Basic components for building mHealth devices.

One step beyond the platform is adding other components. What do you create when your motto is “Computing stuff tied to the physical world?”  A tiny, fairly well featured kit with wireless capability. The JeeNode wireless communication platform.

It looks like a fun and cost effective way to get into experimenting with RF communication. By combining an Arduino-compatible processor (ATmega328) with a low-cost HopeRF radio module, Jean-Claude Wippler in a town called Houten, The Netherlands,  creates these building blocks and offering them for sale as a kit, or, since it is an open source hardware design, you can just download the PCB layout and roll your own. You can think of lots of applications (remote candle lighter, interactive cat toy:)) that aren’t worth a full xBee-based solution, where it would be handy to have a development board like this that I could just drop in and use.

Jee Labs also has a weblog with daily news about projects being worked on in the fascinating world of physical computing, wireless comm’s, sensors, lights, switches, motors, robots, WSN’s, Arduino’s, you name it.

Building a sensornetwork for mHealth purposes.

For a wireless sensor network you need a platform to start with. But what? Arduino is an open-source electronics prototyping platform based on flexible, easy-to-use hardware and software. It’s intended for artists, designers, hobbyists, and anyone interested in creating interactive objects or environments.

Arduino can sense the environment by receiving input from a variety of sensors and can affect its surroundings by controlling lights, motors, and other actuators. The microcontroller on the board is programmed using the Arduino programming language (based on Wiring) and the Arduino development environment (based on Processing). Arduino projects can be stand-alone or they can communicate with software on running on a computer (e.g. Flash, Processing, MaxMSP).

The boards can be built by hand or purchased preassembled. The software can be downloaded for free. The hardware reference designs (CAD files) are available under an open-source license, you are free to adapt them to your needs.

Wireless Sensor Networks and mHealth basics 3.

Last theory on Wireless Sensor Networks coming up. What about the software, middleware and programming languages?

Software

Energy is the scarcest resource of WSN nodes, and it determines the lifetime of WSNs. WSNs are meant to be deployed in large numbers in various environments, including remote and hostile regions, with ad-hoc communications as key. For this reason, algorithms and protocols need to address the following issues:

• Lifetime maximization
• Robustness and fault tolerance
• Self-configuration

Middleware

There is considerable research effort currently invested in the design of middleware for WSN’s. In general approaches can be classified into distributed database, mobile agents, and event-based.

Programming languages

Programming the sensor nodes is difficult when compared with normal computer systems. The resource constrained nature of these nodes gives rise to new programming models although most nodes are currently programmed in C.

• c@t (Computation at a point in space (@) Time)
• DCL (Distributed Compositional Language)
• galsC
• LabVIEW
• nesC
• Protothreads
• SNACK
• SNAPpy (Python)
• SQTL
• Java Sun SPOT
• uSWN

Wireless Sensor Networks and mHealth basics 2.

What standards, hardware and operating systems are  used for wireless sensor networks? There are three. I wrote some articles about ZigBee. It´s a proprietary mesh-networking specification intended for uses such as embedded sensing, medical data collection and home automation. WirelessHART is specifically designed for Industrial applications. 6LoWPAN is the IETF standards track specification. Also relevant to sensor networks is the emerging IEEE 1451 which attempts to create standards for the smart sensor market. The main point of smart sensors is to move the processing intelligence closer to the sensing device.

Hardware

The main challenge is to produce low cost and tiny sensor nodes. With respect to these objectives, current sensor nodes are mainly prototypes. Miniaturization and low cost are understood to follow from recent and future progress. Some of the existing sensor nodes are given below. Some of the nodes are still in research stage. Also inherent to sensor network adoption is the availability of a very low power method for acquiring sensor data wirelessly.

Operating systems

Operating systems for wireless sensor network nodes are typically less complex than general-purpose operating systems both because of the special requirements of sensor network applications and because of the resource constraints in sensor network hardware platforms. Wireless sensor network hardware is not different from traditional embedded systems and it is therefore possible to use embedded operating systems such as eCos or uC/OS for sensor networks. However, such operating systems are often designed with real-time properties. Unlike traditional embedded operating systems, however, operating systems specifically targeting sensor networks often do not have real-time support.

TinyOS is perhaps the first operating system specifically designed for wireless sensor networks. Unlike most other operating systems, TinyOS is based on an event-driven programming model instead of multithreading. TinyOS programs are composed into event handlers and tasks with run to completion-semantics. When an external event occurs, such as an incoming data packet or a sensor reading, TinyOS calls the appropriate event handler to handle the event. Event handlers can post tasks that are scheduled by the TinyOS kernel some time later. Both the TinyOS system and programs written for TinyOS are written in a special programming language called nesC which is an extension to the C programming language.

There are also operating systems that allow programming in C. Examples of such operating systems include Contiki, MANTIS, BTnut, SOS and Nano-RK. LiteOS is a newly developed OS for wireless sensor networks, which provides UNIX like abstraction and support for C programming language.

Mobile Health can have a serious impact on disastermanagement.

The impuls to look for your mobile phone when you see an accident is rising. Is this just excitment or usefull behavior? Disaster experts are taking the use of mobile phones dead seriously.

Dr. Jeannette Sutton of the University of Colorado at Boulder’s National Hazards Center spoke yesterday about the role of the micro-content communications network. Prior to her research results, which will come out this summer, she focused on how people used Twitter during the recent Tennessee Valley Authority coal ash spill. “Twitter hosted conversations about the spill, despite the fact that mainstream press attention was almost entirely absent” she said. “These tools are creating tremendous opportunities that we know are going to lead to safer communities.”

From the earthquake in China’s Sichuan Province to the Australian brush fires to the plane crash in the Hudson River to the Mumbai attacks, people have mobiles and access to Twitter. “When a crisis hits, people use what they are familiar with and what’s close at hand. Twitter on mobiles allows users to rely on pre-existing social relationships, and that’s tremendously hard to replicate by outside aid groups. Disaster experts are looking to mobile Twitter-use to boost situational awareness, warning dissemination and recovery coordination”, said Sutton It even could have an impact on the Disaster Healthcare Core Competenties list as educated on the National Disaster Life Support Foundation.

In the immediate aftermath of disasters, myths about what has happened arise. Looting and panic doesn’t happen very often. That said, researchers have found, said Sutton, that both online and off “there’s a lack of antisocial behavior in the immediate aftermath of a disaster.” In fact, Twitter supports some self-validation. Speaking of post-TVA spill tweets, Sutton reported that “they consistently contained a URL. Almost every post that was information linked to a credible source of information.”

Researchers are eager to dive more deeply into how people are organically using Twitter on mobiles during times of crisis. Tracking how conversations flow and how information ripples out isn’t straightforward. Twitter makes automated data collection difficult, but there is hard work on new tools. As the use of Twitter rises, and both people and organizations grow to depend on it, understanding how long-term conversations are sustained will be key to making sense of the new medium; already, people are using the #coalash hashtag popularized during last spring’s TVA spill to talk about, for example, a spill upstream of Washington DC earlier this month.

Breakthru for Patient-Centered Medical Home model.

In the Patient-Centered Medical Home (PCMH) model, patients receive more comprehencive and coördinated care. They have their primary-care physician. Are we going back in time? Is this an answer to our healthcareproblems nowadays? Medical help is fragmented and episodic from various health care providers or facilities operating without all the information needed.

The American Academy of Pediatrics (AAP) introduced the medical home concept in 1967. The news is that in Arizona a medical home program has started between IBM, which has 11,000 employees there, and UnitedHealth, its insurer. Two huge corporations working together to make this succeed.

In the PCMH model, primary-care physicians partner with their patients to understand thier needs and preferences. They manage their healthcare and facilitate any care needed from other professionals. The model places special emphasis on preventing disease and improving the car of chronic conditions. It emphasizes behavioral health support and patient education, not simply the diagnosis and treatment of injury and illness. The main principles are:

• Personal physician: each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care.
• Physician directed medical practice: the personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care.
• Whole person orientation: the personal physician is responsible for providing for all the patient’s health care needs or taking responsibility for appropriately arranging care with other qualified professionals. This includes care for all stages of life; acute care; chronic care; preventive services; and end of life care.
• Care is coordiated an/or integrated: across all elements of the complex health care system and the patient’s community. Care is facilitated by registries, information technology, health information exchange and other means to assure that the patients get the indicated care when and where they need and want it.
• Quality and safety and enhanced access: to care is available  through systems such as open scheduling, expanded hours and new options for communication between patients, their personal physician and practice staff.

Paul Grundy, IBM’s director of health care says: “We’re not doing this because we expect to see huge savings. The medical home is more about whether patients have access to care at the right time an whether that care is appropriate”.

mHealth changedriver: yes we can!

For who’s not confinced that mobile devices will be the driver in our changing Healthcare this amazing new device. I enjoyed seeing it. So it’s also for the mhealth believer.

Towards mHealth Business Models.

To be succesful, the existing healthcare industry will need to help find solutions to alter patients habits. What kind of answers are we talking about? In what direction are we heading? Mobile health needs a new concept.

Mobile health initiatives fall into one or more of these five functions:

1. collecting: also using new devices like sensors and RFID-tags.
2. sharing: starting of with all initiatives concerning the creation of digital records, knowledge on medical issues, but also the formation of healthcommunities. This last brings me to …..
3. communicating: interacting by transporting all kinds of data on short or long distances over the mobile channel.
4. collaborating: working with healthcareproviders on a prescribed treatment.
5. co-creating: to be developed given the expected shift in role models within healthcare.

So what about a concept for these functions plotted on possible market movements. Nowedays Healthcare has a enormous responsibilty concerning the wellbeing of the population and we want to strive to more selfmanagement. The major difference in IT is in the mobile channel.

We’ve created four segments. Up/left represents the current situation. A big Healtcare responsibility, combined with Mobile computing is supported in more communication and collaboration from patiënts to medical centers and between seperate healthcareproviders. Bottum/left we find opportunities for independent service providers, expending on collecting and sharing data and communication. In the last quarter the mutually reinforcement of selfmanagement and mobile computing will lead to co-creation facilities.

Identifying value in customer driven mHealth.

We have to create an appealing surrounding if we want selfmanagement from patients. How do we create a better business experience so we can seduce them? Our focus of strategic analysis is not the careprovider or even the healthcare industry but the value-creating system within the medical sector itself. It’s totality of different economic actors working together to produce value.

The goal is not to create value for people asking medical assistance. It’s the other way around. Customers have to create their own value from the various offerings made by healthcare. Startingpoint are the customer preferences. That’s where the value is captured in terms of:

• revenue generation: getting the right medical assistance at the right time at the right price.
• productivity improvement: boosting health by leveraging userfriendly mobile functions.
• cost savings: using less expensive means of communication with healthcareproviders and -organisations.
• provider acquisition: acquiring healthcare-assistance by reaching a wider transparant offer unconstrained by time and space.
• provider retention: retaining healthcare-assistance by voluntarily coöperate with the terms prescribed.

The value of the medical-assistance will occur in five solution phases, that correspond to the evolution of mobile technology.

1. Mobile medical-assistance provides value through the ability to interact with others.
2. Mobile medical-assistance enhances customers connectivity to medical information.
3. Mobile medical-assistance realizes value from transacting business via the mobile channel.
4. Mobile medical-assistance transforms the connection of processes within and between healthcareproviders.
5. Mobile medical-assistance absorbs mobility as part of standard business practice.

Today, healthcareproviders and their customers are in the second phase, moving in the direction of the third. Shifting from one phase to the next is dependent on the user adoption rate of the mobile Internet. This, in turn, is subsidiary to how well their devices meet customer needs.

Where do personal m-Health monitoring systems fit in?

In this post we focus on the term “mobile”, which implies portability. So a mobile device travels with you. But does the term also imply that it has an “always on” connection to the Internet? m-Health is about the use of mobile devices occuring in offline and online scenarios.

Mobile offline means that you can use the device to run self-contained programs. Most times it will sooner or later “sync” with a PC or needs an energy upload. The quantity of device-resident applications and local databases may vary.

Mobile online is commonly called wireless. Users are connected via satellite, cellular or radio transmissers. It can exchange data real-time with a system also connected to that same network.

The distinction between offline and online affects how mhealth applications are designed and used.

Assistance in self-management in healthcare can roughly be devided into 4 areas of attention: acute, chronic, wellness and fitness assistance. To give an idea of some devices, here a view examples. Acute assistance with devices like Cardio Event Recorders and Cholesterol, Triglycerids Ketones and Glucose Meters. Chronic assistance with Glucose, Peak Fow and Spirometers. A Blood Pressure Wrist Band and Weight and Body Mass Index Scale can be interpreted as wellness assistance. Finally Fitness assistance with devices like Heart Rate Monitors, Pulse Oximeters and Strength Measurers.

It’s useful to clarify key distinctions within the new reality of Healthcare and Wellbeing. The concept of m-Health is related to m-Business aswell as to e-Health and e-Business. e-Health simpley refers to the matching of question and delivery of healthcare products and services. The larger concept of e-Business represents all the technological applications and business processes that enable a healthcareprovider to service his transaction. Including front- and back-office systems. e-Business translates old business models based on technology innovation.

Most applications that are now in development assume fixed or stationary users. A view m-Health pilots see their clients as “on the move”. The importance of datacollection, communicating and information sharing evaluate withing time and place. M-Health is not possible without m-business. The commodities of mobile devices, the infrastructure, the processes and the services equip the growth of m-Health. M-Business creates new channels and benefits on which m-Health can flourish, even when you are offline.

Would welcome your comments 🙂