Saleem Bhatti, Computer Science, University of St Andrews, UK.  


World healthcare costs will continue to increase as the world's population grows, and the life-expectancy of individuals increases. If future health systems can allow remote monitoring by end-users so that personal medical bio-readings (such as heart rate) can be sent as required by end-users, then there are a number of possible benefits.

  • Timeliness of information. Information about those users can be can be made available as needed, on demand, to give up-to-date information for a given context. This could be useful for both diagnosis and treatment.
  • Better quality treatment. If routine measurement tasks (such as heart rate, blood pressure, etc.) can be gathered without the need for a medical professional, the time saved can be use to provide medical care, improving the quality of medical treatment overall.
  • Improved experience for patients. Patients do not have to spend time going to clinics for routine monitoring and measurement of bio-readings. They can also take measurements when they want to help diagnosis or treatment. Patients can also then involve informal caregivers (e.g. family members, friends, and volunteers) as well as medical professionals, in the care of their health -- the carer network.

This work is focussed on enabling self-remote monitoring of users. The aim to have open source systems using, as much as possible, existing systems, so that systems are easily deployable and upgradeable, as well as being affordable.

Self-measurement for end-users

A key enabler for scalable remote health deployment will be allowing users (patients) to be able to make and control their own, personal bio-measurements.

C. Khorakhun, S. N. Bhatti. mHealth through quantified-self: a user study. HealthCom 2015 - 17th IEEE Intl. Conf. e-Health Networking, Applications and Services. Boston, MA, USA. Oct 2015.
| PDF | .bib | 10.1109/HealthCom.2015.7454520 | abstract We describe a user study of a mHealth prototype system based on a wellbeing scenario, exploiting the quantified-self approach to measurement and monitoring. We have used off-the-shelf equipment, with opensource, web-based, software, and exploiting the increasing popularity of smartphones and self- measurement devices in a user study. We emulate a mHealth scenario as a pre-clinical experiment, as a realistic alternative to a clinical scenario, with reduced risk to sensitive patient medical data. We discuss the efficacy of this approach for future mHealth systems for remote monitoring. Our system used the popular Fitbit device for monitoring personal wellbeing data, the Diaspora online social media platform (OSMP), and a simple Android/iOS remote notification application. We implemented remote monitoring, asynchronous user interaction, multiple actors, and user-controlled security and privacy mechanisms. We propose that the use of a quantified-self approach to mHealth is particularly valuable to undertake research and systems development.
C. Khorakhun, S. N. Bhatti. Wellbeing as a proxy for a mHealth study. QSPH 2014 - IEEE Wkshp. The Role of Quantified Self for Personal Healthcare. Belfast, UK. Nov 2014.
| PDF | .bib | 10.1109/BIBM.2014.6999286 | abstract The quantified-self is a key enabler for mHealth. We propose that a wellbeing remote monitoring scenario can act as a suitable proxy for mHealth monitoring by the use of an online social network (OSN). We justify our position by discussing the parallelism in the scenario between purpose-driven wellbeing and mHealth scenarios. The similarity between these two scenarios in terms of privacy and data sharing is discussed. By using such a proxy, some of the legal and ethical complexity can be removed from experimentation on new technologies and systems for mHealth. This enables technology researchers to carry out investigation and focus on testing new technologies, system interactions as well as security and privacy in healthcare in pre- clinical experiments, without loss of context. The analogy between two purpose-driven scenarios, i.e. fitness monitoring in wellbeing scenario and remote monitoring in mHealth, is discussed in terms of a practical example: we present a prototype using a wellbeing device -- Fitbit -- and an open source online social media platform (OSMP) -- Diaspora.
D. Rehunathan, S. N. Bhatti, O. Chandran, P. Hui. vNurse: Using virtualisation on mobile phones for remote health monitoring. HealthCom 2011 - IEEE Intl. Conf. e-Health Networking Applications and Services. Columbia, MO, USA. Jun 2011.
| PDF | .bib | 10.1109/HEALTH.2011.6026792 | abstract We present vNurse, a system based on a smartphone platform that permits comprehensive, secure and modular patient remote monitoring outside a clinical environment, e.g. in the home. Using both virtualisation of the phone OS and virtual mobile networks of sensors with full Internet Protocol (IP) connectivity, we enable real- time remote sensor readings of patient Wireless Body Area Networks (WBANs) to be stored, processed and forwarded securely to healthcare practitioners based at clinical sites, while patients are remote or mobile.
D. Rehunathan, S. Bhatti. Application of Virtual Mobile Networking to Real-Time Patient Monitoring. ATNAC 2010 - Australasian Telecommunication Networks and Applications Conf.. Auckland, New Zealand. Nov 2010.
| PDF | .bib | 10.1109/ATNAC.2010.5679557 | abstract We aim to merge the benefits of network mobility and virtualisation to provide a simple, mobile and secure method for providing mobile network (as opposed to mobile host) platforms. We demonstrate our approach by showing the use of a mobile network of sensors and wide area connectivity for maintaining and managing a Wireless Body Area Networks (WBAN) for healthcare. WBANs are a mature field of research, where the challenges and applications have been explored for quite some time. One of the most promising applications for WBANs is healthcare. Wireless sensors are used to monitor patient health statistics and activity. With the ubiquity of wireless mobile personal devices (such as smart phones), their increased CPU and power capability, the feasibility of using them to build mobile network platforms is increasingly possible. In this paper we describe our novel approach, which is to utilise, through virtualisation, an individual's smartphone not only as a mobile router that manages his personal mobile network, but also as a platform to host his WBAN.

Enabling the carer network

Future health-care is likley to be more particpative of the the patients and informal caregivers, especially when dealing with chronic conditions. A carer-network that involves the patient and informal caregivers, as well as medical professionals provides a possible path for such an interaction.

C. Khorakhun, S. N. Bhatti. Remote Health Monitoring Using Online Social Media. EAI Endorsed Transactions on Ubiquitous Environments, vol. 14, no. 3. Nov 2014.
| PDF | .bib | 10.4108/ue.1.3.e2 | abstract Remote monitoring is an essential part of future mHealth systems for the delivery of personal and pervasive healthcare, especially to allow the collection of personal bio-data outside clinical environments. Yet, by its very nature, it presents considerable challenges: it will be a highly distributed task, requiring collection of bio-data for a myriad of cources, to be marshalled at the clinical site via secure communication channels. To address these challenges, we propose the use of an online social media platform (OSMP) as a key component of a near-future remote health monitoring system. By exploiting existing infrastructure, initial costs can be reduced, at the same time as allowing fast and flexible application development. An OSMP would have user benefits also: patients and healthcare professionals can be presented with familiar interfaces, while application developers can work with a set of technologies that are widely used and well-known. Internet-based access also helps to provide wide-ranging connectivity for mobile applications. Additionally, the use of a social media context allows existing social interactions within the healthcare regime to be modelled within a *carer network*, working in harmony with, and providing support for, existing relationships and interactions between patients and healthcare professionals. We focus on the use of an OSMP to enable two primitive functions which we consider essential for mHealth, and on which larger personal healthcare services could be built: *remote health monitoring* of personal bio-data, and an *alert system* for asynchronous notifications. We analyse the general requirements in a carer network for these two primitive functions, in terms of four different viewpoints within the carer network: the *patient*, the *doctor* in charge, a professional *carer*, and a *family* member (or friend) of the patient. We discuss the suitability of OSMPs in terms of functionality, performance, security & privacy, as well as the potential for cost reduction.
C. Khorakhun, S. N. Bhatti. Using Online Social Media Platforms for Ubiquitous, Personal Health Monitoring. HealthCom 2014 - 16th IEEE Intl. Conf. e-Health Networking, Applications and Services. Natal, BR. Oct 2014.
| PDF | .bib | 10.1109/HealthCom.2014.7001856 | abstract We propose the use of an open and publicly accessible online social media platform (OSMP) as a key component for ubiquitous and personal remote health monitoring. Remote monitoring is an essential part of future mHealth systems for the delivery of personal healthcare allowing the collection of personal bio-data outside clinical environments. Previous mHealth projects focused on building private and custom platforms using closed architectures, which have a high cost for implementation, take a long time to develop, and may provide limited access and usability. By exploiting existing and publicly accessible infrastructure using an OSMP, initial costs can be reduced, at the same time as allowing fast and flexible application development at scale, whilst presenting users with interfaces and interactions that they are familiar with. We survey and discuss suitability of OSMPs in terms of functionality, performance and the key challenge in ensuring appropriate levels of security and privacy.
C. Khorakhun, S. N. Bhatti. Alerts for Remote Health Monitoring Using Online Social Media Platforms. HealthCom 2013 - 15th IEEE Intl. Conf. e-Health Networking, Applications and Services. Lisbon, PT. Oct 2013.
| PDF | .bib | 10.1109/HealthCom.2013.6720662 | abstract Alerts are an essential part of future remote health monitoring. We assess the feasibility of leveraging online social media for such capability to enable the delivery of healthcare outside clinical sites. We have implemented alerts triggered by bio-data and to act as notifications of management-related actions in relation to the operation of an example heart-monitoring application. We have examined the suitability of online social media platforms using Facebook and Twitter as example platforms. A Facebook application was developed to deliver configurable alerts to four different actor viewpoints in a *carer network*; the patient; the doctor in charge; the professional carer; and a family member of the patient. The suitability of the application was analysed as well as an initial examination of the reliability of alert delivery. We conclude that online social media systems could offer suitable platforms for alerts in remote health monitoring.
C. Khorakhun, S. N. Bhatti. Remote Health Monitoring Using Online Social Media Systems. WMNC 2013 - IFIP/IEEE Joint Wireless and Mobile Networking Conference. Dubai, UAE. Apr 2013.
| PDF | .bib | 10.1109/WMNC.2013.6548953 | abstract Remote monitoring is considered an essential part of future eHealth systems to enable the delivery of healthcare outside clinical sites at reduced cost, while improving quality of patient care. We examine the use of online social networks for remote health monitoring. By exploiting the existing infrastructure, initial costs can be reduced and fast application development is possible. Facebook is used as an example platform: as a platform allowing user-defined applications, development is flexible and can be arranged quickly to suit different requirements of patients and health professionals. We analyse the general requirements of a remote monitoring scenario and the process of building and using a Facebook application to meet these requirements. Four different access viewpoints are implemented to suit the requirements of each user in our example scenario to form a carer network: the patient, the doctor in charge, professional carers, and family members of the patient. The suitability of the application is analysed including security and privacy issues. We conclude that online social media systems could offer a suitable platform for developing certain types of remote monitoring capability.