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Machine to Machine (M2M) communication in Health Care : Development of Policy Guidelines

by

A.K.MittalSr.DDG & Head

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INDEX

Telecommunication Engineering center – A brief Introduction

What is M2M

M2M Projections

M2M frame work for health Monitoring

M2M Standardization

M2M Value Chain

International organizations working on standards

Policy Framework

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A brief introduction

TEC develops standards for the telecommunication sector in India and certifies telecom equipment as per standard, in order to ensure development of world class telecom network and smooth interconnection of individual networks and devices in the country.

TEC provides support and advice to DoT on technology, spectrum and licensing related issues and produces standards related documents.

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Telecommunication Engineering Centre

TEC strives to enhance Indian contribution in the development of international standards so that the national interests are adequately safeguarded. Various divisions in TEC chair the National working Groups (NWGs) corresponding to the study group of ITU-T. TEC also chair NWG-5 corresponding to study group 5 of ITU-R, which inter-alia deals standards for mobile radio systems.

This is achieved through proactive, stakeholder sensitive & responsive approach, knowledge sharing, competency enhancement and continuance of a conducive work culture.

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What is M2M?

A conceptual picture …

A “DEVICE”, sensor, meter, etc., captures “something”, e.g., location, level, heat, motion, vital sign, usage, etc.

that is transported through a “NETWORK” (wireless, wired or mixed)

to an “APPLICATION”, which makes sense of the captured data, e.g., stolen vehicle is located, etc.

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Pipe (vertical):1 Application, 1 NW,

1 (or few) type of Device

Horizontal (based on common Service Layer)

Applications share common infrastructure, environments and network elements

Local NW

BusinessApplicatio

n

Device

CommunicationNetwork (mobile, fixed,

Powerline ..)

Gateway

CommunicationNetwork 1

CommunicationNetwork 2

Local NW

Device

Device

Device

Device

Common Application Infrastructure/Service layer

GatewayIP

BusinessApplication

#1

BusinessApplication

#2

BusinessApplication

#n

Application Application

A A A A A

Things Things Things

Things representations

Things representations (shared)

Application Application

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M2M ProjectionsProjections by research agencies

According to GSMA (GSM Association) and Machina Research (World’s leading advisor on M2M, Internet of Things and Big Data), there may be 24 billion connected devices globally by 2020, having a business impact to be worth US$ 4.3 Trillion.

According to the GSMA, this amounts to $1.3 trillion revenue opportunities for mobile network operators alone spanning vertical segments such as health, automotive, utilities and consumer electronics.

As per projections, Indian M2M market may rise from 30 Million devices in 2013 to more than 250 million in 2020.

M2M domain shall encompass no. of verticals such as Automotive (connected vehicles), Energy (smart meters & smart grid), health care, security and surveillance, Intelligent buildings, smart homes, smart city etc.

M2M applications will make the living smart and improve the quality of life.

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M2M framework for health monitoring

Personal Connected Health (PCH) allows providers and patients to:

Use technology to collect data conveniently and securely

Communicate more frequently with little manual intervention

Effectively monitor and better understand personal health data

It is broadly M2M in Health

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Remote monitoring of patients after surgery, while resting at home.

Transmission of vital parameters of a patient from ambulance to hospital.

Remote monitoring of old aged patients. Remote consultation e-ICU

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© ETSI 2014. All rights reserved

Communications network

Field area network

Applications

A

DeviceA

Device

A

Device

GWA

Device

Things

Things representations

Blood pressure

Pulse oximeter

PedometerSmart

bandage

Smart phone serving as an M2M device

Communications network

Applications

Linked things and digitalrepresentations

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Remote patient monitoring / assisted living is the service category currently identified by FG M2M as work focus in ITU. E-health ecosystem is shown below

◦

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Development Life Cycle

1. Submission of ideas

2. Use Case development

3. Decomposition into Work Items

4. Gap Analysis

5. Guidelines Development

6. Approval

7. Testing

8. Public Release & Comment Period

Use Cases

Requirements

Standards

Guidelines

M2M Standardization

Open Process: Developing Design Guidelines

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M2M Standardization activities in TEC

Working Groups in M2M domain formed in TEC

It is a new area taken up by TEC for standardisation. To begin with followingsectoral working groups have been formed :

Vehicle Telematics

Power (Smart Grid & Smart Metering)

Health (e-Health, M-Health, Telemedicine)

Security & surveillance

M2M Gateway & Architecture working group has also been setup to develop a common M2M service layer, involving stakeholders from the M2M and vertical market communities which would provide a cost-efficient platform and can be easily deployed in hardware and software, in a multi-vendor environment, and across sectors.

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M2M Standardization activities in TECMembers actively involved in Working group on M2M in Health

Apollo Tele Health Biosense India Continua Health Alliance – India Working Group Deep Biz Technologies P Ltd. DeitY Ericsson ETSI HCL Huwaei iDiagnosis NIC Robonic India STMicroelectronics TCS TEC Tech Mahindra Track My Beat Wipro

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M2M Standardization activities in TEC

Working Group activities:- For framing specifications / standards

Working groups will, inter-alia, identify a minimum set of common requirements of vertical markets, focusing on vertical related market and application programming interfaces (APIs) and protocols supporting applications and services, and draft technical reports in these areas.

Working group will benefit from the work already carried out by any other organization to the extent feasible to avoid duplication of work. Working group will study standards and specifications developed / being developed by international bodies such as ETSI, IEEE and OneM2M etc. While preparing report / contribution, Indian interest will be kept in mind.

Working group are having con call every fortnight and F2F meeting generally on quarterly basis.

F2F meeting along with Joint Working Group (JWG) meeting is being scheduled this month to review the progress and carry the work forward.

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ModuleMachine Network MiddlewareSystemIntegrator

ServiceProvider

IC

Senso

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odem

Gat

eway

Tran

spor

tSer

vice

mgm

tEna

bler

s

App’s

Inte

grat

ion

Ope

ratio

nsCus

tom

er

Servic

e

End U

ser

Application Developers

System Integrators

Network Equipment Providers

Service Providers

Middleware Providers

Machine & DeviceManufacturers

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M2M Value Chain

How to Connect ?

Enabling technologies for M2M

Sensor networks, Radio frequency Identification (RFID), Location-Based Services (LBS), Lab-on-a-Chip (LOC) etc.

WiFi, ZigBee, Bluetooth, NFC, 6LOPAN for short range communication (TAN, PAN, LAN)

(TAN- Touch area network, PAN- Personal area network, LAN- Local area network )

GSM 2G/ 3G/ 4G, WiMax, wire line broadband for long range communication (WAN).

IPv6 capable of providing unique IP addresses to all the devices available on earth as IP4 addresses are going to exhaust.

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International Organisations working on standards

WHO- World Health Organisation

ISO- International standards organisation

ITU- International Telecommunication Union

OneM2M – It is a partnership project created by 7 SDOs, that publish telecom standards: TTC, ARIB (Japan), ATIS, TIA (USA), TTA (Korea) CCSA (China), ETSI (Europe) to avoid creation of competing M2M standards and are working to create standards for the common service layer. It is having 226 members.

IEEE- Institute of Electrical and Electronics Engineers

W3C (World Wide Web Consortium) - W3C is an industry consortium which seeks to promote standards for the evolution of the Web and interoperability between WWW products by producing specifications and reference software.

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International Organisations working on standards

cen - European committee for standardization

DICOM - The Digital Imaging and Communications in Medicine (DICOM) standard is used for the exchange of images and related information.

GS1 - international organization that develops and maintains standards for supply and demand chains across multiple sectors.

HL7 - Health Level Seven, is a standard for exchanging information between medical applications.

epSOS - European electronic Health (e-health) interoperability project co-funded by the European Commission and 47 beneficiaries. It focuses on improving medical treatment of citizens while abroad by providing health professionals with the necessary patient data. epSOS identifies several means of interoperability which shall enable the use of cross-border services

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International Organisations working on standards

IHE (Integrating the health care enterprise) - It works to ensure that all required information for medical decisions is accurate and available to healthcare professionals. It defines a technical framework for the implementation of established messaging standards to achieve specific clinical goals.

Continua - International non-profit industry organization enabling end-to-end, plug-and-play connectivity of personal health devices, systems and services in Personal Connected Health

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Sensors

11073

PAN Transport EHRs

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HealthRecordNetwork(HRN)

Interface

Personal Device

Weight Scale

Pulse Oximeter

Independent Living Activity

Cardio / Strength

MedicationAdherence

Glucose Meter

Pulse /Blood

Pressure

Thermometer

Physical Activity

Peak Flow

Electrocardiogram

Insulin Pump

AggregationManager

PersonalArea

Network(PAN)

Interface

WideArea

Network(WAN)

Interface

TelehealthServiceCenter

HealthRecords/Networks

EHR

PHR

NHIN

HIE

WiFi, 2G, 3G & 4G

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Interoperability Conformance Security & Privacy of data KYC norms EMF radiation norms

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Policy Framework

Policy formation activities

DoT circulated a questionnaire to various stake holders expected to be in M2M value chain . These includes

Academia /Consultants

Application/Content Developers/ System Integrators/ Equipment vendors

End User

Associations

Telecom Service Providers

Government organisations

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Responses were summarized in 27 questions on policy and their probable answers.

Discussions are going on, to stream line the various issues.

Meetings / Conferences held along with all stakeholders including industry associations.

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Policy Framework

Important points to be addressed in the policy

The policy need to be forward looking, technology neutral, flexible, addressing end to end M2M requirements and able to promote competition with focus on standardization of devices, interfaces and services covering almost all the verticals.

The data ownership and security also need to be addressed along with separate classification of M2M connections by TSP’s.

Issues pertaining to KYC, Certification of devices and services, role of stake holders need to be enumerated.

SIM ownership, transferability, security and management issues are to be addressed afresh for M2M domain.

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M2M devices and sensors need to be IPv6 based.

Policy should focus on IPv6 roll-out, standardization of devices and application for universal adaptability.

Use of Cloud based applications shall be governed to the extant Cloud policy of the Government.

Security standards and Interoperability standards have to be defined

Guidelines for including M2M adoptions in all national infrastructure projects will need to be worked out.

Coordination with BIS.

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M2M devices need to conform with safety standards from radiation/ power perspectives.

Open standards and protocols.

Compatibility of devices and applications with SIM management platform.

M2M devices need to be certified, while focusing on international standards deployment.

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