Role Of Wireless Communication In Telemedicine

Keeping up with the improvement of wireless technology, wireless devices have taken over the medical market due to their potential and wide range of capabilities. Wireless technology also helps and enables clinicians to observe and monitor patients remotely and give them timely health information, reminders, and support as needed – extending the scope of health care by making it accessible everywhere and at any time, apart from improving the quality of life of the patients and doctor-patient productivity,

Recently, a lot of interest in wireless systems for medical applications and the medical market has been steadily increasing. With several benefits and advantages over wired alternatives, like the ease of use, diminished risk of infection due to shared wires, reduced risk of failures, decrease in patient discomfort as the patient could be at the comfort of their home, enhanced mobility and lower cost of transport, wireless applications bring forward exciting and thrilling prospects as well as alternatives for new applications in the medical market.

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The purpose is to provide skilled and the best health-care to remote locations where access to traditional devices could be difficult through latest and modern technology (wireless communication) and information technologies. One of the benefits is cost savings because data is cheaper to transport than people. Improvement in medical technologies have led to an accelerated development of the elderly people in many countries, resulting in an increasing demand for home health monitoring to guarantee that elderly patients can lead independent lives. Many physiological signals can be used to extensively calculate from individuals, in their living environments, their daily activities and are potentially applied to observe and understand the anomaly of health status in the early time or to alert the paramedics automatically if there is an emergency. Particularly for remote monitoring of physiological factors, all the studies formulated and presently used in this domain can be categorized through various aspects: type of data communication, type of sensors, signal processing, medical algorithms and monitoring device.

Main components of the system

Some communication technologies are eligible for healthcare systems while others are not. Choice of the right communication technology depends on the particular healthcare condition as well as on the user population. Healthcare systems are progressively delivering biomedical communication and other healthcare information over long distances using communication technologies. These corresponding services can be delivered anytime from anywhere using mobile communication systems with higher speed and reliability. Such mobile communication technologies can be applied to a mobile hospital (M- hospital), illness rehabilitation, emergency ambulance services, generic healthcare, early warning systems for diseases and so on. As part of hospital medical care, patient data including videos, electrocardiogram (ECG) data, images and pulse biomedical signals can be transmitted via General Packet Radio Service (GPRS), Global System for Mobile communication (GSM), WiMAX, third-generation and fourth-generation (3G and 4G) mobile cellular systems, and mobile satellite communication (MSC) systems.

Portable devices such as spirometers,heart rate supervisors, blood pressure monitors and pulse oximeters and are necessary instruments in intensive care units. Originally, the detectors for these devices are connected to the patient by several wires and the patient then, of course, becomes bed ridden. Besides, whenever a patient needs to be moved, all these monitoring devices have to be taken off and disconnected and then again connected later. Presently, all of these time-consuming work could be terminated and patients could be free from instrumentation and bed by wireless technology. These devices can communicate with the medical center's network and transmit data to health data stores for controlling, monitoring or evaluating in real-time or offline after storage.

Continuous and prevalent medical monitoring is now available with the presence of wireless healthcare systems and telemedicine services. In emergencies, real-time health parameter is essential. Reported by the American Heart Association, the treatment of a patient having ventricular fibrillation within the initial 12 minutes of a cardiac arrest brings a survival rate of 47%-76%. The survival rate drops to 2-4% after 12 minutes have passed. With wireless continuous medical monitoring systems, patients' information such as blood pressure, heart rate, and electrocardiogram can be sent instantly to expert medical centers to store and process properly. Emergencies can be detected faster and proper treatment can be applied. Health care power in various situations has improved significantly with the contribution of wireless communication technologies.

Wireless technology could be the best answer for mass crisis like natural or human-included disasters and military battles where patients' records such as medication history, personal identity, and other critical information are necessary. With the help of handheld devices, the amount of time the doctors need to identify the problem, trace the medication history of the patient and consult fellow doctors will be reduced significantly. Furthermore, patients’ information that can be built up by uninterrupted medical observation can be accessed and updated with ease. As a result, the amount of paper works required and the duplication of patient records will be dropped down.

In many mission-critical applications, devices must not fall into battery exhaustion. Most wireless network-based devices are battery-run. Therefore, the blueprint of a system must not require devices to use up excessive energy. The creators have to consider the longevity of the devices and extend it by using scheduling algorithmic rules and power management strategies such that energy consumption should be divided over the whole network, rather than having a few devices carrying the whole network's load.

From the patient's view, one of the most significant issues is how comfortable they feel when using these new applications. Therefore, the applications should not only be helpful but also specifically small, lightweight, etc. Also, patients' information must be private and secure but remain accessible to authorized persons. Power and process availability of the wireless-based network is very restricted while to ensure the privacy of information, extra power and computation must be used to encrypt transmitted data. Thus guarantee of information security can be an issue and challenge for system developers.

Wireless systems for medical applications are now not only focused by a healthcare provider and the government but also by researches and industry. Important academic and corporal resources are being oriented towards researching and developing fresh wireless healthcare systems. Several other innovative applications based on this concept are developed or are under development in research.

Home monitoring systems for elderly and chronic patients is rapidly growing in quantity and quality. Using the system can reduce the hospital stay of patients and increase patient safety and mobility. The scheme collects daily and continuous information and then conveys it to the centralized server. Patients' information is accessed by physicians remotely. These applications save a large amount of time for doctors as well as patients. The doctors can supervise several patients at the same time which can not be done by conventional monitoring, in which the patients are monitored straightaway by the doctors. The patients are no more obligated to be there at the hospitals periodically.

Wireless detector networks can be applied to medical domain to build up information and databases for long-term clinical activity. It also can be used for emergency medicare and several different applications.

The use of wireless technologies in medical environments is bringing major advantages to the existing medicare services. However, they have several crucial research challenges such as data integrity, various types of network communication infrastructure, low-power consumption, transmission delay, fault-tolerance, node failure, etc.

Reliability is one of the most important factors in a flourishing healthcare method. To ensure this factor, system designers have to care about the adaptation of nodes when its location, connection, and link quality is changed. Different network communications infrastructure should be used in an appropriate situation. For example, with high-risk patients, the services with higher Quality of Service (QoS) should be used.

The integrity of the distributed data system and fault-tolerance should be given a proper consideration also. Every instrument can function differently at various times, particularly sensor-based devices. One link in a system can have a failure at any time for any reason including batteries exhaustion, natural issues or human-related issues. Ensuring a seamless service during the lifetime of the system could be a big challenge.

How to come through the transmission delay of several types of communications in the scheme is an unquestioned challenge. With the system using WBAN or wireless sensor networks, data must go through several hops before it reaches the sink. Also, these hops are sometimes located in very critical conditions, such as magnetic fields or areas bearing interference of radio waves. As a result, various delays occur and require the extra effort of system designers to synchronize the whole system.

The mentioned challenges are associated with skilled implementation. However, there are many other challenges associated with the deployment of new technology. Specifically, the new system should not be too expensive and not interfere with the previously existing infrastructure. So balancing interference between the old and the new system and using spectrum properly are challenges of wireless technology applied to medical field.

From the patient's perspective, one of the most important issues is how comfortable they feel when using these new applications. Hence, the applications must be not only helpful but also unobtrusive, generally small, light in weight, etc. Also, patients' information must be private and secure but remain accessible to authorized personnel. Power and process availability of wireless-based networks is very limited while to ensure the privacy of information, extra power and computation must be used to encrypt transmitted data. Thus, assurance of information security could be an issue and can be a challenge for developers.

Although wireless medical applications have been efficiently implemented not only in research but in practice as well, there are still many challenges for developers and researchers. The potential of wireless technology in the medical realm can not be exploited completely when mentioned challenges are not solved, which required a long term effort of researchers and investors.

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