G. Boopathy, E. Aoki, F. Norcéide, C. Thompson, E. Lewis and K. Chandra, 2025 IEEE International systems Conference (SysCon), Montreal, QC, Canada
The need for point-of-care health solutions and digital health interventions continues to increase, driven by an aging population and those displaced from the systemic impacts of environmental, infrastructural, and economic factors. These demographic and social shifts are placing unprecedented strain on the
healthcare system. In response to these challenges, digital health solutions are emerging, although data indicates low confidence among both consumers and healthcare professionals due to a lack of regulatory oversight compared to traditional medical systems. This research explores the use of augmented reality (AR) technology in physical therapy and rehabilitation as a potential digital health intervention. The focus is on improving upper limb and hand mobility. This study em
ploys a digital engineering design process in collaboration with physical therapists and clinical researchers. The goal is to utilize data from the AR sensors to capture quantitative information about a patient’s therapeutic progress. The Digital Engineering framework presented can be applied for improving the validation and verification of technology-based digital health interventions, with the potential to enhance access to rehabilitation resources. Use-case and requirement diagrams are developed through close collaboration with physical therapy clinicians, to assess user engagement and therapeutic outcomes. Activity diagrams capture successive stages of improvement in the proposed system. The performance of the AR application in tracking joint angles and measuring mobility during prescribed gestures is evaluated against published normative values, highlighting the potential of this technology to improve upon manual measurement methods.
Batarseh, O; Chandra, K; Aoki, E; Norcéide, F; Boopathy, G; and Lewis, E. INCOSE HWG Systems Engineering in Healthcare Conference 2025.
The digital transformation of healthcare organizations is taking place on many different levels ranging from digital platforms for patient management to digital health solutions with emerging technology. Even as technology advances at a rapid pace with potential fo
r more equitable access to healthcare, culture and mind-set, organizational structure and governance have been cited by medical experts as the key barriers to digital transformation. We investigate the application of modern system engineering tools and methods for engaging healthcare professionals, systems engineers and other stakeholders in a collaborative effort to drive this transformation. The Unified Architecture Framework (UAF) is considered for digitally capturing strategic elements such as vision, goals, missions, capabilities, along with resources, and security profiles and connecting them to the roadmaps within UAF. This approach will highlight how UAF can enable healthcare organizations to align their strategies with actionable, evolving roadmaps, moving beyond static documents. UAF will be employed to architect and model the enterprise elements, and the Systems Modeling Language (SysML) will be employed to model the technical details of the system. These platforms can provide healthcare professionals experience on model-based system design throughout the lifecycle phases. Examples of modular training material designed to engage stakeholders with varied backgrounds in healthcare systems are presented.
Aoki,E; Boopathy, G; Norc´eide, F; Thompson, C; Lewis, E; Batarseh, O; and Chandra, K. IEEE Technology and Society Magazine. Submitted July 15, 2025. Manuscript submitted to IEEE Journal Special Issue on Social Impact of the Internet of Medical Things. (Under Review)
Digital health interventions and wearable health devices have the potential to become significant enablers for proactive management of individual and population health. For this to happen, their effectiveness integration in the larger health ecosystem must be considered from the perspectives of all stakeholders involved. Considerations of enabling trust in wearable health technology, ensuring secure data exchange, transparency in the goals of the health enterprise, reducing burn-out of healthcare professionals and cost of healthcare are system-wide factors that need to be addressed for the digital transformation of healthcare systems. A unified architecture framework (UAF) is presented in this work to capture the strategic and operational viewpoints of the health enterprise, where the enterprise includes the network of people, processes, organizations, technologies and other resources involved in receiving and delivery of healthcare. The strategic motivation view specifications in the UAF highlight drivers, challenges and opportunities and their alignment to the enterprise goals and capabilities. The operational viewpoints present the taxonomy, structure and connectivity of various performers in a scenario representing remote delivery of physical therapy (PT) through wearable health systems. The case study of an augmented reality system that enables remote PT shows the extension of the enterprise UAF to a solution architecture of the system using elements of model-based systems engineering.
Boopathy, G; Aoki,E; Norc´eide, F; Thompson, C; Lewis, E; and Chandra, K. IEEE International Conference on Healthcare Informatics (ICHI). Paper # 1775608762671. June 1–3, 2026 · Minneapolis, MN.
Future work in digitalized environments will engage a multi-generational workforce in new work contexts that can include immersive technology and interaction with remote robotic systems. The overall health and well-being of workers will be a high priority for organizations, as envisioned in the Industry 5.0 framework. This vision requires an architectural framework that integrates work contexts with associated health data and engages health providers as key stakeholders in the design. Digital models created using a model-based systems engineering (MBSE) methodology are proposed as context-aware informatics that can support these needs. A case study of an augmented reality (AR) system that customizes hand gestures to support humans with varied abilities to conduct required tasks is presented. The conceptual design of this system is presented using MBSE models that can serve as context-aware informatics to the work place and the connected health enterprise.
Accurate assessment of hand function is crucial in clinical and rehabilitation settings, particularly for patients undergoing hand surgery and hand rehabilitation. Traditional static methods, including manual goniometry, provide reliable measurements of joint angles but are limited to static snapshots. Motion analysis techniques require cumbersome equipment such as markers or gloves. Emerging markerless hand tracking technologies, including augmented reality (AR)-based computer vision with AI/ML and MediaPipe (MP)-based AI camera applications, enable dynamic, real-time assessment of hand gestures and functional tasks. We hypothesize that these MP- and AR-based systems will demonstrate strong agreement and high reliability compared to standard goniometric measurements while providing additional clinically meaningful information.
Aoki, E; Boopathy, G; Norcéide, F; Venkata, R; Thompson, C; Lewis, E; and Chandra, K. INCOSE International Symposium (2026)
This research will demonstrate a Model Based Systems Engineering (MBSE) architecture of the digital health system from both the conceptual problem domain and solution domain phases. It will describe our experience in engaging with stakeholders who include clinical PT researchers, PT clinic owners, and PT clients to derive their needs and requirements and the mapping of this information into MBSE models. We will present the following four key stages of this work using various views with the systems modeling language (SysML) on the CATIA platform: (1) Data organization from the human-subject study that involved participants use an AR system to perform hand gestures and exercises designed by clinical PT researchers; (2) Calibrating AR generated data on gesture dynamics with traditional PT instruments, such as the goniometer; (3) Eliciting needs of all stakeholders, identifying functional and non-functional requirements and developing related system contexts through an iterative process; and (4) Engaging therapists in building customized protocols using the NCARS framework.
Batarseh, O; Chandra, K; Aoki, E. INCOSE Systems Engineering in Healthcare Conference 2026.
Healthcare delivery environments are complex, multi-stakeholder ecosystems characterized by fragmented information flows, heterogeneous systems, evolving regulatory constraints, and growing demands for transparency, quality, and sustainability. This paper presents a model-based systems engineering (MBSE) approach, grounded in the Unified Architecture Framework (UAF), to structure and analyze the healthcare enterprise as an integrated, traceable digital architecture. The work introduces a reference healthcare ecosystem architecture capturing key elements including stakeholders, operational activities, clinical and enterprise capabilities, enabling services and systems, data exchanges, and regulatory drivers. Stakeholder needs are translated into architectural viewpoints spanning strategic, operational, services, resources, and standards domains. The resulting UAF model enables end-to-end traceability from stakeholder needs to capabilities, operational processes, services, systems, and compliance requirements. Using this integrated architecture, the presentation shows how UAF supports digital-thread visibility across clinical and administrative workflows, enables impact and dependency analysis for capability gaps and modernization decisions, and facilitates evaluation of risks and trade-offs. This work demonstrates how MBSE and UAF improve decision-making and alignment across healthcare stakeholders.
