Cloud Development of Medical Systems By Oleg Kruk, Embedded Research Lab Leader, DataArt

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1 Cloud Development of Medical Systems By Oleg Kruk, Embedded Research Lab Leader, DataArt Abstract Wireless electronic medical devices have made remote medicine a reality. Disease prevention, monitoring of chronic illnesses and eldercare capabilities have expanded beyond the restraints of physical location. It is now possible to view up-to-the-minute data on patient health via a wireless monitoring system, and to share a patient s diagnostic data with clinics around the world in real time. As wireless electronic medical devices become more widely employed, practitioners seek improved communication between them in order to maximize their effectiveness. Introduction A period of rapid growth for embedded technologies is underway. This is not only the result of more widely accessible chips, debug boards and development/debugging environments, but also of the increased demand for embedded technologies from the modern IT market. In the 1990s, the ease of access to the World Wide Web caused millions of people to buy PCs so they could connect. Now the internet is reaching further and connect billions of devices of all shapes and sizes. This phenomenon is called the Internet of Things or IoT, and is the main reason embedded technologies are developing so quickly. So what should we expect when billions of devices go online? For one, there will be many more Man-Device and even fully automated Device-Device data exchanges on a regular basis. Fig. 1. Management of devices through cloud technologies in the internet Interactions of the latter type are known as Machine-to-Machine or M2M. Devices that take part in M2M interactions are usually wired, wireless sensor or parameter (temperature, stock level, location, etc.) monitoring systems. M2M is also actively used in security systems, e-commerce, wearables, healthcare, industrial telemetry (manufacturing, power industry, the housing and public utility sector, etc.) and moving object positioning systems based on GPS / GLONASS.

2 Until recently, M2M projects were embedded systems designed around custom hardware, custom software, and custom network connectivity. The challenge in developing these projects stemmed from the large customization and integration costs, and the limited re-usability across similar engagements. The results were often proprietary systems leveraging proprietary protocols. The emergence of the service gateway model, which operates on the edge of an M2M deployment as an aggregator and controller, has opened up new possibilities. Cost-effective service gateways are now capable of running modern software stacks, opening the world of M2M to enterprise technologies and programming languages. Advanced software frameworks, which isolate the developer from the complexity of the hardware and the networking sub-systems, can now be offered to complement the service gateway hardware into an integrated hardware and software solution. M2M Medicine Today s public health services paradigm is a counterbalance of preventative, maintenance-focused medicine and traditional medicine that is focused on treatment. M2M Medicine systems create new possibilities for both. Medical IT as a whole has become an effective tool for the professional development of doctors, through video consultations, lectures and direct transmissions of operations. But the key factor in development of M2M Medicine is the remote interaction between the doctor and the patient. This involves not only operative diagnostics by means of specialized devices, but actual remote treatment as well. Mobile medicine is a highly effective and efficient way to deliver medical services to a mass audience. Most modern mobile devices have apps for fitness and maintenance of a healthy lifestyle. Medical devices suitable for out-patient use (electrocardiographs, tonometers, and various technologies of the wireless communication) can send and receive various indicators of patient health to attending physicians. 70 % of medical companies are engaged in mobile development, investing more than 10 % of their IT budget in it. The mobile emergency help is distributed in cases of accidents, is used in the telemedicine sphere, for health indicators of separate patients and even groups of patients. Telemedicine technologies are especially valuable in remote areas. Full-scale cloud platforms for storage of electronic medical cards are available today, with a considerable quantity of accompanying services, including electronic recipes, electronic directions, an appointment reminder service, physician search by specialty, the second opinion service (additional consultation), and an electronic catalogue of medical products with automatic comparison of all options accepted by the physician. They are typically free both for doctors and for the patients.

3 Open Source Platforms Controlling these dispersed, wirelessly connected device fields is a daunting task. How does an M2M developer focus on the areas where they are most needed? How is their time best used? Open source platforms use networking and cloud technologies to implement better solutions for M2M data exchange, absorbing some of the timeconsuming procedural work typically devoted to such projects and offering a framework that can effectively manage M2M connections. It allows developers to put aside the implementation of protocols and messaging libraries and focus on the main functionality of the system. Connecting Wireless Medical Devices How is the healthcare industry embracing M2M technology? An increasingly common scenario for elderly heart patients, for example, is to have a wireless heart monitor in place for outpatient care. Whether patients are in their own homes or in assisted living facilities, doctors have the ability to view up-to-the-minute data on their cardiovascular health without requiring in-person examinations. This saves time and money for both practitioner and patient, and all those in between who would normally have to facilitate such visits. Doctors can quickly determine if the patient s drug dosage must be adjusted, or if a new drug altogether must be prescribed. When necessary, doctors can then share their data with specialists anywhere in the world for expert opinions. There is no slowdown in sight in the number of wireless electronic medical devices hitting the market. Like the obstacles facing M2M solutions more broadly, the challenge within this growing vertical is the inefficient development process. Traditional approaches require specialists in different areas, from electronic engineers to front-end developers. Again, open source frameworks can be used to streamline the process. IoT Solutions for Medical Devices Medical professionals can use M2M technology to work intuitively with their devices (through the internet) as if they were novice developers. In some cases, the platform will merely enhance the capabilities of the hardware and software they are already using. For higher-level tuning, programmers with experience in software development for medical equipment can create customized user applications and write new control utilities, with API to assist with the editing of programs stored in Flash-memory modules. Medical equipment varies greatly across the globe. In emergencies, wireless medical technology eliminates the need for set jumper cables since the transition of the parameters measured can be carried via Bluetooth on a measuring device for remote analysis. The solution works with all sorts of common and professional devices, including blood pressure monitors, heart rate limiting measurement devices, blood

4 glucose meters and cardiographs. The solution can also be implemented with household Bluetooth-diagnostic medical devices such as pulse oximeters, blood pressure monitors, thermometers, weighing scales and glucose meters. Wireless medicine reduces expenses on public health services, raises the quality of care of patients and overcomes any lack of experts in the field of public health services. By means of wireless medicine and M2M communications, medical institutions and manufacturers of medical equipment can combine devices on a uniform platform in a secure cloud. Thus, doctors and medical institutions will get unified access to the biometric information of patients. As a rule, such platforms are a protected cloud service, not dependent on any concrete technology, thus connecting medical devices for the purpose of free data exchange between users of such devices and medical institutions. The data is collected from the patient s medical equipment and sent through protected channel of a mobile communication. For connection to such platforms, mobile phones and other mobile devices, and also interfaces of the appendices providing access to a client service platform are used. Communication is carried out through a SIM-card that guarantees continuous work of a platform and decisions. M2M platforms overcome the economic and technological barriers to development of innovative services in patient care. Connecting to such platforms will combine data from several medical devices in one information stream. It will allow doctors to better coordinate work on patients, and to reduce the quantity and duration of hospital visits. The diagram below shows the M2M platform in conjunction with another wireless medical device; a surgically imbedded wireless heart monitor. This device provides continuous ECG (electrocardiogram) monitoring. The measured data from the heart rate monitor is permanently transferred to the Gateway via a Bluetooth channel. The Gateway then sends processed data to the doctor. The heart rate monitor enables measurement of dynamic ECG changes over several days and different modes of patient behavior. If the measured values exceed specified limits, the emergency alarm will be sent to the doctor.

5 Fig. 6. Medical devices connecting to M2M cloud Conclusion In healthcare technology and across other verticals, IT project managers should be looking for ways to utilize programmers at their highest level of expertise in order to maximize profitability. Money can be saved by using general-purpose cloud services for IT infrastructure, but these services tend to leave too many development tasks undone. As the hours add up, the savings fly out the window. Open source frameworks minimize the learning curve, amplify the accomplishments of more people, and help projects get completed faster. We are especially excited to see the accelerating integration of medical devices into the IoT. The next generation of heart monitors will be compatible with electronic consumer systems (home networks, TVs, desktop computers, and PDAs) and with devices from different manufacturers.