Health Informatics and -Technology (HIT)
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About 

The Health Informatics and -Technology (HIT) group (former: Medical informatics & telemedicine (MI&T) group) at the Department of Computer Science, Faculty of Science and Technology, UiT The Arctic University of Norway was established in 1994-95. From the beginning, the group has been responsible for teaching Medical Informatics / Health Informatics courses. In the years 1995-2015, the HIT group was closely connected to Norwegian Centre for Integrated Care and Telemedicine (NST)  and the Norwegian Centre for E-health Research (NSE) (2017-2018). The group has a long tradition working with clinicians at the University Hospital of North Norway (UNN).

The research group

The HIT group has currently 3 full professors, 1 ass. professor, 1 professor II, 1 assoc. prof. II, 1 visiting professor, 8 research fellows and a varying number of MSc students. The research group is responsible for an integrated master’s degree in health technology, experience-based master’s degree in digital health services and participates in the department’s bachelor’s, master’s, and PhD programs. Since 2000, the HIT group has graduated 17 PhD candidates and over 80 MSc candidates. Three of these PhDs achieved in 2014 (n=2) and 2021 (n=1) academic competence as full professor in eHealth/Health Informatics. During the same period, the members of the research group have published more than 300 scientific articles in journals and conference proceedings.

Description of research activities

In the Health Informatics and Technology (HIT) research group, we are doing research on how we with various technological tools can contribute to better treatment, self-help, and quality of life for people with chronic conditions. We are also studying how to improve public health for vulnerable groups, and the general population, through increased physical activity and better knowledge about one’s own health. These are all global health challenges.

Most of the research in the group is international with active participation of researchers in Europe and the USA.  The members of the research group participate in several EU-funded projects.  Our projects usually include clinicians and patients and/or users from different groups in the population.

Existing research in the HIT group

Research in the HIT group is mainly experimental where we develop and test various health applications, either as part of larger clinical trials or as explorative projects. Health informatics research is by its very nature interdisciplinary. The aim of the research is to contribute in both (health) informatics and health sciences. This also means that large parts of our publications are indexed in PubMed/MEDLINE.

Our research includes various aspects of m-health, e-health, telemedicine and medical informatics, especially self-help systems for people with chronic conditions, electronic health surveillance, social media and serious games for people with chronic conditions, medical sensor systems, human-computer interaction (“HCI”) for mobile systems,  telemedicine systems for private homes, motivational mechanisms in e-health, telehealth, sensor equipment for physical activity, m-health applications for people with cognitive impairment, digital communication with patients and context-sensitive communication.

The group has a long tradition of working with clinicians at the University Hospital of North Norway (UNN) and other hospitals and health institutions. The projects are funded by the EU’s Horizon programme, the Research Council of Norway, the Northern Norway Regional Health Authority, the Tromsø Research Foundation, and the Regional Research Fund. In addition, UiT of course contributes a significant share of the funding in the form of operating funds, research fellows and academic staff’s research time. In the following sections, we present a selection of research topics and areas that we research.

Diabetes

The biggest activity in the HIT group is in diabetes. The research on diabetes, which started over twenty years ago, aims to improve the treatment and quality of life of people with diabetes (type 1 and type 2). The diabetes diary (“Diabetesdagboka”), which was developed in collaboration with a group of people with type 1 and 2 diabetes, has since 2008 been adopted by thousands of users in Norway, the Czech Republic, and some English-speaking countries. The diabetes diary has been used in several clinical trials, RCTs and technological research projects in diabetes. These include:

  • Bluetooth-based blood glucose meter: By connecting the blood glucose monitoring device to our proprietary Bluetooth unit, blood glucose values could automatically be transferred to a diabetes diary on the patient’s phone. When this was developed in 2002, there were no similar solutions on the market.
  • Digital diabetes diary (“Diabetesdagboka”): Norway’s first (and only) digital diabetes diary was first developed for type 2 diabetes in 2008, for type 1 diabetes in 2010 and then a diary for both variants of the disease, launched on Google Play and Apple’s app store in 2013.
  • Bluetooth-based step counter: Sensor for recording physical activity with automatic transfer of data via Bluetooth to the diabetes diary app, with motivational feedback to the user. This was developed in 2008, several years before today’s smartwatches got this feature.
  • Smartwatch version of the Diabetes diary: In 2014, this was the first diabetes app for smartwatches.
  • Visual display of blood glucose value: By connecting the app “Diabetesdagboka” to a light bulb that changed colour depending on whether the blood glucose was above, within or below the recommended blood glucose value, it was possible to quickly see whether the user/patient was at risk of hypoglycaemia or hyperglycaemia. The measured values were communicated from the smartphone via a cloud solution, which in principle made the values available to everyone who had access to the cloud solution. This feature was introduced in 2011.
  • Talking robot for children with diabetes: Using Raspberry Pi, Amazon Alexa, and a smart toy figure (Furby), we developed in 2016 a diabetes buddy for children with type 1 diabetes who used the Diabetes Diary. The toy figure told the child about when they needed to take insulin and taught the child about the connection between nutrition and blood glucose.
  • Games for children with diabetes: Using various computer games, the children gained knowledge about how different foods affected their blood glucose and what measures were needed to stabilize blood glucose.
  • Juice machine for optimal control of blood sugar: Many people with type 1 diabetes have difficulty regulating their blood glucose value. It tends to be too high or too low. If blood glucose value is too low, sugar must be added to avoid serious injuries. At the same time, it is important not to take too much sugar because then the blood glucose value becomes too high. In 2018, we developed a juice machine that receives information about the person’s blood glucose value from the Diabetes Diary so that an optimal amount of sweet juice (containing sugar) can be bottled up.
  • Mobile juice machine for optimal control of blood sugar: Mobile version of the juice machine is now (2023) under development. The goal is that people at risk of hypoglycaemia (low blood glucose) during physical activity should be helped to consume the right amount of carbohydrates before they reach critically low glucose levels.
  • Notification of the spread of infectious diseases: By analysing data from the Diabetes diary, i.e., blood glucose, insulin, and carbohydrates, we have developed a method for detecting the spread of infectious diseases at the earliest possible stage and before people who are infected know that they are infected. The aim of the project is to develop an alert system for infection in the population.

Another result of the diabetes research is Hubro, a system for easier administration of all phases of clinical trials.

Together with researchers, health professionals and engineers at Oslo University Hospital, the University of Oslo, the Norwegian Diabetes Association and Abel Technologies, we are conducting a study of the effects of weight loss, physical activity, and close follow-up of people with pre-diabetes and type 2 diabetes. The research question is whether it is possible to achieve full remission of type 2 diabetes through such an intervention.  The project involves several of the country’s foremost researchers and clinicians in diabetes research.

The research group is currently participating in two Horizon projects where the issues include artificial intelligence and diabetes. In the WARIFA project (Watching the risk factors: Artificial Intelligence and the prevention of chronic conditions), we are researching how we can detect pre-diabetes, as well as complications of the disease, by analysing various risk factors. The main objective of WARIFA is to develop a personalized risk assessment system that can be used to support individual preventive measures for non-communicable diseases, such as cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes, i.e., the leading causes of death in the world. The system will be available to the individual citizen and patient on their smartphone via the WARIFA app. The AI-based technology developed in the project will also be made available to other third-party applications. The WARIFA app provides a personalized set of lifestyle recommendations according to the individual risk profile identified using AI technology. In this way, the user should be motivated to improve unhealthy habits and choose good lifestyle choices. People at very high risk of developing non-communicable diseases are advised to contact health care professionals.

Another Horizon project is HEIR (A holistic cyber-intelligence platform for secure healthcare environments). The aim of the HEIR project is to facilitate vulnerability assessment, status monitoring and threat hunting in real time based on reliability logic, consisting of forensic services and a SIEM module (Security Information and Event Management) that provides intelligent warnings about real-time security, privacy, and data protection to all stakeholders in the healthcare ecosystem.  Four complementary end-users (HYGEIA, PAGNI, NOKLUS and CUH) with leading roles in the health domain will validate, demonstrate, and conduct experimental evaluation of the proposed framework on four different health pilots in sensitive medical environments. The HIT group is involved in proposing a new and secure way of transferring health data directly from the patient to NOKLUS, the national diabetes registry for adults with diabetes.

We have previously participated with our diabetes research in two other EU projects – Renewing Health and FI-STAR. In Renewing Health (Better Solutions for Citizens with Chronic Conditions), the goal was to involve the patient in their own coping and treatment, and in this way achieve better health and user satisfaction. The project dealt with monitoring and treatment of patients with chronic conditions, including diabetes, COPD, and heart disease.  In FI-star (Future Internet – Social Technological Alignment in Healthcare), the goal was, among other things, to implement the “Future Internet Private-Public Partnership” in healthcare. This was to be done by providing society with standardized and certified software, including a safe, secure, and resilient platform, taking advantage of all Cloud Computing benefits and guaranteeing the protection of sensitive and personal data traveling in public cloud solutions. We participated here with further development of services related to the self-management app “Diabetesdagboka”.

These were some of the results of our diabetes research. Our efforts in the research field have, among other things, led to us being represented in the Norwegian Diabetes Association’s Medical Advisory Council, the Technological Expert Group in Diabetes, the editorial board of the international diabetes journal Diabetes Science and Technology.  There is no doubt that diabetes represents a global health challenge. The World Health Organization (WHO) reports that the number of people with diabetes increased from 108 million in 1980 to 422 million in 2014.[1] The International Diabetes Federation (IDF) reports that in 2021, there were 537 million people in the 20-79 age group who have diabetes, and that the number is expected to increase to 643 million in 2030 and 783 million in

2045.[2] Three out of four adults with diabetes live in low- and middle-income countries, which is particularly challenging since the resources to treat and combat diabetes are unequally distributed. The IDF claims that 541 million adults are at risk of developing type 2 diabetes. All our results in diabetes can potentially contribute to the improvement of global health.

Intellectual disability (cognitive impairment)

In addition to diabetes, we are researching how we can use different types of mobile health systems (m-health) and gaming technology to contribute to increased physical activity and thereby also better health and improved quality of life for people with intellectual disabilities.

In the project “Effect of physical activity with e-health support in people with intellectual disabilities” (PA-ID), the goal is to strengthen physical activity in adolescents and adults with intellectual disabilities, or cognitive impairment as it is now called. Compared to the general population, people with cognitive impairments have poorer health, lower activity levels and greater barriers to participating in exercise activities and accessing established health services. Since low physical activity is a determinant of health, and as increasing activity has positive effects on cardiovascular and psychosocial health, it is very important to identify effective interventions for use in everyday settings.

The goals of this project include integrating theory with users’ need to design a flexible person-centred physical activity program using motivational e-health support in natural settings, and further test the activity program in adolescents and adults with cognitive impairment. Users and user organizations are involved in all stages of the project. The project is funded by Northern Norway Regional Health Authority and led by Audny Anke, professor and senior physician at the University Hospital of North Norway (UNN). The HIT group has contributed to the development of several apps aimed at people with cognitive disabilities. The app Sorterius, like a Pokémon Go-inspired game, where the goal is to sort the garbage that pops up on the phone as the user moves. In the training app AGA, the user will repeat exercises that an avatar performs on the phone. In the cycling app, the user can watch movies or cycle through a landscape where different effects appear. The display stops when the user stops cycling. The first app is available on the App Store and Google Play, while AGA is not currently widely distributed. Most apps are available in Norwegian and English.

In the Erasmus+ project MOVE-IT, Sorterius and AGA are translated and adapted into Spanish, Portuguese and Italian. The apps are also being systematically tested by users at several Spanish and Portuguese institutions for people with cognitive impairment. The project also prepares training materials related to the applications.

Population studies and general physical activity

A significant activity in the research group is mapping and measuring physical activity using different types of activity sensors (smartwatches from several manufacturers, Oura rings, ActiGraph, Actiheart, etc.). This is carried out in collaboration with researchers at the Department of Community Medicine, UiT, and researchers affiliated with the Tromsø Study. Here we have also developed mSpider, which is a back-end solution for receiving and storing such data from various sensors.

mSpider started as a project in UiT’s strategic inititiative on Population studies in the North (BiN). One of the goals of the work with activity sensors and mSpider is to develop an infrastructure for collecting and storing health-related data that can be used in upcoming editions of the Tromsø Study. The goal is for as many participants as possible to collect as much health-related data as possible over the longest possible period. This data can then be made available to future users of data from the Tromsø Study.

In the research group, we still have two PhD students affiliated with BiN.  In one of the PhD projects, the goal is to develop a (rudimentary) digital twin that can then be used to identify health changes at the earliest possible time. Input is, among other things, from smartwatches and smart scales.

In the second PhD project, research is being conducted on lifestyle modelling based on accelerometer raw data, mainly from the Tromsø Study. The project uses, among other things, deep learning methods to distinguish between different phases in the week-long 100 Hz 3-axis time series measured with ActiGraph sensors of over 6000 participants. The phases include episodes in which the sensor was not on the body (non-wear time), sleep, sedentary, light, and moderate-to-high physical activity.

mSpider will be used in RESTART project in the period 2023-2027. RESTART is funded by the Research Council of Norway and is a full-scale RCT where the goal is to evaluate whether a complex lifestyle intervention can establish long-term improvements in risk factors and physical capacity in older people at high risk of cardiovascular disease. mSpider will be used to collect activity data from smartwatches worn by participants over four years of age.

All the sub-projects in this group work with global issues.

Migraine

In the migraine project, we collaborate with researchers at the Department of Community Medicine, UiT, on using sensors to predict migraine attacks. Migraine is neurological chronic disease that causes pulsating headache attacks, often long, frequent, and severe. If one can predict upcoming seizures early enough, it is possible to reduce the symptoms or prevent the seizure altogether.

We are working on developing a system for collecting sensor data from a research-based wrist sensor (watch) that has a high measurement rate of, among other things, acceleration, and wrist pulse. The aim of the project is to collect data over time from patients with migraine, use relevant machine learning methods to detect migraine attacks before they occur, and make recommendations back to the patient based on this.

Sickle cell anaemia

Together with researchers at the University of Geneva and Karolinska Institutet in Stockholm, we have researched the development of self-help systems for people with sickle cell anaemia.  This is a genetic and chronic disease that affects people of African ancestry. The disease arose by a mutation in which red blood cells were shaped like a sickle. This was supposed to protect against malaria, but unfortunately this also had several side effects in the form of blood clots and anaemia because of the shorter lifespan of the sickle-shaped blood cells. The disease is characterized by high morbidity and mortality. Although globally there are 25 million people with sickle cell anaemia and every year 300,000 children are born with the disease, there is minimal research on this disease or specialists are trained on the disease. The consequence is that patients are left to fend for themselves and in many countries receive minimal follow-up.

In this project, we have worked on the development of a self-help system for patients with sickle cell anaemia. The goal of the system is to contribute to the healthiest possible lifestyle and contribute information about the disease. Sickle cell anaemia is so complex and the provoking factors of symptoms so many that only 1% of patients are even able to cope with the disease. The project is part of the research project “Reusing Heterogeneous Health Information to Empower People with SCD” at the University of Geneva.

Motivation and persuasive technology

A common problem for treating people with chronic conditions is motivation to be in a continuous treatment program. The use of mobile health applications (m-health apps) for follow-up of one’s own health is important to improve the health effects for patients with chronic conditions. These applications range from disease management apps (e.g., diabetes diary) to health and fitness apps (e.g., diet apps and fitness apps). However, there seems to be a lack of motivation on the part of most users to continue using these health apps for an extended period. This may be due to the way these apps were designed and developed, i.e., lack of user/patient participation in the design, development, and testing of the applications. The goal of the motivation project is to identify motivational factors that will increase the use of m-health apps. Researchers from Norway, Switzerland, Spain, and the USA participate in projects.

Telemedicine

From the mid 1990’ies and until the centre was closed in December 2015, several of the HIT group’s members held full or parttime positions at the then Norwegian Centre for Telemedicine (NST). From around the year 2000, most of the research in the group took place in connection with NST. The group’s master’s and PhD students also had their daily work on the premises of NST. The research activity was mainly in self-help systems for people with chronic diseases, electronic disease surveillance, context-sensitive systems, and digital health services. In 2006, something happened that, in a positive sense, would have major consequences for the research in the HIT group – UNN/NST received a grant from the Research Council of Norway to establish Tromsø Telemedicine Laboratory (TTL), one of Norway’s first 14 Centres for Research-based Innovation (SFI). Professor Gunnar Hartvigsen, head of the HIT group, became centre director for TTL, professor Eirik Årsand led R&D in diabetes, and the group’s other members were given various positions in the centre. TTL gave us all an opportunity to intensify and scale up research, which meant a sharp increase in the production of scientific publications and master’s and PhD candidates. We also had funds to attend international conferences, send our students and researchers on shorter or longer stays at outstanding universities and research institutions and invite international researchers to spend a few weeks or months in Tromsø. In this way, our international network was also significantly strengthened.

Through the opportunities TTL provided, we were able to enhance or establish extensive collaborations with several of the world’s foremost environments in telemedicine and medical informatics, including the University of Washington, Seattle, USA; Illinois Institute of Technology, Chicago, USA; University of California, Davis, USA; University of Texas Health Science Center, Houston, USA; Columbia University, New York, USA; Technische Universität München, Germany; Czech  Technical University, Czech Republic;  Technical University of Valencia, Spain; University of Geneva, Switzerland;  Aalborg University, Denmark; and Karolinska Institutet, Sweden. We have subsequently expanded our collaboration to several other international research communities.

HIT Group’s contribution to national and global health

Over the past 25 years, research in the Health Informatics and Technology (HIT) research group has contributed with research in diabetes, cognitive impairment, sickle cell anaemia, public health studies and public health. Our research is experimental, and the results are mainly published within PubMed/MEDLINE-indexed journals. The projects use various medical sensors, telemedicine equipment and health applications. The research group collaborates with several national and international researchers and research groups in health and technology. The group has established extensive collaboration with the clinical community at the University Hospital of North Norway (UNN), Oslo University Hospital (OUS) and researchers at the Norwegian Centre for E-health Research (NSE).

The health challenges that the group’s members do research on, are mainly global. The HIT group’s main goal is to contribute to combating some of the major health challenges on a global basis. We do this mainly in collaboration with research groups in Europe and the USA.

[1] https://www.who.int/news-room/fact-sheets/detail/diabetes

[2] https://idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html

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