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Title:
A SYSTEM, METHOD, SOFTWARE APPLICATION AND DATA SIGNAL FOR DETERMINING MOVEMENT
Document Type and Number:
WIPO Patent Application WO/2014/015390
Kind Code:
A1
Abstract:
The invention, in one aspect, provides a system for determining movement. The system comprises at least one receiving module arranged to receive movement data indicative of movement from a remote device, a processing module arranged to process the moving data to determine the type of movement, and an alert module arranged to provide an alert in the event that the type of movement falls within at least one predetermined type.

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Inventors:
VISVANATHAN RENUKA (AU)
RANASINGHE RANKOTHGE DAMITH CHINTHANA (AU)
Application Number:
AU2013/000838
Publication Date:
January 30, 2014
Filing Date:
July 29, 2013
Export Citation:
Click for automatic bibliography generation   Help
Assignee:
ADELAIDE RES & INNOVATION PTY (AU)
International Classes:
G01P15/00; A61B5/11
Foreign References:
US20110098608A12011-04-28
US20110066081A12011-03-17
Other References:
See also references of EP 2877861A4
Attorney, Agent or Firm:
WRAYS (56 Ord StreetWest Perth, Western Australia 6005, AU)
Download PDF:
Claims:
CLAIMS:

1 . A system for determining movement, comprising at least one receiving module arranged to receive movement data indicative of movement from a remote device, a processing module arranged to process the moving data to determine a type of movement, and an alert module arranged to provide an alert in the event that the type of movement falls within at least one predetermined type.

2. A system in accordance with Claim 1 , wherein the movement data includes acceleration data.

3. A system in accordance with Claim 1 or 2, wherein the movement data is utilised to calculate a motion vector indicative of the movement of the remote device.

4. A system in accordance with Claim 3, wherein the type of movement is determined, in part, by analysing variations in the motion vector over a period of time.

5. A system in accordance with any one of Claims 1 to 4, wherein the receiving module is arranged to receive movement data from a plurality of remote devices.

6. A system in accordance with any one of Claims 1 to 5, wherein the at least one receiving module is arranged to receive the movement data as a radiofrequency signal.

7. A system in accordance with Claim 5, wherein the receiving module incorporates a radiofrequency signal emitter arranged to send an activation signal to the remote device.

8. A system in accordance with Claim 6, wherein the remote device is a passive radiofrequency device arranged to emit a radiofrequency signal encoding the movement data upon exposure to the activation signal.

9. A system in accordance with any one of the preceding claims, wherein the types of movements include movements by a person or object.

10. A system in accordance with Claim 9, wherein the predetermined types of movements are movements that are one of movements likely to cause injury and movements likely to carry a high risk of injury when performed.

1 1 . A system in accordance with any one of the preceding claims, wherein the at least one remote device is wearable by a user.

12. A system in accordance with any one of Claims 9 to 1 1 , wherein the processing module is arranged to determine whether the type of movement corresponds to one of the predetermined movement types.

13. A system in accordance with Claim 1 2, wherein the processing module selects a movement type from a group including walking through a doorway, sitting, standing, lying, getting up from lying and walking without a walking aid.

14. A system in accordance with Claim 13, wherein the processing module is arranged to calculate the radial velocity of the at least one remote device over a defined period of time.

15. A system in accordance with Claim 14, wherein the processing module is further arranged to determine whether the direction of the radial velocity has changed over the defined period of time.

16. A system in accordance with Claim 15, wherein the processing module is further arranged to classify the type of movement as walking through a doorway when the direction of the radial velocity has changed over the defined period of time.

17. A system in accordance with Claim 12, wherein the processing module is arranged to calculate the acceleration component in one predefined axis over a defined period of time.

18. A system in accordance with Claim 1 7, wherein the predefined axis is an axis substantially vertical relative to a ground surface.

19. A system in accordance with Claim 18, wherein the processing module is further arranged to analyse the acceleration component over a period of time to determine whether a pattern exists.

20. A system in accordance with Claim 19, wherein the processing module is further arranged to classify the type of movement as walking without a walking aid when the pattern of a first device does not correspond with the pattern of a second device.

21 . A system in accordance with Claim 1 7, wherein the predefined axis is an axis substantially horizontal relative to a ground surface.

22. A system in accordance with Claim 21 , wherein the processing module is further arranged to classify the type of movement as lying prone when the acceleration component is approximately zero.

23. A system in accordance with Claim 12, wherein the processing module is arranged to calculate the angular displacement of the at least one remote device relative to a predefined axis over a defined period of time.

24. A system in accordance with Claim 23, wherein the processing module is arranged to determine whether the angular displacement of the at least one remote device increases to a maximum value from a base level and subsequently returns to the base level.

25. A system in accordance with Claim 24, wherein the processing module is further arranged to classify the type of movement as sitting when the angular displacement has changed over the defined period of time to the maximum state and subsequently returns to a base level.

26. A system in accordance with any one of the preceding claims, wherein the alert module sends an alert within a predefined amount of time after determining the type of movement.

27. A system in accordance with any one of the preceding claims, wherein the alert module sends an alert to a person, wherein the alert is sent at defined intervals to the person until such time as the person satisfies a criterion.

28. A system in accordance with Claim 27, wherein the system keeps a record of the amount of time elapsed between the sending of the alert to the person and the time at which the person satisfies the criterion.

29. A system in accordance with Claim 27 or Claim 28, wherein the criterion is the locating of a first remote device into proximity with a second remote device.

30. A system in accordance with any one of the preceding claims, wherein the receiving module receiving identification data from the remote device.

31 . A system in accordance with Claim 30, wherein the alert module utilises the identification data to, in part, determine the alert condition.

32. A method for determining movement, comprising the steps of receiving movement data indicative of movement from at least one remote device, processing the movement data to determine the type of movement, and providing an alert in the event that the type of movement falls within at least one predetermined type.

33. A method in accordance with Claim 32, wherein the movement data includes acceleration data.

34. A method in accordance with Claim 32 or 33, wherein the movement data is utilised to calculate a motion vector indicative of the movement of the remote device.

35. A system in accordance with Claim 34, wherein the type of movement is determined, in part, by analysing variations in the motion vector over a period of time.

36. A method in accordance with any one of Claims 32 to 35, including the further step of receiving movement data from a plurality of remote devices.

37. A method in accordance with any one of Claims 32 to 36, including the further step of receiving the movement data as a radiofrequency signal.

38. A method in accordance with Claim 37, wherein the receiving module incorporates a radiofrequency signal emitter arranged to send an activation signal to the remote device.

39. A method in accordance with Claim 38, wherein the remote device is a passive radiofrequency device arranged to emit a radiofrequency signal encoding the movement data upon exposure to the activation signal.

40. A method in accordance with any one of Claims 32 to 39, wherein the types of movements include movements by a person or object.

41 . A method in accordance with Claim 40, wherein the predetermined types of movements are movements that are one of movements likely to cause injury and movements likely to carry a high risk of injury when performed.

42. A method in accordance with any one of Claims 32 to 41 , wherein the at least one remote device is wearable by a user.

43. A method in accordance with any one of Claims 40 to 42, including the further step of determining whether the type of movement corresponds to one of the predetermined movement types.

44. A method in accordance with Claim 43, including the further step of selecting a movement type from a group including walking through a doorway, sitting, standing, lying, getting up from lying and walking without a walking aid.

45. A method in accordance with Claim 44, including the further step of classifying the radial velocity of the at least one remote device over a defined period of time.

46. A method in accordance with Claim 45, including the further step of determining whether the direction of the radial velocity has changed over the defined period of time.

47. A method in accordance with Claim 46, including the further step of classifying the type of movement as walking through a doorway when the direction of the radial velocity has changed over the defined period of time.

48. A method in accordance with Claim 47, including the further step of calculating the acceleration component in one predefined axis over a defined period of time.

49. A method in accordance with Claim 48 wherein the predefined axis is an axis substantially vertical relative to a ground surface.

50. A method in accordance with Claim 49, including the further step of analysing the acceleration component over a period of time to determine whether a pattern exists.

51 . A method in accordance with Claim 50, including the further step of classifying the type of movement as walking without a walking aid when the pattern of a first device does not correspond with the pattern of a second device.

52. A method in accordance with Claim 51 , wherein the predefined axis is an axis substantially horizontal relative to a ground surface.

53. A method in accordance with Claim 21 , including the further step of classifying the type of movement as lying prone when the acceleration component is approximately zero.

54. A method in accordance with Claim 45, including the further step of calculating the angular displacement of the at least one remote device relative to a predefined axis over a defined period of time.

55. A method in accordance with Claim 54, including the further step of determining whether the angular displacement of the at least one remote device increases to a maximum value from a base level and subsequently returns to the base level.

56. A method in accordance with Claim 55, including the further step of classifying the type of movement as sitting when the angular displacement has changed over the defined period of time to the maximum state and subsequently returns to a base level.

57. A method in accordance with any one of Claims 32 to 56, including the further step of the alert module sending an alert within a predefined amount of time after determining the type of movement.

58. A method in accordance with any one of Claims 32 to 57, including the further step of the alert module sending an alert to a person, wherein the alert is sent at defined intervals to the person until such time as the person satisfies a criterion.

59. A method in accordance with Claim 58, including the further step of keeping a record of the amount of time elapsed between the sending of the alert to the person and the time at which the person satisfies the criterion.

60. A method in accordance with Claim 58 or 59, wherein the criterion is the locating of a first remote device into proximity with a second remote device.

61 . A method in accordance with any one of Claims 32 to 60, including the further step of the receiving module receiving identification data from the remote device.

62. A method in accordance with Claim 61 , including the further step of the alert module utilising the identification data to, in part, determine the alert condition.

63. A computer program including at least one instruction, which, when executed on a computing system, causes the computing system to carry out the method steps in accordance with any one of Claims 32 to 62.

64. A computer readable medium incorporating a computer program in accordance with Claim 63.

65. A data signal including at least one instruction, wherein the data signal is receivable and interpretable by a computing system to carry out the method steps in accordance with any one of Claims 32 to 62.

Description:
A SYSTEM, METHOD, SOFTWARE APPLICATION AND DATA SIGNAL FOR

DETERMINING MOVEMENT

Technical Field

[0001 ] The present invention relates to a system, method, software application and data signal for determining movement. The device, system, method, software application and data signal finds particular, but not exclusive, use in the monitoring of patients and objects in a hospital, aged care or other supervised environment, where it is important to track not only the location, but also the movement and change in position of a patient or object.

Background Art

[0002] Persons who are injured, weakened (due to disease, such as a stroke, for example) or aged are more prone to accidents or falls. Such accidents or falls can cause injury, which can result in hospital stays or the need for ongoing monitoring and treatment. More importantly, accidents or falls can lead to a loss of independence, a decline in health status and the development of psychological consequences such as anxiety, depression and loss of confidence.

[0003] Moreover, it is not only the person who falls who is affected by the fall. Where a patient in a hospital or a person in an aged care facility is injured, staff and family can feel fear, guilt and anxiety. These feelings can result in defensive actions being taken by the staff or family members, which may contribute to poorer care, more conflict and a rise in complaints, coroner's inquests and litigation.

[0004] Falls in Australian hospitals alone are estimated to increase the total number of hospital bed days by 886,000 per year. Such alarming figures will only increase over time due to an aging population in many countries.

Summary of Invention

[0005] In a first aspect, the present invention provides a system for determining a type of movement, comprising at least one receiving module arranged to receive movement data indicative of movement from a remote device, a processing module arranged to process the movement data to determine the type of movement, and an alert module arranged to provide an alert in the event that the type of movement falls within at least one of a plurality of predetermined types of movement.

[0006] The movement data may include acceleration data, which may be utilised to calculate a motion vector indicative of the movement of the remote device.

[0007] In one embodiment, the type of movement is determined, in part, by analysing variations in the motion vector over a period of time.

[0008] The receiving module is arranged in one embodiment to receive movement data from a plurality of remote devices and may receive the movement data as a radiofrequency signal.

[0009] In one embodiment, the receiving module incorporates a radiofrequency signal emitter arranged to send an activation signal to the remote device, such that where the remote device is a passive radiofrequency device, the remote device emits a radiofrequency signal encoding the movement data upon exposure to the activation signal.

[001 0] The types of movements may include movements by a person or object. Where the predetermined types of movements are movements by a person, they include movements likely to cause injury and movements likely to carry a high risk of injury when performed.

[001 1 ] The at least one remote device is arranged, in one embodiment, to be wearable by a person. The remote device may be adhered, attached, or integrated into a wearable item, such as an item of clothing.

[001 2] In one embodiment, the processing module selects a movement type from a group including walking through a doorway, sitting, standing, lying, getting up from a lying down position and walking without a walking aid. However, it will be understood that the processing module may also be programmed to identify other movement types.

[001 3] In one embodiment, the processing module is arranged to calculate the radial velocity of the at least one remote device over a defined period of time and may be further arranged to determine whether the direction of the radial velocity has changed over the defined period of time. [0014] In one embodiment, the processing module is further arranged to classify the type of movement as walking through a doorway when the direction of the radial velocity has changed over the defined period of time.

[001 5] In one embodiment, the processing module is arranged to calculate the acceleration component in one predefined axis over a defined period of time and the predefined axis may be an axis substantially vertical relative to a ground surface.

[001 6] The processing module may be further arranged to analyse the acceleration component over a period of time to determine whether a pattern exists.

[001 7] The processing module may be further arranged to classify the type of movement as walking without a walking aid when the pattern of a first device does not correspond with the pattern of a second device.

[001 8] The processing module may be further arranged to classify the type of movement as lying when the acceleration component is approximately zero and may additionally be arranged to calculate the angular displacement of the at least one remote device relative to a predefined axis over a defined period of time.

[001 9] The processing module may also be arranged to determine whether the angular displacement of the at least one remote device increases to a maximum value from a base level and subsequently returns to the base level.

[0020] The processing module may be further arranged to classify the type of movement as sitting when the angular displacement has changed over the defined period of time to the maximum state and subsequently returns to a base level.

[0021 ] The alert module may be arranged to send an alert to a person, wherein the alert is sent at defined intervals to the person until such time as the person satisfies a criterion. The system keeps a record of the amount of time elapsed between the sending of the alert to the person and the time at which the person satisfies the criterion.

[0022] In one embodiment, the receiving module receives identification data from the remote device and optionally, the alert module utilises the identification data to, in part, determine the alert condition. [0023] In a second aspect, the present invention provides a method for determining movement, comprising the steps of receiving movement data indicative of movement from at least one remote device, processing the movement data to determine the type of movement, and providing an alert in the event that the type of movement falls within at least one predetermined type.

[0024] In a third aspect, the present invention provides a computer program including at least one instruction, which, when executed on a computing system, causes the computing system to carry out the method steps in accordance with a third aspect of the invention.

[0025] In a fourth aspect, the present invention provides a computer readable medium incorporating a computer program in accordance with a third aspect of the invention.

[0026] In a fifth aspect, the present invention provides a data signal including at least one instruction, wherein the data signal is receivable and interpretable by a computing system to carry out the method steps in accordance with a second aspect of the invention.

Brief Description of the Drawings

[0027] Notwithstanding any other forms which may fall within the scope of the present invention, a preferred embodiment will now be described, by way of example only, with reference to the accompanying drawings in which:

Figure 1 is a diagram illustrating a system in accordance with an embodiment of the present invention;

Figure 2 is a diagram illustrating the calculation of a velocity vector in accordance with an embodiment of the present invention;

Figure 3a is a diagram illustrating the relative positioning of RFID readers utilised to calculate a transition (walking through a door) in accordance with an embodiment of the invention; Figure 3b is a graph of collected and processed data illustrating a pattern indicative of a person walking through a door, in accordance with an embodiment of the invention;

Figure 4 is a graph of collected and processed data illustrating a pattern indicative of a person transitioning through a sit/stand movement, in accordance with an embodiment of the invention;

Figure 5 is a graph of collected and processed data illustrating a pattern indicative of a person walking without a walking aid, in accordance with an embodiment of the invention;

Figure 6 is a schematic of a computing system in accordance with an embodiment of the invention;

Figure 7 is a diagram illustrating a system in accordance with an embodiment of the invention;

Figure 8 is a diagram illustrating an algorithm developed in accordance with an embodiment of the invention;

Figures 9 and 10 are diagrams illustrating survey results collected to demonstrate the effectiveness of an embodiment of the invention;

Figure 1 1 is a diagram illustrating a test layout of antennas in a room in accordance with an embodiment of the invention;

Figure 1 2 is an automatically generated 'visual cue' (bed side poster) using the HIT tool in accordance with an embodiment of the invention;

Figure 1 3 is a diagram illustrating a system in accordance with an embodiment of the invention;

Figure 14 is a flowchart illustrating a process flow in accordance with an embodiment of the invention; and

Figures 15a and 15b are screenshots illustrating a user interface in accordance with an embodiment of the present invention. Description of Embodiments

Overview of an Embodiment

[0028] Reference numerals in the following description represent like (or equivalent) functional and/or structural components or features in the related Figures.

[0029] Broadly, the embodiment described herein is a system, method and software application for determining movement. The system comprises at least one receiving module arranged to receive movement data indicative of movement from a remote device, a processing module arranged to process the moving data to determine the type of movement, and an alert module arranged to provide an alert in the event that the type of movement falls within at least one predetermined type.

[0030] In more detail, with reference to Figure 1 , there is shown a schematic diagram which provides an overview of the components that make up a system 1 00 for determining movement (i.e. the real time monitoring of patient movement) in accordance with an embodiment of the invention. The system is described herein by way of example with reference to a hospital or aged care facility and is referred to as the AmbiGEM™ system.

[0031 ] It will be understood that the system may find use in any suitable environment where it is desirable to monitor high risk movement activities. While the example refers to a hospital or aged care facility, the system may also be used in individual homes to allow for people with dementia to live independently.

[0032] Moreover, the system may find use in industrial or commercial applications, to monitor workers who engage in high-risk activities that require compliance with occupational health and safety laws and regulations. In yet another example, the system may find use in high risk recreational activities, where participants in sporting activities are engaged in movement or actions that may pose a risk of injury.

[0033] The system includes a receiving module, which in the embodiment described herein, includes plurality of radiofrequency identification (RFID) readers 102 and associated antennas 104 that are connected via a wireless local area network (WLAN) 106. The RFID readers 102 communicate with a computing system 108 which in turn includes (or is connected to) a database 1 1 0. The computing system 108 includes a processing module which is arranged to execute monitoring software which receives data (information) via the wireless local area (WLAN) infrastructure 106. The computing system includes an appropriate interface (not shown) to allow direct interaction with the monitoring software. The monitoring software will be described in more detail below.

[0034] Patients (i.e. persons) 1 12 who are under the care of the facility (e.g. the aged care facility or hospital) and are physically located within the physical grounds of the facility (i.e. they are within the "environment" of the facility) are equipped with remote devices in the form of wearable Wireless Sensing and Identification (WISP) devices 1 14.

[0035] In turn, caregivers 1 1 6 carry pagers 1 18 or other mobile devices (such as mobile (cell) phones which are arranged to receive alerts generated by an alert module which is associated with or incorporated into the computing system.

[0036] Alerts are generated when the processing module executes the monitoring software (which includes an inference engine) to detect the occurrence of predetermined movement types, such as a high-risk action or a "fall". That is, the monitoring software utilises the inference engine, which includes a series of algorithms to classify movement into one of a number of "types". If the type detected falls into one of a predetermined number of categories of high-risk actions (which are described in more detail below), then the alert module is arranged to provide an alert to one or more caregivers 1 1 6.

[0037] Moreover, in one embodiment, caregivers wear RFID name badges to facilitate the automatic identification and localization of caregivers to monitor that an intervention is being administered or prevent activation of alert as caregiver supervision was already in place.

WISP Devices

[0038] In more detail, the remote (WISP) devices 1 14 are Wireless Identification and Sensing devices which include passive (i.e. battery-less) Radio Frequency Identification (RFID) technology and a motion sensor, such as a tri-axial accelerometer. WISP devices are sometimes colloquially referred to as "tags". [0039] Known WISP devices are approximately 20 mm χ 20 mm in size and approximately 2 mm thick and include an antenna for transmitting and receiving radio frequency signals. WISP devices weigh approximately 2 grams.

[0040] As a WISP device is light and small in size, it is easily and generally undetectably incorporated into a number of different items, such as badges, "stickers", clothing, and/or shoes or belts. It can also be attached or incorporated into any type of object, including walking aids, wheelchairs, etc.

[0041 ] WISPs are powered by harvested energy from radio waves transmitted from RFID readers. The harvested energy operates a 1 6-bit microcontroller (MSP430F2132) and a tri-axial accelerometer (ADXL330). The microcontroller can perform a variety of computing tasks, such as collecting (sampling) sensor data and reporting the sensor data to a remotely located receiving module, such as a RFID reader.

[0042] For completeness, it is noted that there are two different methods for transferring power from a RFID reader to the WISP device - magnetic induction and coupling to the electromagnetic (EM) waves transmitted by an RFID reader. The powering method depends on the distance of the WISP device to the RFID reader antennas where a distinction is made between a near field (energy storage field) and a far field (where electromagnetic wave propagation is dominant). Through various modulation techniques, data is also encoded onto the same transmitted signal from the reader to the WISP device and the received signal from the WISP device to the RFID reader. The embodiment described herein and the broader inventive concepts are equally capable of operating with both methods.

WISP Attached to a Patient's Sternum

[0043] In one embodiment of the invention, a WISP tag is located over the sternum of a patient (user) at a location on top of their attire. It will be understood that the WISP tag may be incorporated in clothing or otherwise securely attached to the user.

Mattress Attached WISP Method

[0044] In another embodiment, a WISP is attached to the side of the bed opposite the side of the bed most frequently used by the patient to get in or out of bed. This is done to avoid damage to the device or occlusion from the subject's body. The signal of interest corresponds to the acceleration readings of the z axis ( z p ), perpendicular to both gravity and the side of the mattress, in percentage values (where 50% is equivalent to 0 g) and its derivative z p . If a patient lies or sits on the mattress, the change of the alignment of the sensor as a result of the deformation of the mattress during the activity causes a change in z p . It is known that if a patient keeps a static posture in bed or if the mattress is empty, the derivative of z p ( z p ) remains in a defined value range. An algorithm was developed considering the changes in z p and z p to identify a significant movement in bed as a PT out of a static state or significant movement made by the subject while remaining in a static state.

Receiving Modules (RFID Readers)

[0045] In more detail, the receiving modules (in the form of RFID readers) are located at fixed locations with their antennas strategically placed to detect objects that incorporate a WISP device. The receiving modules further incorporate a module arranged to emit an electromagnetic field, such that power is transferred to WISP devices within a particular area around the RFID reader. RFID readers can read multiple co-located WISP devices simultaneously (up to several hundred WISP devices per second can be read by many known RFID systems). The reading distance ranges from a few centimetres to more than 10 meters, depending on the type of WISP device, the transmitted power of the RFID reader, antenna gain and interference from other radio frequency radiation.

[0046] Ultra High Frequency (UHF) RFID readers operate between 920 MHz and 926 MHz in Australia. Based on currently available studies, there are no known adverse effects from RFID readers operating in the UHF region on pace makers or implantable cardioverter-defibrillators, physiological monitors (such as electrocardiogram monitors) and intravenous pumps, making such RFID readers suitable for use in aged care or hospital environments.

[0047] In the embodiment described herein, the reader antenna configuration used is capable of communicating with conventional RFID tags (up to 10 metres away) and WISP devices (up to 3 metres away). However, it will be understood that different configurations arranged to operate at larger distances are within the purview of a person skilled in the art, and the example given herein should not be considered to be limiting on the broader inventive concept described and defined herein.

Analysis and Identification of High Risk Activities by the Processing Module

[0048] Falls commonly occur around patients' or residents' beds, bathrooms and/or toilets or bathrooms. Consequently, high risk activities within an environment such as an aged care facility or a hospital that are likely to lead to a fall include but are not limited to:

1 . entering a room or bathroom or toilet through a doorway;

2. getting up from a chair or sitting down in a chair;

3. getting into our or out of a bed; and

4. walking without the required walking aid.

[0049] The acceleration data and/or the resultant velocity vector received by the computing system from the receiving module (which in turn has received the data from a WISP device) is used to determine the movement type performed by the patient.

[0050] In particular, movement data is collected over a defined period of time and analysed using a number of techniques and/or algorithms. Each movement type is detected by determining the presence (or absence) of certain patterns in the movement data over a defined period of time. In the embodiment described herein, the algorithms utilised to determine the four particular movement types listed above are described in detail. It will be understood, however, that other relevant movement types are detected/detectable by the computing system.

Algorithms for Detecting Movement Types

Entering a Room Through a Doorway

[0051 ] In order to detect movement from one area to another (i.e. through a doorway), it is necessary to extract the velocity vector from the acceleration data provided by the WISP, to then in turn estimate the projection of the projection of the WISP velocity vector on to the line of sight between the WISP and the reader [0052] The projection of the WISP velocity vector on to the line of sight between the WISP and the RFID reader can be estimated by Time Domain Phase Difference of Arrival (TD-PDOA) measuring the phase of a tag at different time moments at the same frequency, as illustrated in Figure 2. The difference of phase (φ2-φ1 ) at different times is measured and attributed to the path difference d2 - d1 . In turn, the radial velocity of the RFID tag is given by equation (1 ):

[0053] where A=c/f (c is the speed of light and f is the frequency of the transmitted wave from the reader). The negative sign defines the direction of the radial velocity in the derivation as being opposite to the change in distance of the tag at times t1 and t2.

[0054] By analysing the radial velocity over time at two overhead antennae and determining the point at which the direction of the radial velocity changes from negative to positive, the time at which the person moves across a hypothetical "centre line" between the first and second antennas can be determined. This is shown at Figure 3(a). Therefore by using two overhead antennae (as illustrated in Figure 3(a), strategically placed at each side of a doorway entrance or other transition point, a person's traversing direction can be identified by analysing and comparing the centre-crossing evaluated by both antennae, as shown in Figure 3(b).

[0055] In practice, to achieve an accurate and predictable result, the antennae of the two RFID readers are generally suspended from a ceiling (or a surface above "head height') and the antenna of each RFID reader is leaned to an angle approximately 50 degrees from the vertical.

Getting Up or Sitting Down on a Chair

[0056] In order to identify a sitting or standing (from a sitting position) movement, it is instructive to note that in the natural sitting/standing movement, there are two phases in standing-to-sitting (StSi) and sitting-to-standing (SiSt) transitions:

(i) an initial leaning forwards followed by;

(ii) a leaning backwards (SiSt follows the opposite order). [0057] In both StSi and SiSt transitions, the displacement of Θ (inclination angle between the trunk and vertical axis) approaches a maximum value and then recovers. A similar trend also occurs in the change in sin Θ, as indicated in Figure 3. Using sin Θ provides a non-linear scale which increases the sensitivity of the results.

[0058] That is, a StSi and SiSt postural transition (PT) is detected by analysing the pattern of sin Θ. Figure 3 is a graph which plots an estimation of the time at which PT of StSi or SiSt occurs (i.e. the time corresponding to the maximum of sin Θ). The transition duration (TD) is the time interval estimated from the beginning of the leaning forward phase (P1 ) to the end of the leaning backward phase (P2). Hence TD = tp1 - tp2, where tp1 and tp2 and are the times related to P1 and P2, which are estimated as the time corresponding to the two nearest minima, respectively. It is not necessary to determine the angle Θ exactly, as an estimate is sufficient for the purposes of identifying a transition. The value of Θ can be estimated because the contribution of acceleration components from the posture transition can be assumed to be negligible compared to that of gravity.

[0059] Therefore,≥ tan " 1 (2 -

[0060] In order to determine whether the transition is a "sit to stand" transition or a "stand to sit" transition, the Received Signal Strength Indicator (RSSI), which is the strength of the signal reflected from the WISP and detected at the antenna, is used as a method of estimating the distance of the person to the antenna and hence whether the person is standing or sitting at the end of the PT. RSSI is reported by the reader in steps of 0.5 dBm for each received signal from the WISP. A WISP at any given time will have different RSSI readings reported by different antennae and therefore each antenna is a reference point for the location and displacement of the WISP.

[0061 ] In more detail, after filtering to remove noise using a band pass direct-form II second-order Butterworth filter with cut-off frequencies at 0.04 and 0.7 Hz, the aforementioned three components are evaluated.

[0062] First, a true PT has a TD above 1 .725 seconds and sin Θ larger than 0.275 at tpT. Second, the RSSI (inversely proportional to the quadruple of distance) indicates that the distance variation from the antenna due to the displacement of the body results in the RSSI reading decreasing (or increasing) depending on the location of the antenna relative to the person. As a result, when standing, the distance from the WISP to the antenna is shorter than when the person is sitting, causing a negative gradient during a StSi and positive gradient during a SiSt transition (see Figure 4).

[0063] In short range measurements, such as within a room, RSSI can be used to successfully discriminate between SiSt and StSi transitions, as shown in Figure 4, where the dotted line shows the RSSI values.

Getting In and Out of Bed

[0064] A "lying down" state is determined by analysing the acceleration readings from the anteroposterior axis (xg) where readings of approximately 0 and 1 g correspond to lying and standing/sitting respectively. In practice, to eliminate noise and also reduce or remove components such as walking, the signal is filtered with a direct-form II second-order Butterworth low pass filter with cut-off frequency at 0.16Hz.

[0065] PTs of sitting-to-lying and lying-to-sitting are detected based on threshold values before and after the event. The sitting-to-lying PT is detected using the pattern of the derivative of xg. This is the estimated time at which sitting-to-lying occurs and corresponds to the minimum of the derivative of xg while and are the times corresponding to two nearest maxima of the derivative of xg before and after tpi, respectively. The PT is classified as such if the mean of xg before and after the tp T value is above 0.7g or below 0.4g respectively.

Mobilizing Without a Walking Aid

[0066] Walking is detected by analysing the vertical acceleration component every 5 seconds - the signal is filtered to distinguish the stepping patterns by isolating signals within 0.62 and 5 Hz approximately. To detect a walking period, negative peaks below a threshold of -0.05 g are considered as possible steps if 2 or more consecutive steps occur with intervals between peaks of 0.25 to 2.25 seconds.

[0067] The activity of a patient walking without a walking aid is detected if a person is found to leave or enter a room or leave a position without their walking aid. A person identified as moving through a threshold without also simultaneously detecting the walking aid moving across the threshold signals the positive identification of a subject mobilizing without a walking aid. Inference is achieved by using the tag direction algorithm which indicates the direction of movement and the resultant acceleration aR reported by the WISP attached to the walking aid which in turn indicates whether the aid is being used. A value of around 1 g (gravity) confirms that the walking aid is not being used (as shown in Figure 5) where a R is given by:

Results

[0068] A study was conducted, using a number of volunteers, to determine the average sensitivity and specificity of the algorithms described above. The volunteers, in total, performed 1 97 Patient Transitions (PTs) including standing-to-sitting, sitting-to-lying, lying-to-sitting and sitting-to-standing with 99 lying conditions: supine and prone position and left and right side lying. Importantly, there were very few false positives.

[0069] Table 1 , below, provides the final results from the 197 PTs performed.

Table 1: Results of Sensitivity and Specificity of Algorithms Utilised to Detect Various Patient

Transitions from Data Collected from WISPs

[0070] As can be seen from the table, both the sensitivity and specificity of all the aforementioned algorithms and techniques is quite high, making the algorithms and techniques very suitable for the accurate determination of various movement types. Data Collection

[0071 ] Each subject was given scripted routines of postural transitions that included getting into bed, lying and getting out of bed; walking (for example walking from the bed to the chair and vice versa); and sitting down on or getting up from a chair.

[0072] Each subject was given three separate scripts with random orderings of these postural transitions. The algorithms were not customized to each subject. The transitions were recorded by the patient monitoring software and annotated simultaneously in the software system by a researcher during the data collection process. This allowed for subsequent evaluation of the results.

Statistical Analysis

[0073] True positives were the correctly identified bed exit events (in the case of WISP on sternum algorithm, both lying to sitting followed by sitting to standing was detected correctly). True negatives were events of no interest that were correctly identified as not bed exits events (for example, getting into bed). False negatives were known bed exit events that were not identified (i.e. misses). False positives are other movements that were identified as a bed exit event. Sensitivity, and specificity, of identifying bed entry and exit was then estimated to compare the performance of the two methods. Receiver operating characteristic (ROC) curves were also evaluated.

Results

[0074] Subjects performed over 180 PTs including standing to sitting, sitting to lying, lying to sitting and sitting to standing for the WISP attached a body trunk algorithm and 1 00 PTs for the algorithm based on the WISP sensor attached to mattress including, sitting, standing (implying bed empty) and lying. The results (Table 1 ) suggest that the WISP over the sternum method demonstrated higher sensitivity in detecting entry into and exit out of bed when compared to the WISP on mattress method. Whilst both methods recorded similar specificity in terms of detecting entry into bed, the WISP on mattress method had marginally better (97.4% vs 93.8%) specificity in terms of identification of bed exit events. [0075] Both methods have most of their data scattered close to the left side of their graphs indicating low False Positives (i.e. false alarms) (Figure 9). The areas under the ROC curves (AUC) were calculated by trapezoidal integration of the data. The body worn WISP AUCs were 0.931 and 0.859 for getting in and out of bed respectively and the sensor on bed algorithm had AUCs of 0.882 and 0.855 respectively. The WISP over sternum method demonstrated a better response as its curves depicted closer alignment to optimal performance (top left corner) and larger AUC for both getting in and out of bed compared to the WISP on mattress method.

[0076] Loosely fitted hospital garments may not allow the sensor to closely follow body movements affecting the effectiveness of body worn WISP algorithms to detect bed exit posture transitions. However, since the algorithms are based on thresholds and patients are automatically and uniquely identified by their electronic ID within a WISP is possible for staff to adjust the threshold levels for each patient.

Bed-Exit Recognition Algorithm

[0077] An algorithm (Figure 8) was developed based on Conditional Random Field (CRF) learning applied in machine learning. The CRF Classifier in Figure 8 considers an input sequence of observations to recognize multiple activities in such a sequence. Conditional models select an activity label 800 from a given set of activity labels {Lying, Sitting-on-bed, Out-of-bed) that best represents (maximizes the conditional probability) an input datum given a set of input observations. The CRF Classifier is trained using collected sensor data observations so that it is capable of predicting (since the truth about the input is unknown to the CRF Classifier) the activity label of a given input during testing of the CRF Classifier.

[0078] The raw sensor data extracted from the sensor is inputted to the algorithm without any pre-processing (such as digital filtering). Each sensor observation input to the algorithm consists of the accelerometer readings at, a v and a. \ (frontal, vertical and lateral axes respectively; with the sensor as reference), the strength of the signal received from the sensor, antenna identifier, body tilting angle with respect to the vertical given by sin(9), where Θ = arctan (af/a v ) and the time difference between consecutive observations. The CRF Classifier uses: the strength of the signal sent from the sensor and received by RFID antennae as an indicator of relative distance or position of a participant with respect to an antenna (or bed if the antenna is located near the bed); therefore, a weaker signal is indicative of a person moving away from a given antenna (i.e. leaving the bed); and the body angle as source of information about a person's activity.

[0079] The activity model considered the following activity labels:

(i) Lying;

(ii) Sitting-on-bed; and

(iii) Out-of-bed.

[0080] These labels correspond to the activities to be predicted (labelled) for each sensor input datum by the CRF Classifier (see Figure 8). The bed exit recognition algorithm considers a bed exit event to be a prediction 802 of Out-of-bed label by the CRF Classifier for the current sensor datum, provided that the previous sensor datum was labelled as either Lying or Sitting-on-bed. The alert signal 804 needs to be triggered only once, i.e. only the first Out-of-bed Ίη the sequence will trigger the signal if the previous predicted state by the CRF Classifier is either Lying or Sitting-on-bed.

Example Study

[0081 ] A pilot study with 14 healthy older volunteers aged between 66 and 86 years and a male to female ratio was 2.5 was conducted. For this study, the participants were 65 years or older, living at home, able to consent to the study and mobilize independently. The subjects were recruited from geriatrician clinics and from volunteer lists from other studies. The study was completed over a two-month period where each trial with each volunteer lasted between 60 to 90 minutes.

Table 1: Scripted Lists Used for Performance Study Trials

Script One Script Two

Walk to Chair Walk to Bed

Sit on Chair Sit on Bed

Walk to Bed Lay on Bed Lay on Bed Get Up and Walk to Chair

Sit on Bed Walk to Door Sit on Chair

Walk Back to Bed Walk to Bed

Lay on Bed Lay on Bed

Walk to Door Walk to Door

Performance Study

[0082] Participant performed activities which included:

(i) lying on the bed;

(ϋ) sitting on the bed;

(iii) getting out of the bed;

(iv) sitting on the chair;

(v) getting out of the chair; and

(vi) going from A to B {A and B represent the bed, chair or door) during the study.

[0083] Each participant performed activities on two scripted activity lists (see Table 1 ). No particular order was used for selecting the scripts and the number of scripted routines (where a routine is performing activities on one selected script) used in a trial was based on:

(i) a participant's level of fatigue; and

(ii) the trial duration where each trial period lasted no more than 90 minutes.

Participants were told to undertake the scripted activities at their own pace so as to minimise physical stress. Furthermore, the volunteers were also instructed, prior to each trial, to lie on the bed in a manner most natural and comfortable to them (i.e. no specific instruction regarding lying position was given; in the trial many participants lay down on their backs or sides, none lay in the prone position). All activities were annotated in real time by a researcher during each trial. The researcher's trialled two practical hardware deployments in two different room settings {RoomSetl and RoomSet2 illustrated in Figure 9) that differed in room layout (antennae placement and number of antennae deployed).

Acceptability Study

[0084] Two surveys were designed. The first survey (administered pre and post-trial) gives an indication of a person's expectations before the trial and change in perception after the trial. The questions measured participants' perception of the system to prevent falls, their apprehension towards the use of the equipment and any changes in appreciation at the conclusion of a trial. The first survey also measured the level of motivation of the participants since a participant that is highly motivated for this investigation can influence user acceptance.

[0085] The second survey was completed after a trial concluded to measure acceptability and privacy concerns perceived by the users. The questions were formulated in positive or negative statements and used an eleven point semantic differential scale (0-10) corresponding to a completely agree to disagree or no-problem to problem range. Both surveys are shown in Figure 9 and 1 0, and responses to questions Q1, P1, E1, E2 and V1, have been reversed for a standardised meaning where a score of 10 indicates full satisfaction or conformity to the system.

Statistical Analysis

[0086] In this study, two parameters were evaluated:

(i) Sensitivity = True Positives I { True Positives + False Negatives); and

(ii) Specificity = True Negatives I ( True Negatives + False Positives).

[0087] True positives (TP) were correctly recognized bed exits by the classification algorithm. True negatives were activities of no-interest that were correctly identified as not bed exit events (getting into bed and lying in bed). False negatives were known bed exits that were not recognized (i.e. misses). False positives were incorrectly recognized bed exits where the person was still in bed (lying or sitting in bed).

[0088] A 10-fold cross validation which involves partitioning the sensor data set into 10 mutually exclusive subsets and validating the bed exit recognition algorithm on one subset to evaluate performance after training on the other subsets was used. The process 1 0 times where a particular subset was used exactly once for evaluating performance, and mean of sensitivity and specificity were determined after averaging the results of the 1 0 validation subsets. Data subsets used were not obtained by partitioning by a single subject or a trial but were obtained from the data sets for all participants constructed after randomly ordering data sets for scripted routines of all the participants in the study per room setting. This process ensures generalizability as well as the unbiased evaluation of the performance of the proposed bed exit recognition algorithm. The sensitivity and specificity between the two datasets (from RoomSet2, the more economical deployment, to that from RoomSetl) using an independent one-tailed Mest where statistical significance was at p-values < 0.05 was compared.

Table 2: Sensitivity and Specificity of Bed Exit Recognition

Results

[0089] The system collected a total of 75,108 sensor observations (readings) from both datasets and the datasets included 130 bed exits performed by 14 participants. Table 2 shows sensitivity and specificity for the two datasets. The performance in RoomSet2 was better with a higher mean sensitivity value, moreover, the sensitivity value of RoomSet2 was statistically significantly higher (p-value = 0.016). However, the mean specificity values for both rooms were comparable that is RoomSet2 specificity was not statistically significantly higher (p-value = 0.629). Consequently RoomSet2 is considered the better deployment configuration.

[0090] In Figure 9 the post-trial response (solid line 900) shows a positive shift in perception (the larger outer hexagon with scores higher than the smaller inner hexagon) compared to the pre-trial response (dashed line 902). In fact, the overall score improved to >9.7 after the use of the system for all questions. In particular, the participants awarded maximum score post-trial to two questions [Q1 and Q6 shown in Figure 1 0) corresponding to confidence in the overall system performance and its safety. In general, the male participants showed relatively lower scores than the female participants at the start of the trials but changes in perception by the male participants after the trial showed that both female and male participants felt overwhelmingly positive with similarly high scores for all questions.

[0091 ] Analysis of the second survey shown in Figure 10 established the high level of acceptance of the wearable sensor based on the high scores recorded for all four factors (>9.5 overall) of the Sensor Acceptance Model (physical activity, anxiety, equipment and privacy). The lowest score was awarded to P2, indicating a possible slight discomfort while lying, especially notable in the female participants, however the response by the female participants and the overall score was still high (> 9.2).

Software Analysis

[0092] The computing system 1 00 of Figure 1 is now described in more detail with reference to Figure 6 which is a schematic diagram of a computing system 600 (equivalent to computing system 108 of Figure 1 ) suitable for use as a processing module. That is, the computing system 600 may be used to execute applications and/or system services such as the monitoring software in accordance with an embodiment of the present invention.

[0093] The computing system 600 preferably comprises a processor 602, read only memory (ROM) 604, random access memory (RAM) 606, and input/output devices such as a keyboard, mouse, display and/or printer (generally denoted by 610), The computing system 600 also has one or more communications links 612. The computer includes programs that may be stored in RAM 606, ROM 604, or disk drives 608 and may be executed by the processor 602. The communications link 61 2 connects to a computer network such as the Internet but may be connected to a telephone line, an antenna, a gateway or any other type of communications link. Disk drives 608 may include any suitable storage media, such as, for example, floppy disk drives, hard disk drives, CD ROM drives, DVD drives or magnetic tape drives. The computing system 600 may use a single disk drive 608 or multiple disk drives. The computing system 600 may use any suitable operating systems, such as Windows™ or Unix™. [0094] It will be understood that the computing system described in the preceding paragraphs is illustrative only, and that an embodiment of the present invention may be executed on any suitable computing system, with any suitable hardware and/or software.

[0095] In one embodiment, the present invention is implemented as a software application 612 which interacts with a database 614, arranged to be executable on the computing system 600.

[0096] Referring to Figure 7, the software application 612 comprises an architecture based on an event driven paradigm, where data received from the WISP devices (i.e. the passive sensors 702) via the receiving module are classified into movement types and consequently into high risk events and non-high risk events. The high risk events are then analysed by a processing module generally denoted by numeral 706. High risk events that warrant an action are then passed to the alert module.

[0097] The inference engine processes data received and collected by the RFID readers from the WISPs to identify patient activities in real-time. The interface between the Inference Engine and the RFID readers is the Low-Level Reader Protocol (EPCGIobal, Low level reader protocol (LLRP), version 1 .0.1 . Available from: http://www.gs1 .org/gsmp/kc/epcglobal/llrp). Sensor data is gathered from the distributed network of RFID readers using the LLRP interface.

[0098] Multiple data streams (accelerometer readings, location information, direction of motion or velocity, strength of the received signal from the tags, time of event) are analysed and used to detect high risk activity by the inference engine. Then the monitoring application uses Event-Condition-Action (ECA) type rules to determine the course of action to take given high risk activity events reported by the inference engine. ECA rules are a paradigm for specifying behaviour, for example:

Rule 1: ON patient leaving room IF (no walking aid AND unsupervised) DO send alarm

[0099] In more detail, a rule based, multi-level response system is employed in the falls management system as illustrated in Figure 6. An alerting module (the monitoring application 708) is responsible for determining whether to send an alert to caregivers based on assessing the particular high risk activity of the patient, the presence or absence of caregivers, as well as their individual assessment of falls risk recorded at the time of admittance to the hospital.

[001 00] The alerting module may also include a series of rules which govern the manner in which alerts are managed. False positives and negatives will be minimized. For example, the alert module may be arranged to send an alert to a caregiver within a predefined amount of time after determining the type of risk movement.

[001 01 ] Moreover, the alerting module may monitor the caregiver such that the alert is sent at defined intervals to the caregiver until such time as the caregiver satisfies a criterion, such as manually switching off the alert, or coming into proximity with the patient. If the primary caregiver has not responded within a preset time, the alert module may be arranged to alert a second caregiver.

[001 02] The alerting module may also determine the closest caregiver and alert that caregiver even if it is not the usual caregiver to allow the fastest response time so as to prevent a fall.

[001 03] The alerting module when detecting that a fall has occurred may trigger an emergency response to all caregivers in that area. It will also be understood, that in another embodiment, the alerting module may instruct an autonomous entity, such as a robot, which may then travel to location of the patient to determine whether the patient requires assistance. Alternatively, where cameras are fitted in a building, the alerting module may begin recording an image of the patient, for a caregiver to check or review to determine whether the alert is a "false positive".

[001 04] Importantly, the alerting module will be customizable to the area and meet the needs of end users. In one embodiment, the system collects identification information from the WISP to uniquely identify the person wearing the WISP. The alert module has a pre-programmed alert "profile"ior each person.

[001 05] For example, one person, who is more active and less likely to suffer from a serious injury, may have a reduced alert profile, such that certain movement types do not automatically trigger an alert condition. In contrast, a particularly frail person, who has a very likely to fall and suffer a serious injury, may have a high alert profile, such that any high risk movement type automatically triggers an alert condition. That is, the alert profile for each person is customisable and can be made unique to the needs of each individual.

[001 06] In more detail, it will be understood that the algorithms used to monitor certain movements (as described above) do not, by definition, trigger an alert condition. The information derived from the algorithms can be used, in combination with other information or with knowledge about certain expected or known behaviours related to individuals and circumstances, to provide a more complex and nuanced set of conditions which need to be satisfied to trigger an alert condition. For example:

1 . It is less likely that a person will suffer a fall when moving from a standing to a sitting position, than when a person is moving to a standing from a sitting position. Therefore, the alert module may be arranged to only sound an alert when a person is attempting to stand up, but not in all situations when they are attempting to sit down;

2. Similarly, a person lying down may not automatically trigger an alert condition if the person is already sitting on a bed;

3. Coming to a stationary position on the ground may be significant (i.e. such a condition may indicate a fall) and may automatically trigger an alert condition;

4. A person who is at a large distance from their walking aid may also cause an alert to be issued;

5. A person moving through a doorway to a specific room, such as a bathroom, may be considered higher risk than a person moving from their bedroom to a sitting room and therefore the location or direction of movement of a person may influence whether an alert condition is triggered;

6. A person walking or positioned for a defined period of time without an aid may also be significant and trigger an alert condition; and

7. Also, the system may be arranged to not provide an alerts during the day but to automatically provide alerts at night.

Further Embodiment— Health Information Technology (HIT) Tool

[001 07] The system described and defined above can also be integrated with a handheld Health Information Technology (HIT) tool, which can utilise data regarding patient mobility and a 'falls' or 'incident' history to automatically generate bedside posters.

Health Information Tool

[001 08] A simple and easy to use user interface design is the output desired of the bedside poster produced by the HIT tool in accordance with an embodiment of the invention. Simplified cues are provided (see Figure 12 generally at 1202, 1204, 1206, etc.) and the number of icons are reduced by only showing those icons associated with falls risk. This simplifies the final design of the poster and reduced the amount of information that needed to be processed by viewing the poster. Moreover, the icons were selected based on the activities that might increase risk of falling.

[001 09] A system which interacts with the HIT tool is shown in Figure 13. Patient falls risk assessment are stored in a database and subsequently retrieved and updated. The HIT tool 1302 automatically generates and prints the visual cues (poster) on a designated printer 1 304. A detailed description of the tool designed is illustrated Figure 13 as a workflow diagram in Unified Modelling Language (UML) whilst Figures 15a and 15b are screen captures of the HIT tool deployed on an iPad-mini. Following entry of risk profile into the HIT tool (see Figure 15b), a poster for display at the bedside is printed (Figure 1 2) omitting the need for the manual sticker process and enabling the integration of this clinical duty into the daily bed to bed nursing clinical handover process. Furthermore, where bedside computer are available, falls risk information can potentially be directly displayed in colour on bedside computers as opposed to the current approach of producing bedside posters.

HIT Tool Internal Loqie

[001 10] Referring to Figure 14, there is shown a process flow in accordance with an embodiment of the HIT tool described herein. At 1400 there is shown a configuration page which allows a user to switch between different hospitals. At 1402 there is shown a new patient page which allows a user to enter basic information to create a new patient or to assign a new patient to an available bed. At 1404 there is shown a ward page which allows a user to present beds in selected wards, discharge patients from a bed or transfer patients. At 1406 there is shown a hospital page which allows a user to present wards in a selected hospital. At 1408 there is shown a patient info page which allows a user to present/modify basic information of the selected patient. At 1410, 1412 and 1414 there are shown respective tags which allow patients to be tagged with certain information. For example, at 1410 a patient can be tagged with a walk aid tag if the patient requires a walk aid. If the patient presents a risk during the day, the patient may be tagged as a day risk 1412, and similarly if the patient presents a risk at night, the patient may be tagged as a night risk at 1414. As can be seen by the arrows in Figure 14, a user may navigate through the various options and may "add" or "remove" patients, assign patients to particular wards or hospitals, and tag patients as having certain requirements. These requirements can then be translated and automatically printed into the label shown generally at Figure 12. Printing is achieved by the print "pop-up" menu which is shown generally at 1416 in Figure 14.

The Survey

[001 1 1 ] In order to evaluate the usability and nursing staff perception of the handheld Health Information Technology (HIT) tool the Questionnaire for User Interface Satisfaction (QUIS) was modified for use in this study by adding six questions {Q19 to Q24) (Table I) to evaluate staff perception of the technology in addition to the usability of the HIT tool. Staff provided responses to likert scales with scores between 0 and 9 and in this study the researchers opted to consider 0-3 as a negative response and 7-9 as a positive response. Scores in between were classified as ambivalence. Scores are also presented as mean and standard error of mean (SEM).

Study Participants

[001 12] The survey occurred at the Queen Elizabeth Hospital in Australia, a 300 bed general hospital. Nursing staff members from two medical wards (Geriatric Evaluation and Management Unit and Acute Medical Unit) were approached to participate between the hours of 0900 and 1 700 over two days in January 2013.

Results

[001 13] Responses to the modified QUIS survey were obtained from 25 nurses with a mean age of 40.9 years (standard deviation 1 1 .8) and an average of 14.9 years (SD 10.9) working experience. Survey results are presented as percentages or mean and standard deviation (SD). The proportions of positive responses (score of 7-9) to survey questions are reported in Table I.

Table I: Summary of Nursing Survey Results

Modified Questionnaire for User Interface Positive Mean

Satisfaction (%) (SEM) *

Appearance of Screen

Q1 Wonderful 80.0 7.24 (0.28)

Q2 Easy 88.0 7.64 (0.28)

Q3 Satisfying 76.0 7.20 (0.29)

Q4 Stimulating 60.0 7.04 (0.23)

Q5 Flexible 76.0 7.24 (0.23)

Q6 Characters on screen easy to read 96 8.24 (0.18)

Ease of Use

Highlighting on screen simplifies task very

Q7 88.0 7.80 (0.36) much

Organization of information on screen very

Q8 92.0 7.88 (0.19) clear

Q9 Sequence of screens very clear 92 7.88 (0.19)

Use of terms throughout the system

Q10 92 7.76 (0.21 ) consistent

Terms are always related to the task I am

Q11 87 7.52 (0.25) doing

Messages on screen which prompt user for

Q12 95.8 7.79 (0.24) input clear

Q13 Error message helpful 82.6 7.43 (0.27)

Q14 Learning to operate the system easy 91 .7 7.96 (0.26)

Tasks can always be performed in a

Q15 91 .7 7.92 (0.19) straightforward manner

Q16 System speed fast enough 91 .7 8.00 (0.19)

Q17 Correcting mistakes easy 82.6 7.30 (0.41 )

Experienced and inexperienced user's

Q18 91 .7 7.63 (0.24) needs are always taken into consideration Additional Questions Addressing Staff Perception of Usability And Benefits

I feel that this tool will be easy to use

Q19 during the bed to bed handover or on ward 94.7 7.84 (0.28) rounds

I feel that this tool will help me provide

Q20 78.9 7.53 (0.33) safer care for patients at risk of falls

I feel this tool will assist me update

Q21 information about the patient's risk in a 94.7 7.84 (0.26) timely manner

I think the tool will be quicker in terms of

updating the information and preparing

Q22 89.5 7.95 (0.27) poster/visual cue for display at bedside

compared to the current method

I feel the tool will improve quality of patient

Q23 84.2 7.48 (0.32) care

Q24 I will use this tool if it is made available 94.7 8.21 (0.25)

SEM— Standard Error of the Mean.

[001 14] For all questions, the mean score was 7 or more. A large proportion of nursing staff responded positively to other aspects of the tool (78% to 94.7%). One of the key finding was that the surveyed population of nurses overwhelmingly agreed (highest positive response of 94.7% for Q24) that the HIT tool was useful. Nursing staff also confirmed that they felt that the tool could be incorporated into their clinical handover process to aid them with their work and to improve the safety and quality of care provided to patients (Q19 and Q21, >94%).

[001 15] The study confirms that nursing staff felt positive about the HIT tool and indicated a strong likelihood of using the tool and integrating it into their daily clinical bed to bed handover process. Although falls risk assessment using standardized falls risk assessment tools exist, clinicians have previously reported difficulties in effectively communicating the falls risk status to each other as well as to patients and their family and this is where visual cues can potentially play a role. The HIT tool improves the completion rate as well as accuracy of bedside posters within the hospital and integrates seamlessly with the system method, and software application and data signal for determining movement broadly described herein. Advantages

[001 16] The embodiment described herein provides a number of advantages over known devices and techniques. The embodiment simplifies real-time monitoring of persons who are engaging in any type of movement, but finds particular application in the monitoring of persons who are at risk of injuring themselves.

[001 17] In other words, the system, methods and software application embodiments described herein, and the broader inventive concepts defined in the claims, provide a technological intervention to monitor patient mobility and therefore prevent falls in many high risk environments, such as hospitals and aged care facilities.

[001 18] Advantageously, the system described herein utilises passive, battery-less WISP devices which are cheap to manufacture, add no burden or weight to the patient (due to their small size and insignificant weight) and have very high sensitivity and specificity rates, as previously described.

[001 19] The system, method and software application largely ameliorate traditional sensor based systems, which require battery power and are therefore heavier, more expensive, more prone to failure and less accurate than the embodiments described herein.

[001 20] Additionally, the system is customizable to individual patients and care environments and automatically determines the level of monitoring and care required for each patient based on the expert knowledge of clinicians or caregivers.

[001 21 ] Moreover, the system is capable of being used to detect the presence and/or movement of inanimate objects, such as canes, walking sticks, walking frames, etc. By utilising a combination of devices on both persons and objects, sophisticated and complex actions (such as whether a person is using a walking aid) can be easily and accurately detected.

[001 22] It will be appreciated by persons skilled in the art that numerous variations and/or modifications may be made to the invention as shown in the specific embodiments without departing from the spirit or scope of the invention as broadly described. The present embodiments are, therefore, to be considered in all respects as illustrative and not restrictive. [001 23] Throughout the specification and claims, unless the context requires otherwise, the word "comprise" or variations such as "comprises" or "comprising", will be understood to imply the inclusion of a stated integer or group of integers but not the exclusion of any other integer or group of integers.