A REMOTE DATA ACCESS ARCHITECTURE FOR HOME-MONITORING HEALTH-CARE APPLICATIONS

Due to the medical advancement and the improvement in hygiene welfare, health conditions and average life span of the people have promoted a lot. The general public then changes the behavior and requires medical services of higher quality. In Taiwan, the society is moving towards advanced age and many problems are found associated with healthcare and social welfare for the elders and the patients with chronic diseases. Therefore, lots of issues regarding medical system, regulations, medical environment and facilities, are worthy to be investigated. For example, to fulfill the requirements of homecare and telemedicine, the technologies and devices for disease monitoring should be improved, the network infrastructure for medical information exchange should be built, and the homecare information and management system should be developed. The requirement of medical equipments is another issue; the elders and the patients with chronic diseases usually need some permanent or temporary medical devices to improve their lives and to treat diseases. These devices can capture and analyze physiological data of the patients, monitor the progress of patients’ health conditions, and diagnose and raise medical care in time.
With the aging of the population and the increasing patient preference for receiving care in their own homes, remote home care is one of the fastest growing areas of health care in Taiwan and many other countries. In addition, mobile healthcare has progressed a lot during the past few years because of the maturity of Internet-related technologies, the high-speed and wide-bandwidth communication networks, affordable and massive storage media, and trustable wireless information exchanges and computer encryption technologies. The wide spread of Internet and personal computer offer people a low cost and efficient platform for information collection, deposition and transport. The popularization of portable devices and mobile communication networks make people able to access various information and mobile services. The integration of Internet and mobile communication will eventually impact the medical environment and management to reorganize different medical services. It is believed that Internet and mobile communication will promote the benefit and value outputs, reduce cost and mistakes, and improve patients’ care and treatment for medical organizations. For the patients, the Internet and mobile communication networks will also make medical care become more rigorous, prompt and diversified.
The mobility of the patients and the dispersion of the medical services are the principal challenge of medical technologies in the future. This results from the change of medical environments and systems, multiple participants of caregivers, and various channels of medical services. Home care and decentralization of medical services will become the major trends because there will be more and more elders and the patients with chronic diseases. Therefore, to establish a network among the elders, the patients with chronic diseases and the medical organizations is an important issue for a modern medical environment. With this network, the caregivers can collect and manage patients’ information for diagnosis and treatment. The patients can also keep appropriate communication with hospitals, and receive suitable information and treatment in time. With this viewpoint we recognize that Internet and mobile communication are playing important roles.
Many remote home-monitoring applications have been developed and implemented to enable both formal and informal caregivers to have remote access to patient data so that they can respond instantly to any abnormalities of in-home patients. The aim of this technology is to give both patients and relatives better control of the health care, reduce the burden on informal caregivers, reduce visits to hospitals, and thus result in a better quality of life for both the patient and his/her family. To facilitate their widespread adoption, remote home-monitoring systems take advantage of the low-cost features and popularity of the Internet and PCs, but are inherently exposed to several security risks, such as virus and denial-of-service (DoS) attacks. These security threats exist as long as the in-home PC is directly accessible by remote-monitoring users over the Internet. Another issue is that most of the patients with chronic diseases are mobile and the remote home-monitoring system should take the roaming requirements into considerations. The purpose of our research is to improve the security of such systems, with the proposed architecture aimed at increasing the system availability and confidentiality of patient information. A broker server is introduced between the remote-monitoring devices and the in-home PCs. This topology removes direct access to the in-home PC, and a firewall can be configured to deny all inbound connections while the remote home-monitoring application is operating. This architecture helps to transfer the security risks from the in-home PC to the managed broker server, on which more advanced security measures can be implemented. The broker server also functions as a presence management server to maintain the presence information of the registered devices. With this presence management function, instead of being confined to a single place, the patients can roam across this collaboration network and the remote caregivers can still stay in touch with the patients. The pros and cons of this novel architecture design are also discussed and summarized.