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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Survivable and Scalable Wireless Solution for E-health and E- emergency Applications</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Abdellah Chehri</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Hussein. T. Moutah</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>School of Information Technology and Engineering</institution>
          ,
          <addr-line>800 King Edward Avenue Ottawa, Ontario</addr-line>
          ,
          <country country="CA">Canada</country>
          ,
          <addr-line>K1N 6N5</addr-line>
        </aff>
      </contrib-group>
      <fpage>25</fpage>
      <lpage>29</lpage>
      <abstract>
        <p>Most conventional medical systems use fixed wired LAN, cable, and other land line systems to transmit medical data or operations. As wireless technology becomes increasingly pervasive, e-health professionals are considering wireless networks for their mobile medicine systems with the advent of e-health care, a wide range of technologies can now be applied to provide medical care products and services. Wireless Sensor Networks (WSNs) are composed by small devices that possess the ability to measure and to exchange a variety of vital data. In this paper we evaluate the performance of wireless sensor network technology for patient's remote monitoring. The system is mainly composed of static biomedical sensor nodes, which are mounted on the patient body in under to collect the main vital data such as temperature, ECG etc. The main characteristic of the networks such as the throughput and ratio delivery packet have been evaluated in this paper.</p>
      </abstract>
      <kwd-group>
        <kwd>E-health application</kwd>
        <kwd>wireless body area sensor networks</kwd>
        <kwd>IEEE 208</kwd>
        <kwd>15</kwd>
        <kwd>4</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>
        As the population ages and the risk of chronic disease
increases, the cost of healthcare will rise. The solution to
decrease both the cost of healthcare services and also the
load of medical practitioners requires a dramatic change in
the way future healthcare services are provided [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. The
expected necessary changes are: moving from reactive to
preventive medicine [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ], [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ].
      </p>
      <p>
        By the summer of 2005, the initiative of marrying
information technology to medicine seemed clear, and the
media was heralding what some called “the e-health”
revolution [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ].
      </p>
      <p>Copyright © 2011 for the individual papers by the papers'
authors. Copying permitted only for private and academic
purposes. This volume is published and copyrighted by
the editors of EICS4Med 2011.</p>
      <p>The employment of new technologies for medical
healthcare could reduce the cost and improve the efficiency
of treatment.</p>
      <p>
        Wireless technology capabilities are growing at a fantastic
rate. There appears to be no limit to what technology might
accomplish, given infinite resources [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ].
      </p>
      <p>In this paper, we analyze a survivable and scalable wireless
solution for E-health and E-emergency applications. We
focus mainly of the performance of wireless body area
sensor networks for remote monitoring application.
Using this architecture, patients, doctors, and nurses could
be empowered to receive or provide real-time, distant
health care services. Both patients and providers would
have the freedom to be anywhere in the world while
sending, receiving, checking, and examining medical data
in a timely fashion.</p>
      <p>
        At the health institutions, patients are monitored during
treatment and recovery. This will be the monitoring of vital
body functions such as ECG and blood pressure. Compared
to wired solutions, the wireless transmission for monitoring
provides several advantages [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ].
      </p>
      <p>The patient mobility will be improved, and that it will
provide the opportunity for monitoring patients outside the
health institutions. Patients' well-being and retention of
health care has also influenced the recovery time. A
transition to wireless systems will therefore help to improve
patients' wellbeing and reduce recovery time.</p>
      <p>In addition, we describe a global mobile system to provide
unconfined e-health services, one that combines WLAN
(Wireless Local Area Network) with wireless body sensor
networks (WBANs), and the Internet or UMTS (Universal
Mobile Telecommunications System, or GSM).</p>
      <p>The reminder of the paper is organized as follows: section
II gives an overview of a scalable wireless solution for
ehealth and e-emergency applications. In section III deals
with system description. The performance evaluation of the
wireless body area sensor networks is given in section IV.
Finally, we conclude the paper in section V.</p>
      <p>
        SCALABLE WIRELESS SOLUTION FOR E-HEALTH AND
E-EMERGENCY APPLICATIONS
The recent advances in wireless technology have led to the
development of wireless body area sensor networks
(WBASN), where a set of communicating devices are
located around the human body [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ].
      </p>
      <p>
        The application and use of wireless devices and
computer-based technologies in health care have undergone
an evolutionary process. Advances in information,
telecommunication, and network technologies have led to
the emergence of a revolutionary new paradigm for health
care that some refer to as e-health [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ].
      </p>
      <p>These systems use modern wireless communication and
information technologies to provide clinical care to remote
located individuals. With more research progresses in this
field it will be possible to provide a better quality of life to
patients while reducing healthcare costs.</p>
      <p>
        Enabling underlying infrastructures such as wireless
medical sensor devices, wearable medical systems
integrating sensors on body's patient can offers pervasive
solutions for continuous health status monitoring through
biomedical, biochemical and physical measurements.
Remote monitoring systems typically collect these patient
readings and then transmit them to a remote server for
storage and later examination by healthcare professionals
[
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]-[
        <xref ref-type="bibr" rid="ref3">3</xref>
        ].
      </p>
      <p>Once available on the server, the readings can be used in
numerous ways by home health agencies, by clinicians, by
physicians, and by informal care providers. However
remote healthcare monitoring systems will be exploited to
their full potential when the analysis is also performed
automatically through clinical decision support systems fed
by expert knowledge.</p>
      <p>
        A clinical practice guide line constitutes the most suitable
source of information for building such clinical decision
support systems [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ].
      </p>
      <p>In this scalable wireless solution for E-health and
Eemergency applications, we select several wireless
communication standards with publicly available
specifications, which are namely Bluetooth
(IEEE802.15.1.), Wi-Fi (IEEE 802.11), WPAN (IEEE
802.15.4 / ZigBee) and wireless Mesh networks (IEEE
802.11s).</p>
      <p>While comparing all wireless technologies, we had to
choose relevant criteria for an evaluation. The main criteria
that should be considered in this architecture were
robustness, range, energy consumption, availability,
usability and security.</p>
      <p>
        This system interfaces to healthcare providers, doctors,
care-givers and the medical call centers (see Fig. 1) and
also is integrated with a mobile platform for the occupant to
remote control his home and another mobile platform for
the doctors and nurses to view the state of their patients.
Typically they will receive an alarm in case of a health
problem of their patients. This figure shows that the system
is integrated with vital sign monitoring devices and sensors.
WIRELESS BODY AREA SENSOR NETWORKS
In general, wireless body area sensor networks (WBASNs)
are wireless networks that support the use of biomedical
sensors and are characterized by its (1) very low transmit
power to coexist with other medical equipments and
provide efficient energy consumption, (2) high data rate to
allow applications with high QoS (Quality-of-Service)
constraints, (3) low cost, low complexity and miniature size
to allow real feasibility [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ].
      </p>
      <p>BSN, unlike wired monitoring systems, provide long term
and continuous monitoring of patients under their natural
physiological states even when they move. The system
allows unobtrusive ubiquitous monitoring and can generate
early warnings if received signals deviate from predefined
personalized ranges.</p>
      <p>
        The information is then received at a relay station and
passed on through a backbone network. In the end, the
information can be viewed at terminals or monitoring
stations that are connected to the network. This system has
the potential of making remote monitoring and immediate
diagnostics a reality [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ], [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ], [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ].
      </p>
      <p>
        Sensors are heterogeneous, and all integrate into the human
body. The number and the type of biosensors vary from one
patient to another depending on the state of the patient. The
most common types of biosensors are EEG
“Electroencephalography” to measure the electrical activity
produced by the brain, ECG “Electrocardiogram” to record
the electrical activity of the heart over time, EMG
“Electromyography” to evaluate physiologic properties of
muscles, Blood pressure, heart rate, glucose monitor, SpO2
“Oxymeter” to measure of oxygen saturation in blood, and
to measure temperature of the body [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ], [
        <xref ref-type="bibr" rid="ref14">14</xref>
        ].
      </p>
    </sec>
    <sec id="sec-2">
      <title>SIMULATION AND RESULTS</title>
      <p>We investigate on wireless body sensor network
architecture for smart healthcare that possesses the
following proprieties:</p>
      <p>
        Real-time and long-term remote monitoring;
Tiny sensor with very low complexity;
Can be integrated with existing medical practices
and technology;
To meet these requirements, we have planned scenario
where a patient has been equipped with an important
biosensors nodes. Ns2 simulator with WPAN models is
used [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ].
      </p>
      <p>We have considered a wide range of network topologies
and test-validated the performance of WBASN with all
considered topologies.</p>
      <p>Due to the posed space limitation, we present our results for
a static network. We set a 2 m x 2 m area to simulate
patient body. We consider a static network configuration
with six nodes and a gateway.</p>
      <p>These nodes are mounted around his body (Fig. 2). Each
node is implemented with one medical biosensor ECG,
SpO2, body temperature, glucose monitoring, respiration
and blood pressure.</p>
      <p>All sensors, including sink node (gateway) are considered
static (see fig 2). Transmit power of devices are configured
based on the realistic radio map of sensor node around
body network. In addition, the propagation model between
nodes which are different from general indoor/outdoor
models [16].</p>
      <p>In the simulations, we evaluate system’s the throughput,
and latency of WBASN architecture.
As shown in the Table 1, according to the characteristics of
physiological measurements or type of application services
which can be real-time or non real-time with high or low
rate.</p>
      <sec id="sec-2-1">
        <title>Type of Service Data rate Latency ECG</title>
        <p>EEG, EMG</p>
      </sec>
      <sec id="sec-2-2">
        <title>Blood pressure,</title>
        <p>body
temperature,
heart rate,
glucose
monitoring</p>
      </sec>
      <sec id="sec-2-3">
        <title>Medical image, X-ray, MRI High Low</title>
        <p>Low
Low
Low</p>
      </sec>
      <sec id="sec-2-4">
        <title>High</title>
        <p>Throughput Analysis and packet delivery ratio
In order to analyze the drawbacks of CSMA/CA, we
performed simulations of traditional IEEE 802.15.4
network. A beacon-enabled slotted CSMA/CA was chosen
where beacons are sent by the PAN Coordinator and all
nodes in the network synchronize with the beacon. A
single-hop Star topology was considered.</p>
        <p>The network performance was analyzed using two
transmission scenarios; first where a single node sends data
to the cluster head or PAN Coordinator, and, second, where
6 nodes send data to the PAN Coordinator. The traffic load
was varied from 10 to 500 kbps. The highest throughput
achieved when there is one source is around 160 kbps as
shown in Figure 4.
The packet delivery ratio also falls drastically with an
increase in data rate as shown in Figure 5.</p>
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      </sec>
    </sec>
    <sec id="sec-3">
      <title>CONCLUSION</title>
      <p>The overall goal of this paper was to contribute and help
through simulations towards dimensioning of the sensor
networks for patient’s remote monitoring. We examined the
reliability for both the point-to point communication and
multihop communication using IEEE 802.15.4 standard.
These performances are measured in term of throughput
and packet error rate. The first results show that it is
possible to use wireless body area sensor network to remote
the vital data of the patient with reasonable throughput. In
the future, more scenarios will be investigated.</p>
    </sec>
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