M-Health can be defined as “mobile computing, medical sensor, and communications technologies for health-care.” This emerging concept represents the evolution of e-health systems from traditional desktop “telemedicine” platforms to wireless and mobile configurations. Current and emerging developments in wireless communications integrated with developments in pervasive and wearable technologies will have a radical impact on future health-care delivery systems. This editorial paper presents a snapshot of recent developments in these areas and addresses some of the challenges and future implementation issues from the m-Health perspective. The contributions presented in this special section represent some of these recent developments and illustrate the multidisciplinary nature of this important and emerging concept.

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Guest Editorial Introduction to the Special Section on M-Health: Beyond Seamless Mobility and Global Wireless Health-Care Connectivity

With an increasingly mobile society and the worldwide deployment of mobile and wireless networks, the wireless infrastructure can support many current and emerging healthcare applications. This could fulfill the vision of "Pervasive Healthcare" or healthcare to anyone, anytime, and anywhere by removing locational, time and other restraints while increasing both the coverage and the quality. In this paper, we present applications and requirements of pervasive healthcare, wireless networking solutions and several important research problems. The pervasive healthcare applications include pervasive health monitoring, intelligent emergency management system, pervasive health-care data access, and ubiquitous mobile telemedicine. One major application in pervasive healthcare, termed comprehensive health monitoring is presented in significant details using wireless networking solutions of wireless LANs, ad hoc wireless networks, and, cellular/GSM/3G infrastructure-oriented networks. Many interesting challenges of comprehensive wireless health monitoring, including context-awareness, reliability, and, autonomous and adaptable operation are also presented along with several high-level solutions. Several interesting research problems have been identified and presented for future research.

Pervasive healthcare and wireless health monitoring

The aging population, prevalence of chronic diseases, and outbreaks of infectious diseases are some of the major challenges of our present-day society. To address these unmet healthcare needs, especially for the early prediction and treatment of major diseases, health informatics, which deals with the acquisition, transmission, processing, storage, retrieval, and use of health information, has emerged as an active area of interdisciplinary research. In particular, acquisition of health-related information by unobtrusive sensing and wearable technologies is considered as a cornerstone in health informatics. Sensors can be weaved or integrated into clothing, accessories, and the living environment, such that health information can be acquired seamlessly and pervasively in daily living. Sensors can even be designed as stick-on electronic tattoos or directly printed onto human skin to enable long-term health monitoring. This paper aims to provide an overview of four emerging unobtrusive and wearable technologies, which are essential to the realization of pervasive health information acquisition, including: 1) unobtrusive sensing methods, 2) smart textile technology, 3) flexible-stretchable-printable electronics, and 4) sensor fusion, and then to identify some future directions of research.

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Unobtrusive Sensing and Wearable Devices for Health Informatics

Wireless telemedicine using GSM and GPRS technologies can only provide low bandwidth connections, which makes it difficult to transmit images and video. Satellite or 3G wireless transmission provides greater bandwidth, but the running costs are high. Wireless networks (WLANs) appear promising, since they can supply high bandwidth at low cost. However, the WLAN technology has limitations, such as coverage. A new wireless networking technology named the wireless mesh network (WMN) overcomes some of the limitations of the WLAN. A WMN combines the characteristics of both a WLAN and ad hoc networks, thus forming an intelligent, large scale and broadband wireless network. These features are attractive for telemedicine and telecare because of the ability to provide data, voice and video communications over a large area. One successful wireless telemedicine project which uses wireless mesh technology is the Emergency Room Link (ER-LINK) in Tucson, Arizona, USA. There are three key characteristics of a WMN: self-organization, including self-management and self-healing; dynamic changes in network topology; and scalability. What we may now see is a shift from mobile communication and satellite systems for wireless telemedicine to the use of wireless networks based on mesh technology, since the latter are very attractive in terms of cost, reliability and speed.

Wireless Mesh Networks

Advances in semiconductor technology have resulted in the creation of miniature medical embedded systems that can wirelessly monitor the vital signs of patients. These lightweight medical systems can aid providers in large disasters who become overwhelmed with the large number of patients, limited resources, and insufficient information. In a mass casualty incident, small embedded medical systems facilitate patient care, resource allocation, and real-time communication in the advanced health and disaster aid network (AID-N). We present the design of electronic triage tags on lightweight, embedded systems with limited memory and computational power. These electronic triage tags use noninvasive, biomedical sensors (pulse oximeter, electrocardiogram, and blood pressure cuff) to continuously monitor the vital signs of a patient and deliver pertinent information to first responders. This electronic triage system facilitates the seamless collection and dissemination of data from the incident site to key members of the distributed emergency response community. The real-time collection of data through a mesh network in a mass casualty drill was shown to approximately triple the number of times patients that were triaged compared with the traditional paper triage system.

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The Advanced Health and Disaster Aid Network: A Light-Weight Wireless Medical System for Triage

This paper proposes a mobile patient monitoring system, which integrates current personal digital assistant (PDA) technology and wireless local area network (WLAN) technology. At the patient's location, a wireless PDA-based monitor is used to acquire continuously the patient's vital signs, including heart rate, three-lead electrocardiography, and SpO/sub 2/. Through the WLAN, the patient's biosignals can be transmitted in real-time to a remote central management unit, and authorized medical staffs can access the data and the case history of the patient, either by the central management unit or the wireless devices. A prototype of this system has been developed and implemented. The system has been evaluated by technical verification, clinical test, and user survey. The evaluation of performance yields a high degree of satisfaction (mean=4.64, standard deviation-SD=0.53 in a five-point Likert scale) of users who used the PDA-based system for intrahospital transport. The results also show that the wireless PDA model is superior to the currently used monitors both in mobility and in usability, and is, therefore, better suited to patient transport.

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A wireless PDA-based physiological monitoring system for patient transport

In this paper, we explore the possibility of embedding augmented reality (AR) in authentic inquiry activities to contextualize students’ exploration of medical surgery, and investigate students’ perceptions of the AR lessons and simulators, and their Science, Technology, Engineering, and Mathematics (STEM) interest. Thirty-two senior high school students participated in the two AR lessons related to medical surgery, “laparoscopic surgery” and “cardiac catheterization.” The results showed that the students had positive perceptions of the AR lessons and simulators (overall mean = 4.1) after completing the two lessons. However, the authenticity of the simulators was perceived as the lowest ranking. In contrast, both the motivation and engagement triggered by the AR lessons were high, with most of the mean scores reaching 4.3. The AR lessons did evoke some students’ STEM interest as the survey results indicated that 12 students considered an STEM major in university. This study provides a possible solution for the alignment of instructional approaches (authentic inquiry), technology design (AR), and learning experience in developing STEM lessons.

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Impact of augmented reality lessons on students’ STEM interest

In this paper, we successfully developed a Bluetooth Low Energy (BLE) based blood pressure monitoring system, which integrated a homemade blood pressure measuring device and a smartphone. The device uses single BLE System-on-Chip to process the algorithm of blood pressure measurement and data transmission. Through the newest Bluetooth Low Energy technology, device can send measured results to the smartphone. Therefore, users can get the information of systolic blood pressure, diastolic blood pressure and pulse rate on the smartphone. Besides, the format of data transmission packet is based on the standard Blood Pressure Profile specification from Bluetooth SIG. The homemade blood pressure monitor has high compatibility to communication with other devices using the same Bluetooth profile. The accuracy of pulse rate and blood pressures are verified through the CuffLink simulator. The accuracy of pulse rate is −1.13 ± 0.52 beats, the accuracy of systolic blood pressure is 0.69 ± 1.63 mmHg, and the accuracy of diastolic blood pressure is 0.20 ± 1.02 mmHg. In clinical trials, the systolic blood pressure average difference between our method and auscultatory method is 2.66 ± 2.71 mmHg. The diastolic blood pressure average difference between our method and auscultatory method is 3.42 ± 4.42 mmHg. As a result, this device has high accuracy for measuring blood pressure and pulse rate.

Bluetooth Low Energy (BLE) based blood pressure monitoring system

Body temperature acting an important role in medicine, a number of diseases are characterized by a change in human body temperature. Monitoring body temperature also allows the doctor to track the effectiveness of treatments. But current continuous body temperature measurement (CBTM) system is mainly limited by reaction time, movement noise, and labor requirement. In addition, the traditional contact body temperature measurement has the problem of wasting consumables and causing discomfort. To address above issues, we present a non-contact, automatic CBTM system using a single thermal camera. By applying deep-learning based face detection, object tracking, and calibrated conversion equation, we can successfully extract subject's forehead temperature in real-time. The experimental results show that the overall mean absolute error (MAE) and root-mean-squared-error (RMSE) of our proposed framework compared with industrial instrument are 0.375 °C and 0.439 °C, respectively.

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A Thermal Camera Based Continuous Body Temperature Measurement System

In this paper, we developed a wireless blood pressure monitoring system which provides a useful tool for users to measure and manage their daily blood pressure values. This system includes an ARM-based blood pressure monitor with a ZigBee wireless transmission module and a PC-based management unit with graphic user interface and database. The wireless blood pressure monitor can measure the blood pressure and heart rate and then store and forward the measuring information to the management unit through the ZigBee wireless transmission. On the management unit, user can easy to see their blood pressure variation in the past using a line chart. Accuracy of blood pressure measurement has been verified by a commercial blood pressure simulator and shown the bias of systolic blood pressure is ≤ 1 mmHg and the bias of diastolic blood pressure is ≤ 1.4 mmHg.

Yuan-Hsiang Lin

Papers

A wireless PDA-based physiological monitoring system for patient transport

Impact of augmented reality lessons on students’ STEM interest

Bluetooth Low Energy (BLE) based blood pressure monitoring system

A Thermal Camera Based Continuous Body Temperature Measurement System

A wireless blood pressure monitoring system for personal health management