=Paper= {{Paper |id=Vol-1755/136-140 |storemode=property |title=Framework for a Cloud Based Health Monitoring System |pdfUrl=https://ceur-ws.org/Vol-1755/136-140.pdf |volume=Vol-1755 |authors=A. B. Adeyemo,W. O. Adesanya,O. Ariyo |dblpUrl=https://dblp.org/rec/conf/cori/AdeyemoAA16 }} ==Framework for a Cloud Based Health Monitoring System== https://ceur-ws.org/Vol-1755/136-140.pdf
  Framework for a Cloud Based Health Monitoring System
           A. B. Adeyemo                               W. O. Adesanya                                    O. Ariyo
    Computer Science Department                 Gneneral Studies Department                    Computer Science Department
     University of Ibadan, Nigeria            Federal College of Agriculture Akure                 University of Ibadan
     sesanadeyemo@gmail.com                                 Nigeria                                      Nigeria


ABSTRACT                                                               of eHealth are summarized in the resolutions of the 58th
Cloud computing is a new paradigm that has gained much                 World Health Assembly and these include [7]: The drawing
ground in the software industry and it provides applications,          up a long-term strategic plan for the various areas of the health
platforms and infrastructure over the internet. It has been            sector to help improve the development and implementation of
widely recognized as the next generation’s computing                   health administration, provision of appropriate legal
infrastructure and it offers several advantages to its users.          framework and infrastructure, and encouragement of
Electronic Health Record systems (EHR) are increasingly                public/private partnership; The development of ICT
being deployed within healthcare institutions to reduce the            infrastructure; building closer relationships with private/non-
problems and limitations of the paper-based approach but its           profit ICT organizations; Reaching out to communities and
deployment has been slow due to high investment and                    vulnerable groups and providing them with appropriate
maintenance cost. This study presents a framework for a Cloud          eHealth services; Mobilization of multi-sectoral collaboration
Based Health Monitoring System. The Cloud database acts as             for the determination of evidence-based eHealth standards in
the central data bank to which user’s medical data can be              order to share knowledge of cost-effective models, thereby
uploaded from both mobile device applications and web                  ensuring quality, safety and ethical standards, respect for the
browser devices and then downloaded for analysis by the                principles of confidentiality of information, privacy, equity
medical practitioner for user’s (patient) monitoring and               and equality; Establishment of national centers and networks
guidance. Prototype applications were developed and the                of excellence for best practice, policy coordination, technical
implications of the unconstrained adoption of eHealth                  support, service improvement, information to citizens,
application usage were examined.                                       capacity building and surveillance for health-care delivery;
                                                                       The establishment and implementation of national electronic
CCS Concepts                                                           public-health information systems; Improvement of the
                                                                       capacity for surveillance of and immediate response to disease
• Applied computing ➝ Life and medical sciences ➝ Health
care information systems • Software and its engineering ➝              outbreaks and public-health emergencies.
Distributed systems organizing principles ➝ Cloud computing            The implementation of eHealth systems promises to provide
                                                                       benefits to the patients, members of the public at large, care
Keywords                                                               providers and the health system [1] by: provision of improved
eHealth; cloud computing; mobile computing.                            health care outcomes for all concerned; Provision of support
                                                                       for improved public health protection through easy and readily
                                                                       available self-care, access to patient information wherever the
1. INTRODUCTION                                                        patient may be, which ensures reduced risk of duplicated
The term eHealth has been describe by various authours and             laboratory test and medical conflicts. Other benefits include
international organizations such as the British Columbia               easier access to clinical information, ease of sharing of
eHealth Steering Committee [1] and World Health                        information which provides improved care coordination across
Organization [7] as the application of Information and                 care provides which results in a better cost effective and
Communication Technology (ICT) for the efficient storage               sustainable health care system.
and management of health information for effective provision           Cloud computing is an Internet-based computing model that
of health services. The term eHealth or (e-Health) was said to         provides shared computer processing resources and data to
have carried over to the health sector by marketers and                computers and other devices on demand. It is a framework for
practitioners in the industry rather than academics who saw it         enabling ubiquitous, on-demand access to a shared pool of
as a means of introducing the e-buzzword (such as e-business           configurable computing resources such as computer networks,
and e-commerce ) to health related issues [3]. The broad goals         servers, storage, applications and services which can be
                                                                       rapidly provisioned and released with minimal management
                                                                       effort or service provider interaction [5]. Cloud computing and
                                                                       cloud storage solutions provide users and business enterprises
                                                                       with various capabilities to store and process their data in
CoRI’16, Sept 7–9, 2016, Ibadan, Nigeria.
                                                                       third-party data centers which could be located far from the
                                                                       user.




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The Cloud computing architecture consists of front-end
platforms called clients which could be servers, (fat, thick,
thin, or zero) clients, tablets and mobile devices. The client
platform interacts with the cloud data store through an
application middleware, web browser, or virtual session. The
three main categories of cloud computing are: private clouds,
public clouds and hybrid clouds. Private clouds are used
exclusively by a single organization comprising multiple
consumers. Public clouds are open access clouds that the
general public can access. Hybrid clouds are infrastructures
that combine two or more cloud deployment models (e.g.
private and public). Some studies that have addressed the
problems and implementation techniques for cloud based
systems include: Rolim et al [8] and Saif et al [9].
According to the mobile cloud computing forum, mobile cloud
computing can be described as an infrastructure where both
the data storage and data processing happen outside of the
mobile device [2]. That is a combination of mobile web and
Cloud computing. Mobile devices have nowadays become one
of the most common means by which users can access
applications and services on the Internet. With mobile cloud
computing users with mobile devices do not need a powerful
configuration in terms of CPU speed and memory capacity
because all the complicated computing modules can be
processed in the cloud. Advantages of mobile cloud computing                  Figure 1: Mobile cloud computing architecture [2]
for the mobile device user includes: Extending battery
lifetime, provision of access to processing capabilities beyond
what obtains with a mobile device, improving data storage               2. MATERIALS AND METHODS
capacity, reduction in the cost of computing computer                   The proposed system architecture presents a conceptual
intensive applications, improvement in reliability etc. Mobile          scenario where a user can upload health information at home
cloud computing when applied to mobile healthcare systems               to a cloud based storage facility which can be accessed
helps overcome the limitations of traditional medical services.         remotely by doctors or medical practitioners for the purpose of
It provides users with convenient means to access resources             monitoring and giving of timely medical advice which might
like patient health records and a variety of on-demand services         be needed by the user. Information that the cloud based health
in the cloud rather than having standalone applications on              monitoring system should be able to collect includes data for
local servers. Some of the services mobile cloud computing              medical conditions such as diabetes, hypertension,
can offer in mobile healthcare systems include:                         cardiovascular problems and even common ailments such as
Comprehensive health monitoring services, intelligent                   feverish conditions for which there are household medical test
emergency management systems, health-aware mobile devices               equipment’s that can be used to carry out these tests. In
which can detect pulse rate, blood pressure etc, access to              addition to these data on exercise and dietary programs can
healthcare information etc [2].                                         also be collected at home and uploaded to the cloud based
In this study a framework for a cloud based eHealth software            storage facility. Processing of the data will be carried out using
application that can be used by users at home to upload                 cloud based software applications and results which can also
medical test data obtained from medical test equipment’s to a           be downloaded in real time can be used for monitoring the
cloud storage infrastructure that can be accessed anywhere by           health status of the patient or even automatically give
medical doctors and other authorized health practitioners for           warnings when an anomaly occurs.
effective monitoring of users health status is proposed.




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The components of the framework are:                                       about security issue because it is ensured by the security
                                                                           vendor.
Mobile or web based users (patients) who can carry out basic
health test such as urine analysis, blood pressure test, diabetes          3. IMPLEMENTATION TECHNIQUES
test, calories tracking etc. at home and enter the data into a
mobile application running on an android operating system or               Prototype front end applications for the system were implemented
a web based software application (web site) hosted on a cloud              for either android or Windows based device which would be
                                                                           hosted on a cloud platform. Figure 3 presents the screenshot of the
platform.
                                                                           mobile application version being used by a doctor displaying user
Alternatively the data can be collected at patient’s bedside in a          data that can be accessed by the doctor monitoring them in real
health facility by anyone authorized to do it (such as health              time, while figure 4 shows the web browser based version. A
practitioner, system administrator etc) and uploaded into the              home user will record his test records and input the data to the
cloud based database through either a mobile or web based                  cloud database using either a mobile device app or desktop
interface.                                                                 computing device. When the doctor wants to get the access to
The medical doctor (or medical practitioner) who can access                the health record, he has to be authenticated that he has the
the uploaded data, analyze it and generate reports that can be             right to access the records. The doctor downloads the health
                                                                           record, analyses it and can send back a medical advice to the user
used for monitoring the health status of the user.
                                                                           in real time. Based on this, the system can be used to formulate a
                                                                           health management scheme according to the user’s health status
                                                                           including daily/weekly/monthly meal and exercise plans.
Figure 2 presents the USE CASE diagram of the Cloud Based
Health Monitoring System. The backend database application
will be hosted on a cloud platform e.g. Windows Azure Cloud,
Amazon Web Services or Google cloud. Some of the relations                 4. IMPLICATIONS OF THE
in the database include:                                                   UNCONSTRAINED ADOPTION OF
    1.  Administrator ID: unique identifier for system                     eHEALTH APPLICATIONS
        administrator(s).
                                                                           The use of ICT in healthcare raises a number of challenges
    2. Administrator username: contains information about
                                                                           related to unconstrained adoption of eHealth applications.
        administrator username.
                                                                           Some of these have been categorized as being legal, ethical or
    3. Administrator password: contains information about
                                                                           governance issues. Legal issues include the need for the
        administrator password.
                                                                           provision for adequate legislative framework which provides
    4. Doctor ID: unique identifier for all doctors.
                                                                           legal clarity in terms of products and services that relate to
    5. Doctor username: contains information about doctor
                                                                           eHealth in Nigeria. Those things to be addressed include:
        username.
                                                                           understanding the privacy and protection of personal health
    6. Doctor password: contains information about doctor
                                                                           data such as electronic health records, telemedicine,
        password.
                                                                           pharmaceutical sales over the Internet, and the liability of
    7. Doctor report: contains information on current report
                                                                           health professionals [10]. Ethical issues should address the fact
        on user by the Doctor.
                                                                           that members of the public are increasingly using the Internet
    8. User ID: unique identifier for all users registered in
                                                                           for information on health issues, and sharing information
        the database.
                                                                           through the social network facilities offered by the web [10].
    9. User name: contains information about user name,
                                                                           This has raised information integrity and authority of
        first name and last name.
                                                                           information issues. eHealth governance issues such as the
    10. User gender: contains information about user gender
                                                                           alignment between business and IT governance and how these
        i.e whether male or female.
                                                                           can be harmonized to to achieve a positive effect on healthcare
    11. User age: contains information about user date of
                                                                           performance also have to be addressed [10]. In order to
        birth
                                                                           address these issues there is therefore the need for Nigeria to
    12. User photo: contains the users photograph.
                                                                           have an effective eHealth strategy in place. According to
    13. User address: contains information about the users
                                                                           Naphtal [6] “Nigeria’s slumber in embracing eHealth to
        contact address
                                                                           address the challenges in its healthcare system has cost the
    14. User phone numbers: contain information about
                                                                           country more than N81 billion annually to medical tourism,
        users phone numbers
                                                                           the gainers being India, South Africa, Dubai and some
    15. User primary health facility: contains information
                                                                           European countries where highly developed healthcare system
        about users hospital or medical facility where user
                                                                           integrated with ICT has helped to provide succor for many”.
        normally uses.
                                                                           Nigeria obviously stands to gain from the adoption of eHealth
    16. Consultation date: contains information about date
                                                                           practices considering the statistics attributed to medical
        data is being uploaded.
                                                                           practitioners in the country which shows that the Nigerian
The application will also include relational database tables for           public is grossly underserved health-wise. It is worthy of note
medical test results such as: urine test data, diabetes test data,         that among the developing countries Philippines [7] and South
blood pressure test data, body temperature, heartbeat rate etc.            Africa [4] have been able to develop eHealth
The application will use security as a service on the cloud to             strategies/policies alongside many notable developed
protect mobile applications. The users will not have to worry              countries, while Nigeria is still lagging behind. Evidently

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Nigeria stands to gain a lot from adopting eHealth practices.
However without the necessary regulatory structures being put
in place the whole process is subject to abuse.




                                                                       Figure 4: Screenshot showing user data that can be accessed
                                                                      by doctor monitoring them in real time using web application
                                                                                        hosted on cloud platform


                                                                      With the advent of the Internet cross boarder or Inter-country
                                                                      consultations for health problems, diagnosis and drug
                                                                      administration are taking place and cannot be controlled.
                                                                      Furthermore when eHealth applications are developed and used
                                                                      without the necessary regulatory structures in place, who bears
                                                                      responsibility for any adverse issues arising from drug
                                                                      maladministration or uploading of wrong content in these
                                                                      applications or web sites? All these underscore the urgent need for
                                                                      the Nigerian government to join hands with the stakeholders and
                                                                      ensure that Nigeria has a viable eHealth strategy/policy in place.

                                                                      5. CONCLUSION
                                                                      In this study, a framework for a cloud-based health monitoring
                                                                      system has been proposed. This framework provides a method for
  Figure 2: USE CASE diagram of the Cloud Based Health                monitoring user’s health status in real time by medical
                  Monitoring System                                   practitioner’s irrespective of the location of both the user and the
                                                                      doctor. The medical practitioner who is authorized to view patient
                                                                      data can have access to the data at any time it’s required. Users
                                                                      can also upload results of tests carried out in-house without
                                                                      having to make frequent visits to the health institution for analyses
                                                                      and diagnosis.

                                                                      6. REFERENCES
                                                                      [1]. British Columbia eHealth Steering Committee, (2005),
                                                                          eHealth Strategic Framework for British Columbia, November
                                                                          2005, ISBN 0-7726-5437-9
                                                                      [2]. Dinh, H. T., Lee, C., Niyato, D. and Wang, P. (2013), A
                                                                          survey of mobile cloud computing: architecture, applications,
                                                                          and approaches. Wirel. Commun. Mob. Comput., 13: 1587–
                                                                          1611. doi: 10.1002/wcm.1
                                                                      [3]. Eysenbach G., 2001, What is eHealth?, JMIR Publications,
                                                                          Journal of Medical Internet Research, Vol 3, No 2
                                                                      [4]. Foster R., The development of the South African eHealth
                                                                           Strategy assessed against the recommendations of the
                                                                           WHO/ITU eHealth Strategy Toolkit (undated)
 Figure 3: Screenshot showing user data that can be accessed by
  doctor monitoring them in real time using mobile device app.

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[5]. Hassan Q., 2011, Demystifying Cloud Computing, The                     Solution for Patient’s Data Collection in Health Care
     Journal     of     Defense      Software Engineering.                  Institutions”, Second International Conference on eHealth,
     CrossTalk.2011 (Jan/Feb): pp 16–21.                                    Telemedicine, and Social Medicine, pp. 95 – 99.
[6]. Naphtal A, (2014), Nigeria Must Use ICT to Drive National           [9]. Saif, S., Wani, S., Khan, S., 2010, “A Network Engineering
    eHealth       Policy      Strategy,      Retrieved     from:             Solution for Data Sharing Across Healthcare Providers and
    http://mobileworldmag.com/nigeria-must-use-ict-to-drive-                 Protecting Patients Health Data Privacy Using EHR System”
    national-eHealth-policy-strategy/ (13 April 2015)                        Journal of Global Research in Computer Science, Vol 2, No 8.
[7]. Philippines eHealth Strategic Framework and Plan 2013-              [10]. Whitehouse D., George C., Duquenoy P., 2011, eHealth:
    2017, 2013, Department of Health, Department of Science                   Legal, Ethical, and Governance Challenges: An Overview,
    and Technology, Philippines, September 11, 2013.                          In: Med-e-Tel 2011, 6 - 8 April, Luxembourg, Available
                                                                              from Middlesex University's Research at
[8]. Rolim, C.O, Koch, F.L., Westphall, C.B., Werner, J.,                     http://eprints.mdx.ac.uk/7728/
    Fracalossi, A., Salvador G.S, 2010, ”A Cloud Computing




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