Proposal of a novel remote command and control configuration extension for interoperable Personal Health Devices (PHD) based on ISO/IEEE11073 standard.

New use cases to extend the interoperability standard ISO/IEEE11073 (X73) were found during the development of recent specializations. These use cases expose the need of remote command and control extensions to allow managers to configure agents through the standard. This paper presents a proposal for an extension of remote control and configuration service able to standardize a general procedure within the newest branch of this standard called X73 for Personal Health Devices (X73PHD). In order to develop a service for remote control, several approaches have been studied and discussed in the Personal Health Device Working Group (PHD-WG). The final solution is defined following the PHD-WG guidelines and integrated with the Optimized Exchange Protocol (X73-20601) and device specializations (X73-104xx). Previous works such as the classic command and control and the extended services packages from X73-10201 and X73-20301, respectively, have also been taken into account.

New use cases for remote control and configuration of interoperable medical devices.

The newest branch of the ISO/IEEE 11073 (X73) standard for Personal Health Devices (X73PHD), allow the development of interoperable personal health ecosystems. At the moment of this writing, more than 11 specializations have been successfully published by the Personal Health Device (PHD) Working Group (PHD WG). Nevertheless, some recent specializations at draft stage show the need for a procedure to control configuration parameters. As a solution, some ad-hoc methods have been elaborated to deal with it, but, the aim of the PHD WG is to standardize a general procedure, valid for longer term. Then it is needed to identify use cases requiring remote configuration services. This work identifies and studies new use cases that employ remote configuration services. The resulting use cases, discussed within the PHD WG to get the maximum consensus, are within the scope of the Basic Electrocardiograph (X73-10406), the Sleep Apnea Breathing Therapy Equipment (X73-10424), and the Medication Monitor (X73-10472) specializations. In addition, a classification of the findings is proposed for each use case. These findings could be the basis for the new remote configuration extension.

Implementation experiences of ISO/IEEE11073 standard applied to new use cases for e-health environments.

Recent advances in biomedical engineering and continuous technological innovations in last decade are promoting new challenges, especially in e-Health environments. In this context, the medical devices interoperability is one of the interest fields wherein these improvements require a standard-based design in order to achieve homogeneous solutions. Furthermore, the spreading of wearable devices, oriented to the paradigm of patient environment and supported by wireless technologies as Bluetooth or ZigBee, is bringing new medical use cases based on Ambient Assisted Living, home monitoring of elderly, heart failure, chronic, under palliative care or patients who have undergone surgery, urgencies and emergencies, or even fitness auto-control and health follow-up. In this paper, several implementation experiences based on ISO/IEEE11073 standard are detailed. These evolved e-Health services can improve the quality of the patient's care, increase the user's interaction, and assure these e-Health applications to be fully compatible with global telemedicine systems.

Implementing ISO/IEEE 11073: proposal of two different strategic approaches.

This paper explains the challenges encountered during the ISO/IEEE 11073 standard implementation process. The complexity of the standard and the consequent heavy requirements, which have not encouraged software engineers to adopt the standard. The developing complexity evaluation drives us to propose two possible implementation strategies that cover almost all possible use cases and eases handling the standard by non-expert users. The first one is focused on medical devices (MD) and proposes a low-memory and low-processor usage technique. It is based on message patterns that allow simple functions to generate ISO/IEEE 11073 messages and to process them easily. In this way a framework for MDs can be obtained. Second one is focused on more powerful machines such as data loggers or gateways (aka. computer engines (CE)), which do not have the MDs' memory and processor usage constraints. For CEs a more intelligent and adaptative Plug&Play (P&P) solution is provided. It consists on a general platform that can access to any device supported by the standard. Combining both strategies will cut developing time for applications based on ISO/EEE 11073.

Optimization proposal of a standard-based patient monitoring platform for ubiquitous environments.

This article describes the optimization of a patient telemonitoring platform based on the ISO/IEEE11073 (X73) standard to enable medical device interoperability. In order to achieve this, principal advantages and remaining improvements are evaluated to include in further upgrades towards the new profile evolution, oriented to ubiquitous environments and wearable devices (Personal Health Devices, X73-PHD), and opened to additional plug-and-play features and remote management. After evaluating the possibilities, we describe the platform porting process, a required step to adapt it to the new functionalities and allowing the development of end-to-end standard based systems. The paper details the implementation of the agent-manager architecture, particularized on the X73-PHD communication protocol between a Medical Device (MD) and a central gateway (Compute Engine, CE). Lastly, the obtained results are evaluated, oriented to constitute an X73-PHD tester to prove the challenges currently under discussion in the European Standardization Committee (CEN).

Implementation experience of a patient monitoring solution based on end-to-end standards.

This paper presents a proof-of-concept design of a patient monitoring solution for Intensive Care Unit (ICU). It is end-to-end standards-based, using ISO/IEEE 11073 (X73) in the bedside environment and EN13606 to communicate the information to an Electronic Healthcare Record (EHR) server. At the bedside end a plug-and-play sensor network is implemented, which communicates with a gateway that collects the medical information and sends it to a monitoring server. At this point the server transforms the data frame into an EN13606 extract, to be stored on the EHR server. The presented system has been tested in a laboratory environment to demonstrate the feasibility of this end-to-end standards-based solution.

Proposal of an ISO/IEEE11073 platform for healthcare telemonitoring: plug-and-play solution with new use cases.

Remote patient monitoring in e-Health is everyday closer to be a mature technology / service. However, there is still a lack of development in areas such as standardization of the sensor's communication interface, integration into Electronic Healthcare Record systems or incorporation in ambient-intelligent scenarios. This work identifies a set of use cases involved in the personal monitoring scenario and highlights the related features and functionalities, as well as the integration and implementation difficulties found when these are to be implemented in a system based on the ISO/IEEE11073 (X73) standard. It is part of a cooperative research effort devoted to the development of an end-to-end standards-based telemonitoring solution. Standardization committees are working towards adapting the X73 standard to this emerging personal health devices market and use case identification is essential to direct these revisions.