Patent Publication Number: US-9418536-B1

Title: Hand-washing compliance system

Description:
TECHNICAL FIELD 
     This disclosure relates to an electronic system for compliance monitoring, more particularly for detecting and encouraging industry compliant sanitization and washing procedures. 
     BACKGROUND 
     Tens of thousands of people die each year from infections acquired in hospitals. These “hospital acquired” infections, also referred to as nosocomial infections, are unrelated to a patient&#39;s initial hospital admission diagnosis. In the United States, it has been estimated that as many as one hospital patient in ten acquires a nosocomial infection, or 2 million patients a year. Estimates of annual costs related to nosocomial infection range from $4.5 billion to $11 billion and up. Studies have shown that at least one third of nosocomial infections are preventable. 
     Nosocomial infections due to resistant organisms are an extremely serious problem that threatens the U.S. healthcare system and the welfare of its citizens. Microbes can acquire resistance to antibiotics and anti-fungal and antiviral agents and as the numbers of resistant organisms increase, the number of new antimicrobial agents to treat them has not kept pace. In fact, community acquired nosocomial infections, especially methicillin resistant  staphylococcus aureus  (MRSA), has increased at an alarming rate. 
     It has been reported that more than 50% of all nosocomial infections can be directly related to the transmission of harmful bacteria by healthcare workers who have not properly washed their hands before and after each patient contact. Thus, the best means to prevent transfer of these organisms from patient to patient and to reduce the emergence of resistant organisms is hand-washing with soap and water between patient contacts. The Centers for Disease Control and Prevention (CDC) as well as other regulatory agencies recommend hand-washing before and after each patient encounter. Unfortunately, reports indicate that healthcare workers adhere to hand-washing guidelines less than 70% of the time. Numerous strategies have been attempted to increase healthcare worker compliance to hand-washing, but all have been largely unsuccessful. 
     There are many possible reasons for non-compliance with recommended hand-washing practices. For example, there may not be sufficient time to properly wash hands or wash stations may be placed in inconvenient locations. Some people simply forget to wash their hands. Others may not realize how infrequently or inadequately they comply with recommended hand-washing practices. Others still may not fully understand the benefits of hand-washing. Some or all of these issues may be addressed if means were provided to monitor compliance with recommended hand-washing practices. 
     The problem of insufficient hand-washing is becoming worse. Hospitals, through staff reductions, are requiring healthcare workers to attend to more patients during the healthcare provider&#39;s work shift. Additionally, high transmission rates of antibiotic resistant bacteria and viruses require greater adherence to the CDC hand-washing guidelines. Hospital administrations are searching for products and services that encourage hand-washing, and a means to ensure and measure compliance. 
     Similar concerns exist in other industries, such as those relating to the processing and preparation of food. The U.S. Food and Drug Administration&#39;s Food Code (the “Food Code”) provides guidelines for preparing food and preventing food-borne illness. Retail outlets such as restaurants and grocery stores and other institutions such as nursing homes are subject to the Food Code. In addition to requiring employees to wash their hands, the Food Code requires their employer to monitor the employees&#39; hand-washing. Despite such extensive efforts to ensure that proper hand-washing is performed, more than a quarter of all food-borne illnesses (estimated that food-borne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year) are thought to be due to improper hand-washing. 
     Numerous prior developments have been advanced as a solution to inadequate hand-washing compliance. One prior development was directed to touch-free and automatic soap: dispensers, faucets, and hand dryers. This prior development was an attempt to make it easier for employees to wash and sanitize their hands. This prior development, however; failed to ensure that the employees actually washed or that the wash was adequate or followed best practices. 
     Another prior development was directed to alerting someone of the need to wash their hands. This prior development implemented a reporting system worn by a worker, which was activated when the worker leaves a specific area. The reporting system was deactivated when brought near a hand cleaning station, and then only when it was determined that the worker has used the hand cleaning station. This prior development improved the ability to ensure a hand-wash was done but did not ensure that a hand-wash compliant to standards was performed. 
     Solutions have been long sought but all prior developments have not taught or suggested any complete solutions, and solutions to these problems have long eluded those skilled in the art. Thus there remains a considerable need for devices and methods that can ensure a hand-wash complies with a prescribed government or industry-approved regimen. 
     SUMMARY 
     A compliance system and methods, providing the ability to detect and incentivize compliant sanitization and washing procedures are disclosed. The compliance system and methods can include: a sensor mounted to a chassis, the sensor configured to detect sensor readings; a processor coupled to the chassis and connected to the sensor with a communication conduit, the processor configured to: calculate movement estimations based on differences between the sensor readings at discrete times; count a number of crosses based on how often the movement estimations: are calculated above an upper threshold and are calculated below a lower threshold in consecutive movement calculations, are calculated below the lower threshold and are calculated above the upper threshold in the consecutive movement calculations, or a combination thereof, decrement a countdown timer based on the number of crosses being above a cross-threshold, and pause the countdown timer based on the number of crosses being below the cross-threshold; and a housing mounted to the chassis enclosing the processor and at least partially enclosing the sensor. 
     Other contemplated embodiments can include objects, features, aspects, and advantages in addition to or in place of those mentioned above. These objects, features, aspects, and advantages of the embodiments will become more apparent from the following detailed description, along with the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The compliance system is illustrated in the figures of the accompanying drawings which are meant to be exemplary and not limiting, in which like reference numerals are intended to refer to like components, and in which: 
         FIG. 1  is a side view of the compliance system. 
         FIG. 2  is a front view of the compliance system of  FIG. 1 . 
         FIG. 3  is a graphical view of a main screen display for the compliance system of  FIG. 1 . 
         FIG. 4  is a graphical view of a high score screen display for the compliance system of  FIG. 1 . 
         FIG. 5  is a graphical view of an administrator screen display for the compliance system of  FIG. 1 . 
         FIG. 6  is a graphical view of a view user screen display for the compliance system of  FIG. 1 . 
         FIG. 7  is a graphical view of a user&#39;s list screen display for the compliance system of  FIG. 1 . 
         FIG. 8  is a graphical view of a statistics screen display for the compliance system of  FIG. 1 . 
         FIG. 9  is a control flow for operating the compliance system of  FIG. 1 . 
         FIG. 10  is a control flow for power management of the compliance system of  FIG. 1 . 
         FIG. 11  is a control flow for a conditional count down for the compliance system of  FIG. 1 . 
         FIG. 12  is a graphical view of an initial image captured by the sensors of  FIG. 1 . 
         FIG. 13  is a graphical view of a subsequent image captured by the sensors of  FIG. 1 . 
         FIG. 14  is a graphical view of a difference image between the initial image of  FIG. 12  and the subsequent image of  FIG. 13 . 
         FIG. 15  is a graphical view of a chart for determining the vigor for the compliance system of  FIG. 1 . 
     
    
    
     DETAILED DESCRIPTION 
     In the following description, reference is made to the accompanying drawings that form a part hereof, and in which are shown by way of illustration, embodiments in which the compliance system may be practiced. It is to be understood that other embodiments may be utilized and structural changes may be made without departing from the scope of the compliance system. 
     When features, aspects, or embodiments of the compliance system are described in terms of steps of a process, an operation, a control flow, or a flow chart, it is to be understood that the steps can be combined, performed in a different order, deleted, or include additional steps without departing from the compliance system as described herein. 
     The compliance system is described in sufficient detail to enable those skilled in the art to make and use the compliance system and provide numerous specific details to give a thorough understanding of the compliance system; however, it will be apparent that the compliance system may be practiced without these specific details. 
     In order to avoid obscuring the compliance system, some well-known system configurations are not disclosed in detail. Likewise, the drawings showing embodiments of the system are semi-diagrammatic and not to scale and, particularly, some of the dimensions are for the clarity of presentation and are shown greatly exaggerated in the drawing FIGS. 
     As used herein, the term system is defined as a device or method depending on the context in which it is used. For expository purposes, the term “horizontal” as used herein is defined as a plane parallel to the top plane or surface of the housing, regardless of its orientation. The term “vertical” refers to a direction perpendicular to the horizontal as just defined. Terms, such as “above”, “below”, “bottom”, “top”, “side”, “higher”, “lower”, “upper”, “over”, and “under”, are defined with respect to the horizontal plane. 
     Referring now to  FIG. 1 , therein is shown a side view of the compliance system  100 . The compliance system  100  is shown having a chassis  102  supporting user interface  104 , sensors  106 , and a power unit  108 . 
     The power unit  108  can include electric converters  112  such as transformers, or AC to DC converters. The power unit  108  can be plugged into an external power source (not shown) with a power cable  110 . 
     Power can be provided via the power cable  110  to the power unit  108  either as DC power or AC. If it arrives to the power unit  108  as AC it is converted in the power unit  108 . In one contemplated embodiment, the power unit  108  includes batteries  114  that charge when the power unit  108  is plugged into a DC outlet or an AC outlet. 
     It is contemplated that the compliance system  100  may be placed next to a sink to wirelessly operate from the batteries&#39;  114  power or plugged in with the power cable  110  to operate without the need to recharge and without the expense of outfitting the power unit  108  with the batteries  114 . DC power can travel from the power unit  108  to the sensors  106  via an internal power conduit  116 . 
     The sensors  106  can be image or light sensitive sensors, such as infrared cameras or video cameras. The sensors  106  can have sampling frequencies for sensing the frequencies produced by a user scrubbing his hands. For example, the Nyquist frequency (half the frequency of the data sampling frequency) can be above a likely frequency of scrubbing of a compliant hand-wash. 
     One contemplated embodiment of the compliance system  100  can implement the sensors  106  as a thermal imaging device dependent on long-wave infrared sensing and capable of operating at room temperature without special cooling. For example, the sensors  106  implemented as an Infra Red (IR) camera as just described could collect a grid of 100×100 pixels at a frequency of 9 hertz (Hz). It is contemplated that this embodiment could implement a Nyquist frequency of 4.5 Hz, which results in the data sampling frequency of 9 Hz. 
     A further contemplated embodiment of the compliance system  100  can implement the sensors  106  as a color video camera, which as an illustrative example could operate at a resolution operating at resolution of 1024×768 and a frame rate of 30 Hz. It is contemplated that this embodiment could implement a Nyquist frequency of 15 Hz, which results in the data sampling frequency of 30 Hz. 
     A further contemplated embodiment of the compliance system  100  can implement the sensors  106  as a sound volume sensor collecting the average volume of sound over 50 milliseconds at a rate of 20 Hz. Such a sensor may be tuned to only sense the volume of audio sound at a certain frequency such as a kilohertz. 
     It has been discovered that having the sensors  106  implemented as an IR camera having a Nyquist frequency of 4.5 Hz and a data sampling frequency of 9 Hz or the sensors  106  implemented as a video camera having a sampling frequency of 30 Hz and the Nyquist frequency of 15 Hz provides the unexpected benefit of reducing manufacturing costs while simultaneously excluding false positive signals when detecting vigor and scrubs from a user engaging the compliance system  100 . 
     It has been discovered that the sensors  106  can provide beneficial results when the sensors&#39;  106  sampling frequency is at least four times the likely scrub frequency. This sample rate has been discovered to enable the compliance system  100  to capture and identify a symmetrical scrubbing motion whose data may appear during analysis to be twice the actual repetition rate of the scrub. 
     Illustratively, it can be difficult to detect an apex or midpoint of a perpendicular (back and forth) scrub. That is, it is difficult to detect, for example, when a left hand extended fully forward and a right hand retracted fully backward during the scrubbing motion. The midpoint would be where the hands are aligned. It has been discovered that using a sampling rate with the Nyquist frequency at least double the scrub repetition frequency can accurately detect these scrubbing motions. 
     The sensors  106  can be coupled to the user interface  104  with an internal communication conduit  118  and can deliver the pixel information to the user interface  104 . The user interface  104  is contemplated to be a display screen, an interactive display screen, speakers, or a combination thereof. 
     The sensors  106  can detect when a user is within range of the sink. When the sensors  106  detect the user within range of the sink a game can be activated if the sensors  106  also detect the user is scrubbing or washing their hands. 
     The game can be displayed on the user interface  104  and can provide the user with feedback on the vigor and duration of their scrubbing or washing. The user interface  104  can further provide feedback to the user regarding whether or not the user is complying with hand-washing standards or best practices. 
     The user interface  104  is shown having a processor  120 . The processor  120  may be integrated into the user interface  104 , the sensors  106 , or a combination thereof. In the case that the processor  120  is integrated into the sensors  106  then the output of the processor  120  can be sent to the user interface  104  over the internal communication conduit  118 . 
     It is further contemplated that the processor  120  can exist independently and be mounted independently on the chassis  102 . The processor  120  can process the pixel information, perform analysis, and update the user interface  104  to advise or signal the user. 
     Referring now to  FIG. 2 , therein is shown a front view of the compliance system  100  of  FIG. 1 . The compliance system  100  is shown having the user interface  104  and the sensors  106  partially enclosed within a housing  202 . 
     The housing  202  can be mounted to the chassis  102  of  FIG. 1  and can fully encapsulate the power unit  108  of  FIG. 1 . It is contemplated that user interface  104 , and the sensors  106  can be partially exposed from the housing  202  in order to allow for resistance to splashing liquid. 
     The housing  202  is contemplated to be implemented with antimicrobial plastic using antimicrobial sealant to create a watertight fixture. The housing  202  can further include a cover  204  over the sensor  106 . 
     The cover  204  can be transparent to wavelength of light that is being sensed by the sensors  106 . The cover  204  may enable the sensors  106  to remain within the housing  202  without any physical external exposure. 
     In one contemplated embodiment the cover  204  can be a layer of ethylene, such as a 1/32 inch plastic piece form fitted and sealed to the housing  202 . The housing  202  can provide a water tight seal that allows the compliance system  100  to be scrubbed with cleaners and abrasives for maintaining a sanitary condition. 
     It is further contemplated that the housing  202  can provide a watertight seal for the connection between the power cable  110  of  FIG. 1  and the power unit  108  of  FIG. 1 . It is yet further contemplated that the housing  202  can provide a watertight environment within the housing  202  when the power cable  110  is disconnected and the power unit  108  is running off of the batteries  114  of  FIG. 1 . 
     The processor  120  of  FIG. 1  is contemplated to keep a log of its operation in a local database  206  having non-transitory computer readable medium or in a remote database  208  having non-transitory computer readable medium, and to which the processor  120  may connect via radio  210  such as WiFi or cellular. As an illustrative example, the user interface  104  can be a smartphone that connects to a hospital&#39;s WiFi network or to the Internet via cellular radio transmission. 
     It is contemplated that the compliance system  100  can further include low power sensors  212  exposed from the housing  202  on the compliance system  100 . The low power sensors  212  can be used to detect whether any users are within an observation area. The low power sensors  212  can be motion sensors with a Fresnel lens and a pair of comparator-based single-pixel thermal sensors, commonly referred to as a passive infrared sensor, or “PIR”. 
     Referring now to  FIG. 3 , therein is shown a graphical view of a main screen display  300  for the compliance system  100  of  FIG. 1 . The main screen display  300  may be shown or displayed on the user interface  104  of  FIG. 1 . The main screen display  300  can inform the user about the analysis being conducted by the processor  120  of  FIG. 1  on their hand-washing actions detected by the sensors  106  of  FIG. 1 . 
     The main screen display  300  can include a header  302  that includes a logo  304  and a name  306 . Below the header  302  is a time meter  308  having individual time meter levels  310 . The individual time meter levels  310  can climb or be added cumulatively from one endpoint of the meter to the other endpoint. For example, the individual time meter levels  310  could be added each second a satisfactory or compliant hand-wash is sensed. The individual time meter levels  310  could be added to the time meter  308  starting at the bottom and progressing to the top after the allotted time for a satisfactory or compliant hand-wash had elapsed. 
     It is contemplated that the time meter  308  can correspond to a particular color indicating the amount of time that remains to be analyzed in order for the compliance system  100  to register a user&#39;s hand-wash as compliant or satisfactory. For example, if the compliance system  100  is configured to require the detection of a 30 second hand-wash then the time meter  308  might be completely lit blue at the start of the wash and transition to a different color as the hand-wash approaches the 30 second time threshold. 
     It is further contemplated that the individual time meter levels  310  can correspond to a particular color indicating the amount of time that remains to be analyzed in order for the compliance system  100  to register a user&#39;s hand-wash as compliant or satisfactory. For example, if the compliance system  100  is configured to require the detection of a 30 second hand-wash then the time meter  308  could include 30 individual time meter levels  310  that change color of each successively higher individual time meter levels  310  each second a satisfactory or compliant hand-wash is detected. 
     Adjacent to the time meter  308  is a vigor meter  312 . The vigor meter  312  can include a minimum compliance indicator  314 , a high compliance indicator  316 , and a highest compliance indicator  318 . 
     The vigor meter  312  may indicate the current level of vigor that is perceived by the sensors  106  and the analysis of the information generated by the sensors  106 . The vigor meter  312  can provide feedback to users enabling the users to increase their vigor if they are moving too slowly. The vigor meter  312  can also require a continuous presence and motion from the user, thereby potentially preventing an unconscious rationalization that might prevent a compliance wash. 
     When only the minimum compliance indicator  314  is lit, this can signal the user that a minimum level of vigor is being recognized by the compliance system  100 . When the minimum compliance indicator  314  and the high compliance indicator  316  are lit, this can signal the user that a high level of vigor is being recognized by the compliance system  100 . When the minimum compliance indicator  314 , the high compliance indicator  316 , and the highest compliance indicator  318  are lit, this can signal the user that the highest level of vigor is being recognized by compliance system  100 . 
     It is contemplated that the minimum compliance indicator  314  can be red and can indicate a hand-wash with a low vigor reading and that the current level of the user&#39;s hand-wash vigor would reduce the user&#39;s score in a hand-wash vigor game. It is contemplated that the high compliance indicator  316  can be yellow and can indicate a hand-wash with an adequate vigor reading and that the current level of the user&#39;s hand-wash vigor would slowly increase the user&#39;s score in the hand-wash vigor game. 
     It is contemplated that the highest compliance indicator  318  can indicate a hand-wash with a highly compliant vigor reading and that the current level of the user&#39;s vigor would quickly increase the user&#39;s score in the hand-wash game and could result in a high score. Adjacent to the vigor meter  312  is a scrubs per-minute meter  320 , a total scrubs meter  322 , and a score meter  324 . 
     The scrubs per-minute meter  320  can indicate the scrubs-per-minute (SPM) estimated to be performed if the user&#39;s scrubbing continues as it has been for a full minute. As an example, a value of 60 could indicate that 60 SPM are estimated to be performed if the current scrubbing continues for a full minute. 
     The compliance system  100  can include a threshold that could identify a low SPM. It is contemplated that 60 SPM may be indicative a low SPM. An SPM below the threshold could be used to indicate to the user that an inadequate level of vigor is being used in the current scrubbing motion. 
     The total scrubs meter  322  can indicate to the user the total number of scrubs that have been recognized by the compliance system  100 , which may imbue a sense of accomplishment and encouragement when paired with the individual time meter levels  310  remaining on the time meter  308  slowly changing color downward toward an indication of completion. 
     For example, displaying “55” in the total scrubs meter  322  might be used to indicate to the user that 55 scrubs have been performed. The score meter  324  can be another means of communicating to the user the amount of vigorous scrubbing they have performed. In one contemplated embodiment the score meter  324  calculates a score as a multiple of Total Scrubs. In another contemplated embodiment the score meter  324  calculates a score that increases exponentially so that the rate of score increase increases as the wash continues to progress. 
     Referring now to  FIG. 4 , therein is shown a graphical view of a high score screen display  400  for the compliance system  100  of  FIG. 1 . The high score screen display  400  can be displayed on the user interface  104  of  FIG. 1 . 
     The high score screen display  400  can include a header  402  that includes a logo  404  and a name  406 . Below the header  402  a title  408  is shown. As an illustrative example the title  408  can be “High Scores”. 
     Below the header  402  and the title  408  is a score board  410  having cells  412  arranged in rows  414  and columns  416 . The rows  414  can be seen arranged in five rows and the columns  416  can be arranged in three columns. 
     The row  414  in the top position of the score board  410  can include a day cell  418  indicating that the data in the first row corresponds to data for a day, a day name cell  420  providing the name of the holder of the high score for the current day, and a day score cell  422  providing the record holding score for the current day. 
     The row  414  in the second position from the top of the score board  410  can include a week cell  424  indicating that the data in the second row corresponds to data for a week, a week name cell  426  providing the name of the holder of the high score for the current week, and a week score cell  428  providing the record holding score for the current week. 
     The row  414  in the third position from the top of the score board  410  can include a month cell  430  indicating that the data in the third row corresponds to data for a month, a month name cell  432  providing the name of the holder of the high score for the current month, and a month score cell  434  providing the record holding score for the current month. 
     The row  414  in the fourth position from the top of the score board  410  can include a year cell  436  indicating that the data in the fourth row corresponds to data for a year, a year name cell  438  providing the name of the holder of the high score for the current year, and a year score cell  440  providing the record holding score for the current year. 
     The row  414  in the fifth position from the top of the score board  410  can include an all time cell  442  indicating that the data in the fifth row corresponds to data for all time, an all time name cell  444  providing the name of the holder of the current high score, and an all time score cell  446  providing the record holding score. 
     It is contemplated that when one of the rows  414  corresponds to a time span that has not yet passed, the rows  414  following thereafter, which are for longer time spans, might not list a name or high score since it would be identical to the name and high score above it. As an illustrative example, the score board  410  is shown having the year name cell  438 , the year score cell  440 , the all time name cell  444 , and the all time score cell  446  empty to indicate a year has not passed since the compliance system  100  has collected data. 
     Referring now to  FIG. 5 , therein is shown a graphical view of an administrator screen display  500  for the compliance system  100  of  FIG. 1 . The administrator screen display  500  can be displayed on the user interface  104  of  FIG. 1 . The administrator screen display  500  can provide an interface with the local database  206  of  FIG. 2  or the remote database  208  of  FIG. 2  that store activity records for the compliance system  100 . 
     It is contemplated that the administrator screen display  500  can be used or displayed on a cellular phone or on a web page. The administrator screen display  500  can include a header  502  that includes a logo  504  and a name  506 . Below the header  502  a title  508  is shown. The title  508  shown on the administrator screen display  500  can be “Administrator Monitor”. 
     The administrator screen display  500  can include buttons  510  below the title  508 . It is contemplated that the buttons  510  can enable an Administrator to perform a review or to make changes to the compliance system  100 . 
     The button  510  at the top just below the title  508  is an add user button  512 . The add user button  512  enables an administrator to add a new user, such as a new employee of a hospital in which the compliance system  100  operates. The add user button  512  may bring up a text box that enables entry of the new user&#39;s name. Typing the enter key may complete the add user action and update the local database  206  or the remote database  208  holding the user&#39;s information. 
     The button  510  below the add user button  512  is a delete user button  514 . The delete user button  514  can cause the compliance system  100  to display the user&#39;s list screen display  700  of  FIG. 7 , and allow the administrator to select a user and delete them using the select button  734  of  FIG. 7 . 
     The button  510  below the delete user button  514  is a view user button  516 . The view user button  516  prompts the compliance system  100  to display the view user screen display  600  of  FIG. 6 . 
     The button  510  below the view user button  516  is a view user list button  518 . The view user list button  518  can cause the compliance system  100  to display the user&#39;s list screen display  700  of  FIG. 7 . 
     The button  510  below the view user list button  518  is a statistics button  520 . The statistics button  520  can cause the compliance system  100  to display the statistics screen display  800  of  FIG. 8 . 
     Referring now to  FIG. 6 , therein is shown a graphical view of a view user screen display  600  for the compliance system  100  of  FIG. 1 . The view user screen display  600  can be displayed on the user interface  104  of  FIG. 1 . It is contemplated that the view user screen display  600  can be displayed by the compliance system  100  when an administrator clicks the view user button  516  of  FIG. 5  and then selects a user on the user&#39;s list screen display  700  of  FIG. 7 . 
     The view user screen display  600  can include a header  602  that includes a logo  604  and a name  606 . It is contemplated that the logo  604  can be an active button that will prompt the compliance system  100  to take the administrator back to the administrator screen display  500  of  FIG. 5  when engaged. Below the header  602  a title  608  is shown. The title  608  shown on the view user screen display  600  can be “View User”. 
     Below the title  608  a name cell  610  can be displayed and can contain a user&#39;s name corresponding to the profile that is being displayed by the view user screen display  600 . Adjacent to the name cell  610  and below the title  608  is a select user button  612 . 
     The select user button  612  can be used to enable an administrator to select a different user from the user&#39;s list screen display  700 . When a different user is selected from the user&#39;s list screen display  700 , view user screen display  600  would be refreshed and repopulated with the newly selected user&#39;s information. 
     Below the name cell  610  is a date label  614 . The date label  614  can display a week within which vigor and scrub data for the user is shown. Adjacent to the date label  614  and below the select user button  612  is a select dates button  616 . 
     The select dates button  616  can be engaged after a week has been selected from a calendar display  618 . Once the week from the calendar display  618  is selected and the select dates button  616  is engaged, the data corresponding to the selected weeks will be displayed in a user data chart  620  for the user. 
     The user data chart  620  can be positioned below the select dates button  616  and below the date label  614 . The user data chart  620  can include a top row of day labels  622  that list the days of a week from Sunday through Saturday. 
     The user data chart  620  can further include a scrubs count label  624  and a score label  626 . The scrubs count label  624  can correspond to scrubs data cells  628 . The scrubs data cells  628  can display the total scrubs detected by the compliance system  100  for each day indicated by the day labels  622 . 
     The score label  626  can correspond to score data cells  630 . The score data cells  630  can display the total score calculated by the compliance system  100  for each day indicated by the day labels  622 . Below the user data chart  620  a user data graph  632  is shown graphically depicting the user&#39;s scrubs  634  from the scrubs data cells  628 , the user&#39;s score  636  from the score data cells  630 , or a combination thereof. 
     Referring now to  FIG. 7 , therein is shown a graphical view of a user&#39;s list screen display  700  for the compliance system  100  of  FIG. 1 . The user&#39;s list screen display  700  can be displayed on the user interface  104  of  FIG. 1 . 
     The user&#39;s list screen display  700  can include a header  702  that includes a logo  704  and a name  706 . It is contemplated that the logo  704  can be an active button that will prompt the compliance system  100  to take the administrator back to the administrator screen display  500  of  FIG. 5  when engaged. Below the header  702  a title  708  is shown. The title  708  shown on the user&#39;s list screen display  700  can be “List of Users”. 
     Below the title  708  the user&#39;s list screen display  700  can include a user list  710 . The user list  710  can include a name label  712 , a role label  714 , an SPM label  716 , a total scrubs label  718 , and a score label  720 . 
     The name label  712  can correspond to name fields  722 . The role label  714  can correspond to role fields  724 . The SPM label  716  can correspond to SPM fields  726 . The total scrubs label  718  can correspond to total scrub fields  728 . The score label  720  can correspond to score fields  730 . 
     The user list  710  includes the name fields  722 , the role fields  724 , the SPM fields  726 , the total scrub fields  728 , and the score fields  730  in rows that each correspond to a user  732 . Each of the users  732  can have data occupying a single row. It has been discovered that displaying the users  732  in rows enables an administrator to quickly assess the information and to see overall or recent statistics of all the users on one screen. 
     Below the user list  710  a select button  734  is depicted near the bottom of the user&#39;s list screen display  700 . The select button  734  is contemplated to be a multifunction button based on how the administrator arrived at the user&#39;s list screen display  700 . 
     It is contemplated that the user&#39;s list screen display  700  can be displayed by the compliance system  100  when an administrator clicks the select user button  612  of  FIG. 6 . When the administrator selects the user  732  and engages the select button  734  the compliance system  100  will display the view user screen display  600  of  FIG. 6 . 
     It is contemplated that the user&#39;s list screen display  700  can be displayed by the compliance system  100  when an administrator clicks the view user button  516  of  FIG. 5 . When the administrator selects the user  732  and engages the select button  734  the compliance system  100  will display the view user screen display  600 . 
     It is contemplated that the user&#39;s list screen display  700  can be displayed by the compliance system  100  when an administrator clicks the delete user button  514  of  FIG. 5 . When the administrator selects the user  732  and engages the select button  734  the compliance system  100  can remove the user  732  that the administrator selected from the user list  710 . The compliance system  100  can also remove any of the information for the user  732  that was selected from the local database  206  of  FIG. 2  or the remote database  208  of  FIG. 2 , and the compliance system  100  can then display the administrator screen display  500 . 
     It is contemplated that the user&#39;s list screen display  700  can be displayed by the compliance system  100  when an administrator clicks the view user list button  518  of  FIG. 5 . It is contemplated that when the user&#39;s list screen display  700  is displayed in response to an engagement of the view user list button  518 , the select button  734  may not appear to the administrator. Alternatively it is contemplated that when the user&#39;s list screen display  700  is displayed in response to an engagement of the view user list button  518 , the select button  734  may be visible and when engaged would prompt the compliance system  100  to display the administrator screen display  500 . 
     Referring now to  FIG. 8 , therein is shown a graphical view of a statistics screen display  800  for the compliance system  100  of  FIG. 1 . The statistics screen display  800  can be displayed on the user interface  104  of  FIG. 1 . 
     The statistics screen display  800  can include a header  802  that includes a logo  804  and a name  806 . Below the header  802  a title  808  is shown. The title  808  shown on the statistics screen display  800  can be “Statistics Monitor”. 
     The statistics screen display  800  can include statistics  810  below the title  808 . The statistics  810  can include the number of days the compliance system  100  has been running or the number of hand-washes that sensor analysis has recognized as compliant. 
     Referring now to  FIG. 9 , therein is shown a control flow  900  for operating the compliance system  100  of  FIG. 1 . The control flow  900  provides an overview of how an embodiment of the compliance system  100  assists a user in performing a hand-wash that is compliant with a standard regimen in terms of vigor and time. The level of time and vigor can be configurable. 
     The control flow  900  can begin with a start step  902 . The start step  902  indicates the beginning of the control flow  900  and can initiate or direct a user to a wash required step  904 . The wash required step  904  can signify that a user has transitioned tasks and must wash hands. 
     In the wash required step  904  the user could encounters a situation that calls for washing their hands in order to maintain a compliant environment. The situation could include the exposure of the user to an environment requiring management of harmful microbes, for example, at a hospital. 
     As an illustrative example, the wash required step  904  could be initiated when a nurse transitions from helping a first patient to helping a second patient. In another illustrative example the wash required step  904  could be initiated when a doctor may arrive back from a lunch break and transitions to performing a checkup on a patient. The user can proceed from the wash required step  904  directly to an approach step  906 . 
     During the approach step  906 , the user can proceed to a sink with the compliance system  100 . The compliance system  100  can provide vigor and scrubbing data, as described above, from the sensors  106  of  FIG. 1  for the region in, above, and around the sink where the user is approaching in the approach step  906 . The processor  120  of  FIG. 1  can then analyze the data provided by the sensors  106  for detecting scrubbing and vigor. 
     It is contemplated that when the compliance system  100  is incorporated with fixtures like a sink or a scrub station, the sink or scrub station can be called a sink or scrub station with vigor awareness. The approach step  906  can be connected to a pre-rinse decision step  908 . The pre-rinse decision step  908  can be a decision step determining whether a user rinses before applying soap in a rinse→soap step  910  or whether a user applies soap before rinsing in a soap→rinse step  912 . 
     When the result of the pre-rinse decision step  908  is “NO” then the user will proceed to the soap→rinse step  912 . When the result of the pre-rinse decision step  908  is “YES” the user will proceed to the rinse→soap step  910 . 
     It is contemplated that the user can turn on the faucet and apply the water in the rinse→soap step  910  or during the soap→rinse step  912 . The user might or might not turn the faucet off. 
     It is contemplated that the compliance system  100  can monitor, detect, and store the result of the pre-rinse decision step  908 . In one contemplated embodiment the result of the pre-rinse decision step  908  can be a trigger indicating non-compliance or compliance. 
     The soap→rinse step  912  as well as the rinse→soap step  910  are connected to a scrubbing step  914 . The scrubbing step  914  can be connected to a detection step  916 . 
     It is contemplated that the compliance system  100  can begin detecting vigor and scrubs in the detection step  916  once the sensors  106  detect the hands of a user in the sink region. It is further contemplated that the compliance system  100  can begin detecting vigor and scrubs in the detection step  916  when the sensors  106  detect the hands of the user in motion in or above the sink region. 
     The detection step  916  can be connected to a display step  918 . The display step  918  can update the main screen display  300  of  FIG. 3  with the data detected in the detection step  916 . That is the scrubs per-minute meter  320  of  FIG. 3 , the total scrubs meter  322  of  FIG. 3 , and the score meter  324  of  FIG. 3  can display information derived from the detection step  916 . 
     The main screen display  300  can also be updated with the detected vigor, and the time remaining in a scrubbing time countdown can be displayed. The level of vigor detected by the sensors  106  in the detection step  916  can be displayed in the vigor meter  312  of  FIG. 3 . 
     The time remaining in the scrubbing session can be displayed in the time meter  308  of  FIG. 3 . The time remaining in the scrubbing session can decrement every second during which vigorous repetitive motion is detected in the detection step  916 . 
     Alternatively, it is contemplated that a row of LEDs could be used to signal a user in much the same way as the time meter  308 . It is contemplated that a row of LEDs could proceed from completely unlit, to one LED being lit, to a contiguous group of 2 LEDs being lit including the first LED, and so on until all LEDs in the row are lit, thereby indicating that the compliance system  100  has detected in accordance with its operation that the hand-wash was compliant and is complete. 
     Once complete, the LEDs may then proceed to flash on and off to provide more visual stimuli to the user that the hand-wash is at least compliant. The estimated SPM calculated by the processor  120  of  FIG. 1  based on the timing of the scrubs detected by the sensors  106  in the detection step can be shown in the scrubs per-minute meter  320 . 
     It is contemplated that the compliance system  100  can be implemented without the main screen display  300  but instead could utilize indicators for vigor such as LEDs. As an illustrative example, a set of LEDs including a red LED, yellow LED, and green LED can be used in much the same way as the minimum compliance indicator  314  of  FIG. 3 , the high compliance indicator  316  of  FIG. 3 , and the highest compliance indicator  318  of  FIG. 3  in the vigor meter  312 . 
     The detection step  916  can trigger the highest compliance indicator  318  when a threshold for frequency is met, such as a threshold of 1 Hz or 1.5 Hz. It is contemplated that the main screen display  300  is activated or remains activated and is updated with values derived from analysis by the processor  120  of the data collected by the sensors  106 . 
     It is contemplated that the values detected or calculated by the compliance system  100  can be uploaded to the local database  206  of  FIG. 2  or the remote database  208  of  FIG. 2 . Logging the detected scrubs per second, the detected vigor, the estimated SPM, and the time remaining in a scrubbing time countdown can enable the administrative audit of the user&#39;s performance at a later time. 
     It is contemplated that the detected scrubs per second, the detected vigor, the estimated SPM, and the time remaining in a scrubbing time countdown can be displayed in a waiting area to patients in order to impress upon the patients that the healthcare establishment in which they find themselves takes the reduction of infection very seriously. The compliance system  100  may further display the detected scrubs per second, the detected vigor, the estimated SPM, and the time remaining in a scrubbing time countdown on web page that is updated online and that users may monitor from their smartphones or computers. It is contemplated that the compliance system  100  may be integrated into the sinks of a restaurant and the statistics collected by the compliance system  100  may be used to update a website in order to impress upon customers the high priority that cleanliness is given at the restaurant establishment. 
     It is contemplated that the detection step  916  can be triggered by the activation of the water in the sink prompting the compliance system  100  to attempt the detection of scrubbing. In another contemplated embodiment the compliance system  100  is constantly monitoring for scrubbing in the detection step  916  and does not need to detect the user or the activation of the water in the sink before initiating such monitoring in the detection step  916 . 
     The compliance system  100  can be utilized in many ways to ensure a compliant hand-wash was achieved. It is contemplated that in some embodiments the compliance system  100  would not detect the dispensation of soap or the activation of water. 
     It has been discovered that implementing the compliance system  100  in this low cost embodiment can be more desirable than the added compliance detection that requires the detection of soap dispensation or water activation. This may be the case where the vast majority of noncompliance instances are due to forgetfulness to approach the sink or to continue vigorous scrubbing for a compliant amount of time. In such a case neither the water nor soap dispensing need to be monitored since compliance will only be verified once the scrubbing, an action that succeeds soap and water dispensing, is performed for a sufficient length of time with a sufficient level of vigor. 
     It is contemplated that the compliance system  100  can use data received from the sensors  106  that detect vigor in the detection step  916  both in the case where the water is left running during the wash in the scrubbing step  914  and in the case that the water is not left running during the scrubbing step  914 . It is contemplated that the detection step  916  can include a pre-analysis of the input from the sensors  106  that is designed to detect running water. The compliance system  100  can then choose two different detection methods for the scrubbing and vigor based on whether the pre-analysis detected running water or not. 
     The display step  918  is connected to a complete decision step  920 . The result of the complete decision step  920  is based on a countdown timer  922 . The countdown timer  922  is used to determine if the current hand-wash meets the conditions of a compliant hand-wash. 
     If the countdown timer  922  is found to not have reached zero then the result of the complete decision step  920  is a “NO” and the compliance system  100  can invoke a vigor decision step  924 . The vigor decision step  924  can input new sensor data from the sensors  106 . The new sensor data can be analyzed in order to detect continued vigor and scrubs. 
     It is contemplated that the compliance system  100  can include a parameter  926  that increases or decreases the sensitivity of the compliance system  100  to detect vigor. When the parameter  926  is at a high setting the probability of detecting vigor is increased but would also produce more false positives. When the parameter  926  is in a high setting the probability of correctly detecting a lack of vigor is decreased providing fewer true negatives. 
     Conversely, the parameter  926  can be set low to make detection of vigor and scrubs less probable. It is contemplated that setting the parameter  926  in the high setting may be used in order to decrease the probability of displaying to the user that their hand-wash is noncompliant when the wash is indeed compliant since the vigor detector depends on analysis of the sensors  106  data and is anticipated to occasionally arrive at incorrect conclusions and thus it may be desirable to skew the errors in favor of the user. 
     It is contemplated that the data captured by the sensors  106  may be collected and processed after the fact in order to determine the typical conditions of detecting a noncompliant hand-wash. If it is found that the vast majority of noncompliance occurs due to premature removal of hands from the sink then the parameter  926  may be set higher because it could be concluded that erroneously detecting hand motion as vigorous hand motion is relatively benign consequence and the incorrect labeling of a compliant hand-wash as noncompliant may have the greater danger of decreasing long term user compliance by decreasing user attention to the vigor-awareness display in the long run. 
     If vigor is not detected in the vigor decision step  924 , the vigor decision step  924  will result in a “NO” and trigger a pause step  928 . The pause step  928  can pause the countdown timer  922  and loop back to the vigor decision step  924 . The countdown timer  922  may remain paused until vigor is detected again by the vigor decision step  924 . 
     It is contemplated that the vigor decision step  924  can optionally result in the “NO” output when the vigor has not been detected for a preset length of time. It has been discovered that allowing the vigor decision step  924  to result in the “NO” output only after vigor has not been detected for a preset time period favors the likelihood that the user is continuing to scrub and the vigor-detection is merely encountering a glitch of some kind, which could be the obstruction of the sensor or unexpected sensor noise. 
     Once the vigor decision step  924  detects vigor again, the vigor decision step  924  will result in a “YES” output and the compliance system  100  will invoke a resume step  930 . The resume step  930  will continue the countdown of the countdown timer  922 . 
     It is contemplated that the compliance system  100  can optionally track the number of times that the pause step  928  is invoked without returning to the resume step  930 . It is contemplated that the compliance system  100  could conclude that the user has stepped away from the sink. In the case where the compliance system  100  concludes the user has stepped away from the sink, the compliance system  100  may reset the countdown timer  922  and return to the detection step  916  for detecting a new user. 
     If the countdown timer  922  is found to have reached zero then the result of the complete decision step  920  is a “YES” and the compliance system  100  can invoke a finish step  932 . The finish step  932  can provide the user an indication that they have successfully completed the monitoring portion of the hand-wash. 
     It is contemplated that the users may then optionally proceed to wash hands in an unmonitored fashion. In one contemplated embodiment, when continued hand-washing is detected, the compliance system  100  can continue to update the total scrubs meter  322  and may transition the time meter  308  from a countdown timer to a total time display so that the user is still informed as to how long they have been washing their hands. 
     Further, when the finish step  932  is invoked, the compliance system  100  may provide a “compliance complete” signal to the user. Further, the finish step  932  can provide the user with instructions to dry their hands and apply hand lotion. 
     It is contemplated that a graphical representation of lotion or a lotion dispenser can be shown on the user interface  104  of  FIG. 1  to encourage the user to proceed with moisturizing their hands to avoid dermatitis. Further it is contemplated that a light attached to the hand lotion dispenser could flash, thereby providing additional stimuli to the user that encourages the use of moisturizer. 
     By encouraging the use of moisturizer the compliance system  100  may encourage long term compliance by preventing hand discomfort that may occur due to dryness which has an increased chance of occurring when hand-washing is performed more frequently. 
     Referring now to  FIG. 10 , therein is shown a control flow  1000  for power management of the compliance system  100  of  FIG. 1 . Control flow  1000  depicts a process whereby the compliance system  100  negotiates between a low power state and a high power state in order to conserve power over the lifetime of the compliance system  100 . 
     It has been discovered that the process depicted in the control flow  1000  is advantageous to embodiments dependent upon batteries or low power generation such as generation of power by turbine integrated into the sink piping. In embodiments where a pipe-integrated micro turbine generates power from water flowing down the sink, water only flows down the drain a small percentage of the time so the total power generation of a pipe-integrated micro turbine is low. 
     However by transitioning between low power and high power states it has been discovered that the compliance system  100  is able to maintain low power in order to accommodate such a configuration. Upon the activation of the high power state and the continuous detection of vigor and scrubs the compliance system  100  enters into the control flow depicted in  FIG. 11 , which in this contemplated embodiment, constitutes the beginning a countdown game. 
     The control flow  1000  is shown beginning with a start step  1002 . The start step  1002  indicates the beginning of the control flow  1000  and can initiate an entity detection step  1004 . 
     The entity detection step  1004  can utilize the low power sensors  212  of  FIG. 2  on the compliance system  100  to detect whether any new users are detected within an observation area. The low power sensors  212  can be motion sensors with a fresnel lens and a pair of comparator-based single-pixel thermal sensors, commonly referred to as a passive infrared sensor, or “PIR”. 
     The low power sensors  212  may remain deactivated and unpowered most of the time if the initialization time of the sensor is sufficiently low. For example if the sensor has a 50 millisecond boot time and a response time for high power-up of 1 second is satisfactory, then the low power sensors  212  may remain deactivated and unpowered 105% of the time if it is activated once per second. 
     In this exemplary illustration, the compliance system  100  would have a mean response time of 0.525 seconds and a worst case response time of 1 second. Furthermore a low power processor may enter a low power state and wake up only once per second if the wakeup time is sufficiently rapid. 
     The compliance system  100  is contemplated to include the processor  120  of  FIG. 1 , which can be a low power processor and can wake up in 50 milliseconds (ms). After the processor  120  wakes up, the processor  120  can be used to wake up the low power sensors  212 , which is contemplated to require 50 ms to collect a sensor reading. It is contemplated an additional 50 ms are required to process the reading from the low power sensors  212  and to determine whether a high power mode should be entered into. 
     It has been discovered that the low power sensors  212  in combination with the processor  120  would have a minimum response time of 150 ms, a maximum response time of 1 second, and an average response time of 5.75 seconds if activated once per second. Such a response time may be quite adequate and result in a power savings of 100% or more, depending on the power consumption while the low power processor is sleeping. 
     If an entity is detected during the entity detection step  1004  within the sensor area of the low power sensors  212  then the sensors  106  of  FIG. 1  can be activated along with the processor  120  in an activation step  1006 . It is contemplated that the sensors  106  can be a high power sensor. It is further contemplated that the processor  120  can have a low power and high power processing functionality or multiple processors can be used. 
     Successful completion of the activation step  1006  can activate a detection step  1008 . During the detection step  1008 , the data from the sensors  106  can be analyzed in real time to detect vigor and scrubs. 
     It is contemplated that in one embodiment the processor  120  can execute at 10 megahertz (MHz) monitoring when monitoring the low power sensors  212  and maintaining a sleep state for the majority of the time during the entity detection step  1004 . When the low power sensors  212  detect that a user has entered the sensing area, the processor  120  can execute at 1 gigahertz (GHz) and the sensors  106  can be brought into a powered-up state from a sleep state. 
     During the detection step  1008  vigor and scrubs of a user may be detected by performing change detection analysis. The processor  120  can compare a previous reading from the sensors  106  with a current reading of the sensors  106 . 
     The aggregation of absolute differences may be used as an overall estimate of change. Alternatively only differences in one direction such as differences resulting from a sensor value going from a lower level to a higher level may be used to contribute to the aggregation and the differences going in the other direction may be discarded. 
     The direction of change can be used to indicate the current state of scrubbing motion. It has been discovered that readings from the sensors  106  collected over a multi-sample period, such as 18 recordings taken over 2 seconds from a 10 Hz camera, can be used in an analysis and to determine if a rhythm is present in the number of times the sensors  106  detect transitions between a high and low state. 
     The number of transitions detected by the sensors  106  may be used as a measure of vigor, where a small number of transitions between high and low motion may be used to indicate low vigor as described below with regard to the detection thresholds of  FIG. 15 . If a high number of transitions are detected indicating sufficient vigor, the control flow of the compliance system  100  will continue vigor for T_Start seconds. 
     If the vigor is detected for more than T_Start seconds, the compliance system  100  will recognize the vigor as continuous in a continuous decision step  1010 . When the vigor is recognized as continuous in the continuous decision step  1010 , a result of “YES” will prompt the compliance system  100  to activate the countdown game of  FIG. 11  in a begin countdown step  1012 . 
     If the vigor is not detected for more than T_Start seconds, the compliance system  100  will recognize the vigor as not continuous in the continuous decision step  1010 . When the vigor is recognized as not continuous in the continuous decision step  1010 , a result of “NO” will prompt the compliance system  100  to deactivate the high power monitoring of the sensors  106  in a deactivation step  1014 . 
     The deactivation step  1014  will place the compliance system  100  back into the low power mode of the entity detection step  1004 . In one contemplated embodiment the T_Start second limit can be one second or two seconds. 
     Referring now to  FIG. 11 , therein is shown a control flow  1100  for a conditional count down for the compliance system  100  of  FIG. 1 . The control flow  1100  depicts a countdown game or sensor analysis-driven conditional countdown. 
     The control flow  1100  can monitor the vigor of hand-washing and enters a paused or a reset mode depending on when vigor is detected and when it is not detected. It is contemplated that the control flow  1100  can be performed in a high power state activated by the activation step  1006  of  FIG. 10  where the sensors  106  of  FIG. 1  and the processor  120  of  FIG. 1  runs in a high power mode. 
     The control flow  1100  is shown beginning with a begin countdown step  1102 . The begin countdown step  1102  indicates the beginning of the control flow  1100  can correspond to the begin countdown step  1012  of  FIG. 10 . The begin countdown step  1102  can initiate a set T_Current step  1104 . 
     The set T_Current step  1104  can set the variable T_Current to T_Total minus T_Start. In the set T_Current step  1104  a value is stored in a variable T_Current. The new value stored in T_Current is derived by subtracting a variable T_Start from T_Total. 
     T_Total can be the length of time over which vigorous hand-washing would suggest a compliant hand-wash. As an illustrative example, values for T_Total could be 20 seconds and could identify that a compliant hand-wash must have vigorous hand-washing detected for at least 20 seconds. 
     The value for T_Total could be other values as well such as: 30 seconds, 40 seconds, 1 minute, or other desired amounts of time. It is contemplated that a particular vigor-aware sink may be configured with a T_Total of 3 minutes if the sink is commonly used by hospital workers that wash their hands very rigorously before proceeding to their next task. It is contemplated that the desired length represented by T_Total could be a set individually for specific each user. It is contemplated that the compliance system  100  could identify specific users by speech recognition, gesture recognition, face recognition, or a multimodal combination. 
     The variable T_Start corresponds to the amount of time during which vigorous hand-washing is estimated to already have occurred. For example if the activation step  1006 , the detection step  1008  of  FIG. 10 , the continuous decision step  1010  of  FIG. 10 , and the begin countdown step  1012  take one second to execute and wake up the sensors  106  and the processor  120  during which time the sensors  106  is unlikely to detect the user&#39;s vigorous hand-washing, T_Start may be set to a time of 1 second. 
     In contrast when the compliance system  100  is operating in a continuous high power setting or the sensors  106  identify vigorous hand-washing immediately, T_Start might be set significantly lower or even to zero. Completion of the set T_Current step  1104  can initiate the execution of a set T_pause step  1106 . 
     The set T_pause step  1106  initializes the T_pause variable to zero. The T_pause variable stores the length of time during which the compliance system  100  estimates the user may not have been washing vigorously. 
     The T_pause variable will be updated later on in the control flow  1100  and used to determine whether countdown timer  922  of  FIG. 9  and graphically depicted in the time meter  308  of  FIG. 3  or the individual time meter levels  310  of  FIG. 3 , should be paused or even reset. Once the set T_pause step  1106  has been executed, a receive data step  1108  can be initiated. 
     In the receive data step  1108  real-time data arrives at the processor  120  from the sensors  106  ready for analysis. The data represents what has been detected by the sensors  106  over the last T_tick seconds. An example value of T_tick might be 0.03333 seconds, such as in the case of a sensor that collects 30 frames per second. Other examples for T_tick are 0.125 seconds or 0.1111 seconds which might be used with a thermal sensor collecting data at 8 Hz or 9 Hz, respectively. 
     The data received in the receive data step  1108  can be analyzed in an analyze data step  1110 . The analyze data step  1110  can implement the processor  120  to analyze the data collected previously. As an example, the processor  120  can analyze the data received from the sensors  106  during previous executions of the receive data step  1108  along with the data received from the sensors  106  during the most recent execution of the receive data step  1108 . 
     The analysis of the data from the sensors  106  enables a determination of whether vigor was detected in a vigor detection decision step  1112 . The vigor detection decision step  1112  can branch the control flow  1100  path based on whether the data of the sensors  106  is likely to have been caused by vigorous washing action or by something else. 
     It is contemplated that the previous data analyzed during the analyze data step  1110  can be stored as a variable such as x. It is contemplated that the variable x could represent the previous portions of data received. An example value for x could be 18 in the case that the most recent 2 seconds of data are being analyzed for vigor detection and the sensor is reading data at 9 Hz. 
     When it is determined that sufficient vigor is being sensed, the vigor detection decision step  1112  will return a “YES”. A YES result from the vigor detection decision step  1112  can invoke a zero T_pause step  1114 . 
     When it is determined that sufficient vigor is not being sensed, the vigor detection decision step  1112  will return a “NO”. A NO result from the vigor detection decision step  1112  can invoke an increase T_pause step  1116 . 
     The zero T_pause step  1114  is reached in the case that the most recent attempt to detect vigor in the vigor detection decision step  1112  and the analyze data step  1110  resulted in positive detection of vigor. In this case T_pause is set to 0 which has the effect of pushing back the point at which the compliance system  100  may enter the paused state, for example the pause step  928  of  FIG. 9  during which countdown ceases, to at least a minimum pause threshold. 
     Completion of the zero T_pause step  114  can initiate the decrease T_Current step  1118 . When the vigor detection decision step  1112  determines that no vigor was detected during the most recent executions of the vigor detection decision step  1112  and the analyze data step  1110 , the increase T_pause step  1116  can be initiated. 
     During the increase T_pause step  1116  the T_pause variable is set to the sum of its previous value plus T_tick. For example, if this is the first time the compliance system  100  has entered the increase T_pause step  1116  then the previous value for T_pause will be zero. Continuing the example, if T_tick is equal to 0.125 then the new value of T_pause will be 0.125. 
     After the execution of the increase T_pause step  1116  a minimum pause threshold decision step  1120  can be initiated. The minimum pause threshold can be a time setting threshold that must be exceeded to trigger the paused condition and stop the countdown. 
     The minimum pause threshold could, for example, be 2 seconds. If vigor has not been detected in the vigor detection decision step  1112  during the last 2 seconds, under this example, the countdown timer  922  would be paused. 
     The minimum pause threshold decision step  1120  can determine whether the compliance system  100  is in a paused state. Determination of the paused state is accomplished by comparing T_pause to the minimum pause threshold. 
     If T_pause is less than the minimum pause threshold then the compliance system  100  is not in the paused state and the minimum pause threshold decision step  1120  will return a “YES”. When a YES result is obtained from the minimum pause threshold decision step  1120 , the decrease T_Current step  1118  can be invoked. 
     If T_pause is greater than or equal to the minimum pause threshold then the compliance system  100  is in the paused state and the minimum pause threshold decision step  1120  will return a “NO”. When a NO result is obtained from the minimum pause threshold decision step  1120 , a maximum pause threshold decision step  1122  can be invoked. 
     The decrease T_Current step  1118  performs the countdown step by decreasing T_Current. T_Current represents the current remaining time in the hand-wash. The decrease T_Current step  1118  decreases T_Current from its previous value to its previous value minus T_tick. For example if its previous value of T_Current was 15 seconds and T_tick is equal to 0.125 seconds then the new value for T_Current set in the decrease T_Current step  1118  is 14.875. 
     Once T_Current has been decreased in the decrease T_Current step  1118 , a T_Current zero decision step  1124  can be initiated. The T_Current zero decision step  1124  can determine whether the hand-wash countdown is complete. 
     When the T_Current zero decision step  1124  determines that T_Current is less than or equal to zero a “YES” result is returned. When a YES is returned from the T_Current zero decision step  1124  a successful step  1126  can be invoked. The successful step  1126  signifies to the user that the game has been completed successfully. 
     When the T_Current zero decision step  1124  determines that T_Current is greater than zero a “NO” result is returned. When a NO is returned from the T_Current zero decision step  1124  the receive data step  1108  can be invoked and the countdown continues with the loop from the T_Current zero decision step  1124  to the receive data step  1108 . 
     The maximum pause threshold decision step  1122  is reached when the compliance system  100  is in the paused state and the minimum pause threshold decision step  1120  returns a NO. The maximum pause threshold decision step  1122  can compare the T_pause variable, which represents the length of time that the process has been in the paused state, to a maximum pause threshold. 
     When T_pause is greater than or equal to the maximum pause threshold then the maximum pause threshold decision step  1122  will return a “NO”. When a NO result is obtained by the maximum pause threshold decision step  1122  an unsuccessful step  1128  is invoked. The unsuccessful step  1128  signifies to the user that the game has not been completed successfully. 
     When T_pause is less than the maximum pause threshold then the maximum pause threshold decision step  1122  will return a “YES”. When a YES result is obtained by the maximum pause threshold decision step  1122 , the receive data step  1108  is invoked and completes a loop from the maximum pause threshold decision step  1122  to the receive data step  1108 . 
     It is contemplated that when the transition from the maximum pause threshold decision step  1122  to the receive data step  1108  is taken, it is not too late for the user to resume scrubbing and continue the countdown process without starting over. 
     In one contemplated embodiment the minimum pause threshold could be less than or equal to the maximum pause threshold to represent the condition that a reset is only performed after the paused state is entered into. In this contemplated embodiment a NO result from the T_Current zero decision step  1124  indicating that T_Current is greater than zero could invoke the maximum pause threshold decision step  1122  rather than the receive data step  1108 . 
     It is contemplated that this alternative embodiment could result in a more efficient implementation because it could allow for a more compressed program, which might thereby result in the ability to use a lower power computer to perform the control flow  1100 . 
     Referring now to  FIG. 12 , therein is shown a graphical view of an initial image  1200  captured by the sensors  106  of  FIG. 1 . The initial image  1200  can be an initial sensor reading at a discrete time and is shown having pixels  1202 . 
     The pixels  1202  are shown as black pixels  1204  in the shape of a hand and white pixels  1206  around the black pixels  1204 . The black pixels  1204  depict the shape of a human hand while the white pixels  1206  depict the background. 
     For descriptive clarity the initial image  1200  will be discussed in terms of an image captured with a thermal imaging camera, it is contemplated that the techniques may be adapted to work with other types of imagery such as color camera imagery. Imagery that is directly output from a thermal camera, such as the sensors  106 , may have the value of each of the pixels  1202  represented in degrees Kelvin with some number of decimal places depending on the accuracy of the sensors  106 . 
     One way of depicting the sensors  106  imagery that represents thermal values is to assign the pixels  1202  that are increasingly dark to a hotter temperature, which is the so called “black hot” image representation. Temperature differences can be represented by different shades of gray. It is contemplated that the initial image  1200  does not depict any gray values because it has been processed by the processor  120  of  FIG. 1  to determine those exact pixels which belong to human hand shown as the black pixels  1204 , and which do not shown as the white pixels  1206 . 
     It is contemplated that the processing of the initial image  1200  may be performed by using a stationary camera for the sensors  106  with a background that is not moving. The sensors  106  may then take a picture of the background and store it as a background thermal image while no hand is present. The background thermal image may be stored in memory for use in processing subsequent imagery which may have human or other warm-bodied object present. 
     A method of determining which of the pixels  1202  belong to a warm-bodied object is to subtract the background thermal image stored in memory from values of the current image, such as the initial image  1200 , for each of the pixels  1202 . A positive result for any of the pixels  1202  indicates that the specific pixel  1202  is warmer now than was detected in the background thermal image and may indicate that the pixel  1202  is landing on or detecting a human hand or other warm object. 
     It contemplated that this detection of a warm body might have some noise as the temperature of the background thermal image is known to fluctuate. To eliminate noise, a filter may be used. It is contemplated that one such filter may have a lower filter threshold and that only the pixels  1202  that differ from the background thermal image more than the lower filter threshold will be recognized by the compliance system  100  as representing a human hand. 
     It is contemplated that any of the pixels  1202 , which do not differ from the background thermal image more than the lower filter threshold value, will not be recognized by the compliance system  100  as representing a human feature. Illustratively, one contemplated value for the lower filter threshold may be 3 degrees Celsius. 
     It is contemplated that the background thermal image may be updated from time to time in order to compensate for systemic error such as may be present in thermal cameras that lack active cooling. For example, the temperature of a thermal camera can indicate how it perceives the temperature of each pixel it senses. 
     As one example it is possible for a thermal camera to believe that pixels are getting hotter when in fact they land on objects that are the same temperature. This type of error can be introduced by the heating-up of the camera. 
     Updating the background thermal image from time-to-time when no warm bodies are present, can correct for such fluctuations. It has been discovered that compensating the sensors  106  by updating the background thermal image can be valuable for cameras that lack alternative calibration methods such as physical shutter calibration. 
     Referring now to  FIG. 13 , therein is shown a graphical view of a subsequent image  1300  captured by the sensors  106  of  FIG. 1 . The subsequent image  1300  is a sensor reading captured at a discrete time subsequent to the initial image  1200  of  FIG. 12 . The initial image  1200  can be considered a previous frame in reference to the subsequent image  1300 . 
     The subsequent image  1300  is shown having pixels  1302  including black pixels  1304  and white pixels  1306 . The subsequent image  1300  shows the black pixels  1304  depicting a hand shifted right. 
     The rightward shift of the black pixels  1304  can indicate that the hand detected in the initial image  1200  has moved to the right. The subsequent image  1300  further depicts less of the black pixels  1304  that correspond to fingers of the hand shown in the initial image  1200  and more of the black pixels  1304  that correspond to a wrist of the user. 
     It is contemplated that other embodiments can be implemented without requiring the capture and storage of the background thermal image as discussed above with regard to  FIG. 12 . It has been discovered that when it is desirable to estimate the amount of movement that a warm body is undergoing over time in the field of view of the sensors  106 , the background thermal image is not required to be stored but instead the compliance system  100  may rely on a previous image, such as the initial image  1200 . 
     In such a contemplated embodiment, the initial image  1200  might be stored and subtracted from the subsequent image  1300 , to identify only the pixels  1302  that are hotter in the subsequent image  1300  than the pixels  1202  of  FIG. 12  in the initial image  1200 . The number of the pixels  1302  that differ, more than the lower filter threshold, in the subsequent image  1300  from the pixels  1202  in the initial image  1200  can be regarded by the compliance system  100  as movement of the warm body in front of the sensors  106 . 
     Referring now to  FIG. 14 , therein is shown a graphical view of a difference image  1400  between the initial image  1200  of  FIG. 12  and the subsequent image  1300  of  FIG. 13 . The difference image  1400  can show pixels  1402  as a result of identifying the white pixels  1206  of  FIG. 12  and that changed to the black pixels  1304  of  FIG. 13 . 
     It can be seen from the subsequent image  1300  that when the sensors  106  of  FIG. 1  captured the subsequent image  1300  the hand depicted in the initial image  1200  had moved to the right within the frame of the sensors  106 . Black or newly hot pixels can represent movement estimations  1404 . 
     The movement estimations  1404  can correspond to the white pixels  1206  of the initial image  1200  that were not hot enough to be estimated as part of a warm body but increased in temperature to be classified as the black pixels  1304  of the subsequent image  1300  when they were hot enough to be estimated as representing the warm body. 
     The movement estimations  1404  can be calculated based on the movement of the hand from left in the initial image  1200  to right in the subsequent image  1300 . It can be seen that the fingers that are orthogonal (at a right degree angle from) the direction of motion result in the most detection of the movement estimations  1404 . 
     The total number of the movement estimations  1404  can be an estimate of motion for the user. It is contemplated that once the difference between the pixels  1202  of  FIG. 12  and the pixels  1302  of  FIG. 13  is calculated, the compliance system  100  can isolate only the newly hot pixels when determining the movement estimations  1404 . 
     It is contemplated that the pixels that changed their value from the black pixels  1204  of  FIG. 12  to the white pixels  1306  of  FIG. 13  will not be registered within difference image  1400  or regarded as the movement estimations  1404  since such pixels are not newly hot but are more aptly termed newly cold pixels; therefore, the movement estimations  1404  are isolated only to differences that are based on movement of warm objects. 
     When two warm bodies, such as two human hands, move from not occluding each other in the image to occluding the number of the pixels  1402  that are estimated to be the movement estimations  1404  may be few since the increase in occlusion means fewer pixels will be representing a hot body that is because the surface area of the detected objects decreases due to occlusion. 
     It has been discovered that by calculating the movement estimations  1404  as newly hot pixels rather than just changed pixels the change in a polarity can be detected, which is valuable because it can be used to determine the phase within a repetitive motion, such as the position of hands engaged in a scrubbing motion and the phase within the scrubbing cycle that those hands are in. 
     It is contemplated that a newly cold pixel count can be compared to the black pixel  1404  count in order to further determine a phase of motion for the hands of a user. It has been discovered that comparing the newly cold pixels with the movement estimations  1404  can also be used for determining the kind of motion being performed (e.g. non-occluding). 
     It is contemplated that the amount of motion can be represented by the movement estimations  1404  alone or, in the alternative, by the number of the movement estimations  1404  plus newly cold pixels. The difference image  1400  is shown having 31 of the movement estimations  1404 . 
     Referring now to  FIG. 15 , therein is shown a graphical view of a chart  1500  for determining the vigor for the compliance system  100  of  FIG. 1 . The chart  1500  depicts graphically a method of calculating the vigor of a hand-wash by using the count of the movement estimations  1404  of  FIG. 14 , which indicate newly hot pixels measured over time. 
     The y-axis  1502  of the chart  1500  corresponds to the number of the movement estimations  1404 . The x-axis  1504  corresponds to time. The current time is T, which is the rightmost position of the graph, represented by the “T” label on the x-axis  1504 . Example units for time are contemplated to be tenths of a second, such that the data point positioned at time T-10 represents data collected one second prior to the current time. 
     The chart  1500  is shown having an upper threshold  1506 , an average  1508 , and a lower threshold  1510 . The upper threshold  1506 , the average  1508 , and the lower threshold  1510  can be used to analyze the movement estimations  1404  for determining a frequency, or rate of repetition, of hand-washing. The chart  1500  is further depicted with a chart line  1512  connecting the movement estimations  1404  that are calculated at each time increment along the x-axis  1504 . 
     It is contemplated that one embodiment could include the upper threshold  1506  and the lower threshold  1510  being equal to the average  1508 . It is contemplated that when the upper threshold  1506  and the lower threshold  1510  are equal to the average  1508  the analysis of the movement estimations  1404  may proceed by counting crosses such as the line crosses  1514 . The line crosses  1514  can be the number of times the chart line  1512  crosses the average  1508 . 
     As can be seen in the chart  1500 , the line crosses  1514  can be counted or detected a total of six times. When the upper threshold  1506  and the lower threshold  1510  are equal to the average  1508 , one method of determining the number of scrubbing repetitions utilizes the assumption that the hands occlude each other twice during a single repetition. 
     The occlusions occur once where the left hand is moving forward, and once where the right hand is moving forward. These occlusions are detected as a lower number of the movement estimations  1404 , which appear below the average  1508 . In contrast, as the hands move out from the occlusion and the forward hand covers more area of the frame of the sensors  106  of  FIG. 1 , the number of the movement estimations  1404  increases significantly, which appears as a detection above the average  1508 . 
     The average  1508  may be derived as the average of the movement estimations  1404  recorded over a certain period of time, such as 1 or two seconds. It has been discovered that when a user&#39;s scrubbing style changes, the amount of motion for the new style generally has a smaller rise and fall in the movement estimations  1404  so it could be detected as a lack of motion. That is, a lack of the movement estimations  1404  transitioning through the average  1508 . 
     Conversely when a user changes scrubbing motions and the movement estimations  1404  increases the scrub may result in many readings above the average  1508 . In both scenarios where the user&#39;s scrubbing motion changes, the compliance system  100  may erroneously identify the scrub as having stopped. 
     One solution that has been discovered to detect scrubs, when the user changes hand-washing motions, is to detect a pause in the scrubbing motion only if the line crosses  1514  that are detected fall below a cross-threshold  1516  for a specified time  1518 . The specified time  1518  can be the same or longer than the timespan that the current hand scrub state is analyzed over. 
     For example, if the chart line  1512  is being analyzed over a timespan of 1 second, as is the case for the chart  1500 , then the compliance system  100  may continue to perform countdown with the countdown timer  922  of  FIG. 9  for the specified time  1518  of one or two seconds even though the line crosses  1514  falls below the cross-threshold  1516 . If the line crosses  1514  falls below the cross-threshold  1516  longer than the specified time  1518 , it can be recognized by the compliance system  100  that the detected scrubbing exceeding the minimum pause threshold, which can be the same threshold used in the minimum pause threshold decision step  1120  of  FIG. 11 . When the minimum pause threshold is exceeded then the compliance system  100  may pause the countdown of the countdown timer  922  in anticipation of a resumption of scrubbing vigor. 
     The line crosses  1514  may thus be used as a measure of vigor and the cross-threshold  1516  can represent a minimum level of vigor that must be maintained to ensure the countdown timer  922  continues without pause. The average  1508  may be derived by the processor  120  of  FIG. 1  as the average of the movement estimations  1404  present in the analysis timespan (T through T-10). It is contemplated that an analysis of 1 or 2 seconds or some other amount of time may be used. 
     The analysis timespan can be a sliding window, for calculating the average  1508  as well as calculating the line crosses  1514 . It has been discovered that in some scenarios noise can trigger or increase the detection of the line crosses  1514 . 
     The increase in the number of times the compliance system  100  detects the line crosses  1514  due to noise can be compensated for by implementing the upper threshold  1506  and the lower threshold  1510  that are not equal to the average  1508 . It is contemplated that the number of times the chart line  1512  transitions from above the upper threshold  1506  to below the lower threshold  1510 , or transitions from below the lower threshold  1510  to above the upper threshold  1506  during consecutive movement calculations can be counted as crosses such as threshold crosses  1520 . 
     Further, it is contemplated that the chart line  1512  does not need to transition from one estimation of the movement estimations  1404  through both the upper threshold  1506  and the lower threshold  1510  to a next estimation of the movement estimations  1404 , but the threshold crosses  1520  may still be counted even if intermediate estimations of the movement estimations  1404  fall between the upper threshold  1506  and the lower threshold  1510 . It has been discovered that the upper threshold  1506  and the lower threshold  1510  beneficially reduce the false detection of vigor. 
     It is contemplated that implementing the upper threshold  1506  and the lower threshold  1510  for noise filtering can include estimating the movement estimations  1404  from oldest to newest (left to right in the chart  1500 ). A variable S will be set as soon as the movement estimations  1404  are estimated to be above the upper threshold  1506  or below the lower threshold  1510 . If the first estimation of the movement estimations  1404  not falling between the upper threshold  1506  and lower threshold  1510  is above the upper threshold  1506  then variable S can be set to “Upper”. If the first estimation of the movement estimations  1404  not falling between the upper threshold  1506  and lower threshold  1510  is below the lower threshold  1510  then variable S is set to “Lower”. 
     The variable S may be set to “Upper” or “Lower” whenever the movement estimations  1404  are estimated above the upper threshold  1506  or below the lower threshold  1510 , respectively. Whenever the variable S transitions from “Upper” to “Lower” or “Lower” to “Upper” the threshold crosses  1520  is incremented. It is contemplated that when the movement estimations  1404  are estimated between the upper threshold  1506  and the lower threshold  1510  the value of the variable S is not changed. It is further contemplated that a number of crosses can be incremented by either the threshold crosses  1520  or the line crosses  1514 . 
     Thus, it has been discovered that the compliance system furnishes important and heretofore unknown and unavailable solutions, capabilities, and functional aspects. The resulting configurations are straightforward, cost-effective, uncomplicated, highly versatile, accurate, sensitive, and effective, and can be implemented by adapting known components for ready, efficient, and economical manufacturing, application, and utilization. 
     While the compliance system has been described in conjunction with a specific best mode, it is to be understood that many alternatives, modifications, and variations will be apparent to those skilled in the art in light of the preceding description. Accordingly, the compliance system is intended to embrace all such alternatives, modifications, and variations, which fall within the scope of the included claims. All matters set forth herein or shown in the accompanying drawings are to be interpreted in an illustrative and non-limiting sense.