IEEE JOURNAL ON SELECTED AREAS IN COMMUNICATIONS, VOL. 27, NO. 4, MAY 2009
361
Guest Editorial Wireless and Pervasive Communications for Healthcare
T
he timing of this special issue could not have been any better. At the time of writing this editorial, the newly elected President of the United States, Barack H. Obama has successfully led the congress in passing an economic stimulus package bill worth some US$ 780 billion to jump start the economy. The bill has an allocation of more than US$1.5B in new expenditures to the applications of information technology in healthcare, and another US$2.5B are allocated to broadband and telemedicine applications, an endeavor which will stimulate socio-economical growth in one of the most critical areas by which the betterment of society is measured: quality of its healthcare services. Although technology has improved the quality of healthcare in the form of medical and imaging equipment and tools, the same could not be said about the adoption of information technology in the healthcare field. At a time when wireless technology is one of the leading agents of growth in the technology sector; the applications of wireless technologies in healthcare has been surprisingly sluggish. We hope that this will change in the very near future. Wireless and Pervasive Communications for improved Healthcare services, a new and vastly growing interdisciplinary field, calls for innovation in information and communications technology for facilitating reliable, comprehensive, and high quality clinical care service. It will eventually contribute to improving the quality of health care services for everyone. Advances in networking infrastructure as well as middleware are vital to delivering telemedicine services regardless of the patient physical location. Billions of dollars are wasted every year- in the United States alone- because of the lack of seamless interoperability between the myriad of medical software systems that are needed to process medical insurance claims, medical billing, and keeping accurate medical records for patients. Most software systems and medical equipment and tools used in hospitals (especially in operating rooms) today lack a means of smart interfaces for inter-communications and often require frequent manual intervention, for provisioning and configuration, that may lead to serious errors causing death in some cases. There is a serious lack of industry-wide standards for developing reliable and open software systems that can inter-communicate with each other regardless of the underlying equipment, tools, or interfaces. Care for elderly persons who live at home is costly and often causes loss of life because of the lack of sensors, wireless monitoring devices, and networking infrastructure and middleware that can automatically contact emergency services in case of emergencies such as sudden drop in blood pressure or heart attacks or strokes where a few minutes could mean the difference
Digital Object Identifier 10.1109/JSAC.2009.090501
between life and death. Patients entering emergency rooms- in case of car accidents or other similar accidents- do not have any means of tracing their health history, such as prior medications, allergies, or existing conditions that may interfere with newly prescribed medications or procedures. Physicians and nurses often prescribe redundant imaging or other laboratory works for patients because of the lack of a simple means of tracking such imaging or laboratory works that have already been done in the near past. These inefficiencies, and in many cases unacceptable use of outdated or even no technology, cost society billions of dollars of wasted resources not mentioning the loss of human lives that could have been saved. In rural areas and less developed countries, patients sometimes have to wait months to see a specialist or get admitted to a hospital that is specialized in a certain area of medicine or has advanced imaging equipment such as MRI or CT-scan. Such prolonged waits could cost the patients their lives. Equipping such rural areas with simple medical facilities that are connected (via high capacity pipes and other middleware software systems) could allow such patients immediate access to high quality medical care that is physical available thousands of miles away, cut down costs significantly and even save lives in some cases. Mobile software services in new mobile phones and PDAs could be easily used to track the health conditions of patients and relate such information in real-time to their nearest health care provider or medical doctor. Strokes and other serious calamities could very well be avoided if such devices are used to alert medical staff in time to send to the patient an emergency responsive team, or even send an automatic message to the patient’s device alerting him or her that he or she should check himself/herself into the nearest medical facility. Wireless and pervasive communications in the healthcare domain as well as future personal communication services will provide new dimensions to existing medical services and areas of outreach that were not possible in the current generation of healthcare systems. Communications research for healthcare applications is, in some meaningful manner, distinctly different from communications research in general (e.g., sensor networks, error-correction coding, waveform design, etc.). Specific examples could be: • Failure of traditional communications networks (say voice communication) is a nuisance. Failure of healthcare-based telecom means someone may die. • Veridical and time-accurate acquisition of physiological data is extremely important and leads to additional challenges over the more temporally forgiving applications of traditional telecom used for voice and data traffic. • Patient transport creates additional challenges of data communication within an urban environment with sustained moderate data rates or transmission from remote areas.
0733-8716/09/$25.00 © 2009 IEEE
362
IEEE JOURNAL ON SELECTED AREAS IN COMMUNICATIONS, VOL. 27, NO. 4, MAY 2009
• Research on how to transmit medical imaging such as MRI, video feeds in remote-surgery utilizing robots.This requires the transmission of un-compressed video. One possible solution is to use dynamic setup and release of end-to-end connections at high bandwidth rates using MPLS and GMPLS control plane. Some interesting problems arise such as scheduling of requests for high bandwidth connections and how they can be resolved. What other solutions other than setting up end to end connections would be viable? How would solutions like Fast TCP and others that do not need setting up end to end connections compare to connection oriented networks? • Service Enabling Middleware: Software platforms that enable services especially mobile ones or those that traverse mobile/wireline networks are application-specific. They are designed with specific applications to plug into them such as GPS on mobile phones, or downloading music into mobile phones,video feeds to mobile phones,..etc. Medical applications require connecting many mobile equipment available in ambulances and with emergency personnel to hospitals and emergency rooms. Personal medical monitoring devices could be used to transmit patients’ vital signs to local or remote hospitals and physicians. Designing software platforms to enable such services is quite specific for medical applications. • Similarly there is a need to develop software platforms that would provide seamless interoperability between different software systems used by different medical insurance and minimize or eliminate the manual process of having patients filling out multiple forms, lacking the capability for accessing a unique patient database where patient information including medications, imaging data like MRI and others are stored and could be securely accessed by any health care professional. Healthcare application is motivating unique basic research challenges in wireless and pervasive communications due to near-lossless coding for medical images, signal propagation characteristics, low network latency, low packet loss and need for safe, secure, and dependable operation. The goal of this issue is to report to the community cuttingedge research achievements in the field of applications of Networks for Healthcare. We believe that this special issue will serve as an impetus for the community to push research and development activities in this crucial area where the benefits of networking technologies will contribute immensely to the welfare of the society. We have been very fortunate having a number of eminent contributors who as being the leaders in the field contributed immensely to this issue. Our sincere thanks go the reviewers who did a superb job providing the authors with a critical yet highly constructive and helpful feedback. Undoubtedly, this feedback was essential in improving the quality of the issue in many tangible and important ways. Last but not least, we would like to express our thanks to the Editor-in-Chief, Pamela Cosman, for her interest and continuous encouragement for this project.
ATHANASIOS V. VASILAKOS, Guest Editor Department of Computer and Telecommunications Engineering University of Western Macedonia, 50100, Kozani, Greece Email:
[email protected] HSIAO-HWA CHEN, Guest Editor Department of Engineering Science National Cheng Kung University Tainan City, 70101 Taiwan Email:
[email protected] HUSSEIN MOUFTAH, Guest Editor School of Information Technology and Engineering University of Ottawa, Ottawa, Ontario, Canada K1N 6N5 Email:
[email protected] IBRAHIM HABIB, Guest Editor Department of Electrical Engineering City College and Graduate School City University of New York Convent Avenue at 140th Street New York, NY 10031 E-mail:
[email protected] KEVIN MONTGOMERY, Guest Editor National Biocomputation Center 701A Welch Road, Suite 1128 Stanford, CA 94305 E-mail:
[email protected] STEVEN LOW, J-SAC Board Representative
A. V. Vasilakos is currently Professor at the Dept.of Computer and Telecommunications Engineering, University of Western Macedonia, Greece and visiting Professor at the Graduate Programme of the Dept. of Electrical and Computer Engineering, National Technical University of Athens (NTUA). He has authored or co-authored over 200 technical papers in major international journals and conferences, He is author /coauthor of five books, 20 book chapters in the areas of communications. He served as general chair, TPC chair and symposium chair for many international conferences. He served or is serving as an Editor for many technical journals such as IEEE Transactions on Systems, Man and Cybernetics (TSMC-PartB), IEEE Transactions on Information Technology in Biomedicine, (TITB), IEEE Communications Magazine, ACM/Springer Wireless Networks and Guest Editor for many journals such as IEEE JSAC, ACM Transactions on Autonomous and Adaptive Systems. He is founding Editor-in-
IEEE JOURNAL ON SELECTED AREAS IN COMMUNICATIONS, VOL. 27, NO. 4, MAY 2009
chief of the journals: International Journal of Adaptive and Autonomous Communications Systems (IJAACS, http://www. inderscience.com/ijaacs), International Journal of Arts and Technology (IJART, http://www.inderscience.com/ijart). He is chairman of the Telecommunications Task Force of the Intelligent Systems Applications Technical Committee (ISATC) of the IEEE Computational Intelligence Society (CIS).
Hsiao-Hwa Chen is currently a full Professor in Department of Engineering Science, National Cheng Kung University, Taiwan, and he was the founding Director of the Institute of Communications Engineering of the National Sun Yat-Sen University, Taiwan. He received BSc and MSc degrees from Zhejiang University, China, and PhD degree from University of Oulu, Finland, in 1982, 1985 and 1990, respectively, all in Electrical Engineering. He has authored or co-authored over 300 technical papers in major international journals and conferences, five books and several book chapters in the areas of communications, including the books titled "Next Generation Wireless Systems and Networks" (512 pages) and "The Next Generation CDMA Technologies" (468 pages), both published by John Wiley and Sons in 2005 and 2007, respectively. He has been an active volunteer for IEEE various technical activities for over 20 years. Currently, he is serving as the Chair of IEEE ComSoc Radio Communications Committee, and the Vice Chair of IEEE ComSoc Communications & Information Security Technical Committee. He served or is serving as symposium chair/co-chair of many major IEEE conferences, including VTC, ICC, Globecom and WCNC, etc. He served or is serving as Associate Editor or/and Guest Editor of numerous important technical journals in communications. He is serving as the Chief Editor (Asia and Pacific) for Wiley's Wireless Communications and Mobile Computing (WCMC) Journal and Wiley's International Journal of Communication Systems, etc. He is the founding Editor-in-Chief of Wiley' Security and Communication Networks journal (www.interscience.wiley. com/journal/security). He is also an adjunct Professor of Zhejiang University, China, and Shanghai Jiao Tong University, China. Professor Chen is a recipient of the Best Paper Award in IEEE WCNC 2008.
Ibrahim Habib received the PH.D. degree from the City University of New York, the M.Sc. degree from Polytechnic University of New York, and the B.Sc. degree from Ain Shams University, Cairo, Egypt all in Electrical Engineering. In 1991 he joined the Faculty of the City University of New York where is now
363
a Professor and Director of the Advanced Networking Research Laboratory. From 1997 till 2001 he was with AT&T Labs and then Telcordia Technologies Research Labs. From 2001 till 2008 he has been consulting with a number of industrial and research labs both in the USA and Europe. His research interests spans different areas of networking including architecture design and traffic engineering in IP optical networks, quality of service enabling and optimization of resources in wireless networks, and design of mobile-enabled service enabling platforms. He has published extensively in those areas. He was a Guest Editor for a number of special issues in the Journal on Selected Areas in Communications (JSAC), Communications Magazine, Wireless Communications Magazine, and John Wiley Journal on Wireless Communications and Mobile Computing. He is currently an editor on a number of IEEE and Elsevier networking journals. He has been co-chairman and chairman of many symposia and workshops in various IEEE conferences.
Hussein Mouftah joined the School of Information Technology and Engineering (SITE) of the University of Ottawa in 2002 as a Tier 1 Canada Research Chair Professor, where he became a University Distinguished Professor in 2006. He has been with the ECE Dept. at Queen’s University (1979-2002), where he was prior to his departure a Full Professor and the Department Associate Head. He has six years of industrial experience mainly at Bell Northern Research of Ottawa (now Nortel Networks). He served as Editor-in-Chief of the IEEE Communications Magazine (1995-97) and IEEE ComSoc Director of Magazines (199899), Chair of the Awards Committee (2002-03), Director of Education (2006-07), and Member of the Board of Governors (1997-99 and 2006-07). He has been a Distinguished Speaker of the IEEE Communications Society since 2000. He is the author or coauthor of 5 books, 30 book chapters and more than 800 technical papers, 10 patents and 138 industrial reports. He is the joint holder of 8 Best Paper and/or Outstanding Paper Awards. He has received numerous prestigious awards, such as the 2007 Royal Society of Canada Thomas W. Eadie Medal, the 2007-2008 University of Ottawa Award for Excellence in Research, the 2006 IEEE Canada McNaughton Gold Medal, the 2006 EIC Julian Smith Medal, the 2004 IEEE ComSoc Edwin Howard Armstrong Achievement Award, the 2004 George S. Glinski Award for Excellence in Research of the U of O Faculty of Engineering, the ORION Leadership Award of Merit (2008), the 1989 Engineering Medal for Research and Development of the Association of Professional Engineers of Ontario (PEO), and the Ontario Distinguished Researcher Award of the Ontario Innovation Trust. Dr. Mouftah is a Fellow of the IEEE (1990), the Canadian Academy of Engineering (2003), the Engineering Institute of Canada (2005) and the Royal Society of Canada RSC: Academy of Science (2008).
364
IEEE JOURNAL ON SELECTED AREAS IN COMMUNICATIONS, VOL. 27, NO. 4, MAY 2009
Kevin Montgomery (
[email protected]) is the Technical Director of the National Biocomputation Center at Stanford University, which develops technologies in computation, visualization, and simulation in medicine and surgery. Research projects include systems for computer-based surgical planning, intraoperative assistance systems, surgical simulators, anatomical atlases, as well as wireless telemedicine and telemetry. Before joining Stanford, he led teams at the NASA Ames Research Center to develop systems for 3D reconstruction and visualization of biomedical imaging data and at the Hewlett-Packard Company on networking protocol design and implementation. He earned his B.S. in Computer Science from
the University of Delaware and his M.S and PhD in Computer Engineering from the University of California. He is an IPA with the US Army, regularly serves on several study/review sections for NIH, NSF, and other granting agencies, as well as advises and consults with several small, high-tech companies in the Silicon Valley. In addition to his position at Stanford, he is also an adjunct associate professor in the John A. Burns School of Medicine at the University of Hawaii and at the University of Texas Health Sciences Center, Houston. He has over 18 years of full-time technical experience in industry, government, and academia, 15 years of management experience, and over 50 peer-reviewed journal and conference publications.