1
RESEARCH POSTER PRESENTATION DESIGN © 2015 www.PosterPresentations.com The hand hygiene monitoring system intends to track the health care provider actions inside the health environment, gather useful information and forward these information to a server where several analysis could be done. This system is developed to aid a research hosted by the Infection prevention and control program at the Eastern Health. It is based on Bluetooth Low Energy standard to perform the in-door localization and the transmission of data to the server. The system consists of a badge: that would be worn by the healthcare provider and runs a BLE Central profile and a BLE Broadcaster profile, BLE Broadcaster beacons installed at different locations in the room, and a server. The sensor tag measures the received signal strength of each available beacon and apply a localization algorithm to identify the behavior of the practitioner. The core of the system is CC2650 system on a chip which can be programmed to perform different BLE roles. Throughout this poster the term “hit” means that the health care provider followed the proper hand hygiene behavior that he/she probably washed his/her hands before dealing with the patient. The term “miss” means that he/she missed to probably sanitize his/her hands either before dealing with a patient or between dealing with two patients. INTRODUCTION OBJECTIVES Health provider badge: The healthcare provider actions are detected using this badge, The badge runs two profiles; BLE Central profile which is capable of scanning the other BLE devices, initiate a connection and get/set data to these devices using Generic Attribute (GATT) services, and a BLE Broadcaster profile which is used to broadcast the gathered data to the Inforce 6309. Although the badge supports connecting to other device, Due to the project nature the data is transmitted in a connectionless manner. The badge is configured to be constantly scanning for the nearby beacons, After each complete scan duration it does the following: 1. Read the RSSI values and a specific threshold for every detected beacon. 2. Apply a localization algorithm. 3. Identify hits and misses based on a finite state machine. 4. Loads the collected data to the Advertisement data packet. 5. Broadcasts the data for a certain time duration. The hardware of the badge is a hacked CC2650 SensorTag 2.0. The sensorTag is modified to run on a rechargeable Li-Ion battery. This battery keeps the badge running for 89 hour. SYSTEM COMPONENTS RESULTS CONCLUSION Bluetooth low energy received signal strength alone isn’t reliable enough for accurate in-door localization. The orientation and the placement of the badge are very critical. Using the BLE as a proximity detector improves the results. The badge scan duration and the beacons advertising interval affects the overall system performance. ACKNOWLEDGEMENTS Working in a healthcare environment has it is own risks and challenges, It could be really dangerous if the healthcare provider didn’t follow the right behavior before and after dealing with the patients, As prevention is better than cure the hand hygiene monitoring system aims to: Understand the behaviors of the healthcare providers in the health care environment. Ensures the proper understanding of the hand hygiene concepts and behaviors. Limits the spread of infections amongst the healthcare providers. Avoid the spread of infections from one patient to another through the healthcare provider. Track the change in the behaviors of the healthcare providers before and after hand hygiene trainings and workshops. Reduce the cost of the health services and medications provided to infected health providers. Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John’s, NL, Canada, A1B 3X5 Ahmed Soliman, Dr. Mohamed Shehata, Dr. Mohamed Ahmed Implementation of Hand Hygiene Monitoring System using BLE SYSTEM REQUIRMENTS High accuracy in the sense of counting the hits and misses. High efficiency and low power consumption. Easily to install and maintain. Generic and not highly tailored for a specific room configuration. Limited number of tweaks required for system tuning. Figure 1: CC2650 SensorTag 2.0 Bed beacons: To localize the healthcare provider, Two beacons have to be installed for each bed. These beacons are very simple BLE Broadcaster devices. The beacons are set to a General discoverable mode which keeps it broadcasting all the time. As the system should be applicable to different room configurations, Every beacon transmits a threshold value that’s read by the badge and used in the localization algorithm. This gives some flexibility for the beacon placement with respect to the bed. The threshold value is also loaded into the advertisement data packet because it’s much faster than using a GATT service. BLE enabled ABHR/Soap dispenser: A part of the system cost reduction is to use the currently available Alcohol based handing rubbing and Soap dispensers. This is done by installing a sesnorTag inside the existing dispensers. The usage of the dispenser is detected by a limit switch. The sensorTag inside the dispenser is also programmed as a BLE Broadcaster in Limited discoverable mode. To save the battery power the sensorTag is triggered only when the healthcare provider uses the dispenser. Based on the average of a dispenser usage every 2 minutes, the dispenser will last up to 3.6 month on a 8000mAh rechargeable battery. Inforce 6309 SBC: The SBC runs an android OS, A BLE based android application is installed that starts automatically after the device boots up. The application is a BLE Central profile that scans for a broadcast signal from a badge and gets the hits and misses count from the advertisement data packet. The SBC stores the data collected on an external SD Card, generates reports and periodically upload the data to a FTP server. The upload interval and the server configurations could be changed through the application. The BLE Central profile filters the broadcast packets based on the device name and an identifier in the advertisement packet. As the broadcaster sends more than 1 packet through a connectionless transmission, the SBC make sure that it stores the data only once. Healthcare provider localization: Several approaches have been tested to localize the healthcare provider, they were all based on filtering the RSSI values for all the available beacons followed by an identification for the region that has the beacon with the highest RSSI and then comparing to one or more threshold. It was found that using a Mean filter on a window of 7 RSSI values leads to the best detection accuracy with acceptable detection latency, but even this accuracy wasn’t good enough for the counting logic. Relying on the fact that the healthcare provider will get really close to the bed while dealing with the patient, a proximity approach was used. Getting very close to the beacon leads to a significantly high RSSI value which acts as a strong evidence to localize the healthcare provider. Following the proper operating instructions the system exhibits very high accuracy in counting the hits and misses, But this accuracy is significantly affected by the way that the healthcare provider is wearing the badge. Power consumption: For the battery powered parts of the system, the power consumption is very critical, it greatly affects the usability of the system. Several power consumption optimization approaches were tested to get it to the minimum. The sensorTags used for the system are generic development boards that has more components than what our system needs, Further power consumption optimization is possible by designing our own printed circuit boards. The following figures shows some power measurements for various parts of the system, a current to voltage circuit based on an instrumentation amplifier with gain of 103 was used to do these measurements. Figure 2: Soap dispenser Figure 3: Inside the soap dispenser Figure 4: Inforce 6409 SBC Figure 5: Dispenser-transmitting Figure 6: Dispenser-standby Figure 7: Badge-scanning Figure 8: Badge-scanning and transmitting

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Page 1: Implementation of Hand Hygiene Monitoring …...Ahmed Soliman, Dr. Mohamed Shehata, Dr. Mohamed Ahmed Implementation of Hand Hygiene Monitoring System using BLE SYSTEM REQUIRMENTS

RESEARCH POSTER PRESENTATION DESIGN © 2015

www.PosterPresentations.com

The hand hygiene monitoring system intends to track the health care provider actions inside the health environment, gather useful information and forward these information to a server where several analysis could be done. This system is developed to aid a research hosted by the Infection prevention and control program at the Eastern Health. It is based on Bluetooth Low Energy standard to perform the in-door localization and the transmission of data to the server. The system consists of a badge: that would be worn by the healthcare provider and runs a BLE Central profile and a BLE Broadcaster profile, BLE Broadcaster beacons installed at different locations in the room, and a server. The sensor tag measures the received signal strength of each available beacon and apply a localization algorithm to identify the behavior of the practitioner. The core of the system is CC2650 system on a chip which can be programmed to perform different BLE roles. Throughout this poster the term “hit” means that the health care provider followed the proper hand hygiene behavior that he/she probably washed his/her hands before dealing with the patient. The term “miss” means that he/she missed to probably sanitize his/her hands either before dealing with a patient or between dealing with two patients.

INTRODUCTION

OBJECTIVES

• Health provider badge: The healthcare provider actions are detected using this badge, The badge runs two profiles; BLE Central profile which is capable of scanning the other BLE devices, initiate a connection and get/set data to these devices using Generic Attribute (GATT) services, and a BLE Broadcaster profile which is used to broadcast the gathered data to the Inforce 6309. Although the badge supports connecting to other device, Due to the project nature the data is transmitted in a connectionless manner. The badge is configured to be constantly scanning for the nearby beacons, After each complete scan duration it does the following: 1. Read the RSSI values and a specific threshold for every detected

beacon. 2. Apply a localization algorithm. 3. Identify hits and misses based on a finite state machine. 4. Loads the collected data to the Advertisement data packet. 5. Broadcasts the data for a certain time duration. The hardware of the badge is a hacked CC2650 SensorTag 2.0. The sensorTag is modified to run on a rechargeable Li-Ion battery. This battery keeps the badge running for 89 hour.

SYSTEM COMPONENTS

RESULTS CONCLUSION

• Bluetooth low energy received signal strength alone isn’t reliable enough for accurate in-door localization.

• The orientation and the placement of the badge are very critical. • Using the BLE as a proximity detector improves the results. • The badge scan duration and the beacons advertising interval affects the

overall system performance.

ACKNOWLEDGEMENTS

Working in a healthcare environment has it is own risks and challenges, It could be really dangerous if the healthcare provider didn’t follow the right behavior before and after dealing with the patients, As prevention is better than cure the hand hygiene monitoring system aims to: • Understand the behaviors of the healthcare providers in the health care

environment. • Ensures the proper understanding of the hand hygiene concepts and

behaviors. • Limits the spread of infections amongst the healthcare providers. • Avoid the spread of infections from one patient to another through the

healthcare provider. • Track the change in the behaviors of the healthcare providers before and

after hand hygiene trainings and workshops. • Reduce the cost of the health services and medications provided to

infected health providers.

Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John’s, NL, Canada, A1B 3X5 Ahmed Soliman, Dr. Mohamed Shehata, Dr. Mohamed Ahmed

Implementation of Hand Hygiene Monitoring System using BLE

SYSTEM REQUIRMENTS

• High accuracy in the sense of counting the hits and misses. • High efficiency and low power consumption. • Easily to install and maintain. • Generic and not highly tailored for a specific room configuration. • Limited number of tweaks required for system tuning.

Figure 1: CC2650 SensorTag 2.0

• Bed beacons: To localize the healthcare provider, Two beacons have to be installed for each bed. These beacons are very simple BLE Broadcaster devices. The beacons are set to a General discoverable mode which keeps it broadcasting all the time. As the system should be applicable to different room configurations, Every beacon transmits a threshold value that’s read by the badge and used in the localization algorithm. This gives some flexibility for the beacon placement with respect to the bed. The threshold value is also loaded into the advertisement data packet because it’s much faster than using a GATT service.

• BLE enabled ABHR/Soap dispenser: A part of the system cost reduction is to use the currently available Alcohol based handing rubbing and Soap dispensers. This is done by installing a sesnorTag inside the existing dispensers. The usage of the dispenser is detected by a limit switch. The sensorTag inside the dispenser is also programmed as a BLE Broadcaster in Limited discoverable mode. To save the battery power the sensorTag is triggered only when the healthcare provider uses the dispenser. Based on the average of a dispenser usage every 2 minutes, the dispenser will last up to 3.6 month on a 8000mAh rechargeable battery.

• Inforce 6309 SBC: The SBC runs an android OS, A BLE based android application is installed that starts automatically after the device boots up. The application is a BLE Central profile that scans for a broadcast signal from a badge and gets the hits and misses count from the advertisement data packet. The SBC stores the data collected on an external SD Card, generates reports and periodically upload the data to a FTP server. The upload interval and the server configurations could be changed through the application. The BLE Central profile filters the broadcast packets based on the device name and an identifier in the advertisement packet. As the broadcaster sends more than 1 packet through a connectionless transmission, the SBC make sure that it stores the data only once.

• Healthcare provider localization: Several approaches have been tested to localize the healthcare provider, they were all based on filtering the RSSI values for all the available beacons followed by an identification for the region that has the beacon with the highest RSSI and then comparing to one or more threshold. It was found that using a Mean filter on a window of 7 RSSI values leads to the best detection accuracy with acceptable detection latency, but even this accuracy wasn’t good enough for the counting logic. Relying on the fact that the healthcare provider will get really close to the bed while dealing with the patient, a proximity approach was used. Getting very close to the beacon leads to a significantly high RSSI value which acts as a strong evidence to localize the healthcare provider. Following the proper operating instructions the system exhibits very high accuracy in counting the hits and misses, But this accuracy is significantly affected by the way that the healthcare provider is wearing the badge.

• Power consumption: For the battery powered parts of the system, the power consumption is very critical, it greatly affects the usability of the system. Several power consumption optimization approaches were tested to get it to the minimum. The sensorTags used for the system are generic development boards that has more components than what our system needs, Further power consumption optimization is possible by designing our own printed circuit boards. The following figures shows some power measurements for various parts of the system, a current to voltage circuit based on an instrumentation amplifier with gain of 103 was used to do these measurements.

Figure 2: Soap dispenser Figure 3: Inside the soap dispenser

Figure 4: Inforce 6409 SBC

Figure 5: Dispenser-transmitting Figure 6: Dispenser-standby

Figure 7: Badge-scanning Figure 8: Badge-scanning and transmitting