Health Care IOT - Introduction

• Internet of Things (IoT) has a huge impact on the medical field, especially wearable healthcare.
• The technologies have given rise to small, power-efficient, health monitoring and diagnostic
systems.
• Currently, various IoT-enabled healthcare devices are in wide use around the globe for diagnosing
human diseases, monitoring human health conditions, caring/monitoring for elders, children, and
even infants.
• IoT-based healthcare devices provide access and knowledge about human physiological
conditions through hand held devices.
• With this development, users can be aware of the risks in acquiring various diseases and take
necessary precautions to avoid preventable diseases.
• For IoT-based healthcare services, the sensors are specifically designed to measure and quantify
different physiological conditions of its users/patients.
Health Care IOT - Architecture
• A typical architecture for healthcare IoT is shown in Figure.
• The architecture is divided into four layers.
Health Care IOT - Architecture
Layer 1: Layer 3:
• contains different physiological sensors • This layer receives the data from Layer 2
that are placed on the human body. and performs application specific high-
level analytics.
• These sensors collect the values of
various physiological parameters and • Typically, this layer consists of cloud
are analyzed to extract meaningful architecture or high-end servers.
information. • The data from multiple patients, which
Layer 2: may be from the same or different
locations, are accumulated in this layer.
• Layer 1 delivers data to Layer 2 for
short-term storage and low-level • Post analysis of data, some inferences or
processing. results are provided to the application in
Layer 4.
• The devices that belong to Layer 2 are
commonly known as local processing Layer 4:
units (LPU) or centralized hubs. • The end-users directly interact with Layer
• These units collect the sensed data from 4 through receiver-side applications.
the physiological sensors attached to the • The modes of accessibility of these
body and process it based on the services by an end user are typically
architecture’s requirement. through cellphones, computers, and
• Further, LPUs or the centralized hubs tablets.
forward the data to Layer 3.
Health Care IOT - Components
Figure depicts different components and their usage in an IoT healthcare system.
Health Care IOT - Components
1. Sensors
• Sense the physiological parameter value from a patient’s body
Health Care IOT - Components
2. Wireless Connectivity
• Typically, the communication between the wearable sensors and the LPU is through either
wired or wireless connectivity.
• The wireless communication between the physiological sensors and LPU occurs with the help
of Bluetooth and ZigBee.
• On the other hand, the communication between the LPU and the cloud or server takes place
with Internet connectivity such as Wi- Fi and WLAN.
• These communication protocols vary depending on the type of device in use.
✓ For example, when a service is received by a cellphone, it uses GSM (global system for
mobile communications).
✓ On the other hand, if the same service is received on a desktop, it can be through
Ethernet or Wi-Fi.
Health Care IOT - Components
3. Privacy and Security
• The privacy and security of health data is a major concern in healthcare IoT services.
• different networking devices work between LPU and the server/cloud, via network hops (from one
networked
• device to another) to transmit the data.
• If any of these devices are compromised, it may result in the theft of health data of a patient,
leading to serious security breaches and ensuing lawsuits.
• In order to increase the security of the healthcare data, different healthcare service providers and
organizations are implementing healthcare data encryption and protection schemes.
4. Analytics
• For converting the raw data into information, analytics plays an important role in healthcare IoT.
• Several actors, such as doctors, nurses, and patients, access the healthcare information in a different
customized format.
• This customization allows each actor in the system to access only the information pertinent to their
job/role.
• In such a scenario, analytics plays a vital role in providing different actors in the system to access
meaningful information extracted from the raw healthcare data .
• Analytics is also used for diagnosing a disease from the raw physiological data available.
Health Care IOT - Components
5. Cloud and Fog Computing
• The sensors continuously produce a huge amount of heterogeneous data.
• For storing these huge amounts of heterogeneous health data, efficient storage space is essential.
• These data are used for checking the patient’s history, current health status, and future for
diagnosing different diseases and the symptoms of the patient.
• Typically, the cloud storage space is scalable, where payment is made as per the usage of space and
used to store health data in a healthcare IoT system.
• Analytics on the stored data in cloud storage space is used for drawing various inferences.
• The major challenges in storage are security and delay in accessing the data.
• Therefore, cloud and fog computing play a pivotal role in the storage of these massive volumes of
heterogeneous data.
6. Interface
• Among IoT applications, healthcare IoT is a very crucial and sensitive application.
• Thus, the user interface must be designed in such a way that it can depict all the required
information clearly and, if necessary, reformat or represent it such that it is easy to understand.
• Moreover, an interface must also contain all the useful information related to the services.
Health Care IOT – Advantages
1. Real-time:
• In healthcare sectors, different components, such as the condition of the
patients, availability of doctors and beds in a hospital, medical facilities
with their monetary charges, can vary dynamically with time.
• In such a dynamic scenario, one of the important characteristics of an
IoT-based healthcare system is real-timeliness.
• A healthcare IoT system enables users, such as doctors, end- users at
the patient-side, and staff in a healthcare unit, to receive real-time
updates about the healthcare IoT components.
• Even a healthcare IoT system can enable a doctor to observe a patient’s
health condition in real-time even from a remote location, and can
suggest the type of care to be provided to the patient.
• On the other hand, users at the patient-end can easily take different
decisions, such as where to take a patient during critical situations.
• Also, the staff in a healthcare unit can be better aware of the current
situation of their unit, which includes the number of patients admitted,
availability of the doctors and bed, total revenue of the unit, and other
such information.
Health Care IOT – Advantages
2. Low-cost:
• Healthcare IoT systems facilitate users with different services at low
cost.
• For example, an authorized user can easily find the availability of the
beds in a hospital with simple Internet connectivity and a web-
browser-based portal.
• The user need not visit the hospital physically to check the availability.
3. Easy Management:
• Healthcare IoT is an infrastructure that brings all its users under one
umbrella to provide healthcare services.
• On the other hand, in such an infrastructure, the management of
numerous tangible and intangible entities (such as users, medical
devices, facilities, costs, and security) is a challenging task.
• However, healthcare IoT facilitates easy and robust management of all
the entities.
 Health Care IOT – Advantages
4. Automatic Processing:
• A healthcare unit consists of multiple subsystems, for which manual
interventions are required.
• For example, to register a patient with a hospital, the user may be
required to enter his/her details manually.
• However, automatic processing features can remove such manual
intervention with a fingerprint sensor/device.
• Healthcare IoT enables end-to-end automatic processing in different
units and also consolidates the information across the whole chain:
from a patient’s registration to discharge.
5. Easy Diagnosis:
• Healthcare IoT system stores the data of the patient in a secure
manner. Sometimes, for diagnosing a disease, a huge chunk of prior
data is required.
• In a healthcare IoT system, the diagnosis of the disease becomes
easier with the help of certain learning mechanisms along with the
availability of prior datasets.
 Health Care IOT – Advantages
6. Easy Record:
• Healthcare IoT system, includes a huge number of patients, doctors,
and other staff.
• The timely delivery of health data of the patient to the doctor is
important. In such a situation, the permanent storage of the patients
health data along with their respective details is essential.
• Similarly, for the smooth execution of the healthcare unit, details of
the staff with their daily activity in a healthcare unit are also
required for storage.
• A healthcare unit must also track its condition and financial
transactions for further development of the unit.
• A healthcare IoT enables the user to keep these records in a safe
environment and deliver them to the authorized user as per
requirement.
• Moreover, these recorded data are accessible from any part of the
globe.
Health Care IOT – Risks
Health Care IOT – Risks
Loss of • A healthcare IoT system consists of different physiological sensors that sense and transmit the
connectivity sensed data to a centralized unit.
• Moreover, continuous data transmission from the patient is expected in a good healthcare
system.
• Intermittent connectivity may result in data loss, which may result in a life threatening
situations for the patient. Proper and continuous connectivity is essential in a healthcare IoT
system.
Security • The healthcare system must keep the data confidential.
• This data should not be accessible to any unauthorized person.
• On the other hand, different persons and devices are associated with a healthcare IoT system.
• In such a system, the risk of data tampering and unauthorized access is quite high.
Error • Data analytics helps a healthcare IoT system to predict the patients condition and diagnosis of
diseases.
• A huge amount of data needs to be fed into the system in order to perform accurate analytics.
• Moreover, the management of a huge amount of data is a crucial task in any IoT-based system.
• Particularly, in the healthcare system, errors in data may lead to misinterpretation of symptoms
and lead to the wrong diagnosis of the patient.
• It is a challenging task to construct an error-free healthcare IoT architecture.
 Health Care IOT – Case Study
AmbuSens
• The Smart Wireless Applications and Networking (SWAN) laboratory at the Indian Institute of
Technology Kharagpur developed a system: AmbuSens.
• The system was primarily funded by the Ministry of Human Resource and Development (MHRD) of
the Government of India.
• The primary objectives of the AmbuSens system are summarized as follows:
➢ Digitization and standardization of the healthcare data, which can be easily accessed by the
registered hospital authorities.
➢ Real-time monitoring of the patients who are in transit from one hospital to another. At both
hospitals, doctors can access the patients’ health conditions.
➢ Accessibility by which multiple doctors can access the patient’s health data at the same time.
➢ Provision of confidentiality to the health data of the patients in the cloud.
➢ In the AmbuSens system, wireless physiological sensor nodes are used. These sensor nodes
make the system flexible and easy to use.
 Health Care IOT – Case Study
AmbuSens - Architecture
• The AmbuSens system is equipped
with different physiological sensors
along with a local hub.
• These sensors sense the physiological
parameters from the patient’s body and
transmit those to a local data
processing unit (LDPU).
• The physiological sensors and LDPU
form a wireless body area network
(WBAN).
• Further, this local hub forwards the
physiological data to the cloud for
storing and analyzing the health
parameters.
• Finally, the data are accessed by
different users.
Health Care IOT – Case Study
AmbuSens - Architecture
Layer 1:
• This layer consists of multiple WBANs attached to a patient’s body.
• These WBANs acquire the physiological data from the patient and
transmit them to the upper layer.
• The physiological sensors are heterogeneous, that is, each of these
sensors senses different parameters of the body.
• Moreover, the physiological sensors require calibration for acquiring
the correct data from a patient’s body.
• Layer 1 takes care of the calibration of the physiological sensor
nodes.
• Further, in order to deliver the patient’s physiological data from the
sensor node to the LDPU, it is essential to form a proper WBAN.
• The formation of WBAN takes place by connecting multiple
physiological sensor nodes to the LDPU so that the sensors can
transmit the data to the LDPU, simultaneously.
Health Care IOT – Case Study
AmbuSens - Architecture
Layer 2:
• responsible for handling the cloud-related functions.
• From Layer 1, WBANs attached to the different patients,
deliver data to the cloud end.
• The cloud is used for the long-term analysis and storage of
data in the AmbuSens system.
• Moreover, the previous health records of the patients are
stored in the cloud in order to perform patient-specific
analysis.
• A huge volume of health data is produced by the WBANs,
which are handled by the cloud with the help of big data
analytics for providing real-time analysis.
Health Care IOT – Case Study
AmbuSens - Architecture
Layer 3:
• In the AmbuSens system, the identity of the patients remains
anonymous.
• An algorithm is designed to generate a dynamic hash value
for each patient in order to keep the patient’s identity
anonymous.
• Moreover, in the AmbuSens system, at different time
instants, a new hash value is generated for the patients.
Layer 4:
• The users simply register into the system and use it as per
requirement.
Health Care IOT – Case Study
AmbuSens – Hardware
In the AmbuSens system, a variety of hardware components are used such as sensors, communication units, and other
computing devices.
• Sensors: The sensors used in the AmbuSens system are non-invasive. The description of the sensors used for
forming the WBAN in the AmbuSens system are as follows:
(i) Optical Pulse Sensing Probe: It senses the photoplethysmogram (PPG) signal and transmits it to a GSR expansion
module. Typically, PPG signals are sensed from the ear lobe, fingers, or other location of the human body. Further, the
GSR expansion module transfers the sensed data to a device in real-time.
(ii) Electrocardiogram (ECG) unit and sensor: The ECG module used in AmbuSens is in the form of a kit, which
contains ECG electrodes, biophysical 9” leads, biophysical 18” leads, alcohol swabs, and wrist strap. Typically, the ECG
sensor measures the pathway of electrical impulses through the heart to sense the heart’s responses to physical exertion
and other factors affecting cardiac health.
(iii) Electromyogram (EMG) sensor: This sensor is used to analyze and measure the biomechanics of the human body.
Particularly, the EMG sensor is used to measure different electrical activity related to muscle contractions; it also assesses
nerve conduction, and muscle response in injured tissue.
(iv) Temperature sensor: The body temperature of patients changes with the condition of the body. Therefore, a
temperature sensor is included in the AmbuSens system, which can easily be placed on the body of the patient.
(v) Galvanic Skin Response (GSR) sensor: The GSR sensor is used for measuring the change in electrical
characteristics of the skin.
Health Care IOT – Case Study
AmbuSens – Hardware
• Local Data Processing Unit (LDPU):
✓ In AmbuSens, all the sensors attached to the human body, sense and transmit the sensed data to a
centralized device, which is called an LDPU.
✓ An LDPU is a small processing board with limited computation capabilities.
✓ The connectivity between the sensors and the LDPU follows a single-hop star topology.
✓ The LDPU is programmed in such a way that it can receive the physiological data from multiple
sensor nodes, simultaneously.
✓ Further, it transmits the data to the cloud for long-term storage and heavy processing.
• Communication Module:
✓ Each sensor node consists of a Bluetooth (IEEE 802.15.1 standard) module.
✓ The communication between the sensor nodes and the LDPU takes place with the help of Bluetooth,
which supports a maximum communication range of 10 meters in line-of-sight.
✓ The LDPU delivers the data to the cloud with 3G/4G communication.
Health Care IOT – Case Study
AmbuSens – Front-End
• In the AmbuSens system, three actors—doctor, paramedic/nurse, and patient—are able to participate and
use the services.
• The web interface is designed as per the requirements of the actors of the system.
• Each of the actors has an option to log in and access the system.
• In order to maintain confidentiality of a patient and their physiological data, the system provides different
scopes for data accessibility based on the category of an actor.
For example, the detailed health data of a patient is accessible only to the assigned doctor. These data
may not be required for the nurse; therefore, a nurse is unable to access the same set of data a doctor
can access.
• The system provides the flexibility to a patient to log in to his/her account and download the details of
his/her previous medical/treatment details.
• Therefore, in AmbuSens, the database is designed in an efficient way such that it can deliver the
customized data to the respective actor.
• Each of the users has to register with the system to avail of the service of the AmbuSens. The registration
process is also designed in a customized fashion, that is, the details of a user to be entered into the
registration form is different for different actors.
For example, a doctor must enter his/her registration number in the registration form.