I. a limited area. [8] Typical m-Health applications


today’s scenario, a patient has to carry all his medical reports to doctors
unknowing of the doctor’s specialization fields. This may lead to wrong
treatments. This may also be caused due to uncertified doctors. Necessity of
relationship between patient and health care professionals (doctor or nurse)
and Doctors can’t be in the room with each patient all time even in fully
staffed hospital. Modern technologies have enabled the calculating electrical
activity of the heart, respiration rate, blood pressure, body temperature etc.

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is an emerging field in the intersection of medical informatics, public health
and business, referring to health services and information delivered or
enhanced through the Internet and related technologies. In a broader sense, the
term characterizes not only a

development, but also a state-of-mind, a way of thinking, an attitude, and a
commitment for networked, global thinking, to improve health care locally,
regionally, and worldwide by using information and communication technology.”7


the definitions stated on e-health, it includes aspects of telemedicine and not
actually involve remoteness. In an article ‘E-health prospects’, Joseph Tan
expresses that because of transition and transformation of traditional ICT
applications to wireless platform resulted in emergence of Mobile Health
(m-health) and is considered natural development.6


M-health is the application of
mobile computing, wireless communications and network technologies to deliver or
enhance diverse healthcare services and functions in which the patient has a
freedom to be mobile, perhaps within a limited area. 8 Typical
m-Health applications are automated patient alerts, e-prescriptions and mobile
patient monitoring and tracking.5


patient monitoring is the continuous or periodic measurement and analysis of a
mobile patient’s biosignals from a distance by employing mobile computing,
wireless communications and networking technologies.4




very large number of Mobile patient monitoring system has been proposed. From
those proposals, few systems’ architecture is explained on the basis of
technologies used such as wireless communication technologies, practical
trials, incorporating modern wearable technologies. Based on selected
conditions proposed project works are

Health Monitoring (PHM) system developed by

the University
of Technology Sydney2

patient monitoring system developed as a part

of the
MobiHealth project (supported by Commission of

the European
Union in the frame of the 5th research Framework

under project
number IST-2001-36006) and subsequent projects

Mobile Application such as Vivify, Independa caregiver etc


Health Monitoring System (PHM)

Personal Health Monitor (PHM) system 2 is designed for patients who have a suspected cardiovascular
disease and need to be monitored around the clock. The PHM system proposes use
of off-the-shelf sensor systems which incorporate a built-in sensor

front end. This approach allows a PHM system user to use their own
mobile phone running Microsoft Windows and to buy or rent the required sensors.
The patient downloads the PHM application onto the mobile phone and uses it
like any other mobile application.


 The architecture of PHM
system is shown in Fig. 6. Table 4 describes the PHM system according to our comparison framework. According
to the article 21 the PHM trial demonstrated that

the system is easy to use and, in the majority of cases,
biosignals received by the cardiologists were of sufficient quality to make a proper
assessment. Another feature of the PHM system is that the healthcare
professional can select one or more sensors to be used for a particular patient
for providing personalized monitoring and treatment. The PHM trials highlighted
the need for personalized feedback. Findings were, for example, that some

did not like to interact much with the application as they found
it stressful. Some elderly patients living alone reported that they would have
liked to have audio reminders and


warnings. Further feasibility study of the use of PHM system for a
noninvasive Cardiac Rhythm Management (CRM) System is reported in 26.
Accordingly, to date, this system has been applied on 70 low risk heart
patients and the preliminary results show the commercial potential of this
system for identifying and diagnosing arrhythmia abnormalities. The results of
this study 26 are used to identify potential applications of the PHM system in
the following areas: cardiac rehabilitation, community healthcare, monitoring
of lifestyle changes and athletic performance.




MH Mobile Patient Monitoring System

The main motivation behind the development of the MobiHealth (MH)
system, first developed during the MobiHealth project, was that of providing
ubiquitous medical care by means of mobile monitoring using Body Area Networks
and wireless technology. MobiHealth was the first project to apply Body Area
Network Technology for patient monitoring applications, hence was the
originator of the concept of Health BAN 1,17,18.
The system was further developed in various European and Dutch projects 27,28.

Instead of focusing on patients with one particular health
condition, MH focused on developing a generic BAN which can be specialized for
any particular type of telemonitoring or teletreatment application by
integrating a specific set of sensors and other devices

together with the appropriate application functionality. During the
MobiHealth project the generic BAN was specialized for different conditions
including high-risk pregnancies, trauma, cardio-vascular disease and COPD 29.
The original MH BAN was implemented using both wired (front-end supported)
sensors from TMSI and wireless (self-supporting) sensors from EISlab 30. In
both cases Bluetooth was used for intra-BAN communication 18. The
architecture of the MH system is shown in Fig. 9. Table
7 shows the features of the MH system according to the comparison framework.
The MobiHealth project trials reported positive experience working with the
healthcare organizations and clinicians. However, in the initial version of MH
system, technical failures (such as system instability), sub-optimal interface
design and a difficult (re)start sequence caused irritation and confusion to
users. Preliminary trials showed the feasibility of using the system, however a
number of problems were encountered. For example, ambulatory patient monitoring
was more successful for some biosignals than others, because in some cases
measurements were severely disrupted by movement artefacts 17.
The limited bandwidth provided by 2.5G wireless wide area network (WWAN)
technologies (GPRS) was not sufficient for the applications which required
monitoring many simultaneous signals per user. Where 3G (UMTS) was available
the MobiHealth trials did not suffer from this restriction. A later project,
AWARENESS 31, implemented an epilepsy seizure detection application where,
when available bandwidth is low, an analysis algorithm runs locally on the BAN
and only alarms are sent to the health professional. However, if sufficient
bandwidth is available, the biosignals are transmitted to

the back-end for processing by a more sophisticated detection
algorithm 28. Results from the Myotel project 32 indicated
that continuous local biofeedback
enabled chronic pain patients to adapt their behaviour rapidly and results in
long lasting treatment effects. Adding a teletreatment dimension with feedback
from the remote therapist was shown to further improve clinical outcomes
related to pain and disability



Cloud-Based Mobile Application (Vivify)

 provides cloud-based applications that
patients can usd from home to access their care plan and keep track of their
vital signs. The data is transmitted to physicians, who can access it on mobile
devices, computers and Internet-connected television. The software includes
medical coaching, customized care plans, video conferencing with physicians and
educational videos. The platform is interoperable with EMRs, PHRs and HIEs. The
challenge Vivify and providers will have with many of these patient-data tools
is getting people to use them consistently.9




This project comes up with idea of smart virtual hospital
system. This includes creating unique accounts for individuals and doctors,
wherein each individual’s medical reports are uploaded which are accessible by
the individual and doctor. This system connects with a fit bit in individual
wrist. Through the accessible data personal doctors can frequently monitor
pulse rate and condition of the patient. If patient undergoes any physical
checkups, the files obtained are uploaded to individual’s account. This allows
notifying patients on regular checkups. In case of emergencies (such as
fainting and reduction in pulse rate before reaching critical level, personal
doctor, nearby general doctor and three other caretakers (or Guardians) of the
individual are made an immediate alert message stating condition and location
(latitude and longitude) of the patient. Any of the people notified (especially
nearby General Doctor) sends ambulance to the location concerned. This project
also deals with the exception of doctor being an individual (patient). Signup
page request for Aadhar number which allows the account linked with Aadhar card
and Doctor’s Certification which include doctor’s official id (if any).This
makes people to make trustworthy connection with Certified Doctors. This aids
patients with serious disorders with recommendations of Best Doctors across
nation. Future updations may include Hospital authority to create a local group
of doctors of unique specialization fields.


1  Images from shutterstock images

2 Gay
V, Leijdekkers P. A health monitoring system using smart phones and wearable
sensors. IJARM 2007;8(2):29–36


Jones V, Gay V, Leijdekkers P. Body sensor networks for mobile health monitoring:
experience in Europe and Australia. In: The fourth international conference on
digital society, ICDS 2010, February 10–16, 2010, Netherlands Antilles; 2010


4  Pravin Pawar , Val Jones, Bert-Jan F. van Beijnum, Hermie
Hermens . A framework for comparison of mobile patient monitoring
systems : Journal of Biomedical Informatics 45 (2012) 544–556

Tan J, editor. E-Healthcare information systems: an introduction for students and
professionals. Jossey-Boss; 2005. ISBN 13 978-0-7879-6618-8


6  Tan J. E-health prospects: mobile health,
virtual reality and consumer driven ehealth systems. In: E-healthcare
information systems: an introduction for students and professionals.
Jossey-Boss; 2005. p. 523–53. ISBN 13 978-0-7879-6618-8.


7  Eysenbach G. What is e-health? J Med Internet
Res 2001;3(2) June 18.


Istepanian RSH, Pattichis CS, Laxminarayan S. Ubiquitous M-health systems and
the covergence towards 4G mobile technologies. In: M-health: emerging mobile
health systems. Springer; December 2005. p. 3–14




10 https://www.vivifyhealth.com/