Towards Flexible Remote Therapeutic Interventions
Marc Schickler1, R¨
udiger Pryss1, Johannes Schobel1, Winfried Schlee2, Thomas Probst1, Manfred Reichert1
1Institute of Databases and Information Systems, Ulm University, Germany
2Clinic and Policlinic for Psychiatry and Psychotherapy, University of Regensburg, Germany
1{marc.schickler, ruediger.pryss, johannes.schobel, thomas.probst, manfred.reichert}@uni-ulm.de
Abstract—In the context of therapeutic interventions, smart
mobile devices are becoming increasingly important. First, they
can properly assist patients in performing their homework
– a support required for more efficient therapeutic interven-
tions. Second, mobile applications enable therapists to monitor
homework outcomes. From a technical perspective, frequently
required changes of the mobile applications supporting ther-
apeutic interventions constitute a major challenge. To tackle
the latter for a multitude of remote therapeutic interventions,
e.g., in psychotherapy or physiotherapy, we deploy process
management technology to smart mobile devices. This paper
discusses flexibility issues addressed by the mobile processes.
Particularly, the achieved flexibility, in turn, increases the
practical benefits of smart mobile devices in the context of
remote therapeutic interventions.
Keywords-Mobile service, flexible therapeutic intervention
support, mobile context, mobile process, mobile assistance.
I. INTRODUCTION
Clinical studies have revealed that therapeutic interven-
tions constitute a fundamental part of most therapies. The
variety of therapeutic interventions, in turn, ranges from
simple medication intakes up to complex homework, as-
signed to the patient by a therapist. Taking the diversity
of homework assignments into account, therapists crave for
a flexible IT support. Existing approaches often neglect the
use of smart mobile devices and often focus on specifically
tailored therapeutic intervention tools. Consequently, if ther-
apists want to adjust a therapeutic intervention, costly and
time-consuming changes of these tools become necessary.
To remedy these requirements, we developed an approach,
which relies on process management technology in order
to flexibly cope with remote therapeutic interventions based
on mobile processes. In practice, therapeutic interventions
consist of homework (e.g., daily back exercises) that, in turn,
comprises several activities. For example, in the context of
a daily back exercise, three activities need to be performed.
Mobile processes, in turn, constitute the basis for dealing
with both homework and exercise activities. Furthermore,
mobile processes may capture the context (e.g., being in the
kitchen), in which exercises shall be performed. Finally, they
ease the integration of smart mobile devices sensors [1].
Section II discusses how mobile processes foster flexible
therapeutic interventions. Section III presents related work,
whereas Section IV concludes the paper.
II. FLEXIBLE THERAPEUTIC INTERVENTION SUPPORT
When developing our approach, we aimed at reducing
the complexity of configuring and adjusting therapeutic
interventions by domain experts. The configurator we devel-
oped, therefore, adopts concepts from end-user development,
which have proven feasibility [2]. Particularly, the developed
approach shall address flexibility issues in order to meet
practical demands. This section discusses these issues along
the three major lifecycle phases (cf. Fig. 2):
(1) Design time flexibility is enabled through the con-
figurator. Thereby, two concepts contribute to the flexible
support of therapeutic interventions. First, we allow for the
exchange of exercise activities based on configurable sub-
processes, e.g., in Fig. 1 activity effort may be exchanged
using a sub-process. The contextual information required
to evaluate whether biking or running shall be configured
for this sub-process is specified by therapists using the
configurator. Second, the way therapeutic interventions are
mapped to mobile processes enables us to assist therapists in
creating executable mobile processes. Therefore, the config-
urator assists therapists when modeling homework as well
as the exercise activities and their interdependencies.
Figure 1. Mobile Process
Figure 2. Providing Flexibility in the Lifecycle of Remote Therapeutic Interventions
(2) Deployment time. The designed therapeutic interven-
tion is mapped to a process model, which is then deployed
to the respective smart mobile device(s). In order to enable
a flexible and robust execution of the therapeutic interven-
tion procedure on the smart mobile device, mobile process
management technology is applied [1].
(3) Run time flexibility addresses various issues. First, a
process engine is run on the smart mobile device. It enables
the robust execution of the therapeutic intervention process
model defining its logic, i.e., the process engine enacts and
executes the respective process model. In turn, a particular
process activity (e.g., showing an instruction video) and
its corresponding user interface is realized using executable
components [1]. The process engine dynamically loads the
components needed for an application scenario during run
time. Second, a sensor framework allows connecting sensors
(e.g., heart rate) with the smart mobile device. Third, mobile
processes enable us to monitor therapeutic interventions.
III. RELATED WORK
Several approaches deal with the IT support for ther-
apeutic interventions in the context of patient treatments.
In particular, they target at the support of psychotherapies
[3], [4]. Recent works, e.g., [5], have revealed that mobile
applications can be used to properly perform therapeutic
interventions. In addition, there exist IT-driven approaches
that may be configured by domain experts to increase the
efficacy of a psychotherapy [6]. However, none of these
approaches aims at a generic technical solution covering var-
ious therapeutic interventions (i.e., not only psychotherapy)
and using smart mobil devices.
IV. SUMMARY AND OUTLOOK
Smart mobile devices offer promising perspectives for
remote therapeutic interventions. This paper introduced the
concept of mobile processes, which enables flexibility along
the lifecycle phases of remote theraupeutic interventions.
Our configurator indicates that the complexity to configure
and adjust therapeutic interventions can be reduced. In this
context, an evaluation study is currently designed to im-
prove the usability of the developed configurator. Moreover,
patients benefit from personalized therapeutic interventions
running on smart mobile devices. Altogether, the support of
therapeutic interventions on smart mobile devices constitutes
an important step towards more effective patient therapies.
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