“Mobile Nurse” Platform for Ubiquitous Medicine Z. R. Struzik 1 , K. Yoshiuchi 2 , M. Sone 3 , T. Ishikawa 3 , H. Kikuchi 2 , H. Kumano 2 , T. Watsuji 3 , B. H. Natelson 4 , Y. Yamamoto 1 1 Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Tokyo, Japan 2 Department of Psychosomatic Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan 3 Corporate Research and Development Group, Sharp Corporation, Nara, Japan 4 Department of Neurosciences, UMDNJ-New Jersey Medical School, East Orange, NJ, USA Summary Objectives: We introduce “Mobile Nurse” (MN) – an emerging platform for the practice of ubiquitous medicine. Methods: By implementing in a dynamic setting of daily life the patient care traditionally provided by the clinical nurses on duty, MN aims at integral data col- lection and shortening the response time to the patient. MN is also capable of intelligent interaction with the patient and is able to learn from the patient’s behavior and disease sign evaluation for improved personalized treatment. Results: In this paper, we outline the most essential concepts around the hardware, software and methodo- logical designs of MN. We provide an example of the implementation, and elaborate on the possible future impact on medical practice and biomedical science research. Conclusions: The main innovation of MN, setting it apart from current tele-medicine systems, is the ability to integrate the patient’s signs and symptoms on site, providing medical professionals with powerful tools to elucidate disease mechanisms, to make proper diag- noses and to prescribe treatment. Keywords Ubiquitous computing, ecological momentary assess- ment (EMA), real-time analysis, wearable sensors, wireless technologies Methods Inf Med 2007; 46: 130–134 1. Introduction Medical diagnoses and treatment are gen- erally preceded by an evaluation of the patient’s signs and symptoms. The signs, changes from the “normal” baseline of physical variables or states, are objective in- formation used by doctors, e.g., arrhythmia, tachycardia and fever. The symptoms, on the other hand, are mostly subjective and re- ported by patients, e.g., dizziness, tiredness and pain.Traditionally, this objective as well as subjective information has been obtained and integrated in dedicated facilities, namely medical clinics. Emerging information technologies, in- cluding small, wearable but powerful com- puters, fast networking environments, and small biomedical sensors, are changing this environment. Now the patient’s signs can be remotely captured by wearable sensors, giv- ing rise to the advocacy of the concept of “tele-medicine” [1]. The availability of small and programmable computers allows doctors to assess the psychological and so- matic symptoms momentarily while they occur. This is known as computerized eco- logical momentary assessment (EMA) [2]. In this way, the medical information required for patient care and treatment is becoming ubiquitous. The problem tackled in this paper is whether we can combine and integrate this ubiquitous information on site. This task is considered important because, for instance, symptom collection with coexisting disease signs would generally be more powerful in elucidating disease mechanisms, making proper diagnoses and prescribing treatment. In the clinic, this task is usually performed by nurses on duty, while in the ubiquitous medical environment, having such person- nel is very difficult. Here, we propose a small computer platform, called Mobile Nurse (MN), which can perform exactly this task. We introduce the hardware/software designs, some examples of the implemen- tation, and the possible future impact on medical practice and biomedical science research. 2. Mission Statement 2.1 “Mobile Nurse” – Definition MN is the name of a small, wearable, but powerful computerized diagnostic system capable of performing tasks normally as- signed to a human (nurse). Like the human nurse, the system is capable of performing the routine tasks of recording and evaluating the patient’s signs and symptoms according to the protocol specified by the medical doctor. It can be programmed to monitor dynamic disease processes, continuously evaluate the outcome of treatment, and even provide on site treatment. It is capable of in- telligent interaction with the patient and is able to learn from the patient’s behavior and disease sign evaluation for improved per- sonalized treatment. Unlike the human nurse, MN can assist patients in their daily settings. The MN will help not only the pa- tients but also medical doctors in their ef- forts to better understand the disease pro- 130 © 2007 Schattauer GmbH Methods Inf Med 2/2007