Future Internet of Things Platform for Ubiquitous Integration of Clinical Environments at Patient’ s House Antonio J. Jara, Miguel A. Zamora-Izquierdo, and Antonio F. Gómez-Skarmeta Abstract —This work presents a next generation clinical architecture based on the Future Internet of Things for extending a patient’s environment to integrated clinical environments. It introduces technological innovations and advanced services which allow patient monitoring and supervision by remote centers, and personal multimedia platforms such as smart phones and tablets. From the hardware point of view, it consists of a platform/gateway named Monere, and a personal clinical device/sensor adaptor named Movital, used for the wireless integration of clinical devices through 6LoWPAN, and patient identification through RFID. Movital additionally supports communication capabilities to allow a secure, scalable and global integration of the sensors deployed at the patient’s environment. This paper presents the architecture, and how it provides support for mobility and ubiquitous connectivity, extended devices integration, reliability, and in definitive offers a bridge between the sensors connected to the patient and the information systems, in conjunction with the user interfaces, in order to reach a Ubiquitous Integration of Clinical Environments. This solution is being deployed and evaluated in a clinic in Barcelona, and in Assisted Living Environments for patients with respiratory illnesses under the AIRE project. Index Terms— Internet of Things, Sensor and RFID technologies for e-health, Architecture, Integrated Clinical Environment, Ambient Assisted Living. I. INTRODUCTION The evolution of technologies for, on the one hand, the identification of objects, with applications such as Radio Frequency Identification (RFID), and, on the other hand, for communication and consumer devices, providing solutions which offer ubiquitous access to information -such as wireless personal devices, embedded systems and smart objects-, together with the capabilities presented by the Future Internet with IPv6 protocol and technologies, such as IPv6 over Low Power Area Networks (6LoWPAN), which allow the Internet extension to small and smart devices. This Manuscript received December 15th, 2011. The authors would like to thank the Spanish ministry for Industry, Tourism and infrastructure, and the ministry for education, social politic and sport for sponsoring the research activities under the grants AIRE – Architecture for Insufficiency Respiratory Evaluation Project (TSI-020302-2010-95), and the FPU program (AP2009-3981). This work has been carried out by the Intelligent Systems group of the University of Murcia, awarded as an excellence researching group by the “Fundación Séneca” (04552/GERM/06), and in the framework of the IoT6 European Project (STREP) from the 7th Framework Program (Grant 288445). Finally thanks to PhD. Fred Hosea from Kaiser Permanente, Mr. Miguel Yasuhiko Tsuchiya and Mr. Javier Sancho from Flowlab, and M.D. Bienvenido Barreiro and his team from the neuomology service, as such as the team from “Centro de Atención Primaria” i.e. medical centre and Addom services from Mutua Terrasa. Antonio J. Jara, Miguel A. Zamora and Antonio F. G Skarmeta are with the Department of. Information and Communications Engineering (DIIC), Computer Science Faculty at the University of Murcia, ES-3100, Spain. (phone: +34-868-88-8771; fax: +34-868-88-4151; e-mail: [email protected]). extension is a key element that is making it feasible to identify, sense, locate, and connect all the people, machines, devices and things surrounding us among them. These new capabilities for linking Internet with everyday sensors and devices, forms of communication among people and things, and exploitation of data capture, define the so called Future Internet of things (IoT) [1]. The IoT is considered one of the major communication advances in recent years, since it offers the basis for the development of independent cooperative services and applications. An extensive research on using this concept in different areas such as building automation, Intelligent Transport Systems, and healthcare is being carried out. For example, its potential for mobile health applications has been recently reported in [2], showing its potential from the identification capacities for drugs identification [3], and its communication capabilities to offer ubiquitous therapy by providing wireless and mobility capabilities for personal devices and smart objects, in addition to allowing the collection of data anytime and anywhere [4]. An example of an application where these capabilities are exploited for chronic diseases management is presented in the solution for diabetes, found in [5]. However, even when specific solutions are located for IoT [2,5] and wireless networks [6], no study to date presents a platform to address this concept and offer support for ubiquitous personalized healthcare. This work goal is to exploit the aforementioned IoT capabilities in order to build a platform for personalized healthcare in the patient’s environment. In this respect, this platform goal is the extension of those environments towards a clinical environment. Thereby, it can be reached, what we have defined as, a Ubiquitous Integration of Clinical Environments. This denomination is inspired, firstly, in the ubiquitous feature, because it is not only oriented towards hospitals and specialized clinical environments, but also towards patient’s environments, such as the patient’s house, senior citizen residence, or gym, and mobile environments such as an ambulance, mobile clinics, and travel health services, where support for mobility is going to be required. Secondly, the term is inspired in integration, since it is focused on its integration and interoperability with the current information infrastructure and e-Health platforms, instead of offering an additional alternative for the market. This integration factor is the key element, since as it was mentioned by Dr Najeeb Al-Shorbaji, director of knowledge management and sharing at the World Health Organization, “It cannot be viewed as a standalone proposition and must be seen as a subset of e- health, which in turn is an integral part of a more general, comprehensive healthcare strategy, encompassing all security, ethical and standards issues.” This integrator spirit is fundamental for the current Internet and IoT. Furthermore, and in order to reach a proper integration, application-level interoperability among clinical devices and the existing platforms is required, together with security and privacy support since medical data are highly sensitive.
This work presents a next generation clinical architecture based on the Future Internet of Things for extending a patient’s environment to integrated clinical environments. It introduces technological innovations and advanced services which allow patient monitoring and supervision by remote centers, and personal multimedia platforms such as smart phones and tablets. From the hardware point of view, it consists of a platform/gateway named Monere, and a personal clinical device/sensor adaptor named Movital, used for the wireless integration of clinical devices through 6LoWPAN, and patient identification through RFID. Movital additionally supports communication capabilities to allow a secure, scalable and global integration of the sensors deployed at the patient’s environment.
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Future Internet of Things Platform for Ubiquitous
Integration of Clinical Environments at Patient’s House Antonio J. Jara, Miguel A. Zamora-Izquierdo, and Antonio F. Gómez-Skarmeta
1Abstract —This work presents a next generation clinical
architecture based on the Future Internet of Things for
extending a patient’s environment to integrated clinical
environments. It introduces technological innovations and
advanced services which allow patient monitoring and
supervision by remote centers, and personal multimedia
platforms such as smart phones and tablets. From the
hardware point of view, it consists of a platform/gateway
named Monere, and a personal clinical device/sensor
adaptor named Movital, used for the wireless integration
of clinical devices through 6LoWPAN, and patient
identification through RFID. Movital additionally supports
communication capabilities to allow a secure, scalable and
global integration of the sensors deployed at the patient’s
environment. This paper presents the architecture, and
how it provides support for mobility and ubiquitous
connectivity, extended devices integration, reliability, and
in definitive offers a bridge between the sensors connected
to the patient and the information systems, in conjunction
with the user interfaces, in order to reach a Ubiquitous
Integration of Clinical Environments. This solution is
being deployed and evaluated in a clinic in Barcelona, and
in Assisted Living Environments for patients with
respiratory illnesses under the AIRE project.
Index Terms— Internet of Things, Sensor and RFID
technologies for e-health, Architecture, Integrated Clinical
Environment, Ambient Assisted Living.
I. INTRODUCTION
The evolution of technologies for, on the one hand, the
identification of objects, with applications such as Radio
Frequency Identification (RFID), and, on the other hand, for
communication and consumer devices, providing solutions
which offer ubiquitous access to information -such as
wireless personal devices, embedded systems and smart
objects-, together with the capabilities presented by the
Future Internet with IPv6 protocol and technologies, such as
IPv6 over Low Power Area Networks (6LoWPAN), which
allow the Internet extension to small and smart devices. This
Manuscript received December 15th, 2011. The authors would like to
thank the Spanish ministry for Industry, Tourism and infrastructure, and the
ministry for education, social politic and sport for sponsoring the research activities under the grants AIRE – Architecture for Insufficiency
Respiratory Evaluation Project (TSI-020302-2010-95), and the FPU
program (AP2009-3981). This work has been carried out by the Intelligent Systems group of the University of Murcia, awarded as an excellence
researching group by the “Fundación Séneca” (04552/GERM/06), and in
the framework of the IoT6 European Project (STREP) from the 7th Framework Program (Grant 288445).
Finally thanks to PhD. Fred Hosea from Kaiser Permanente, Mr. Miguel
Yasuhiko Tsuchiya and Mr. Javier Sancho from Flowlab, and M.D. Bienvenido Barreiro and his team from the neuomology service, as such as
the team from “Centro de Atención Primaria” i.e. medical centre and
Addom services from Mutua Terrasa. Antonio J. Jara, Miguel A. Zamora and Antonio F. G Skarmeta are with
the Department of. Information and Communications Engineering (DIIC),
Computer Science Faculty at the University of Murcia, ES-3100, Spain. (phone: +34-868-88-8771; fax: +34-868-88-4151; e-mail: [email protected]).
extension is a key element that is making it feasible to
identify, sense, locate, and connect all the people, machines,
devices and things surrounding us among them.
These new capabilities for linking Internet with everyday
sensors and devices, forms of communication among people
and things, and exploitation of data capture, define the so
called Future Internet of things (IoT) [1].
The IoT is considered one of the major communication
advances in recent years, since it offers the basis for the
development of independent cooperative services and
applications. An extensive research on using this concept in
different areas such as building automation, Intelligent
Transport Systems, and healthcare is being carried out. For
example, its potential for mobile health applications has
been recently reported in [2], showing its potential from the
identification capacities for drugs identification [3], and its
communication capabilities to offer ubiquitous therapy by
providing wireless and mobility capabilities for personal
devices and smart objects, in addition to allowing the
collection of data anytime and anywhere [4]. An example of
an application where these capabilities are exploited for
chronic diseases management is presented in the solution for
diabetes, found in [5]. However, even when specific
solutions are located for IoT [2,5] and wireless networks [6],
no study to date presents a platform to address this concept
and offer support for ubiquitous personalized healthcare.
This work goal is to exploit the aforementioned IoT
capabilities in order to build a platform for personalized
healthcare in the patient’s environment. In this respect, this
platform goal is the extension of those environments
towards a clinical environment. Thereby, it can be reached,
what we have defined as, a Ubiquitous Integration of
Clinical Environments.
This denomination is inspired, firstly, in the ubiquitous
feature, because it is not only oriented towards hospitals and
specialized clinical environments, but also towards patient’s
environments, such as the patient’s house, senior citizen
residence, or gym, and mobile environments such as an
ambulance, mobile clinics, and travel health services, where
support for mobility is going to be required. Secondly, the
term is inspired in integration, since it is focused on its
integration and interoperability with the current information
infrastructure and e-Health platforms, instead of offering an
additional alternative for the market. This integration factor
is the key element, since as it was mentioned by Dr Najeeb
Al-Shorbaji, director of knowledge management and sharing
at the World Health Organization, “It cannot be viewed as a
standalone proposition and must be seen as a subset of e-
health, which in turn is an integral part of a more general,
comprehensive healthcare strategy, encompassing all
security, ethical and standards issues.” This integrator spirit
is fundamental for the current Internet and IoT.
Furthermore, and in order to reach a proper integration,
application-level interoperability among clinical devices and
the existing platforms is required, together with security and
privacy support since medical data are highly sensitive.
Therefore, our platform aims to support ubiquitous and
mobile healthcare, as well as integration of the deployed
home platform and clinical devices in the current e-Health
infrastructure, interoperability, security and privacy based
on the integration of IoT technologies for patient’s sensors.
Ubiquitous Integration of Clinical Environments defines
complex design challenges and requirements, which need a
bottom-up approach, from the clinical devices and network
infrastructure to the e-Health platforms.
At the e-Health platforms level, several projects are found
to reach a unified Electronic Health Record among different
hospitals, organizations and countries, as well as a definition
of personalized services, electronic prescription, support
Personal Health Record, and collaborative Decision Support
Systems. However, we do not see the next-generation of
devices, gateways and systems which offer the capabilities
required to provide the bottom support for the pursued
solution as being so developed.
For that purpose, the specifically built platform which is
installed in the patient’s environment, denominated Monere,
presents multi-technology support. This platform can be
considered as a gateway, which is what the ISO/IEEE
11073-20601 Personal Health Data Exchange Protocol
(HDP) [7] defines as IEEE manager. This links between the
clinical devices located at the patient’s house and the
external network, and carries out additional administrative
functions such as configuration management, reliability
monitoring, live performance metrics, and support for risk.
The connection of the clinical sensors (sources) to
Monere is through their native technology, e.g. wired
technologies such as serial, USB or wireless such as
Bluetooth and ZigBee.
In addition, Monere is complemented by a clinical device
integrator (adaptor), called Movital, which is like an IEEE
agent following the HDP protocol. Movital extends current
sensors to a mobile and wireless device. This offers the
support for the device lifecycle management and complex
network transactions such as mobility support, in addition to
offering the adapter functionality from native protocol to a
suitable protocol, denominated YOAPY, for the
requirements and constrains from 6LoWPAN technology.
Finally, Movital also offers the integration of a RFID
reader to identify the patient and caregivers, or loads the
patient's profile from the personal health card.
In particular, the new capabilities and functionalities for
the clinical devices and design issues considered for the
proposed network infrastructure have been defined by a
group of experts from clinical technology, hospitals and
assisted living, to satisfies the requirements from patient’s
monitoring and e-Health platform integration.
All these requirements and considerations are presented
in the next section, which defines the additional
functionalities needed for the clinical devices to reach the
defined Ubiquitous Integrated Clinical Environments.
Section IV presents the architecture showing the integration
of patient’s environment with the current platforms. This
integration is satisfied with the developed gateway
(Monere), and clinical device integrator (Movital), which
are presented in Sections V and VI, respectively. Finally,
Section VII presents the use case of the proposal for assisted
living of fragile patients with serious breathing problems
from AIRE project with the performance evaluation of the
communications protocols defined for the different clinical