Driven to distraction: How Veterans Affairs uses monitoring technology to help returning veterans

Fujitsu provides the Sprout device to collect and analyze sensor data in real time

Veterans Affairs is collaborating with Fujitsu on a complex and interesting use of sensor data to help rehabilitate veterans suffering from Post Traumatic Stress Disorder (PTSD). I recently talked about this initiative with Dr. Steven Woodward, Principal Investigator of the study at the VA Palo Alto Health Care System, and with Dr. Ajay Chander, Senior Researcher in Data Driven Health Care at Fujitsu Laboratories of America (FLA).

The study is focused on evaluating strategies for driving rehabilitation. During deployments, veterans adapt their driving behavior to survive in dangerous war zones that are laced with combat fire, ambushes, and the threat of improvised explosive devices. Among veterans suffering from PTSD, these behaviors are hard to unlearn upon their return from such deployments. For example, some veterans veer instinctively into the middle of the road, reacting to deep-seated fears of improvised explosive devices. Others refuse to stop at stop signs for fear of attack. Other risky behaviors range from road rage to scanning the sides of the road instead of focusing on the road ahead. At-fault accident rates are significantly higher for veterans upon return from a deployment than before it.

The VA’s research objective is to understand the triggers for PTSD and discover remedies that will enable veterans to return to normal life. For the study, the VA instrumented a car as well as its veteran driver with a variety of sensors that collect data on how the car is being driven and the driver’s physiology while driving it. These sensors included wireless accelerometers on the brake and accelerator pedals and on the steering wheel, a GPS system, and an EKG monitor placed on the driver and wired to an in-car laptop for real-time viewing of cardiological signals, as well as manual recording of the driver’s state and environmental cues by an in-car psychotherapist. With such a system, the VA’s goal was to record and analyze driving trails of veterans and assess the efficacy of driving rehabilitation techniques.

As Dr. Woodward explained, the VA had been assessing veterans’ driving habits for quite a while before getting introduced to Fujitsu’s real-time monitoring technology. ASsessments had been a significant challenge for multiple reasons. On the data collection and visualization front, the disparate sensors, the laptop, and the power supplies added up to a significant in-car IT footprint. More importantly, since all sensor systems were manufactured by different vendors and didn’t share data with each other, the data streams were not synchronized. This made it difficult for the VA researchers to get an accurate understanding of how the driver’s physiology coupled with the car’s drive and location data.

Fujitsu Labs’ Sprout device has allowed the VA researchers to address both issues. The Sprout, which runs Linux 3.0, collects data from multiple sensors in real-time, time synchronizes and stores the data, and runs applications that analyze the data in real-time. The Sprout is designed for mobile data collection and analysis: it runs off a battery, and is smaller than a pack of cards. It is general purpose in that it can support any sensor that speaks Bluetooth or WiFi and provides a general API for building real-time applications that use multi-sensor data.

Body sensors on a Zephyr chest strap measure EKG, heart rate, respiration, and other physiological data from the veteran driver. Accelerometers on iOS devices are used to capture pedal and steering wheel motion. An iPhone collects GPS location, and is used by the in-car therapist to record driving and environmental events by choosing them from a pre-populated list.

All these sensors send their data continuously over Bluetooth and WiFi to the in-car Sprout, which synchronizes and stores them. The Sprout then makes this data available to an iPhone application that visualizes it in real-time for the in-car therapist. After the drive, VA researchers have been able to easily correlate all these data streams because they are all time synchronized. So far, more than 10 veterans have gone on more than 25 drives using this new infrastructure.

Fujitsu anticipates that many applications of its real-time monitoring and analysis platform will emerge as more sensors are integrated and new services are built on top of it. Some of these applications include:

  • Monitoring health, rehabilitation, medication adherence, and well=being in a patient-centered medical home

  • Tracking workers on assembly lines to enhance safety and discover system-wide troublesome hotspots

  • Monitoring call center phone operators in order to route calls to the least stressed operator

  • Monitoring workers in high-risk jobs, such as train drivers

“As we become more digitally readable through increasingly cheaper and ubiquitous sensors, algorithms will afford us greater awareness of our own selves and advice on living and navigating our lives well,” wrote Dr. Chander.

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