Rehabilitation and Health Care Robotics 53.5 Augmentation for Diagnosis and Monitoring 1243 diagnostics.provide better information to physicians. detection systems based on identity badges with embed- and provide faster alerts.Key enabling technologies in ded radiofrequency identification(RFID)chips that can this field are advanced materials and nanotechnologies. be sensed in a hallway work,but only if the resident is For all devices that are worn on the body,the inter- wearing it.A robotic sentry system,including mobile face must be skin compatible.A grand challenge for platforms to aid in solving this problem,especially at this field in the near term is the better incorporation of night,has not yet been developed. active and sensing elements with textiles.Several proto- A serious rehabilitation issue in institutionalized fa- type sensor shirts show promise,but rehabilitation will cilities is the transfer of residents from bed to wheelchair have a much richer toolset for diagnosis and monitoring and other surfaces.A number of manual,electric,and with advances in this area.Nanotechnology,an enabling robotic devices have been developed to assist the nurs- technology for the longer term,has the promise to minia- ing staff to safely transfer residents and patients who turize virtually everything mechatronic that is currently may be significantly heaver than they are.This remains macroscopic.Injected devices such as nanorobotic drug an unmet clinical need,though not for lack of innovative dispensers and clot-busters will aid in rehabilitation. attempts [53.144,145]. 53.5.2 Smart Clinics with Automated Health 53.5.3 Home-Based Rehabilitation Care Monitoring and Care Monitoring Systems A special class of fixed-station rehabilitation robots is Numerous smart homes have been developed for non- an automation system designed to provide a safe envi-rehabilitation as well as assistive purposes [53.146]. ronment to assist and monitor a person with a disability These systems have as their goal the safety of people art living at home or in an institutionalized setting such as with disabilities living in the home and communication an assisted living facility or nursing home. with care-givers outside of the home.Care-givers can be live-in family or attendants who,even when they are not Smart Nursing Home Automation home,need to be kept informed on the status of the dis- un An assisted living,hospice or nursing care institutional abled person.as well as clinicians who need to be sent facility will include residents who have mild to severe regular vital signs and other medical/therapy reports. cognitive impairment in addition to physical disabilities. In-home systems typically feature the same principal The facility may have zones to separate residents who elements: have different levels of dependency since the architec- tural,monitoring,and personnel needs are different.To 1.sensors to monitor both ambient as well as people- better serve residents and guests,to optimize function, and object-specific parameters(e.g.,person location, and to minimize cost,only the areas for persons with stove-top operation);actuators to modify ambient high dependency have a 24 hour staffed vital signs mon- conditions (heat,lighting,sound system,etc.)and itoring and alert capability,for example.Facility care operate devices(doors,refrigerator,etc.); is highly staff-intensive,though automation through di- 2.a means to network all the sensors and actuators agnostic vital signs monitoring.electronic surveillance. for uni-or bidirectional communication with the and patient tracking continue to improve safety and ef- host computer.This network can be wireless (e.g.. ficiency.Robotics and automation are beginning to find 802.11g),wired (e.g.,coaxial cable),or dependent applications in the physical tasks associated with pa- on an existing network (e.g.,signals superimposed tient care,therapy,and oversight.Some examples are on current carried by the electrical mains or phone described below. wiring): 3.a host computer that allows all sensor states to be Examples of the State of the Art displayed and actuators to be operated from one or Wandering,especially at night,is a significant problem more locations in the home by the inhabitant(s)us- for institutional facilities with ambulatory residents who ing common computer input/output (1/O)devices. are cognitively impaired.Simple architectural modifica- Higher-order functions are built upon this basic tions include painting the hallway in front of doors black capability; to make them look like deep holes.An automated voice 4. an external network to allow communication with the system triggered by a motion detector to say Go back Internet via phone,cable,satellite or other means. to bed is effective.but not fool-proof.either.Resident This capability allows for remote monitoring andRehabilitation and Health Care Robotics 53.5 Augmentation for Diagnosis and Monitoring 1243 diagnostics, provide better information to physicians, and provide faster alerts. Key enabling technologies in this field are advanced materials and nanotechnologies. For all devices that are worn on the body, the inter￾face must be skin compatible. A grand challenge for this field in the near term is the better incorporation of active and sensing elements with textiles. Several proto￾type sensor shirts show promise, but rehabilitation will have a much richer toolset for diagnosis and monitoring with advances in this area. Nanotechnology, an enabling technology for the longer term, has the promise to minia￾turize virtually everything mechatronic that is currently macroscopic. Injected devices such as nanorobotic drug dispensers and clot-busters will aid in rehabilitation. 53.5.2 Smart Clinics with Automated Health Care Monitoring and Care A special class of fixed-station rehabilitation robots is an automation system designed to provide a safe envi￾ronment to assist and monitor a person with a disability living at home or in an institutionalized setting such as an assisted living facility or nursing home. Smart Nursing Home Automation An assisted living, hospice or nursing care institutional facility will include residents who have mild to severe cognitive impairment in addition to physical disabilities. The facility may have zones to separate residents who have different levels of dependency since the architec￾tural, monitoring, and personnel needs are different. To better serve residents and guests, to optimize function, and to minimize cost, only the areas for persons with high dependency have a 24 hour staffed vital signs mon￾itoring and alert capability, for example. Facility care is highly staff-intensive, though automation through di￾agnostic vital signs monitoring, electronic surveillance, and patient tracking continue to improve safety and ef- ficiency. Robotics and automation are beginning to find applications in the physical tasks associated with pa￾tient care, therapy, and oversight. Some examples are described below. Examples of the State of the Art Wandering, especially at night, is a significant problem for institutional facilities with ambulatory residents who are cognitively impaired. Simple architectural modifica￾tions include painting the hallway in front of doors black to make them look like deep holes. An automated voice system triggered by a motion detector to say Go back to bed is effective, but not fool-proof, either. Resident detection systems based on identity badges with embed￾ded radiofrequency identification (RFID) chips that can be sensed in a hallway work, but only if the resident is wearing it. A robotic sentry system, including mobile platforms to aid in solving this problem, especially at night, has not yet been developed. A serious rehabilitation issue in institutionalized fa￾cilities is the transfer of residents from bed to wheelchair and other surfaces. A number of manual, electric, and robotic devices have been developed to assist the nurs￾ing staff to safely transfer residents and patients who may be significantly heaver than they are. This remains an unmet clinical need, though not for lack of innovative attempts [53.144, 145]. 53.5.3 Home-Based Rehabilitation Monitoring Systems Numerous smart homes have been developed for non￾rehabilitation as well as assistive purposes [53.146]. These systems have as their goal the safety of people with disabilities living in the home and communication with care-givers outside of the home. Care-givers can be live-in family or attendants who, even when they are not home, need to be kept informed on the status of the dis￾abled person, as well as clinicians who need to be sent regular vital signs and other medical/therapy reports. In-home systems typically feature the same principal elements: 1. sensors to monitor both ambient as well as people￾and object-specific parameters (e.g., person location, stove-top operation); actuators to modify ambient conditions (heat, lighting, sound system, etc.) and operate devices (doors, refrigerator, etc.); 2. a means to network all the sensors and actuators for uni- or bidirectional communication with the host computer. This network can be wireless (e.g., 802.11g), wired (e.g., coaxial cable), or dependent on an existing network (e.g., signals superimposed on current carried by the electrical mains or phone wiring); 3. a host computer that allows all sensor states to be displayed and actuators to be operated from one or more locations in the home by the inhabitant(s) us￾ing common computer input/output (I/O) devices. Higher-order functions are built upon this basic capability; 4. an external network to allow communication with the Internet via phone, cable, satellite or other means. This capability allows for remote monitoring and Part F 53.5