Caracterización de Procesos Propuesto

iVitality is a digital research platform for medical research, using smartphones and health sensors. The goal is to provide a generic research platform allowing participants to measure different things at home, using their smartphone. Researchers can outsource measuring to the participants, and monitor a particular aspect over an extended period of time for little costs. The initiative for iVitality comes from the Institute of Evidence Based Medicine in Old-age, a research institute associated with the Leiden University Medical Center. For participants, use of the application provides insight in their own health. In the current version, the iVitality focuses on monitoring blood pressure, reaction time, activity and sleep (iVitality website).

Figure 5-1: Overview of iVitality components

Form the medical perspective, iVitality is a research platform first. This is an important note, because e-health applications focus mainly on relocating healthcare moves from the hospital to the patients themselves, while iVitality’s emphasis is on medical research. All participants sign a form of informed consent, which is standard procedure in medical research. It is important to note two things about the technological setup. First, all participants’ personal data and all medical data are stored on two separate servers (5 and 6 in Figure 5-1 above). Second, only the research-doctor can make the connection between the two and get the

complete picture (9 and 10). This is important in case the research data indicate a person with risk of high blood pressure, the doctor has to contact this person so as to advise him to see his general practitioner. For this study however, none of these things were viewed or used. All empirical research consisted of interviews with participants concerning their experience in using iVitality and their personal views of health and blood pressure. The medical research parameters state that participants are aged 50 to 70; have never been diagnosed with dementia or any other memory condition; have never had a cerebrovascular accident13 (CVA); and have experience in the use of cell phones and email. However, since this is not a

13

A stroke, in Dutch: beroerte of herseninfarct.

Component

1. Sensors for measuring a participant’s health.

2. Bluetooth connection between sensor and smartphone.

3. iVitality app for the smartphone.

4. Internet connection between smartphone and databases.

5. Database with participant personal data.

6. Database with medical data.

7. Database with sensor data.

8. User website.

9. Website for research-doctor.

10. Statistical export of sensor and medical data.

medical study, there parameters were not of importance. Several of the participants were aged under 50 and one had a CVA.

In this version, the sensors (1) consist of a blood pressure meter, reaction time, activity, and sleep. The blood pressure is a separate device, with cuff to put around the left arm, and one button ‘start’. Reaction time is measured with a mini-game in the app. Activity and sleep use several of the smartphone’s sensors to construct an image of the participant’s activity and sleep. Currently, blood pressure is the only external health sensor connected via Bluetooth. However, the application can easily be extended to support other sensors as well, such as blood sugar measure. For the next version of the smartphone app there are also different mini-games in development, to measure different aspects of cognitive capabilities. With multiple sensors, iVitality can become a personal health platform.

From the participants’ perspective iVitality is an e-health application first. The research aspect was part of their motivation in the sense that they wanted to help further research and development in e-health applications and get a first contact with the technology. For some participants the motivation was specifically related to blood pressure, which meant a medical motivation for participating.

The iVitality application is built by the software development company Rotterdam Community Solutions (Rotterdam Community Solutions website). The smartphone app’s start screen provides several modules, presented in the leftmost screen in Figure 5-2. ‘Berichten’ is a message services allowing contact with the research-doctor. ‘Mijn Metingen’ provides a graphic overview of the measures, such as the one shown in the rightmost screen in Figure 5-2. ‘Nu meten’ is the most used function, leading to measuring blood pressure and reaction time. The first time a participant measures his blood pressure, the app makes a Bluetooth-pairing with the blood pressure meter. After that, the app automatically connects to the blood pressure meter, shown in the screen second from left in Figure 5-2. ‘Help’ provides some answers to frequently asked questions, and ‘Instellingen’ allows the participant to share information about medication or quit the study.

Figure 5-2: several screenshots of the iVitality smartphone app.

In addition, the app asks a question concerning the participant’s health once or twice a day. The question pops up in a screen, overlaying other apps, reminding the participant of iVitality in a quite strong manner. The questions are for example:

“how many glasses of alcohol have you had in the past 24 hours?” or “has one of your parents even been diagnosed with dementia or any other memory condition?” Some of these questions are asked once in the whole duration of the study (questions such as the latter one about dementia). Other questions are asked more frequently, to provide an extended view of the participant’s health in a similar fashion to blood pressure measuring (questions such as the former one about the use of alcohol). Finally there is a user website which offers mostly the same functionality as the smartphone app, aside from the sensors. The main added functionality compared to the smartphone app is an extended view of the graphs. While the app always shows a fixed number of days for the graphs in ‘Mijn Metingen’, the website allows widening and shortening the scope of the graph, presented in Figure 5-3.

Figure 5-3: screenshot of the user website.

iVitality provides a generic research platform for medical researchers. The current version of the application focuses on blood pressure, as a blood pressure meter is currently the only external device that can be used. For the users, iVitality is an e- health app allowing them to monitor their blood pressure. Participants will be interviewed about their expectations and experiences using iVitality. The methodological support for the empirical research concerning this case study is presented in the next section.