless data exchange. In many forms, the technology also
has an incorporated interpretation function. One example is the envisioned
application of BAN for monitoring epilepsy patients (Holst Centre 2007).
The BAN application in this case will incorporate sensor nodes integrated in
wearables such as hats or caps. The sensors will be capable to communicate
wirelessly with a mobile gateway unit, which can be the mobile phone of the
patient. The data that are sent (e.g., EEG) are interpreted via software in a
way to anticipate on a possible seizure in advance. This way the patient can
be alarmed in time and instructions can be sent to prepare the patient for the
attack (cf. to search for a safe place). This application has its added value in
creating more freedom and independence, and should bring more comfort
to the life of an epilepsy patient. However, the reliability of the software pro-
gram that interprets data should be guaranteed. What happens if a seizure
goes undetected owing to some kind of system failure and the patient comes
into a tragic accident? The lack of legal framework and guidelines in this
respect can have dramatic impacts in case an accident happens.
12.3.3.6 Issue of Responsibility and Availability in
Multiactor e-Health Platforms
Related to the issue of safety and responsibility, it should be mentioned that
future envisioned e-health platforms will not be exclusively delivered by
the traditional actors in the health-care chain, such as the medical devices
industry, hospitals, GPs, and health-care insurance companies. Many other
industries such as the mobile network providers, health and wellness con-
sultancies, and even cable companies, housing institutions, and companies
specialized in installing home automation equipment see opportunities to
be involved in delivering services. As the future scene in the health-care
industry becomes more crowded, the roles and responsibilities that have
to be fulfilled and allocated to different actors become highly complex to
manage and as a result quality control might become more difficult to real-
ize. All interviewees have highlighted the utmost importance of develop-
ing protocols and clear descriptions of responsibilities before services
can be delivered. Because the field of BAN is only emerging, the issues of
responsibilities and legal obligations are not clearly defined. This causes
many actors to remain in a “waiting game,” or not move away from pilot
settings. An eventual outcome might be that such projects only remain in
