A Study for Home and Mobile U-Healthcare System

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1 , pp A Study for Home and Mobile U-Healthcare System Regin Joy Conejar 1 and Haeng-Kon Kim 1* 1 School of Information Technology, Catholic University of Daegu, Korea [email protected], * [email protected] Abstract Mobile technologies usage is becoming more integrated with the delivery of patient care. Mobile technology has the potential to have a positive impact on healthcare. The number of people suffering from chronic diseases is growing rapidly and poses an ever increasing strain on the health care sector. An ageing population is now the leading healthcare concern of many countries in the world. Aged patients need more healthcare efforts as they present more cases of chronic illnesses involving higher healthcare costs. Keywords: U-Healthcare, RFID 1. Introduction Mobile technologies have transformed the way healthcare providers communicate and these mobile devices are poised to revolutionize the way hospital deliver care. Mobile technology offers ways to help these challenges. Through mobile health applications, sensors, medical devices, and remoter patient monitoring products, there are avenues through which healthcare delivery can be improved. Now this technology is poised to alter how health care is delivered, the quality of the patient experience, and the cost of health care. Mobile technology is helping with chronic disease management, empowering the elderly and expectant mothers, reminding people to take medication at the proper time, extending service to underserved areas, and improving health outcomes and medical system efficiency. Today s healthcare industry emphasizes safety, efficiency, patient-oriented approach, timeliness and balance. U-Healthcare makes it possible to safely deliver appropriate services from any location at any time. To explain the emergence of u-healthcare, one must invoke, first of all, progress in IT and medical technology, and then the desire and willingness on the part of health care institutions to adopt the new service concept and increased health care demand. Digitalization of information, introduction of broadband communication and leaps made in healthcare technology in recent years have provided the technological capacity necessary for the achievement of u-healthcare. 2. Related Works Complex mobile health applications help in areas such as training for health care workers, the management of chronic disease, and monitoring of critical health indicators. They enable easy to use access to tools like calorie counters, prescription reminders, appointment notices, medical references, and physician or hospital locators. These applications empower patients and health providers proactively to address medical conditions, through near real-time monitoring and treatment, no matter the location of the patient or health provider. 2.1 Innovations in Mobile Healthcare A major limitation for today s healthcare is that vital signs cannot be measured often enough [3]. With the current assortment of health monitoring devices available in the ISSN: IJSEIA Copyright c 2015 SERSC

2 market for purchase by anyone (such as the digital pulse oximeter by Nonin Medical [4] and the heart monitor by Alive Technologies [5]), vital signs may now be measured more often but this leads to the problem of non-optimal analysis of results by the patient which normally would best be examined by a specialist or doctor. Four major aspects of home health care involve [6]: 1. preventative health care programs; 2. physiological monitoring; 3. functional monitoring and 4. assessment of quality of life Remote Testing and Diagnosis There has been a growth recently in wearable sensors and remote monitoring devices. Some of these products have been listed with the FDA, while others are off-shore devices that are not for sale in the United States. For example, researchers have developed a portable electrocardiogram (ECG) system for high-risk cardiac patients. It uses smart phones attached to heart monitors to transmit heart rhythm data to health providers. Software analyzes the ECG waveforms for possible abnormalities. Those requiring special attention are notified of possible problems that need to be addressed [7] Mobile-Based Healthcare Monitoring System A robust wireless CDMA-Based healthcare diagnosis system is designed and implemented to transmit physiological signals between IEEE wireless networks and CDMA cellular networks, allowing seamless roaming between hospital and home environments. Until now most of mobile healthcare system send the health data from the smartphone to the internet connected to the server. These mobile healthcare systems are connected continuously to the internet and have to pay expensive data fee. To solve the high cost problem, software solution architecture is developed in this study. Instead of sending vital data for monitoring and diagnostic analysis to a server over a mobile network, this system comprises an external stand-alone ECG diagnosis system in the smartphone which checks the abnormality of ECG first in the smartphone inside and send the data to the server for detail inspection when it find abnormality in the signal. The mobile healthcare system enables patients to measure their health parameters anytime, and allows caregivers to continue the real-time monitoring of physiological signs using the smartphone. When an unknown or suspect pattern of signals is detected, the smartphone immediately forwards them to the server and sends an alert to medical caregivers. This not only helps to decrease traffic congestion caused by inessential overhead/data over the mobile network, but also reduces the relapse rate, together with overall hospitalization cost and length of stay Empowering Frontline Health Workers with Medical Knowledge In many places around the world, frontline health workers have difficulty accessing medical information or learning from the experiences of health colleagues. Often times, they don t have common medical reference materials or basic knowledge about diagnosis, treatment, and prescriptions. A project called mpowering Frontline Health Workers is addressing this problem by using mobile devices to provide the latest medical information to frontline health care providers. Through a digital repository provided by health experts, people such as midwives, nurses, and community health workers can use cell phones, smart phones, tablets, and laptops to get information on neo-natal care, immunization, and childhood 256 Copyright c 2015 SERSC

3 diseases. This helps them become more effective in delivering health care and reducing the death of children and mothers in developing nations [9]. These are just some of the ways that mobile devices improve health care by providing timely and up-to-date information at people s fingertips. If health providers can check on adverse side effects that arise from certain treatments or how particular medications affect patients, those are tremendous benefits for the health care system. They help to reduce costs while also improving the quality of medical care. 3. Mobile Device Services Figure 1 shows eight stages of doctor patient interaction in the context of the current episode-based care where the interaction between the patient and doctor happens only during patient visits [8]. In case the patient needs closer observation, he/she would need to be admitted to the hospital. 1. Patient and doctor are brought together as a result of a patient complaint. 2. The doctor performs an investigation on the patient s condition. This may require physical examination, test and specialist consultations. 3. The doctor diagnoses the condition. Specialist collaboration and negotiation may be required. 4. The doctor collaborates with specialists and the patient to design a treatment plan. 5. The treatment is carried to completion and the patient s condition returns to normal. 6. The interaction concludes. Patient and doctor separate. 7. Occasional patient doctor interaction: Patient seeks information from doctor. Doctor checks up on patient. 8. Until the next complaint when the cycle is repeated. Figure 1. Event-Based U-Healthcare Monitoring Scenario 4. Mobile-Based Healthcare System This system architecture is constructed with the aim of developing concepts and tools for wireless mobile healthcare services. Since such services allow constant remote access to clinical applications at patient point-of-care, they help to improve the quality of care. Moreover, by eliminating handwriting and paper records, the use of wireless technology may also lead to a reduction in the number of medical errors. Continuous local selfmonitoring and diagnosing of physiological signals are likely to drive down relapse rates and thereby overall hospitalization costs and length of stay. The developed system architecture utilizes mobile computing technology in a merged infrastructure consisting of IEEE networks and CDMA networks. It employs IEEE enabled medical Copyright c 2015 SERSC 257

4 devices to empower caregivers to access vital information and provide quality patient care in a cost-effective manner. Depicts the architecture design of the system, composed of three main parts: sensing units, communication infrastructures, and healthcare management. Sensing units include wearable IEEE enabled devices, such as body sensor nodes or wireless ECG sensor, which aggregate and transmit collected vital signs to a server outside the hospital. These data are then relayed to the hospital via mobile. Thus, the major communication protocols in this system are the IEEE wireless network protocol and the CDMA network protocol. The third part of the system, i.e., healthcare management, includes a web server used to handle received data and to respond to requests to and from mobile, and a monitoring system which provides real-time monitoring, analyzes the acquired data, and formulates a diagnosis in case of abnormal data. However, due to the memory limitations of mobile and the cost of data communication, a simple ECG diagnosis algorithm is constructed, permitting the mobile application to continuously analyze the signals it receives. It only forwards unknown or suspicious signals. This architecture was designed with the aim of developing concepts and tools for wireless mobile healthcare services. Since such services allow constant, remote access to clinical applications at patient point-of-care, they help to improve the quality of care. Moreover, a wearable mobile platform is distributed to patients, based on wireless sensor network technology. These mobile platforms are responsible for gathering patient medical condition. The gathered data is transmitted wirelessly over radio to the receiving base station. The base station is connected to a workstation where the data is processed and analyzed using the software created specifically for this work, the ECG Test. The outcome determined by this software is sent over mobile back to the patient, to inform them about their medical condition. 5. Network Architecture of Mobile Health Monitoring System System architecture consists of Java-based agents of each human role (e.g. doctors, patients) residing on the gadget (e.g. PDA or PC). Therefore we defined the network architecture consisting of clients (for doctors and patients) and servers that would provide communication and coordination between these clients. Although many users have personal computers (PCs) at home, getting these PCs to connect to body sensors would require patients to come to a fixed location and many users are not comfortable with that. Also PCs are still expensive for some sections of the population. Hence we decided to use mobile phones/portable digital assistants (PDAs) as the patient-side network client. Figure 2. Healthcare Network Architecture through Mobile Technology 258 Copyright c 2015 SERSC

5 6. Conclusion Mobile technologies offer the ability to connect patients with their doctors, care-givers and loved ones and enable timely health monitoring which suggests improved patient engagement and better health outcomes. Mobile technology can aid in providing access to information, helping to lower costs, facilitating remote care and increasing efficiencies by connecting patients to their providers virtually anywhere. Mobile health applications and services are becoming an essential tool in extending health care resources around the world. Acknowledgement This research was Supported by the MSIP (Ministry of Science, ICT and Future Planning), Korea, under the CITRC (Convergence Information Technology Research Center) support program (NIPA-2014-H ) supervised by the NIPA (National IT Industry Promotion Agency). This research was also supported by the International Research & Development Program of the National Research Foundation of Korea (NRF) funded by the Ministry of Scinece, ICT & Future Planning (Grant number: K ). References [1] K. Myung Nam, P. H. Jun and K. Ki Ryung, Trend of u-healthcare Service, Korea Multimedia Society Academy Paper, Korea Multimedia Society, vol. 11, no. 2, (2009). [2] S.-H. Lee and D.-W. Lee, A Study on Review and Consideration of Medical Industry Convergence Based on U-healthcare, The Journal of Digital Policy & Management, The Society of Digital Policy & Management, vol. 11, no. 6, (2013), pp [3] Schwaibold, M., Gmelin, M., von Wagner, G., et al.: Key factors for personal health monitoring and diagnosis devices. The 2nd Conf. on Mobile Computing, Heidelberg, [4] Nonin: 4100 bluetooth enabled oem digital pulse oximeter, available at: accessed 25 March 2015] [5] Alive Technologies Products, available at: accessed 5 March 2015 [6] Basilakis, J., Mathie, M., Lovell, NH., et al.: Integrating home telecare technologies in primary heatlh care: the technical revolution of health care in the home. Proc. Australian HIC2000 [7] Don Batory, R.C., & Yannis Smaragdakisi. Object-Oriented Frameworks and Product-Lines. in First Conference on Software Product Lines Denver, Colorado [8] Duck Lee, Jaesoon Choi, Ahmed Rabbi, and Reza Fazel-Rezai, Development of a Mobile Phone Based e-health Monitoring Application, International Journal of Advanced Computer Science and Applications, Volume 3, 2012, pp [9] Mazzi, C., Ganguly, P., and Ray, P.: Healthcare applications based on networked agents. EEE/IEC Int. Conf. Enterprise Networking, Applications, and Services, Atlanta, USA, 2001 [10] mhealth Alliance, mpowering Frontline Health Workers, June 14, 2012 Copyright c 2015 SERSC 259

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