Ubiquitous Healthcare Services Research Articles

Architecture Integrating Wireless Body Area Networks with Web Services for Ubiquitous Healthcare Service Provisioning

Architecture Integrating Wireless Body Area Networks with Web Services for Ubiquitous Healthcare Service Provisioning

Toward Ubiquitous Healthcare Services With a Novel Efficient Cloud Platform

Ubiquitous healthcare services are becoming more and more popular, especially under the urgent demand of the global aging issue. Cloud computing owns the pervasive and on-demand service-oriented natures, which can fit the characteristics of healthcare services very well. However, the abilities in dealing with multimodal, heterogeneous, and nonstationary physiological signals to provide persistent personalized services, meanwhile keeping high concurrent online analysis for public, are challenges to the general cloud. In this paper, we proposed a private cloud platform architecture which includes six layers according to the specific requirements. This platform utilizes message queue as a cloud engine, and each layer thereby achieves relative independence by this loosely coupled means of communications with publish/subscribe mechanism. Furthermore, a plug-in algorithm framework is also presented, and massive semistructure or unstructured medical data are accessed adaptively by this cloud architecture. As the testing results showing, this proposed cloud platform, with robust, stable, and efficient features, can satisfy high concurrent requests from ubiquitous healthcare services.

Acceptability of the Consumer-Centric u-Health Services for Patients with Chronic Obstructive Pulmonary Disease

We developed and implemented a system for u-health (ubiquitous healthcare) services for patients with chronic obstructive pulmonary disease (COPD) and studied the level of acceptability by the patients in the context of home visits and telephone education. To determine its effectiveness, the u-health service system was used for 2 years with 144 COPD patients in a clinical environment. Patients were provided with the u-healthcare service. Patients with COPD were highly satisfied with the u-healthcare service, which incorporated telemonitoring, teleconsultation, and tele-education along with home visits. The average acceptable fees (in USD) of the service system are as follows: u-health device, $421.28; home visit, $21.53/visit; tele-education, $0.53/min or $26.57/month; and total service fee, $44.26/month. COPD patients accepted u-health services with a high satisfaction rate, promising a new paradigm of consumer-centric healthcare services.

Ambulatory Cardiogenic Pulmonary Edema Monitoring as an Essential Ubiquitous Healthcare Service – Development of a Simulation Model

Ambulatory Cardiogenic Pulmonary Edema Monitoring as an Essential Ubiquitous Healthcare Service – Development of a Simulation Model

Ubiquitous Healthcare Service Has the Persistent Benefit on Glycemic Control and Body Weight in Older Adults With Diabetes

The use of information technology such as the Internet and mobile communication devices in medicine is known as telemedicine or ubiquitous healthcare (u-healthcare). U-healthcare can help improve glycemic control (1–3), and we have reported that a u-healthcare service for older adults with type 2 diabetes resulted in better glycemic control with less hypoglycemia than conventional care (1). In the current study, we investigated whether the beneficial effects of this u-healthcare service on glycemic control and BMI persist after completion of the service. This was a prospective follow-up study of our previous study (1). Briefly, 144 subjects with type 2 diabetes older than 60 years of age were randomized to one of three groups: a u-healthcare group, a self-monitored blood glucose (SMBG) group, or a routine care group (control group). After completion of the study, …

Using Health Information Technology to Prevent and Treat Diabetes

Using Health Information Technology to Prevent and Treat Diabetes

Ubiquitous Healthcare Information System: Assessment of its Impacts to Patient’s Information

In recent years, healthcare systems around the globe have undergone an increasing pressure to improve healthcare services, for chronic-disease patients as well as the general population, through effective prevention and post-operative care. Growth in governments’ healthcare spending which is fuelled by an ageing population, limited financial and human resources plus an increase in the rate of chronic diseases are considered as the reasons for the increase in healthcare organisations’ pressure. With advancement in technology, healthcare organisations are now moving towards Ubiquitous healthcare, which is an emerging field of technology that uses a large number of environmental and patients’ sensors and actuators to monitor patient’s mental and physical conditions. Once a ubiquitous healthcare service is in place, then the ubiquitous healthcare information system will “always be on” and hence promising better health and well-being for the general population. Despite the presence of various promises that Ubiquitous healthcare brings to individuals as well as to the society, it also introduces myriad challenges potential for serious abuses such as privacy violations, staff discrimination and even threatening security attacks. Based upon extensive review of international literature, this paper investigates the impacts of ubiquitous healthcare information systems on patients, doctors, healthcare organisations and society in general. Thereafter, we analyse if these systems should be used in healthcare or not.

Access stratum resource management for reliable u-healthcare service in LTE networks

With the rapid growth of elderly population, ubiquitous healthcare (u-healthcare) service combined with advanced wireless networking technology is gaining popularity. The advance in medical sensor technology has boasted up the u-healthcare market potential. However, the global connectivity with a sufficient level of reliability is still an issue to study for its prototype development. In our previous study (Lee et al. In: Proc BodyNets 2010, Lee et al. in J Commun Netw 13(2):160---166, 2011), the energy efficient packet-level scheduling was studied but the scheduling and management topics in the access stratum, which is the beginning part of end-to-end connection for ubiquitous healthcare service, are still open. In this paper, we study an efficient and adaptive method that can provide u-healthcare user devices with an increased level of access privilege so that the healthcare related user data, which is sometimes delay-critical, can be more favorable admitted to the access stratum. We develop a mathematical formulation for the access control in access stratum domain over the existing 3.9-th generation cellular communication standard, called long term evolution (LTE) and devise an efficient and exact algorithm to solve it. The proposed method has simplicity in implementation and efficiency in operation. In addition, it can improve key performance measures, such as call blocking and call dropping performance.

Design and implementation of a wireless sensor network architecture using smart mobile devices

Wireless sensor networks improve the quality of human daily life like ubiquitous city and healthcare services as well as the fundamental monitoring such as environment pollution, tunnel monitoring, earthquake diagnostic, and so on. To increase usability and feasibility of collected sensor data, a wireless sensor network should be required to apply a variety of mobile devices to give the information at anytime and anywhere to users. Thus, we present multi-sensor centric smart sensor network architecture using general mobile devices in order to provide more efficient and valuable sensor network application and services. The proposed system architecture is based on IEEE 802.15.4-2006 standard with smart mobile devices. We also show some scenarios with on-demand request and real time event driven data to show the feasibility of the proposed architecture using five kinds of sensors such as magnetic, photodiode, microphone, motion and vibration. Based on the experiment results, we show that the proposed system has the potential as smart mobile device-based wireless sensor network architecture.

Improved Glycemic Control Without Hypoglycemia in Elderly Diabetic Patients Using the Ubiquitous Healthcare Service, a New Medical Information System

OBJECTIVETo improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology.RESEARCH DESIGN AND METHODSWe conducted a 6-month randomized, controlled clinical trial involving 144 patients aged >60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C <7% without hypoglycemia at 6 months. U-healthcare system refers to an individualized medical service in which medical instructions are given through the patient’s mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server. Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone.RESULTSAfter 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (P < 0.001) in the u-healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (P = 0.020) in the SMBG group, compared with 7.9 ± 0.8% to 7.8 ± 1.0% (P = 0.274) in the control group. The proportion of patients with A1C <7% without hypoglycemia was 30.6% in the u-healthcare group, 23.4% in the SMBG group (23.4%), and 14.0% in the control group (P < 0.05).CONCLUSIONSThe CDSS-based u-healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients.

Effects of Nutrition Education Using a Ubiquitous Healthcare (u-Health) Service on Metabolic Syndrome in Male Workers

The objective of this study was to investigate the effects of nutrition education based on ubiquitous healthcare (u-health) service on changes in dietary habits, nutrition intake, and risk factors for metabolic syndrome in male workers. In total, 72 male office workers with at least three risk factors of the National Cholesterol Education Program-Adult Treatment Panel III were recruited as subjects. Anthropometric measurements and biochemical analyses were conducted on all subjects. Dietary habits and nutrient intake were determined by a questionnaire using the 24-hour dietary recall method before and after nutrition education. Subjects measured their body composition, blood pressure, and physical activity more than once per week during the 12 weeks using the u-health care equipment and sent these data to a central database system using a personal computer. Individual nutrition counseling was provided four times on the first, fourth, eight, and twelfth weeks. The results showed significant decreases in abdominal circumference, body fat (%), diastolic blood pressure, serum triglycerides, and serum total cholesterol during the 12 weeks. Subjects with more than 12 measurements showed significant reductions in abdominal circumference, body fat (%), serum triglyceride, and serum total cholesterol. Mean intake of dietary fiber, animal calcium, potassium, vitamin C, and folic acid after nutrition education were higher than those before nutrition education. Participants showed significant increases in the frequencies of consuming protein foods (meat, fish, eggs, beans, tofu, etc. ) and vegetables. In conclusion, nutrition education through the u-health service resulted in positive effects on the risk factors for metabolic syndrome, nutrient intake, and dietary habits. (Korean J Nutr 2011; 44(3): 231 ~ 242)

A Survey on Ubiquitous Healthcare Service Demand among Diabetic Patients.

BackgroundAdvanced information technology can be used when developing diagnostic and treatment strategies to provide better care for diabetic patients. However, the levels of need and demand for the use of technological advances have not been investigated in diabetic patients. We proposed and developed an individualized, ubiquitous (U)-healthcare service using advanced information technology for more effective glucose control. Prior to our service initiation, we surveyed patient needs and other pertinent information.MethodsDuring August 2009, we conducted a 34-item questionnaire survey among patients with diabetes who were older than 40 years in two certain hospitals in Korea.ResultsThe mean age of the 228 participants was 61.2±9 years, and males made up 49.1% of the sample. Seventy-one percent replied that they wanted individualized healthcare service, and they also wanted their health information to be delivered through mobile devices such as a cellular phone or a personal digital assistant (40.4%). Most patients had never heard of U-healthcare services (81.1%); however, after explaining the concept, 71.1% of participants responded that they would use the service if it was provided. Despite their willingness, participants were concerned about technical difficulty in using the service (26.3%) as well as the cost of the service (29.8%).ConclusionThe current study suggests that more than 70% of diabetic patients are interested in using U-healthcare services. To encourage widespread use, the application program or device of U-healthcare services should be simple, easy to use and affordable while also including a policy for the protection of private information.

U-Health: an example of a high-quality individualized healthcare service.

National Taiwan University Hospital (Taipei, Taiwan), which is one of the largest hospitals in Taiwan, is undergoing healthcare service reforms: it is combining the home healthcare service network and sensors network into a new service known as the Ubiquitous Healthcare (U-Health) service system in order to continually provide a personalized healthcare service to patients who live in remote areas. The U-Health service system is comprised of six service components that are introduced in an integrated manner: tele-education, telediagnosis, telemonitoring, teleconsultation, teletherapy and lifetime health. The target patient segments are postdischarge patients, patients suffering from cardiovascular diseases, patients suffering from chronic diseases and patients in hospice care. Since its launch in October 2009, the U-Health service system has effectively reduced the rehospitalization rate from 12% in October 2009 to 6% in May 2010 and the rate of visiting the emergency room from 21% in October 2009 to 9% in May 2010, during the 14-day postdischarge follow-up period.

Ubiquitous Healthcare Service System with Context-awareness Capability: Design and Implementation

The rises of the life index quality together with the medical technology improvement lead to a longer life expectancy. Thus a better health care program, especially for elderly, is needed. The common health problems facing those senior citizens are changed from acute diseases to chronic diseases, such as diabetes, hypertension, etc. Along with these changes, medical tourism is becoming the trend of the future. In this paper, we propose a decision support systems, the Ubiquitous Context-aware Healthcare Service System (UCHS), which uses micro sensors integrate RFID to sense user’s life vital signal, such as electrocardiogram (ECG/EKG), heart rate (HR), respiratory rate (RR), blood pressure (BP), blood sugar (BS), and temperature and light. The UCHS is composted of Situation-Aware Medical Tourism Service Search Subsystem (SAMTS 3), Healthy-life Map Guiding Subsystem (HMGS), Intelligent Curative Food Decision Support Subsystem (ICFDSS), and 4D Emergency Indication and Ambulance Dispatch Subsystem (4DEIADS) to provide relevant nature medicine recommendations to its user. The UCHS built upon an integrated service platform in which medical experts’ knowledge and all position and negative influence of the proposed therapy are inferred by using semantic network.

Fostering User Participation in Ambient Assisted Living Projects

Participatory design has been widely accepted as an effective strategy for understanding and including users’ needs in technology development. But the successful integration of user participation depends on the way it is carried out, that is, when and how are the users involved in the process, how are the users’ needs and requirements transferred to the technologists, and how is it verified that these requirements have been satisfied in the developed prototypes? These questions can be summarized as, how can one make the users’ voice heard across the development of complex ubiquitous healthcare services? Finding adequate answers to these questions normally is complex due to the challenges that arise when using new and untested technology, as is the case of ubiquitous healthcare services. This paper will present answers to such questions from experience gathered during European projects in the AAL (Ambient Assisted Living) area, in which qualified specialists collaborate to provide a pool of competences that are vital in guaranteeing the success of ubiquitous healthcare services.

유비쿼터스 헬스케어 서비스를 위한 태스크 중심의 임상 프로토콜 개발 방법론

유비쿼터스 서비스 인프라의 확충에 따라 헬스케어 분야가 중요한 서비스 영역으로 주목받고 있다. 유비쿼터스 헬스케어는 서비스의 실현에 있어서 의료종사자뿐만 아니라 환자 및 환자보호자의 역할이 요구되고, 또한 정보 인프라에서의 지원도 필수적이다. 의료서비스의 정형화 및 품질보증을 위해서 의료분야에서는 임상 프로토콜을 정의하고 이를 임상에 적용하고 있다. 유비쿼터스 환경에서의 의료 서비스 품질을 보증하기 위해서는 마찬가지로 임상 프로토콜을 활용하는 것이 필요하다. 유비쿼터스 헬스케어 서비스에는 의료종사자 뿐만아니라 환자 및 환자보호자, 정보 시스템이 각자의 고유 역할을 하는 것이 요구된다. 이러한 유비쿼터스 헬스케어 서비스에서의 요구사항을 만족하면서 임상프로토콜을 효과적으로 개발할 수 있도록 하는 유비쿼터스 헬스케어 임상 프로토콜을 개발하는 방법을 소개한다. 제안된 방법은 헬스케어 참여자별 태스크들을 명확히 식별하도록 하면서, 태스크간의 관계를 명확히 하도록 하여 가시화가 가능하도록 한다. 개발된 방법론은 유비쿼터스 환경에서 과민성방광 환자관리를 위한 임상 프로토콜을 개발하는데 적용하여 적용가능성을 확인했다. With the advances in ubiquitous service infrastructure, healthcare services have drawn attention as one of promising application domains. In ubiquitous healthcare services, patients or care-givers as well as medical personnel are asked to play their roles and, in addition, the information system is supposed to have active roles. In medicine, clinical protocols have been developed and put into practice in order to reduce treatment variances and assure the service quality. In the same token, clinical protocols on ubiquitous service practices are need to be developed which takes into account both the clinical details and the ubiquitous service functionality. This paper introduces a clinical protocol modeling methodology which pays attention to participants and their tasks including contextual information. The proposed method has been successfully applied to a real application domain, OAB(overactive bladder) syndrome patient care to see how it builds a clinical protocol.

U-Health 서비스 지원을 위한 착용형 옥시미터를 이용한 맥파 분석 시스템

This paper describes a real time reliable monitoring method and analysis system using wrist type oximeter for ubiquitous healthcare service based on IEEE 802.15.4 standard. Photoplethysmograph(PPG) is simple and cost effective technique to measure blood volume change. In order to obtain and monitor physiological body signals continuously, a small size and low power consumption wrist type oximeter is designed for the measurement of oxygen saturation of a patient unobtrusively. The measured data is transferred to a central PC or server computer by using wireless sensor nodes in wireless sensor network for storage and analysis purposes. LabVIEW server program is designed to monitor stress indicator from heart rate variability(HRV) and process the measured PPG to accelerated plethysmograph(APG) by appling second order derivatives in server PC. These experimental results demonstrate that APG can precisely describe the features of an individual's PPG and be used as estimation of vascular elasticity for blood circulation.

Development of portable breast self-examination device using enhanced tactile feedback

A simple tactile imaging system for detecting possible breast lumps is proposed. The breast cancer detection system (BCDS) consists of a palm-sized, portable, wireless scanning probe with a nine-force sensor array, a web camera, and a PC program to display the location and stiffness of hard breast lesions based on tactile pressure profiles. The results of performance evaluation tests using various breast phantoms demonstrated that palpable abnormalities larger than 5 mm located at depths less than 25 mm can be detected accurately. It is expected that this low-priced BCDS will extensively benefit all adults and ubiquitous healthcare services who apply regular breast self-examination by providing remote magnified palpation with enhanced tactile sensitivity.

Mobile u-healthcare system in IEEE 802.15.4 WSN and CDMA network environments

This paper describes a robust mobile u-healthcare system with multiple physiological signs measurement capability in real time with integration of WSN(wireless sensor network) technology and CDMA(code division multiple access) network. A cellular phone receives health data in WSN and performs local physiological signs analysis at a phone processor, and then transmits abnormal data to server for further detail or precise health signal evaluation by a medical doctor over a CDMA network. Physiological signs of the patients are continuously monitored, processed and analyzed locally at cellular phone process to produce useful medical information for diagnosis and tracking purposes. By local simple analysis in cellular phone processor we can save the data transmission cost in CDMA network. By using the developed integrate ubiquitous healthcare service architecture, patients can realize self-health checking so that the prevention actions can be taken earlier. Appropriate self-monitoring and self-management can cure disease and relieve pain especially for patients who suffer from chronic diseases that need long term observation.

Ubiquitous healthcare service using Zigbee and mobile phone for elderly patients

Objective To investigate the efficacy of a u-healthcare service using Zigbee and mobile phone for elderly patients with diabetes mellitus or heart diseases. Materials and methods From July to October, 2005, 29 patients were enrolled in our study. Two selected u-healthcare items, ECG and blood glucose measurement, were monitored. Twenty patients were provided with ZigBee built-in blood glucometer and mobile phones, and were instructed on using a web service where the measured blood glucose could be transmitted directly to the web and be administrated. Nine patients participated in ECG monitoring, by using a wireless, transmittable ECG recording instrument equipped with ZigBee protocol attached to their chest. Daily average transmission frequency, rate of transmission loss, and error reasons were analyzed. In addition, the patients were asked to score their degree of satisfaction about the sensors and u-healthcare services. Results The mean transmission frequencies were 2.1 times/day in blood glucose monitoring and 6.1 times/day in ECG. The patients’ satisfaction scores of the blood glucometer and service used in this research were 8.59 and 9.01 of 10 points, respectively. The mean satisfaction scores about ECG sensor and ECG monitoring services were 5.79 and 7.29, respectively. Discussion Despite the many problems still encountered such as technological problems related to sensors and some problems like battery replacement, we could transfer the data of glucometer and ECG sensors to web-server via ZigBee protocol. Authors think the ZigBee could be one of components of wireless u-healthcare systems in the future due to its advantages of lower power consumption.