2007/12/03 - ICUTalk released as opensource; for more information visit oatsoft.org
2007/01/24 - ICUTalk website has been archived into a simple page (for now at least)... i had thought about other routes (e.g. cms / wiki) but since we're not doing much work on it at the moment that seemed to be overkill. If you have any enquiries please get in touch with me. Althought the ICUTalk research is currently in limbo, it is something i'm keen to discuss and develop further... it clearly made in impact in the AAC and ICU communities and it would be a real shame if it doesn't get developed further. If you have ideas / want to get involved please do get in touch with me. ICUTalk is software designed specificaly for use in ICU, but the problem is not just a software issue, there are significant hygene issues in all hospitals and even more so in their ICUs. As such, any device that is going to be used and touched by patients has to withstand thorough cleaning... so after lots of searching, our current favoured platform is the ixplore ruggedised tablets (discussed below). As far as the software goes, i'm trying to prepare a decent version for the first open source release, in the mean time you can see it demo'd in a screencast.
2006/09/23 - ICUTalk was my first research project and the basis for my phd. I'm now finding i don't really have the time to maintain it or even develop it further, but i really wish i could especially as interest in this problem & our solution is increasing. The consortia have decided to open source icutalk - so once some key fixes are sorted i'll update the icutalk website (which i started doing months ago); then i'll work on releasing the software, developing the documentation, and seeking the help of others... probably via the oatsoft community (which i'm involved in). There is a lot to be done, but i see this as a great moment, and a key stage in the future of icutalk... now we can work together to make communication in an extreme situation plausible, simple and beneficial. Once i've completed several key tasks (e.g. floss licensing, speech volume) i'll make the source / executables available on this site, but in the mean time, please get in touch if you are interested in getting involved either as a developeror as a user such as Ninewells Hospital ICU.
2005/12/08 - ICUTalk has been, on one level in limbo (because our funding expired), but on another progressing (as my phd). With increased knowledge and wider interest in ICUTalk, we're planning to re-introduce the system at ninewells in the next few months. The software has both, grown and simplified since 2002. New hardware has appeared on the market that's smaller and in theory robust enough for the ICU environment. Over the past few years, and particularly the recent months there has been many requests to get hold of / purchase icutalk, and now I hope to be able to direct my attentiontowards this. Please get in contact with me if you are interested.
2002/11/05 - ICUTalk project has completed its 3 years of initial research. Over the three years the project specified, designed, built and evaluated the ICUTalk device with a total of 19 patients. The software was designed specifically for intubated patients in ICU who are alert and attempting to communicate, but unable to write. The ICUTalk system contains a database of phrases, some of which are common to all patients and some of which are patient specific. Providing this communication aid for intubated patients in ICU has demonstrated several important points. Patients would like something to help them communicate. Nurses and medical staff would like something to help patients communicatemore effectively and efficiently. The success of this project has been partly due to the multi disciplinary nature of the research, which has utilised expert knowledge and experience from members of the research team. An initial prototype was built and tested with 17 patients and then a refined ICUTalk incorporating a smaller portable platform was evaluated with a further 2 patients providing positive results. Staff feedback suggests that the reduced size of the new platform will make integration into ICU eminently more viable. The response from the international ICU community has been extremely positive with offers to trial and/or purchase ICUTalk. This research, although preliminary, has provided a prototype solution to a problem which affects patients, relatives, nurses and other medical staff at a time when effective communication is seen as an important part of the patients’ holistic care. Funding is currently being sought for a multi-centre randomised control trial to evaluate the effectivenessof ICUTalk in augmenting the communication of intubated patients.
2002/10/06 - ICUTalk - "An innovative new system developed at the University of Dundee to help people in intensive care communicate with relatives and friends has been selected for a British Computer Society Award medal." The panel unanimously decided that the University of Dundee project was a worthy member of the final group of 9 medallists in a competition open to all UK companies and universities. Professor Ian Ricketts, the new head of the Division of Applied Computing led a team of researchers to develop the ICUTalk system. He will attend an award ceremony along with other members of the team in London next month where they will demonstrate the project and may yet secure the overall title of British Computer Society Award for IT." [University of Dundee Press Release 2002/10/08]. Unfortunately we did not win one of the overallawards, but we were really pleased to be one of nine medalists.
The ICU patient is critically ill and in the majority of cases the patient has the support of an artificial ventilator to augment their breathing. A side effect of artificial ventilation is the incapacity for the patient to speak; combine this with the affects of their condition, the treatment they receive, the ICU environment and the array of drugs controlling their pain and sedation,then a patient's visit to ICU becomes a highly emotional and frightening experience.
In 2002, Scotland 's 8748 ICU patients stayed in the unit on average 2 days, 21.9% of them died as ICU patients, and a further 7.5% died as patients on another ward. Communication is believed to be an important factor in improving ICU patients' overall experience of intensive care, their well-being and their chances of survival. To date, though, little has been successfully achieved with Augmentative and Alternative Communication (AAC) methods in ICU. Current methods used by patients include: mouthing, gesture, and alphabet charts. However, these have been shown to be time consuming and frustrating. The investigation of ICU patients' usage of VOCAs has really just begun. In 2000, positive results were reported on the usage of a commercial VOCA where patients were trained prior to their visit to ICU. A study in 2004 reported further promising results with VOCA usage by patients who were not trained prior to their visit; this study did however find that device complexity, among other factors, to be a significant drawback. In both of these studies the VOCAs used were designed for the long-term AAC user, that is, they used abstract symbolic images to link to pre-stored conversational items. Existing VOCAs are designed for the long term user and in many instances use symbolic representations of language concepts or symbolic representation to link to pre-stored conversational items. Although off-the-shelf VOCAs can be used for non-elective ICU patients, the environment, impact of medication on the patient's ability to concentrate and the limited duration of stay means that the patient is not able to receive the time needed for training. Training ICU patients to use VOCAs that require hours of training is thus difficult, if not impossible to deliver.
ICUTalk was a research project, funded by the Engineering and Physical Sciences Research Council (EPSRC) from 1999 to 2002. The project developed an Augmentative and Alternative Communication (AAC) system to help patients in Intensive Care Units (ICU) who are temporarily unable to speak due to their medical condition or treatment, namely the intubation procedure. This was a multi-disciplinary collaborative project involving staff from Dundee Speech & Language Therapy Department, Ninewells Intensive Care Unit and the University of Dundee’s Department of Applied Computing and School of Nursing & Midwifery. The core research team consisted of four members, with serveral managers from different disciplines, and Professor Ian Ricketts as the principle investigator.
Following a user-centred design methodology, the development of ICUTalk provided patiets with 3 possible interfaces: the first and second interfaces provide alternative layouts to approximately 200 pre-stored text-based utterances, organised into 8 categories; whilst the third provides an alphabet board. Following the development and pilot evaluation stages, the system was introduced to the Ninewells Hospital ICU (Dundee, Scotland), for evaluation by patients over a 1 year period. Based on the evidence collated through various questionnaires and automated logging, ICUTalk was shown to be successfully used by patients after about 5 minutes of training. The results of the ICUTalk research show that a (bespoke) VOCA could be used by ICU patients, though there is still a lot to be learnt and improved. Conventional VOCAs, however, may not be the most appropriate solution as they are usually designed for a vastly different user group.
Due to the nature of the ICU environment, you can't just use any old pc or laptop. The hardward needs to be robust and cleanable, ideally a ruggedised tablet pc should be used. Thus you need to think carerfully about the hardware you choose to run the system. We recommend the ix104c2 dual mode tablet pc from xplore technologies which are extremely rugged and sufficiently powerful.
ICUTalk will be released under the GPL open source license model, as such you'll be able to download and use the software for free. I'm currently working on a version suitable for this first public release... so watch this space.
ICUTalk is designed to run on tablet PCs, thus it requires a Microsoft Windows, Java 1.4.2; it makes use of the Microsoft Speeh API, and can interact with third party speech engines (e.g. the high quality and expensive Cepstral voices) as well as the basic but free Microsoft voices. The system is designed to run at a resolution of 1024x768, and there are currently 3 different interfaces for patients to use for communication, the alphatbet board, boxes and bubbles. Screenshots of each interface are below, and there is a screencast you can watch of ICUTalk being used.
AlphabetBoard
Doctorates
Journals
Conferences
Awards
Articles
Reports, Magazines & Newsletters
EPSRC Engineering & Physical Sciences Research Council Funding Grant of £250,000 for 1999 - 2002.
Development Team
University of Dundee Applied Computing
Management Team
University of Dundee Applied Computing
University of Dundee Nursing & Midwifery
Ninewells Hospital Intensive Care Unit
Ninewells Hospital Speech & Language Therapy