robert istepanian kingston-university-masterclass_wed_zone-2

M-health and LTE

LTE World Summit 2012

Barcelona 23-24 may 2012 MINT Research

Centre

©Robert S.H. Istepanian 2012

Robert S. H. Istepanian

Professor of Data Communications for healthcare

Director of the Medical Information and Network Technologies Centre

Faculty of Science, Engineering and Computing

Kingston University, London, UK

E-mail: [email protected]

Healthcare and ICT Technology Trends in 2012

Shift in care models

$$

Quality of life

Home care

Residential care

Acute care

Mobility in Healthcare

Work flow Optimisation

Improved clinical outcomes

Cost

Wireless and IP based Infrastructure Growth Smart wireless medical Sensors


Barcelona 23-24 may 2012

MINT Research

Centre


1- There is ever increasing demand on the increasing care for elderly care

and chronic patients.

2- The trend for the personalisation of the care.

3- Major reforms and new healthcare delivery models demanded by

current Economic constraints.

4- The fast pace of ICT Technology advances .

Healthcare and ICT Technology Trends in 2012

Mobile Health Care (m-Health) ‘Emerging Mobile Communication ,Network and Sensor

Technologies For Healthcare Systems and Applications’

REF: Istepanian (etal.), ‘m-health: Beyond Seamless Mobility for Global Wireless Healthcare Connectivity ’,

IEEE Trans. Information Technology in Biomedicine, Vol. 8, 4, pp. 405-412, 2004.

M-health ‘A decade on’

5

What is Mobile HealthCare (m-Health)?

Reference: m-health Istepanian etal., Springer - 2004

M-health

Medical

Sensors

and Devices

Information and

Communication

Systems

Computing and

Internet

Technologies

20/09/2011 © Robert Istepanian. 2011

M-health in 2012

Some Interesting ‘ Google’ Statistics:

Google Search - March 2011

‘m-health’ > 102,000,000 Hits

In the US, Verizon launched in November 2009 a health

focused business unit, ‘Verizon Connected Health’.

In the UK, Vodafone and in France Orange outlined plans in

December 2009 for the mobile health business.

m-health is one of the fastest growing vertical

market within the Mobile service domain

Opportunities in the global mobile healthcare market are

estimated to be worth between $50bn and $60bn in 2010

Source: McKinsey & Company-2010

Source: research2guidance.com

500M people will be using healthcare mobile applications in 2015


The Long Term Evolution of m-health

4G Health



Definition of ‘4G Health’

REF: Istepanian, IEEE Trans. Info. Tech. Biomedicine- 2012


Concept of 4G health

REF: Istepanian, IEEE Trans. TITB- 2012




Some Potential applications of ‘long term evolution of m-health’ services :

•4G Wellness, prevention and long term chronic diseases management systems.

•4G medical Multimedia services and diagnostics systems.

•4G mobile emergency care and response systems.

•4G smart personalised healthcare.

Key 4G Health Categories :

Daily Alert

mobile-end

Patient with

medical sensors

M-health System

Internet

Cloud

Responses

Medical Data

Updates

Alert Mechanism

Alerting

Feedback

Visit, call, and etc.

Aggregate the medical

data

m-health Monitoring as successful business opportunity

HSPA/LTE

Smart terminals

Diabetes as Global Epidemic

Diabetes Atlas-2011 from www.idf.org

Common m-health business applications

Ref: Istepanian etal, JTT, 15,3 2009

Mobile Diabetes Management Systems

Mobile Diabetes Systems as a healthcare

business

PositiveID announced that the FDA had cleared its

mobile health diabetes management system, iGlucose.

Mhealth News, Nov. 2011 Cellnovo from CE

Interest in mobile health (mHealth)

applications for self-management of diabetes

is growing. In July 2009, we found 60

diabetes applications on iTunes for iPhone;

by February 2011 the number had increased

by more than 400% to 260. Ref: J. Med. Internet. Res. 14, 2012

Benefits of m-health for Diabetes management

•Self-management (empowerment) is key to

minimising the long-term complications of diabetes. •Lifestyle and behaviour. •Personal responsibility for his/her care. • Giving the patient the necessary medical information he/she requires • Provision of patient engagement with his/her carer

• ‘Implicit enforcement’ of compliance by providing the nurse/doctor with the information needed to know if the patient is taking SMBG or not.

m-health clinical trials and evidence


4G health: m-health Challenges from the LTE Perspective

Mission Critical v/s non-Mission Critical 4G Health Applications

1- Convergence and Interoperability challenges

2- Security and Privacy and confidentiality challenges

3- Inadequate Standards for m-health applications.

4- Development of ‘ m-health’ grade smart terminals

5- m-health based Quality of Service issues



Key LTE 4G Health Application

Real-time mobile Diagnostics; (Mobile ultrasound video

streaming over Mobile LTE/WiMAX)


Barcelona 23-24 may 2012 ©Robert S.H. Istepanian 2012


In general QoS is an important area for the successful growth of LTE

networks. m-health applications have various requirements from the

transport network in terms of delay, bandwidth and error rate that they

desire for optimal performance or user experience. This poses a

challenge for deployment of LTE networks.

QoS issues in LTE

In general there are two types of bearers that have been defined in the LTE

Rel-8 :

(i) Guaranteed Bit Rate and (ii) Non-Guaranteed Bit Rate:

In (i) where network resources equivalent to a certain bit rate are reserved

at the time of the creation of the bearer.

In (ii) is typically used for interactive applications such as IMS signaling,

progressive video streaming, web browsing, chat, etc


Medical QoS (m-QOS)

REF: Istepanian etal. - IEEE J Selected Areas in Communications, May 2009

To manage m-QoS Cross Layer Optimization is required

CLO Input: Layer Abstraction (Video streaming Quality)

IP

TCP/UDP/RTP

Session

Presentation

Application

MAC

Phy

CLO Output: Cross layer strategy

External m-QoS

policy and network

limitations

Abst

ract

ion

CLO Input: Layer Abstraction (Link Status)

Abst

ract

ion

Sk =(V k , L k

)

S´k =(V´ k , L´ k )

1-Frame Size

2-Frame Rate

3-PSNR

1-Modulation and coding

2-SNR

3-BER

4-Utilization

5-Operation Frequency

Cross-layer

Optimizer


Barcelona 23-24 may 2012 ©Robert S.H. Istepanian 2012

PSNR Vs Throughput

A sample of the average throughput of the ultrasound data stream captured by the expert using the

WiMAX and HSUPA platform is shown. Experimental results show that both WiMAX and HSUPA

support uplink medical video streaming with average 0.6 Mbps.

RTT results of different ultrasound

video stream packet sizes over WiMAX

and HSUPA

Fig. 1 and 2 show the comparative results of the RTT values for different packet sizes over

HSUPA and different WiMAX modulation and coding schemes. The results show that the

WiMAX provides better RTT performance compared to HSUPA network.

Firewall Core

network

Access

network Medical

Multimedia

Public

network (Internet)

Secure HTTP

Server

m-QoE

reporting

M-health

m-QoE

monitor

M-QoE report

M- QoE activation trigger

eND

M-health

user

M-health based Quality of Experience ( m-QoE)


Collaboration m-

health education Real time (Live

Medical Video

Streaming)

ECG & Video sign

Monitoring

Medical

Text Messaging

Blood pressure &

Glucose level

monitoring

Mobile Tele-

consultation

Well being

Management

Weight

Management

High

Medium

Low

Low Medium High

Level of Interactivity

M-h

ealt

h U

sa

ge

Do

ma

in a

nd

Co

mp

lex

ity

m-QOE based classifications with regard to degree of

interactivity and m-health usage domain

M-health based Quality of Experience ( m-QoE)


ITU Focus Group on Machine-to-Machine Service Layer standardisation

(FG M2M)

Focus e-health/mhealth

Next Group Meeting in Beijing- China

26-28June 2012. Remote participation will also be available

http://www.itu.int/en/ITU-T/focusgroups/m2m/Pages/default.aspx

First Meeting in Geneva- 17-18 April 2012

WG1: Use cases and service models (with

focus on ehealth/mhealth)




Nucleus

cell

Nucleus

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Nucleus

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Final Thought on 4G Health !

THANK YOU

Robert S. H. Istepanian

[email protected]

http://cism.kingston.ac.uk/mint

MINT Research

Centre

http://www.kingston.ac.uk/

mailto:[email protected]

robert istepanian kingston-university-masterclass_wed_zone-2

Health & Medicine

ict technology trends

guaranteed bit rate

long term evolution

health based quality

4g health

layer abstraction

health applications

ieee trans