Reporting an Experience on Design and Implementation of e-Health Systems on Azure Cloud

Electronic Health (e-Health) technology has brought the world with significant transformation from traditional paper-based medical practice to Information and Communication Technologies (ICT)-based systems for automatic management (storage, processing, and archiving) of information. Traditionally e-Health systems have been designed to operate within stovepipes on dedicated networks, physical computers, and locally managed software platforms that make it susceptible to many serious limitations including: 1) lack of on-demand scalability during critical situations; 2) high administrative overheads and costs; and 3) in-efficient resource utilization and energy consumption due to lack of automation. In this paper, we present an approach to migrate the ICT systems in the e-Health sector from traditional in-house Client/Server (C/S) architecture to the virtualised cloud computing environment. To this end, we developed two cloud-based e-Health applications (Medical Practice Management System and Telemedicine Practice System) for demonstrating how cloud services can be leveraged for developing and deploying such applications. The Windows Azure cloud computing platform is selected as an example public cloud platform for our study. We conducted several performance evaluation experiments to understand the Quality Service (QoS) tradeoffs of our applications under variable workload on Azure.Comment: Submitted to third IEEE International Conference on Cloud and Green Computing (CGC 2013

Telemedicine using mobile telecommunication: towards syntactic interoperability in teleexpertise

Telemedicine allows collaborative activities between health professionals for the deployment of medical procedures carried out remotely by means of device using information and communication technologies. This article focuses on the Teleexpertise that allows collaboration between medical professionals in order to share knowledge and expert advices used as explanation elements for decision support. We propose a conceptual model integrating the FIPA (Foundation for Intelligent Physical Agents) Contract Net Protocol which permits to collect medical professionals’ answers for a request for teleexpertise in an efficient manner. Our model satisfies four requirements (coverage, QoS (Quality of Service) guarantees and prioritisation, mobility and roaming, service usability) on the configuration and operation of the underlying network and the services. Therefore, we provide an operational assistance by improvement of the networks quality of service via interoperable web services. Finally, we hope to bring a tangible contribution on the implementation of this suggested conceptualization that will allow to generate relevant and action-oriented finding

Cloud and mobile infrastructure monitoring for latency and bandwidth sensitive applications

This PhD thesis involves the study of cloud computing infrastructures (from the networking perspective) to assess the feasibility of applications gaining increasing popularity over recent years, including multimedia and telemedicine applications, demanding low, bounded latency and sufficient bandwidth. I also focus on the case of telemedicine, where remote imaging applications (for example, telepathology or telesurgery) need to achieve a low and stable latency for the remote transmission of images, and also for the remote control of such equipment. Another important use case for telemedicine is denoted as remote computation, which involves the offloading of image processing to help diagnosis; also in this case, bandwidth and latency requirements should be enforced to ensure timely results, although they are less strict compared to the previous scenario. Nowadays, the capability of gaining access to IT resources in a rapid and on-demand fashion, according to a pay-as-you-go model, has made the cloud computing a key-enabler for innovative multimedia and telemedicine services. However, the partial obscurity of cloud performance, and also security concerns are still hindering the adoption of cloud infrastructure. To ensure that the requirements of applications running on the cloud are satisfied, there is the need to design and evaluate proper methodologies, according to the metric of interest. Moreover, some kinds of applications have specific requirements that cannot be satisfied by the current cloud infrastructure. In particular, since the cloud computing involves communication to remote servers, two problems arise: firstly, the core network infrastructure can be overloaded, considering the massive amount of data that has to flow through it to allow clients to reach the datacenters; secondly, the latency resulting from this remote interaction between clients and servers is increased. For these, and many other cases also beyond the field of telemedicine, the Edge and Fog computing paradigms were introduced. In these new paradigms, the IT resources are deployed not only in the core cloud datacenters, but also at the edge of the network, either in the telecom operator access network or even leveraging other users' devices. The proximity of resources to end-users allows to alleviate the burden on the core network and at the same time to reduce latency towards users. Indeed, the latency from users to remote cloud datacenters encompasses delays from the access and core networks, as well as the intra-datacenter delay. Therefore, this latency is expected to be higher than that required to interconnect users to edge servers, which in the envisioned paradigm are deployed in the access network, that is, nearby final users. Therefore, the edge latency is expected to be reduced to only a portion of the overall cloud delay. Moreover, the edge and central resources can be used in conjunction, and therefore attention to core cloud monitoring is of capital importance even when edge architectures will have a widespread adoption, which is not the case yet. While a lot of research work has been presented for monitoring several network-related metrics, such as bandwidth, latency, jitter and packet loss, less attention was given to the monitoring of latency in cloud and edge cloud infrastructures. In detail, while some works target cloud-latency monitoring, the evaluation is lacking a fine-grained analysis of latency considering spatial and temporal trends. Furthermore, the widespread adoption of mobile devices, and the Internet of Things paradigm further accelerate the shift towards the cloud paradigm for the additional benefits it can provide in this context, allowing energy savings and augmenting the computation capabilities of these devices, creating a new scenario denoted as mobile cloud. This scenario poses additional challenges for its bandwidth constraints, accentuating the need for tailored methodologies that can ensure that the crucial requirements of the aforementioned applications can be met by the current infrastructure. In this sense, there is still a gap of works monitoring bandwidth-related metrics in mobile networks, especially when performing in-the-wild assessment targeting actual mobile networks and operators. Moreover, even the few works testing real scenarios typically consider only one provider in one country for a limited period of time, lacking an in-depth assessment of bandwidth variability over space and time. In this thesis, I therefore consider monitoring methodologies for challenging scenarios, focusing on latency perceived by customers of public cloud providers, and bandwidth in mobile broadband networks. Indeed, as described, achieving low latency is a critical requirement for core cloud infrastructures, while providing enough bandwidth is still challenging in mobile networks compared to wired settings, even with the adoption of 4G mobile broadband networks, expecting to overcome this issue only with the widespread availability of 5G connections (with half of total traffic expected to come from 5G networks by 2026). Therefore, in the research activities carried on during my PhD, I focused on monitoring latency and bandwidth on cloud and mobile infrastructures, assessing to which extent the current public cloud infrastructure and mobile network make multimedia and telemedicine applications (as well as others having similar requirements) feasible

Managing the outsourcing of information security processes: the 'cloud' solution

Information security processes and systems are relevant for any organization and involve medium-to-high investment; however, the current economic downturn is causing a dramatic reduction in spending on Information Technology (IT). Cloud computing (i.e., externalization of one or more IT services) might be a solution for organizations keen to maintain a good level of security. In this paper we discuss whether cloud computing is a valid alternative to in-house security processes and systems drawing on four mini-case studies of higher education institutions in New England, US. Our findings show that the organization’s IT spending capacity affects the choice to move to the cloud; however, the perceived security of the cloud and the perceived in-house capacity to provide high quality IT (and security) services moderate this relationship. Moreover, other variables such as (low) quality of technical support, relatively incomplete contracts, poor defined Service License Agreements (SLA), and ambiguities over data ownership affect the choice to outsource IT (and security) using the cloud. We suggest that, while cloud computing could be a useful means of IT outsourcing, there needs to be a number of changes and improvements to how the service is currently delivered

Recent advances in industrial wireless sensor networks towards efficient management in IoT

With the accelerated development of Internet-of- Things (IoT), wireless sensor networks (WSN) are gaining importance in the continued advancement of information and communication technologies, and have been connected and integrated with Internet in vast industrial applications. However, given the fact that most wireless sensor devices are resource constrained and operate on batteries, the communication overhead and power consumption are therefore important issues for wireless sensor networks design. In order to efficiently manage these wireless sensor devices in a unified manner, the industrial authorities should be able to provide a network infrastructure supporting various WSN applications and services that facilitate the management of sensor-equipped real-world entities. This paper presents an overview of industrial ecosystem, technical architecture, industrial device management standards and our latest research activity in developing a WSN management system. The key approach to enable efficient and reliable management of WSN within such an infrastructure is a cross layer design of lightweight and cloud-based RESTful web service

Contemporary analysis and architecture for a generic cloud-based sensor data management platform.

An increasing volume of data is being generated by sensors and smart devices deployed in different areas, often far from computing facilities such as data centres. These data can be difficult to gather and process using local computing infrastructure. This is due to cost and limited resources. Cloud computing provides scalable resources that are capable of addressing such problems. However, platform-independent methods of gathering and transmitting sensor data to Clouds are not widely available. This paper presents a state-of-the-art analysis of Cloud-based sensor monitoring and data gathering platforms. It discusses their strengths and weaknesses and reviews the current trends in this area. Informed by the analysis, the paper further proposes a generic conceptual architecture for achieving a platform-neutral Cloud-based sensor monitoring and data gathering platform. We also discuss the objectives, design decisions and the implementation considerations for the conceptual architecture.IC

Serviços de imagem médica suportados na cloud

Mestrado em Engenharia de Computadores e TelemáticaHoje em dia, as instituições de cuidados de saúde, utilizam a telemedicina para suportar ambientes colaborativos. Na área da imagem médica digital, a quantidade de dados tem crescido substancialmente nos últimos anos, requerendo mais infraestruturas para fornecer um serviço com a qualidade desejada. Os computadores e dispositivos com acesso à Internet estão acessíveis em qualquer altura e em qualquer lugar, criando oportunidades para partilhar e utilizar recursos online. Uma enorme quantidade de processamento computacional e armazenamento são utilizados como uma comodidade no quotidiano. Esta dissertação apresenta uma plataforma para suportar serviços de telemedicina sobre a cloud, permitindo que aplicações armazenem e comuniquem facilmente, utilizando qualquer fornecedor de cloud. Deste modo, os programadores não necessitam de se preocupar onde os recursos vão ser instalados a as suas aplicações não ficam limitadas a um único fornecedor. Foram desenvolvidas duas aplicações para tele-imagiologia com esta plataforma: repositório de imagens médicas e uma infraestrutura de comunicações entre centros hospitalares. Finalmente, a arquitetura desenvolvida é genérica e flexível permitindo facilmente a sua expansão para outras áreas aplicacionais e outros serviços de cloud.Healthcare institutions resort largely, nowadays, to telemedicine in order to support collaborative environments. In the medical imaging area, the huge amount of medical volume data has increased over the past few years, requiring high-performance infrastructures to provide services with required quality. Computing devices and Internet access are now available anywhere and at anytime, creating new opportunities to share and use online resources. A tremendous amount of ubiquitous computational power and an unprecedented number of Internet resources and services are used every day as a normal commodity. This thesis presents a telemedicine service platform over the Cloud that allows applications to store information and to communicate easier, using any Internet cloud provider. With this platform, developers do not concern where the resources will be deployed and the applications will not be restricted to a specific cloud vendor. Two tele-imagiologic applications were developed along with this platform: a medical imaging repository and an interinstitutional communications infrastructure. Lastly, the architecture developed is generic and flexible to expand to other application areas and cloud services

Medical application of the Internet of Things (IoT): prototyping a telemonitoring system

The Internet of Things (IoT) is a technological paradigm that can be perceived as an evolution of the internet. It is a shift from the traditional way of connecting devices to the internet, both in number and diversity of connected devices. This significant and marked growth in the number and diversity of devices connected to the internet has prompted a rethink of approaches to interconnect devices. The growth in the number of connected devices is driven by emerging applications and business models and supported by falling device costs while the growth in the diversity is driven by the reduction in the cost of manufacturing these devices. This has led to an increase in the number of users (not limited to people) of the internet. According to statistics by the ITU, by the end of 2015, about 3.2 billion people were using the Internet. Significantly, 34% of households in developing countries had Internet access, with more than 80% of households in developed countries. This indicates that it is realistic to leverage the IoT in living spaces. Appreciating this potential, many sectors of society are already positioning themselves to reap the benefits of this great promise. Hence the health sector would do well to adopt this technological paradigm to enhance service delivery. One specific area where the health sector can benefit from the adoption of the IoT is in telemonitoring and the associated early response to medical emergencies. Statistics and research show that there are areas in the medical field, that still need improvement to enhance service delivery. The Nursing Times has summed up these areas into four categories. The first one is a need to have a regular observation of patients and their vital signs. Here, health service providers (SPs) need to adopt creative and non-obtrusive methods that will encourage patients' participation in the monitoring of these vital signs. As much as possible, vital signs readings should be taken at convenient locations and times. Therefore, devices that have consistent internet access and are usually a part of daily life for most patients, such as the mobile phones would prove to be a key enabler of regular observation of vital signs. Furthermore, miniaturization of the vital signs monitoring or sensing devices would be a key step towards realizing this scenario. A lot of work is already being done to miniaturize these devices and make them as much a part of daily life as possible, as evidenced by advancements in the field of fitness and wearables. To map this use to the medical field, a system needs to be created that would allow for the aggregation of these disparate measuring and monitoring devices with medical information management systems. The second potential area of improvement is in the early recognition of deterioration of the patients. With regular observation of patients, it is possible to recognize deterioration at its early stage. Taking cognizance of the different needs of the various stakeholders is important to achieve the intended results. The third potential area of improvement is in the communication among stakeholders. This has to do with identifying the relevant data that must be delivered to the stakeholders during the monitoring and management process. Lastly, effective response to medical concerns is the other potential area of improvement. It is noted that patients do not generally get the right response at the right time because the information does not reach the rightly qualified personnel in good time. The regular and real-time capture of vital signs data coupled with added analytics can enable IoT SPs to design solutions that automate the management and transmission of medical data in a timely manner. This work addresses how the medical sector can adopt IoT-based solutions to improve service delivery, while utilizing existing resources such as smartphones, for the transmission and management of vital signs data, availing it to stakeholders and improve communication among them. It develops a telemonitoring system based on IoT design approaches. The developed system captures readings of vital signs from monitoring devices, processes and manages this data to serve the needs of the various stakeholders. Additionally, intelligence was added to enable the system to interpret the data and make decisions that will help medical practitioners and other stakeholders (patients, caregivers, etc.) to more timely, consistently and reliably provide and receive medical services/assistance. Two end user applications were developed. A cloud-based web application developed using PHP, HTML, and JavaScript and an Android mobile application developed using Java programming language in Android studio. An ETSI standards-compliant M2M middleware is used to aggregate the system using M2M applications developed in Python. This is to leverage the benefits of the standards-compliant middleware while offering flexibility in the design of applications. The developed system was evaluated to assess whether it meets the requirements and expectations of the various stakeholders. Finally, the performance of the proposed telemonitoring system was studied by analyzing the delay on the delivery of messages (local notifications, SMS, and email) to various stakeholders to assess the contribution towards reducing the overall time of the cardiac arrest chain of survival. The results obtained showed a marked improvement (over 28 seconds) on previous work. In addition to improved performance in monitoring and management of vital signs, telemonitoring systems have a potential of decongesting health institutions and saving time for all the stakeholders while bridging most of the gaps discussed above. The captured data can also provide the health researchers and physicians with most of the prerequisite data to effectively execute predictive health thereby improving service delivery in the health sector

A Decision Support Framework for Public Healthcare: An approach to Follow-up Support Service

The literature on the development of measurement help researchers consider two broad issues: the qualitative tasks of conceptually modelling constructs and operationalizing them in a set of indicators and the more quantitative issues of using estimation procedures to convert their data into estimates. While these issues are interdependent, these two streams of literature have been largely separate. With this paper, we aim to contribute toward the establishment of integral guidance on measurement development. We propose a conceptual framework that should connect more explicitly the qualitative issues of measurement design with its quantitative issues. By analysing common sources of error, we show how it can be used to identify the sources of error specific to a measurement. We further provide initial guidelines on how problematic indicators can be remedied. Finally, we suggest how future research could take a next step in synthesizing qualitative with quantitative issues to provide more integral guidelines