- 學位論文
提出醫療物聯網(IoMT)用於居家老人照顧之服務模式
Propose a Service Model of Internet of Medical Things (IoMT) in Home Care for the Elderly People
摘要
台灣自民國82年起，老年人口占總人口比率超過 7%，開始進入高齡化社會。再加上少子化的影響，106 年 2 月底戶籍登記人口，老年（65歲以上）人口首次較幼年（0-14歲）人口多。根據調查，大約有70%以上的老人希望能與子女或是配偶同住，但隨著家庭結構改變，居家老人照顧逐漸出現人力不足的問題。隨著資通訊科技的發展，市面上已有許多產品能夠應用在居家老人照顧上，例如：可利用物聯網穿戴式裝置或是感測器來偵測基本的生理訊號，並將這些資料上傳至雲端平台，有狀況時能夠發出警訊，使其家人能夠知道生理狀況，也可與醫院或是照顧機構連結，讓醫師和護理人員能夠即時監控，達成遠距照護的功能，提供更完善的照顧服務。 本研究目的有以下四點，首先，探討常見的老人照顧需求，了解健康照顧、心理調適、經濟、生活照顧以及居住等不同需求，針對健康照顧以及生活照顧做細部討論。其二，探討物聯網的發展，包含物聯網的運作模式與基本架構。其三，了解物聯網在醫療上的應用，探討物聯網在醫療照顧或是醫院內部等領域應用，可以如何幫助提高醫療照顧品質。最後一項，則是提出一套完善的醫聯網用於居家老人照顧服務模式，整合相關居家老人照顧需求，透過物聯網的科技將各項服務串聯起來，來針對居家老人照顧提供完整的照顧服務。 研究方法，則是透過文獻分析法，去蒐集2010年到2017年間相關的國內碩博士論文、政府研究計畫以及國外的期刊和研討會發表學術論文，總共整理出199篇關於醫療物聯網對於老人照顧的相關的學術論文。並將其分類成健康監測、服用藥物、環境安全、活動與運動、位置監控與求救以及復健復健等六項，針對各項內容去做討論，了解醫療物聯網可以如何幫助解決老人照顧需求。 本研究在最後提出一套完善的醫聯網用於居家老人照顧服務模式，首先，在使用者身上配置穿戴式裝置和感測器來監控身體狀況，居家環境中也建置感測器與監視器。再來，將所蒐集的相關資料上傳至雲端儲存及分析。最後，用來提供健康管理、疾病監控、飲食、運動以及復健等服務，來滿足各種醫療照顧以及日常生活等不同需求。能夠提供預防性的照顧，預防失能或提早檢測出疾病的發生，並提供相對應的醫療照顧服務。對於健康的老人，能夠用來做自我的健康管理；對於具有慢性病的老人，能夠即時監控其病情；對於長期照顧失能的老人，能夠用來監控其身體狀況。此照顧服務模式能夠減輕居家老人照顧者的負擔，並降低照顧及醫療成本，提升照顧品質。 本研究限制在於資料蒐集部分，僅利用文獻分析法來探討，缺少專家們的意見。因此，未來研究可加入問卷調查與訪談，加入相關人員的意見，來使資料收集的內容更加完整。另外，本研究所提出的服務模式只是一個概念，並未實際開出一套系統。針對這的未來研究方向，則是希望開發出能夠實際使用的系統，並與相關人員進行討論，使系統的介面及功能更加完善，最後加強安全防護和傳輸，來保障使用者的個人隱私安全。
並列摘要
Since 1982, the elderly population of Taiwan has accounted more than 7% of the total population and has started to move in an aging society. Impact of decreasing birthrate, at the end of February 2017, the registered elderly population (over 65 years old) are more than the younger population (0-14 years old). According to the survey, about 70% of the elderly want to live with their children or spouses. But the family structure is slowly changing, and the care of the elderly people at home are going to be challenging. With the development of information and communications technology (ICT), several healthcare care systems and tools can be employed for the care of the elderly people at home. For example, Internet of things (IoT) such as wearable devices or sensors can be applied to sense basic physiological signals and upload these directly to the cloud platform. When there is an emergency situation, it can send out warning signals to the family to warn about the physiological condition. It can also be connected with the hospital or the care organization, which allows physicians and caregivers to monitor instantly and provide better care employing the remote care system. There are four purposes of the current study. First, explore the common needs required for elderly care. Understand the different needs of healthcare, psychological adjustment, economy, life care, and housing. Then a detailed discussion on health care and life care was employed. Second, explore the development of the IoT, including its operational model and basic structure. Third, understand the application of the IoT in medical care and explore how IoT can be applied in fields such as medical care or hospitals, and how it can be employed to improve the quality of medical care. The last item is to propose a comprehensive medical network for the elderly care service model. Integrate the care needs of the elderly at home, and connect the various services through the technology of the IoT to provide comprehensive care services for the elderly people. The literature review from 2010 to 2017 was employed to collect data. We include doctoral thesis, government research projects, publication of foreign journals and academic papers published in seminars are included for current study. A total of 199 published academic papers on the elderly care population related with IoT were finally included for the current study. All these studies are classified into six categories: health monitoring, using drugs, environmental safety, activities and sports, location monitoring and help, and rehabilitation. Discuss the several contents to understand how the Internet of Medical Things (IoMT) can solve the needs of elderly care. At the end of the study, a medical network structure was proposed for the home care service model of the elderly population. First, wearable devices and sensors are placed on the user to monitor their physical condition. Sensors and monitors are also built in a way which can work in the homely environment. Then, upload the relevant data to the cloud for storage and analysis. Finally, it is used to provide services such as health management, disease monitoring, diet, exercise, and rehabilitation to meet several medical care and daily needs. It can be used to provide preventive care and prevent disability or help to detect the disease in early stage and provide corresponding medical care services. It can be employed as self-health care management for healthy elderly people. Elderly people suffering from chronic diseases and have long-term care for disability can use it to monitor their physical condition instantly. However, it can be employed to reduce the burden on home caregivers, indirectly reduce the medical care costs, and improve the quality of care. The limitation of this study is that the data was collected only from published academic articles. Thus, there are lacks the opinions of experts. Therefore, future research should use questionnaires, interviews, and the opinions of relevant personnel to make the study findings more comprehensive. In addition, the service model proposed in this study is only a concept and has not been actually implemented. In the future research, it is expected to develop a system that can be used in practice, and discuss the system functions in the more precise way. Finally, security protection and transmission of users’ information are reinforced to protect the privacy of users.