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Context Sensitive Navigation in Hospitals
Jan Balata, Miroslav Macik, and Zdenek Mikovec
Department of Computer Graphics and Interaction, Faculty of Electrical Engineering,
Czech Technical University in Prague, Czech Republic
{balatjan,macikmir,xmikovec}@fel.cvut.cz
http://dcgi.felk.cvut.cz
Abstract. In this paper we introduce an in-hospital navigation system suitable for motor im-
paired, visually impaired and elderly people. GPS localisation and Wi-Fi triangulation are often
not suitable in indoor environments due to poor signal or complicated calibration. We present a
navigation system that does not depend on precise electronic localisation aids. User interfaces used
are automatically accustomed to target user’s abilities and preferences. Four different terminal
types are used for the navigation system prototype.
Keywords: navigation; UI generation; context modelling; accessibility
1 Introduction
The way finding in hospitals is a problem that is be-
ing solved in many hospitals around the world. A
study of a major tertiary care hospital, conducted
by the Robert Wood Johnson Foundation[1], cal-
culated the annual cost of way-finding at $220,000
mainly due to the time spent direction-giving (more
than 4,500 staff hours) by people other than in-
formation staff. Navigation and orientation in un-
known environment can be a challenging task for
people with limited ability of navigation and ori-
entation. Especially motor impaired, visually im-
paired, and elderly people have difficulties with ori-
entation in complex buildings like hospitals. Reduc-
ing the probability of getting lost and dependency
on other people during navigation reduces the level
of stress and increase the self-confidence.
We propose a navigation system NaviTerier UIP
(NUIP), which focuses on navigation support for
users with limited ability of navigation and orienta-
tion. In particular we target three main user groups
- visually impaired, people using wheelchair and
elderly people. The NUIP navigation system inte-
grates results of our previous research. Navigation
is based on our know-how in navigation of visually
impaired in an unknown environment – NaviTerier
project [2]. Generation and delivery of personal-
ized UIs accustomed to abilities and preferences
of individual users is realized using integration of
the UIP platform [3]. NUIP navigation system ad-
dresses the following objectives. First, it provides
a routing algorithm to generate an optimal route
corresponding to user abilities. Second, it provides
personalised descriptions of the routes. Finally, it
generates user interfaces (UI) adapted to specific
needs of our three user groups.
2 Related Work
Logic Junction system [4] is a navigation system de-
ployed in the Cleveland Clinic’s main campus. The
navigation is realised by a touch-controlled naviga-
tion panel. Avatars communicate with users in or-
der to make the interaction more natural. The sys-
tem is capable of providing turn-by-turn route de-
scription as well as presenting the route on a map.
Route description can be also printed or sent to
user’s mobile phone. Logic Junction navigation sys-
tem provides very good navigation for users without
limited abilities of orientation and navigation. Un-
fortunately, the current version lacks accessibility
features for visually impaired people and adaptive
route planning for people with motor impairments.
It is also questionable if the system is suited for use
of elderly users.
In Japans Kanazawa Medical University Hospi-
tal there is deployed a navigation system based on
3D visualisation of routes [5]. It uses an OpenSim-
ulator virtual world server [6] to depict the hospital
layout, connected to a touchscreen monitor. 3D vi-
sualisation of the route can be suitable for users
experienced with good spatial orientation, but is
not suitable for users with limited orientation and
especially for visually impaired people. This system
does not provide route optimisation for people with
motor impairments.
Accordingly to Fallah et al. [7], navigation sys-
tems based on GPS are not suitable for indoor us-
age because of missing GPS signal. Similarly in-
door navigation systems based on Wi-Fi localisa-
tion are expensive to maintain. Neither of those sys-
tems provides navigation information, routing algo-
rithms, and user interfaces suitable for people with
special needs.
2
(a) (b)
Fig. 1: Accessibility problems found in current nav-
igation system of the hospital. Main hospital infor-
mation panel (a). Horizontal navigation line (b).
NaviTerier [2] project deals with design and im-
plementation of a navigation system for visually im-
paired people inside buildings using a regular mo-
bile phone. This system does not require any spe-
cialised technical equipment. It relies only on mo-
bile phones with voice output, which visually im-
paired people already use. The navigation system
works on a principle of sequential presentation of
carefully prepared descriptions of the building seg-
ments to visually impaired user by means of mobile
phone voice output.
Regarding user capabilities and preferences, most
designers of current systems try to solve the prob-
lem of disabled users by means of introducing var-
ious assistive technologies. Better solution to this
problem is Ability-based design [8]. It employs
context-awareness to provide adaptations to user-
specific abilities, instead of forcing users to use a
specific assistive technology. In order to provide
context-aware adaptations, there must be a context
model. Context models typically consist of models
of user, device, and environment. According to [8],
the problem with currently used context models is
that they leverage the users’ disabilities rather than
the users’ abilities.
3 Field Study
We have conducted an expert evaluation of the cur-
rent in-hospital navigation system used in Univer-
sity Hospital in Motol (see figures 1a and 1b). We
found out that coloured horizontal navigation lines
are not raised above ground level thus visually im-
paired people cannot be use them. In many cases
these navigation lines continue through walls as an
effect of recent reconstructions. Most elevators lack
description of floor buttons in Braille code. Another
source of orientation and navigation problems is a
high axial symmetry of the hospital building.
Other findings emerged from the interview con-
ducted with one of the doctors. The doctor men-
tioned that s/he has encountered a situation when
UIP Server
UI Generator
Smart kiosk
Smartphone
Simple
navigation
terminal
Smart tactile
kiosk
Context model
Device
model
User
model
Environ-
ment
model
AT
model
NaviTerier navigation system
Navigational
description Map
Application
backend
Patient
appoint-
ments
AUI CUI
Last
position
Access
rights
CUI
CUI
CUI
Fig. 2: NUIP architecture overview.
elderly people lost their orientation in the hospi-
tal. Concurrently s/he said that if s/he has doubts
whether patient can navigate safely s/he could
manage patients escort by hospital attendant.
4 NUIP navigation system
Our navigation system combines several methods
that provide personalised information for people
with special needs. First, we developed a route plan-
ner, which supports customising of the route ac-
cording to the user abilities and preferences. Sec-
ond, we developed a navigation description genera-
tor, which creates description of the route with re-
spect to the users limitations. Finally, our context-
sensitive UI generator [3] adapts the user interface
according to navigation terminals and personal de-
vices used during the navigation.
Figure 2 depicts architecture of the proposed
NUIP in-hospital navigation system. The central
component is the UIP Server, which is connected
to a navigation planner that generates navigation
plan according to users abilities and preferences.
The UIP Server is also connected to the in-hospital
information system (Application backend) to get
information about patients planned appointments,
access rights and last position of the user.
5 Results
Individual components of our system have been
implemented in the framework of the NaviTerier
project [2] and in the framework of User Interface
Platform (UIP) project [3]. User testing showed
that NaviTerier navigation system provides efficient
navigation of blind people in both outdoor and in-
door environments. In the framework of the UIP
project an in-hospital navigation system based on
various terminals with adaptive UIs have been de-
veloped (see figure 2).
3
Fig. 3: Smart kiosk.
Fig. 4: Simplified navigation terminal.
Figures 3 and 4 show an example of generated UI
for Smart kiosk and Simplified navigation terminal.
The Smart kiosk provides a generic UI that adapts
to users abilities as soon as the user identifies him-
self/herself. Besides a traditional form-based login
the identification is possible by scanning invitation
letter directly through the kiosk display surface.
The Simplified terminal serves as interaction point
at the corridor junctions. It provides simple direc-
tional instructions to the user. Any in-hospital ter-
minal can be used for calling help in case of an
emergency.
Figure 5 shows a Smart tactile kiosk. The Smart
tactile kiosk compounds of a passive tactile map
frequently used for passing navigation and environ-
ment information to visually impaired people [9],
and active tactile segments which erect from the
passive map to form a navigation route. The active
tactile segments feature coloured diodes to convey
the information easily to sighted people.
Passive tactile floor plan
Inactive tactile segments
Active tactile segments
Fig. 5: Smart tactile kiosk.
6 Conclusion
In this paper we present a navigation system that
addresses problems of navigation of people with
limited navigation and orientation capabilities in
the hospital environment. Route planning, its de-
scription as well as UIs are automatically gener-
ated with respect to user abilities and preferences.
The system introduces four types of terminals with
adaptive UIs that provides efficient navigation.
Acknowledgements
This research has been supported by the project
Design of special user interfaces funded by grant no.
SGS13/213/OHK3/3T/13 (FIS 161 – 832130C000)
and it has been supported by the Technology
Agency of the Czech Republic under the research
program TE01020415 (V3C – Visual Computing
Competence Center).
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