Ing Widya

Mobile patient monitoring: The MobiHealth system

The emergence of high bandwidth public wireless networks and miniaturized personal mobile devices give rise to new mobile healthcare services. To this end, the MobiHealth system provides highly customizable vital signs tele-monitoring and tele-treatment system based on a body area network (BAN) and a mobile health care (m-health) service platform utilizing next generation public wireless networks. The developed system allows the incorporation of diverse medical sensors via wireless connections, and the live transmission of the measured vital signs to healthcare providers as well as real-time feedback to the patient. Since 2002 the system has undergone substantial development in consecutive EU and national research projects. Diverse trials with different healthcare scenarios and patient groups in different European countries have been conducted in all projects. These have been performed to test the service and the network infrastructure including its suitability for m-health applications.

BANip: Enabling Remote Healthcare Monitoring with Body Area Networks

This paper presents a Java service platform for mobile healthcare that enables remote health monitoring using 2.5/3G public wireless networks. The platform complies with todayrsquos healthcare delivery models, in particular it incorporates some functionality of a healthcare call center, a healthportal for patients that aggregates healthcare services from collaborative care centers. Our service platform simplifies the development of mobile healthcare applications, because application developers are shielded from the complexity of communicating with mobile devices over 2.5/3G networks. In this paper we focus on the (BAN) interconnect protocol (BANip) which is our solution to extend the local services offered by a Body Area Network (BAN) to remote healthcare center.

Mobihealth: Mobile Health Services Based on Body Area Networks

In this chapter we describe the concept of MobiHealth and the approach developed during the MobiHealth project (MobiHealth, 2002). The concept was to bring together the technologies of Body Area Networks (BANs), wireless broadband communications and wearable medical devices to provide mobile healthcare services for patients and health professionals. These technologies enable remote patient care services such as management of chronic conditions and detection of health emergencies. Because the patient is free to move anywhere whilst wearing the MobiHealth BAN, patient mobility is maximised. The vision is that patients can enjoy enhanced freedom and quality of life through avoidance or reduction of hospital stays. For the health services it means that pressure on overstretched hospital services can be alleviated.

A scenario guideline for designing new teletreatments: a multidisciplinary approach

Lack of user acceptance of telemedicine services is an important barrier to deployment and stresses the need for involving users, i.e. medical professionals. However, the involvement of users in the service development process of telemedicine services is difficult because of (a) the knowledge gap between the expertise of medical and technical experts; (b) the language gap, i.e. the use of different terminologies between the medical and the technical professions; and (c) the methodological gap in applying requirement methods to multidisciplinary scientific matters. We have developed a guideline in which the medical and technical domains meet. The guideline can be used to develop a scenario from which requirements can be elicited. In a retrospective analysis of a myofeedback-based teletreatment service, the technically-oriented People-Activities-Context-Technology (PACT) framework and medically-oriented principles of evidence-based medicine were incorporated into a guideline. The guideline was developed to construct the content of a scenario which describes the new teletreatment service. This allows the different stakeholders to come together and develop the service. Our approach provides an arena for different stakeholders to take part in the early stages of the design process. This should increase the chance of user acceptance and thus adoption of the service being developed.

Biosignal and context monitoring: Distributed multimedia applications of Body Area Networks in healthcare

We are investigating the use of body area networks (BANs), wearable sensors and wireless communications for measuring, processing, transmission, interpretation and display of biosignals. The goal is to provide telemonitoring and teletreatment services for patients. The remote health professional can view a multimedia display which includes graphical and numerical representation of patientspsila biosignals. Addition of feedback-control enables teletreatment services; teletreatment can be delivered to the patient via multiple modalities including tactile, text, auditory and visual. We describe the health BAN and a generic mobile health service platform and two context aware applications. The epilepsy application illustrates processing and interpretation of multi-source, multimedia BAN data. The chronic pain application illustrates multi-modal feedback and treatment, with patients able to view their own biosignals on their handheld device.

Context aware body area networks for telemedicine

A Body Area Network (BAN) is a body worn system which provides the user with a set of mobile services. A BAN incorporates a set of devices (eg. mp3 player, video camera, speakers, microphone, head-up display, positioning device, sensors, actuators). A BAN service platform for mobile healthcare and several health BANs targetting different clinical applications have been developed at the University of Twente. Each specialization of the BAN is equipped with a certain set of devices and associated application components, as appropriate to the clinical application. Different kinds of clinical data may be captured, transmitted and displayed, including text, numeric values, images and multiple biosignal streams. Timely processing and transmission of such multimedia clinical data in a distributed mobile environment requires smart strategies. Here we present one approach to designing smart distributed applications to deal with multimedia BAN data; namely the context awareness approach developed in the FREEBAND AWARENESS project.

QoC-based Optimization of End-to-End M-Health Data Delivery Services

This paper addresses how quality of context (QoC) can be used to optimize end-to-end mobile healthcare (m-health) data delivery services in the presence of alternative delivery paths, which is quite common in a pervasive computing and communication environment. We propose min-max-plus based algebraic QoC models for computing the quality of delivered data impeded by the QoS of the resources along the alternative delivery paths. The constructed algebraic structures in those models directly relate to the resource configurations represented as directed graphs. The properties of the applied algebras correspond to the properties of the operations of the addressed QoS dimensions. To rank all the possible resource configurations and therewith select from those the most optimal one(s) we introduce a workflow management metric based on the quality dimensions like freshness and availability. We focus on the pre-establishment phase of m-health data delivery services; dynamic QoC issues existing during service execution are not considered

Making medical treatments resilient to technological disruptions in telemedicine systems

Telemedicine depends on Information and Communication Technology (ICT) to support remote treatment of patients. This dependency requires the telemedicine system design to be resilient for ICT performance degradation or subsystem failures. Nevertheless, using telemedicine systems create a dependency between medical and technological concerns. We propose a layering technique that links medical and technological concerns by using a two-staged scenario based requirements elicitation method. This layering technique provides functional relations between technological variables (e.g. raw ECG signal) and their technological context (e.g. measurements conditions), clinical variables (e.g. heart rate), and clinical abstractions (e.g. physical exercise target heart rate) and the non-functional quality of data relations between the layers. We use a hierarchical ontology to specify these functional and nonfunctional relations, which enables the development of technological context and quality-aware telemedicine systems that are able to cope with technological disruptions whilst preserving patient safety.

Remote Monitoring for Healthcare and for Safety in Extreme Environments

In this chapter we examine the potential use of remote health monitoring using Body Area Networks (BANs) to support individuals who are working or pursuing recreational activities in extreme environments.

A mobility-aware broadcasting infrastructure for a wireless internet with hotspots

In this paper, we consider the problem of adaptively delivering live multimedia broadcasts (e.g., for applications such as TV, radio, or e-cinema) to a potentially large number of mobile hosts that roam about in a wireless internet with hotspots. We take a user-oriented approach based on an application-level delivery infrastructure consisting of and managed by (value-added) service providers. The service providers are mobility-aware and offer broadcasts in configurations that are optimized for wireless links and mobile hosts. In hotspots, mobile hosts may be able to simultaneously reach several localized service providers through different interfaces. Within this context, we present the design of a lightweight application-level protocol that enables mobile hosts to select a service provider from which they want to receive a broadcast. Mobile hosts use the protocol to begin receiving a broadcast and to remain connected to the same logical broadcast as they move across subnets. The protocol is independent of the actual stream control protocol (e.g., RTSP) that service providers might use. We show how our protocol can be realized with the existing protocols SIP and SDP. The realization uses SIP in combination with SDPs offer-answer model in a new way.