WO2019105542A1

WO2019105542A1 - Compliance for usage of hygiene equipment

Info

Publication number: WO2019105542A1
Application number: PCT/EP2017/080798
Authority: WO
Inventors: Håkan Lindström
Original assignee: Essity Hygiene And Health Aktiebolag
Priority date: 2017-11-29
Filing date: 2017-11-29
Publication date: 2019-06-06

Abstract

A system for estimating compliance indicating use of hygiene equipment by one or more users, the system comprising locating equipment comprising one or more locating devices being arranged to provide information on a position of an object in an environment, and processing equipment comprising a receiving section configured to receive the information on a position of the object from said environment; a first pattern recognition section configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment; a second pattern recognition section configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

Description

COMPLIANCE FOR THE USAGE OF HYGIENE EQUIPMENT

Technical Field

The present disclosure generally relates to estimating a compliance in the context of hygiene equipment, such as soap, disinfectant, and/or towel dispensers, and the like. More particularly, the present disclosure relates to ways of obtaining the base information in the field for determining a an estimate that indicates actual use of hygiene equipment.

Background

Hygiene equipment is commonplace today in many facilities, such as hospitals, medical service centers, intensive care units, day clinics, private practices, lavatories, rest rooms, hotels, restaurants, cafes, food service places, schools, kindergartens, manufacturing sites, administration and office buildings, and, in general, places and facilities that are accessible to the public or to a considerable number of individuals. The mentioned hygiene equipment thereby includes various types of individual devices and installations such as soap dispensers, dispensers for disinfectant solutions, manual pump bottles, gels or substances, towel dispensers, glove dispensers, tissue dispensers, hand dryers, sinks, radiation assisted disinfectant points, and the like.

Although such hygiene equipment is commonplace today in many places, the use thereof by the individuals visiting these places or working in these places is still oftentimes not satisfactory. For example, hospitals, and, in general, medical service centers often suffer from hygiene deficiencies, which, in turn, may lead to the spread of infections and related diseases. In particular, such insufficient hygiene amongst medical care personnel coming into close contact with patients and bodily fluids can lead to the spread of infectious diseases amongst the personnel and other patients. It is also known that infections by highly resistant bacteria pose a severe problem in such places, above all, hospitals. In general, so-called Healthcare Associated Infections (HAI) are a real and tangible global problem in today's healthcare. HAI can be found to be currently the primary cause of death for 140.000 patients/year, affecting millions more and costs society more.

At the same time, however, it is known that hygiene, and, in particular, hand hygiene, is an important factor as far as the spread of infectious diseases are concerned. Specifically, medical care personnel should make proper use of hand hygiene as often as possible so that the spread of bacteria and other disease causing substances is minimized. The actual use of such hygiene equipment, however, may depend on - amongst others - the management of the facility, accessibility and usability of the equipment, culture, the cooperation and will exercised by the individuals working in these places or visiting such places, and possibly also other factors. In other words, an important factor remains the fact that individuals may not make use of installed and provided hygiene equipment although they are supposed to. Furthermore, it is generally accepted that an increased use of hygiene equipment can substantially contribute in reducing the spread of bacteria and the like, which, in turn, can drastically reduce the appearance of related infections and diseases.

As a consequence, one may have considerable interest in a so- called compliance that in some way or another compares the actual use of hygiene equipment to some sort of target usage, e.g. a usage at the right place at the right time. For example, a corresponding relatively low compliance may indicate that the actual use of hygiene equipment is not satisfactory, whilst relatively high compliance may indicate that the actual use of hygiene equipment corresponds, within a given threshold, to some target usage, and, consequently, may be regarded as being satisfactory. Such compliance may provide many advantages, since it gives a concise picture to operators of the corresponding facility so that they may initiate measures for increasing the actual use of hygiene equipment. The compliance as such may be mapped to some numerical value the range of which representing possible compliance situations from low (=bad) to high (=good) compliance. For example, compliance can be mapped to a percent value, where "100%" could indicate full compliance to the applicable rules, whereas "0%" would indicate no compliance at all.

There are already ways of estimating such compliance values in the arts, wherein the conventional approaches usually rely on measuring and/or observe "manually" by a human observer so- called opportunities and comparing these obtained opportunities to a measured/detected actual use of the hygiene equipment. In other words, the opportunities indicate any event when hygiene equipment should or could have been used. By then comparing this "should/could"-value to an actual usage value a compliance metric can be calculated. In general, the opportunities can be well defined figures, since they may be associated to specific rules and/or recommendations. For example, the World Health Organization (WHO) has defined the so-called "Five Moments Of Hand Hygiene" (cf. www.who.int/psc/tools/ Five_moments/en/) including as explicit definitions for opportunities: 1. Before patient contact; 2. Before aseptic task; 3. After body fluid exposure risk; 4. After patient contact; and 5. After contact with patient surroundings. Moreover, measurements on a corresponding hand hygiene compliance is becoming a regulatory requirement for the healthcare sector and may serve as an important quality improvement tool. In this context it should be noted that, whilst it is commonplace to implement sensor arrangements in hygiene equipment for measuring the actual usage, it may be more difficult to implement sensor arrangements for measuring, detecting, and/or sensing opportunities. In general, any sensor arrangement needs to integrate itself into an existing environment of , for example, an intensive care unit, a ward, or even an entire hospital or nursing home.

There is therefore a need for an improved system and method of estimating a compliance that fits well in any existing environments with as little interference and intrusion as possible, whilst providing a sufficient degree of reliability in the sense that the obtained data can be assumed to sufficiently reflect the reality.

Summary

The mentioned problems and drawbacks are addressed by the subject matter of the independent claims. Further preferred embodiments are defined in the dependent claims.

According to one aspect of the present invention there is provided a system for estimating compliance indicating use of hygiene equipment by one or more users, the system comprising locating equipment comprising one or more locating devices being arranged to provide information on a position of an object in an environment, and processing equipment comprising a receiving section configured to receive the information on a position of the object from said environment; a first pattern recognition section configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment; a second pattern recognition section configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

According to one aspect of the present invention there is provided a processing entity for estimating compliance indicating use of hygiene equipment by one or more users, the entity comprising a receiving section configured to receive from locating equipment, comprising one or more locating devices, information on a position of an object in an environment; a first pattern recognition section configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment; a second pattern recognition section configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

According to one aspect of the present invention there is provided a method for estimating compliance indicating use of hygiene equipment by one or more users, the method comprising the steps of receiving from locating equipment, comprising one or more locating devices, information on a position of an object in an environment; performing a first pattern recognition for determining, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment; performing a second pattern recognition for determining, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and estimating said compliance based on determined opportunity events and usage events.

According to one aspect of the present invention there is provided a compliance estimating entity comprising a receiving section configured to receive from locating equipment, comprising one or more locating devices, information on a position of an object in an environment; a first pattern recognition section configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment; a second pattern recognition section configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

According to one aspect of the present invention there is provided a compliance estimating system comprising image acquisition equipment comprising one or more imaging devices being arranged to provide image information on an object in an environment, and processing equipment comprising: a receiving section configured to receive the image information on the object from said environment; an image recognition section configured to process the received image information, to obtain a movement and/or behavior pattern of said object, and, as a result therefrom, to determine an opportunity event indicating an opportunity to use a piece of hygiene equipment and a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

According to one aspect of the present invention there is provided a compliance estimating entity comprising: a receiving section configured to receive image information on an object from an environment; an image recognition section configured to process the received image information, to obtain a movement and/or behavior pattern of said object, and, as a result therefrom, to determine an opportunity event indicating an opportunity to use a piece of hygiene equipment and a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events. Brief description of the drawings

Embodiments of the present invention, which are presented for better understanding the inventive concepts but which are not to be seen as limiting the invention, will now be described with reference to the figures in which:

Figure 1 shows a schematic view of a system for estimating compliance according to an embodiment of the present invention;

Figures 2 and 2A show schematic views of a typical environment for a deployment of a system for estimating compliance according to another embodiment of the present invention;

Figures 3A and 3B show schematic views in conjunction with a neural network being used for determining a function as a way of estimating compliance according to a further embodiment of the present invention;

Figure 4 shows a schematic view of a general processing entity embodiment of the present invention;

Figure 5 shows a flowchart of a general method embodiment of the present invention;

Figures 6A and 6B show schematic views of locating and positioning schemes applicable for at least some embodiments of the present invention; and Figures 7A and 7B show schematic views of ranging and positioning schemes applicable for at least some embodiments of the present invention.

Detailed Description

Figure 1 shows a schematic view of a system for estimating a compliance according to an embodiment of the present invention. The system estimates a compliance that indicates the usage of hygiene equipment by one or more users, e.g. personnel in a hospital, nursing home or any other suitable environment 1 in which compliant use of hygiene equipment shall be attained. The system comprises locating equipment 100 comprising one or more locating devices 11-1, 12-1, 13, 14 being arranged to provide information on a position of an object 11-2, 12-2, U in an environment. The system further comprises processing equipment 300 which, in turn, comprises a receiving section 31 configured to receive the information on a position of the object from the environment 1. In this way, field data can be received in any suitable form. In general, "raw" data is considered that can be identified as data indicating a position or several positions over time, i.e. a movement, of an object.

As depicted, the object can be any suitable device, such as a tag device 11-2 or smartphone 12-2, i.e. any suitable device that can be carried by a user who is supposed to use the hygiene equipment and who is subject to compliance. Methods, systems, and concepts for locating equipment in the context of devices carried by the users are explained in greater detail in conjunction with Figures 6A to 7B. Generally, however, the object can also be the user U him-/herself or even only a part of a user (e.g. as depicted a user's hand that usually receives the hand hygiene procedure) . Further, as an object also a bed, medical devices such as catheters or catheter bags can be identified. Further, patients or bodily fluids can also be identified. For this purpose, the locating equipment 100 may also comprise camera or optical equipment 13, proximity sensors 14, and the like. Also such equipment usually provides raw position information on an observed object. However, also early stage data processing can be considered, in which already concrete data on determined opportunities or usage events are conveyed. As an example for the latter, the system may also comprise hygiene equipment 200 with reporting capabilities. Specifically, the environment may be provided with dispensers 20 for soap or disinfectant that can directly or via a sniffer device 21 report a usage thereof in the form of, for example, a data message u-2.

The processing equipment 300 of the system further comprises a first pattern recognition section 32-1 configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment, and a second pattern recognition section 32-2 configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment. The first and second pattern recognition sections 32-1, 32-2 may employ any suitable pattern recognition procedure that allows determining an opportunity to use and an actual use of hygiene equipment from position, location, or movement information.

For example, so-called hot zones can be defined in the form of virtual boarders around place of interest, such as a patient's station or bed. Specifically, if the location data indicates that a user (e.g. a nurse) as an object has approached a specific location of a bed it may be determined that this event as such can be identified as an opportunity to use hygiene equipment before entering this hot zone and/or after having left the zone. If then a usage event is received that can be associated to the determined opportunity any compliance value may be adjusted so as to represent a good or better compliance. Likewise, if no usage event is received or no usage event can be associated to the determined opportunity said compliance value may be adjusted so as to represent a bad or worse compliance. In general, "pattern recognition" of the present disclosure may be a procedure that determines whether the object's location enters or leaves virtually defined areas or boundaries. In other words, if the object is detected to cross a borderline then a pattern for an opportunity or use of hygiene equipment may be recognized.

In general, however, also more complex processing may apply. Specifically, trajectories, speed, and timing information may be obtained and be compared to target patterns that indicate a typical "behavior" in the context of an opportunity to use hygiene equipment or an actual use event. Further, the first and second pattern recognition sections 32-1, 32-2 may employ any one of image processing, image recognition, object recognition, object tracing, machine learning, deep learning, data mining, and artificial intelligence for the purpose of recognizing patterns that indicate opportunities and use events. For this or any other purposes, the sections 32-1, 32- 2 may have access to a data repository 34.

The system further comprises a calculation section 33 configured to estimate said compliance based on determined opportunity events and usage events that are received from the first and second pattern recognition sections 32-1, 32-2. In the calculation section 33 any suitable processing may be employed for calculating a metric on the observed compliance as the desired output figure of the system. Specifically, opportunity event and usage events may be associated to one another by means of identification information, timing information or absolute or relative position information. Further, rules may be defined that allow a determination of whether or not received opportunity and usage events actually qualify for compliant behavior. The calculation section 32 can further be configured to employ a trained function F for estimating the compliance metric from the received data including, for example, usage and opportunity data. Generally, the calculation section 32 can employ a trained function F which can consist of a set of correlation parameters that allows for estimating a compliance from a given set of received data. According to an embodiment of the present invention, the function F is trained in the sense that it can correlate specific data patterns to compliance metric in a fashion as accurate as possible. In an embodiment of the present invention, the function F is implemented as a machine/statistical learning structure as explained in greater detail elsewhere of the present disclosure .

Generally, the locating equipment may comprise any suitable selection of cameras, low resolution cameras (so it may be difficult to identify individuals in the image data) , time-of- flight cameras, infrared (IR) cameras, heat/thermo-cameras , micro-phones, image recognition resources, vicinity sensors, radar, ultrasonic sensors, IR sensors, photocell sensor, conductive and/or capacitive sensors (presence, touching), laser range sensors, time-of-flight sensors (e.g. sensors that employ the delay of RF-, e/m-pulse or light signals for determining a location, a distance and/or movements), RFID readers and/or NFC equipment (e.g. also for identifying a badge carried by an operator) , door pass sensors, a light barrier, and the like.

Direct usage or opportunity signals (u-1, u-2, o-l, ...) can be typically signaling "now there is/was an opportunity" (e.g. by carrying a Boolean value "TRUE" or by simply carrying data such as a dispenser or location ID) . In a way, the mere fact that a signal is received may indicate to the system 30 that there is an opportunity to use some piece of hygiene equipment. However, the signal may also include more information, including information on when the piece of hygiene equipment could have been used (e.g. timestamp), information on how much of the dispensed substance should have been used (e.g. dosage size, number of towels etc.), information on who could have used it (if the individual operator is tagged and sensed or recognized by the system) , and/or information on what could have been used by the operator if there are alternatives (for example, soap, towel, or disinfectant) . Alternatively or additionally, the opportunity data or signals may also include information on a physical movement of a person or object throughout the facility. In this way also indirect indications to opportunities to use the hygiene equipment may be considered.

Figure 2 shows a schematic view of an exemplary deployment of a system for estimating compliance according to an embodiment of the present invention. As an example, there is shown as a facility an intensive care unit 400 with corresponding intensive care points: first and second patient stations 410, 420 and first and second patient care equipment 411, 421. As can be seen, the intensive care unit 400 may be occupied by one or two patients in the shown configuration, whilst the embodiments of the present invention may naturally envisage also other intensive care units with any number of patients and personnel and/or other facilities as mentioned elsewhere in the present disclosure.

In general, however, the number of actually occupied intensive care points (beds) as well as other information (e.g. on a number of individuals working/visiting, on a shift, a time of day, a day of week, a holiday) can be considered as optional metadata M, likewise stored, for example, in the database 34 of Figure 1. Further examples include information on a type of care given (intensive, orthopedic, surgery, child, emergency, ear/nose/throat, etc.) and data measured by corresponding equipment (e.g. a pressure/weight sensor in a bed to indicate if there is a patient in the bed or not) . Said metadata M can thus contribute in the calculation section 33 when determining the compliance and/or also training phases in which the function F is trained or built up. For example, the metadata M can contribute in rendering the function F sensitive to the actual environment (e.g. beds occupied or not) so that it can produce an improved estimate for situations when all or most beds are occupied and when only some beds are occupied.

Specifically, activity data with regard to opportunities and usage can be acquired from distributed equipment including locating equipment and optionally further sensor arrangements. The locating equipment may be in the form of, for example, a locating device 11, proximity sensors 14, 15, ranging devices 12, and optical image acquisition means such as a camera 13. The locating device 11 and/or the ranging device 12 may interact with other devices that are integrated into or associated to individual pieces of hygiene equipment, stations 410, 420, equipment 411, 421, and/or other mobile units such as service trolley 43. Further, they may interact with devices that are carried by users, i.e. the individuals working or being present and ultimately subject to compliance (i.e. it is them who are supposed to use the hygiene equipment according to the applicable rules so as to be compliant) .

Further, there are also provided individual pieces of hygiene equipment in the form of sink 22, dispensers 20, and mobile dispenser 20' . Some or all of these devices may be provided with equipment sensors 21 so that the system is able to receive usage data u-2 directly as possibly individual signals from each corresponding device/sensor. Further, also locating devices such as the proximity sensor 14 may provide an opportunity signal o-l directly to the system. For example, a user in the proximity of a bed 410 may be detected by sensor 14 which could be seen as an equivalent to an opportunity to use one of the provided dispensers 20. In this way, the system is in principle also able to process data for obtaining a compliance metric that does not involve pattern recognition. In general, however, the locating equipment provides information on a position of an object in an environment, for example of users and/or equipment as objects and in ward 400 as the environment. This information can be fed to the pattern recognition sections that determine opportunities and usage events. For example, a user carries a tag or device (e.g. smartphone, etc.) that allows the locating device 11 or 12 to locate the user. A simple pattern may be if the user enters zone 401 which can be a virtually defined area. Since the system may know that there is an occupied bed 410 in zone 401, an opportunity may be determined. If the movement pattern indicates an approximation of the user toward dispenser 20 with some kind of minimum retention time, the pattern recognition section may determine also a usage event. An exemplary pattern P is shown in conjunction with bed 410, zone 401 and dispenser 20 in the inset Figure 2A.

If both the opportunity and usage event satisfy some criterion on association (e.g. they occur subsequently within some time period) , then the calculation section may adjust the compliance estimate toward the better. Similarly, the camera 13 may observe objects moving inside zone 402, and, by employing image recognition, also a pattern of a moving object within zone 402 can be traced and recognized to be either associated to an opportunity or a usage event.

Figures 3A and 3B show schematic views in conjunction with a neural network being used for determining a function F for compliance estimation according to a further embodiment of the present invention. In a way, the employment of a neural network is one way of determining the function as a product of a machine learning procedure. Specifically, Figure 3A schematically shows a node (neuron) 331 of a neural network. As is as such known, the neuron 331 has one or more inputs 332 and one output 333. In general, the neuron 331 receives input values a _j at the corresponding input 332, multiplies each input value _j by a corresponding coefficient w^ and forms the corresponding sum _j = åi wi_j ^c a _j at the output 333. Furthermore, the output P could also be normalized to a value between 0 and 1, or be made binary so that it either assumes 0 or 1 (P_j e {0, 1}) by means of applying a rounding and/or Heavyside function. As then shown in Figure 3B, a neural network 334 is composed of a corresponding manifold of neurons 331 as one is individually shown in Figure 3A. As a consequence, the network 334 provides at the bottom a number (e.g. k) of inputs 332' receiving the a_ki (at k inputs) and, after one or more hierarchy levels of individual neurons 331, at the output 333' the output Pi of the topmost neuron of the network 334.

According to an embodiment of the present invention, the calculation section 33 of the system employs such a neural network 334 for both determining the function F from initial (learning) data 335 comprising usage event data U, opportunity data 0, and, optionally, meta data M. Since in this phase the data can be directly correlated to a specific compliance metric Cc (e.g. a use rate derived from U divided by an opportunity rate derived from 0) , the neural network 334 can be trained with this data to determine the coefficient wi_j . In other words, the w^ are trained so that the network 334 gives the correct Cc at output 333' for the given U, 0, and, optionally, M. It is noted that in the context of the present embodiment, a group of or the entirety of the determined coefficients w^ corresponds to the function F as mentioned elsewhere in the present disclosure. In other words, the neural network 334 with the trained coefficients w^ represents the function F in this embodiment.

The present embodiment then envisages to employ the trained neural network 334 (function) to determine at the output 333' an estimated compliance value (metric) based on operation data 336 that may be even a reduced set of second opportunity data O' , corresponding user data U, and, optionally, again corresponding meta data M' . It is noted that the usage data U as part of data 335 may be recorded at the same time, or at least at overlapping intervals, during which the first opportunity data 0 and the meta data M is obtained. Likewise, the user data of the data set 336 may be determined (measured, detected) while the second opportunity data O' , and, optionally, the second meta data M' is obtained. In a certain embodiment, the time periods during which 0 and U are measured are the same.

In an operation phase, the function F can thus be employed to provide the compliance estimate for any results of the pattern recognition (and optionally M' ) so as to be an accurate estimate to a corresponding "true" or "complete" compliance estimate However, since the function F is trained and the corresponding parameters have been learned, an algorithmic implementation would need to evaluate the mentioned inputs with the learned parameters. The latter learned parameters provide that the output compliance estimate is calculated taking into account the learned correlations. In other words, Figures 3A and 3B depict two process steps in one, namely the training step which calculates the F in an iterative process between the "complete" initial set of learning data 335 in relation to a known Cc (at the top of the triangle) , and an operational step which uses the known F (in the triangle) which calculates (or estimates) an estimated compliance with the aid of the "incomplete" set of data 336.

In general, however, the function F in the calculation section 33 may represent any algorithm and implementation for obtaining a compliance estimate from the received recognized patterns. Specifically, the function F need not to be trained individually for each system but may be applicable to more than one system in the form of a preloaded function. In this way, the calculation section 33 has generally the ability to receive recognized patterns, associate opportunities and usage events, and, ultimately, determine a compliance estimate in the sense of the more opportunities can be associated to usage events the better is the compliance. In other words, if the system determines that users use hygiene equipment at more opportunities (i.e. in situations where a rule says that the users are supposed to use hygiene equipment) then the system will determine a relatively good compliance. However, if the system for example fails to determine usage event for a larger number of determined opportunities, then the system is faced with users that do not use the hygiene equipment when they are supposed to, and, accordingly the system will determine a relatively poor compliance.

Figure 4 shows a schematic view of a general processing entity embodiment of the present invention. A processing entity 30 is specifically adapted to estimate compliance indicating the usage of hygiene equipment by one or more users. The processing entity 30 can be a server computer or a part of processing resources of such a server or processing resources as provided by a plurality of individual computers such as a data center. The processing entity 30 will however in any way comprise a processing resource 301, a memory resource 302, and a communication resource 303. By means of the latter communication resource 303, the entity 30 is able to communicate data from and to a network 304, such as the internet, a local or wide area network (LAN, WAN) , a telecommunications network (GSM, PCS, GPRS, 3G, UMTS, 4G, LTE, LTE-A, 5G, etc . ) .

In the processing resource 301 a receiving section, a first and second pattern recognition section, and a calculation section can be implemented. Each section can be implemented on the same hardware or they can be implemented at different locations of a hardware system interconnected by some kind of communication network. The receiving section is configured to receive from locating equipment, comprising one or more locating devices, information on a position of an object in an environment. The first pattern recognition section is configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment. The second pattern recognition section is configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment. The calculation section is configured to estimate said compliance based on determined opportunity events and usage events.

Figure 5 shows a flowchart of a general method embodiment of the present invention. Specifically, the method is for estimating compliance indicating the usage of hygiene equipment by one or more users and comprises the following steps: A step 501 of receiving from locating equipment, comprising one or more locating devices, information on a position of an object in an environment. A step 502 of performing a first and second pattern recognition for determining, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment and for determining, from the received information, a usage event indicating a usage of said piece of hygiene equipment. Further, the method comprises a step 503 of estimating said compliance based on determined opportunity events and usage events.

Figures 6A and 6B show schematic views of locating and positioning schemes applicable for at least some embodiments of the present invention. Specifically, these embodiments are directed at implementations of the locating devices and at obtaining the information on a position of an object in a given environment. Figure 6A shows a schematic view of locating equipment for determining, as an intermediate product, information on a direction or an angle of arrival according to an embodiment of the present invention. Specifically, it is shown a possible implementation of a corresponding locating device 11 which provides in this embodiment an antenna array 111 and a phase run time line 112. In this embodiment, a device 1 (or 11-2 of Figure 1), which is carried by a user or is integrated or associated to a piece of hygiene equipment, is assumed to emit a radio signal that then can reach the positioning device 11, and, with this, the antenna array 111 along two paths A and B along the line of sight. These paths will intersect a given base line with corresponding angles aA and aB . It is known to determine information on a distance and/or a position with two, three or more angles available. This concept is known as triangulation and methods exist in the arts.

The angles aA and aB can be for example determined by means of said phase run time line 112 where signals received by the individual antennas run and establish a certain phase relation to each other. This phase relation is a figure for a timing difference with regard to points in time when the radio signal has hit the antennas along the different paths. With this information angles can be obtained, which can serve as a basis for determining the information on a position and/or distance. Likewise, a series of arrival times over the antenna array can be measured from which then one or more angles, and, in turn, information on a position of the originator (e.g. object) of the radio signal can be calculated.

Figure 6B shows a schematic view of positioning equipment for determining information on a direction or an angle of arrival according to another embodiment of the present invention. This alternative embodiment considers the device 11 being arranged to measure information on an angle aA' in the x-y-plane and an angle aA" in the x-z- or y-z-plane. Specifically, this embodiment considers an array of antennas 111 in the form of a two-dimensional matrix (as shown) or a circular matrix with antennae arranged along polar coordinates as shown in the option box 0. An incoming radio signal will trigger the individual antennae of the matrix at different times and thus allows the calculation of the two angles aA' and aA" for, ultimately, determining information on a position in 2 or 3 dimensions of a radio signal source (i.e. a tag) . Further, a spherical antenna may be employed that provides the individual antennae on a surface of a sphere.

Figures 7A and 7B show schematic views of ranging and positioning schemes applicable for at least some embodiments of the present invention, i.e. for a locating device and the respective information on a position of an object. Figure 7A shows a schematic view of a mechanism for ranging by employing a time-of-flight determination of radio signals according to an embodiment of the present invention. Specifically, Figure 7A shows a schematic view of a general variant of so-called two way ranging (TWR) between a locating device 12 and a device 1 (or 11-2 of Figure 1) carried by a user or integrated into or associated to a piece of hygiene equipment, when, for example, the device 12 acts as a beacon. It is thus assumed that the device 12 transmits beacon signals Sl-1, Sl-2, in regular or irregular intervals. At some given time, the device 1 can receive the beacon signal Sl-3. The device 1 can obtain information on the timing when the signal Sl-3 was emitted (Tl) and received (T2) and obtain information on when a response signal S2 is transmitted (T3) toward and received (T4) at the device 12. Optionally, a third signal S3 can be employed to convey all the required information and data to device 1.

A payload in the beacon signal SI may contain information on identifying the device 12, and this information may be encoded, together with relative or absolute information on the receiving/transmission timings, onto the payload of the response signal S2. The device 1 can thus obtain information on the timing when the signal S2 was received (T4) and obtain information on the timing when the signal Sl-3 was transmitted (Tl) . Together with the timing information contained in payload data of signal S2, the device 1 is able to determine the distance d between the device 12 and the device 1 by employing a calculation such as [ ( T4 - Tl) ( T3 - T2) ]

d c (1)

2

where c denotes the speed of light, the applicable propagation speed for radio signals. Further, the conveyed payload may also be employed to ensure that the signal S2 is in actual response to the beacon signal Sl-3. In addition to this, further signals may be employed for any one of improving accuracy, employing cancelling techniques or adding redundancy. If one or more additional distance (s) to another or other device (s), or one or more additional distance to device 12 (e.g. with respect to a second and further antenna thereof) is obtained, multiple distances are available for also compiling information on a relative position in two or even three dimensions.

A similar ranging scheme can be employed where it is assumed that the device 1 transmits beacon signals Sl-1, Sl-2, in regular or irregular intervals. The ranging is carried out similar to the situation of Figure 7A, taking into account - at least indirectly - the timings Tl to T4. An additional signal may be employed if the distance determination is made at the site of the device 12 but information on the determined distance should be conveyed back to the device 1.

Figure 7B shows a schematic view of time difference of arrival (TDOA) scheme between more than one device and a detection and reporting device 1. Specifically, two devices 12 and 12' represent beacon devices and transmit beacon signals Sll-1,... and, respectively, S12-1,... into some overlapping range. At some point in time, the device 1 is assumed to have received the two beacon signals Sll-2 and S12-1. Both devices 3 and 3' obtain information on timing when the signals Sll-1 and S12-1 are transmitted by their respectively coupled antennae. In this embodiment, the information on the timing can be identified as an instruction or synchronization signal employed for the plurality of devices 12 and 12' to transmit the signals Sll-1 and S12-1 at substantially the same time Tl.

In this way, the device 1 may determine different timings when the different signals are received. Namely, the signal Sll-2 can be assumed to be received at T2 at device 1, and the signal S12-1 can be assumed to be received at T3 at device 1. With this knowledge, the device 1 can initiate ranging calculations. Again, further signals may be employed for any one of improving accuracy, employing cancelling techniques or adding redundancy. In addition, any determined distance or difference may be conveyed via an optional signal S21 to any one of the involved devices.

Similarly to the one described in conjunction with Figure 7B, the device 1 can be the originator of the beacon signal. Therefore, also the device 1 can be assumed to transmit the beacon signals at regular or irregular intervals. It may now be assumed that device 12 receives a particular signal at time T2, whereas device 12' receives this particular signal at time T3. Again, the payload carried by the signal may be employed for facilitating identification and association of any received signals. The devices can obtain information on the receiving times T2 and T3 and can decode any payload to accomplish the mentioned association, so as to determine a time difference of arrival of one signal at different locations. This information may be fed back to the device 1. As for further possible ways of initiating the sequence, it is noted that the configurations shown in the Figures 6A to 7B can be modified so that a device 1 is passive and 'listening' until another device sends out a signal to initiate the process (ranging) . According to a further embodiment there is provided a system for estimating compliance indicating use of hygiene equipment by one or more users, the system comprising image acquisition equipment comprising one or more imaging devices being arranged to provide image information on an object in an environment, and processing equipment comprising a receiving section configured to receive the image information on the object from said environment; an image recognition section configured to process the received image information, to obtain a movement and/or behavior pattern of said object, and, as a result therefrom, to determine an opportunity event indicating an opportunity to use a piece of hygiene equipment and a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

According to a modification of the above embodiment, the camera 13 as shown in conjunction with Figures 1 and 2 can be adapted to implement the above-mentioned image acquisition equipment and imaging device. The environment may be the same or similar as the one as described so far in the present disclosure. Further, the processing entity 30 of Figure 4 can be well employed for implementing the mentioned receiving section, image recognition section, and calculation section. It is to be noted that, as soon as the opportunities and usage events are determined, the calculation of the compliance metric can proceed in the same way as described so far.

In general, as imaging devices any camera can be employed including low-cost and small cell- and smart-phone cameras that are coupled to local (e.g. Raspberry Pi) or remote (server, cloud, etc.) processing resources that perform the image recognition. In this way, one or more pre-trained objects can be recognized, including for example beds, bed side tables, bed-rails, dispensers, IV-catheters , catheter bags or other objects related to hygiene, and, in particular, hand hygiene. Further, health care workers (nurses, physicians, etc.) can be distinguished from others, such as patients, visitors, relatives etc. Such image recognition may involve a (virtual and computational) breaking down of a body into parts and detect joints - meaning that the system can locate or pinpoint the location of major joints in the body - thus drawing a "skeleton" or a "stick drawing" by joining the joints with straight lines. More importantly, this allows for detection of hands and other body parts and their movements, or, more generally, detection of behavior patterns (as opposed to movement patterns in which the movement of the entire object, e.g. human user, is traced and analyzed) .

This can further be employed in any one of determining opportunities (detect if the hands touch a "dirty object", e.g. catheter bag, bed-rail or bedside table) before touching the patient (or, to relax the rules a bit, at least before doing an invasive procedure such as touching an IV-catheter) ; determining a usage (the position of the hand versus the position of the dispenser can be measured to detect usage, and/or the position of the right versus left hand can be studied to measure time spent rubbing the alco-gel (which should be 30sec according to WHO) . All the above can be carried out in three-dimensions by processing image input from at least two imaging devices (e.g. cameras) observing at least an overlapping area of the same environment and respective stereoscopic image processing. Further embodiments specifically relate to an according processing entity and methods for estimating compliance.

Although detailed embodiments have been described, these only serve to provide a better understanding of the invention defined by the independent claims and are not to be seen as limiting .

Claims

Claims :

1. A system for estimating compliance indicating use of hygiene equipment by one or more users, the system comprising : locating equipment comprising one or more locating devices being arranged to provide information on a position of an object in an environment, and processing equipment comprising: a receiving section configured to receive the information on a position of the object from said environment; a first pattern recognition section configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment ; a second pattern recognition section configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

2. The system according to claim 1, further comprising at least a mobile device arranged to be carried by a user, wherein at least one of the locating devices is arranged to provide information on a position of the mobile device as an object in the environment.

3. The system according to claim 2, wherein the mobile device and at least one of the locating devices are configured to receive and/or transmit radio signals.

4. The system according to claim 3, wherein the mobile device and/or at least one of the locating devices is configured to obtain timing information indicating timings when radio signals are received and/or transmitted .

5. The system according to claim 4, wherein said timing information is processed for obtaining said information on a position.

6. The system according to any one of claims 1 to 5, wherein at least one of the locating devices is configured to receive radio signals, and to determine an angle of arrival of a received radio signal.

7. The system according to any one of claims 1 to 6, wherein the first pattern recognition section is configured to store one or more target patterns and to compare a recognized pattern to the one or more stored patterns for determining an opportunity event.

8. The system according to any one of claims 1 to 7, wherein the second pattern recognition section is configured to store one or more target patterns and to compare a recognized pattern to the one or more stored patterns for determining a usage event.

9. The system according to any one of claims 1 to 8, wherein during estimating compliance the calculation section is configured to employ any one of timing information relating to a usage and/or opportunity event, information on associating a usage event to an opportunity event, a trained function, and a rule.

10. The system according to any one of claims 1 to 9, further comprising an equipment sensor arrangement configured to generate usage signals in response of using a piece of hygiene equipment and a receiving section configured to receive the usage signals.

11. The system according to claim 10, wherein said equipment sensor arrangement is configured to sense any one of proximity of an object, a light intensity, an IR light intensity, an UV light intensity, a vibration, a sound, a weight, a force, an electric signal, a temperature.

12. A processing entity for estimating compliance indicating use of hygiene equipment by one or more users, the entity comprising : a receiving section configured to receive from locating equipment, comprising one or more locating devices, information on a position of an object in an environment; a first pattern recognition section configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment ; a second pattern recognition section configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

13. A compliance estimating entity comprising: a receiving section configured to receive from locating equipment, comprising one or more locating devices, information on a position of an object in an environment; a first pattern recognition section configured to determine, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment ; a second pattern recognition section configured to determine, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

14. A method for estimating compliance indicating use of hygiene equipment by one or more users, the method comprising the steps of: receiving from locating equipment, comprising one or more locating devices, information on a position of an object in an environment; performing a first pattern recognition for determining, from the received information, an opportunity event indicating an opportunity to use a piece of hygiene equipment ; performing a second pattern recognition for determining, from the received information, a usage event indicating a usage of said piece of hygiene equipment; and estimating said compliance based on determined opportunity events and usage events.

15. A compliance estimating system comprising: image acquisition equipment comprising one or more imaging devices being arranged to provide image information on an object in an environment, and processing equipment comprising: a receiving section configured to receive the image information on the object from said environment; an image recognition section configured to process the received image information, to obtain a movement and/or behavior pattern of said object, and, as a result therefrom, to determine an opportunity event indicating an opportunity to use a piece of hygiene equipment and a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.

16. A compliance estimating entity comprising: a receiving section configured to receive image information on an object from an environment; an image recognition section configured to process the received image information, to obtain a movement and/or behavior pattern of said object, and, as a result therefrom, to determine an opportunity event indicating an opportunity to use a piece of hygiene equipment and a usage event indicating a usage of said piece of hygiene equipment; and a calculation section configured to estimate said compliance based on determined opportunity events and usage events.