1 of 4 Abstract— We describe the design and implementation of an intelligent reporting and alerts system that has been designed with a specific goal to address the needs of managing chronic and complex disease through the use of home telecare technology. Our approach has been to develop these tools using as far as possible, open standards. Clinical measurement data gathered using home telecare and stored in a relational database in XML format is extracted and converted into a Clinical Document Architecture (CDA) as defined by the Health Level 7 (HL7) organization. Data trends are presented to the clinician as simple graphs and summary statistics (means, standard deviations) over time for an individual patient. Clinicians may receive this data by display through a Web-interface or by email or faxed reports. A Ripple Down Rules (RDR) knowledge base supports more complex decision-making provided in the Alerts module. The RDR output is incorporated into the output reports as a textual statement, and/or a graphical highlighting of key parameters in the trends images and tables. Rule development and validation is part of on- going research. The database storage of longitudinal patient data introduces new ways to improve the quality and variety of information about a patient’s health status to the clinician. Measures of physiological monitoring can be translated into accurate predictors of health risk - this information is invaluable in identifying and treating problems, sometimes at an early stage. A Home Health Monitoring System Including Intelligent Reporting and Alerts H. Garsden 1 , Member, J. Basilakis 1 , B.G. Celler 1 , K. Huynh 1 , N.H Lovell 2,3 Senior Member 1 School of Electrical Engineering, University of New South Wales, Sydney, Australia 2 Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia 3 NICTA, Sydney, Australia To make use of the collected patient data we have implemented a software monitoring and alert system, for use with the HTS. The system can monitor patient health data over time and produce graphical and statistical summaries that allow comprehensive monitoring of vital signs and recognition and alerting of potential patient problems. This is useful because: • It will save time • It will enable clinician’s to be presented with summary reports that aggregate large amounts of patient data • Feedback has been shown to influence clinician behavior [5]. It is envisaged that these benefits will allow clinicians to provide better care to patients. The system uses knowledge- based rules for the alerts, and statistical analysis for the trend summaries. Keywords— clinical measurements, home telecare, knowledge management, ripple-down rules, XML, HL7 We describe the system architecture of a knowledge management and intelligent reporting tool, customized for use with home telecare data, and based on industry standards for data representation and data exchange. I. INTRODUCTION Home telecare is the use of information, communications, measurement and monitoring technologies to evaluate health status and deliver healthcare from a distance to patients at remote locations [1]. Home telecare has significant potential for contributing to the management of patients with chronic disease as well as at-risk elderly people living alone at home [2]. Usability and clinical trials of home telecare technology have demonstrated wide acceptance of the technology by users [3] and enormous potential cost benefits in specific chronic disease target populations – for example, congestive heart failure (CHF) [4]. II. METHODOLOGY The reporting system is depicted in Fig. 1. We focus on the Trends Path and the Alerts Path. Data is taken from the patient database, which consists of parameters extracted from the raw signals of vital signs, going back as far as the patient has been in the system. Parameters are, for example, heart rate, lung capacity, blood pressure (systolic/diastolic) and blood oximetry. The Trends Path performs statistical analyses and summarizes the results. The Alerts Path uses a rule-based system to generate clinical warnings and alerts, which are merged with the statistics and displayed in a variety of representations. A home telecare system (HTS) has been developed at the University of New South Wales over a period of more than five years [2,3]. A clinical trial in 2001-2002 funded by the Australian Commonwealth Department of Health and Ageing demonstrated that the system was acceptable and useable by patients and clinicians alike, and provided high quality data from the home. The information extracted from the patient database is also converted into a Clinical Document Architecture (CDA) file [6] for exchange with other systems. The CDA format is defined by the Health Level 7 (HL7) organization representing clinical data, and is similar in many respects to an electronic health record. It can be digitally signed with