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= 3.1 Usage Scenario for Health Care Monitoring system =

Functional Usage Scenario
-initial series of questions (family history, age, current risk factors, and critical stats) used by device to determine frequency of sampling -device activates -user is sampled -sample is analyzed -results are interpreted/compared -results reported (to user, health care system) -user disengages -device resets, cleans -environmental considerations -indoor and outdoor

-cardiovascular disease, blood tests, EKG, heart rate, blood pressure, blood sugar, kidney function, liver function, etc. (rule out imaging such as electrocardiogram or angiogram)
 * Sampling**

-battery of tests that can be done in a doctor's office for the detection of cardiovascular disease
 * Scenario**

-don't regularly go to doctor - so device does sampling without person activating -reward provided as incentive eg. bonus internet time, reduced fees for recreational activities, tax credit incentive because health care costs would be reduced -could also be set up for those interested in monitoring to take regular samples -able bodied or disabled, ill or not ill - would determine frequency of test -user answers series of questions about history, critical stats and device determines frequency of sampling depending on level of risk -no children - adults 20 and over -system provides information at many levels - only when needed in case of emergency for those not interested in the information - or could be provided for user if they are interested
 * Agent/User**

= 3.2 Pairwise Comparison Chart and 2-page Summary =

Identifying the criteria to be ranked
The Product Design Specification (PDS) was used for the pairwise comparison. The Product Characteristics (PCs) in the PDS that defined the criteria to be compared were: The PCs were then placed in a square matrix to facilitate the comparison (shown below).
 * Functionality ||
 * Durability ||
 * Quality ||
 * Maintainability ||
 * Communicatability ||
 * Usability ||
 * Safety ||
 * Customizability ||
 * Accessibility ||
 * Sustainability ||



Ranking
Once the comparison was executed by the group, a ranking was created for the criteria. The ranking was based on the number of cells containing their designated letter (shown below).



Assignation of Weights
The weights were to be associated with the criteria to satisfy the relative ranking from the pairwise comparison.

To execute this, first the ranking above was summed to a total of 56 which is equivalent to 100% and the weights were determined to obey the relative ranking from the pairwise comparison.

A linear proportion was assumed between the weights to set the initial set of values and the below equation was solved: 100 = 7x + 2x + 8x + 3x + 7x + 9x + 8x + 3x + 4x + 5x and x was calculated to be 1.786

The final weights of the criteria were then calculated and the weights determined as shown below.



= 3.3 Concept Ideation by Product Characteristic =

Ideation was conducted by the group for the individual health monitoring system. Ideas were generated based on Product Characteristics developed in the PDS, modified slightly for the purposes of ideation. The ideas the group came up with fell into the following categories:
 * Rewards/Incentives (how will the patient be motivated to use the individual monitoring health system; this was a functional requirement)
 * Interface (how the user will interface with the device)
 * Structure (what could be the physical structure of the system)
 * Collection System (how will patient vitals and bodily fluids be collected)
 * Communication (how will the system communicate with the patient and the external health system)
 * Power (ways that power could be delivered to the system)
 * Analysis (how will patient data be analyzed)
 * Security (how will patient data/results be secured)
 * Cleaning (how will the system be maintained in clean/sterile state)


 * Rewards/Incentives**
 * Tax incentive || Cash || Employee benefit -get work bonus (RRSP matching) ||
 * Store discounts || Airmiles/rewards points || For employer- reduced health care premiums for workers ||
 * Bonus minutes/internet/bandwidth use on mobile devices || Free game time || Extension of medical coverage (top up eg. Extra physio) ||
 * Discount prescription costs || Free lottery tickets || Draw prize -trip to the sun and coverage of expenses ||
 * Gift card (visa card) || Employer requirement -need to do at workplace || Cover VISA bill for month ||
 * Free pass to local theme park or attraction || Groceries for a month || Movie passes -net flicks ||
 * Ticket master gift certificate ||  ||   ||

=3.4 Generated Concepts=
 * Interface**
 * -screen || -joystick || -retinal scan ||
 * -big sensor (e.g steering wheel) || -accelerometer || -touch screen ||
 * -glasses/ HUD || -holographic projection || -EEC ||
 * -auditory-speech activation || -finger print sensor || -eye movement ||
 * -buttons (e.g steering wheel) || -motion tracking || -wind ||
 * -RFID |||| -keypad/trackball ||
 * Structure**
 * -desktop || -kiosk || -button || -watch ||
 * -toothbrush || -mobile device || -credit card || -shower ||
 * -peripheral to PC || -band aid/patch || -clothing || -ring/jewelry ||
 * -chip/capsule || -TV (Remote or set) || -room || -key ||
 * -hand held device (independent) || -small box || -HR monitor || -steering wheel ||
 * -light switch || -chair || -toilet ||  ||
 * Collection**
 * -BP cuff || -sensor || -needle ||
 * -suction || -swab || -scan (a la Star Trek) ||
 * -chip -nano? Micro? || -patch ||  ||
 * Communication** - *overlap with **Interface** � see for more ideas
 * -auditory || -cell network || -EEC ||
 * -WIFI || -telegraph || -IR ||
 * -Blue Tooth || -USB || -Fiber Optic ||
 * -LAN || -RFID || -Scent ||
 * -carrier pigeon || -text (print) || -vibratory ||
 * Power**
 * -solar || -battery -rechargeable ||
 * -kinetic || -battery pack ||
 * -biofuel engine || -wind ||
 * -AC || -hydro ||
 * Analysis**
 * -lab (external) || -processor ||
 * -chip || -query ||
 * Security**
 * -encryption || -backup ||
 * -firewall || -redundancy ||
 * -system isolation || -self destruct (shut down) ||
 * -sanitization || -denial of service ||
 * -password || -shock ||
 * -bio ID ||  ||
 * Cleaning**
 * -steam sterilizing || -water ||
 * -chemical || -heat treatment ||
 * -ozone || -dishwasher ||
 * -pressurized air || -discard parts (replaceable) ||

The above ideation activity led to the creation of the concepts listed in the linked document below.

= 3.5 Concept Drawings =

Group members' concept drawings are shown in pictures that follow.

















= 3.6 Explanation of Concepts = This is a detailed explanation of the concepts resulting from the ideation:

Desktop Health Station

 * At home desktop diagnostic station, meant for one-person-at-a-time use
 * Touch screen display would be the interface; the user would securely access his/her personal profile with a password
 * Blood pressure and heart rate measurements collected via wrist blood pressure (BP) cuff
 * Blood sample collected just above the wrist unit, using a needle and tube, sending the blood to the test chip. The needle-tube unit is replaceable after each use
 * Capable of storing health records for several people
 * The unit uses Wi-Fi to connect to a Local Area Network (LAN) and therefore to the internet and in turn to a healthcare network in order to transmit the data to a physician
 * The unit plugs into a wall and requires a mechanical switch to turn on, to avoid using power when the unit is on standby
 * The chip analyzing the blood is cleaned with an antiseptic
 * The incentive for a patient to use this unit are rewards points that can then be used towards various retailers

Hand-Held Device

 * The hand-held device may be part of a cellular phone or a similar object; a text message or call is made to user at appropriate interval to remind them to do a quick health check.
 * User-interface would be a touch-screen, similar to a touch-screen cellular phone,
 * A fingerprint scan enables secure access
 * Blood, BP and heart rate would be collected via user's finger; blood collection and analysis to be performed by a needle pricking the finger, blood would drop directly onto the microchip chip that performs analysis
 * Communication with the world wide web would be provided by a cellular telephone network
 * Once blood is collected, the needle would be automatically discarded
 * The hand-held would be powered by solar energy
 * The user is rewarded with bonus airtime minutes or megabytes of data on his/her cell phone plan

Toothbrush

 * The unit would be an electric toothbrush with a programmable dock, that reminds the user of his/her scheduled test date with a voice command; convenient, because everyone needs to brush their teeth
 * A fingerprint scan allows the user to access the diagnostic features
 * The dock is equipped with a finger slot where blood collection (through a needle pricking a finger) and blood pressure measurement take place; microchip analyzes the collected blood
 * The unit communicates with the user through auditory commands; the unit also has a Wi-Fi connection through which connects to the home network, eventually sending the data from the tests to a health network
 * The unit is powered through a rechargeable battery
 * The unit is sterilized by steam
 * The user is entered in a draw prize as a reward for completing the diagnostic test

Chair-Recliner: 2 options

 * This is a reclining chair, like a Barcalounger or a La-Z-Boy, putting the potential user in a comfortable position and environment while test are being done
 * The chair is connected to a television set that displays a diagnostic program; the user interfaces with the program through using a joystick and the selections are reflected on the TV screen
 * Requires a bio-id to enter the diagnostic features
 * The chair is A/C powered
 * The reward for having the tests performed is a discount on the user's TV channel package

//**Option 1**//

 * The user has an implanted microchip that analyzes blood, measures BP and heart rate
 * The chip communicates wirelessly with the recliner which in turn sends the analyzed data to a health network via a fibre-optic cable connected to the internet
 * No cleaning is required

**// Option 2 //**

 * The chair has blood collection (via needle pricking finger), microchip analysis, BP and heart-rate measuring units embedded in the arm rest
 * Data is sent to a health network via a fibre-optic cable connected to the internet
 * The diagnostic components are cleaned in a dishwasher

Multi-Patches: 2 options

 * This is a multifunctional diagnostic patch that looks like a band-aid and sticks with an adhesive to a user's arm, a quick and easy way to complete a test
 * The user purchases these patches in a pharmacy and has a schedule as to when it should be worn
 * The patch is motion-activated - begins diagnostic work upon sensing the user`s motion
 * Blood is collected by the patch which has a sand-paper like surface; the abrasion created enables the blood to come out; the blood is then absorbed by the patch
 * When not performing diagnostic tests, the patch can deliver through the skin vitamins, vaccines or nicotine if the user is trying to quit smoking
 * The patch is only good for a one-time use
 * The incentive for the use of the patch is a discount coupon to a retailer once the test is completed

// Option 1: RFID Patch //

 * The patch has a microchip that analyzes the collected blood
 * The results are sent from the patch via the RFID to a health network
 * Powered kinetically
 * If a breach of security is detected, the patch self-destructs

// Option 2: Band-Aid-Like- Patch //

 * This type of patch has no analysis capabilities; once the blood is collected, the user mails the patch in to an analysis center
 * It is secured with a bar code that is specific to a given user

Hospital Kiosk

 * Walk-in/walk-through kiosk located within hospitals and pharmacies; a single Push button turns the unit on and activates collection process
 * The kiosk communicates with the user via voice commands
 * Access to user's personal records given by passing his/her health card through a scanner
 * Contains blood pressure cuff in a format similar to ones presently at pharmacy kiosk stations
 * Blood collected from finger - the user inserts his/her finger into designated slot. The finger would be pricked, blood would drop directly into a storing system; The measurements and blood are collected by the company servicing the kiosk and analyzed externally
 * Lancet which pricks the finger automatically replaced with a new one after blood is collected
 * The user reward is a discount on prescription medication

Grocery Store Kiosk

 * Walk-in/walk-through kiosk located in local grocery stores - convenient access because most people get their groceries from a store
 * The user accesses his/her personal records by passing his/her health card through a scanner and a password
 * The user interface is a screen with a joystick; the kiosk also issues auditory commands to the user
 * Will contain blood pressure cuff in a format similar to ones presently at pharmacy kiosk stations
 * Blood is collected from the finger in a slot and immediately analyzed by a microchip, results are sent to a health network
 * The kiosk is A/C powered; cleaning is done by ozone gas
 * As incentive, user plays a video game-like scenario in the kiosk competing for high score (while being monitored) and high scores get awarded prizes regularly

Steering Wheel of Work Vehicle/Equipment

 * Prompts operator to do health check (at indicated times, such as every 6 months) and the vehicle won't operate until test is done (like breathalyzer)
 * Activated with a bio-id: fingerprint
 * Steering wheel could continuously collect heart rate data (like exercise machines)
 * There is a BP cuff and a slot for the finger to collect the user's blood; microchip embedded for blood analysis
 * Bluetooth capabilities to send data to health system through a cellular network
 * Powered up by turning on the vehicle
 * The system is chemically cleaned
 * Employer incentive to keep workers healthy and reduce their health insurance rates

TV Remote

 * Device integrated into TV remote; in order to turn on the TV, the user must first proceed through the test steps; the TV and the remote are the interface
 * Activated through a bio-id, such as a fingerprint scan
 * The remote comes with a testing patch containing a microchip - for blood collection and analysis, and a BP cuff
 * The analyzed results are sent to the TV vial infra-red signal and subsequently to the home network via a Wi-Fi connection and then to a health network
 * The remote is battery powered and chemically cleaned
 * The reward for having the tests performed is a discount on the user's current TV channel package

Gaming Console

 * Unit that plugs into Nintendo Wii; operational interface being television screen and game console controller
 * Unit performs blood collection via needle in controller and blood pressure measurement via arm cuff; heart rate measured wirelessly via Active Z technology
 * Unit is powered through a USB connection with the main Wii console; the USB connection also provides for communication between the measuring unit and console
 * Software disc provides results in via the built-in Wi-Fi on the console; results are sent to health network
 * Software provides exercises and diet options to improve/maintain desired health level; will monitor exercises performed and keep a diet log, in this way overseeing whether progress in health improvement is being made; software encryption would secure the user's personal data
 * The diet and exercise record can be sent to the doctor if desired
 * User is rewarded for use by receiving a game e-card

As Part of A Desktop Computer

 * Unit that plugs into the computer's CPU; the interface being the computer screen, keyboard and mouse
 * Unit performs blood collection via disposable needle and blood pressure measurement via arm cuff
 * Unit is powered through a USB connection with CPU; the USB connection also provides for communication between the measuring unit and console
 * Software provides results via the built-in Wi-Fi on the console
 * Software encryption would secure the user's personal data
 * User is rewarded for use by receiving a game e-card

Watch

 * Trendy watch, worn regularly
 * User interface is the watch screen and a button on the watch
 * Can collect heart rate continuously (the watch is the BP cuff) and do blood pressure periodically; must prompt however for blood collection - the watch has the capability for testing and analyzing through a disposable needle and microchip; needle is disposable after one-time use
 * The results are transmitted via blue tooth technology to a cellular network and then to a health network
 * The diagnostic data is password protected
 * The incentive for completing the test is discounts to local attractions

Clothing

 * System consisting of a dry-fit shirt, and a mobile device ; the clothing is touch-sensitive and activates once the user puts the shirt on through motion and bio-id
 * The shirt contains a patch with a microchip for blood collection and analysis, the sleeve doubles as a BP cuff
 * Once the blood is collected and the BP measured, it is stored within the shirt until the user connects the shirt to a mobile device via an embedded USB plug
 * Cleaning done by laundering the shirt
 * The incentives are: the shirt is also a sun-block; with the purchase of the shirt, the customer receives a future discount at the place of purchase

Alarm Clock

 * This is a radio alarm clock, commonly found on people's nightstands, with additional features: it contains a calendar which has a pre-programmed schedule for testing the user. Hitting the snooze button on a given morning alerts the user to be tested; will not quiet down until the user has completed the test
 * Secured with bio-id
 * The snooze button contains a disposable needle and microchip for blood testing and analysis; there is a finger BP cuff
 * Clock connected to a LAN capable of transmitting data to a health network
 * It is powered by A/C and rechargeable batteries
 * As an incentive, the hydro provider pays part of the user's bill

Mobile Device on a Stand

 * A device brought to the person or available in a waiting room, usually on a little cart - convenient because people are always looking for something to do in a waiting room
 * It has a single use login for security; the interface is a touchscreen
 * Embedded is a system to collect blood with a disposable needle from the finger and analyze through a microchip
 * The device transmits the data to a health network via Wi-Fi; user contacted by medical personnel later on
 * Powered by a rechargeable battery
 * User is enticed to complete the test by various immediate retail rewards

Credit Card Prompt

 * The user’s credit card is connected with a health network. When a scheduled test date comes up and the user is using his/her credit card, the credit card will prompt the user to go the in-store kiosk (modeled after the grocery store kiosk described above)
 * The user receives cash rewards

Shower

 * An in-shower alert and diagnostic system; when scheduled, the user is prompted by an auditory system to have the tests completed while taking a shower; a screen interface accompanies the system
 * A needle near the screen interface collects blood from the finger and analyzes it via microchip; a BP cuff is included as well
 * Results are sent to a health network via the system’s Wi-Fi connection
 * It is secured by a bio-id – the user’s footprint
 * The system is washable with a special soap
 * Water powered
 * Incentive is a discount on the user’s water bill and on shower-related toiletries

= 3.7 Initial Decision Matrix and Grouping of Concepts =

This is a link to the initial decision matrix completed by the group. It contains an explanation of the scoring.


Twenty-one concepts were initially rated using a decision matrix as shown in the link. Our ten product characteristics were compared for each concept against a reference. The reference used is the current healthcare system where a user must go to their physician to get heart rate and blood pressure taken and a referral for blood work. They then must go to the laboratory for blood samples. After several days for transportation of the samples, analysis at a laboratory and communication of results to their physician, they must return to their physician for results. Rating was done on a scale from +2 (greatly superior) to -2 (greatly inferior), with a 0 representing no change over the current system. All five team members provided a score in each case and the majority or consensus score is reported.

The pairwise comparison resulted in overall weightings for each product characteristic. As shown in the link, the highest rated characteristics were usability (16%), safety and quality (each 14%), and functionality and communicatability (each 12.5%). Usability was largely influenced by whether it was unobtrusive, comfortable during use and readily able to accommodate multiple users. As such, the handheld device, watch concept and toothbrush rated highly, in the later case because the toothbrush docking station could accommodate multiple users. The RFID patch, and mail-in patch were single use concepts, rating lower for usability. The hospital kiosk was considered similar to the current healthcare system for usability. Safety was either the same or slightly improved over the current system for all concepts (0 or 1). The group considered some home use devices safer than the current system because users would not be traveling to and from a doctors�office and lab, and also not exposed to other sick patients in waiting rooms.

Quality was affected by functional requirements of repeated use, lightweight strong material and low maintenance. Once again the RFID patch and mail-in patch were single use and therefore rated lower on quality. The shirt and chest-strap were rated slightly lower on quality since it was felt they would not stand up to wear and tear as well as devices such as the remote control or handheld concept. Functionality was rated greatly superior to the current system for most concepts because they could monitor health indices and provide results in a timely manner. Only the concepts that had delays in reporting results had slightly lower scores, such as the hospital kiosk, RFID patch and mail-in patch and credit card notification. Communicatibility was influenced by whether the user received immediate analysis results, for example by way of a screen, or whether the influence was delayed (such as with the hospital kiosk where samples went to the laboratory for processing, or the mail-in patch).

Once the concepts were scored, they were grouped into three clusters of to aid in the determination of the most viable concept:

When the scores were examined across the columns for consistency of reasoning the highest variance was on usability which is also one of the highest weightings. The high scores were examined to see where they could be improved (which features were lowest ratings). The medium scored concepts were not immediately dismissed either, as some of the concepts (like the chest strap) were thought that they could be cheaper and easier to produce - and could benefit from some of the sub-concepts of other ideas to improve the scores. Another idea was to combine some of the concepts into a single concept that might be used in multiple locations (i.e. something in a small console that could work in the home, handheld, waiting room, at the retail check-out, in a vehicle, etc.).
 * Low scores (<1) |||||| RFID patch (0.25) ||  ||
 * ||  |||||| mail-in patch (0.125) ||   ||
 * ||  |||| hospital kiosk (0.143) ||   ||   ||
 * ||  |||||| credit card (0.393) ||   ||
 * Medium scores (1-1.4) |||||| desktop (1.25) ||  ||
 * ||  |||||||| implanted recliner (1.25) ||
 * ||  |||||| chair recliner (1.25) ||   ||
 * ||  |||||| gaming kiosk (1.375) ||   ||
 * ||  |||||||| PC peripheral (1.393) ||
 * ||  |||||| shirt (1.339) ||   ||
 * ||  |||||| chest strap (1.339) ||   ||
 * Higher scores (>1.4) |||||| handheld (1.768) ||  ||
 * ||  |||||| toothbrush (1.679) ||   ||
 * ||  |||||| TV remote (1.536) ||   ||
 * ||  |||||| console (1.607) ||   ||
 * ||  |||||| watch (1.643) ||   ||
 * ||  |||||| alarm clock (1.5) ||   ||
 * ||  |||||| waiting room (1.625) ||   ||
 * ||  |||||||| retail check-out (1.625) ||
 * ||  |||||| shower (1.725) ||   ||
 * ||  |||||| vehicle (?) ||   ||
 * ||  |||||| shower (1.725) ||   ||
 * ||  |||||| vehicle (?) ||   ||

= 3.8 Concept Refinement = Once the clusters and concepts were reexamined, the list of concepts was reduced to the following:
 * Hand Held
 * Toothbrush
 * Vehicle
 * Watch
 * Waiting Room Device
 * Shower

These concepts were issued the following improvements to increase their overall score according to the functional requirements:
__Hand held__
 * More rugged material that maintains lightweight characteristic
 * Redundant cleaning system (improves safety and maintainability) - automatic application of disinfectant along with disposable option
 * Testing site is not exposed to open air between use -sealed
 * Has potential ability to interface with vehicle concept

__Toothbrush__
 * Improve communications by having a screen in the base unit / recharger or projection onto mirror/wall
 * Display talks and listens to individual and allows function/results choice
 * BP measurement via cue to squeeze toothbrush harder

__Vehicle__
 * More rugged material and water repellent - weight less impactful since vehicle based
 * Increased temperature resistance to withstand summer height and winter cold
 * If durability on steering wheel is a concern, shift to being an add-on device or add as a more secured device to the steering wheel
 * Improved maintainability by having mechanic/technician change components - downside is that may require certification for technicians (recall concept is work based)
 * Counterpoint - docking station with handheld and ignition lockout - useable outside of vehicle - covers people that don't work with driving, a vehicle
 * Maintainability challenge is who takes responsibility - employer or employee
 * After market purchase that is transferrable to all commercially
 * Screen interface with other device - perhaps incorporates GPS capability to allow information feedback
 * If purchased as a GPS unit -sync's with steering wheel and has a different device for out of car use, eg docking station or steering wheel in other car

__Watch__
 * Durability - caution it could cause a weight increase
 * Could make cellular communication but still cannot see any more information due to limitations on the size of the watch face

__Waiting room based (check out, salon)__
 * Addition of self-cleaning thing to improve maintainability and safety
 * Ability to have outer shell customized to the environment that it is used

__Shower__
 * Powered device from shower flow makes screen and associated things work
 * Customizability enabled by screen choice and out cover options to match with decor
 * Challenge - if power from shower head can't be used for people taking a bath or vice versa

= 3.9 Revised Decision Matrix =

Once the above refinements were taken into account the decision matrix was revised. It is attached below. The file also includes a second sheet, which details the new remaining concepts:

= 3.10 Overview of Selected Concept and Problems Encountered = The final list common concept was reexamined and the common characteristics were extracted, arriving at the coveted final concept

__Hand held / portable base unit__

 * Portable base unit that is transferable from home, work, waiting room and docks locally for power and vehicle lockout capability
 * Has ability for employer use through peripherals that can be used in a vehicle
 * Capable to be mounted in a portable stand, kiosk for stationary use
 * Has a display screen for user interaction - touch interface that can display multiple pieces of information simultaneously
 * Incorporates other daily use information, eg. GPS for vehicle, clock for information
 * Talks out with own cellular connection to allow those without cell phones to utilize
 * Incentives can be usage context based eg. employers get discounts for setup, installation and medical benefits; how users can get extended cellular usage to use as see fit

The concept, while encompassing most of the desired traits, has some challenges that needed to be identified and resolved:

 * Those in poor cellular reception area (includes vehicle use) how does the communication with the medical system happen? It could store data until area where reception occurs eg. picks up in open wifi zone, or uploaded from home since portable


 * Device powered from solar and when docked (USB or vehicle power)
 * Testing method same as others - does testing happen externally or within the base unit?

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