基于物联网技术的医疗监测研究综述

阐述医疗监测系统研究现状,包括移动医疗、生理指标检测设备、医疗机构级监护系统和家用监护系统几方面。对医疗监测系统研究热点进行分析,包括云健康监测平台、穿戴式医疗仪器及人体传感器网络3方面。指出基于物联网的医疗监测系统存在问题,预测其未来发展方向。     

A Secure Cloud-Assisted Wireless Body Area Network in Mobile Emergency Medical Care System

Recent advances in medical treatment and emergency applications, the need of integrating wireless body area network (WBAN) with cloud computing can be motivated by providing useful and real time information about patients’ health state to the doctors and emergency staffs. WBAN is a set of body sensors carried by the patient to collect and transmit numerous health items to medical clouds via wireless and public communication channels. Therefore, a cloud-assisted WBAN facilitates response in case of emergency which can save patients’ lives. Since the patient’s data is sensitive and private, it is important to provide strong security and protection on the patient’s medical data over public and insecure communication channels. In this paper, we address the challenge of participant authentication in mobile emergency medical care systems for patients supervision and propose a secure cloud-assisted architecture for accessing and monitoring health items collected by WBAN. For ensuring a high level of security and providing a mutual authentication property, chaotic maps based authentication and key agreement mechanisms are designed according to the concept of Diffie-Hellman key exchange, which depends on the CMBDLP and CMBDHP problems. Security and performance analyses show how the proposed system guaranteed the patient privacy and the system confidentiality of sensitive medical data while preserving the low computation property in medical treatment and remote medical monitoring.     

iCHRCloud: Web & Mobile based Child Health Imprints for Smart Healthcare

Reducing child mortality with quality care is the prime-most concern of all nations. Thus in current IT era, our healthcare industry needs to focus on adapting information technology in healthcare services. Barring few preliminary attempts to digitalize basic hospital administrative and clinical functions, even today in India, child health and vaccination records are still maintained as paper-based records. Also, error in manually plotting the parameters in growth charts results in missed opportunities for early detection of growth disorders in children. To address these concerns, we present India’s first hospital linked, affordable automated vaccination and real-time child’s growth monitoring cloud based application- Integrated Child Health Record cloud (iCHRcloud). This application is based on HL7 protocol enabling integration with hospital’s HIS/EMR system. It provides Java (Enterprise Service Bus and Hibernate) based web portal for doctors and mobile application for parents, enhancing doctor-parent engagement. It leverages highchart to automate chart preparation and provides access of data via Push Notification (GCM and APNS) to parents on iOS and Android mobile platforms. iCHRcloud has also been recognized as one of the best innovative solution in three nationwide challenges, 2016 in India. iCHRcloud offers a seamless, secure (256 bit HTTPS) and sustainable solution to reduce child mortality. Detail analysis on preliminary data of 16,490 child health records highlight the diversified need of various demographic regions. Thus, primary lesson would be to implement better validation strategies to fulfill the customize requisites of entire population. This paper presents first glimpse of data and power of the analytics in policy framework.     

Monitoring Indoor Air Quality for Enhanced Occupational Health

Indoor environments are characterized by several pollutant sources. Because people spend more than 90% of their time in indoor environments, several studies have pointed out the impact of indoor air quality on the etiopathogenesis of a wide number of non-specific symptoms which characterizes the “Sick Building Syndrome”, involving the skin, the upper and lower respiratory tract, the eyes and the nervous system, as well as many building related diseases. Thus, indoor air quality (IAQ) is recognized as an important factor to be controlled for the occupants’ health and comfort. The majority of the monitoring systems presently available is very expensive and only allow to collect random samples. This work describes the system (iAQ), a low-cost indoor air quality monitoring wireless sensor network system, developed using Arduino, XBee modules and micro sensors, for storage and availability of monitoring data on a web portal in real time. Five micro sensors of environmental parameters (air temperature, humidity, carbon monoxide, carbon dioxide and luminosity) were used. Other sensors can be added for monitoring specific pollutants. The results reveal that the system can provide an effective indoor air quality assessment to prevent exposure risk. In fact, the indoor air quality may be extremely different compared to what is expected for a quality living environment. Systems like this would have benefit as public health interventions to reduce the burden of symptoms and diseases related to “sick buildings”.     

云计算虚拟应用服务平台支持下的远程移动医疗工作站

中山市人民医院通过建立云计算虚拟应用服务平台结合通信运营商3G或4G网络实现远程移动医疗（办公）工作站,在移动终端上调用各种应用系统,在院内或院外都可以对医疗文书（含医学影像）进行查询和编辑,方便医护人员和管理人员实时处理事务。让“无处不网络”变成了“无处不应用”,实现网络可达,应用可达。移动医疗建设成本更经济,维护成本更低,应用范围更大、更灵活。     

基于移动医疗技术的家庭医生慢病管理系统

通过整合智能终端健康监测设备、无线通讯技术、云平台数据库和医护端APP应用构建基于移动医疗技术的家庭医生慢病管理系统。阐述系统架构、工作流程及云端数据交互管理、用户端实现,指出该系统对各类慢病管理具有重要意义。     

Distributed Denial of Service (DDoS) Attack in Cloud- Assisted Wireless Body Area Networks: A Systematic Literature Review

Wireless Body Area Networks (WBANs) have emerged as a promising technology that has shown enormous potential in improving the quality of healthcare, and has thus found a broad range of medical applications from ubiquitous health monitoring to emergency medical response systems. The huge amount of highly sensitive data collected and generated by WBAN nodes requires an ascendable and secure storage and processing infrastructure. Given the limited resources of WBAN nodes for storage and processing, the integration of WBANs and cloud computing may provide a powerful solution. However, despite the benefits of cloud-assisted WBAN, several security issues and challenges remain. Among these, data availability is the most nagging security issue. The most serious threat to data availability is a distributed denial of service (DDoS) attack that directly affects the all-time availability of a patient’s data. The existing solutions for standalone WBANs and sensor networks are not applicable in the cloud. The purpose of this review paper is to identify the most threatening types of DDoS attacks affecting the availability of a cloud-assisted WBAN and review the state-of-the-art detection mechanisms for the identified DDoS attacks.     

医院服务器群及网络智能监控系统的开发

针对医院服务器群及网络的主动性监控问题，建立基于Cacti的分布式监控报警系统，采用集中管理的监控模式，实现对物理位置上分布的多个信息系统进行不间断的集中式监控，保障服务器和网络的正常运行。分析Cacti应用于信息系统和网络监控的必要性和可行性，阐述改进前的状况及存在问题，并就改进步骤、措施、成效等做出思考。     

An IoT-cloud Based Wearable ECG Monitoring System for Smart Healthcare

Public healthcare has been paid an increasing attention given the exponential growth human population and medical expenses. It is well known that an effective health monitoring system can detect abnormalities of health conditions in time and make diagnoses according to the gleaned data. As a vital approach to diagnose heart diseases, ECG monitoring is widely studied and applied. However, nearly all existing portable ECG monitoring systems cannot work without a mobile application, which is responsible for data collection and display. In this paper, we propose a new method for ECG monitoring based on Internet-of-Things (IoT) techniques. ECG data are gathered using a wearable monitoring node and are transmitted directly to the IoT cloud using Wi-Fi. Both the HTTP and MQTT protocols are employed in the IoT cloud in order to provide visual and timely ECG data to users. Nearly all smart terminals with a web browser can acquire ECG data conveniently, which has greatly alleviated the cross-platform issue. Experiments are carried out on healthy volunteers in order to verify the reliability of the entire system. Experimental results reveal that the proposed system is reliable in collecting and displaying real-time ECG data, which can aid in the primary diagnosis of certain heart diseases.     

智慧健康管理系统开发与应用前景

介绍智慧健康管理的含义、必要性和面临的主要问题,详细阐述其系统开发,包括物联网、云计算等技术的开发应用,数字健康与移动健康等,最后对智慧健康管理系统的应用前景进行展望.     

Computerized Disease Profiling Using GPS-Linked Multi-Function Sensor Cartridges

Disease identification in public health monitoring routinely employs analyte detection systems capable of discriminating mixtures of analytes, toxins, cells and/or bacteria in medical and/or environmental solutions. The development of smart sensors capable of discriminating such compounds has become increasingly important for clinical, environmental, and health applications. While some sensors have been fashioned for single analyte detection, methods and systems that facilitate rapid screening of multiple clinical components are needed, serving as triggers for potential epidemics or more specific confirmatory testing. In public health applications, there is like need for immediate collection of geocoded data tagged by disease identification characteristics, with corresponding alerting capabilities. In this technology review we propose one promising model for using a combination of emerging systems-based technologies in multi sensor cartridges, integrated with GPS-enabled, alert-capable mobile phone devices.     

Nonintrusive Remote Monitoring of Sleep in Home-Based Situation

Sleep deprivation can lead to loss of concentration, and risky decision-making. Nevertheless, some people may underestimate the importance of getting quality sleep. The standard health care systems might not be suitable for long-term monitoring of sleep. As an example, the polysomnography, i.e., the gold standard for assessing sleep disorders is cumbersome, expensive, and time-consuming. As a result, portable, nonintrusive and inexpensive systems for monitoring quality of sleep are greatly needed. This paper demonstrates a novel nonintrusive system for monitoring quality of sleep using an optical fiber embedded sensor mat. The proposed system is deployed in real-life conditions over a one-month period. Three senior female residents were enrolled for the study, where the sensor mat is placed under the bed mattress. Sleep quality is assessed based on several parameters, such as duration of sleep, sleep interruption, vital signs (heart rate and respiration). The proposed system shows an agreement with a user’s survey collected before the study. Furthermore, the system is integrated within an existing ambient assisted living platform with a user-friendly interface to make it more convenient for the caregivers to follow-up the sleep parameters of the residents.     

移动医疗对心电信息系统的优化

随着移动医疗的成熟,在信息化飞速发展的同时,移动医疗能为信息化带来很好的优化。使用平板电脑及无线网络在床边心电及远程心电的移动心电检查系统优化了心电检查流程,提高了检查效率,同时居家心电诊疗方便居民获得优质、高效、便捷的医疗卫生服务。     

Wireless Body Sensor Network Using Medical Implant Band

A wireless body sensor network hardware has been designed and implemented based on MICS (Medical Implant Communication Service) band. The MICS band offers the advantage of miniaturized electronic devices that can either be used as an implanted node or as an external node. In this work, the prototype system uses temperature and pulse rate sensors on nodes. The sensor node can transmit data over the air to a remote central control unit (CCU) for further processing, monitoring and storage. The developed system offers medical staff to obtain patient’s physiological data on demand basis via the Internet. Some preliminary performance data is presented in the paper.     

A Mutual Authentication Framework for Wireless Medical Sensor Networks

Wireless medical sensor networks (WMSN) comprise of distributed sensors, which can sense human physiological signs and monitor the health condition of the patient. It is observed that providing privacy to the patient’s data is an important issue and can be challenging. The information passing is done via the public channel in WMSN. Thus, the patient, sensitive information can be obtained by eavesdropping or by unauthorized use of handheld devices which the health professionals use in monitoring the patient. Therefore, there is an essential need of restricting the unauthorized access to the patient’s medical information. Hence, the efficient authentication scheme for the healthcare applications is needed to preserve the privacy of the patients’ vital signs. To ensure secure and authorized communication in WMSN, we design a symmetric key based authentication protocol for WMSN environment. The proposed protocol uses only computationally efficient operations to achieve lightweight attribute. We analyze the security of the proposed protocol. We use a formal security proof algorithm to show the scheme security against known attacks. We also use the Automated Validation of Internet Security Protocols and Applications (AVISPA) simulator to show protocol secure against man-in-the-middle attack and replay attack. Additionally, we adopt an informal analysis to discuss the key attributes of the proposed scheme. From the formal proof of security, we can see that an attacker has a negligible probability of breaking the protocol security. AVISPA simulator also demonstrates the proposed scheme security against active attacks, namely, man-in-the-middle attack and replay attack. Additionally, through the comparison of computational efficiency and security attributes with several recent results, proposed scheme seems to be battered.     

基于传感器技术的移动应急医疗平台架构设计

为应急环境下提供方便、可行、高效的医疗平台,提出基于传感器技术的移动应急医疗平台架构方案。利用便携式、移动化、无线化的医疗传感器采集生命体征,通过移动自组织网络、3G网络等传输途径,结合移动终端等设备,实现应急环境下移动医疗平台。平台实现应急环境下生命体征采集与传输、随时随地的移动医疗,提高应急医疗救援效率,降低伤亡率。     

Real-time Medical Emergency Response System: Exploiting IoT and Big Data for Public Health

Healthy people are important for any nation’s development. Use of the Internet of Things (IoT)-based body area networks (BANs) is increasing for continuous monitoring and medical healthcare in order to perform real-time actions in case of emergencies. However, in the case of monitoring the health of all citizens or people in a country, the millions of sensors attached to human bodies generate massive volume of heterogeneous data, called “Big Data.” Processing Big Data and performing real-time actions in critical situations is a challenging task. Therefore, in order to address such issues, we propose a Real-time Medical Emergency Response System that involves IoT-based medical sensors deployed on the human body. Moreover, the proposed system consists of the data analysis building, called “Intelligent Building,” depicted by the proposed layered architecture and implementation model, and it is responsible for analysis and decision-making. The data collected from millions of body-attached sensors is forwarded to Intelligent Building for processing and for performing necessary actions using various units such as collection, Hadoop Processing (HPU), and analysis and decision. The feasibility and efficiency of the proposed system are evaluated by implementing the system on Hadoop using an UBUNTU 14.04 LTS coreTMi5 machine. Various medical sensory datasets and real-time network traffic are considered for evaluating the efficiency of the system. The results show that the proposed system has the capability of efficiently processing WBAN sensory data from millions of users in order to perform real-time responses in case of emergencies.     

Development of a Smart Mobile Data Module for Fetal Monitoring in E-Healthcare

The fetal heart rate (FHR) is a marker of fetal well-being in utero (when monitoring maternal and/or fetal pathologies) and during labor. Here, we developed a smart mobile data module for the remote acquisition and transmission (via a Wi-Fi or 4G connection) of FHR recordings, together with a web-based viewer for displaying the FHR datasets on a computer, smartphone or tablet. In order to define the features required by users, we modelled the fetal monitoring procedure (in home and hospital settings) via semi-structured interviews with midwives and obstetricians. Using this information, we developed a mobile data transfer module based on a Raspberry Pi. When connected to a standalone fetal monitor, the module acquires the FHR signal and sends it (via a Wi-Fi or a 3G/4G mobile internet connection) to a secure server within our hospital information system. The archived, digitized signal data are linked to the patient’s electronic medical records. An HTML5/JavaScript web viewer converts the digitized FHR data into easily readable and interpretable graphs for viewing on a computer (running Windows, Linux or MacOS) or a mobile device (running Android, iOS or Windows Phone OS). The data can be viewed in real time or offline. The application includes tools required for correct interpretation of the data (signal loss calculation, scale adjustment, and precise measurements of the signal’s characteristics). We performed a proof-of-concept case study of the transmission, reception and visualization of FHR data for a pregnant woman at 30 weeks of amenorrhea. She was hospitalized in the pregnancy assessment unit and FHR data were acquired three times a day with a Philips Avalon® FM30 fetal monitor. The prototype (Raspberry Pi) was connected to the fetal monitor’s RS232 port. The emission and reception of prerecorded signals were tested and the web server correctly received the signals, and the FHR recording was visualized in real time on a computer, a tablet and smartphones (running Android and iOS) via the web viewer. This process did not perturb the hospital’s computer network. There was no data delay or loss during a 60-min test. The web viewer was tested successfully in the various usage situations. The system was as user-friendly as expected, and enabled rapid, secure archiving. We have developed a system for the acquisition, transmission, recording and visualization of RCF data. Healthcare professionals can view the FHR data remotely on their computer, tablet or smartphone. Integration of FHR data into a hospital information system enables optimal, secure, long-term data archiving.     

Ubiquitous Healthcare Computing with Sensor Grid Enhancement with Data Management System (SEGEDMA)

Wireless Sensor Network (WSN) can be deployed to monitor the health of patients suffering from critical diseases. Also a wireless network consisting of biomedical sensors can be implanted into the patient’s body and can monitor the patients’ conditions. These sensor devices, apart from having an enormous capability of collecting data from their physical surroundings, are also resource constraint in nature with a limited processing and communication ability. Therefore we have to integrate them with the Grid technology in order to process and store the collected data by the sensor nodes. In this paper, we proposed the SEnsor Grid Enhancement Data Management system, called SEGEDMA ensuring the integration of different network technologies and the continuous data access to system users. The main contribution of this work is to achieve the interoperability of both technologies through a novel network architecture ensuring also the interoperability of Open Geospatial Consortium (OGC) and HL7 standards. According to the results, SEGEDMA can be applied successfully in a decentralized healthcare environment.     

门诊移动输液系统在武汉市某三甲医院的应用

从业务流程、系统功能、应用模式等角度详细分析介绍门诊移动输液系统在武汉市某医院的应用。门诊移动输液系统在优化该院门诊输液流程、管理工作模式,提升护士护理、医嘱执行效率与质量,降低医疗事故,改善护患关系等方面发挥良好的作用。