Fog Computing in Medical Internet-of-Things: Architecture, Implementation, and Applications

In the era when the market segment of Internet of Things (IoT) tops the chart in various business reports, it is apparently envisioned that the field of medicine expects to gain a large benefit from the explosion of wearables and internet-connected sensors that surround us to acquire and communicate unprecedented data on symptoms, medication, food intake, and daily-life activities impacting one's health and wellness. However, IoT-driven healthcare would have to overcome many barriers, such as: 1) There is an increasing demand for data storage on cloud servers where the analysis of the medical big data becomes increasingly complex, 2) The data, when communicated, are vulnerable to security and privacy issues, 3) The communication of the continuously collected data is not only costly but also energy hungry, 4) Operating and maintaining the sensors directly from the cloud servers are non-trial tasks. This book chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog Computing is a service-oriented intermediate layer in IoT, providing the interfaces between the sensors and cloud servers for facilitating connectivity, data transfer, and queryable local database. The centerpiece of Fog computing is a low-power, intelligent, wireless, embedded computing node that carries out signal conditioning and data analytics on raw data collected from wearables or other medical sensors and offers efficient means to serve telehealth interventions. We implemented and tested an fog computing system using the Intel Edison and Raspberry Pi that allows acquisition, computing, storage and communication of the various medical data such as pathological speech data of individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate estimation, and Electrocardiogram (ECG)-based Q, R, S detection.Comment: 29 pages, 30 figures, 5 tables. Keywords: Big Data, Body Area Network, Body Sensor Network, Edge Computing, Fog Computing, Medical Cyberphysical Systems, Medical Internet-of-Things, Telecare, Tele-treatment, Wearable Devices, Chapter in Handbook of Large-Scale Distributed Computing in Smart Healthcare (2017), Springe

Medical data processing and analysis for remote health and activities monitoring

Recent developments in sensor technology, wearable computing, Internet of Things (IoT), and wireless communication have given rise to research in ubiquitous healthcare and remote monitoring of human\u2019s health and activities. Health monitoring systems involve processing and analysis of data retrieved from smartphones, smart watches, smart bracelets, as well as various sensors and wearable devices. Such systems enable continuous monitoring of patients psychological and health conditions by sensing and transmitting measurements such as heart rate, electrocardiogram, body temperature, respiratory rate, chest sounds, or blood pressure. Pervasive healthcare, as a relevant application domain in this context, aims at revolutionizing the delivery of medical services through a medical assistive environment and facilitates the independent living of patients. In this chapter, we discuss (1) data collection, fusion, ownership and privacy issues; (2) models, technologies and solutions for medical data processing and analysis; (3) big medical data analytics for remote health monitoring; (4) research challenges and opportunities in medical data analytics; (5) examples of case studies and practical solutions

An IoT based Virtual Coaching System (VSC) for Assisting Activities of Daily Life

Nowadays aging of the population is becoming one of the main concerns of theworld. It is estimated that the number of people aged over 65 will increase from 461million to 2 billion in 2050. This substantial increment in the elderly population willhave significant consequences in the social and health care system. Therefore, in thecontext of Ambient Intelligence (AmI), the Ambient Assisted Living (AAL) has beenemerging as a new research area to address problems related to the aging of the population. AAL technologies based on embedded devices have demonstrated to be effectivein alleviating the social- and health-care issues related to the continuous growing of theaverage age of the population. Many smart applications, devices and systems have beendeveloped to monitor the health status of elderly, substitute them in the accomplishment of activities of the daily life (especially in presence of some impairment or disability),alert their caregivers in case of necessity and help them in recognizing risky situations.Such assistive technologies basically rely on the communication and interaction be-tween body sensors, smart environments and smart devices. However, in such contextless effort has been spent in designing smart solutions for empowering and supportingthe self-efficacy of people with neurodegenerative diseases and elderly in general. Thisthesis fills in the gap by presenting a low-cost, non intrusive, and ubiquitous VirtualCoaching System (VCS) to support people in the acquisition of new behaviors (e.g.,taking pills, drinking water, finding the right key, avoiding motor blocks) necessary tocope with needs derived from a change in their health status and a degradation of theircognitive capabilities as they age. VCS is based on the concept of extended mind intro-duced by Clark and Chalmers in 1998. They proposed the idea that objects within theenvironment function as a part of the mind. In my revisiting of the concept of extendedmind, the VCS is composed of a set of smart objects that exploit the Internet of Things(IoT) technology and machine learning-based algorithms, in order to identify the needsof the users and react accordingly. In particular, the system exploits smart tags to trans-form objects commonly used by people (e.g., pillbox, bottle of water, keys) into smartobjects, it monitors their usage according to their needs, and it incrementally guidesthem in the acquisition of new behaviors related to their needs. To implement VCS, thisthesis explores different research directions and challenges. First of all, it addresses thedefinition of a ubiquitous, non-invasive and low-cost indoor monitoring architecture byexploiting the IoT paradigm. Secondly, it deals with the necessity of developing solu-tions for implementing coaching actions and consequently monitoring human activitiesby analyzing the interaction between people and smart objects. Finally, it focuses on the design of low-cost localization systems for indoor environment, since knowing theposition of a person provides VCS with essential information to acquire information onperformed activities and to prevent risky situations. In the end, the outcomes of theseresearch directions have been integrated into a healthcare application scenario to imple-ment a wearable system that prevents freezing of gait in people affected by Parkinson\u2019sDisease

Implementation of the IoT-Based Technology on Patient Medication Adherence: A Comprehensive Bibliometric and Systematic Review

The dynamic field of the Internet of Things (IoT) is constantly increasing, providing a plethora of potential integration across various sectors, most notably healthcare. The IoT represents a significant technological leap in healthcare management systems, coinciding with the rising preference for personalized, proactive, cost-effective treatment techniques. This review aimed to thoroughly assess the existing literature through a systematic review and bibliometric analysis, identifying untapped research routes and possible domains for further exploration. The overarching goal was to provide healthcare professionals with significant insights into the impact of IoT technology on Patient Medication Adherence (PMA) and related outcomes. An extensive review of 314 scientific articles on the deployment of IoT within pharmaceutical care services revealed a rising trend in publication volume, with a significant increase in recent years. Pertinently, from the 33 publications finally selected, substantial data support the potential of the IoT to improve PMA, particularly among senior patients with chronic conditions. This paper also comments on various regularly implemented IoT-based systems, noting their unique benefits and limitations. In conclusion, the critical relevance of PMA is highlighted, arguing for its emphasis in future discussions. Furthermore, the need for additional research endeavors is proposed to face and overcome existing constraints and establish the long-term effectiveness of IoT technologies in maximizing patient outcomes

How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution

eHealth in hypertension and cardiovascular disease:Opportunities and challenges

In this thesis we investigate different aspects of eHealth for hypertension and cardiovascular disease, with a focus on remote monitoring programs for chronic care. We use the Dutch HartWacht program for patients with hypertension, cardiac arrhythmias and heart failure as an example that has been implemented in routine clinical care. We first focus on hypertension and identify areas that are attractive for future implementation of eHealth because of poor hypertension control. In the following chapters we present economical, legal and technical challenges that accompany eHealth implementation, in each chapter followed by potential solutions and opportunities. We identify success factors for cost-effective eHealth, provide a roadmap for GDPR-compliant solutions, present a novel technique for heartbeat detection through a bracelet and describe a protocol for efficient data handling in remote monitoring programs. In the second part of this thesis, we zoom in on the patients participating in eHealth programs. We evaluate the impact on quality of life of patients participating in the HartWacht program for cardiac arrhythmias and demonstrate equivalence compared to usual care. We then describe the feasibility of the HartWacht program for patients with hypertension in reducing blood pressure and present rationale, design and cohort profile of the Effectiveness of home-Monitoring of blood pressure in PAtients with difficult to Treat HYpertension (EMPATHY) trial. We conclude with an evaluation of the impact of the COVID-19 pandemic on the uptake of eHealth in primary care in the Netherlands

Assistive Technology for Elderly Care: An Overview

Global demographic changes have resulted in a growing technological demand to meet the arisen social needs. In particular, the increasingly ageing population requires assistive technologies to stay at home for longer independently while receiving continuous healthcare. In this sense, a wide academic and industrial research is taking place, introducing these technologies in hospitals and rehabilitation centres. This paper aims at providing an overview of research projects for elderly care and assistance, focusing on cognitive and robot assistants due to their popularity in the area. More precisely, physical and/or cognitive rehabilitation are presented. This paper also discusses their limitations and the open challenges to be tackled in order to be successfully integrated in our society

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe