GISFI TR IOT.101V1.0.0(2011-12)
Technical Report
Global ICT Standardisation Forum for India
Internet of Things
mHealth Use Cases
(Release 1)
The present document has been developed within GISFI and may be further elaborated for the purposes of GISFI.
GISFI TR IOT.101 V1.0.0 (2011-12)
1
Release 1
GISFI
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Contents
Foreword......
Introduction......
1Scope......
2References......
3Definitions, symbols and abbreviations......
3.1Abbreviations......
4mHealth (Mobile Healthcare) General Description
5mHealth System Use cases......
5.1Detailed Use cases......
5.1.1List of Use cases......
5.1.2Use case Actors
5.1.3Authentication, Authorization and Registration
5.1.3.1General Use Case Description
5.1.3.2Stakeholders
5.1.3.3Scenario
5.1.3.4Information Exchanges
5.1.3.5Requirements
5.1.4Pre-disease......
5.1.4.1General Use Case Description
5.1.4.2Stakeholders
5.1.4.3Scenario
5.1.4.4Information Exchanges
5.1.4.5Requirement
5.1.5Incubation Period
5.1.5.1General Use Case Description
5.1.5.2Stakeholders
5.1.5.3Scenario
5.1.5.4Information Exchanges
5.1.5.5Requirements
5.1.6Disease Identification
5.1.6.1General Use Case Description
5.1.6.2Stakeholders
5.1.6.3Scenario
5.1.6.4Information Exchanges
5.1.6.5Requirements
5.1.7Treatment
5.1.7.1General Use Case Description
5.1.7.2Stakeholders
5.1.7.3Scenario
5.1.7.4Information Exchanges
5.1.7.5Requirements
5.1.8Observation
5.1.8.1General Use Case Description
5.1.8.2Stakeholders
5.1.8.3Scenario
5.1.8.4Information Exchanges
5.1.8.5Requirements
5.1.9Discharge
5.1.9.1General Use Case Description
5.1.9.2Stakeholders
5.1.9.3Scenario
5.1.9.4Information Exchanges
5.1.9.5Requirements
5.1.10Enable &Disable, restart of healthcare equipments in Patient Station
5.1.10.1General Use Case Description
5.1.10.2Stakeholders
5.1.10.3Scenario
5.1.10.4Information Exchanges
5.1.10.5Requirements
5.1.11mHospital maintenance mode
5.1.11.1General Use Case Description
5.1.11.2Stakeholders
5.1.11.3Scenario
5.1.11.4Information Exchanges
5.1.11.5Requirements
5.1.12Kiosk Mobile maintenance mode
5.1.12.1General Use Case Description
5.1.12.2Stakeholders
5.1.12.3Scenario
5.1.12.4Information Exchanges
5.1.12.5Requirements
Annex <X>: Change history......
Foreword
This Technical Report has been produced by GISFI.
The contents of the present document are subject to continuing work within the Technical Working Group (TWG) and may change following formal TWG approval. Should the TWG modify the contents of the present document, it will be re-released by the TWG with an identifying change of release date and an increase in version number as follows:
Version x.y.z
where:
xthe first digit shows the release to which the document belongs
ythe second digit is incremented for all changes of substance, i.e. technical enhancements, corrections, updates, etc.
zthe third digit is incremented when editorial only changes have been incorporated in the document.
Introduction
Medical science has made revolutionary changes in the past decades. Contemporaneously however, healthcare has made incremental changes at best. The growing discrepancy between the revolutionary changes in medicine and the minimal changes in healthcare processes is leading to ineffective healthcare delivery. Thus one if not the significant contributor to the exponentially increasing costs plaguing healthcare globally.
The healthcare quality in bothdeveloped and developing countries leaves lots to desire for. Thus, improving the healthcare quality throughout the world will open up a huge market. In fact there are many areas in the world where medical coverage is not there but there ismobile coverage (even if it is sometimes in forms of mobile kiosks).
These challenges can be overcome by using the Mobile healthcare (mHealth) systems thathasattracted a great deal of attention due to their potential to improve the quality of diagnosis, reduce medical costs and help address the challenges posed also by the aging society. It can scale the healthcare market and equals the human population of the entire earth. Combination of the healthcare and mobile communication would result in providing mHealth – a business with high potential and highly beneficial to our society.
1Scope
The mHealth system is essential for protecting and monitoring the human health in any circumstances. The scope of this document is to develop mHealth related use cases and derive requirements from the use cases.
2References
The following documents contain provisions which, through reference in this text, constitute provisions of the present document.
[1]GISFI IOT2-2010007:”M2MCommunication.doc
[2] making wireless M2M easy
[3] -m2m overviews
[4] -m2m for home appliances
[5]ETSI TS 102 689 V1.1.1 (2010-08) :“Machine-to-Machine communications (M2M);
- Smart Metering Use Cases”
3Definitions, symbols and abbreviations
3.1Abbreviations
4mHealthGeneral Description
Figure 1 illustratesthe Mobile Healthcare (mHealth) system. The mHealth system includes subsystems like LTE transport network (besides LTE we could have other mobile or wireless system too– in this document we refer to LTE),expert station and patient station. The other subsystems are government sector, insurance company and global patient record management system. Here the expert station is the part of the fixed hospital network and patient station is part of mobile hospital.
The expert station, where the doctor resides, should includehealthcare equipments and other healthcare support system.The connectivity between the mobile hospital and expert station can be provided by the LTE network.The expert station is connected with LTE network and it provides the transportation to access equipmentsin the expert station by mobile hospital.
Healthcare equipments in the patient station would collect the parameters from patients and send to the actual healthcare equipments in the expert station. Once the calculation has done in the expert station, it would send the result back patient station.
The mobile kioskwill provide the personal healthcare service for the patient. The mobile kiosk is like handheld device which is having the personal healthcare applications. The connectivity between the personal healthcare device and expert station is provided by the LTE network.
The Patient Record Management (PRM) system is placed in the Figure as a global system. The doctors canaccess this system from anywhere in the world. The hospital is responsiblefor updating the system PRM when patient undergoestreatments.
The ambulance and Insurance system can be accessible by the patient and hospital.
Basic usage scenarios are:
1)Check and communicate: Patient uses patient station to check health statuscommunicates with expert station (to expert human being or machine, i.e.,healthcare applications). This can be done by visiting a local kiosk or by using one’s mobile terminal with health measurement devices and sensors. The kiosk can have medical staff.
2)Mobile kiosk: Same as 1 except that the equipments areavailable in a kiosk as inFigure 1in a vehicle which is mobile. The mobile kiosk can have medical staff.
3)Mobile medical: In this case the medical expert might visit patients’location; this is common in some parts of India. Then the medical expert will use her/his device to communicate with expert station and utilize test/measurement equipments that he/she is carrying or the patient has.
4)The expert station is one where the doctors would be available and patient station where the patient shall be there
Note: Here instead of the LTE network other wireless network can be considered.
GISFI
GISFI TR IOT.101 V1.0.0 (2011-12)
1
Release 1
GISFI
GISFI TR IOT.101 V1.0.0 (2011-12)
1
Release 1
5mHealth Use cases
5.1Detailed Use cases
5.1.1List of Use cases
The mHealth system use cases are listed below. These use case shallhelps to derive requirements.
The Personal healthcare service use case shall be helpful to patients when they are in different stages of human lifecycle.
The healthcare equipments maintenance use cases shall be helpful when the administrator want torecover healthcare equipments from fault and to do software upgrade for equipment.
- Personalhealthcare service
In the following we have listed the use cases associated with mHealth personal healthcare services. The use cases are given as steps of illness or disease.
1.1Authentication, authorization and registration
1.2Pre-disease
1.3Incubation
1.4Disease identification
1.5Treatment
1.6Observation
1.7Discharge
1.8Other, e.g., payment
- Healthcare equipments maintenance
- Enable &Disable, restart the healthcare equipments from the patient station
- mHospital maintenancemode
- Kioskmobilemaintenance mode
5.1.2Use case Actors
Patient:Person whotake the treatment for diseases usingmobile kiosk or MobileHospital (mHospital)
Doctor: Person is responsible for provide the treatment for the patients from the expert station
Hospital Support Staff: Staff who will work in the mHospital and Expert station as support todoctor.
Network Operator:Organization or person whois responsible for managing the network, configuring and maintaining the service
5.1.3Authentication, Authorization and Registration
5.1.3.1General Use Case Description
Patient authentication is a necessary security requirement in remote health care scenarios. The Health care system needs to make sure that the data is coming from the right person before any medical or financial decisions are made based on the data.
This use case describes the authentication, authorization and registration of patientsto get mHealth service. The first step of course is the registration of the patient. Once registered, the patient can get services after authentication and authorization. If the patient is not authenticated or authorized for specific service then the expert station shall react on it, information will also be provided to patents’ mobile hospital.
5.1.3.2Stakeholders
Patient, mHealth service provider and others (FFS)
5.1.3.3Scenario
Pre Conditions:
-mHealth application should be installed in the mobile and be ready for service
-Patient shall have the prior knowledge about the usage of the mHealth service
-Healthcare application and wireless equipment shall be in ready state to take the request and process
Post Conditions:
The mobile kiosk/MobileHospital(mHospital) shall connect to the LTE network
Trigger:
The mobile kioskuser/mHospital shall do the trigger for network entry manually or by power on/off of mobile kioskor mHospital
5.1.3.4Information Exchanges
Basic Flow:
- The mobile kioskuser or mHospital user shall trigger the network entry
- In the part of the UE network entry,authentication andauthorization would be triggered
- Once authentication andauthorization isdone then soon there after network connectivity shall be completed
The application shall start and work
5.1.3.5Requirements
-The UE should have network subscription
-Transport network shall support user level authentication procedure,timers for sending the messages, resend and retry of the procedure
-Network shall have error andfault handling procedure while doing the user level authentication and authorization
5.1.4Pre-disease
5.1.4.1General Use Case Description
Diseases such as diabetes, high blood pressure, osteoporosis and obesity lead to premature death of 90% of the population. These are the big four diseases that destroy quality of life. To stem the rising incidence of these conditions, health experts have now identified "pre-diseases". These are the predetermined markers, or clear warning signs of the four mentioned diseases. Identifying pre-diseases and tackling them before they become full-blown conditions is the best way towards a long-term good health.
This use case describes how patients (mobile kiosk user) and patients in mHospitalcanget periodical or continuous health checkup in pre diseases stage.
5.1.4.2Stakeholders
Patient, support staff from the Mobile-hospital, expert station and others.
5.1.4.3Scenario
Pre Conditions:
-mHealth application has to be install in mobile and readily available for service
-mHospital has to be installed and readily available for service
-Patient and support staff in mHospitalshall have the prior knowledge about the usage of the mHealth service
-Mobile kiosk and or mHospital shall be Authenticated, Authorized
-Patient and mHospital shall register for mHealth pre-disease service
Post Conditions:
The mobile kiosk/mHospital shall get updates periodically about pre-disease information’s.
Trigger:
The patient health check trigger would come from periodic Health check system in Expert station orpatients
5.1.4.4Information Exchanges
Basic Flow:
- The patient or support staff shall trigger events (Health check request) from the mobilekiosk or Patient station. The automatic trigger would come from periodic health care system if the patient is registered for the periodic health care service
- The relevant parameters would be measured from patient and send to relevant back end system
- The expert station shall receive request and process, send back the response
5.1.4.5Requirement
-The mobile kiosk and mHospital shall have the functionality to measure relevant parameters from patients. The final measurement report shall be send to expert station.
-The Expert station shall have the functionality to evaluate measurementparameters andgenerate the result
-The Expert station shall have the functionality to sent result back to mobile kiosk
-The mobile kiosk and mHospital shall have the functionality to check and indicate the current state of expert station
-The mobile kiosk and mHospital shall have the functionality to indicate issue or error if expert station is not in ready state
-The mobile kiosk and mHospital shall have the functionality for fault recovery
5.1.5Incubation Period
5.1.5.1General Use Case Description
Incubation period: In medicine, the time from the moment of exposure to an infectious agent until signs and symptoms of the disease appear. For example, the incubation period of chickenpox is 14-16 days.
This use cases shall describes & notify aboutdiseases spreading medium, source of diseases, awareness to be taken, precaution and other information during disease Incubation period. Patientscan get this informationdirectly from mobile kiosk and mHospital who registered for mHealth services.This personal health care service shall provide service to mobile kioskpatients and patients in Mobile-Hospital to protect them from seasonal diseases and other factors. The incubation period advertisementshall be initiated from expert stationwhere information will be collected from various source.
Currently there is a constant emergency of new symptoms and new diseases. To protect from diseases patients needs constant update on the symptoms of the diseases. Doctors and Para-medical staff also require updates on new symptoms and new diseases information to treat the patients. The expert station will provide periodical updates to the Mobile hospital and Mobile-Kiosk.
5.1.5.2Stakeholders
Patients, Doctor, Advertisement agent in Expert station (for periodic case)
5.1.5.3Scenario
Pre Conditions:
-mHealth application has to be install in mobilekiosk andmHospital,make readily available for service
-mHospitalmobile kiosk has to be install in network and readily available for service
-Patients and support staff in mHospital shall have prior knowledge about the usage ofmHealth service
-Mobile kiosk andmHospital shall be Authenticated ,Authorized and permitted to transport network
-Patients and mHospital shall register for mHealth service
Post Conditions:
The expert station advertisement shall be available in mobile kiosk and mHospital
Trigger:
Based on the intelligent input, severity of dieses the expert station shall trigger advertisement message
5.1.5.4Information Exchanges
Basic Flow:
- The expert station shall send advertisement message to all mobile kiosk and mHospital whoever register for health care service
- Patients and supportstaff in mHospitalshall get information about diseases Incubation
5.1.5.5Requirements
Specific Requirements:
-The expert station shall have intelligence to collect information about diseases and other factors
-The expert station shall have functionality to compose and send the advertisement information
-The system shall have the functionality to handle error &fault
5.1.6Disease Identification
5.1.6.1General Use Case Description
In order to help treat human diseases, it is important to understand what causes them to occur. Understanding what causes a disease is the first step in understanding the entire abnormal course of disease. Sometimes it is fairly easy to determine what causes a disease. So this use case will describe about patients disease identification using remote health care service.
Patient needs to get advice with doctors and medical staff in mHospital or expert station based on the symptoms and severity of the disease.Patient condition can also be measured in mHospital when the patient visits mHospital for consultation.mHospital and mKiosk will send this disease related information to expert station.Expert station will identify the disease and communicate the same with prescription and advice to the patient.
5.1.6.2Stakeholders
Patients, Doctor and Hospital support staff.
5.1.6.3Scenario
Pre Conditions:
-mHealth application has to be install in mobile kiosk and mHospital, readily available for service
-mHospitalmobile kiosk has to be install and readily available for service
-Patient and support staff in mHospital shall have the prior knowledge about usage of the mHealth service
-Mobile kiosk or and mHospital shall be Authenticated ,Authorized and permitted to the network
-Patient and mHospital shall register for mHealth service
Post Conditions:
Patients symptoms input shall be processed at the expert station and will be responded with treatment prescription and other inputs
Trigger:
Patients of mobile kioskor andmHospital Staff shall send query as patient symptoms using the mobile kiosk or mHospital
5.1.6.4 Information Exchanges
Basic Flow:
- Mobile kiosk and mHospital shall send patient symptomsto expert station
- The expert station shall processes the patient symptoms and will send back the result
5.1.6.5Requirements
Specific Requirements:
- The expert station shall havefunctionality to validate patient symptoms and process
-The expert station shall have functionality to identify patients disease using the symptoms
-The expert station shall have functionality to send back the result to the mobile kiosk and mHospital
-The system shall have the functionality to handle error and fault while process the queries
5.1.7Treatment
5.1.7.1General Use Case Description
Once patients has beendiagnosed and disease identified, doctor in the expert station shall advise patient to take the treatment via mobile kiosk or Mobile-Hospital according to patient s disease severity. Sothis use cases shall describes about how mobile kiosk patients and patients in Mobile-Hospital shall get treatment after disease diagnostics
5.1.7.2Stakeholders
Patient, Doctor and mHospital support staff
5.1.7.3Scenario
Pre Conditions:
-mHealth application should be installed in the mobilekiosk, mHospital and be ready for service
-mHospital, mobile kioskand expert system should be readily available for service.