Mobile and Wireless Technologies for Healthcare
Mohsen GuizaniWestern Michigan University
Wired or Not
Depends on where, why, what and how we will measure.* Emergency * Anesthesia * Intensive care (IC) * Ward * Doctor’s office * Patients’ home
* On street! * Everywhere!!
Contents
� Wireless Telemedicine, its components, and Body Area Networks (BANs)
� E-health-care Systems Framework� Middleware Approach to Ubiquitous
Health-care Systems� Emerging Health-care Technologies &
Applications (3 systems).
What is telemedicine?
� Medicine at a distance� Medicine as we know it from practice,
education, etc., using information-communication technology in all forms
Body Area Network (BAN)
� Broad range of possible devices� Broad range of media types� Connect everything you carry
on you and with you� Offer “Connected User” experience� Matches low power environment� Challenge: scalability, data rate, power
Wireless Sensor and Body-Area Networks
� Wireless Sensor and Body-Area Networks� Consist of a (potentially) large number of devices with
sensor or actuator functionality.� Broad range of applications and services� Broad range of bandwidth requirements and network
topologies� May interact with other networks in close proximity
(‘instant partner communication’)� Devices may be ‘always-on’ or ‘low duty cycle’� Devices may be ‘context aware’
Wireless Sensor and Body-Area Networks
� WG5 scope: short-range radio communication systems� The Immediate Environment: elements and devices
surrounding us, the ‘nearest’ objects, including those that might be part of our body
� Personal and Area Networks� Local Area Networks� Sensor and Body-Area Networks
2009 Sendai International Workshop 1 / 7
Body Area Networks –Target Position
Average power consumption, sustained data rate
1000 mW500 mW100 mW50 mW10 mW
1 Gbit/s
100 kbit/s
1 Mbit/s
10 Mbit/s
100 Mbit/s
1 kbit/s
10 kbit/s
Wireless USB
IEEE 802.11 a/b/g
Bluetooth
ZigBee
200 mW20 mW
Body Area Network
5 mW2 mW
Components of Telemedicine
Non-invasive WBANs
� Monitoring and sensing signals from the human body for medical applications
� Distributed communications over the human body
Invasive WBANs� Invasive or “In-Body” Area Networks wirelessly connect
implanted medical devices operating in the MICS bands (402-405 MHz) and on-body sensors operating in ISM bands or using UWB with monitoring equipment to provide patient health data in real-time.
� Miniature “Pill camera” takes hundred of thousands of imagesduring typical eight-hours test.
� Images and medical data are transmitted to a “reader” machine:� Workstation allows to view, edit, archive and e-mail the live
video, images and data.� Physician can observe and detect exact location of suspected
“in-body” disorder� Patient data can be sent through the network to establish a
diagnosis and trigger the required actions via actuators.
An invasive WBAN Body Area Networks
� Usage Scenarios� Body senor network� Fitness monitoring� Wearable audio� Mobile device centric� Video stream� Remote control & I/O
devices
Body Sensor Network� Medical application
� Vital patient data� Wireless sensors� Link with bedside monitor� Up to 10 – 20 sensors
� Five similar networks in range� Minimum setup interaction� Potentially wide application� Total traffic/patient < 10 kbps
Fitness Monitoring� Central device is MP3 player� Wireless headset included� Expand functionality
� Speed, distance� Heart rate, respiration monitor� Temperature sensor� Pacing information� Location information� Wristwatch display unit, etc.
� Total system load < 500 kbps� Synchronization may go faster
2009 Sendai International Workshop 2 / 7
Wearable Audio� Central device is headset� Stereo audio, microphone� Connected devices
� Cellular phone� MP3 player, PDA� CD audio player� AP at home� Handsfree car� Remote control, Others
� Requires priority mechanism� Network load < 500 kbps
Mobile Device Centric� Mobile terminal is central point� Covers broad set of data
� Sensors – vital, other� Headset� Peripheral devices� Handsfree / car
� Provide gateway to outside� Offload sensor data, other
� Requires priority mechanism� Network load < 500 kbps
Personal Video� Central device is video camera
� Camera sensor, recording, display� Stream video content SDTV, HDTV� Connect other devices
� Personal storage device� Playback device w/ large display� Remote beam finder� Location information (meta data)� Mobile communications device (MMS)� Home media server (sync)
� Total traffic load: 10 – 60 Mbps
Real-Time Telemedicine
� Requirements� Good audio+video-conferencing capabilities� Real-time medical data transmission + feedback
� The Remote Ultrasound Challenge� Challenge #1: Data size
� Data compression/transmission� Challenge #2: Real-time feedback on image quality� Challenge #3: Remote 3D reconstruction
� Need to ensure 2D images are good quality
Use of Radio Frequency IDs (RFIDs)
�Assistance for the disabled�Hospital management�Implants�Smart Implants�Medical Monitoring
Penetration of Sensors into Wireless Telemedicine
E-health-care Systems Framework
Telemedicine can use a number of technologies!
� RFID (Active and passive) Short range, reader/tags for identification and tracking
� The most common frequencies are 124 kHz, 1356 MHz, 860-960 MHz and 245 GHz
� Zigbee (Sensor networks) � Up to 100 m range, up to 250 kB/s, 2.4 GHz
� Bluetooth� Up to 100 m range, up to 760 kB/s, 2.4 GHz
� WLAN/Wi-Fi� Up to 100 m range, up to 54 MB/s, 2.4 GHz, 5.2 GHz
� UWB (Ultra-wideband)� Up to 10 m range, up to 1 GB/s, 3.1 – 10.5 GHz
� Bluetooth 3.0 will use UWB radio� WMTS: Wireless Medical Telemetry Services
� Up to kilometers, 608 to 614 MHz, 1395 to 1400 MHz, 1429 to 1432MHz
2009 Sendai International Workshop 3 / 7
Available TechnologiesWith many ways of communicating …
… and many user interfaces.WIREH: A Wireless Solution Framework in Healthcare
Requirements of E-healthcare Framework
Global wireless healthcare roadmap
Modus-OperandieHealth-Care
Server
NGOs,Government,Other Health
Initiatives,Donors,
Corporates
WEB
PHC Hospital
Generic Architecture
Wired Access
Wireless Access
HTB
Oracle10g
ApplicationServer 10gWith wireless component
Data Display Data Retrieval Data Storage
2009 Sendai International Workshop 4 / 7
Business Process Overview
Nutritionist
Diet TypeFor
Patient
defines
SetsOf menus
Patient
Selects one set from
Delivery Man
delivers
Social Services
Feeds BackInformationsAbout patient
1 2 3
4
Application Programming Interface
HTBSingle Source of
Truth
Remote Monitoring
New Applications
Existing Applications
Supporting New Healthcare Applications and Processes
Integrating Information
HTB
PersonServices
MessageServices
Single RecordPatient: 123456
HL7 Version 3.0
Delaminated File
HL7 version 2.X
XML
Bespoke Standard
Flat File
InterfaceEngine
HL7 Version 3
Protecting Patient Privacy
HTBSingle Source of
Truth
SecurityService
AuditingService
Oracle Fusion Middleware
A glance at the Benefits of using Oracle Fusion Middleware for E-healthcare
Develop
Orchestrate
Deploy
Secure
Access
Integrate
Manage
Analyze
Optimize
Emerging Health-care Technologies & Applications
AGAPEAGAPE� Context awareness for anytime and anywhere
assistance manage ad hoc assistance groups
A B
Context awareness is crucial in group management supports
Context awareness can also help reduce bystander apathy
UbiquitousEmergency assistance Ad hoc Network
2009 Sendai International Workshop 5 / 7
Motivation & ProblemMotivation & Problem
� Anytime and anywhere outdoor assistance requires1. formation of first response groups wherever
emergency events occur� Not only medical personnel, but also friends,
neighbors, and passer-by can contribute2. the interactions among first responders needed to
make rapid decisions in unexpected situations � to coordinate assistance tasks depending on user
skills, location, and device characteristics
Experimental SetupExperimental Setup
� Deployment setting� Mobile Ad hoc Network(MANET) scenario
- IEEE 802.11b(wireless cards) - static IP- AODV(Ad hoc On Demanding Distance Vector) routing protocol
� Xybernauts MA-V wearable device -Elderly users and physicians
Pc Expo inJapan 2001.6.29http://www.watch.impress.co.jp
Experimental SetupExperimental Setup
� Deployment setting� ECG Pocket View Holter
- monitors arrhythmia disorders through skin-contact electrodes
Institute Renatahttp://www.instituutrenata.com/
ANGELAHANGELAH (AssistiNG ELders At Home)
� Home networks� Set-top box is nowadays a web server at home� Connect all devices to set-top box include the door lock
system� Your PDA has your profile except password� When your PDA is connected to the home server devices
know your profile and customize services
Bluetooth,WIFI
Homeserver
Any server
Hand held device
ANGELAHANGELAH
� Reliability concerned with network bandwidth and connectivity should be considered significantly in emergency assistant system.
� Context aware middleware is essential application not only in healthcare, but also in all other ubiquitous environments like homenetworks. � The ANGELAH framework is envisioned to support elders at home.
Objectives of ANGELAH� ANGELAH presents a middleware-level solution
integrating both ”elder monitoring and emergency detection” solutions and networking solutions.
� ANGELAH has two main features: � Enables efficient integration between a variety of sensor
entities (SEs) and actuators deployed at home for emergency detection
� Provides a solid framework for creating and managing rescue teams composed of individuals willing to promptly assist elders in case of emergency situations.
� A prototype of ANGE-� A prototype of ANGELAH has already been designed and
implemented for helping indoor elders with vision impairments.
ANGELAH Framework
SurveillanceCenter (SC)
Room 3Room 3
Room 1Room 1
Elder
Home Manager (HM)
Locality Manager (LM)
Home Network
Room 2Room 2
Locality 1
LocalResponders
SE1.1
SE1.2
SE1.3
AE1
SE3.1
SE3.2
SE3.3
AE3
SE2.3
SE2.2
SE2.1
SE1
LR1
LR2
LR3
LR4
AE2
Brief Functionality of ANGELAH
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RespondersSelection
CollaborationManagement Support
Choice ofinteraction mode
ExemptedVolunteer
EmergencyNotification
EmergencyInformation
VolunteerAvailability
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2009 Sendai International Workshop 6 / 7
Various Players in ANGELAH
UsesMADMAlgorithm
An Example of Computer Vision based Emergency Detection (integrated with ANGELAH)
PEACH (PervasiveEnvironment for AffeCtive Healthcare)
� PEACH integrates affective/emotional computing with ubiquitous networking to provide a unique middleware-level healthcare solution.
� Integrates sensors in the human’s Body Area Network (BAN) to monitor individuals’ emotionalstates and detect emergency situations.
� Formulates emergency ad hoc rescue teams to assist the victims.
� Envisaged for drug abuses/overuses scenarios.
PEACH Framework
Telemedicine�Cost Reduction & Reaching more people
And . . . Conclusion� Wireless Telemedicine, its components, and
Body Area Networks (BANs)� E-health-care Systems Framework� Middleware Approach to Ubiquitous Health-
care Systems� Emerging Health-care Technologies &
Applications (3 systems)� Future of Telemedicine� Challenges in Telemedicine
2009 Sendai International Workshop 7 / 7
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