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

Patient generated health data and electronic health record integration, governance and socio-technical issues: A narrative review

Patients’ health records have the potential to include patient generated health data (PGHD), which can aid in the provision of personalized care. Access to these data can allow healthcare professionals to receive additional information that will assist in decision-making and the provision of additional support. Given the diverse sources of PGHD, this review aims to provide evidence on PGHD integration with electronic health records (EHR), models and standards for PGHD exchange with EHR, and PGHD-EHR policy design and development. The review also addresses governance and socio-technical considerations in PGHD management. Databases used for the review include PubMed, Scopus, ScienceDirect, IEEE Xplore, SpringerLink and ACM Digital Library. The review reveals the significance, but current deficiency, of provenance, trust and contextual information as part of PGHD integration with EHR. Also, we find that there is limited work on data quality, and on new data sources and associated data elements, within the design of existing standards developed for PGHD integration. New data sources from emerging technologies like mixed reality, virtual reality, interactive voice response system, and social media are rarely considered. The review recommends the need for well-developed designs and policies for PGHD-EHR integration that promote data quality, patient autonomy, privacy, and enhanced trust

TACTICAL BLOCKCHAIN TO PROVIDE DATA PROVENANCE IN SUPPORT OF INTERNET OF BATTLEFIELD THINGS AND BIG DATA ANALYTICS

This capstone project evaluated the use of blockchain technology to address a number of challenges with increasing amounts of disparate sensor data and an information-rich landscape that can quickly overwhelm effective decision-making processes. The team explored how blockchain can be used in a variety of defense applications to verify users, validate sensor data fed into artificial intelligence models, limit access to data, and provide an audit trail across the data life cycle. The team developed a conceptual design for implementing blockchain for tactical data, artificial intelligence, and machine learning applications; identified challenges and limitations involved in implementing blockchain for the tactical domain; described the benefits of blockchain for these various applications; and evaluated this project’s findings to propose future research into a wider set of blockchain applications. The team did this through the development of three use cases. One use case demonstrated the use of blockchain at the tactical edge in a “data light” information environment. The second use case explored the use of blockchain in securing medical information in the electronic health record. The third use case studied blockchain’s application in the use of multiple sensors collecting data for chemical weapons defense to support measurement and signature intelligence analysis using artificial intelligence and machine learning.Civilian, Department of the ArmyCivilian, Department of the ArmyCivilian, Department of the ArmyCivilian, Department of the ArmyCivilian, Department of the ArmyApproved for public release. Distribution is unlimited

Holistic System Design for Distributed National eHealth Services

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A Semantic Web approach to ontology-based system: integrating, sharing and analysing IoT health and fitness data

With the rapid development of fitness industry, Internet of Things (IoT) technology is becoming one of the most popular trends for the health and fitness areas. IoT technologies have revolutionised the fitness and the sport industry by giving users the ability to monitor their health status and keep track of their training sessions. More and more sophisticated wearable devices, fitness trackers, smart watches and health mobile applications will appear in the near future. These systems do collect data non-stop from sensors and upload them to the Cloud. However, from a data-centric perspective the landscape of IoT fitness devices and wellness appliances is characterised by a plethora of representation and serialisation formats. The high heterogeneity of IoT data representations and the lack of common accepted standards, keep data isolated within each single system, preventing users and health professionals from having an integrated view of the various information collected. Moreover, in order to fully exploit the potential of the large amounts of data, it is also necessary to enable advanced analytics over it, thus achieving actionable knowledge. Therefore, due the above situation, the aim of this thesis project is to design and implement an ontology based system to (1) allow data interoperability among heterogeneous IoT fitness and wellness devices, (2) facilitate the integration and the sharing of information and (3) enable advanced analytics over the collected data (Cognitive Computing). The novelty of the proposed solution lies in exploiting Semantic Web technologies to formally describe the meaning of the data collected by the IoT devices and define a common communication strategy for information representation and exchange

Validation of design artefacts for blockchain-enabled precision healthcare as a service.

Healthcare systems around the globe are currently experiencing a rapid wave of digital disruption. Current research in applying emerging technologies such as Big Data (BD), Artificial Intelligence (AI), Machine Learning (ML), Deep Learning (DL), Augmented Reality (AR), Virtual Reality (VR), Digital Twin (DT), Wearable Sensor (WS), Blockchain (BC) and Smart Contracts (SC) in contact tracing, tracking, drug discovery, care support and delivery, vaccine distribution, management, and delivery. These disruptive innovations have made it feasible for the healthcare industry to provide personalised digital health solutions and services to the people and ensure sustainability in healthcare. Precision Healthcare (PHC) is a new inclusion in digital healthcare that can support personalised needs. It focuses on supporting and providing precise healthcare delivery. Despite such potential, recent studies show that PHC is ineffectual due to the lower patient adoption in the system. Anecdotal evidence shows that people are refraining from adopting PHC due to distrust. This thesis presents a BC-enabled PHC ecosystem that addresses ongoing issues and challenges regarding low opt-in. The designed ecosystem also incorporates emerging information technologies that are potential to address the need for user-centricity, data privacy and security, accountability, transparency, interoperability, and scalability for a sustainable PHC ecosystem. The research adopts Soft System Methodology (SSM) to construct and validate the design artefact and sub-artefacts of the proposed PHC ecosystem that addresses the low opt-in problem. Following a comprehensive view of the scholarly literature, which resulted in a draft set of design principles and rules, eighteen design refinement interviews were conducted to develop the artefact and sub-artefacts for design specifications. The artefact and sub-artefacts were validated through a design validation workshop, where the designed ecosystem was presented to a Delphi panel of twenty-two health industry actors. The key research finding was that there is a need for data-driven, secure, transparent, scalable, individualised healthcare services to achieve sustainability in healthcare. It includes explainable AI, data standards for biosensor devices, affordable BC solutions for storage, privacy and security policy, interoperability, and usercentricity, which prompts further research and industry application. The proposed ecosystem is potentially effective in growing trust, influencing patients in active engagement with real-world implementation, and contributing to sustainability in healthcare

Ambient-aware continuous care through semantic context dissemination

Background: The ultimate ambient-intelligent care room contains numerous sensors and devices to monitor the patient, sense and adjust the environment and support the staff. This sensor-based approach results in a large amount of data, which can be processed by current and future applications, e. g., task management and alerting systems. Today, nurses are responsible for coordinating all these applications and supplied information, which reduces the added value and slows down the adoption rate. The aim of the presented research is the design of a pervasive and scalable framework that is able to optimize continuous care processes by intelligently reasoning on the large amount of heterogeneous care data. Methods: The developed Ontology-based Care Platform (OCarePlatform) consists of modular components that perform a specific reasoning task. Consequently, they can easily be replicated and distributed. Complex reasoning is achieved by combining the results of different components. To ensure that the components only receive information, which is of interest to them at that time, they are able to dynamically generate and register filter rules with a Semantic Communication Bus (SCB). This SCB semantically filters all the heterogeneous care data according to the registered rules by using a continuous care ontology. The SCB can be distributed and a cache can be employed to ensure scalability. Results: A prototype implementation is presented consisting of a new-generation nurse call system supported by a localization and a home automation component. The amount of data that is filtered and the performance of the SCB are evaluated by testing the prototype in a living lab. The delay introduced by processing the filter rules is negligible when 10 or fewer rules are registered. Conclusions: The OCarePlatform allows disseminating relevant care data for the different applications and additionally supports composing complex applications from a set of smaller independent components. This way, the platform significantly reduces the amount of information that needs to be processed by the nurses. The delay resulting from processing the filter rules is linear in the amount of rules. Distributed deployment of the SCB and using a cache allows further improvement of these performance results

A patient agent controlled customized blockchain based framework for internet of things

Although Blockchain implementations have emerged as revolutionary technologies for various industrial applications including cryptocurrencies, they have not been widely deployed to store data streaming from sensors to remote servers in architectures known as Internet of Things. New Blockchain for the Internet of Things models promise secure solutions for eHealth, smart cities, and other applications. These models pave the way for continuous monitoring of patient’s physiological signs with wearable sensors to augment traditional medical practice without recourse to storing data with a trusted authority. However, existing Blockchain algorithms cannot accommodate the huge volumes, security, and privacy requirements of health data. In this thesis, our first contribution is an End-to-End secure eHealth architecture that introduces an intelligent Patient Centric Agent. The Patient Centric Agent executing on dedicated hardware manages the storage and access of streams of sensors generated health data, into a customized Blockchain and other less secure repositories. As IoT devices cannot host Blockchain technology due to their limited memory, power, and computational resources, the Patient Centric Agent coordinates and communicates with a private customized Blockchain on behalf of the wearable devices. While the adoption of a Patient Centric Agent offers solutions for addressing continuous monitoring of patients’ health, dealing with storage, data privacy and network security issues, the architecture is vulnerable to Denial of Services(DoS) and single point of failure attacks. To address this issue, we advance a second contribution; a decentralised eHealth system in which the Patient Centric Agent is replicated at three levels: Sensing Layer, NEAR Processing Layer and FAR Processing Layer. The functionalities of the Patient Centric Agent are customized to manage the tasks of the three levels. Simulations confirm protection of the architecture against DoS attacks. Few patients require all their health data to be stored in Blockchain repositories but instead need to select an appropriate storage medium for each chunk of data by matching their personal needs and preferences with features of candidate storage mediums. Motivated by this context, we advance third contribution; a recommendation model for health data storage that can accommodate patient preferences and make storage decisions rapidly, in real-time, even with streamed data. The mapping between health data features and characteristics of each repository is learned using machine learning. The Blockchain’s capacity to make transactions and store records without central oversight enables its application for IoT networks outside health such as underwater IoT networks where the unattended nature of the nodes threatens their security and privacy. However, underwater IoT differs from ground IoT as acoustics signals are the communication media leading to high propagation delays, high error rates exacerbated by turbulent water currents. Our fourth contribution is a customized Blockchain leveraged framework with the model of Patient-Centric Agent renamed as Smart Agent for securely monitoring underwater IoT. Finally, the smart Agent has been investigated in developing an IoT smart home or cities monitoring framework. The key algorithms underpinning to each contribution have been implemented and analysed using simulators.Doctor of Philosoph

Networking Architecture and Key Technologies for Human Digital Twin in Personalized Healthcare: A Comprehensive Survey

Digital twin (DT), refers to a promising technique to digitally and accurately represent actual physical entities. One typical advantage of DT is that it can be used to not only virtually replicate a system's detailed operations but also analyze the current condition, predict future behaviour, and refine the control optimization. Although DT has been widely implemented in various fields, such as smart manufacturing and transportation, its conventional paradigm is limited to embody non-living entities, e.g., robots and vehicles. When adopted in human-centric systems, a novel concept, called human digital twin (HDT) has thus been proposed. Particularly, HDT allows in silico representation of individual human body with the ability to dynamically reflect molecular status, physiological status, emotional and psychological status, as well as lifestyle evolutions. These prompt the expected application of HDT in personalized healthcare (PH), which can facilitate remote monitoring, diagnosis, prescription, surgery and rehabilitation. However, despite the large potential, HDT faces substantial research challenges in different aspects, and becomes an increasingly popular topic recently. In this survey, with a specific focus on the networking architecture and key technologies for HDT in PH applications, we first discuss the differences between HDT and conventional DTs, followed by the universal framework and essential functions of HDT. We then analyze its design requirements and challenges in PH applications. After that, we provide an overview of the networking architecture of HDT, including data acquisition layer, data communication layer, computation layer, data management layer and data analysis and decision making layer. Besides reviewing the key technologies for implementing such networking architecture in detail, we conclude this survey by presenting future research directions of HDT