L. Serrano

Analysis and Description of HOLTIN Service Provision for AECG monitoring in Complex Indoor Environments

In this work, a novel ambulatory ECG monitoring device developed in-house called HOLTIN is analyzed when operating in complex indoor scenarios. The HOLTIN system is described, from the technological platform level to its functional model. In addition, by using in-house 3D ray launching simulation code, the wireless channel behavior, which enables ubiquitous operation, is performed. The effect of human body presence is taken into account by a novel simplified model embedded within the 3D Ray Launching code. Simulation as well as measurement results are presented, showing good agreement. These results may aid in the adequate deployment of this novel device to automate conventional medical processes, increasing the coverage radius and optimizing energy consumption.

Telemonitoring Systems Interoperability Challenge: An Updated Review of the Applicability of ISO/IEEE 11073 Standards for Interoperability in Telemonitoring

Advances in Information and Communication Technologies, ICT, are bringing new opportunities and use cases in the field of systems and Personal Health Devices used for the telemonitoring of citizens in Home or Mobile scenarios. At a time of such challenges, this review arises from the need to identify robust technical telemonitoring solutions that are both open and interoperable. These systems demand standardized solutions to be cost effective and to take advantage of standardized operation and interoperability. Thus, the fundamental challenge is to design plug-&-play devices that, either as individual elements or as components, can be incorporated in a simple way into different Telecare systems, perhaps configuring a personal user network. Moreover, there is an increasing market pressure from companies not traditionally involved in medical markets, asking for a standard for Personal Health Devices, which foresee a vast demand for telemonitoring, wellness, Ambient Assisted Living (AAL) and e- health applications. However, the newly emerging situations imply very strict requirements for the protocols involved in the communication. The ISO/IEEE 11073 family of standards is adapting and moving in order to face the challenge and might appear the best positioned international standards to reach this goal. This work presents an updated survey of these standards, trying to track the changes that are being fulfilled, and tries to serve as a starting-point for those who want to familiarize themselves with them.

Standard-Based Middleware Platform for Medical Sensor Networks and u-Health

Advances in information and communication technologies, ICT, are bringing new opportunities in the field of middleware systems oriented to ubiquitous environments and wearable devices used for patient telemonitoring. At a time of such challenges, this paper arises from the need to identify robust technical telemonitoring solutions that are both open and interoperable in home or mobile scenarios. These middleware systems demand standardized solutions to be cost effective and to take advantage of standardized operation and interoperability. Thus, a fundamental challenge is to design a plug-&-play platform that, either as individual elements or as components, can be incorporated in a simple way into different telecare systems, perhaps configuring a personal user network. Moreover, there is an increasing market pressure from companies not traditionally involved in medical markets, asking for a standard for personal health devices (PHD), which foresee a vast demand for telemonitoring, wellness, ambient assisted living (AAL) and applications for ubiquitous-health (u-health). However, the newly emerging situations imply very strict requirements for the protocols involved in the communication. The ISO/IEEE 11073 (X73) family of standards is adapting to new personal devices, implementing high quality sensors, and supporting wireless transport (e.g. Bluetooth) and the access to faster and reliable communication network resources. Its optimized version (X73-PHD) is adequate for this new technology snapshot and might appear the best-positioned international standards to reach this goal. This work presents an updated survey of this standard and its implementation in a middleware telemonitoring platform.

Implementation Methodology for Interoperable Personal Health Devices With Low-Voltage Low-Power Constraints

Traditionally, e-Health solutions were located at the point of care (PoC), while the new ubiquitous user-centered paradigm draws on standard-based personal health devices (PHDs). Such devices place strict constraints on computation and battery efficiency that encouraged the International Organization for Standardization/IEEE11073 (X73) standard for medical devices to evolve from X73PoC to X73PHD. In this context, low-voltage low-power (LV-LP) technologies meet the restrictions of X73PHD-compliant devices. Since X73PHD does not approach the software architecture, the accomplishment of an efficient design falls directly on the software developer. Therefore, computational and battery performance of such LV-LP-constrained devices can even be outperformed through an efficient X73PHD implementation design. In this context, this paper proposes a new methodology to implement X73PHD into microcontroller-based platforms with LV-LP constraints. Such implementation methodology has been developed through a patterns-based approach and applied to a number of X73PHD-compliant agents (including weighing scale, blood pressure monitor, and thermometer specializations) and microprocessor architectures (8, 16, and 32 bits) as a proof of concept. As a reference, the results obtained in the weighing scale guarantee all features of X73PHD running over a microcontroller architecture based on ARM7TDMI requiring only 168 B of RAM and 2546 B of flash memory.

Towards e-Health Device Interoperability: The Spanish Experience in the Telemedicine Research Network

The expansion of e-Health solutions is hindered by the high costs and low flexibility of home and mobile telemonitoring systems. This situation may be improved by the use of standards to design open, plug-and-play and interoperable devices. This work describes the joint efforts of three research groups in Spain towards the interoperability of their telemonitoring solutions based on the ISO11073/IEEE1073 family of standards

Seamless Integration of ISO/IEEE11073 Personal Health Devices and ISO/EN13606 Electronic Health Records into an End-to-End Interoperable Solution

The new paradigm of personal health demands open standards and middleware components that permit transparent integration and end-to-end interoperability from new personal health devices to healthcare information system. The use of standards seems to be the internationally accepted way to face this challenge. In this article, the implementation of an end-to-end standard-based personal health solution is presented. It integrates the ISO/IEEE11073 standard for the interoperability of personal health devices in the patient environment and the ISO/EN13606 standard for the interoperable exchange of electronic healthcare records and proposes a new approach for the end-to-end ISO/IEEE11073-ISO/EN13606 communication. The design strictly fulfills all the technical requirements of the most recent versions of both standards. An entire prototype has been designed, developed, and tested as a proof-of-concept of a personal health solution.

Proposal of an ISO/IEEE11073 Platform for Healthcare Telemonitoring: Plug-and-Play Solution with new Use Cases

Remote patient monitoring in e-Health is everyday closer to be a mature technology/service. However, there is still a lack of development in areas such as standardization of the sensors communication interface, integration into electronic healthcare record systems or incorporation in ambient-intelligent scenarios. This work identifies a set of use cases involved in the personal monitoring scenario and highlights the related features and functionalities, as well as the integration and implementation difficulties found when these are to be implemented in a system based on the ISO/IEEE11073 (X73) standard. It is part of a cooperative research effort devoted to the development of an end-to-end standards-based telemonitoring solution. Standardization committees are working towards adapting the X73 standard to this emerging personal health devices market and use case identification is essential to direct these revisions.

Standard-Based Homecare Challenge

Advances in Information and Communication Technologies, ICT, are bringing new opportunities in the field of interoperable and standard-based systems oriented to ubiquitous environments and wearable devices used for digital homecare patient telemonitoring. It is hoped that these advances are able to increase the quality and the efficiency of the care services provided. Likewise they should facilitate a home monitoring of chronic, elderly, under palliative care or have undergone surgery, leaving beds in the Hospital for patients in a more critical condition. In any case telemonitored patients could continue to live in their own homes with the subsequent advantages as more favorable environment, less need for trips to the hospital, etc.

Implementation Experience of a Patient Monitoring Solution based on End-to-End Standards

This paper presents a proof-of-concept design of a patient monitoring solution for Intensive Care Unit (ICU). It is end-to-end standards-based, using ISO/IEEE 11073 (X73) in the bedside environment and EN13606 to communicate the information to an Electronic Healthcare Record (EHR) server. At the bedside end a plug-and-play sensor network is implemented, which communicates with a gateway that collects the medical information and sends it to a monitoring server. At this point the server transforms the data frame into an EN13606 extract, to be stored on the EHR server. The presented system has been tested in a laboratory environment to demonstrate the feasibility of this end-to-end standards- based solution.

Implementation of Context Aware e-Health Environments Based on Social Sensor Networks

In this work, context aware scenarios applied to e-Health and m-Health in the framework of typical households (urban and rural) by means of deploying Social Sensors will be described. Interaction with end-users and social/medical staff is achieved using a multi-signal input/output device, capable of sensing and transmitting environmental, biomedical or activity signals and information with the aid of a combined Bluetooth and Mobile system platform. The devices, which play the role of Social Sensors, are implemented and tested in order to guarantee adequate service levels in terms of multiple signal processing tasks as well as robustness in relation with the use wireless transceivers and channel variability. Initial tests within a Living Lab environment have been performed in order to validate overall system operation. The results obtained show good acceptance of the proposed system both by end users as well as by medical and social staff, increasing interaction, reducing overall response time and social inclusion levels, with a compact and moderate cost solution that can readily be largely deployed.