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Sensor Networks for Medical Care. Authors: Victor Shnayder , Borrong Chen, Konrad Lorincz , Thaddeus R. F. Fulford Jones, Matt Welsh. Presenter: Velin Dimitrov. Introduction. Motivation. Why do we need WSNs in medicine Continuously monitor patients long term
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Sensor Networks for Medical Care Authors: Victor Shnayder, Borrong Chen, KonradLorincz, Thaddeus R. F. Fulford Jones, Matt Welsh Presenter:VelinDimitrov
Motivation • Why do we need WSNs in medicine • Continuously monitor patients long term • Emergency/Disaster Scenario • “Active Triage Tag” • Immediate life-critical notifications • Augment/replace existing wired telemetry systems • Improve overall care of patients
Medical Applications • Real time continuous patient monitoring • In-Hospital setting • Home Monitoring – Elderly/Chronic • Continuous data • Long term care/trend analysis • Collection of clinical data Adapted from Matt Welsh’s presentation on CodeBlue at UCSD
Current Implementations • Stationary nodes with low data rates to central station • Improvements • High Data Rates • Reliable communications • Multiple receivers • In-network aggregation cannot be used
Current Implementations • Wireless medical monitors • EKG • Pulse Oximeters • Fetal Heart Rate • Maternal Uterine • “Cut the cord” implementations • Bluetooth, WMTS, Wi-Fi • Systems do not scale well
CodeBlue Goals Develop tiny, wearable, wireless sensors for medical care and disaster response Scalable, robust wireless communication protocols Integrate real-time sensor data into medical care Explore a range of clinical applications Adapted from Matt Welsh’s presentation on CodeBlue at UCSD
CodeBlue – Hardware Sensor modules compatible with Mica2, MicaZ, and Telos mote designs Pulse Oximeter Two lead electrocardiogram (EKG) Motion analysis sensor SFF Telos design for wearable use telosb_datasheet_rev 20111109 (1).pdf
CodeBlue - Software • Device Discovery • Publish/Subscribe multi- • hop routing • Query interface – simplicity • RF-based localization • Low power Bluetooth and 802.15.4 (WPAN)
Requirements • Wearable Sensor Platform • “…large batter packs and protruding antennas are suboptimal for medical use.” • Small, Lightweight, Wearable sensors • Reliable Communications • Data Availability • How much packet loss is acceptable? • Sample rates vary 1Hz to 10’s kHz
Requirements • Multiple Receivers • Multicast capabilities • Device Mobility • Multi-hop routing • Device Discovery • Security • Health Insurance Portability and Accountability Act
HIPAA A review of the implementation of the HIPAA Privacy Rule by the U.S. Government Accountability Office found that health care providers were "uncertain about their legal privacy responsibilities and often responded with an overly guarded approach to disclosing information...than necessary to ensure compliance with the Privacy rule". Wilson J (2006). "Health Insurance Portability and Accountability Act Privacy rule causes ongoing concerns among clinicians and researchers". Ann Intern Med
Related Work • Disaster Response Research • Funded US National Library of Medicine • SMART • AID-N • WiiSARD • Centralized systems • Reliability and Scalability Concerns
Pulse Oximeter • Mature technology (1970s) • Measures heart rate and SpO2 • Catch hypoxemia before visible symptoms • Array of Infrared LEDs • Array of IR detectors • 650nm and 805nm • BCI Medical Micro-Power Pulse Oximeter
EKG • Two different types • Standard EKG • 30 sec of data from 12-15 probes • Diagnose wide range of cardiac arrythmias • Continuous EKG • 2-3 probes • Diagnose intermittent problems
Mote-Based EKG Single pair of electrodes INA321 CMOS instrumentation amplifier 94dB CMRR Gain of 5 TinyOS samples at 120Hz
Motion Capture Systems Parkinson's Disease and Stroke Wired systems with many wires carried in a waist harness Sensors are placed on limbs of interest Accelerometers Gyroscopes EMG
Mercury Motion Analysis Board Wireless 3 Axis Acc – STMicroelectronics 1 Axis Gyro – Analog Devices 1 EMG unit – Motion Lab Systems One mote is placed on each segment of interest
Pluto Mote • Mica2Dot • No 802.15.4 • Pluto • TI MSP430 • ChipCon CC2420 radio • 120 mAh Li-Ion battery • Mini USB
Publish/Subscribe Routing Layer • Sensors publish data to relevant channel • Requirements • Requested data rates/local filters to limit bandwidth • Multi-hop routing • Mobility of senders/receivers in calculation of routing paths
ADMR • Adaptive Demand-Driven Multicast Routing interface PubSub { command result_t publish(uint16_t chan); command result_t subscribe(uint16_t chan); command result_t leave(uint16_t chan); command result_t send(uint16_t channel, uint8_t length, TOS_Msg* msg); event result_tsendDone(TOS_MsgPtrmsg, result_t success); event TOS_MsgPtr receive(TOS_MsgPtr m, uint16_t channel, uint16_t srcAddr); }
Multi-Hop/Multicasting • Implemented by forwarders • Rebroadcasts messages to a given channel with duplicate suppression • Route discovery • Node table indexed by Publisher ID • Each entry has path cost and previous hop to the publisher • Path costs are updated continuously
Calculating Path Cost PDR – path delivery ratio CC2420 radio provide Link Quality Information (LQI) LQI mapped to Link Delivery Ratio (LDR) Summed for the path making PDR Link Cost is 1-PDR or Path Loss Ratio PDR is held and updated in the header of the ADMR messages
Discovery Protocol • Very simple • Periodically all nodes broadcast metadata • Node ID • Sensor types • Receivers subscribe to the broadcast channel
Query Interface CBQ query are supplied by the GUI Instructs CB to publish data to a specific channel that meets query conditions S – Node IDs Tau – Sensor Type Rho – Sampling Rate Chan – Channel to publish to C – Total Number of Samples
Inefficiencies ADMR and CBQ are separate Simplifies CBQ protocol Inefficiencies arise that ADMR and CBQ both flood the network with broadcast requests CBQ may not be sufficient in all situations but is for most
Sensor Interface Generic interface for sensors getData() dataReady()
RF Based Location Tracking MoteTrack, KonradLorincz, Harvard University
Future Work • Sharing bandwidth across sensors • Data priority • Security • Private Key encryption • Public Key protocol • Integration outside of a hospital setting
From 2009 http://www.ted.com/talks/eric_topol_the_wireless_future_of_medicine.html 2:45 minutes
Questions What characteristic make this a CPS? What potential challenges exist in the successful real-world implementation of CodeBlue? How does the boom in smartphonesand ubiquitous computing help CodeBlue or does it make it obsolete? Is current encryption technology adequate to secure the system?