IoMT Platform for Pervasive Healthcare Data Aggregation, Processing, and Sharing Based on OneM2M and OpenEHR

Standardizing Corneal Transplantation Records Using openEHR: Case Study

BACKGROUND

Corneal transplantation, also known as keratoplasty, is a widely performed surgical procedure that aims to restore vision in patients with corneal damage. The success of corneal transplantation relies on the accurate and timely management of patient information, which can be enhanced using electronic health records (EHRs). However, conventional EHRs are often fragmented and lack standardization, leading to difficulties in information access and sharing, increased medical errors, and decreased patient safety. In the wake of these problems, there is a growing demand for standardized EHRs that can ensure the accuracy and consistency of patient data across health care organizations.

OBJECTIVE

This paper proposes the use of openEHR structures for standardizing corneal transplantation records. The main objective of this research was to improve the quality and interoperability of EHRs in corneal transplantation, making it easier for health care providers to capture, share, and analyze clinical information.

METHODS

A series of sequential steps were carried out in this study to implement standardized clinical records using openEHR specifications. These specifications furnish a methodical approach that ascertains the development of high-quality clinical records. In broad terms, the methodology followed encompasses the conduction of meetings with health care professionals and the modeling of archetypes, templates, forms, decision rules, and work plans.

RESULTS

This research resulted in a tailored solution that streamlines health care delivery and meets the needs of medical professionals involved in the corneal transplantation process while seamlessly aligning with contemporary clinical practices. The proposed solution culminated in the successful integration within a Portuguese hospital of 3 key components of openEHR specifications: forms, Decision Logic Modules, and Work Plans. A statistical analysis of data collected from May 1, 2022, to March 31, 2023, allowed for the perception of the use of the new technologies within the corneal transplantation workflow. Despite the completion rate being only 63.9% (530/830), which can be explained by external factors such as patient health and availability of donor organs, there was an overall improvement in terms of task control and follow-up of the patients' clinical process.

CONCLUSIONS

This study shows that the adoption of openEHR structures represents a significant step forward in the standardization and optimization of corneal transplantation records. It offers a detailed demonstration of how to implement openEHR specifications and highlights the different advantages of standardizing EHRs in the field of corneal transplantation. Furthermore, it serves as a valuable reference for researchers and practitioners who are interested in advancing and improving the exploitation of EHRs in health care.

Multisource Data Framework for Prehospital Emergency Triage in Real-Time IoMT-Based Telemedicine Systems

BACKGROUND AND OBJECTIVE

The Internet of Medical Things (IoMT) has revolutionized telemedicine by enabling the remote monitoring and management of patient care. Nevertheless, the process of regeneration presents the difficulty of effectively prioritizing the information of emergency patients in light of the extensive amount of data generated by several integrated health care devices. The main goal of this study is to be improving the procedure of prioritizing emergency patients by implementing the Real-time Triage Optimization Framework (RTOF), an innovative method that utilizes diverse data from the Internet of Medical Things (IoMT).

METHODS

The study's methodology utilized a variety of Internet of Medical Things (IoMT) data, such as sensor data and texts derived from electronic medical records. Tier 1 supplies sensor and textual data, and Tier 3 imports textual data from electronic medical records. We employed our methodologies to handle and examine data from a sample of 100,000 patients afflicted with hypertension and heart disease, employing artificial intelligence algorithms. We utilized five machine-learning algorithms to enhance the accuracy of triage.

RESULTS

The RTOF approach has remarkable efficacy in a simulated telemedicine environment, with a triage accuracy rate of 98%. The Random Forest algorithm exhibited superior performance compared to the other approaches under scrutiny. The performance characteristics attained were an accuracy rate of 98%, a precision rate of 99%, a sensitivity rate of 98%, and a specificity rate of 100%. The findings show a significant improvement compared to the present triage methods.

CONCLUSIONS

The efficiency of RTOF surpasses that of existing triage frameworks, showcasing its significant ability to enhance the quality and efficacy of telemedicine solutions. This work showcases substantial enhancements compared to existing triage approaches, while also providing a scalable approach to tackle hospital congestion and optimize resource allocation in real-time. The results of our study emphasize the capacity of RTOF to mitigate hospital overcrowding, expedite medical intervention, and enable the creation of adaptable telemedicine networks. This study highlights potential avenues for further investigation into the integration of the Internet of Medical Things (IoMT) with machine learning to develop cutting-edge medical technologies.

Health Care Equity Through Intelligent Edge Computing and Augmented Reality/Virtual Reality: A Systematic Review

Intellectual capital is a scarce resource in the healthcare industry. Making the most of this resource is the first step toward achieving a completely intelligent healthcare system. However, most existing centralized and deep learning-based systems are unable to adapt to the growing volume of global health records and face application issues. To balance the scarcity of healthcare resources, the emerging trend of IoMT (Internet of Medical Things) and edge computing will be very practical and cost-effective. A full examination of the transformational role of intelligent edge computing in the IoMT era to attain health care equity is offered in this research. Intelligent edge computing-aided distribution and collaborative information management is a possible approach for a long-term digital healthcare system. Furthermore, IEC (Intelligent Edge Computing) encourages digital health data to be processed only at the edge, minimizing the amount of information exchanged with central servers/the internet. This significantly increases the privacy of digital health data. Another critical component of a sustainable healthcare system is affordability in digital healthcare. Affordability in digital healthcare is another key component of a sustainable healthcare system. Despite its importance, it has received little attention due to its complexity. In isolated and rural areas where expensive equipment is unavailable, IEC with AR / VR, also known as edge device shadow, can play a significant role in the inexpensive data collection process. Healthcare equity becomes a reality by combining intelligent edge device shadows and edge computing.

Fuzzy-Based Efficient Healthcare Data Collection and Analysis Mechanism Using Edge Nodes in the IoMT

The Internet of Things (IoT) is an advanced technology that comprises numerous devices with carrying sensors to collect, send, and receive data. Due to its vast popularity and efficiency, it is employed in collecting crucial data for the health sector. As the sensors generate huge amounts of data, it is better for the data to be aggregated before being transmitting the data further. These sensors generate redundant data frequently and transmit the same values again and again unless there is no variation in the data. The base scheme has no mechanism to comprehend duplicate data. This problem has a negative effect on the performance of heterogeneous networks.It increases energy consumption; and requires high control overhead, and additional transmission slots are required to send data. To address the above-mentioned challenges posed by duplicate data in the IoT-based health sector, this paper presents a fuzzy data aggregation system (FDAS) that aggregates data proficiently and reduces the same range of normal data sizes to increase network performance and decrease energy consumption. The appropriate parent node is selected by implementing fuzzy logic, considering important input parameters that are crucial from the parent node selection perspective and share Boolean digit 0 for the redundant values to store in a repository for future use. This increases the network lifespan by reducing the energy consumption of sensors in heterogeneous environments. Therefore, when the complexity of the environment surges, the efficiency of FDAS remains stable. The performance of the proposed scheme has been validated using the network simulator and compared with base schemes. According to the findings, the proposed technique (FDAS) dominates in terms of reducing energy consumption in both phases, achieves better aggregation, reduces control overhead, and requires the fewest transmission slots.

Security Risks and User Perception towards Adopting Wearable Internet of Medical Things

The Wearable Internet of Medical Things (WIoMT) is a collective term for all wearable medical devices connected to the internet to facilitate the collection and sharing of health data such as blood pressure, heart rate, oxygen level, and more. Standard wearable devices include smartwatches and fitness bands. This evolving phenomenon due to the IoT has become prevalent in managing health and poses severe security and privacy risks to personal information. For better implementation, performance, adoption, and secured wearable medical devices, observing users' perception is crucial. This study examined users' perspectives of trust in the WIoMT while also exploring the associated security risks. Data analysed from 189 participants indicated a significant variance (R² = 0.553) on intention to use WIoMT devices, which was determined by the significant predictors (95% Confidence Interval; p < 0.05) perceived usefulness, perceived ease of use, and perceived security and privacy. These were found to have important consequences, with WIoMT users intending to use the devices based on the trust factors of usefulness, easy to use, and security and privacy features. Further outcomes of the study identified how users' security matters while adopting the WIoMT and provided implications for the healthcare industry to ensure regulated devices that secure confidential data.

Internet of medical things-based real-time digital health service for precision medicine: Empirical studies using MEDBIZ platform

The aim of this study was to introduce the implemented MEDBIZ platform based on the internet of medical things (IoMT) supporting real-time digital health services for precision medicine. In addition, we demonstrated four empirical studies of the digital health ecosystem that could provide real-time healthcare services based on IoMT using real-world data from in-hospital and out-hospital patients. Implemented MEDBIZ platform based on the IoMT devices and big data to provide digital healthcare services to the enterprise and users. The big data platform is consisting of four main components: IoMT, core, analytics, and services. Among the implemented MEDBIZ platform, we performed four clinical trials that designed monitoring services related to chronic obstructive pulmonary disease, metabolic syndrome, arrhythmia, and diabetes mellitus. Of the four empirical studies on monitoring services, two had been completed and the rest were still in progress. In the metabolic syndrome monitoring service, two studies were reported. One was reported that intervention components, especially wearable devices and mobile apps, made systolic blood pressure, diastolic blood pressure, waist circumference, and glycosylated hemoglobin decrease after 6 months. Another one was presented that increasing high-density lipoprotein cholesterol and triglyceride levels were prevented in participants with the pre-metabolic syndrome. Also, self-care using healthcare devices might help prevent and manage metabolic syndrome. In the arrhythmia monitoring service, during the real-time monitoring of vital signs remotely at the monitoring center, 318 (15.9%) general hikers found abnormal signals, and 296 (93.1%) people were recommended for treatment. We demonstrated the implemented MEDBIZ platform based on IoMT supporting digital healthcare services by acquiring real-world data for getting real-world evidence. And then through this platform, we were developing software as a medical device, digital therapeutics, and digital healthcare services, and contributing to the development of the digital health ecosystem.

Design and Implementation of a Web Editing and Publishing System Based on a Semantic Network Generation Algorithm

In order to solve the problem of web editing data mining effectively, a semantic network generation algorithm is proposed. First of all, on the basis of preprocessing the variant short text, the maximum matching distance between short text is calculated by using the dictionary to expand the semantics of the Chinese words, which is used as an index to measure the formal distance between short text. Finally, a weighted method is used to synthesize formal distance and unit semantic distance into text distance, which is applied to the clustering analysis of online comments. The length of the word list is used to punish the distance. Results show that the most popular query topics on the Internet are shopping 10%, entertainment 10%, pornography 12%, computer 9%, research 9%, healthy life 5%, travel 5%, games 5%, family medical 5%, sports 3%, personal economic plan 3%, holiday 1% and others. It is proved that the improved algorithm proposed in this paper is superior to other methods and the clustering performance is significantly improved.

Technologies for Interoperable Internet of Medical Things Platforms to Manage Medical Emergencies in Home Care and Prehospital Care: Protocol for a Scoping Review (Preprint)

Background

Population growth and aging have highlighted the need for more effective home and prehospital care. Interconnected medical devices and applications, which comprise an infrastructure referred to as the Internet of Medical Things (IoMT), have enabled remote patient monitoring and can be important tools to cope with these demographic changes. However, developing IoMT platforms requires profound knowledge of clinical needs and challenges related to interoperability and how these can be managed with suitable technologies.

Objective

The purpose of this scoping review is to summarize the best practices and technologies to overcome interoperability concerns in IoMT platform development for medical emergencies in home and prehospital care.

Methods

This scoping review will be conducted in accordance with Arksey and O’Malley’s 5-stage framework and adhere to the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols) guidelines. Only peer-reviewed articles published in English will be considered. The databases/web search engines that will be used are IEEE Xplore, PubMed, Scopus, Google Scholar, National Center for Biotechnology Information, SAGE Journals, and ScienceDirect. The search process for relevant literature will be divided into 4 different steps. This will ensure that a suitable approach is followed in terms of search terms, limitations, and eligibility criteria. Relevant articles that meet the inclusion criteria will be screened in 2 stages: abstract and title screening and full-text screening. To reduce selection bias, the screening process will be performed by 2 reviewers.

Results

The results of the preliminary search indicate that there is sufficient literature to form a good foundation for the scoping review. The search was performed in April 2022, and a total of 4579 articles were found. The main clinical focus is the prevention and management of falls, but other medical emergencies, such as heart disease and stroke, are also considered. Preliminary results show that little attention has been given to real-time IoMT platforms that can be deployed in real-world care settings. The final results are expected to be presented in a scoping review in 2023 and will be disseminated through scientific conference presentations, oral presentations, and publication in a peer-reviewed journal.

Conclusions

This scoping review will provide insights and recommendations regarding how interoperable real-time IoMT platforms can be developed to handle medical emergencies in home and prehospital care. The findings of this research could be used by researchers, clinicians, and implementation teams to facilitate future development and interdisciplinary discussions.

International Registered Report Identifier (IRRID)

DERR1-10.2196/40243

Performance of an openEHR based hospital information system

BACKGROUND

A desirable feature of hospital information systems is interoperability, which is generally quite limited due to the lack of standardization of the data model. This results in high development and maintenance costs for such systems. The openEHR standard addresses this problem. Due to its two-level modelling, it allows the separation of demographic and medical data and the storage of this data so that it can be easily processed and exchanged. However, it introduces an additional software layer that may affect system performance. This article examines the performance of a system based on the openEHR standard and compares it with the performance of a proprietary system developed in a classic way.

METHODS

Two hospital information systems with the same functionality were designed and developed. One was based on an openEHR server, and another was using proprietary data model having both demographic and medical data. Systems were deployed on Azure platform and load tests using JMeter were conducted to calculate statistics of elapsed time of requests as well as throughput of both systems.

RESULTS

Endpoints which fetch only demographic data had the same performance, but when medical data had to be queried, a decrease in performance of the openEHR based system was noticed. The system based on a proprietary data had about 6 times bigger throughput in terms of medical data fetching.

CONCLUSIONS

OpenEHR adds another layer to the architecture of a hospital information system which might result in performance issues. Such a system must be designed to operate on a sufficiently strong architecture if it is intended to serve many users.

Scalable OneM2M IoT Open-Source Platform Evaluated in an SDN Optical Network Controller Scenario

Software Defined Networking represents a mature technology for the control of optical networks, though all open controller implementations present in the literature still lack the adequate level of maturity and completeness to be considered for (pre)-production network deployments. This work aims at experimenting on, assessing and discussing the use of the OneM2M open-source platform in the context of optical networks. Network elements and devices are implemented as IoT devices, and the control application is built on top of an OneM2M-compliant server. The work concretely addresses the scalability and flexibility performances of the proposed solution, accounting for the expected growth of optical networks. The two experiment scenarios show promising results and confirm that the OneM2M platform can be adopted in such a context, paving the way to other researches and studies.

A Perspective Roadmap for IoMT-Based Early Detection and Care of the Neural Disorder, Dementia

The Internet of Medical Things (IoMT) has emerged as one of the most important key applications of IoT. IoMT makes the diagnosis and care more convenient and reliable with proven results. The paper presents the technology, open issues, and challenges of IoMT-based systems. It explores the various types of sensors and smart equipment based on IoMT and used for diagnosis and patient care. A comprehensive survey of early detection and postdetection care of the neural disorder dementia is conducted. The paper also presents a postdiagnosis dementia care model named “Demencare.” This model incorporates eight sensors capable of tracking the daily routine of dementia patient. The patients can be monitored locally by an edge computing device kept at their premises. The medical experts may also monitor the patients' status for any deviation from normal behavior. IoMT enables better postdiagnosis care for neural disorders, like dementia and Alzheimer's. The patient's behavior and vital parameters are always available despite the remote location of the patients. The data of the patients may be classified, and new insights may be obtained to tackle patients in a better manner.

Reliable Internet of Things: Challenges and Future Trends

The Internet of Things (IoT) is a vital component of many future industries. By intelligent integration of sensors, wireless communications, computing techniques, and data analytics, IoT can increase productivity and efficiency of industries. Reliability of data transmission is key to realize several applications offered by IoT. In this paper, we present an overview of future IoT applications, and their major communication requirements. We provide a brief survey of recent work in four major areas of reliable IoT including resource allocation, latency management, security, and reliability metrics. Finally, we highlight some of the important challenges for reliable IoT related to machine learning techniques, 6G communications and blockchain based security that need further investigation and discuss related future directions.

Internet of things in health: Requirements, issues, and gaps

BACKGROUND AND OBJECTIVES

The Internet of Things (IoT) paradigm has been extensively applied to several sectors in the last years, ranging from industry to smart cities. In the health domain, IoT makes possible new scenarios of healthcare delivery as well as collecting and processing health data in real time from sensors in order to make informed decisions. However, this domain is complex and presents several technological challenges. Despite the extensive literature about this topic, the application of IoT in healthcare scarcely covers requirements of this sector.

METHODS

A literature review from January 2010 to February 2021 was performed resulting in 12,108 articles. After filtering by title, abstract, and content, 86 were eligible and examined according to three requirement themes: data lifecycle; trust, security, and privacy; and human-related issues.

RESULTS

The analysis of the reviewed literature shows that most approaches consider IoT application in healthcare merely as in any other domain (industry, smart cities…), with no regard of the specific requirements of this domain.

CONCLUSIONS

Future efforts in this matter should be aligned with the specific requirements and needs of the health domain, so that exploiting the capabilities of the IoT paradigm may represent a meaningful step forward in the application of this technology in healthcare.

Representation of Diagnosis and Nursing Interventions in OpenEHR Archetypes

OBJECTIVE

The study aimed to represent the content of nursing diagnosis and interventions in the openEHR standard.

METHODS

This is a developmental study with the models developed according to ISO 18104: 2014. The Ocean Archetype Editor tool from the openEHR Foundation was used.

RESULTS

Two archetypes were created; one to represent the nursing diagnosis concept and the other the nursing intervention concept. Existing archetypes available in the Clinical Knowledge Manager were reused in modeling.

CONCLUSION

The representation of nursing diagnosis and interventions based on the openEHR standard contributes to representing nursing care phenomena and needs in health information systems.

Smart Assistive Architecture for the Integration of IoT Devices, Robotic Systems, and Multimodal Interfaces in Healthcare Environments

This paper presents a new architecture that integrates Internet of Things (IoT) devices, service robots, and users in a smart assistive environment. A new intuitive and multimodal interaction system supporting people with disabilities and bedbound patients is presented. This interaction system allows the user to control service robots and devices inside the room in five different ways: touch control, eye control, gesture control, voice control, and augmented reality control. The interaction system is comprised of an assistive robotic arm holding a tablet PC. The robotic arm can place the tablet PC in front of the user. A demonstration of the developed technology, a prototype of a smart room equipped with home automation devices, and the robotic assistive arm are presented. The results obtained from the use of the various interfaces and technologies are presented in the article. The results include user preference with regard to eye-base control (performing clicks, and using winks or gaze) and the use of mobile phones over augmented reality glasses, among others.

Big Data Analytics + Virtual Clinical Semantic Network (vCSN): An Approach to Addressing the Increasing Clinical Nuances and Organ Involvement of COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has revealed deep gaps in our understanding of the clinical nuances of this extremely infectious viral pathogen. In order for public health, care delivery systems, clinicians, and other stakeholders to be better prepared for the next wave of SARS-CoV-2 infections, which, at this point, seems inevitable, we need to better understand this disease-not only from a clinical diagnosis and treatment perspective-but also from a forecasting, planning, and advanced preparedness point of view. To predict the onset and outcomes of a next wave, we first need to understand the pathologic mechanisms and features of COVID-19 from the point of view of the intricacies of clinical presentation, to the nuances of response to therapy. Here, we present a novel approach to model COVID-19, utilizing patient data from related diseases, combining clinical understanding with artificial intelligence modeling. Our process will serve as a methodology for analysis of the data being collected in the ASAIO database and other data sources worldwide.

The Internet of Things: Impact and Implications for Health Care Delivery

The Internet of Things (IoT) is a system of wireless, interrelated, and connected digital devices that can collect, send, and store data over a network without requiring human-to-human or human-to-computer interaction. The IoT promises many benefits to streamlining and enhancing health care delivery to proactively predict health issues and diagnose, treat, and monitor patients both in and out of the hospital. Worldwide, government leaders and decision makers are implementing policies to deliver health care services using technology and more so in response to the novel COVID-19 pandemic. It is now becoming increasingly important to understand how established and emerging IoT technologies can support health systems to deliver safe and effective care. The aim of this viewpoint paper is to provide an overview of the current IoT technology in health care, outline how IoT devices are improving health service delivery, and outline how IoT technology can affect and disrupt global health care in the next decade. The potential of IoT-based health care is expanded upon to theorize how IoT can improve the accessibility of preventative public health services and transition our current secondary and tertiary health care to be a more proactive, continuous, and coordinated system. Finally, this paper will deal with the potential issues that IoT-based health care generates, barriers to market adoption from health care professionals and patients alike, confidence and acceptability, privacy and security, interoperability, standardization and remuneration, data storage, and control and ownership. Corresponding enablers of IoT in current health care will rely on policy support, cybersecurity-focused guidelines, careful strategic planning, and transparent policies within health care organizations. IoT-based health care has great potential to improve the efficiency of the health system and improve population health.

A Review of Internet of Things Technologies for Ambient Assisted Living Environments

The internet of things (IoT) aims to extend the internet to real-world objects, connecting smart and sensing devices into a global network infrastructure by connecting physical and virtual objects. The IoT has the potential to increase the quality of life of inhabitants and users of intelligent ambient assisted living (AAL) environments. The paper overviews and discusses the IoT technologies and their foreseen impacts and challenges for the AAL domain. The results of this review are summarized as the IoT based gerontechnology acceptance model for the assisted living domain. The model focuses on the acceptance of new technologies by older people and underscores the need for the adoption of the IoT for the AAL domain.