Tokyo, Japan, 4-5 February 2013 BAN Portable Clinic toward Affordable Healthcare M2M Service Masahiro Kuroda Manager, Standardization Promotion Office,

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

[email protected]

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


Obesity: Essential Amino Acids

Wooden bucket theory

Balance in Essential amino acids

his

tidin

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leuci

ne

meth

ionin

e

lysin

e

isole

uci

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thre

onin

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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


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


Preventive Medicine


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



Sensor selection

Analysis bank


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


IEEE802.15.6: Frequency Band

Wireless LAN, ZigBee, Bluetooth 2.4GHz

IEEE802.15.6

Quality of Service is ensured


IEEE802.15.6:Strict Security Enforcement

Encrypted beacon


IEEE802.15 6:Priority Control

Top-priority data transfer for emergency data


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


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


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


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


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.


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


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


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


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)


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



M2

M se

rvice

pla

tform

Analysis bankSelf checkup


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

Documents

Tokyo, Japan, 4-5 February 2013 BAN Portable Clinic toward Affordable Healthcare M2M Service Masahiro Kuroda Manager, Standardization Promotion Office,