Routing Biomedical Data Between Applications Through Ad Hoc

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Routing Biomedical Data Between Applications
Through Ad Hoc Networks
Lic. Fabio Bruschetti
Universidad Nacional de San Martín
Email: [email protected]
Mg. María Claudia Abeledo
Universidad Nacional de San Martín
Email: [email protected]
Tech. Sebastián José Emilio Lorandi
Universidad Nacional de San Martín
Email: [email protected]
Pedro Facundo Iriso, Cristian Miño
Universidad Nacional de San Martín
Email: [email protected], [email protected]
María de las Mercedes Cresta
Universidad CAECE
Email: [email protected]
Abstract-- This work is intended to demonstrate that ad hoc
networks can transport biometric information such as
electrocardiogram, plethysmography, body temperature, blood
pressure, breath and cardio frequency in a reliable and secure
way taking advantages of routing capabilities, high speed,
minimal infrastructure and reduced costs. Biometric data will
come from medical devices that capture, digitilize and store data
in electronic files. The solution presented here combines those
medical devices and personal computers with small pieces of free
software. Connecting patients located far away from high
complexity medical centers with the help of Internet will result in
fast diagnostic, appropriate analysis and immediate response
without moving professionals from one site to another.
on these locations always need communication services for
voice and data but there may be an inappropriate
telecommunications infrastructure. At present, health care
devices can meter and digitize human medic information and
store it in computer files. Such devices have affordable prices
and can easily be connected to a computer to transfer its data.
As healthcare services are essentials in mentionated cases
the lack of telecommunications infrastructure seems to be a
common barrier. Communication facilities for low density and
low economic level communities is one of the most difficult
issue to solve by any government, specially in underdeveloped
countries where most government resources attend social,
political, economic problems [1][ 2].
Index Terms-- Ad hoc networks, Communication equipment,
Data acquisition, Prognostics and health management, Rural
areas, Wireless networks.
II. RELATED WORK
I. INTRODUCTION
T
aking care of remote patients is a challenge for any public
or private healthcare organization. Medic professionals are
not available in any place and any time, not to mention in
communities located far away from cities and even worst if
their economic activity is significantly low.
Dealing with emergencies or long term healthcare situations
This work was supported in part by San Martín National University
UNSAM (Public) and CAECE University (Private).
IEEE, Sección El Salvador.
A. Ad Hoc etworks: A Brief Description
Ad-hoc voice communication was used in many ancient
societies to send messages [3]. The history of wireless
networks started in the 1970’s and the interest has been
growing ever since. During the last decade, and especially at
the end of it, the interest has almost exploded probably
because of the fast growing Internet. Today we see two kinds
of wireless networks but the difference between them is not as
obvious as it may seem. The first kind and most used today is a
wireless network built on-top of a wired network and thus
creates a reliable infrastructure wireless network [4] (figure 1).
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CONCAPAN XXXI
Wireless communication enables information transfer
among a network of disconnected, and often mobile, users.
Popular wireless networks such as mobile phone networks and
wireless LANs are traditionally infrastructure-based, i.e. base
stations, access points and servers are deployed before the
network can be used. In contrast, ad hoc networks are
dynamically formed amongst a group of wireless users and
require no existing infrastructure or pre-configuration (figure
2).
Fig. 1. Infrastructure-based wireless network
Fig. 2. Ad hoc network [5]
The dynamic and self-organizing nature of ad hoc networks
makes them particular useful in situations where rapid network
deployments are required or it is prohibitively costly to deploy
and manage network infrastructure. [6]
B. Applications of ad hoc wireless networks
As a first approximation, we could simply define ad hoc
applications as pieces of software that run on ad hoc networks.
We do not believe however that this definition adequately
characterizes the essence of ad hoc applications. Defining a
class of applications (ad hoc applications) by coupling it to
one (but only one) possible implementation technology (ad
hoc networks) reduces the generality and effectiveness of the
definition. This is particularly true in such a changing arena as
mobile network technology. Indeed, no widely adopted ad hoc
network exists nowadays. However, many researchers work on
the subject in order to build what will probably be the next
generation networks. [7].
Nevertheless, we can mention some ad hoc network
applications:
• Attendees in a conference room sharing documents and
other information via their laptops and handheld
computer;
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•
•
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Armed forces creating a tactical network in unfamiliar
territory for communications and distribution of
situational awareness information;
Small sensor devices located in animals and other
strategic locations that collectively, monitor habitats and
environmental conditions;
Emergency services communicating in a disaster area and
sharing video updates of specific locations among workers
in the field, and back to headquarters. [6].
C. Risks in wireless ad-hoc connections
Wireless ad-hoc connections are generally considered a
security risk for the following reasons:
• o physical access needed: outside nodes can gain
connection to the network by the simple fact of being
located in the radio range of any other trusted network
node
• There is no centralized management: failures such as
packet dropping and transmission impairments cannot be
easily traced avoiding to understand whether this failures
are normal or caused by an malicious attack [8]
• Compromise of links or nodes: Attackers may attempt to
take control of a trusted node to perform malicious actions
that can be very difficult to detect because of ad-hoc
nodes may perform diverse behaviors [9].
• Restricted power supply: nodes that may not have
continuous external appropriate DC or AC voltage cannot
suddenly cooperate or support wireless network functions
[10]
D. Why Wireless etworks for Medical Applications
Due to advances in the wireless networks field, new and
innovative applications are being thought of in medical as well
as healthcare field [11]. In the medical field applications
ranging from equipment management to patient management
are being developed. Efficiency among hospital staff is
increased by using some of these newly available applications
and tools. In the healthcare field, issues such as long-term
patient care, support for elderly people and smart homes are
being discussed in the realm of wireless networks. There is
also research being done on creating teletrauma systems using
the wireless channel. This will potentially allow trauma
specialist to be virtually on patient’s bed sides while they are
being moved to the trauma center. In the near future homes can
be designed to take care of patients or people with disabilities
without the presence of a healthcare provider. A patient who is
located far away can be cared for remotely by communicating
his/her status in real-time to caregivers. Another issue that
concerns the healthcare field is the very large number of
expensive medical devices that are incompatible with each
other. Tedious routines are involved in translating results from
one machine to another. With Wireless Technology this
compatibility issue can be reduced
Another hot issue in the wireless networks field is
implantable devices. These devices can be implanted on
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CONCAPAN XXXI
normal day to day wearable. Wireless sensor implanted inside
patient's body has their own significant benefits . Patients can
wear sensors that monitor vital signs and report them in realtime to their doctor. This helps towards the issue of access
because now the patient doesn't need to be around the hospital
all the time. This improves access and quality of healthcare for
patients and saves money for care providers.
E. Scope Of This Work
This work exposes a simple and cost effective solution that
can be implemented using ad hoc networks to transport
sensored health data from medical devices connected to a
patient (such as electrocardiograph device) to a doctor being in
front of a hospital’s computer. This approach also provides a
reliable data transfer using ad hoc networks connected to the
Internet.
According to bioethics and human rights [12], collected
data from a human patient was replaced with simulated data
generated with a personal computer using an emulator (Java
ECG Generator [25]).
F. Scenery
This work was based on an ad hoc wireless network
configured in a rural zone. Computer nodes are limited and
only one of them has an ADSL [13] Internet connection.
In this zone, there are patient with some risk pathologies
but there are not enough professionals and equipment to attend
or solve patient’s deceases.
A software application installed in personal computers
(desk or laptop) with wireless capabilities will transfer data
collected from medic devices to specialized centers. Data
packages will be routed among active nodes from patient’s the
node that is connected to the Internet.
Medical professionals located on the other side of Internet
cloud will receive diagnosed data, analyze them and then
return their conclusions like treatment with medicines, care to
provide, need to transfer the patient, specific maneuvers, etc.
G. The Solution Proposed In This Work
As shown in figure 3, the solution includes the following
hardware and software components:
• Hardware:
- A digital ECG collector device (Dev01) with standard
USB cable
- 2 PCs (Node02 and Noder03) with wireless capability
and fixed IP addresses from 192.168.1.2 and
192.168.1.3.
- Dev01 connected to Node03 through USB (ECG).
- 1 PC (Node01) with a fixed IP address is 192.168.1.1.
connected to:
a) the wireless ad hoc network with Node02 and
b) an Internet Service Provider through ADSL
(Upload speed of 250 Kbps and download speed of
630 Kbps [14])
- Node02 and Node03 has no access to Internet
- 1 PC (Node04) located at a healthcare center far away
from the rural zone and connected to Internet through
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ADSL (Upload speed of 2,32 Mbps and download
speed of 2,48 Mbps [14]).
- All nodes in the rural zone are in different houses, and
Node03 is in patient’s home.
•
Software:
- Ubuntu 10.10 [18] operating system in Node02 and
Node03 with kernel version 2.6.38 with B.A.T.M.A.N.
[15][16] routing protocol installed
- Microsoft Windows XP Service Pack 3 operating
system in Node01 and Node04
- Custom Java Software Applications in nodes using Java
ECG Generator application (open source) [25]
- Java Runtime Environment (JRE) 1.6 [17] in nodes
running Custom Java Software Applications (Node01
and Node04)
Rural Zone
Node02
192.168.1.2
Wireless ad-hoc
connections
ISP
ADSL
Modem
Patient
Node03
192.168.1.3
Node01
192.168.1.1
Wireles Ad-Hoc
Network
Dev01
Internet
ADSL
Modem
Node04
Specialist
ISP
Urban Zone
Fig. 3. Hardware and connectivity components: rural zone
H. Environment Set-up
Nodes Node01 to Node03 is configured to build the ad hoc
network. Ubuntu Node01 with Firestarter [19] is configured to
share the wireless ad hoc network (wlan0) and the Internet
connection through 3G (ppt0).
Node03 is far enough from Node01 so they cannot be
linked without the presence of Node02, between them. To
check routing features, once all nodes had access to Internet,
Node02 was moved away so nodes Node02 and Node03 lost
theirs connections to Internet. Figure 4 shows when
connections were lost.
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CONCAPAN XXXI
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Fig. 5. Batch file processing messages
Fig. 4. Connection lost when routing node is out of wireless range
There are two batch files needed for the operation. One for
the patient’s computer and the other for the doctor’s computer
as follows:
Patient’s computer NURSE.BAT:
On patient’s side (NURSE), the application will popup a
screen form (figure 6). The operator must fill out input fields
with data form patient and from himself (patient’s name, clinic
record, observations, etc.). In addition, single measures (i.e.
body temperature) and multiple measures contained in
electronic files (i.e. electrocardiogram) can be added.
Once the form is completed, the operator can send this
captured data to doctors (DOCTOR). After that, popup
message will indicate that NURSE is waiting for DOCTOR’s
diagnostic and treatment (figure 7).
REM Client’s Application
SET APLICACION_PATH=C:\PROGRAM FILES\EXEC
SET
CLASSPATH=%APLICACION_PATH%\lib\Nurse.jar
;%APLICACION_PATH%\lib\Commoncomponents.j
ar;%APLICACION_PATH%\lib\javacsv.jar
SET HOST=router-pedro.no-ip.info (1)
SET PORT=1000
SET JAVA_HOME= %JAVAHOME%\bin
JAVA NURSE.APLICACIONMAIN %HOST% %PORT%
(1) The application resolves the IP address through a
domain name. It was used a free Web Domain Name Service
provider [20]
Doctor’s computer DOCTOR.BAT:
REM Doctor’s Application
SET APLICACION_PATH= C:\PROGRAM FILES\EXEC
SET
CLASSPATH=%APLICACION_PATH%\lib\Doctor.ja
r;%APLICACION_PATH%\lib\Commoncomponents.
jar
SET PORT=1000
SET JAVA_HOME= %JAVAHOME%\bin
JAVA DOCTOR.APLICACIONMAIN %PORT%
Batch files and applications must be in local disks prior to
operation
Fig. 6. NURSE application input form screenshot
Fig. 7. NURSE application popup waiting message
On doctor’s side, the application will popup a screen (figure
8).
I. Solution Operation
The initial step is to connect Dev01 USB to Node03. Then
generate and store a file with collected data from the (ECG).
Generated file will be accessed from Node03.
The both batch files (NURSE.BAT and DOCTOR.BAT as
shown in figure 5) are started on Node03 and Node04
computers respectively.
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CONCAPAN XXXI
Fig. 8. Doctor’s form screenshot
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J. Results obtained
All ad hoc and Internet transfer response times were
captured and measured using the network protocol analyzer
Wireshark [21].
An average ECG takes a few minutes [22]. In our sample
we consider a standard ECG with 12 leads [23] and an average
of 6 seconds for each lead [24] resulting the Total ECG
Measurement Time (TECGTotal):
TECGTotal: 12 leads * 6 sec = 72 sec
leads
As Dev01 takes 256 samples per second, the total number
of samples (TS) needed is:
TS=72 sec * 256 samples = 18.432 samples
sec
Results are as follows:
• The average ad hoc network routing time to transfer ECG
(18.432 samples) plus additional information (maximum
1.024 bytes) from Node03 (NURSE) to Node01
connected to Internet in the rural zone is:
TtoAdhoc Avg = 9,8713 sec
Fig. 9. DOCTOR application popup waiting message
Once data has from NURSE arrives, it will be displayed int
the screen form (figure 9) for doctors or professionals.
Multiple data colleted can be opened and graphed in an
additional screen (figure 10) and the user can type in feedback
into the application. This feedback will be transmitted to
NURSE using Internet and the ad hoc network on patient’s
side. When diagnostic or treatment is received on patient’s
side, the popup message (figure 9) will be turned off.
•
The average network transfer time from Node01 to
Node04 (DOCTOR) through Internet (1) to transfer ECG
plus additional information is:
TtoDInternet Avg = 72,0791 sec
•
The total average network transfer time from NURSE to
DOCTOR is:
TtoDTotal Avg = TtoAdhoc Avg + TtoDInternet Avg
TtoDTotal Avg = 9,8713 sec + 72,0791 sec = 81,9504 sec
•
The average network transfer time from Node04
(DOCTOR) to Node01 through Internet (1) containing
diagnosis information (about 2.048 bytes) is:
TDtoInternet Avg = 3,8541 sec
•
TtoAdhoc Avg = 2,8345 sec
Fig. 10. DOCTOR application multiple data presentation (Electrocardiogram)
Files generated by Dev01 (ECG) are ASCII plain text
format, each row ends with hex values 0Dh 0Ah (Carriage
Return and Line Feed). File name extension is “.DAT”. The
content and parameters of these files are as follows:
• Time: Time of sample (starting always from zero)
• Voltage: Sample measure in mV (10-3 Volts)
• Peak: “3” when peak is reached (previous and next
voltage values al less than the voltage of the sample)
The average ad hoc network routing time from Node01 to
Node03 (NURSE) with diagnosis is:
•
The total average network transfer time from DOCTOR to
NURSE is:
TDtoTotal Avg = TDtoInternet Avg + TtoAdhoc Avg
TDtoTotal Avg = 3,8541 sec + 2,8345 sec = 6,6886 sec
•
The complete network transfer is in average:
TTotalAvg = TtoDTotal Avg + TDtoTotal Avg
TTotalAvg = 81,9504 sec + 6,6886 sec
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CONCAPAN XXXI
TTotalAvg = 88,6390 sec
(1) Internet file transfer latency may vary depending on both
sides ADSL real connection speeds.
K. Conclusions
The proposed solution enables the transport of health data
from patients to any destination. We identify the following
type benefits:
a) Related to ad hoc networks:
•
•
•
They allow a fast deployment with an easy configuration
and reliable data transmission.
They are available at a very reasonable and affordable
costs
Only one computer needs public Internet access for the
entire wireless ad hoc network. The network can be
geographically extended by adding nodes.
b) Related to the solution
•
•
Provides more efficient results in terms of quality, costs
and time savings because qualified feedback come in
minutes, professionals are virtual (there is o need to
travel), information is digitally recorded (there is no need
for papers).
This solution can co-operate with future fixed wireless
infrastructure when available.
III. REFERENCES
[1] Budget 2008–09: economic issues, Parliamentary Library,
Parliament of Australia, 4 June 2008
http://www.aph.gov.au/library/pubs/rp/BudgetReview/Econo
mic_Issues.htm
[2] Wi-Fi Pilots for Development in Latin America and the
Caribbean, International Development Research Centre,
October 2003, Canada
[3] Ad hoc Wireless Networks – Architectures and Protocols – C.
Siva Ram Murthy and B. S. Manoj – Prentice Hall
Communications Engineering and Emerging Technologies
Series.
http://www.idrc.ca/en/ev-86101-201-1-DO_TOPIC.html
[4] Ad hoc Protocol Evaluation and Experiences of Real World
Ad Hoc Networking – David Lundberg – Department of
Information Technology, Uppsala University
http://www.update.uu.se/~davidl/msthesis/thesis.pdf
[5] Pohang University of Science and Technology
http://monet.postech.ac.kr/research.html
[6] The ARC Communications Research Network
http://www.acorn.net.au/home.cfm
[7] From Ad Hoc Networks to Ad Hoc Applications - Position
Paper – Benoît Garbinato, Philippe Rupp – Institut
d’Informatique et Organisation (INFORGE) – Ecole des HEC
– Université de Lausanne
[8] Yongguang Zhang and Wenke Lee, Security in Mobile Ad hoc
Networks, in Book Ad Hoc Networks Technologies and
Protocols (Chapter 9), Springer, 2005.
IEEE, Sección El Salvador.
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[9] Panagiotis Papadimitraos and Zygmunt J. Hass, Securing
Mobile Ad Hoc Networks, in Book The Handbook of Ad Hoc
Wireless Networks (Chapter 31), CRC Press LLC, 2003.
[10] Mishra, Amitabh: Security and Quality of Service in Ad Hoc
Wireless Networks. Cambridge University Press (2008)
[11] Medical Applications of Wireless Networks, Tam Vu Ngoc,
Washington University in St. Louis, 21 April 2008
http://www.cse.wustl.edu/~jain/cse57408/ftp/medical/index.htm l
[12] Universal Declaration on Bioethics and Human Rights,
Records of the General Conference, 33rd session, Paris, 3 –
21 October 2005
http://unesdoc.unesco.org/images/0014/001428/142825e.pdf
#page=80
[13] ADSL (Asymmetric Digital Subscriber Line)
http://www.techterms.com/definition/adsl
[14] BandwithPlace Internet Speed Tester
http://www.bandwidthplace.com/
[15] Simple pragmatic approach to mesh routing using
B.A.T.M.A.N. (Better Approach To Mobile Ad hoc
Networking) – Johnson, Ntlatlapa and Aichele – 2nd IFIP
International Symposium on Wireless Communications and
Information Technology – October 2008
http://researchspace.csir.co.za/dspace/handle/10204/3035
[16] Linux Users Group Rosario – Argentina – March 2011
http://lugro-novedad.blogspot.com/2011/03/se-libero-elkernel-2638-incluye-batman.html
[17] Java Technology
http://www.oracle.com/us/technologies/java/index.html
[18] The Ubuntu Project – Free Operating System
http://www.ubuntu.com/project
[19] Firestarter – Open Source visual firewall program
http://www.fs-security.com/
[20] Role of the Domain Name System (DNS), J.C. Klensin, J.
Klensin – February 2003
http://tools.ietf.org/html/rfc3467
[21] Free multiplatform software Wireshark Version 1.4.0 for
Windows
http://www.wireshark.org/
[22] British heart foundation – ECG
http://www.bhf.org.uk/heart-health/tests/ecg.aspx
[23] The Standard 12 Leads ECG – Frank G. Yanowitz, MD –
Professor of Medicine – University of Utah School of
Medicine
http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson1/inde
x.html
[24] Tratado de Enfermería y Cuidados Críticos Pediátricos y
Neonatales – Chapter 56
http://www.eccpn.aibarra.org/temario/seccion4/capitulo56/c
apitulo56.htm
[25] A Dynamical Model for Generating Synthetic
Electrocardiogram Signals
http://www.mit.edu/~gari/CODE/ECGSY/JAVA/APPLET2/
ecgsyn/ecg-java/software.html
IV. BIOGRAPHIES
Fabio Bruschetti (1964): IT Information Systems graduate with honors
from CAECE University. Current researcher on Computer Networks at
UNSAM and lecturer on Data Processing Systems at UNSAM, Computer
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Architectures at CAECE University, Networking Essentials at CAECE
University and Information Technology at UBA postgraduate department.
María Claudia Abeledo (1962): IT Information Systems graduate with
honors from CAECE University. Magister computer networking graduate
with honors from La Plata University. Current researcher and lecturer on
Computer Networks at UNSAM and current lecturer on Computer Networks
and Networking Essentials at CAECE University.
Sebastián José Emilio Lorandi (1987): Electro-medicine technician
from UNSAM. Current researcher and lecturer on Electronic Measurements,
Medical Instruments and Biomedical Signal Acquisition and Processing at
UNSAM.
Pedro Facundo Iriso (1989): Advanced student of Networking
Technician Degree from UNSAM.
Cristian Miño (1983): Advanced student of Networking Technician
Degree from UNSAM.
María de las Mercedes Cresta (1979): Advance student of IT
Information Systems from CAECE University.
IEEE, Sección El Salvador.
EL Salvador, Noviembre 2011