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7/31/2019 (2007-12-18)
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2Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
EducationEducation
National Taiwan University, Mechanical Engineering, B.S., 1981/0National Taiwan University, Mechanical Engineering, B.S., 1981/099--1985/06.1985/06.
Stanford University, of Mechanical Engineering, M.S., 1987/09Stanford University, of Mechanical Engineering, M.S., 1987/09--1988/06.1988/06.
Stanford University, Mechanical Engineering, Ph.D., 1989/07Stanford University, Mechanical Engineering, Ph.D., 1989/07--1992/06.1992/06.
ExperienceExperience
Professor, Department of Mechanical Engineering, YuanProfessor, Department of Mechanical Engineering, Yuan ZeZe University,University,2001/022001/02--present.present.
Secretary General, YuanSecretary General, Yuan ZeZe University, 2005/08University, 2005/08--present.present.
Chairman, Department of Mechanical Engineering, YuanChairman, Department of Mechanical Engineering, Yuan ZeZe University,University,1999/081999/08--2005/07.2005/07.
Director, Office of Physical Education, YuanDirector, Office of Physical Education, Yuan ZeZe University, 2002/08University, 2002/08--present.present. Director, Gerontechnology Research Center, YuanDirector, Gerontechnology Research Center, Yuan ZeZe University, 2000/08University, 2000/08--
present.present.
Columnist, Car Magazine, 1995/06Columnist, Car Magazine, 1995/06--present.present.
Dean, Office of Information Services, YuanDean, Office of Information Services, Yuan ZeZe University, 1997/08University, 1997/08--1999/07.1999/07.
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3Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Aging SocietyAging Society
Population aged 65 and above, projection in 2020 by WHOPopulation aged 65 and above, projection in 2020 by WHO
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4Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
GerontechnologyGerontechnology
How can technology be best used to support the needs of agingHow can technology be best used to support the needs of agingsociety?society?
Gerontechnology includes the research and development of techniqGerontechnology includes the research and development of techniques andues andtechnological products, based on the knowledge of aging processetechnological products, based on the knowledge of aging processes, for thes, for the
benefit of a preferred living and working environment and adaptebenefit of a preferred living and working environment and adapted medicald medical
care for the elderly. [care for the elderly. [GraafmansGraafmans andand BoumaBouma, 1993], 1993]
Although technology can greatly aid older adults, it must firstAlthough technology can greatly aid older adults, it must first be designed tobe designed to
accommodate their needs.accommodate their needs. There is a great need for both basic and appliedThere is a great need for both basic and applied
research to address the usability of devices of the aged.research to address the usability of devices of the aged.
The increasing needs for elderly care cannot be solved by increaThe increasing needs for elderly care cannot be solved by increasing thesing thenumber of carenumber of care--givers.givers.
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5Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Gerontechnology Research Center (GRC)Gerontechnology Research Center (GRC)
Facilities andFacilities and
infrastructureinfrastructure
AcademicAcademic
programsprogramsHumanHuman
resourcesresources
YuanYuan ZeZe UniversityUniversity
GovernmentGovernment
resourcesresources
Older adultsOlder adults
ServiceService
InstitutionsInstitutions
EducationEducation
AcademicAcademic
researchresearch
GRCGRC AcademicAcademicresourcesresources
IndustrialIndustrial
companiescompanies
AdvancedAdvanced
technologiestechnologies
ProductProduct
developmentdevelopment
On the basis of the support from Yuan Ze University,
the Gerontechnology Research Center
further integrates external resources,
to develop technologies,
products, academic research,
and educational programs in
the field of Gerontechnology,
in the aim of improving thequality of life of older adults.
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7/457Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Telemedicine,Telemedicine, TelehealthTelehealth, e, e--HealthHealth
TelemedicineTelemedicine generally refers to the use of communications and informationgenerally refers to the use of communications and information
technologies for the delivery oftechnologies for the delivery ofclinical careclinical care. It is the use of medical. It is the use of medical
information exchanged from one site to another via electronicinformation exchanged from one site to another via electronic
communications to improve patientscommunications to improve patients health status.health status.
TelehealthTelehealth is often used to encompass a broader definition of remoteis often used to encompass a broader definition of remote
healthcare that does not always involve clinical services [ATA].healthcare that does not always involve clinical services [ATA].
ee--HealthHealth is a term used particularly in the UK and Europe for healthcareis a term used particularly in the UK and Europe for healthcare
practice which is supported by electronic processes and communicpractice which is supported by electronic processes and communication.ation.
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TeleTele--homecare, Homehomecare, Home telehealthtelehealth
TeleTele--homecarehomecare ++ TelehomecareTelehomecare 54,300 hits in Google;54,300 hits in Google; HomeHome
telehealthtelehealth 48,200 hits in Google;48,200 hits in Google;
Definition:Definition: TeleTele--homecare can be defined as the use of information andhomecare can be defined as the use of information and
communication technologies to enable effective delivery and manacommunication technologies to enable effective delivery and management ofgement of
health services at a patienthealth services at a patients residence. [Office of Health and Informations residence. [Office of Health and Information
Highway, Canada, 1998]Highway, Canada, 1998]
Users:Users:
TeleTele
--homecare differs from telemedicine in the sense thathomecare differs from telemedicine in the sense that
peoplepeople
who transmit and receive medical information are not medical docwho transmit and receive medical information are not medical doctors buttors but
the patients themselves and their families, nurses, carethe patients themselves and their families, nurses, care--givers, homegivers, home--helpershelpers
and medical technical expertsand medical technical experts, etc. [, etc. [MasatsuguMasatsugu, 2002], 2002]
Goal:Goal: HomeHome telehealthtelehealth allows the patient the dignity of remaining in theirallows the patient the dignity of remaining in their
own home for as long as possible and by providing care that is eown home for as long as possible and by providing care that is equal to orqual to or
superior than approaches that rely solely on health providers cosuperior than approaches that rely solely on health providers coming into theming into thehome for scheduled visits. [ATA]home for scheduled visits. [ATA]
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Philips Lifeline Service (http://Philips Lifeline Service (http://www.lifelinesys.comwww.lifelinesys.com/)/)
Lifeline is the first and most establishedLifeline is the first and most establishedPersonal Emergency Response SystemPersonal Emergency Response System
(PERS). It was developed in 1974 by(PERS). It was developed in 1974 by
Lifeline System, Inc., which wasLifeline System, Inc., which was
recently acquired by Philips (2006/01).recently acquired by Philips (2006/01).
Story of a lifeline call.Story of a lifeline call.
On average, Lifeline costs a little moreOn average, Lifeline costs a little more
than a dollar a day, depending uponthan a dollar a day, depending upon
where you live.where you live.
No longNo long--term service contracts or needterm service contracts or need
to purchase equipment.to purchase equipment.
Over 500,000 subscribers continuouslyOver 500,000 subscribers continuouslymonitored.monitored.
http://www.lifelinesys.com/flash/story.htmlhttp://www.lifelinesys.com/flash/story.htmlhttp://www.lifelinesys.com/flash/story.html7/31/2019 (2007-12-18)
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Lifeline Service in TaiwanLifeline Service in Taiwan
65
1500
Lifeline SystemsCall Center
200649,7284,622
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TunstallTunstallss Lifeline 4000+ (http://Lifeline 4000+ (http://www.tunstall.co.ukwww.tunstall.co.uk/)/)
50 years in50 years in telecaretelecare andand telehealthtelehealth (started in UK, 1957), over 2.5 million users(started in UK, 1957), over 2.5 million users
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TunstallTunstall: Activities of Daily Living Monitoring: Activities of Daily Living Monitoring
Activities of Daily LivingActivities of Daily Living
(ADL) Monitoring: To(ADL) Monitoring: To
provide an unobtrusiveprovide an unobtrusive
method of capturing amethod of capturing a
personpersonss behaviourbehaviour
patterns so if a deviationpatterns so if a deviation
from the norm occurs, itfrom the norm occurs, itcan be identified, thecan be identified, the
cause investigated andcause investigated and
preventative action taken.preventative action taken.
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TunstallTunstall TaiwanTaiwan (http://(http://www.tunstall.com.twwww.tunstall.com.tw/)/)
Lifeline 400 + Trigger + 12 months monitoring free:Lifeline 400 + Trigger + 12 months monitoring free: 299299
Monthly Service Charge:Monthly Service Charge: 1212
15001500 30003000
13001300 15001500
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Health Hero Network (http://Health Hero Network (http://www.healthhero.comwww.healthhero.com/)/)
Health BuddyHealth Buddy Appliance : USD 99Appliance : USD 99
Monthly Service Charge: USD 49.99Monthly Service Charge: USD 49.99
Health Hero Network has received 57 U.S. patents.Health Hero Network has received 57 U.S. patents.
Health BuddyHealth Buddy
SystemSystem
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Health BuddyHealth Buddy
ApplianceAppliance
Interactive interface forInteractive interface for
diabetic patientsdiabetic patients
Health Hero NetworkHealth Hero Networksshealth managementhealth management
programs cover over 30programs cover over 30
health conditions.health conditions.
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16Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
MediCompassMediCompass (http://(http://www.medicompass.comwww.medicompass.com/)/)
Monthly Subscription Plan: $4.95; Annual Subscription Plan: 39.9Monthly Subscription Plan: $4.95; Annual Subscription Plan: 39.955
MetriklinkMetriklink, one time cost: $79.95;, one time cost: $79.95; 20032003
Connecting Patients, Care Professionals, and Health PlansConnecting Patients, Care Professionals, and Health Plans
PHR: Personal Health RecordPHR: Personal Health Record
Our site is an online resource that allowsOur site is an online resource that allows
you to store and track all of your healthyou to store and track all of your health
related data in a completely secure andrelated data in a completely secure and
private environment. Monitoring thisprivate environment. Monitoring this
information keeps you informed of yourinformation keeps you informed of your
progress. You are also able to shareprogress. You are also able to share
information online with your healthcareinformation online with your healthcare
teamteam
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17Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
(Fujitsu Taiwan, http://(Fujitsu Taiwan, http://www.fujitsu.com/twwww.fujitsu.com/tw/)/)
(The
Ministry of Health and
Welfare, MHW)199712
2000
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18Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
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19Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
(http://(http://www.netown.net.twwww.netown.net.tw))
BMI
25,000
999
(2007/05)(2007/05)
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20Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
20
2,50035,0001,500200
10~20/20~30/ 70002000
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21Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Card Guard (http://http://Card Guard (http://http://www.cardguard.comwww.cardguard.com/)/)
Card Guard Wireless inCard Guard Wireless in
MotionMotion
The PMP4 wirelessThe PMP4 wireless
medical monitorsmedical monitorscommunicate with a PDAcommunicate with a PDA
or cellular phone, thusor cellular phone, thus
allowing acquisition andallowing acquisition andtransmission of data fromtransmission of data from
the patient to the PMP4the patient to the PMP4
webbasedwebbased medical center.medical center.
Physicians and patientsPhysicians and patients
alike can access this webalike can access this web
center using a PC basedcenter using a PC based
browser.browser.
http://ecg%20final%20with%20cwim.wmv/http://ecg%20final%20with%20cwim.wmv/http://ecg%20final%20with%20cwim.wmv/7/31/2019 (2007-12-18)
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22Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
WHO
2993,588
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23Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Mini Bond (http://Mini Bond (http://www.minibond.twwww.minibond.tw))
AGPS
MiniBond18,0006,999)699
3,000
1,000
http://minibond_scene4old.wmv/http://lifeline%20service/minibond_scene4old.wmvhttp://minibond_scene4old.wmv/7/31/2019 (2007-12-18)
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24Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
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25Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Personal Emergency Response System (PERS): Lifeline,Personal Emergency Response System (PERS): Lifeline, TunstallTunstallss telecaretelecare,,
Card Guard, Mini Bond.Card Guard, Mini Bond.
Long term wellness monitoring:Long term wellness monitoring: TunstallTunstallss ADL monitoring, Health BuddyADL monitoring, Health Buddy
System,System, MediCompassMediCompass, Fujitsu,, Fujitsu,
Home Health Care ProviderHome Health Care Provider
Lifeline service,Lifeline service, TunstallTunstall, Health Hero, Health Hero
Network,Network, MediComapssMediComapss, Card Guard, Fujitsu,, Card Guard, Fujitsu,
(I)(I)
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26Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Home Health Care ProviderHome Health Care Provider
(PHR)(PHR)
Brand and TrustBrand and Trust
(II)(II)
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27Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Individual needs and perceived benefitsIndividual needs and perceived benefits
A study by Teasdale and Roush [2001] used Lifeline to see if useA study by Teasdale and Roush [2001] used Lifeline to see if users felt morers felt more
secure with the technology. All users reported a greater sense osecure with the technology. All users reported a greater sense of security duringf security during
their PERS use.their PERS use.
Cost: device cost and monthly fee, health insurance and governmeCost: device cost and monthly fee, health insurance and government subsidynt subsidy
User friendliness: installation and operationUser friendliness: installation and operation
Data security and issues on privacy, control, choice, and dignitData security and issues on privacy, control, choice, and dignityy
Whether people want their entire house wired and monitored,Whether people want their entire house wired and monitored,
What activities are monitored and how,What activities are monitored and how, Where the information gathered goes and who sees it or has accesWhere the information gathered goes and who sees it or has access to it,s to it,
Whether the consumer has the choice to turn it off when privacyWhether the consumer has the choice to turn it off when privacy is desired,is desired,
What happens to it in relation to decisions about whether a persWhat happens to it in relation to decisions about whether a person can stay in theon can stay in thehome or not.home or not.
Evaluation of HomeEvaluation of Home TelehealthTelehealth Systems: User AcceptanceSystems: User Acceptance
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Through proactive monitoring, selfThrough proactive monitoring, self
--care education, medication managementcare education, medication management
and behavior modification to improve clinical outcome.and behavior modification to improve clinical outcome.
System reliability and accuracy of the measurements at home.System reliability and accuracy of the measurements at home.
Who will receive and review the data, human or computer algorithWho will receive and review the data, human or computer algorithm? Whom? Who
will take action?will take action?
Will the users change their health management attitudes and behaWill the users change their health management attitudes and behaviors?viors?
In 2002, a VA analysis of those participating in its home healthIn 2002, a VA analysis of those participating in its home health--monitoringmonitoring
program, similar to Health Buddy, showed a 63 percent drop in hoprogram, similar to Health Buddy, showed a 63 percent drop in hospitalspital
admissions, a 40 percent drop in emergency room visits, a 60 peradmissions, a 40 percent drop in emergency room visits, a 60 percent declinecent decline
in bed days of care, a 64 percent drop in nursing home admissionin bed days of care, a 64 percent drop in nursing home admissions, and an 88s, and an 88
percent reduction in nursing home bed days of care. Patient satipercent reduction in nursing home bed days of care. Patient satisfaction ratessfaction ratesexceeded 90 percent.exceeded 90 percent.
Evaluation of HomeEvaluation of Home TelehealthTelehealth Systems: Clinical OutcomeSystems: Clinical Outcome
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29Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
20062006 Innovative Approach to the Delivery of HealthcareInnovative Approach to the Delivery of Healthcare ABBY AwardABBY AwardWinner: Health Hero Network, honored for itsWinner: Health Hero Network, honored for its Health BuddyHealth Buddy telehealthtelehealth
interface between patients at home and their providers.interface between patients at home and their providers.
Health Buddy is currently in use by over 12,000 patients and hasHealth Buddy is currently in use by over 12,000 patients and has proven itsproven its
worth in clinical trials: reduced hospital admissions by 63%; reworth in clinical trials: reduced hospital admissions by 63%; reducedduced
congested heart failure (congested heart failure (CHFCHF)) hospitalizations by 72%; reduced CHF inpatienthospitalizations by 72%; reduced CHF inpatient
bed days from 8.6 to 1.7; increased medication compliance from 3bed days from 8.6 to 1.7; increased medication compliance from 34% to 94%;4% to 94%;
reduced CHF costs/patient/year from $25.0K to $11.8K.reduced CHF costs/patient/year from $25.0K to $11.8K.
Evaluation of HomeEvaluation of Home TelehealthTelehealth Systems: Economic AnalysisSystems: Economic Analysis
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30Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
COMCOM--COMCOM COMplexCOMplex
COstCOst MotivationMotivation
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31Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
What is theWhat is the smallest possiblesmallest possible homehome teletele--health system?health system?
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32Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
The Decentralized HomeThe Decentralized Home TelehealthTelehealth SystemSystem Information StructureInformation Structure
Sensor 1
Cable/wireless
transmitter
Cable/wireless
receiverPIC Server
MMC
Distributed Data ServerDistributed Data Server
HouseholdHousehold
E-mail server/SMS
Java applet server
Application serverApplication server
CareCare--giver/Client usergiver/Client user
Browser
E-Mail box/
Mobile phone
EventEvent
alertalert
Request/DataRequest/Data
VB program
AppletApplet
RegularRegular
reportreport
EventEvent
messagemessage
Sensor 2
Sensor 3
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33Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Advantages of the Decentralized HomeAdvantages of the Decentralized Home TelehealthTelehealth System StructureSystem Structure
This system is aThis system is a useruser--centered, productcentered, product--oriented systemoriented system instead of a serviceinstead of a service--oriented system.oriented system.
The system can be easily adapted and implemented in a home envirThe system can be easily adapted and implemented in a home environmentonment
at a very low cost. The user does not have to subscribe to serviat a very low cost. The user does not have to subscribe to service from thece from the
home healthcare provider.home healthcare provider.
Health monitoring data is stored within the household. Only authHealth monitoring data is stored within the household. Only authorizedorized
caregivers can access the data. Privacy is more greatly protectecaregivers can access the data. Privacy is more greatly protected.d.
The route from the sensor to server is much shorter. Data transmThe route from the sensor to server is much shorter. Data transmission isission is
easier and more reliable. Data integrity will be better preserveeasier and more reliable. Data integrity will be better preserve
d.d.
The distributed structure of the system can be adapted to integrThe distributed structure of the system can be adapted to integrate with aate with a
centralized database and the home healthcare provider.centralized database and the home healthcare provider.
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Applications:Applications:Environment Monitoring SystemEnvironment Monitoring System
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37Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Applications:Applications:Monitoring of Activities of Daily Living (ADL)Monitoring of Activities of Daily Living (ADL)
A i i Sl Q li i i S ( )
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38Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Cable PIC Server
MMC
Distributed Data ServerDistributed Data Server
HouseholdHousehold
E-mail server/SMS
Java applet server
Application serverApplication server
CareCare--giver/Client usergiver/Client user
Browser
E-Mail box/
Mobile phone
EventEvent
alertalert
Request/DataRequest/Data
VB program
AppletApplet
RegularRegular
reportreport
EventEvent
messagemessage
Upper LimbConductiveMat
BodyConductiveMat
LegConductiveMat
Applications:Applications: Sleep Quality Monitoring System (I)Sleep Quality Monitoring System (I)
A li i Sl Q li M i i S (II)
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39Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Applications:Applications: Sleep Quality Monitoring System (II)Sleep Quality Monitoring System (II)
A B
BedBed ActigraphyActigraphy ------Physical Activity Detecting MatPhysical Activity Detecting Mat
A i iA li i Sl Q li i i S ( )Sl Q li M i i S (III)
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40Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Applications:Applications: Sleep Quality Monitoring System (III)Sleep Quality Monitoring System (III)
Normal
Arousal
Sensitivity 89.5%, PPV 94.8%, Specificity 84.3%
TRICTRIC Telepresence Robot for Interpersonal CommunicationTelepresence Robot for Interpersonal Communication
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41Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
TRICTRIC Telepresence Robot for Interpersonal CommunicationTelepresence Robot for Interpersonal Communication
Aging is associated with an increased risk for isolation.Aging is associated with an increased risk for isolation.
The main aim behindThe main aim behind TRICTRICss development is to allow elderly populations todevelopment is to allow elderly populations to
remain in their home environments, while loved ones and caregiveremain in their home environments, while loved ones and caregivers are able tors are able to
maintain a higher level of communication than via traditional memaintain a higher level of communication than via traditional methods.thods.
TRICTRIC aims to be a lowaims to be a low--cost, lightweight robot, which can be easily implementedcost, lightweight robot, which can be easily implementedin the home environment.in the home environment.
A li tiA li ti
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42Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
Sensor 1
Cable/wireless
transmitter
Cable/wireless
receiverPIC Server
MMC
Distributed Data ServerDistributed Data Server
HouseholdHousehold
E-mail server/SMS
Java applet server
Application serverApplication server
CareCare--giver/Client usergiver/Client user
Browser
E-Mail box/
Mobile phone
EventEvent
alertalert
Request/DataRequest/Data
VB program
AppletApplet
RegularRegular
reportreport
EventEvent
messagemessage
Sensor 2
Sensor 3
1
2
3
5 4
6
1. BP/BG Meter2. Pressure Cuff3. Lancet Device
4. Lancets5. Test Strips6. Strips Box
Applications:Applications:
ThTh Di tDi t tt C A hC A h
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43Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
$$
TheThe DirectDirect--toto--Consumer ApproachConsumer Approach
PP
PP
ii$$ SSCash flow Product flow Information flow Service flowPP
ii
ii
SS
iiDDSDDS
SS
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44Gerontechnology Research Center, YZUGerontechnology Research Center, YZU
ii$$ SSCash flow Product flow Information flow Service flowPP
$$PP PP
ii
ii
SS
iiDDSDDS
SS
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Thank YouThank You
Home healthcare research in Gerontechnology Research CenterHome healthcare research in Gerontechnology Research CenterYuanYuan ZeZe UniversityUniversity
YehYeh--Liang HsuLiang Hsu
[email protected]@saturn.yzu.edu.tw
http://http://GRC.yzu.edu.twGRC.yzu.edu.tw//
http://http://designer.mech.yzu.edu.twdesigner.mech.yzu.edu.tw//