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Tokyo, Japan, 4-5 February 2013
BAN Portable Clinic towardAffordable Healthcare M2M Service
Masahiro KurodaManager, Standardization Promotion Office,
National Institute of Information and Communications Technology
ITU Workshop on “E-health services in low-resource settings:
Requirements and ITU role”
(Tokyo, Japan, 4-5 February 2013)
Epidemic of Obesity Communicable ?
Yes and No
Global status report on noncommunicable diseases (NCD) 2010This report … particular attention … in low- and middle-income countries, which … bear nearly 80% of the burden from diseases like cardiovascular disease, diabetes, cancer and chronic respiratory diseases. The health consequences of the worldwide epidemic of obesity are also addressed.
A large percentage of NCDs are preventable through the reduction of their four main behavioural risk factors: tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet.
(“Forward” from Dr Margaret Chan, Director-General, World Health Organization)
Tokyo, Japan, 4-5 February 2013 2
Obesity: Fat Burning with JoyTissue oxygen saturation (StO2) is used to know whether entered aerobic-exercise state
Measure de-oxidationized hemoglobin / oxidized hemoglobin by StO2 sensorCompute fat-burn grams from consumption calorie by 3-axis accelerometer when entered aerobic-exercise state
From Assoc. Prof. , Masatsugu Niawayama, Shizuoka university
Mobile phone vibrates when enter aerobic-exercise state
Body Area Network (BAN)
Glimpse fat –burn amount
Beautiful posture
Tokyo, Japan, 4-5 February 2013 3
Obesity: Essential Amino Acids
Wooden bucket theory
Balance in Essential amino acids
his
tidin
e
leuci
ne
meth
ionin
e
lysin
e
isole
uci
ne
thre
onin
e
Cannot use for protein composition!
Cannot use for protein composition!
Energy pooling as fat
Nutritive value is decided by lysine and other excessive amino acid is accumulated as discharge or fat
From Prof. Osamu Tochikubo, Medical School, Yokohama City University
Tokyo, Japan, 4-5 February 2013 4
Prevent lifestyle-related illnesses for incipient and healthy people
Hypertension(H), Abdominal obesity(O), Glucose intolerance(G), Lipidemia(L) and so on
Alcohol(A)Smoking(S1)Salt intake(S2)Saturated fat(S3)Stress(S4)Sleeplessness(S5)Lack of Exercise(E) and so on
Lifestyle-related illness
Lifestyle irregularity
Living environment
change …
5
From Prof. Osamu Tochikubo, Medical School, Yokohama City University
Preventive Medicine
Tokyo, Japan, 4-5 February 2013
Feedback Loop in Preventive Medicine
Meal delivery industry
Association of preventive medicine
Hospital
Acute care hospital
General medical checkup
Nutritional supplements or exercise instruction
Health industry
Ubiquitous sensing
6
Body Area Network (BAN)
From Prof. Osamu Tochikubo, Medical School, Yokohama City University
Sensor selection
Analysis bank
Tokyo, Japan, 4-5 February 2013
PHY NB
PHY UWB
PHYHBC
Media AccessContro
l(MAC)
First Medical BAN published in 2012 1 common MAC with 3 PHYs
From 15-11-0826-01-0006-ieee-802-15-6-tutorial
7
The BAN Standard IEEE802.15.6
Tokyo, Japan, 4-5 February 2013
IEEE802.15.6: Frequency Band
Wireless LAN, ZigBee, Bluetooth 2.4GHz
IEEE802.15.6
Quality of Service is ensured
Tokyo, Japan, 4-5 February 2013 8
IEEE802.15.6:Strict Security Enforcement
Encrypted beacon
Tokyo, Japan, 4-5 February 2013 9
IEEE802.15 6:Priority Control
Top-priority data transfer for emergency data
Tokyo, Japan, 4-5 February 2013 10
20mA
10mA
Bluetooth Low Energy
IEEE802.15.6NB
Margin of processing in a sensor
Peak current
Rechargeable battery(Maxell CLB2032)
Flexible processing in a sensor by low peak current
From 15-11-0826-01-0006-ieee-802-15-6-tutorial.ppt
IEEE802.15.6:Low Power Consumption
Tokyo, Japan, 4-5 February 2013 11
Protection from Radio Wave EnvironmentSAR(Specific Absorption Ratio) is less than 2 W per every KgAverage power less than 20mW is outside of this limitation
Narrow Band (NB)Designed at 1mW or less in ISM, Medical telemeter, and specific small electric power bands
Ultra Wide Band (UWB)Below the allowable noise level (less than -41.3dBm/MHz< 20mW)
Human Body CommunicationWeak radio level (<<20mW)
IEEE802.15.6:Secure SAR Level
*http://www.tele.soumu.go.jp/j/sys/ele/body/protect/index.htm
Tokyo, Japan, 4-5 February 2013 12
Portable Clinicby Kyushu U. and Grameen
Geneva, Switzerland, 26-27 April 2012 13
Kyushu University and Grameen Communications prototyped an affordable “portable clinic” and experimented in villages and cities, Bangladesh
Confirm functionalities and usability of the systemNICT and the QoL-SN council provide BAN-based portable clinic functions for the experimental use
Point-of-care medical examination and remote diagnosis
Remote database
Blood pressureBlood ,Urine etc
Diagnosis and prescription
(Epidemiologic study)
Examinees
Use health-check devices for automatic categorization
Portable health clinic management
Cellular/Internet
Remote medical help center
Non-invasive medical devices/sensorsBlood testUrinalysis
BAN Portable Clinic Model
B-Logic
Tokyo, Japan, 4-5 February 2013 14
Paramedics
Green Yellow Orange Red
Blood Pressure (mmHg)
<140 mmHg 140≦ <160 mmHg 160≦ <180 180≦
<90 mmHg90≦ <100 mmHg
100≦ <110 110≦
Blood Sugar <100mg/dl100≦ <126mg/dl
126≦ < 200mg/dl
≧200mg/dl
Postprandial Blood Sugar
<140mg/dl140≦ <200mg/dl
200≦ < 300mg/dl
≧300mg/dl
Urine test
…
SpO2 ≧96% 93≦ <96% 90≦ <93% <90%
Red: Emergent -Telemedicine + Encouragement to visit clinic
Orange: Affected -Telemedicine
Yellow: Caution -Provide a leaflet about health care in Bengal
Green: Normal
Designed by Naoki Nakashima, M.D., Kyushu University Hospital and Kunihisa Kobayashi, M.D., Fukuoka University Chikushi Hospital
B-Logic
Tokyo, Japan, 4-5 February 2013 15
Medical Checkup and Remote Diagnosis in Rural Area Bangladesh
16
Remote examinee Wait for remote
Physical examination scene
Reg. , Interview Informed consent
Woman doctor for Women examinees
Start
Measured data on android tablet
Doctor’s remote exam.
Tokyo, Japan, 4-5 February 2013
BAN height meter
BAN weight meter
Android terminal BAN blood pressure
BAN SpO2 sensor
BAN waist meter
BAN body Temperature
BAN-enabled Devices and Android Terminal
Tokyo, Japan, 4-5 February 2013 17
Open software/hardware and standard
Real Technologies for BAN Portable Clinic
Unstable power supply and batteries may not be chargedData transfer via cell phone may not be availableLimited space/location is available in setting up the clinicUser-friendly interface for examiners
Tokyo, Japan, 4-5 February 2013 18
The QoL-SN Council is Working
Promote and help in providing really usable experimental systems, such as health-check KIOSK in disaster-stricken area, BAN portable clinic and others
Tokyo, Japan, 4-5 February 2013 19
www.qolsn.org
M2M Service Platform
ITU-T Focus Group is working on Healthcare M2MHealthcare M2M platform is an enabler of affordable BAN portable clinic because of sharing backend resourcesIn the near future, large number of sensors are used for NCDs protectionTo keep Quality-of-Service, sensors require simple-and-cheap identification, such as PUF (physically unclonable function)
Tokyo, Japan, 4-5 February 2013 20
M2 service platform
Feedback Loops in Preventive Medicine
Meal delivery industry
Association of preventive medicine
Hospital
Acute care hospital
General medical checkup
Nutritional supplements or exercise instruction
Health industry
Ubiquitous sensing
21
Body Area Network (BAN)
From Prof. Osamu Tochikubo, Medical School, Yokohama City University
M2
M se
rvice
pla
tform
Analysis bankSelf checkup
Tokyo, Japan, 4-5 February 2013
Nutritional guidancewith evidence
Non communicable diseases are common issues in the world and can be reduced by preventive medicine using easy-to-use technologies with open standardsThe first medical BAN standard IEEE02.15.6 is introduced for medical/health-related devices and sensorsBAN-enabled Portable Clinic and the service is a good candidate to provide really usable functions for preventive medicineExperimentally use open standards, provide feedbacks to the standards, and then deploy everywhere
22
Conclusions and Recommendations
Thank you
23