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Using Heterogeneous Wireless Sensor Networks in a Telemonitoring System for Healthcare 1
Chapter 1
Introduction
People are currently surrounded by technology, which tries to increase their uality of life
and facilitate the daily acti!ities" #n addition, the continuous ad!ancement in mobile
computing makes it possible to obtain information about the conte$t and also to react
physically to it, in more inno!ati!e ways" Howe!er, there are situations, where technology is
difficult to be handled or people ha!e lack of knowledge to use it" %or these reasons, ambient
intelligence &'m#( tries to adapt the technology to the people)s needs by proposing three
basic concepts* ubiuitous computing, ubiuitous communication, and intelligent user
interfaces" #n order to reach this ob+ecti!e, it is necessary to de!elop new frameworks and
models to allow access to functionalities, regardless of time and location restrictions"
This report describes a telemonitoring system aimed at impro!ing healthcare and
assistance to dependent people at their homes" This system makes use of the Services laYers
over Light PHysical devices &S-PH( platform" S-PH is based on a ser!ice.oriented
architecture &S/'( model for integrating heterogeneous wireless sensors networks &WSNs(
into 'm# systems" S-PH focuses on distributing the systems) functionalities into
independent functionalities &i"e", ser!ices(" This model pro!ides a fle$ible distribution of
resources and facilitates the inclusion of new functionalities in highly dynamic en!ironments"
1.1 Ambient Intelligence:
#n computing, ambient intelligence &AmI( refers to electronic en!ironments that are
sensiti!e and responsi!e to the presence of people" 'mbient intelligence is a !ision on the
future of consumer electronics, telecommunications and computing that was originallyde!eloped in the late 100s for the time frame 21322" #n an ambient intelligence world,
de!ices work in concert to support people in carrying out their e!eryday life acti!ities, tasks
and rituals in easy, natural way using information and intelligence that is hidden in the
network connecting these de!ices" 's these de!ices grow smaller, more connected and more
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integrated into our en!ironment, the technology disappears into our surroundings until only
the user interface remains percei!able by users"
1.2 Service Oriented Architecture*
#n software engineering, a service-oriented architecture &SOA( is a style of software
architecture for designing and de!eloping software in the form of interoperable ser!ices"
These ser!ices ha!e well.defined business functionalities that are built as software
components &discrete pieces of code and8or data structures( which can be reused for
different purposes" S/' design principles are used during the phases of systems
de!elopment and integration"
S/' generally pro!ides a way for consumers of ser!ices, such as web.based
applications, to be aware of a!ailable S/'.based ser!ices" %or e$ample, se!eral disparate
departments within a company may de!elop and deploy S/' ser!ices in different
implementation languages9 their respecti!e clients will benefit from a well.defined interface
to access them" :;- is often used for interfacing with S/' ser!ices"
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Chapter 2
"istor$
5$cessi!e centrali>ation of ser!ices negati!ely affects the systems) functionalities,
o!ercharging, or limiting their capabilities" 4lassical functional architectures are
characteri>ed by trying to find modularity and a structure oriented to the system itself"
;odern functional architectures like S/', consider integration and performance aspects that
must be taken into account when functionalities are created outside the system" 'n S/'.
based system is a network of independent ser!ices, machines, the people who operate, affect,
use, and go!ern those ser!ices, as well as the suppliers of euipment and personnel to these
people and ser!ices" The term ser!ice can be defined as a mechanism that facilitates the
access to one or more functionalities &e"g", functions, network capabilities, etc"("
The S/' model is aimed at the interoperability between different systems,
distribution of resources, and the lack of dependency of programming languages" Ser!ices
are linked by means of standard communication protocols that must be used by applications
in order to share resources in the ser!ices network" The compatibility and management of
messages that the ser!ices generate to pro!ide their functionalities is an important and
comple$ element in any of these approaches" ' distributed architecture pro!ides more
fle$ible ways to mo!e functions to where actions are needed, thus obtaining better responses
at e$ecution time, autonomy, ser!ices continuity, and superior le!els of fle$ibility and
scalability than centrali>ed architectures" Unfortunately, the difficulty in de!eloping a
distributed architecture is higher" This way, it is necessary to ha!e a more comple$ system
analysis and design, which implies more time to reach the implementation stage"
'm#.based de!elopments will reuire the use of se!eral sensors and actuatorsstrategically distributed in the en!ironment" This pro!ides the systems with conte$t.aware
capabilities in order to change its beha!ior automatically" #t is possible to make a difference
between sensor networks* wired and wireless" There are se!eral technologies for creating
wired sensors networks, such as :1, -on Works, or ?N:" Howe!er, wired networks are not
as fle$ible as WSNs and reuire more infrastructural support" /n the other hand, wireless
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technologies enable easier deployments than the wired ones, a!oiding the need of wiring
homes or hospitals and decreasing the costs, and drawbacks of the setup phase" The AigBee
standard allows operating in the freuency range belonging to the radio band known as
industrial, scientific, and medical S;(, especially in the CDC ;H> band in 5urope, the 01E
;H> in the U"S"'", and the 2"@ FH> in almost all o!er the world" The underlying #555
C2"1E"@ standard is designed to work with low.power and limited computational resources
nodes" AigBee incorporates additional network, application, and security layers o!er the
C2"1E"@ standard" The AigBee standard allows up to DE E7@ nodes connected in a star, tree,
or mesh topology network" 'nother standard to deploy WSNs is Bluetooth" This standard
allows multiple wireless personal 'rea networks &WP'N( and wireless body area networks
&WB'N( applications for interconnecting mobile phones, earphones, personal computers,
printers, etc" Bluetooth operates also in the #S; 2"@ FH> band" #t allows creating star
topology networks of up to eight de!ices in which one of them acts as master and the rest as
sla!es" Se!eral Bluetooth networks can be interconnected by means of Bluetooth de!ices that
belong simultaneously to two or more networks, creating more e$tensi!e networks"
'lthough there are plenty of options for creating WSNs, the main problem is the
difficulty for integrating de!ices from different technologies in a single network" #n addition,
the lack of a common architecture may lead to additional costs due to the necessity of deploying nontransparent interconnection elements between networks" ;oreo!er, the
de!eloped elements &e"g", de!ices( are too dependent on the application to which they belong,
thus complicating their reutili>ation" Some de!elopments try to reach the de!ices integration
by implementing middleware layers as reduced !ersions of !irtual machines &e"g", Suawk
e or more costly miniaturi>ation" These drawbacks are !ery important
regarding WSNs, as it is essential to deploy applications with reduced resources and low
infrastructural cost, especially in home care scenarios" The S-PH platform integrates an
S/' approach for facilitating the distribution and management of resources &i"e", ser!ices(
into heterogeneous WSNs"
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There are se!eral attempts to integrate WSNs and an S/' approach" #n S-PH,
unlike these approaches, ser!ices are directly embedded on the WSN nodes and can be
in!oked from other nodes in the same network or other network connected to the former one"
#t is necessary to pro!ide efficient solutions that allow building 'm# en!ironments for
pro!iding dependent people healthcare at their homes" /ne of the key aspects for the
construction of these en!ironments is obtaining conte$t information through sensor networks"
There are se!eral healthcare de!elopments for telemonitoring based on WSNs" Howe!er,
these de!elopments do not take into account their integration with other systems and are
difficult to be adapted to new situations" The use of S-PH is proposed in order to face some
of the issues"
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Chapter 3
Architecture
3.1 SY"!:
The following figure 7"1 illustrates the S-PH architecture layers"
%igure 3.1: SY!" architecture la$ers.
S-PH can be e$ecuted o!er multiple wireless de!ices independently of their
microcontroller or the programming language they use" S-PH works in a distributed way
so that the application code does not ha!e to reside almost completely on only central node"
S-PH allows the interconnection of se!eral networks from different wireless technologies,
such as AigBee or Bluetooth" Thus, a node designed o!er a specific technology can be
connected to a node from a different technology" #n this case, both WSNs are interconnected
by means of a set of intermediate gateways connected to se!eral wireless interfaces
simultaneously" S-PH allows applications to work in a distributed way and independent of
the lower layers related to the WSNs formation &i"e", network layer(, and the radio
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transmission amongst the nodes that conform them &i"e", data link and physical layers("
S-PH implements an organi>ation based on a stack of layers" %ig" 7"1 shows the different
layers of S-PH, which are added o!er the application layer of each WSN stack" The
S-PH message layer &S;-( offers to the upper layers the possibility of sending
asynchronous messages between two wireless de!ices through the S-PH ser!ices protocol
&SSP("
The SSP is the internetworking protocol of the S-PH platform" SSP has
functionalities similar to those of the internet protocol P(" That is, it allows sending packets
of data from one node to another node regardless of the WSN to which each one belongs"
The messages specify the origin and target nodes, and the ser!ice in!ocation in a S-PH
ser!ices definition language &SS6-( format" The SS6- describes the ser!ice itself and its
parameters to be in!oked" 'pplications can directly communicate between de!ices, using the
S;- layer or by means of the S-PH ser!ices directory sub layer &SS6S( that uses in turn
the mentioned S;- layer" The SS6S offers functionalities related to the disco!ering of the
ser!ices offered by the network nodes" ' node that stores and maintains ser!ices tables is
called S-PH directory node &S6N("
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The figure 7"2 below represents the S-PH basic operation"
%igure 3.2: SY!" basic operation.
The main components of S-PH are now described*
3.2 SY!" Services
The beha!ior of S-PH is in essence similar to the one of any other S/'" Howe!er,
S-PH has se!eral characteristics and functionalities that make it different from other
models" %ig" 7"2 shows the basic operation of S-PH" %irst, a ser!ice registers itself on the
S6N and informs its location in the network, the parameters it reuires and the type of
returned !alue after its e$ecution" #n order to do this, SS6- is used, which has been created
to work with limited resources nodes" SS6- is the interface definition language -( used
by S-PH" 6istributed architectures use an #6- in order to enable communication between
software components, regardless their programming language or hardware implementation"
Un. like other #6-s as WS6-, based on e$tensible markup language &:;-( and used on
web ser!ices" SS6- use a few intermediate separating tags and its ser!ices descriptions are
short binary data seuences" The reason for these constraints is to reduce processing in the
de!ices microcontrollers" Using a simple #6- allows, conseuently, utili>ing nodes with
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fewer resources, less power consumption, and lower cost" #n most cases, it is enough with a
few float point data for informing the status of a sensor" Thus, most ser!ice definitions
reuire only a few bytes" SS6- considers the basic types of data &e"g", integer, float, or
Boolean(, allowing more comple$ data structures as !ariable length arrays or character
strings" #n this way, SS6- is fle$ible enough to specify more comple$ ser!ices if reuired"
/nce the ser!ice has been registered in the S6N, it can be in!oked by any application by
means of S-PH" Both the S6N and the ser!ices can be stored in any node of the WSN or in
other subsystem connected to the WSN" This system can be, for instance, a simple personal
computer connected through a uni!ersal serial bus &USB( port to a wireless interface" Thus,
de!elopers decide, which nodes or subsystems will implement each part of the distributed
application" 'ny node in the network can ask the S6N for the location of a determined
ser!ice and its specification, using SS6-" This aspect is described in the following section"
The figure 7"7 below describes the S-PH 6irectory Nodes"
%igure 3.3: SY!" &irector$ 'odes.
3.3 SY!" &irector$ 'odes
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With the aim of the architecture to be the more distributed as possible, it is allowed to
be more than one S6N in the same network, so that can e$ist redundancy or ser!ices
organi>ed in different directories" The S6N can be stored in a node of the network, with a
memory e$ternal to the microcontroller if necessary, or be contained on a computationally
higher machine connected to the WSN, as is the case of a data ser!er or a personal computer
with wireless connection" %ig" 7"7 shows how a node can disco!er ser!ices in the network"
%or e$ample, node 1 registers itself in the WSN by means of S-PH" Then, it sends a
broadcast message after connecting to the WSN searching for e$isting S6Ns in the network"
't this moment, only the node is acti!e, therefore, after recei!ing the broadcast message, it
sends a message to the node 1 informing of its situation &i"e", SSP address( and its setup
parameters"
'n e$ample of a setup parameter is whether the S6N will inform periodically of its
presence or if the nodes will ha!e to poll it" 'fter this, the node 1 is able to communicate
with the node in order to obtain information about the possible ser!ices e$isting in the
network" -ater, the node 7 registers itself on the WSN" 's it has S6N functionalities, it
informs of this to the rest of the nodes by means of a broadcast message" The node 1 stores
this information on its SS6S entries list and informs node 7 about its role as S6N" 'ny node
in the network cannot only offer or in!oke S-PH ser!ices, but also includes S6N
functionalities in order to pro!ide ser!ices descriptions to other network nodes" S6Nsinclude additional information about ser!ices, whose locations in the network maintain as,
for e$ample, a uality of ser!ice rate and a time stamp that represents the last time the S6N
checked the ser!ice was a!ailable" 'n S6N can be configured to check the ser!ices, whose
location stores or can be the ser!ices the responsible for broadcast themsel!es periodically"
Chapter (
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)elemonitoring S$stem
This section describes the main features of a telemonitoring system aimed at impro!ing
healthcare of dependent people at their homes" The system makes use of se!eral WSNs in
order to gather conte$t information in an automatic and ubiuitous way" Thus, thetelemonitoring system enables an e$tensi!e integration of WSNs and pro!ides a greater
simplicity of deployment, thus optimi>ing the reutili>ation of the a!ailable resources in such
networks"
Se!eral functionalities are directly embedded on the WSN nodes and can be in!oked
from other nodes in the same network or other network connected to the former one by
means of the S-PH platform" S-PH gateways are used in order to interconnect different
heterogeneous WSNs" This way, S-PH contemplates the possibility of connecting WSNs
based on different radio and link technologies &e"g", AigBee, Bluetooth, Wi.%i, etc"(, while
other approaches do not" #n addition, S-PH focuses specially on de!ices with small
resources in order to sa!e microcontrollers) computing time, memory data si>e, and energy
consumption" Biomedical sensors &e"g", electrocardiogram, blood pressure, body temperature,
etc"( and automation sensors &e"g", building temperature, light, humidity, etc"( ha!e
significant differences, especially on how they collect data" Biomedical sensors obtain
continuous information about !ital signs, whose samples are important and should not be
lost" /n the other hand, automation sensors obtain information at a relati!ely lower
freuency compared to biomedical sensors" #n addition, biomedical sensors should be smaller
and easier to wear" #t is necessary to interconnect se!eral WSNs from different radio
technologies in a telemonitoring scenario" Ha!ing a compatible distributed platform for
deploying healthcare applications o!er the different networks facilitates the de!elopers) work
and the integration of the heterogeneous de!ices"
The figure @"1 illustrates basic schema of 4ommunication and infrastructure of the
telemonitoring system as shown below*
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%igure (.1: Communication and in#rastructure schema o# the telemonitoring s$stem
' network of AigBee de!ices has been designed to co!er the home of each patient to
be monitored" There is a AigBee remote control carried by the monitored patient that
incorporates a button, which can be pressed in case of remote assistance or urgent help"
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;oreo!er, there are a set of AigBee sensors that obtain information about the home
en!ironment &e"g", light, smoke, temperature, doors) states, etc"( in which the user li!es and
that physically response to the changes &e"g", light dimmers, fire alarms, or door locks(" 5ach
of these AigBee nodes includes a 4CE1%121 microcontroller and a 442@2 #555 C2"1E"@
radio freuency transcei!er" There are also se!eral Bluetooth biomedical sensors placed o!er
the monitored patient)s body" Biomedical sensors allow the system to acuire continuously
data about the !ital signs of the patient" #n the telemonitoring system presented in this paper,
each patient carries three different biomedical sensors* an 54F monitor, a respiration
monitor &implemented by means of an air pressure sensor(, and a micro.electro.mechanical
systems &;5;S( tria$ial accelerometer for detecting possible patient)s falls" These Bluetooth
nodes use a [email protected]$t chip with a reduced instruction set computer &=#S4(
microcontroller with @C ?B of ='; and 12@ ?B of e$ternal flash memory, and are
compatible with the Bluetooth 2" standard" 'll these AigBee and Bluetooth de!ices work as
S-PH nodes and can both offer and in!oke functionalities &i"e", ser!ices( throughout the
entire sensor network"
There is also a computer connected to a remote healthcare telemonitoring center !ia
#nternet" 'lerts can be forwarded from the patients) homes to the caregi!ers in the remote
center, allowing them to communicate with patients in order to check the possible incidences"These alerts can be, for instance, the detection of a patient)s fall or a high smoke le!el in the
patient)s home" This computer acts as a AigBee master node through a physical wireless
interface &e"g", a AigBee network adapter as a AigBee USB dongle, or a AigBee node
connected through the computer)s USB port(" The computer is also the master node of a
Bluetooth network formed by the biomedical sensors working as sla!e nodes" 't the S-PH
le!el, the computer performs as a S-PH gateway so that it connects both WSNs to each
other" #f, for instance, the monitored patient falls o!er the floor, his fall detector gets from its
Bluetooth accelerometer, a measurement higher than a pre!iously specified threshold" This
sensor &i"e", accelerometer( in!okes a ser!ice stored in the WSNs. #nternet S-PH gateway"
Such ser!ice initiates a !oice o!er #nternet Protocol &o#P( and webcam connection
to be established between the telemonitoring center and the patient)s home through #nternet"
This way, caregi!ers in the remote center can watch the patient)s home and talk with him in
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order to !erify the accident" 's the telemonitoring center accesses directly to a patients
database, caregi!ers can see his medical data and home address" #f the accident is confirmed,
the caregi!ers send an ambulance to his home" 'lthough this system is mainly focused on
monitoring tasks, it also pro!ides additional useful facilities to the patients and caregi!ers"
%or e$ample, the remote center can consult really simple syndication &=SS( sources from
e$ternal and internal web ser!ers in order to obtain weather reports or entertainment options
for patients and inform them of their scheduled medical staff !isits" Such information is
shown on a graphical user interface &FU#( on a display connected to the computer at home"
This display is in fact a touch.sensiti!e screen, so that the interaction is easy and intuiti!e for
patients" ;oreo!er, the application includes home automation capabilities, so that a light
sensor can make a lamp to be switched on or dimmed by means of the in. !ocation, or a
certain ser!ice stored in a wireless actuator node connected to the relay or dimmer of the
respecti!e lamp"
Chapter *
+esults
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The telemonitoring system presented in this report impro!es security at home to dependents"
#t implements monitoring and alerting subsystems, as well as additional ser!ices to
automatically react to emergency situations" We ha!e done se!eral test cases in order to
e!aluate the o!erall performance of the system, especially the management of emergency
situations" The tests, which in!ol!ed 17 patients and si$ caregi!ers, allowed us to e!aluate
the system" Specifically, the results of the S-PH system were studied o!er a period of four
weeks"
#t has been e!aluated that this approach in terms of the four main ob+ecti!es, defined
for WSN applied in healthcare de!elopments* minimi>e error rates, conduct diagnosis with
real time patient data, impro!e efficiency, and reduce costs" We ha!e collected data before
and after the implantation of the telemonitoring system, with data collected from %eb" 20
to ;ar" 20" The system was adopted on ;ar" 1, 20"
%igure *.1: %alse positives occurred during the test period o# the alert subs$stem
%irstly, our approach pro!ides the system with a higher ability to reco!er from errors"
%ig" E"1 shows the percentage of error that occurred in the alert subsystem during the tests"
The initial tests showed an error rate abo!e 10I" This percentage was primarily due to errors
in the use of the system by the caregi!ers" 'fter the third test, the error rate was reduced to
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11I" %rom this point the error rate remained stable at @I" This error could be reduced with a
higher le!el of training in the use of the telemonitoring system" Secondly, we ha!e worked
with real.time data from the patients"
These data ha!e not been used for diagnosis, but to assess the need for pro!iding
healthcare to the patients" #n this sense, S-PH reaches this goal because it can work with
real.time data" Howe!er, it is necessary to include a reasoning mechanism in order to
facilitate the decision making for diagnosis" %inally, the efficiency of the telemonitoring
system has been enhanced and the infrastructure costs ha!e been reduced" S-PH allowed us
to determine the time needed to respond to alerts generated by the users or the sensors" #n
order to generali>e reactions to common situations, the system does not only take response
time into account, but also the time elapsed between alerts and the user)s profile and
reliability"
The telemonitoring system allows a reduction of the response time to incidents &i"e",
alerts(" When comparing data before and after the implantation of the telemonitoring system,
we concluded that telemonitoring system pro!ides an a!erage response time to incidents of C
min, which reduces the time employed by the caregi!ers in a GI" ;oreo!er, the a!erage of
assisted incidents per day was 12, pro!iding a reduction of 11I" This reduction can be
directly associated to the impro!ement in the detection of false positi!es" Besides, the time
employed by the medical staff to attend an alert has been notably reduced"
Chapter ,
Conclusion
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S-PH allows wireless sensor de!ices from different radio technologies to work together in
a distributed way" These sensor de!ices do not ha!e to be pro!ided with large memory chips
or fast microprocessors" The S-PH model allows the possibility of adding or remo!ing
components at e$ecution time" This way, it is possible to add a new automation sensor in the
patient)s home at e$ecution time with no need of reprogram or redeploy the system" #f, for
e$ample, it is decided to add a new smoke sensor in the patient)s home, the technician will
+ust ha!e to fi$ it to the ceiling and supplies it with electrical power" The AigBee node will
+oin automatically to the AigBee automation network, and its S-PH layers will look for
S6Ns and ser!ices in the S-PH network and register its own ser!ices on them" This way, if
the new smoke sensor detects a dangerous smoke le!el, it will automatically in!oke the
smoke alarm ser!ice in the alarm nodes in the home and the WSNs #nternet S-PH gateway"
The telemonitoring system)s architecture goes a step ahead in designing systems for
home care by offering features that make it easily adaptable to any per!asi!e en!ironment"
Unlike other telemonitoring systems as, the presented system allows to integrate
heterogeneous sensor networks from different technologies, e!en wired ones" Therefore, it is
possible to +oin automation and biomedical sensors in the same telemonitoring system, using
the technology that better fits each sensor)s data characteristics"
'lthough the initial results are promising, the telemonitoring systems still reuires
some impro!ements" /ur future work focuses on finding a modeling facility to pro!idelearning and decision.making capabilities to the system"
+e#erences
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J1K F" T" heimer patients, agent technology for healthcare,M Decis. Support Syst., !ol"
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