INTERNET OF THINGS FOR E-HEALTH: AN APPROACH TO MEDICAL APPLICATIONS

Iuliana Chiuchisan1,2, Iulian Chiuchisan1, and Mihai Dimian1,2

1
Department of Computer Science, Automation and Electronics, “Stefan cel Mare” University, Suceava,
13 Universitatii Street, Suceava, 720229, Romania
2
Integrated Center for Research, Development and Innovation in Advanced Materials,
Nanotechnologies, and Distributed Systems for Fabrication and Control, “Stefan cel Mare” University,
Suceava, Romania

ABSTRACT data communication capabilities, linked to a network to

provide data transportation [2]. In health sciences, these
Monitoring individuals at risk is one of the great technologies have been developed in recent years based on
challenges of modern society, especially because the their capabilities to monitor various health parameters [3].,
number of people who work and generate income assets in that can be now transmitted by health devices via a gateway
society has decreased while the number of the inactive onto secure cloud base platforms where they are stored and
population has increased. Increased life expectancy of the analyzed [4].
elderly and the technological evolution led to innovative and Let us imagine a scenario where an older patient’s
effective solutions for in-home monitoring and treatment of medical profile and vital parameters are captured using
patients with chronical diseases. In this paper, a survey of medical devices attached to his body. This can track
Internet of Things (IoT) and its applications to e-Health is lifestyle-related diseases such as hypertension, diabetics,
presented along with a case study using the K53 Tower asthma or obesity which need continuous monitoring and
System platform for e-Health. This platform offers a broad provide an in-home health management for the elderly [5].
range of technologies for body area network (BAN) In addition, by using portable devices designed for a specific
measurements and communications in healthcare and other purpose, the patient does not have to move from home to
medical applications. This paper proposes novel solutions to receive the treatment or to check the health parameters.
monitor people at risk, focusing on two fundamental and Data gathered from these devices can be stored and
very important aspects: prevention as well as effective analyzed by the medical specialists helping them in
intervention in cases of medical emergency. diagnosis and enabling the possibility to monitor the patient
from any location and respond in a timely manner, based on
Index Terms— Internet of Things, e-Health, the alert received.
personalized healthcare, Tower System, home-monitoring With an appropriate advanced network of sensors and
wireless technology, one can provide solutions that will
1. INTRODUCTION support older adults in order to live independently and
actively in their homes.
The Internet of Things (IoT) is defined by International Freescale Semiconductor Inc., for example, offers a
Telecommunication Union (ITU) and European Research broad range of technologies for BAN measurements and
Cluster on the Internet of Things (IERC) as “a dynamic communications in healthcare and other medical
global network infrastructure with self-configuring applications. They have developed a packaging concept to
capabilities based on standard and interoperable integrate these technologies into a compact form factor,
communication protocols where physical and virtual things using pressure sensors, gyroscopes, and accelerometers.
have identities, physical attributes, and virtual personalities,
use intelligent interfaces and are seamlessly integrated into 2. E-HEALTH CONCEPT
the information network” [1]. Over the years, IoT has
evolved from a futuristic vision to a growing market reality. The e-Health concept is used to describe the new
Nowadays, the Internet of Things is recognized as one of the "model centered on consumer" of health systems, that
most sophisticated technologies that have a global combine the health science and technologies with
economical and societal impact, including a great potential information and communication technologies that can be
to improve the human health and safety. used as a key solution to provide significant health benefits
The IoT comprises a set of physical objects that are at individual level as well as at society level [7].
embedded with sensors, actuators, computing devices and

978-1-4673-8457-5/15/$31.00 ©2015 IEEE

 In recent years many extensive research has been significantly decrease the number of cases in the emergency
performed in e-Health area. Most of this research was rooms.
focused on the use of Internet to improve the health Recent advances in wireless technology have created
services, especially for reducing the cost for health services. new opportunities that could revolutionize provision of
Gradually, the discussions was extended to the role of the healthcare [11]. Constant on-distance monitoring and real-
Internet in improving the quality of medical services and the time data transmission and processing [12] are just a few
communication between patients, medical specialists, health examples of applications in the medical wireless
providers and other authorities in the health system. technologies, but opportunities are countless. For example,
The e-Health includes a wide range of information, development of personal wireless networks (Wireless
communication, and technology applications, the ultimate Personal Area Networks - WPANs), wireless networks
goal being to improve the management and the use of tangible WBAN (Wireless Body Area Networks - WBANs),
information in order to support a wide range of clinical the technology 802.15.1/Bluetooth [3], IEEE 802.15.3
processes, at operational, financial, and decision-making technology/4 [11] and local wireless networks (WLANs)
level as well as to improve the health service delivery [8]. [13], combined with wireless networks over large areas
The e-Health potential benefits may include [9]: increased (WWAN), such as the mobile 2G, 2.5G, 3G and 4G, to
access to information and resources, increasing patients' which is added the Internet, allows the development of an
ability to make better choices related to medical healthcare, ubiquitous network that can be used to improve health care
improved organizational processes, and improved safety and for wide range of users.
quality of patient’s life. To achieve greater mobility and global connectivity
Integrated e-Health systems, including clinical needed, it is necessary to integrate heterogeneous wireless
information systems, information systems, radiology, technologies. The 3G cellular network has restrictions on
telemedicine systems etc. are useful not only in solving capacity and it’s not capable of supporting medical
clinical problems (reporting results tests, allowing direct applications that require real-time work for many patients
access to clinical orders, supporting telemedicine [14]. Therefore, WBAN technologies, WPAN and WLAN -
applications, or decision-making process), but also in which usually carry higher data flows [14], but have much
administrative and financial matters (e.g., the location of the smaller coverage area than cellular systems can be
patient from the hospital, the management of materials and integrated and used for achieving connectivity in non-
inventory management, administrative staff and medical and medical environment, hospitals, clinics, and
management of payments), related research (e.g., analysis home.
results associated with the treatments and procedures, The first step in the implementation of an integrated
quality assurance, clinical experiments support and health system involves the use of smart sensors and proper
implementation of various treatment protocols), and the instrumentation to convert an amount of variation in signal
related scientific information (e.g., access to digital of interest, usually measured electrically. Another issue is
scientific libraries, supporting and providing access to the need of appropriate instrumentations and data analysis
databases) [7]. methods that could process the complex data and provide
health solutions.
3. TELEMEDICINE AND HOME MONITORING
USING INTERNET OF THINGS 4. PLATFORM K53 TOWER SYSTEM

Telemedicine and home monitoring have an important role 4.1 Medical applications
in management of chronic diseases, such as asthma, heart
diseases and diabetes [10]. Information and communication The platform K53 Tower System from Freescale
technologies (ICT) including various smart sensors, Semiconductor Inc. (Fig. 2) supports hardware and software
monitoring devices, technologies, portable medical devices, for understanding the functioning of representative medical
provide the venue for electronic transmission of health applications, and development of custom monitoring
parameter of patients to doctors who can thus monitor the applications [16]. The family of microcontrollers (MCU)
patient health condition (e.g. heartbeat, blood pressure, Kinetis K50 has a core ARM Cortex M-4 type and can be
blood sugar, etc.) from distance. In this manner, the quality used for data acquisition in industrial, networking,
of self-care can be improved: the patient is able to automation and medicine [17].
communicate frequently with medical specialists; the This platform can be used for prototyping medical
physician is notified when needed, may prescribe necessary application, which can be loaded into a micro-miniaturized
medication, may carry other procedures and may also form afterwards and used to remotely monitor or diagnose
schedule face-to-face meetings in a manner much more patients. Applications developed on this platform are well-
appropriate and efficient than in the ITC absence. By using suited for monitoring people with risk or elderly in hospitals
these new ICT technologies, telemedicine systems and as well as at home, for connecting patients with doctors and
portable medical devices for home monitoring can family.
 stairs etc.; for the home mo
onitoring of patients with
risk the most importtant function of the
accelerometer is detecting a possible falls that may
require the intervention ofo a medical team [19],
[20].

4.2 Proposed system

A general system for monitoring the status of the health

Fig.2 K53 Tower System - assembled systtem components
condition is proposed, including the t following functions:
and modules [17]
EKG, pulse oximeter, thermomeeter, accelerometer, and
sphygmomanometer. The structu ure of this system is
Data can be viewed on a computer or caan be transmitted
illustrated in Fig. 3, the centerpiecee being the platform K53
over the Internet to a server using Etherneet interface. Data
Tower System from Freescale Semiconductor Inc. This
linkage with remote servers can be pperformed using
system can collect data from conneected sensors and transfer
Ethernet protocols, ZigBee or CAN [188] and the USB
them via USB, Bluetooth or Wi-F Fi, to a local computer,
interface can be used to debug operations or for direct
Cloud server or smartphone.
connection to a PC. Wireless ZigBee type m modules are used
Let us consider the case of an a 80 years old, female
when the wired network is not available or when the device
patient, with moderate Alzheimer disease, which also has
caregivers should be mobile within a certainn coverage area.
heart problems. She must be consttantly monitored, due to
In addition to the signal processing unitts, access signals
health risk factors. By using Ho olter monitor and pulse
and I/O ports are available. The software modules can run
oximeter, the patient is monitored for 24 hours, acquiring
both Flash memory and in RAM [17]. Thhe Code Warrior
the blood pressure, SYS – systolic pressure,
p DIA – diastolic
Development Studio is based on Eclipse ID DE platform and
pressure and pulse. At night, the patient is also monitored in
represents a programming and debuggingg microcontroller
order to detect if she has the sleeep apnea. The activities
board [19].
associated to the 48 hours of mon nitoring are summarized
Freescale MQX RTOS operating system m provides real-
below:
time application performance, including facilities boot,
multithreading or execution threads per coree priorities [20]. Table 1 Patient’s activities
For this paper, we analyzed a series of modules for
Time Activities
A
medical applications that can be connectted to the tower
ning to music, TV
Alimentation, listen
system platform: 5a.m. – 8a.m.
watching
i. MED-EKG - to obtain an electroccardiogram signal
type and measure heart rate [21] – [23]; 8a.m. – 4m.p. Alimentation, stayin
ng with a family member
ii. MED-SPO2 for pulse oximetrry – it is a
noninvasive method to measuree blood oxygen 4p.m. – 8p.m. Forgot to take her medication
m (event 1)
saturation (SpO2);
8p.m. – 11p.m. Alimentation, TV watching
w
iii. MED-BPM for blood pressure - it is defined as the
hydrostatic pressure exerted by tthe blood on the 11p.m. – 5a.m. Climbing steps, sleeeping (event 2)
arteries, where the left ventriclle of the heart
contracts; the systolic (TA SYS)) is the pressure
more manifested after systoole (ventricular In Fig. 4, the monitoring experiiments showing the heart
contraction) and diastolic pressur ure (TA DIA) is rate, blood oxygen level, and blood pressure, carried out
smaller and its manifest during diaastole (ventricular during the day, sleep and exerciise (climbing steps) are
relaxation); presented.
iv. MED-SPI for Spirometer - it invoolves a series of
tests to assess a person's respiratoory capacity; the 5. RELATION TO PRIOR WORK
device takes measurements on thhe amount of air
inspired and expired in determiningg lung capacity; In previous research [4], a health caare system for monitoring
v. Monitoring based acceleration seensors for home of patients at risk in a smart env vironment was proposed,
monitoring of patients with risk [224] – it involves using an ICT-based solution and IoT technologies. In article
an acceleration sensor designed to detect body [6] an approach to developing a deecision support and home
movements and orientation deppending on the monitoring system for patients witth neurological disorders
accelerations acting in the three dirrections (x, y, z); using Internet of Things concepts was
w presented.
this function is used to deteect whether the
monitored person stands, sits, sleepps, walks, climbs
 Fig.3 A general architecture of a home monnitoring using platform K53 Tower System and modules for medical applications

Fig. 4 Holter monitoring for the old femaale patient: blood pressure: SYS – systolic pressure and DIA – diastolic pressure
measured in millimeeters of mercury; pulse measured in beats per minute (bpm m)

In reference [15], a medical image processsing system was anthropometrical measurements acqquired using the KinectTM
proposed using Verilog HDL and FPGA (Field sensor for measuring abdominal circumference, biochemical
Programmable Gate Array) based the novel hardware data or other medical examinationss, in order to describe an
architecture of a real-time configurable syystem for digital algorithm capable to elaborate and
d generate a personalized
image processing. This system was used too obtain real-time diet (daily nutritional requiremennts and disease status)
results more suitable than the originaal images with adapted to one type of cancer.
applications in medical devices. In the article [24] was
presented a health care system for Neurollogical Disorders 6. CONCLUSIONS
Screening and Rehabilitation. The system m manages data
acquired from the patients with Parkinson’ss disease in order The use of Internet of Things teechnologies in medicine
to support physicians in diagnosis, treatmennt and monitoring offers a rapid flow of information between the patient and
the patients and also to facilitate the innteraction at the the doctor, enables easy and instanttaneous access to current
distance between doctors and patients. Other proposed patient health parameters as well as to patient health history,
system [25] combines data about patient’s medical history, reduces overall healthcare costs and
d can drastically improve
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