A new framework architecture for next generation e-Health services

eHealth: A Survey of Architectures, Developments in mHealth, Security Concerns and Solutions

The ramifications of the COVID-19 pandemic have contributed in part to a recent upsurge in the study and development of eHealth systems. Although it is almost impossible to cover all aspects of eHealth in a single discussion, three critical areas have gained traction. These include the need for acceptable eHealth architectures, the development of mobile health (mHealth) technologies, and the need to address eHealth system security concerns. Existing survey articles lack a synthesis of the most recent advancements in the development of architectures, mHealth solutions, and innovative security measures, which are essential components of effective eHealth systems. Consequently, the present article aims at providing an encompassing survey of these three aspects towards the development of successful and efficient eHealth systems. Firstly, we discuss the most recent innovations in eHealth architectures, such as blockchain-, Internet of Things (IoT)-, and cloud-based architectures, focusing on their respective benefits and drawbacks while also providing an overview of how they might be implemented and used. Concerning mHealth and security, we focus on key developments in both areas while discussing other critical topics of importance for eHealth systems. We close with a discussion of the important research challenges and potential future directions as they pertain to architecture, mHealth, and security concerns. This survey gives a comprehensive overview, including the merits and limitations of several possible technologies for the development of eHealth systems. This endeavor offers researchers and developers a quick snapshot of the information necessary during the design and decision-making phases of the eHealth system development lifecycle. Furthermore, we conclude that building a unified architecture for eHealth systems would require combining several existing designs. It also points out that there are still a number of problems to be solved, so more research and investment are needed to develop and deploy functional eHealth systems.

Smartphone-based photochemical sensor for multiplex determination of glucose, uric acid, and total cholesterol in fingertip blood

The physical picture of the proposed system, which consists of a photochemical dongle, a cloud-enabled smartphone, and disposable test strips.

Applying eHealth for Pandemic Management in Saudi Arabia in the Context of COVID-19: Survey Study and Framework Proposal

BACKGROUND

The increased frequency of epidemics such as Middle East respiratory syndrome, severe acute respiratory syndrome, Ebola virus, and Zika virus has created stress on health care management and operations as well as on relevant stakeholders. In addition, the recent COVID-19 outbreak has been creating challenges for various countries and their respective health care organizations in managing and controlling the pandemic. One of the most important observations during the recent outbreak is the lack of effective eHealth frameworks for managing and controlling pandemics.

OBJECTIVE

The aims of this study are to review the current National eHealth Strategy of Saudi Arabia and to propose an integrated eHealth framework that can be effective for managing health care operations and services during pandemics.

METHODS

A questionnaire-based survey was administered to 316 health care professionals to review the current national eHealth framework of Saudi Arabia and identify the objectives, factors, and components that are key for managing and controlling pandemics. Purposive sampling was used to collect responses from diverse experts, including physicians, technical experts, nurses, administrative experts, and pharmacists. The survey was administered at five hospitals in Saudi Arabia by forwarding the survey link using a web-based portal. A sample population of 350 was achieved, which was filtered to exclude incomplete and ineligible samples, giving a sample of 316 participants.

RESULTS

Of the 316 participants, 187 (59.2%) found the current eHealth framework to be ineffective, and more than 50% of the total participants stated that the framework lacked some essential components and objectives. Additional components and objectives focusing on using eHealth for managing information, creating awareness, increasing accessibility and reachability, promoting self-management and self-collaboration, promoting electronic services, and extensive stakeholder engagement were considered to be the most important factors by more than 80% of the total participants.

CONCLUSIONS

Managing pandemics requires an effective and efficient eHealth framework that can be used to manage various health care services by integrating different eHealth components and collaborating with all stakeholders.

ICT-Based Health Care Services for Individuals with Spinal Cord Injuries: A Feasibility Study

In the Republic of Korea, 90.5% of those living with spinal cord injury (SCI) are faced with medical complications that require chronic care. Some of the more common ones include urinary tract infections, pressure sores, and pain symptomatology. These and other morbidities have been recognized to deteriorate the individual's health, eventually restricting their community participation. Telerehabilitation, using information and communication technology, has propelled a modern-day movement in providing comprehensive medical services to patients who have difficulty in mobilizing themselves to medical care facilities. This study aims to verify the effectiveness of health care and management in the SCI population by providing ICT-based health care services. We visited eight individuals living with chronic SCI in the community, and provided ICT-based health management services. After using respiratory and urinary care devices with the provision of home visit occupational therapy, data acquisition was achieved and subsequently entered into a smart device. The entered information was readily accessible to the necessary clinicians and researchers. The clients were notified if there were any concerning results from the acquired data. Subsequently, they were advised to follow up with their providers for any immediate medical care requirements. Digital hand-bike ergometers and specialized seating system cushions are currently in development. The ICT-based health care management service for individuals with SCI resulted in a favorable expected level of outcome. Based on the results of this study, we have proposed and are now in preparation for a randomized clinical trial.

Blood Cholesterol Monitoring With Smartphone as Miniaturized Electrochemical Analyzer for Cardiovascular Disease Prevention

Currently, cardiovascular diseases become one of the major threat to human's life. The early prevention of cardiovascular diseases plays a critical role in the healthcare engineering. Point of care monitoring the blood lipid level is capable of making the positive contribution to the prevention of cardiovascular disease. Ubiquitous smartphones paved the way as the flexible and widespread platform for the interaction of various health information. In this manuscript, we report the world's first medical smartphone as an electrochemical analyzer for blood lipid monitoring. Integrating an electrochemical analyzer into a smartphone allows us to measure the current generated by the enzymatic reaction with the total cholesterol test strip. The disposable test strip is used to convert the biochemical signal to electrical signal through the electrochemical reaction. The proposed medical smartphone can provide accurate evaluation of patient's blood lipid level as compared to the clinical biochemical analyzer. The proposed medical smartphone system is a promising platform as a point-of-care device for blood total cholesterol (TC) monitoring, which can be applied for long-term prevention of cardiovascular disease due to its portability, reliability, lower cost, convenience, and internet-based medical data interaction.

A Trust Model for Ubiquitous Healthcare Environment on the Basis of Adaptable Fuzzy-Probabilistic Inference System

Trust is considered to be a determinant on psychologist selection which can ensure patient satisfaction. Hence, trust concept is essential to be introduced into ubiquitous healthcare (UH) environment oriented on patients with anxiety disorders. This is accomplished by trust model estimating psychologists' trustworthiness, a priory to service delivery, with the use of patient's and his/her acquaintances testimonies, i.e., personal interaction experience and reputation (R). In this paper, a trust model is proposed to be materialized via an adaptable cloud inference system (ACIS) that performs trust value (TV) estimation. Taking advantage of a cloud theory, the introduced ACIS estimates TVs via fuzzy-probabilistic reasoning incorporating a cloud relation operator (soft AND) which is proposed to be tuned by trust information sources consistency and coherency. Theoretical analysis along with comparative study conducted within MATLAB environment and experimental investigation verify the effectiveness of the proposed ACIS materialization under different conditions. Especially, the innovative features of ACIS enable TV to be estimated with 45.5% and 62% on average higher accuracy to that providing state-of-the-art trust models, within clean environment and under the influence of large-scale collusive malicious attacks, respectively. The enhanced robustness permits the untrustworthy UH providers to be discriminated with true positive rate at the range of 0.9 although 40% of R testimonies are erroneous. Finally, experimental investigation validates that the adoption of the proposed trust model for psychologists trustworthiness estimation facilitates patient satisfaction to be achieved into UH environment.

A new mHealth communication framework for use in wearable WBANs and mobile technologies

Driven by the development of biomedical sensors and the availability of high mobile bandwidth, mobile health (mHealth) systems are now offering a wider range of new services. This revolution makes the idea of in-home health monitoring practical and provides the opportunity for assessment in "real-world" environments producing more ecologically valid data. In the field of insomnia diagnosis, for example, it is now possible to offer patients wearable sleep monitoring systems which can be used in the comfort of their homes over long periods of time. The recorded data collected from body sensors can be sent to a remote clinical back-end system for analysis and assessment. Most of the research on sleep reported in the literature mainly looks into how to automate the analysis of the sleep data and does not address the problem of the efficient encoding and secure transmissions of the collected health data. This article reviews the key enabling communication technologies and research challenges for the design of efficient mHealth systems. An end-to-end mHealth system architecture enabling the remote assessment and monitoring of patient's sleep disorders is then proposed and described as a case study. Finally, various mHealth data serialization formats and machine-to-machine (M2M) communication protocols are evaluated and compared under realistic operating conditions.

All-IP wireless sensor networks for real-time patient monitoring

This paper proposes the all-IP WSNs (wireless sensor networks) for real-time patient monitoring. In this paper, the all-IP WSN architecture based on gateway trees is proposed and the hierarchical address structure is presented. Based on this architecture, the all-IP WSN can perform routing without route discovery. Moreover, a mobile node is always identified by a home address and it does not need to be configured with a care-of address during the mobility process, so the communication disruption caused by the address change is avoided. Through the proposed scheme, a physician can monitor the vital signs of a patient at any time and at any places, and according to the IPv6 address he can also obtain the location information of the patient in order to perform effective and timely treatment. Finally, the proposed scheme is evaluated based on the simulation, and the simulation data indicate that the proposed scheme might effectively reduce the communication delay and control cost, and lower the packet loss rate.

Priority-based time-slot allocation in wireless body area networks during medical emergency situations: an evolutionary game-theoretic perspective

In critical medical emergency situations, wireless body area network (WBAN) equipped health monitoring systems treat data packets with critical information regarding patients' health in the same way as data packets bearing regular healthcare information. This snag results in a higher average waiting time for the local data processing units (LDPUs) transmitting data packets of higher importance. In this paper, we formulate an algorithm for Priority-based Allocation of Time Slots (PATS) that considers a fitness parameter characterizing the criticality of health data that a packet carries, energy consumption rate for a transmitting LDPU, and other crucial LDPU properties. Based on this fitness parameter, we design the constant model hawk-dove game that ensures prioritizing the LDPUs based on crucial properties. In comparison with the existing works on priority-based wireless transmission, we measure and take into consideration the urgency, seriousness, and criticality associated with an LDPU and, thus, allocate transmission time slots proportionately. We show that the number of transmitting LDPUs in medical emergency situations can be reduced by 25.97%, in comparison with the existing time-division-based techniques.

Issues and Challenges in Securing eHealth Systems

With the widespread eHealth usage, security of eHealth services is becoming increasingly important. In this paper, we analyze the security problems in eHealth systems, discuss various approaches of securing health data collection and sharing proposed in the recent literature on eHealth security, and provide comparative evaluations that include advantages and limitations of each approach. Possible future research directions on each approach for enhancing security for eHealth applications are also suggested.