ITU Workshop on
“E-health services in low-resource settings:
Requirements and ITU role”
(Tokyo, Japan, 4-5 February 2013)
BAN Portable Clinic toward
Affordable Healthcare M2M Service
Masahiro Kuroda
Manager, Standardization Promotion Office,
National Institute of Information and
Communications Technology
marsh@nict.go.jp
Tokyo, Japan, 4-5 February 2013
Epidemic of Obesity Communicable ?
Yes and No
Global status report on noncommunicable diseases
(NCD) 2010
This 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 Joy
Tissue oxygen saturation (StO2) is
used to know whether entered
aerobic-exercise state
Measure de-oxidationized hemoglobin
/ oxidized hemoglobin by StO2 sensor
Compute fat-burn grams from
consumption calorie by 3-axis
accelerometer when entered aerobicexercise state
Mobile phone vibrates
when enter aerobicexercise state
Body Area Network
(BAN)
Glimpse fat –burn
amount
Beautiful posture
From Assoc. Prof. , Masatsugu Niawayama,
Shizuoka university
Tokyo, Japan, 4-5 February 2013
3
Obesity: Essential Amino Acids
Nutritive value is decided by
lysine and other excessive
amino acid is accumulated
Wooden bucket theory
as discharge or fat
Balance in Essential amino acids
isoleucine
threonine
methionine
lysine
Energy pooling as fat
leucine
histidine
Cannot
Cannotuse
usefor
for
protein
proteincomposition!
composition!
From Prof. Osamu Tochikubo, Medical School, Yokohama City University
Tokyo, Japan, 4-5 February 2013
4
Preventive Medicine
Prevent lifestyle-related illnesses for
incipient and healthy people
Living
environment
change …
Hypertension(H),
Abdominal obesity(O),
Glucose intolerance(G),
Lipidemia(L) and so on
Lifestylerelated illness
Lifestyle irregularity
Alcohol(A)
Smoking(S1)
Salt intake(S2)
Saturated fat(S3)
Stress(S4)
Sleeplessness(S5)
Lack of Exercise(E)
and so on
From Prof. Osamu Tochikubo, Medical School, Yokohama City University
Tokyo, Japan, 4-5 February 2013
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Feedback Loop in Preventive Medicine
General medical checkup
Health
industry
Ubiquitous sensing
Association of
preventive
medicine
Analysis
bank
Sensor selection
Acute care
hospital
Body Area
Network (BAN)
Nutritional supplements or
exercise instruction
Hospital
Meal delivery
industry
From Prof. Osamu Tochikubo, Medical School, Yokohama City University
Tokyo, Japan, 4-5 February 2013
6
The BAN Standard IEEE802.15.6
First Medical BAN published in 2012
1 common MAC with 3 PHYs
PHY NB
Media
Access
Control
(MAC)
PHY
UWB
PHY
HBC
From 15-11-0826-01-0006-ieee-802-15-6-tutorial
Tokyo, Japan, 4-5 February 2013
7
IEEE802.15.6: Frequency Band
Quality of Service is ensured
Wireless LAN, ZigBee,
Bluetooth 2.4GHz
Tokyo, Japan, 4-5 February 2013
IEEE802.15.6
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
IEEE802.15.6:Low Power Consumption
Peak current
20mA
Margin of
processing in
a sensor
10mA
Rechargeable battery
(Maxell CLB2032)
Bluetooth
Low Energy
Flexible processing
in a sensor by low
peak current
IEEE802.15.6NB
From 15-11-0826-01-0006-ieee-802-15-6-tutorial.ppt
Tokyo, Japan, 4-5 February 2013
11
IEEE802.15.6:Secure SAR Level
Protection from Radio Wave Environment
SAR(Specific Absorption Ratio) is less than 2 W
per every Kg
Average 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 Communication
Weak radio level (<<20mW)
*http://www.tele.soumu.go.jp/j/sys/ele/body/protect/index.htm
Tokyo, Japan, 4-5 February 2013
12
Portable Clinic
by Kyushu U. and Grameen
Kyushu University and Grameen Communications
prototyped an affordable “portable clinic” and
experimented in villages and cities, Bangladesh
Confirm functionalities and usability of the system
NICT and the QoL-SN council provide BAN-based
portable clinic functions for the experimental use
Geneva, Switzerland, 26-27 April 2012
13
BAN Portable Clinic Model
Remote medical
help center
(Epidemiologic study)
Remote database
Point-of-care medical examination
and remote diagnosis B-Logic
Examinees
Blood pressure
Blood ,Urine etc
Diagnosis and prescription
Cellular/Internet
Use health-check devices for automatic categorization
Portable health clinic management
Paramedics
Tokyo, Japan, 4-5 February 2013
Non-invasive medical devices/sensors
Blood test
Urinalysis
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B-Logic
Green
Blood Pressure
(mmHg)
<140 mmHg
<90 mmHg
Blood Sugar
<100mg/dl
Postprandial Blood
Sugar
Urine test
<140mg/dl
Yellow
Orange
140≦ <160 mmHg 160≦
90≦ <100 mmHg 100≦
Red
<180
<110
180≦
110≦
≧200mg/d
100≦ <126mg/dl 126≦ < 200mg/dl
l
≧300mg/d
140≦ <200mg/dl 200≦ < 300mg/dl
l
…
SpO2
≧96%
93≦
<96%
90≦
<93%
<90%
Red: Emergent -Telemedicine + Encouragement to visit clinic
Orange: Affected
Yellow: Caution
-Telemedicine
-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
Tokyo, Japan, 4-5 February 2013
15
Medical Checkup and Remote
Diagnosis in Rural Area Bangladesh
Woman doctor
for Women
examinees
Doctor’s remote exam. Remote examinee
Wait for remote
Start
Physical examination scene
Measured data on android tablet
Reg. , Interview Informed consent
Tokyo, Japan, 4-5 February 2013
16
BAN-enabled Devices and Android
Terminal
Android terminal
BAN blood pressure
BAN SpO2 sensor
BAN waist meter
BAN body Temperature
BAN height meter
BAN weight meter
Open software/hardware and standard
Tokyo, Japan, 4-5 February 2013
17
Real Technologies for BAN Portable
Clinic
Unstable power supply and batteries
may not be charged
Data transfer via cell phone may not
be available
Limited space/location is available in
setting up the clinic
User-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 disasterstricken area, BAN
portable clinic and others
www.qolsn.org
Tokyo, Japan, 4-5 February 2013
19
M2M Service Platform
ITU-T Focus Group is working on
Healthcare M2M
Healthcare M2M platform is an
enabler of affordable BAN
portable clinic because of sharing
backend resources
In the near future, large number
of sensors are used for NCDs
protection
To keep Quality-of-Service,
sensors require simple-andcheap identification, such as PUF
(physically unclonable function)
Tokyo, Japan, 4-5 February 2013
M2 service platform
20
Feedback Loops in Preventive Medicine
General medical checkup
Self checkup
Nutritional guidance
with evidence
Body Area
Network (BAN)
Nutritional supplements
or exercise instruction
M2M service platform
Ubiquitous sensing
Health
industry
Association of
preventive
medicine
Analysis
bank
Hospital
Acute care
hospital
Meal delivery
industry
From Prof. Osamu Tochikubo, Medical School, Yokohama City University
Tokyo, Japan, 4-5 February 2013
21
Conclusions and Recommendations
Non communicable diseases are common issues in
the world and can be reduced by preventive
medicine using easy-to-use technologies with open
standards
The first medical BAN standard IEEE02.15.6 is
introduced for medical/health-related devices and
sensors
BAN-enabled Portable Clinic and the service is a
good candidate to provide really usable functions
for preventive medicine
Experimentally use open standards, provide
feedbacks to the standards, and then deploy
everywhere
22
Thank you
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