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Internet of Things: A survey of enabling technologies in healthcare and its applications
Accepted Manuscript
Internet of Things: A Survey of Enabling Technologies in Healthcare and its Applications Mrinai M. Dhanvijay , Shailaja C. Patil PII: DOI: Reference:
S1389-1286(19)30269-5 https://doi.org/10.1016/j.comnet.2019.03.006 COMPNW 6755
To appear in:
Computer Networks
Received date: Revised date: Accepted date:
3 February 2018 8 February 2019 4 March 2019
Please cite this article as: Mrinai M. Dhanvijay , Shailaja C. Patil , Internet of Things: A Survey of Enabling Technologies in Healthcare and its Applications, Computer Networks (2019), doi: https://doi.org/10.1016/j.comnet.2019.03.006
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Internet of Things: A Survey of Enabling Technologies in Healthcare and its Applications Mrinai M. Dhanvijay a,*, Shailaja C. Patilb Research Scholar, Department of Technology, Savitribai Phule Pune University, Pune. b Professor, Department of Electronics and Telecommunication Engineering, Jayawant Shikshan Prasarak Mandal's Rajarshi Shahu College of Engineering, Pune. Email id: [email protected]
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Abstract
Internet of Things (IoT) on the Wireless Body Area Network (WBAN) for healthcare applications is an operative scenario for IoT devices that has gained attention from vast
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research fields in recent years. The IoT connects all subjects and the healthcare system seamlessly. This paper describes the WBAN based IoT healthcare system and reviews the state-of-the-art of the network architecture topology and applications in the IoT based healthcare solutions. Moreover, this paper analyzes the security and the privacy features
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consisting of privacy, authentication, energy, power, resource management, quality of services and the real-time wireless health monitoring that are quite problematic in many IoT
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healthcare architectures. Because, system architecture is not well-defined, data restriction and
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its integrity preservation is still a challenge. At present 90% of the information available is acquired in the recent two years. This survey mainly aims at analyzing healthcare purpose
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which is based on digital healthcare system. Further, it reports many IoT and the e-healthcare policies and systems that decide how to ease all bearable development. Thus, the overall
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system provides large possibilities for future research based on IoT healthcare system. Finally, research gaps are reviewed and the possible future aspects have been discussed. Keywords: - IoT, WBAN, healthcare system, body sensor. LIST OF ABBREVATIONS AAL
Ambient Assisted Living
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ACCEPTED MANUSCRIPT Analog to Digital Converter
ADR
Adverse Drug Reaction
AHS
Automation Healthcare System
BAN
Body Area Network
BP
Blood Pressure
BS
Base Station
BSN
Body Sensor Network
CCN
Content-Centric Networking
CH
Community Healthcare
CHI
Children Health Information
ECG
Electro Cardiogram
EGC
Embedded Gateway Configuration
GUI
Graphical User Interface
ICU
Intensive Care Unit
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IoT
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IEH
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IP
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ADC
Indirect Emergency Healthcare Internet of Things Internet Protocol
MAC
Medium Access Control
m-IoT
Internet of m-health Things
PAN
Personal Area Network
PC
Personal Computer
PDA
Personal Digital Assistant
PWS
Personal Web Server
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ACCEPTED MANUSCRIPT Quality of Service
SIoT
Social IoT
SMA
Semantic Medical Access
U-Health
Ubiquitous Healthcare
WBAN
Wireless Body Area Network
WDA
Wearable Device Access
WLAN
Wireless Local Area Network
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1 Introduction
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QoS
The H-IoT is also known as the health IoT, which is a milestone of information systems development. It plays a major role in enlightening the people health level and
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increases the worth of life [1]. It is a complex system, which involves microelectronics systems, medical and health, computer science and many other fields. According to the
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overall connected healthcare system, the period from 2017 to 2022 is the growth phase of IoT
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healthcare applications that accelerate the healthcare industries and various stakeholders that are stepping up their efforts [2]. Therefore, there is no doubt, that IoT works in transforming
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the healthcare sector by completely redefining the devices, apps and the people related and associated with each other in the healthcare solutions [3]. Thus, the IoT is constantly
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providing new tools, as the efficiencies which make up the integrated healthcare sector ensures better patient care. With this it was observed that the healthcare costs were reduced significantly and further, the treatment outcomes had improved. In future, wearable sensor, the wireless communication technologies, Wireless Sensor Networks (WSN), WBAN and Human Bond Communication are going to become an embryonic research area worldwide [4]. A Body Area Network (BAN) is also referred to as
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ACCEPTED MANUSCRIPT Body Sensor Network (BSN). It is a wireless network of wearable computing devices. BAN is same as that of other wireless network technologies. It covers the human body with a set of resident sensor or devices as depicted in Fig. 1. For example monitoring of person's vital signs, fitness information, cardiac monitoring for the medical purposes etc. The BAN might be embedded into the body by means of fixed position wearable method. However it is a
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system which humans can carry as devices in different positions, pockets and clothes. These tiny smart devices are playing an efficient and important role as data hub or data gateway in BAN applications [5]. Furthermore, the typical BAN consists of battery, transceiver and the
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processor and with this the physiological sensors ECG (Electro Cardiogram), are developed.
Physicians or authorized user
Sensor node
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Internet
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Master node
Medical server
Figure 1: IoT healthcare system
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Base station
A sensor node in the WBAN is capable of sampling, processing, and communicating
one or more vital signs such as heart rate, blood pressure, oxygen saturation, activities or environmental parameters which include location, temperature, humidity, etc. [6]. Ubiquitous health monitoring for extended periods of time is possible by strategically placing these sensors as tiny patches on the human body or by hiding them in the person’s clothes. The Personal Web Server (PWS) receives the relevant data from the sensor nodes which sample 4
ACCEPTED MANUSCRIPT the vital signs without obstruction through wireless personal network making use of Bluetooth or Zigbee [7, 8]. The PWS provides graphical/ audio interface to the user, thereby transferring the information about the health condition to the medical server through Internet or mobile telephone networks. This implementation is done on a Personal Digital Assistant (PDA),
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cellphone or home computer.
On the other hand, the master node manages the network and makes sure that only one sensor node is active at any given moment. Then, the master can implement carrier sensing to reduce collisions with other networks operating in the same band. The master node
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is used for interference avoidance. Either the sensor nodes ask for permission for data transmission or the sensor nodes are polled for data when needed by the master node. Furthermore, loss of synchronization between a sensor node and the network master, create a
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need for the node to listen continuously for the next signal. The master can transmit higher power and act as a gateway to the outside world since it has larger power supply.
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This network is used for an e-healthcare application which includes, early detection of
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medical issues computer-assisted rehabilitation, emergency notifications etc. Nowadays, according to the Social-IoT, the portable device such as smartphones, tabs, wearable etc., are
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essential parts of each individual’s daily life [9]. Therefore, this can be a gateway among the WBAN which is based on IoT technologies. Also, it connects wearable devices to the
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corresponding human body with Internet connection. It is an important and efficient smart healthcare system for the physicians to monitor the patient’s symptoms through BAN in the IoT environment. Nevertheless, the IoT healthcare sector is resourceful and the important characteristic of this sector is security, privacy, authentication, energy, power, resource management, quality of services and the real-time wireless health monitoring, which was quite questionable in many existing IoT healthcare architectures. Since, the architecture of the
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ACCEPTED MANUSCRIPT system is not-well defined, data restriction and preservation of its integrity and also the robustness of the overall system is not achieved. In order to achieve robust performance of IoT system, various approaches are introduced [10]. Therefore, the devices have become an important research area based on efficient security, privacy, and energy mechanism. Consequently, a security framework is needed to protect the overall IoT system from
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unauthorized entities. For healthcare system, the low power device WBAN is used to provide efficient and reliable infrastructure to all implanted, non-implanted and wearable sensor devices for human body [11]. These devices are used to capture numerous symptoms of the patients such as Blood pressure, Heartbeat, Respiration, Body temperature etc., and this
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information is sent to the body network controller, which is a part of WBAN. It is mainly focused on capturing the sensor data and then preprocessing the centralized healthcare server. Besides so many apps, prototypes services are also used in this healthcare field. Thus, it
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provides healthcare architecture, services and applications, security and privacy to end users [12]. In many countries, policies and guidelines are being developed for IoT technologies in
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the healthcare applications. According to these developing policies, current researches in
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healthcare sector is beneficial for several interested parties and other exploration works. The database is chosen according to their importance in the computer science area
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whose characteristics are availability of the study, coverage of indexed articles which belongs to journals or magazines or various reviews and usability for their selection. Selection of
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search engine is given in Table 1. Table 1: Selection of search engine Search engine
Source address
IEEE Xplore
http://ieeexplore.ieee.org/
ACM
http://dl.acm.org/
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ACCEPTED MANUSCRIPT Springer
http://link.springer.com/
Elsevier
http://www.elsevier.com/
This review examines the various IoT based healthcare researches and addresses various healthcare technologies, networks and taxonomy through IoT innovations. In this regard, this
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review contributes to
Modeling an existing method in IoT healthcare network and presenting summary of each for better understanding.
Model a detailed analysis of recent state-of-the-art IoT healthcare methods with their
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objectives, metrics, classification, strength and future scope.
A broad survey of IoT healthcare services and its applications.
Developing a core healthcare systems and healthcare networks, that can reshape
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healthcare technologies based on the IoT.
Modeling a current real-world application to support all researchers and policymakers
Finally, the intention is to overcome the challenges and the open issues to make the
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in integrating the IoT innovation into healthcare technologies in practice.
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IoT-based healthcare technologies robust.
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ACCEPTED MANUSCRIPT Sec. 1 Introduction Sec. 2 Enabling Methods of IoT
Sec 2.1 People-centric IoT Sec 2.2 Human Bond Communication Sec 2.3 Social IoT Sec. 3 Related Works Sec. 4 IoT in Healthcare Applications
Sec 4.2 Remote Monitoring Sec 4.3 Context-Awareness Sec. 5 IoT Healthcare Networks
Sec. 5.1 IoT Network Topology Sec. 5.2 IoT Network Platform Sec. 5.3 IoT Network Architecture
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Sec 4.1 Clinical Care
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Sec. 5.3.1 IoT Architecture Based on WBAN for Healthcare Applications Sec. 6 WBAN Based IoT Healthcare Technologies Sec. 6.1 Security
Sec. 6.1.1 Information Security
Sec. 6.1.2 System Privacy and Confidentiality
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Sec. 6.2 Energy
Sec. 6.2.1 Power
Sec. 6.3 Ubiquitous Healthcare
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Sec. 6.4 Resource Management Sec. 6.5 Quality of Services
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Sec. 6.6 Real Time Wireless Health Monitoring
Sec. 7 IoT Healthcare Services and Applications
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Sec. 7.1 IoT Healthcare Services
Sec. 7.2 IoT Healthcare Applications
Sec. 8 Challenges and Open Issues of IoT Healthcare System Sec. 8.1 Scalability Sec. 8.2 IoT Healthcare Security Sec. 8.3 Low Power in IoT Healthcare Device
Sec. 8.4 Network Architecture Sec. 8.5 Cost Analysis of IoT Healthcare System Sec. 8.6 The app development process Sec. 8.7 Quality of Services Sec. 8.8 Continuous Monitoring for Healthcare Purpose Sec. 9 Conclusions
Figure 2: Overview of the paper 8
ACCEPTED MANUSCRIPT The rest of the survey paper is organized and demonstrated in the Fig. 2. The remaining segments are structured as follows: Section 2 introduces enabling technologies of IoT, Section 3 presents the related work, Section 4 introduces the IoT in healthcare applications, Section 5 explains the IoT healthcare networks, Section 6 explains the WBAN based on IoT healthcare technologies followed by IoT healthcare services and applications in Section 7, the
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Section 8 presents some IoT healthcare challenges, and open issues, and finally Section 9 concludes the overall survey. This work ends with some future research directions. 2 Enabling Methods of IoT
The IoT should be capable of interconnecting billions or trillions of heterogeneous
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objects through the Internet. Such an evolution is enabled by the latest developments in smart sensors, communication technologies, and Internet protocols. A critical need for flexible methods emerged. In such a situation, an IoT can be realized with three important enabling
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methods, which include: People-Centric IoT, HBC, and SIoT. Some of them are based on the
2.1 People-centric IoT
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IoT healthcare system, as explained in the following.
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The People-IoT makes the design establishments for Future IoT network. It is a relevant application to a wide variety of needs and the innovative technologies. In this setting,
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an engineering reference displays the interoperability of IoT frameworks which concentrates on other mechanical issues, such as adaptability, versatility, administration, unwavering
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quality, security and protection [13]. People-centric IoT structures are used for displaying the Internet of People and the things they interface. The wearables are used for measuring the heart rates, calories, speed, temperature etc [14]. Therefore, the main focus of wearables on IoT applications is based on people-IoT services. This system is mainly used for the safety purpose such as biometric, tracking etc. 2.2 Human Bond Communication
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ACCEPTED MANUSCRIPT The HBC is mainly related to the WBAN healthcare system. The Knowledge Home is an important criterion in HBC. Also, it can be used in many applications, but mainly in the healthcare sector. Besides, the important knowledge home has healthcare issues such as predicting or preventing certain harms like heart attack, cardiac problem, etc. HBC is introduced as another hypothesis of transmitting five senses that mankind detects. It
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incorporates the accomplished Knowledge from the HBC transmission with the capacity of transmission of various human emotions and makes Knowledge Home [15]. The five faculties are specific, optic, sound-related, olfactory, gustatory and material. A wearable device is required for the digitalization of this new kind of information. The device will have
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the capability of revealing, transforming the information in digital form and sending the same through a communication channel. So conceptually, humans need to carry a so called BAN for detection and transmission of information. Usually information is sent using wireless link
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due to mobility issues. Moving personal health data has close similarity with HBC data security issues. Since privacy is important to both of the data, it must not be modified or
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accessed by any un-authorized persons.
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2.3 Social IoT
The Social IoT (SIoT) is a late embraced term for the coordination of individuals and
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gadgets into the informal organization worldview [16]. A definitive objective of SIoT is to advance human life via flawlessly coordinating their gadgets into their quotidian schedule.
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We add SIoT with a suggestion that merges the Web, "things" and clients under a semantic approach. This union rises up out of acquiring person to person communication elements and the estimations of intelligence, proposal, separation and benefits creation and recommending a widespread structure to consolidate clients, gadgets and administrations and the connections among them [17]. Smart Buddy idea is created to break down huge information produced by smart city communities to characterize human elements. Smart Buddy is bolstered by a
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ACCEPTED MANUSCRIPT framework design that investigates the surge of approaching information and comprehends human practices progressively, at long last impacting their practices through the ceaseless input [18]. To build up a framework for characterizing human elements, the SIoT-based shrewd city idea is utilized where a few remote and wired sensors, observation cameras, body zone systems are used for restorative applications. Facebook, Twitter, and other fixed gadgets
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convey about healthcare systems [19-20]. Smart Buddy takes the data from social networking applications but shrewd city metropolitan framework is keen in stopping the acquisition of data. 3 Related Works
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Some of the surveys based on the WBAN by means of IoT healthcare applications are documented below
Castillejo et al. presented the integration of wearable devices based on WSN for an e-
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health application where it was based on the WSN for IoT [21]. They mainly focused on the feasible e-health application by means of IoT. They introduced these sensors mainly for the
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usage of fireman and women than to the sportspersons. According to the functionalities, if a
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person reaches the hazardous level, an alarm alerts the user to stop doing the exercise. Thus, it is a real-time monitoring system, where it transmits the alerted message to the users. Their
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proposed system is fully tested and implemented, as it provides efficient real-time applications. Even though it has many advantages for various applications, it has some open
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issues such as accuracy and efficiency. He et al. introduced anonymous authentication for WBAN with provable security
[22]. The wireless networks, integrated circuits and the embedded systems are the emerging technologies in the BAN. Nowadays, the IoT plays an important role with WBAN in modern medical systems, because it has a capacity to collect the real-time medical data through the medical sensor from the patient's body. Even though the BAN was used for many
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ACCEPTED MANUSCRIPT applications, it has a major challenge in keeping the patient data confidential and private. Many schemes are introduced for these challenges, but it still remains a challenging one. Therefore, the proposed system reduced the security weakness on the client side. Zhang et al. produced the interference mitigation for cyber-physical WBAN system using social networks [23]. The WBAN was a key element for real-time monitoring in the
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ubiquitous healthcare applications. The WBAN could operate under dense environments, like hospitals, high mutual communication scenarios etc. These sensor networks depleted the energy more quickly and became unreliable in the collection of healthcare data. It increased the reliability of the system and reduced the power consumption. Many enabling technologies
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were introduced to regulate the overall system, but it remained as an open issue. Therefore, the authors introduced power game-based approach, to mitigate the modeling of interference, developing the social interaction and developing power control while minimizing the power
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consumption of the WBAN. Thus, this system produced the effectiveness in power management.
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Tokognon and Gao explained about the WBAN based on IoT for the healthcare
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applications as it communicated with the individual to individual and the individual to things [24]. According to the author, the IoT was made to be a part of the overall Internet of the
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future and several technologies were used in the IoT such as communication solutions, tracking technology, wired and wireless sensor identification etc. A new current trend IP
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(Internet Protocol) address was introduced, so that it could reach any other node of the network. Another paradigm was introduced called squared, which is a web2.0 evaluation grating web and sensing technologies to enrich this concept. In IoT the squared was an important application on an Internet. The current traditional technology is not fit for IoT, so the squared can be used for further researches. Scalability and efficiency were some of the challenges faced by the research community for efficient applications.
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ACCEPTED MANUSCRIPT Catarinucci et al. modeled a smart healthcare system based on IoT aware architecture [25]. The authors introduced the IoT aware architecture for automatic monitoring and tracking of patient’s biomedical information. They also proposed smart hospital system, with enabling technologies, especially for wireless networks and smart mobile to enable network infrastructure. The wireless Personal Area Network (PAN) with integrating technologies
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sensed the biomedical data and served the clients. Thus, it provided highly efficient real-time monitoring of patient's biomedical information. Furthermore, privacy was an open issue in this system.
Jara et al. described the interconnection framework for m-healthcare application
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based on IoT [26]. The process of communication and the information access process had a personalized health end to end framework. The personalized data was complex and was found to be in an incomplete manner. So, the authors introduced interconnection framework
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for m-healthcare applications based on IoT. It made continuous and real-time vital sign monitoring system which introduced technological innovations for the health monitoring of
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patient's devices by means of Internet system. In addition to this the data aggregation was
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determined by the round-trip delay time with the impact of security. Thus, it provided highly secure communication. Although profitability and scalability were also open issues in this
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framework.
Chen introduced the group mobility protocol for low power PAN based system by
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means of WBAN [27]. The proposed system provided low handoff delay and the signaling cost improved with the help of group mobility and the group based BAN. The packet loss ratio and the overhead criteria of the healthcare systems were reduced by the proposed method. Even though it had many applications, it possesses security challenges in this system. Thus, it acted as an open issue in the proposed system.
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ACCEPTED MANUSCRIPT Rohokale et al. explained the cooperative IoT system for the rural healthcare control and monitoring [28]. The authors mainly focused on the healthcare applications, as the information objects were tagged in persons by browsing with an IoT. In addition, the quality of services was an important paradigm in this work, as the authors developed the proposed IoT for the quality of services. This system was mainly introduced for the monitoring of poor
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people's health parameters, such as Hemoglobin, Abnormal cellular growth, Blood pressure etc. Furthermore, the authentication and the authorization was still an open issue in this system. The scope of the survey paper was to provide suitable research direction to the readers on how to choose the most appropriate IoT healthcare system for their network.
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4 IoT in Healthcare Applications
In the healthcare, IoT plays a very important role in various applications. This criterion is divided into three phases, such as clinical care, remote monitoring and context
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awareness. During data collection, the risks of human error are reduced by means of automatic medical data collection method. This will improve the quality of the diagnosis and
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reduce the risk of human errors, who are involved in the collection or transmission of false
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information which is dangerous for the patients' health. 4.1 Clinical Care
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In the hospitals, the patients, especially those who are in the intensive care, need continuous monitoring and close attention so as to react to the possible crisis and save lives.
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These monitoring systems employ sensors to collect physiological information which is analyzed and stored on the cloud and then it is sent to the Internet caregivers (patient’s family members, nurse) for further analysis [29]. Many health professionals collaborate together and then examine the patients according to each one’s specialty, by analyzing the flow of data collected by the sensors. Then the identification of the emergency condition for risky patients (Urgent or emergent surgery patient, cardiac patients etc) will be an easy task.
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ACCEPTED MANUSCRIPT 4.2 Remote Monitoring Remote monitoring is an important paradigm for many real-world applications. Nowadays, all over the world, there are many people whose health might suffer due to lack of effective healthcare monitoring [30]. Elderly, children or chronically ill people needed to be examined almost daily. The possibility of a remote monitoring system will help to avoid
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making rounds of the hospital for checkup illustrated in Fig. 3. Because of their critical status, sometimes their health goes unnoticed until the diseases develop into a crisis stage. Remote access sensor helps the caregivers to have pre-diagnosis and earlier intervention before things
WBAN 1st tier
Data aggregation 2nd tier
EKG Sensor
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Medical server
Medical doctor
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Motion sensor
WLAN (WiFi) WWAN (3G)
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Spo2 bp sensor.
Communicat ion 3rd tier
Internet
PDA
EMG sensor
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go wrong.
Emergency
Nurse
Figure 3: Real time remote monitoring system
Thus, the people-centric IoT is used for different units of cognitive and the physical infirmities will be enabled to have more autonomous and easy life [31]. As the sensor is attached to the skin at specific locations it can be used for diagnosing the heart condition and the influence of the drug on its activities. Many patients who suffer from chronic illnesses such as cardiopulmonary disease, Asthma, and Heart failure are located far away from the 15
ACCEPTED MANUSCRIPT medical care facilities. The real-time monitoring of such patients through wireless monitoring systems is the most promising application. Some of the real-time healthcare monitoring systems is remote patient tracking and monitoring system, remote monitoring of cardiac patients and heart beat monitoring system. The real-time monitoring system consists of remote medical monitoring unit and the monitoring center. It analyses the information from
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the sensor based on real-time analysis and a warning sign will emerge for emergency and diagnosis. The signals from the body sensor are taken to the corresponding medical center through Wireless Local Area Network (WLAN) system. As a result, this real time monitoring system provides information about patient’s health conditions, and it may also reduce more
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complications and provide treatment at the earliest. Thus, it provides accurate and real-time monitoring system in the healthcare sector. It also helps for faster detection of input sensor and save life.
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4.3 Context-Awareness
Context-awareness is a major criterion in the healthcare IoT applications. As it has the
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ability to find the patient's condition and the environment where the patient was located it
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will greatly assist the healthcare professionals to understand the variations that can influence the health status of these patients. In addition to, the change of physical state of the patient
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may increase the percentage of its vulnerabilities to diseases and be a cause for his/her health deterioration [32]. The use of several types of specialized Sensor capturing various
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information about the patient’s physical condition such as his walking, running, sleeping etc. or the environment where the patient is, such as wet, cold, hot etc., and the collaboration between them to collect the meaningful information, will provide a better understanding of the patient’s conditions, while they are hospitalized, at home or anywhere. Furthermore, it will provide help in emergency cases to locate the patients and be aware of the type of emergency intervention that can be taken.
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ACCEPTED MANUSCRIPT 5 IoT Healthcare Networks Several devices and systems must work together in the context of the IoT, which contributes to the operation and the improvement of the overall healthcare system [33]. The IoT healthcare network is one of the vital elements of the WBAN in the healthcare applications. The transmission and the reception of healthcare data achieve efficient
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communication based on the WBAN network system [34]. The IoT healthcare networks
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Topology: Application framework, physical configuration Architecture: Hierarchical model and software organization
Management
IoT Healthcare Networks
Security
consist of network topology, architecture and the platform as illustrated in Fig. 4.
Platform: Substructure and library network
5.1 IoT Network Topology
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Figure 4: Types of IoT healthcare networks
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The IoT network topology is denoted by the collection of different elements of the
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role of IoT healthcare system and it specifies different characteristic scenarios of the continuous healthcare environments [35]. The IoT in WBAN system can be monitored by the
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wearable devices based on the remote monitoring. The on body sensor and the portable medical devices attached to the patient’s body helps to collect the correct details of patient’s
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health profile. After that, the information are analyzed and stored in a particular database and this information is useful for the aggregations. Based on this process, the caregivers will be able to monitor the patient from any locations or place and also they can respond accordingly [36]. The Fig. 5 represents the streaming of healthcare data by means of an interconnected network with WiMAX, the Internet protocol network and access service networks. Similar conceptual structures are found in fig. 5 [37]. 17
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Tiny OS
6LOWPAN border router
Network
On body sensor Hospital
IP network HSDP A RNC
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Support node
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GSM/WIMAX network
Network
Network
ASN gateway
Access service network
Distributed system
Mobile patient
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Figure 5: IoT network topology on remote healthcare monitoring
The IoT network topology shows the role of gateway systems. The Fig. 5 also represents the iMedpack, which is known to be IoT devices that manage the problem in the pharmaceutical
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compliance, as it avoids the medicine misuse [38]. Moreover, various sensors and the interfaces of multiple wireless network topologies provide important gateway for healthcare
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applications [39]. Also the IoT healthcare system enables the diagnosis and analysis by connecting various wearable devices and IoT devices to the health care gateway.
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Furthermore, in the gateway, it can analyze, store, investigate and then present the collected
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data. Therefore, all IoT network topologies are found and integrated clinical devices are coupled with a lot of IoT healthcare infrastructure. In the IoT network topologies, the
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fundamental factor provides associated activities and roles of medical system and it is mainly for the perception of healthcare service providers. Such activities are used for the emergency medical services [40]. Thus the topology includes medical system in the semantic medical monitoring system. 5.2 IoT Network Platform
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ACCEPTED MANUSCRIPT The IoT healthcare network platform model and the IoT cloud computing healthcare platform model are the two important platform models in the IoT system. Besides, the services platform model mainly focuses on the resident health information as represented in Fig. 6. The IoT network platform structure shows the classified healthcare model of how the agents can access different database from the foremost application layer according to the
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healthcare support layer [41]. This can ensure the associated interoperability and the automatic design methodology platform introduced for the IoT network is mainly for the rehabilitation method which is presented in it. As explained above, the framework includes accessing layer, data persistent layer, business implementation layer and the support layer
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[42]. In order to handle multiple users with multiple sensors, an enabling method is needed for IoT gateway.
IoT platform for healthcare service model
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Community health center Hospital Personal device
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Data persistent later
Health record database User information database Privilege database
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User applications
Personal healthcare record Diagnosis HL7/XML encode
Business layer
Management
Support layer
Analytics
Healthcare records Basic information system Privilege system
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Accessing layer
Figure 6: A functional framework of IoT platform model for health information service model
The method enables the IoT system to handle multiple users by means of multiple sensors during the collection of healthcare data. The IoT database is used in the multi-tenant database and the resource layer is mainly responsible for data sharing of healthcare system and
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ACCEPTED MANUSCRIPT interpolation of healthcare data by means of resource control mechanism. Therefore, the given systematic framework provides user environments and the semantic capabilities of IoT in the healthcare sector. 5.3 IoT Network Architecture The IoT healthcare architecture is referred to as the outline of the specification of
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IoThNet functional organization, physical elements, techniques and its working principles [43]. Some of the key issues that have been identified for this architecture: the interoperability of the IoT gateway and the WLAN, multimedia streaming, and secure communications between IoT gateways and caregivers [44]. Due to the IoThNet system, the
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wearables and the sensors are used for the data transmission over the specified protocols. In the framework of the network data transmission the data is replied back to the sensor nodes by means of user datagram protocol [45]. Thus, it provides seamless connectivity of sensor
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nodes for patients and the medical teams.
5.3.1 IoT Architecture Based on WBAN for Healthcare Applications
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The IoT architecture based on WBAN system design consists of three tiers. Fig. 7
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illustrates the representation of various sensor nodes and small patches positioned in the human body. Those sensors are known to be wearable sensors or the body sensors, which are
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implanted in the skin and can operate by means of wireless networks. Besides, these sensors capture the correct signals and then transmit the vital signs such as temperature, humidity,
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blood pressure, heart activity and the sugar level. The capabilities and the functionalities of the nodes can be preceded on tag or low-level handling system for communications. Then, the collected data from the body sensor is transmitted to the central controller system or primarily communicated controller and then communicated by means of the nearby PWS. Thus, it can be used for emergency alert or as medical database by providing that information to the medical group for real-time processing by means of WLAN system. The registered
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ACCEPTED MANUSCRIPT patient details from the electronic medical records are collected and stored on the medical server. It provides various services to the desired users, medical personals, and informal caregivers. The medical server has the responsibility for authenticating users, format and insert this session, health monitoring, analyze and recognize health analysis, physicians suggested
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exercises etc. The medical server can examine the uploaded data and then introduce alerts in the form of potential medical conditions. In the same way, the organization might be considered contributing to observing and studying of various therapeutic effects.
In the second tier system, the PWS interfaces and the graphical interfaces of the WBAN
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sensor nodes communicates with the other services by means of HBC knowledge home system. The sensor nodes of PWS are connected to the mobile device that can run on the Personal Computer (PC) [46]. It is mainly used for monitoring the elderly people. The
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network coordinator is a main criteria used for WBAN PWS interface. The network configuration consists of initialization, sensor node registration customization and the secure
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communications. If the WBAN is configured, then the PWS manages all the processing fields
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such as network, time, data retrieval, time synchronization, data retrieval etc. Therefore, the PWS application determines the user state and their health status by using the healthcare
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information from different sensors and it also provides feedback over the user interface.
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Distributed data access
Central server Healthcare staff
Patient with sensor
Database
IP network IP
Network Access point or base station
Distributed system
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Network
Network
User
Ward or house
Local server
Tier 1 for data generation, storage and distributed access
Tier 3 for data storage and access
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Tier 2 for data processing, aggregation and storage
Figure 7: Framework of IoT based WBAN for healthcare applications The PWS keeps the patient's authentication information with the server IP address. In addition to, if the medical server is available in the communication channel, the PWS creates
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a secure communication between the medical servers and then it sends the reports into the user's medical record. When medical server and PWS is not available in the communication
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link, then the PWS stores data locally in a particular database and sends that data when the
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link is available. Consequently, this system provides full mobility system with high secure communication and the real-time monitoring and finally the information is uploaded. The
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functionalities of IoT based WBAN are given below. (i) WBAN Sensor Nodes
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The WBAN sensor nodes consist of high communication and computing capabilities,
a small sized minute battery with limited power. Some of the components of sensor nodes are: 1.sensor: for sensing the vital medical signs from the body of the patient by enclosing the embedded chip. 2. Microcontroller: It controls the function of the other components and accomplishes local data processing including data compression. 3. Memory: It temporally stores the sensed information which is obtained from the sensor nodes. 4. Radio Transceiver: 22
ACCEPTED MANUSCRIPT communicates the nodes and then it provides physiological data to wirelessly send/received. 5. Power supply: It is used to supply the sensor nodes with the required power supplied by the batteries. 6. Signal conditioning: It amplifies and filters the physiological sensed data to suitable levels for digitalization. 7. Analog to Digital Converter (ADC): It produces digital signals from the analogue ones to allow further required processes.
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(ii) Personal Web Server
The PWS is a set of core technologies that enables a user to interact with their personal data and applications, which are stored on a personal mobile device, through the public infrastructures. It is also defined as the body gateway, which connects the smartphone
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to the wireless node by means of communication protocols such as Bluetooth, Zigbee etc. It is mainly bounded for the healthcare services that can be arranged by medical server with the IP address. The PWS processes the dynamic signs from the sensor nodes and it provides the
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transmission priority for critical signs and sends it to the healthcare server. Therefore, the PWS application determines the user state and their health status by using the healthcare
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(iii) Medical Server
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information from different sensor and it also provides feedback over the user interface.
The processing, analyzing and the storing of the medical data are the main process of
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medical server. It consists of storing, processing and analyzing software to delivering the healthcare system services. The user’s authentication is a vital measure for the medical
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server. The healthcare data is obtained from the sensors based on IoT medical server for testing. After testing, if any deviation is found from the expected healthcare records of a patient, the medical unit will be notified about it. Therefore, the patient authentication, security, privacy etc., is an outstanding issue and the requirements are addressed in all tiers in the healthcare system. Thus, the limited range of wireless communication provides security issues in the overall communications.
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ACCEPTED MANUSCRIPT 6 WBAN Based IoT Healthcare Technologies Let us condense the key requirements, technologies and design consideration of wireless communication technologies, which have the potential to apply in WBAN based IoT healthcare system applications. These requirements can be characterized into six main subjects: security, energy consumption, U-healthcare, resource management, quality of
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services and real-time monitoring as illustrated in Fig. 8. They are explained below: Internet of things
Security
Energy
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WBAN
U-healthcare
Information security
Resource management
Power
Privacy & confidentiality
QOS
Real time wireless health monitoring
Figure 8: Technologies for WBAN based IoT healthcare system
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6.1 Security
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Nowadays, the smart systems are mainly used for various applications. The advancements in the information and communication technologies facilitate the researchers
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and engineers to realize that the system is authenticated for all applications. In fact, by considering the confidentiality and sensitivity of medical data, a healthcare system must
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fulfill advanced access control procedures with strict security and data quality requirements [47]. Smart healthcare application system is the most significant applications for the
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physician to monitor the condition of corresponding patients remotely through WBAN, based on IoT healthcare environment. Nevertheless, for IoT environment, the most significant characteristic is the security and the privacy of the system, but it is still questionable in various IoT architectures. BSN (Body Sensor Network)-Care: Gope and Hwang [48] proposed the body sensor network system for healthcare applications. They introduced the BSN-Care method to 24
ACCEPTED MANUSCRIPT provide security to the patient information management in the healthcare system. The authors divided the overall security framework into two parts as, network security and the data security. The network security comprises secure localization, authentication and anonymity. The data security consists of data privacy, data integrity and the freshness of the data. Therefore, the system achieves high data security and the network security for further
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requirements. Thus, the proposed method provides mutual authentication property, anonymity property, secure patient information management, defeat forgery attacks and reduce computation overhead.
Content-Centric Networking: Lal and Kumar [49] introduced the Content-Centric
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Networking (CCN) method for WBAN based on the IoT healthcare system. The main objective of this system is to provide security and seamless connectivity to access the patient's data transmission in healthcare systems. The authors focused on the suitability of the
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healthcare communications by means of low cost and low power devices that enhanced the quality of people's lives who were suffering from diseases and emergency problems.
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Therefore, the proposed system provided seamless connectivity, security, high data rate, low
collision.
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latency and very faster, even though, it faced a problem in network connectivity during signal
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Novel Trust Evaluation Model: Boukerche and Ren [50] described the novel trust evaluation model to provide security properties and to prevent the malicious nodes during
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data transmission. It was mainly used for the security assets for the multicast arrangement and then evaluated the overall performance of the system. Their proposed method protects patient's medical records. Then, it provided high security to ensure the data confidentiality and user privacy. 6.1.1 Information Security
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ACCEPTED MANUSCRIPT According to overall performance, it was very crucial for the healthcare providers to obtain reliable information, robust and secure service. These strategies not only provided protection to the healthcare data, but also prevented the offensive conflicts because of the nature of healthcare data and the information security risks in the system. When comparing the cost reduction of the system, protecting the personal information was important and a
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challenging one. So, it needs an information security strategy to safeguard the patient’s healthcare information. Therefore, a good data security service provide efficient inventory and monitor the healthcare information.
Novel authentication and the key agreement protocol: Iqbal and Bayoumi [51] described
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the new authentication and the key agreement protocol for information security and privacy. It was important to secure communication channel, medical sensors or devices and the remote servers. To achieve those requirements the authors introduced the authentication and the key
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agreement protocol, which was a lightweight resource constrain sensor and it is suitable to protect sensitive health-related data. Therefore, the proposed system provides, more secure
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small enough in size.
ED
communication, protected the sensitive health-related data and the devices are cheap and
Novel Anonymous Authentication:
Wu et al. [52] introduced the novel anonymous
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authentication system for a security problem in healthcare applications. It solved security problems and reduced the communication cost and computation time. The authors compared
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the Wang et al. proposed system for achieving security for the system. Therefore, the proposed system possessed secure authentication, reduced security problems, and reduced computation cost to 31.58%. Thus, it achieved high security and performance analysis than the existing methods. 6.1.2 System Privacy and Confidentiality
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ACCEPTED MANUSCRIPT The overall system privacy and confidentiality are generally interchangeable. The privacy represents the right control access and it includes physical privacy. The privacy handles the personal information through privacy principles as well as, the confidentiality obliges the healthcare physicians to keep their patient’s inappropriate personal health information.
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SPPDA: Ara et al. [53] projected the secure privacy-preserving data aggregation method. The WBAN used the medical sensor for continuously monitoring and collecting the patient's health data and then to send them to the remote medical server by means of portable digital assistants. Power, storage, privacy etc. are the computational complexities of the system.
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Also the data aggregation technique was introduced to reduce the complexities and communication overhead. Therefore, the system possessed improved efficiency, data privacy and secures real-time data transmission. Thus, the performance analysis provided the system
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which was secured by means of decisional bilinear assumption.
Secure sensor association and key management protocol: Shen et al. [54] introduced a
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new sensor association and a key management protocol to satisfy the patient's requirements
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as for confidentiality and integrity of healthcare system. The new sensor system with elliptic curve cryptography and the hash function was used for the authentication procedure and the
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key generation. Their proposed technique achieved patient's requirements such as security, privacy and confidentiality in the healthcare system. It was easy to implement and was
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efficient. Also, it reduced the computation and the communication cost. 6.2 Energy
The IoT healthcare system is a small healthcare device with limited power approach.
This device conserves more energy through switching the power-saving mode. During switching of devices, no essential reading of sensor is to be reported. The energy utilization and the network life time had a great link between them. The quality of monitoring the
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ACCEPTED MANUSCRIPT patients based on WBAN is a challenging one. In order to reduce this challenge, the energy consumption in the coordinator node has to be reduced to increase the quality of the system. In contrast, the main role of coordinator node is data packaging and transmitting them to the Base Station (BS) and also aggregation of sensory data to the BS. If the patients miss to recharge the battery, it would be dangerous for the patients, so recharging the battery of the
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coordinator node in short intervals can increase the lifetime of the system. Therefore, an energy-aware security solution is used for finding the energy constraint property of the IoT health devices. Autonomous WBAN:
Wu et al. [55] introduced the efficient autonomous WBAN
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implementation method in IoT based WBAN healthcare applications. To achieve the objective of the work, they focused on the extent of lifetime of the wearable body sensor node and flexible solar energy harvesting to power the sensor node. Therefore, the proposed
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system achieved a 24hrs lifetime of the wearable system, extended the lifetime of nodes, and long-term continuous medical monitoring.
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ANT+ protocol: Mehmood and Culmone [56] introduced the ANT+ protocol for low energy
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consumption of WBAN. The proposed method strengthens the goals of IoT healthcare system. The authors introduced the software architecture which flexibly integrated ANT+
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protocol to deliver the healthcare services. Therefore, the proposed system achieved continuous real-time monitoring system, high energy storage and extended the lifetime of
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devices and reduced the frequent battery replacement. Energy efficient medium access protocol: It was based on the energy classification. Omeni et al. [57] introduced the energy efficient medium access protocol method to reduce energy consumption and reduce the collision in the nearby mode. It avoids collisions using clear channel assessment algorithm based on listen-before-transmit standard. In order to hold those time slot intersections, the wakeup fallback time was introduced. Therefore, their proposed
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ACCEPTED MANUSCRIPT system provides less energy consumption, reduce collision, reduce complexity, and pervasive healthcare applications. Thermal energy harvesting: It was mainly based on the energy classification. Hoang et al. [58], described the thermal harvesting from human warmth for WBAN in healthcare applications. The reliability of the WBAN mainly depended on the lifespan gateway. The
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authors explained the residual energy of the sensor nodes by the system gateway and also the lifetime of the WBAN increased by changing the gateway by thermal energy harvesting system. Therefore, the extension of the wearable devices reduced the complexity, power consumption, and the reliability of the system.
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6.2.1 Power
Power was a vital concept in the healthcare system. In the IoT healthcare system, many devices are made to be a heterogeneous function in terms of transmit, sleep, composite,
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receive mode etc. In addition to, power requirements based on service availability pose additional challenge to each communication layer.
ED
Hybrid data compression scheme: This scheme is mainly meant for the classification of
PT
power based on energy requirements. Heng et al. [59] explained the hybrid data compression technique for reduction of power in WSN based on the IoT healthcare applications. It was
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mainly focused on the power reduction in the IoT technologies. The author focused on the data compression with loss and the lossless method; subsequently it enabled the hybrid
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transmission mode with support data rate selection and then saves power in wireless transmission mode. Thus, the proposed method possesses an enabled hybrid transmission mode, enabling power aware transmission, optimizing utilization of local storage, increased error tolerance etc. Ultra-low power and traffic adaptive MAC (Medium Access Control) rules: It was mainly intended for the power classification in energy requirements. Ullah and Kwak [60]
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ACCEPTED MANUSCRIPT proposed the traffic MAC and ultra-low power control protocol for WBAN. It was mainly applicable for the low power consumption and to reduce traffic problems as idle listening and over-hearing problems. Consequently, the proposed technique provided low cost, low power consumption, and reliable energy transmission. 6.3 Ubiquitous Healthcare
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Nowadays, people have become highly health conscious and views about better health management are getting top priority. Besides, the Ubiquitous Healthcare (U-health) had a great potential in U-telemedicine and mobile application which was integrated with WBAN for efficient healthcare monitoring. It was a combination of medical, telecommunications and
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information technology, which provides medical services for diagnosis and treatment without restricted time or distance.
Smart e-healthcare gateway: It is mainly based on the U-healthcare system. Rahmani et al.
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[61] introduced the smart e-healthcare gateway that brought intelligence to IoT based ubiquitous healthcare system. It provided several higher-level services including embedded
ED
data mining, local storage, monitoring of real-time applications etc. Their proposed system
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provided reduced data ambiguity, robustness, and reliability, extended coverage in time or space, and further increased the quality of data. Furthermore, for the gateway management,
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the expansion of command set made a complete data. Also, the listing of different transport layer protocol sockets capable of generic library was for easy interoperability of a variety of
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nodes with different priorities. Sensor Network Tasking: It was mainly based on the U-healthcare system. Wang et al. [62] described the sensor network tasking for an efficient U-healthcare system for gathering patient’s information. The authors focused on the U-healthcare, based on WBAN system to provide information based probability and the relational model between the key indicators for data gathering and precedence in WBAN. Therefore, the proposed system provided
30
ACCEPTED MANUSCRIPT sequenced data gathering, better priority consideration, high utility gain, reduce energy loss etc. Ubiquitous-healthcare using ECG: Chung et al. [63] projected the ECG system based on the ubiquitous healthcare. It provided a system to transmit all measured data from sensor nodes to the server without the packet loss and for monitoring the physiological data.
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Though, the proposed system possessed small size and was of low power consumption, it was compactable and the sensing and monitoring of communication was more accurate. 6.4 Resource Management
Resource management is an important aspect in the healthcare sector. Proper
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resource management is critical for providing high-quality healthcare. The focus on resource management of healthcare needs more research development and new policies. The resource management strategies need better outcome to access the healthcare around the world.
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Temporal informative analysis: Bhatia and Sood [64] proposed the m-healthcare perspective for smart-ICU (Intensive Care Unit) monitoring based on temporal informative
ED
analysis method. It also provided real-time monitoring as efficient monitoring of various
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events. Their proposed criteria obtained Real-time healthcare monitoring, accurate monitoring and reduced mortality rate. The novel work had some major challenges such as
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continuous data transmission and network load efficiency etc. IoT vehicle healthcare service model: Jeong and Shin [65] introduced the implantable
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devices for vehicle based on IoT healthcare service model. Its main focus was to provide healthcare services in a vehicle installed with IoT devices. Consequently, the proposed system worked automatically and stopped the vehicle when dangerous situation occurred and it took the patient to the nearest safe place and automatically called the emergency services.
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ACCEPTED MANUSCRIPT WSN for monitoring and alarming: Aubidy et al. [66] used the WSN system for patient health monitoring and real-time alarming system based on GUI (Graphical User Interface) monitoring method. The author introduced this system for the patients, particularly for the patients suffering from harmful diseases. Therefore, the new system achieves clear monitoring, scanning the data with reliable communications and was cheap and intelligent in
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decision making. 6.5 Quality of Services
The Quality of Services (QoS) is an important parameter used in the healthcare services which is a highly time-sensitive system. Numerous challenges exist to meet the
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quality requirements of IoT-based applications in terms of energy efficiency, sensing data quality, network resource consumption, and latency. The quality of body sensors determines the accuracy and sensitivity measurements provided by a sensor. Some of the parameters
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for the quality of a body sensor network are determined by the quality of data provided in response to a query. Delay and Delay Variation: It refers to delay and delay variation in data
ED
collection from nodes. Bandwidth, Capacity and Throughput: It indicates the capacity of a
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sensor network to send data over a link within a given time. Accuracy: Depending on the accuracy of the sensor observations, a particular sensor may have less value to the target
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query. Trustworthiness: The data for certain observations may be overlapping, when two or more sensors provide it for the same area. Decisions on determining an optimal subset of
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sensors which has to be kept active in order to meet subscription requirements may be made based on parameters such as sensor accuracy, level of trustworthiness, and available battery level. In contrast, each parameter in the IoT network framework is useful for quantitative measurement of the healthcare data. We consider these parameters in the survey because it provides accurate and robust health care application. There are lots of parameters to ensure the IoT system but these
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ACCEPTED MANUSCRIPT applied parameters provide better results than others. Similarly, it attains better reliability and life time, improve the quality of signals, ensure security and data privacy in the communications etc. Distributed Beamforming: Kisseleff et al. [67] introduced the distributed beamforming for magnetic induction based body area sensor network. The system was used to increase the
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quality of services, data rate and to reduce the vulnerabilities against attenuation and distortion in the signal. Their proposed criteria improved the quality of signals data rate and reduced the signal to noise ratio. Quality-aware ECG monitoring system:
Satija et al. [68] introduced an IoT-based
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healthcare real-time signal quality monitoring method known as ECG telemetry system. It automatically classified the acquired ECG signal, to provide design and development of a light-weight ECG signal quality aware method in IoT healthcare system, even though, the
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battery life of IoT-enabled devices was increased by light-weight ECG signal. Thus, the proposed system achieved better reliability and life time more than the existing method.
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6.6 Real-Time Wireless Health Monitoring
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The real-time wireless healthcare monitoring system is an important research field. This monitoring system may help the doctor or caregiver to monitor the patients in time.
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Automation healthcare system: Velrani and Geetha [69] described the Automation Healthcare System (AHS) to investigate advanced home healthcare services and to provide
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security and real-time monitoring system. They mainly focused on the WBAN based on the IoT healthcare application system. Moreover, one of the models was used for the real-time monitoring of patients as the wearable tags were used for automatic monitoring by means of IoT frameworks. Therefore, the proposed technique possessed reduction in healthcare cost, managed the shortage of nursing staff, high security, and compact size and was easy to
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ACCEPTED MANUSCRIPT handle. Thus, the system used P2P paradigm to ensure security and data privacy in the communications. Hand hygienic monitoring based on IoT: Bal and Abrishambaf [70] introduced the sensor based healthcare information system. Nowadays, the healthcare system lacks security and accurate real-time monitoring. The system is required to detect hand hygiene events in real-
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time, and help to measure the hand hygiene compliance at large-scale health-care facilities where it is deployed. Therefore, the proposed system was scalable and easy to install. It also provided proper use of healthcare facilities than existing techniques.
Wireless structural health monitoring: Si et al. [71] proposed the authentication
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algorithm and real-time damage detection by wireless healthcare monitoring system. It was mainly used for the identification of potential change in the structural system by authentication algorithm. Consequently, the proposed method held attractive functional
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point, efficient real-time monitoring and had high damage detection.
Table 2: Relevant literature on various classification technologies of IoT based WBAN Name of Classification Methods author with year
1
Si et al. (2009) [71]
PT
ED
Sl. No
AC
CE
RWHM
2
Bal and RWHM Abrisham baf (2017) [70]
Advantages
Future scope
Need improvement in functional point, efficient real time monitoring and high damage detection. Scalable, Performance easy to testing required install, for the better use healthcare in ease. facilities.
Metrics
Authentic Real-time ation measurement, algorithm strong potential
Acceleration , time, magnitude, and frequency.
HHM
-
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ACCEPTED MANUSCRIPT AHS
Reducing cost, manage shortage of nursing staff, high security, compact size and easy to handle.
Further Accuracy, improvement in node significant impact number. on healthcare field.
Satija et QoS al. (2017)[6 8]
LRSQ
5
kisseleff et al.(2016) [67]
DB
Improve quality of ECG signals and improved lifetime Improves the quality of signals data rate, reduce SNR.
Improvement for resource utilization, ambulatory physical activity. Unlikely and undesirable for the future BASNs and IoT.
6
Aubidy et RM al. (2016) [66]
7
Jeong RM and Shin (2016) [65]
QoS
GUI AM
& Accurate in scanning, clear in monitoring, reliable in communicati on, intelligent in decision making, and cheap.
Number of ECG segments, time, and amplitude. Number of sensor nodes, sum rate, distance.
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4
RWHM
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Velrani and Geetha (2016) [69]
Further Oscillation, development and pressure possibility of sensor. marketing in the near future.
ED
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3
It automatically stops the vehicle when any dangerous situation occurs, takes the patient to nearest safe place call the emergency services.
Improves the overall system and analyzes network condition values at the beginning.
Communicat ion strength, communicati on overhead, and network efficiency.
TAG
accurate monitoring, reduce mortality rate etc.
Improves the overall system and analyze network condition values.
Delay time, mean absolute sift, temperature and frequency.
AC
CE
PT
AHP
8
Bhatia RM and Sood (2016) [64]
35
ACCEPTED MANUSCRIPT 9
Chung et UH al. (2008) [63]
ECG and Small in size, SpO2 low power consumption, compactable, sensing, and monitoring
Further Time, ECG improvement in data, SpO2 the real time data, and monitoring acceleromete process. r data.
10
Wang et UH al. (2010) [62]
IT
Sequenced data gathering, better priority consideration , high gain, reduce energy loss etc.
Promote the confidentiality and robustness of the system.
11
Rahmani UH et al. (2015) [61]
LZO LZ4
& Reduce data ambiguity, robustness, extended coverage in space and time, and increased quality of data.
Enable a generic library for easy interoperability of variety of nodes with different protocols.
Number of nodes, compression time.
12
Ullah and Power Kwak (2012) [60]
FDC
Low cost, low power consumption and reliable energy transmission.
Improvement required in the system to enable traffic control and power efficiency.
Wakeup period and packet interarrival time.
13
Heng et Power al. (2017) [59]
LL
Enable hybrid transmission mode, power aware, optimizing utilization of local storage etc.
Further improvement in the power consumption and efficiency.
Frequency, power, amplitude, PRD, CR, time.
TEG
Reduce complexity, power consumption, extend the lifespan, reliability
Promotes Energy, robustness and rounds, efficiency of the number of system. nodes, output power load resistance.
Hoang et Energy al. (2009) [58]
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PT
CE
AC 14
Time, energy consumption , and latency.
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ACCEPTED MANUSCRIPT Omeni et Energy al. (2008) [57]
CCA
Decrease the energy consumption, reduce collision, reduce complexity, etc.
Further improvement for power consumption in the MAC protocol.
16
Mehmoo Energy d and Culmone (2015) [56]
ANT+
High energy storage, extend the life time, reduce the frequent battery replacement.
Improvement Time, required for distance. connectivity and life time of battery.
17
Wu et al. Energy (2017) [55]
MPPT
It possesses 24hrs lifetime wearable system, extend the life time
It needed more signal detections to cover many areas of WBAN.
18
Shen et Privacy, ECC al. confidentiality (2015) [54]
Security, privacy, easy to implement, efficient, reduce computation, communicati on cost.
Promotes the Overhead, confidentiality and key robustness of the derivation. system.
19
Ara et al. Privacy, SPPDA (2017) confidentiality [53]
Improved efficiency, data privacy and secure real time data transmission.
Required decrease in computational overhead and increase in efficiency.
CPU time, number of exponentiati on.
Secure authenticatio n, reduce security problems, and reduce computation cost.
Promote the confidentiality and robustness of the system.
Communicat ion cost, computation cost.
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CE
AC 20
Wu et al. Security (2016) [52]
AA
Sleep time, number of retransmissi on, and power.
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15
Voltage, current, Power and time.
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ACCEPTED MANUSCRIPT 21
Iqbal and IS Bayoumi (2016) [51]
KAP AM
22
Boukerch Security e and Ren (2009) [50]
TE
23
Lal and Security Kumar (2017) [49]
CCN
24
Gope and Security Hwang (2016) [48]
BSN-C
& More secure communicati on, protect the sensitive health related data, cheap and small enough in size etc.
Development Processor needed in full cycle and BAN system for CPU cycles. healthcare application in IoT.
the Security overhead, Percentage of malicious nodes.
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Protects Promote patient’s robustness. medical records, to ensure the data confidentialit y and user privacy.
PT
ED
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Provides Improvement seamless required connectivity, connectivity. security, high data rate, low latency, QoS Mutual authenticatio n property, reduce computation overhead etc.
Cache size in and percentage of handover performance.
Little effect Alarm net should be required and BSNon the whole care. network.
AC
CE
RWHM- Real time wireless health monitoring, QoS- Quality of Service, RM- Resource management, UH-Ubiquitous-healthcare, IS- information security, HHM- Hand hygienic monitoring, DB- Distributed beamforming, LRSQ- light-weight real-time signal quality assessment, GUI & AM- monitoring and alarming method, AHP- Analytic hierarchy process technique, TAG-Temporal Associative Granulation method, IT- information-based tasking algorithm, FDC- flexible duty cycling technique, LL-Lossy and lossless techniques, TEGthermoelectric generator method, CCA- clear channel assessment algorithm, MPPT- maximum power point tracking technique, AA- Anonymous authentication approach, KAP & AM- key agreement protocol and authentication method, TE- Trust evaluation technique, CCN- ContentCentric networking protocol.
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ACCEPTED MANUSCRIPT Table 2 given above represents the relevant literature on various classification technologies of IoT based WBAN. It described the overview of technologies used, its advantages, metrics, future scope etc. Table 3: Standard, specification and latest release on various classification technologies of
Author name
Standard
Specifications
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IoT based WBAN Latest releases
Iqbal and 6LoWPAN Bayoumi [51]
1.580 m energy X.509 certificate consumption, 80 byte to 48 byte
Wu et al. [52] Ara et al. [53]
512, 160, 1024 bits 2 GB memory, 64 Oracle VM virtual Box bits Manager
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IEEE 802.15.6 Wi-Fi
Wi-Fi 160, 1024 bits Bluetooth, Wi-Fi 13 V & 2.5 V, (4G) 12.5F superconductor, 5 V Mehmood and Zigbee, 2.4 GHz, 1 MHz Culmone [56] Bluetooth, Wi-Fi Omeni et al. 802.11 or Zigbee 50 kbps, 10 bits, [57] 50–500 Hz
MPPT circuit
Hoang et al. IEEE 802.15.6, 200 bit, 16 kΩ, [58] Bluetooth 952.4 µJ Heng et al. [59] Bluetooth 8-channels 12-bits, 5-bits MSB Ullah and Kwak IEEE 802.15.4 2.4 GHz [60]
HT12D, HT12E
Rahmani et al. Zigbee, [61] 6LoWPAN, Bluetooth, Wi-Fi
-
UT-GATE
Wang et al. [62] IEEE 802.15.4
1 kbit/s to 1 Mbit/s
-
Chung [63]
300 (24.8 dB), 0.05 Accelerometer, ~ 123 Hz, 12 bits, converter, 200 Hz, 2.4 GHz~ transceiver 2.485 GHz, 95 dBm, 250 kbps, 18.8 mA, 17.4 mA,
AC
CE
PT
ED
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Shen et al. [54] Wu et al. [55]
et
al. IEEE 802.15.4
ANT branded LBT, WBASN ASIC, in a 0.13 m CMOS process
0.35 μm CMOS, MIT/BIH TaMAC with IEEE 802.15.4 MAC, WiseMAC, and SMAC protocols
A/D Wireless
39
ACCEPTED MANUSCRIPT 1 µA, 3.3 V
Jeong and Shin Bluetooth [65] Aubidy et al. IEEE 802.15.4 [66] Satija et al. [68]
Bluetooth, Wi-Fi
Velrani and Bluetooth, RFID Geetha [69]
-
IBM SPSS
9600 bits per second 13.56 MHz, 14 kHz, 1 mm, 25 nodes 360 samples/second and 11 bits, 1.2 GHz
GUI, Honeywell 015PDAA5 ISO 14443/15693
-
ASDX
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and RFID
MITABIHA, Lollipop 5.0 android version, 410 MSM8916 processor and 2 GB RAM PIC16F877A Microcontroller, LM35 Temperature Sensor
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Bhatia Sood [64]
ED
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Bal and Zigbee, (UHF)- Raspberry Pi platform, Abrishambaf RFID Python application [70] Si et al. [71] IEEE 802.15.4 0.72 cm by 1.35 AFX model cm, 9XCite wireless modem, 2.87, 8.82, 13.75, 17.68, and 21.06 Hz, 1.3 m/s2
PT
Table 3 represents the specifications, standard and the latest release on various technologies of IoT healthcare system. It explains all the relevant technologies on IoT healthcare system
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that we consider in this survey.
7 IoT Healthcare Services and Applications
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IoT has numerous developed and developing services and applications such as
wearables, smart city, smart grids, connected car, connected health and smart home. However, research indicates the potential of IoT in healthcare system and hence enhances the quality of life in our societies. On behalf of better understanding, this section is generally classified into two sub-sections such as services and applications [72]. The applications of
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ACCEPTED MANUSCRIPT IoT health care are sub-divided as single-condition and clustered-condition in fig 9. Therefore, the services and the applications of IoT based on healthcare are explained below.
IoT Healthcare Services and Applications AAL M-IoT ADR CH CHI WDA SMA IEH EGC ECP
Single condition
Glucose level sensing Electrocardiogram monitoring Blood pressure monitoring Body temperature monitoring Oxygen saturation monitoring
Clustered conditions
Management
Security
Rehabilitation system Medication management Wheelchair management Imminent healthcare solutions Healthcare solutions by smartphones
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IoT healthcare applications
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IoT healthcare services
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Figure 9: IoT healthcare services and applications 7.1 IoT Healthcare Services
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The IoT healthcare services consist of general IoT services and the protocols that are
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required for the IoT structure that might be required for small alterations for the accurate functioning of the healthcare system. For a better understanding of the topic, the reader can refer the literature. Hence, the following subdivisions are given below: A) Ambient Assisted Living The WBAN based IoT healthcare service is mainly offered to elderly people. The IoT platform by artificial intelligence can help the healthcare for ageing and the incapacitated individuals [73]. The main aim of Ambient Assisted Living (AAL) services is 41
ACCEPTED MANUSCRIPT to provide an independent life for elderly people and keep them safe and content. A modular architecture of IoT healthcare provides security, control, and communication. RFID and NFC are used in AAL for flexible monitoring, and provides security for elderly individuals [68]. Therefore, it possesses some limitations such as QoS’s, data storage and feasibility. B) The Internet of m-health things
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The Internet of m-health things (m-IoT) is known as mobile IoT, which includes mobile computing, communication technology and medical sensor, for healthcare services. The IoT share the information with 4G networks for future Internet based on m-health system [74]. Besides, it is used for real-time monitoring system. The context-aware issues
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and the m-IoT are the two main challenges that occur in the services. Introduction of a system for message-exchange-based mobility was done, but it lacks in verification of low network power consumption.
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C) Adverse Drug Reaction
The Adverse Drug Reaction (ADR) happens by taking over dosage of medication.
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The ADR is mainly caused due to the single dosage of drug or continued administration or
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significant medication of combination of more drugs [75]. So, if ADR based IoT is used, it can identify the drug through barcode/NFC device. This will check the drug with electronic
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health record. Hence the iMed pack was introduced in ADR by making use of RFID and
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controlled material technology. D) Community Healthcare The Community Healthcare (CH) information is an important healthcare service.
The CH mainly monitors the area around a local community. Besides, it’s an IoT based network, which monitors around the municipal hospital, a residential area, or a rural community [76]. The specialized CH provides authentication and authorization mechanism to the cooperative network. 42
ACCEPTED MANUSCRIPT E) Children Health Information The Children Health Information (CHI) is mainly used for the awareness around children’s health and their behavioral, emotional or mental health problems. Besides, the pediatric ward offers CHI services for educating, empowering, and amusing the children [77]. The IoT based m-IoT healthcare services encourage the children to inculcate good nutritional
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habits in collaboration with their teachers and parents. Thus it encourages the children to acquire good habits. F) Wearable Device Access
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Various sensors are used for the healthcare applications, particularly WSN for IoT healthcare application. A wearable device monitors the people accurately and calculates their glucose level, pulse etc. by the sensor [78]. According to the concept of S-IoT devices, it includes smart watches and smart phones which are based on Wearable Device Access
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G) Semantic Medical Access
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(WDA) prototype system with numerous healthcare applications.
The Semantic Medical Access (SMA) use large area of medical applications. It shares
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the medical information in between semantics and ontologies. Besides, a separate service needed to transfer information is known to be SMA [79]. Also, the SMA with IoT is applied
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for information retrieval from massive cloud. The SMA data processing method can be used
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to obtain interoperate and incorporate IoT data for emergency medical services. H) Indirect Emergency Healthcare The Indirect Emergency Healthcare (IEH) is an important criterion used for the
major functionality of the healthcare system. Various emergency situations arise when the healthcare is heavily involved in adverse weather conditions, earthen sites collapse, transport accidents and fire. [80]. IEH provides dedicated service to a lot of solutions for the above mentioned problems. 43
ACCEPTED MANUSCRIPT I) Embedded Gateway Configuration The Embedded Gateway Configuration (EGC) is based on the service architectural method that can connect the patient's networks directly to the Internet. The gateway of EGC is formed by IoT which is based on mobile computing device. The real-time ubiquitous healthcare system is an accurate example of EGC system [81]. It provides intelligent and
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automatic real-time monitoring. Therefore, a personal gateway was introduced for the sensor network of IoT healthcare system. 7.2 IoT Healthcare Applications
IoT applications have a close relation with IoT technologies. These applications are
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applied directly to user and patients. Therefore, the services are known to be developercentric and the applications need to be user-centric. Furthermore, the services and the applications in this section has gadgets, wearables etc. Then, the next subdivision provides
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several IoT healthcare applications including clustered-condition and single-condition. They
a) Glucose level sensing
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are as follows.
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Glucose level sensing is a vital monitoring and sensing system for elderly and diabetic patients. The glucose level monitoring is a real-time sensing method. It will give
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accurate results of glucose level. Besides, it helps in planning the medicines, activities, medication times etc. [82]. Consequently, the utility models in the transmission devices
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collect the somatic data of blood glucose by means of IoT networks. Furthermore, monitoring of glucose level in diabetic patients can be accomplished by a generic IoT based medical acquisition detector. b) Electrocardiogram Monitoring For monitoring the activity of heart electrocardiogram is used. It is an electrical activity which can measure the simple heart rate and determine the rhythm, myocardial,
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ACCEPTED MANUSCRIPT ischemia etc. The IoT based ECG provides maximum information about the cardiac system. The ECG monitoring consists of wireless acquisition transmitter and the receiver [83]. The system integrates the search automation about the normal and cardiac abnormal functions based on real time monitoring. c) Blood Pressure Monitoring
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The Blood Pressure (BP) monitoring is mainly used for monitoring the blood pressure level. The blood pressure KIT and the mobile phone enabled kit becomes the fragment of BP monitoring based on IoT [84]. Further, the device composed is based on the apparatus of the body and the communication module, while the location is tracked by the intelligent terminal
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based on IoT network. Thus, it’s an accurate and effective monitoring technique. d) Body Temperature Monitoring
Body temperature monitoring is an essential part of health care applications [85]. In
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the m-IoT concept, the maintenance of homeostasis is varied according to the body
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temperature. The body sensor monitoring is embedded with the TelosBmote and it gives accurate, efficient and successful results during processing. The body temperature monitoring
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is based on the home gateway over the IoT technologies. It also helps in infrared detection
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and RFID module for the monitoring of the body temperature. e) Oxygen Saturation Monitoring
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The nonstop monitoring of the blood oxygen saturation is mainly accomplished by pulse oximetry method. The IoT based oxygen saturation is intended for various wearable pulse oximetry method [86]. The healthcare device profile based on Bluetooth system is used to transmit the information from the sensor. The IoT optimized sensor with low power/ lowcost pulse is used for monitoring. Thus it helps for accurate oxygen saturation monitoring. f) Rehabilitation System
45
ACCEPTED MANUSCRIPT The rehabilitation system and physical medicine can bring back the efficient ability and the quality of human life with some physical disabilities that represents the vital outlet of medicine [87]. The IoT has an ability to enrich the rehabilitation system by means of justifying difficulties that are allied to the elderly individuals besides the shortage of health specialists. The design of rehabilitation system has demonstrated that the IoT is effective for
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all real-time information applications. It helps all effective remote consultations in the comprehensive rehabilitation. g) Medication Management based IoT
The medication management problem is mainly caused due to the packaging problem.
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Besides, it causes serious hazards to public health and it may cause a huge financial wastage. To overcome these issues IoT addresses some solutions. An intelligent packaging method for medicine boxes is based on IoT such as I2pack and Imed box [88]. The e-health services
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designed based on AAL solutions.
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architecture of tags are used for the medication control system and this system is especially
h) IoT Wheelchair management
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Wheelchair management is an essential method for real-time application. Many research developers worked to introduce full automation for disabled persons as well as it had
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an ability to speed up the work. The design of the monitoring system with various sensors was implemented [89]. This smart wheelchair detects and vibrates in unison with the
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sensation of the disabled person. Another method is the design of a wheelchair with Intel’s IoT department. This wheelchair could monitor the vitals of the individuals in chair and then accumulate the data based on user’s environments and permitting for assessment of locations. i) Imminent Healthcare Solutions No explicit demonstration of the integration of medical devices into IoT networks is exhibited even though numerous portable medical devices are available. That is, it was only 46
ACCEPTED MANUSCRIPT a matter of time before these devices became embedded with IoT functions. Growing demand for IoT-based services around the world has given rise to a number of medical devices, healthcare applications and several cases [90]. Some healthcare areas of integration with the IoT appears imminent healthcare which include skin infection, peak expiratory flow, abnormal cellular growth, hemoglobin detection, cancer treatment, eye disorder, and
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remote surgery. Today most of the diagnostic devices are portable having conventional connectivity. j) IoT Healthcare by Smart Phones
The efficient IoT healthcare paradigm is a combination of electronic devices and
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smartphones. This combination mainly highlights one, the IoT technologies (i.e.) S-IoT. Various hardware and the software systems are embedded in the healthcare devices [91]. Fig 10 represents some of the healthcare apps used for accurate monitoring of patients; they are
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chronic care management app, healthcare and fitness app, medical apps, personal health record apps, android Telehealth Chiron app, medication management apps, inpatient care
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mobile app and heart rate tracking apps. They are explained as,
47
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Chronic Care Management App Healthcare And Fitness App Medical Apps Personal Health Record Apps Android Telehealth Chiron App Medication Management Apps Inpatient Care Mobile App Heart Rate Tracking Apps
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IoT HEALTHCARE APPS
Figure 10: Few Healthcare Apps
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The chronic care management apps are based on m-healthcare system. It is mainly used for managing cancer, diabetes, mental health etc. The healthcare and fitness app is mainly used
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for managing the diet, nutrition’s, weight loss etc. The Medisafe is the app used for medication management application. This app stores the list of pills, its intake details, and
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dosages of the medicines; also it differentiates the pills by color. Then, the android
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Telehealth Chiron app allows the doctors to link with the corresponding patient for followup appointments through video conferencing. The inpatient care mobile app is used to
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progress patient communication, literacy and entertainment with the families or caregivers. The heart rate tracking apps can be provided to different sporting organizations and also to healthcare organizations. Besides, military forces with superior information and research on the population’s physical well-being supports the effective training techniques. 8 Challenges and Open Issues of IoT Healthcare System
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ACCEPTED MANUSCRIPT Various research works are made to design and implement the IoT healthcare systems. In contrast, there are several open issues and challenges that are needed to be carefully addressed. Besides, this section explains about various issues in the IoT healthcare services. 8.1 Scalability
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Scalability is a significant criteria needed in healthcare system. It is the ability of a device to adapt the changes in the environment and meet the changing needs in the future. The IoT healthcare systems are less scalable because the IoT healthcare system connects a huge amount of sensors, actuators, and other devices to share information and applications via the
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internet. The lack of uniformity among the connected medical devices reduces the scalability of devices, and these must be managed, maintained, operated and supported using appropriate addressing conventions, protocols, and power. Existing approaches to these
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challenges may be inadequate and fail to scale for the anticipated huge number and range of IoT objects.
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The main goal is to make the wearable device scalable to meet changing needs. The
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importance of scalability is that it helps the system to work gracefully without any delay and unproductive resource consumption and makes a good use of the available resources. Hence
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it is important to make a healthcare device with higher scalability to make it more efficient
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for the present and the future use. 8.2 IoT Healthcare Security
The data privacy and security are the significant open issues in IoT based healthcare applications. Security can be defined as managing credentials and controlling access to applications and patient’s confidential information. Data privacy is very crucial in the context of IoT-based healthcare. Healthcare applications are designed and developed based on acquiring data from IoT devices. The massive data that 49
ACCEPTED MANUSCRIPT is being transferred and stored on a regular basis can be hacked and used against the patient and the doctor. These hackers can also create fake IDs to buy drugs and medicines only to misuse them further. These challenges remain questionable in various applications because the architecture of IoT in healthcare is not well defined and it fails to provide the
8.3 Low Power in IoT Healthcare Device
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information about how to preserve the privacy and security of the data.
A typical IoT healthcare network includes small health devices of limited battery power. Such devices conserve energy by switching on the power-saving mode when no sensor reading needs to be reported. Because of many service requirements, the device faces power
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shortage even though switching on to the power-saving mode. The power consumption of long-term monitoring applications are sufficiently low and allows minimal interaction by the device wearer. Low power device should be designed to reduce the risk of patients being
8.4 Network Architecture
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offline.
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The network architecture of IoT must provide authentication and authorization for the users
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in the healthcare system. There are different types of network architectures have been proposed by researchers. The three layer architecture cannot fulfill the requirements of
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healthcare applications. The recent five layer IoT architecture have lower capacities in storage and energy. Health care devices are low cost and light weight devices that can save
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only few bytes of messages. The network architecture of IoT in healthcare is still considered as an issue, because it fails to fulfill the requirements of IoT regarding storage, security and privacy.
8.5 Cost Analysis of IoT Healthcare System Nowadays, the cost of healthcare devices dominates the healthcare IoT system more than ever before. According to the author’s knowledge, there is no comparative study has been 50
ACCEPTED MANUSCRIPT done based on the cost analysis of IoT healthcare system. Thus, we consider the cost analysis as an open issue in IoT healthcare system. The high cost of monitoring equipment in IoT health care system is a major issue even in developed countries. The IoT has not made the healthcare facilitates affordable to the common man yet. The boom in the healthcare device costs is a worrying sign for everybody.
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8.6 The App Development Process
The mobile app developers are facing challenges in security, privacy and database technology. Numerous devices can be controlled, monitored or maintained through the app.
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The security and privacy is a major concern to preserve patient or user information from leakage and ensure sharing of data to others with the consent of the patient. In addition, the mobile app collects patient’s health related data for every minute in regular basis, so to manage the big data and getting useful insights from it is a challenge. The healthcare mobile
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apps are mostly recommended for patients to get their daily regimes and to enable this; the
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8.7 Quality of Services
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app should be powered with artificial intelligence that provides real-time suggestions.
Nowadays, IoT is mainly used for real-time applications. QoS is directly related to the quality
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and the timeliness of the IoT data that can be used for decision support. It requires data generated from the health care sensors to be collected, transmitted, processed, analyzed, and
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used in a timely manner. But, in some cases the IoT devices fails to provide the necessary data on time. It can be considered as a challenge for the IoT healthcare system on regarding QoS. Also, the IoT devices generate large scale of real-time data in terms of volume, velocity, and variety and make a big data problem. It became a big challenge in combining and analyzing such data with historical patient data to obtain meaningful diagnoses suggestions within acceptable time frames (considering QoS). As the medical wearable 51
ACCEPTED MANUSCRIPT systems deal with real-time and life-critical applications, they require a strict guarantee of QoS. This remains a significant gap in the areas of heterogeneous data collection, real-time patient monitoring, and automated decision support based on QoS. Thus, it is necessary to overcome these challenges based on QoS.
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8.8 Continuous Monitoring for Healthcare Purpose Many patients required long-term monitoring mainly, the elderly people and patients with chronic diseases. In this context, constant monitoring and logging is very critical. For continuous monitoring, it is compulsory that smart devices and sensors send data to the
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required destination on time. However, it faces some limitations which can be a hurdle in continuous monitoring as if patient’s devices start malfunctioning or its battery is about to die then remote data sharing cannot be achieved. Hence, continuous monitoring will be adversely
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affected. 9 Conclusions
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WSN for healthcare applications is becoming an interesting field in the medical
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industry. The researchers throughout the world had started to discover several techniques to increase the healthcare endowment in the way of services by means of mobilizing the
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potential of IoT. This review which has mainly focused on the WBN through IoT healthcare system also offers different network architectures and healthcare platforms that in turn
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support the enabling of healthcare data transmission and data reception. In addition to, this paper provides information of research activities and how they can access the disease supervision, fitness management, pediatric, private health and elderly care management. However, the IoT healthcare sector is resourceful and the most important aspect is security, privacy, authentication, energy, power, resource management, quality of services and the real-time wireless health monitoring, which remains problematic in various IoT framework 52
ACCEPTED MANUSCRIPT since, no well-defined architectures are formed in IoT healthcare framework. This review gives a brief outlook of application of IoT architecture, services technologies etc. For better understanding of WBAN based IoT healthcare system, the paper considers various enabling technologies of IoT and the network system types in IoT healthcare system. Discussion of various technologies of WBAN based IoT healthcare applications and important challenges
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and open issues are described. Furthermore, this review is useful for several engineers, researchers, policymakers, health professionals, and healthcare technologies domain.
In the upcoming eras, the use of WBAN based on IoT healthcare will increase more
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and more. Because of its widespread adoption, the IoT in healthcare is considered as the effective patient session technology. Besides, the IoT devices support the medication, delivering home health, monitoring etc. Moreover, if the size and the prices of the IoT enabling devices are reduced, the scaling of raid technologies will increase. Thus, the IoT has
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a great future and will witness an ever increasing research work in the years to come.
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Biography:-
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Mrinai Maneetkumar Dhanvijay is currently pursuing PhD at Department of Technology, Savitribai Phule Pune University, India. She is working as Assistant Professor in Department of Electronics and Telecommunication at Modern Education Society’s College of Engineering, Pune, India. She has received her post graduate from Pune University, Pune, in 2012, after completing her B.E. from Nagpur University, Nagpur in 1999. She has published paper in IEEE explore, ACM digital Library, IJCA. Her research interests include IOT, HBC
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Dr. Shailaja C. Patil is currently working as professor in Department of Electronics and Telecommunication at Rajarshi Shahu College of Engineering, Pune, India. She has 25 years of teaching experience. The Doctorate of Philosophy in Computer Engineering has been conferred upon her by Saradar Vallabhbhai Patel Natioal Institute of Technology, Surat in April 2013. She has authored a book on Feedback Control System, Satya Prakashan, Delhi, India. She has more than 60 publications in National and International, Journals and Conferences. She is a regular reviewer of peer reviewed journals. Many International Conference and Journal articles have been reviewed by her. She has served as Session chair in several International Conferences. She has fetched funding worth 8 Lacs from BCUDSPPU and AICTE for Research and Faculty developement programs. She is a Fellow of Institution of Engineers and member of various professional bodies, IEEE, ISTE, GISFI, ISA, ACM. Her research domains Wireless Sensor Network, Image Processing and Internet of Things.
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Internet of Things: A Survey of Enabling Technologies in Healthcare and its Applications Mrinai M. Dhanvijay , Shailaja C. Patil PII: DOI: Reference:
S1389-1286(19)30269-5 https://doi.org/10.1016/j.comnet.2019.03.006 COMPNW 6755
To appear in:
Computer Networks
Received date: Revised date: Accepted date:
3 February 2018 8 February 2019 4 March 2019
Please cite this article as: Mrinai M. Dhanvijay , Shailaja C. Patil , Internet of Things: A Survey of Enabling Technologies in Healthcare and its Applications, Computer Networks (2019), doi: https://doi.org/10.1016/j.comnet.2019.03.006
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Internet of Things: A Survey of Enabling Technologies in Healthcare and its Applications Mrinai M. Dhanvijay a,*, Shailaja C. Patilb Research Scholar, Department of Technology, Savitribai Phule Pune University, Pune. b Professor, Department of Electronics and Telecommunication Engineering, Jayawant Shikshan Prasarak Mandal's Rajarshi Shahu College of Engineering, Pune. Email id: [email protected]
a
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Abstract
Internet of Things (IoT) on the Wireless Body Area Network (WBAN) for healthcare applications is an operative scenario for IoT devices that has gained attention from vast
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research fields in recent years. The IoT connects all subjects and the healthcare system seamlessly. This paper describes the WBAN based IoT healthcare system and reviews the state-of-the-art of the network architecture topology and applications in the IoT based healthcare solutions. Moreover, this paper analyzes the security and the privacy features
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consisting of privacy, authentication, energy, power, resource management, quality of services and the real-time wireless health monitoring that are quite problematic in many IoT
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healthcare architectures. Because, system architecture is not well-defined, data restriction and
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its integrity preservation is still a challenge. At present 90% of the information available is acquired in the recent two years. This survey mainly aims at analyzing healthcare purpose
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which is based on digital healthcare system. Further, it reports many IoT and the e-healthcare policies and systems that decide how to ease all bearable development. Thus, the overall
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system provides large possibilities for future research based on IoT healthcare system. Finally, research gaps are reviewed and the possible future aspects have been discussed. Keywords: - IoT, WBAN, healthcare system, body sensor. LIST OF ABBREVATIONS AAL
Ambient Assisted Living
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ACCEPTED MANUSCRIPT Analog to Digital Converter
ADR
Adverse Drug Reaction
AHS
Automation Healthcare System
BAN
Body Area Network
BP
Blood Pressure
BS
Base Station
BSN
Body Sensor Network
CCN
Content-Centric Networking
CH
Community Healthcare
CHI
Children Health Information
ECG
Electro Cardiogram
EGC
Embedded Gateway Configuration
GUI
Graphical User Interface
ICU
Intensive Care Unit
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IoT
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IEH
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IP
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ADC
Indirect Emergency Healthcare Internet of Things Internet Protocol
MAC
Medium Access Control
m-IoT
Internet of m-health Things
PAN
Personal Area Network
PC
Personal Computer
PDA
Personal Digital Assistant
PWS
Personal Web Server
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ACCEPTED MANUSCRIPT Quality of Service
SIoT
Social IoT
SMA
Semantic Medical Access
U-Health
Ubiquitous Healthcare
WBAN
Wireless Body Area Network
WDA
Wearable Device Access
WLAN
Wireless Local Area Network
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1 Introduction
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QoS
The H-IoT is also known as the health IoT, which is a milestone of information systems development. It plays a major role in enlightening the people health level and
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increases the worth of life [1]. It is a complex system, which involves microelectronics systems, medical and health, computer science and many other fields. According to the
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overall connected healthcare system, the period from 2017 to 2022 is the growth phase of IoT
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healthcare applications that accelerate the healthcare industries and various stakeholders that are stepping up their efforts [2]. Therefore, there is no doubt, that IoT works in transforming
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the healthcare sector by completely redefining the devices, apps and the people related and associated with each other in the healthcare solutions [3]. Thus, the IoT is constantly
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providing new tools, as the efficiencies which make up the integrated healthcare sector ensures better patient care. With this it was observed that the healthcare costs were reduced significantly and further, the treatment outcomes had improved. In future, wearable sensor, the wireless communication technologies, Wireless Sensor Networks (WSN), WBAN and Human Bond Communication are going to become an embryonic research area worldwide [4]. A Body Area Network (BAN) is also referred to as
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ACCEPTED MANUSCRIPT Body Sensor Network (BSN). It is a wireless network of wearable computing devices. BAN is same as that of other wireless network technologies. It covers the human body with a set of resident sensor or devices as depicted in Fig. 1. For example monitoring of person's vital signs, fitness information, cardiac monitoring for the medical purposes etc. The BAN might be embedded into the body by means of fixed position wearable method. However it is a
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system which humans can carry as devices in different positions, pockets and clothes. These tiny smart devices are playing an efficient and important role as data hub or data gateway in BAN applications [5]. Furthermore, the typical BAN consists of battery, transceiver and the
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processor and with this the physiological sensors ECG (Electro Cardiogram), are developed.
Physicians or authorized user
Sensor node
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Internet
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Master node
Medical server
Figure 1: IoT healthcare system
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Base station
A sensor node in the WBAN is capable of sampling, processing, and communicating
one or more vital signs such as heart rate, blood pressure, oxygen saturation, activities or environmental parameters which include location, temperature, humidity, etc. [6]. Ubiquitous health monitoring for extended periods of time is possible by strategically placing these sensors as tiny patches on the human body or by hiding them in the person’s clothes. The Personal Web Server (PWS) receives the relevant data from the sensor nodes which sample 4
ACCEPTED MANUSCRIPT the vital signs without obstruction through wireless personal network making use of Bluetooth or Zigbee [7, 8]. The PWS provides graphical/ audio interface to the user, thereby transferring the information about the health condition to the medical server through Internet or mobile telephone networks. This implementation is done on a Personal Digital Assistant (PDA),
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cellphone or home computer.
On the other hand, the master node manages the network and makes sure that only one sensor node is active at any given moment. Then, the master can implement carrier sensing to reduce collisions with other networks operating in the same band. The master node
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is used for interference avoidance. Either the sensor nodes ask for permission for data transmission or the sensor nodes are polled for data when needed by the master node. Furthermore, loss of synchronization between a sensor node and the network master, create a
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need for the node to listen continuously for the next signal. The master can transmit higher power and act as a gateway to the outside world since it has larger power supply.
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This network is used for an e-healthcare application which includes, early detection of
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medical issues computer-assisted rehabilitation, emergency notifications etc. Nowadays, according to the Social-IoT, the portable device such as smartphones, tabs, wearable etc., are
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essential parts of each individual’s daily life [9]. Therefore, this can be a gateway among the WBAN which is based on IoT technologies. Also, it connects wearable devices to the
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corresponding human body with Internet connection. It is an important and efficient smart healthcare system for the physicians to monitor the patient’s symptoms through BAN in the IoT environment. Nevertheless, the IoT healthcare sector is resourceful and the important characteristic of this sector is security, privacy, authentication, energy, power, resource management, quality of services and the real-time wireless health monitoring, which was quite questionable in many existing IoT healthcare architectures. Since, the architecture of the
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ACCEPTED MANUSCRIPT system is not-well defined, data restriction and preservation of its integrity and also the robustness of the overall system is not achieved. In order to achieve robust performance of IoT system, various approaches are introduced [10]. Therefore, the devices have become an important research area based on efficient security, privacy, and energy mechanism. Consequently, a security framework is needed to protect the overall IoT system from
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unauthorized entities. For healthcare system, the low power device WBAN is used to provide efficient and reliable infrastructure to all implanted, non-implanted and wearable sensor devices for human body [11]. These devices are used to capture numerous symptoms of the patients such as Blood pressure, Heartbeat, Respiration, Body temperature etc., and this
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information is sent to the body network controller, which is a part of WBAN. It is mainly focused on capturing the sensor data and then preprocessing the centralized healthcare server. Besides so many apps, prototypes services are also used in this healthcare field. Thus, it
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provides healthcare architecture, services and applications, security and privacy to end users [12]. In many countries, policies and guidelines are being developed for IoT technologies in
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the healthcare applications. According to these developing policies, current researches in
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healthcare sector is beneficial for several interested parties and other exploration works. The database is chosen according to their importance in the computer science area
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whose characteristics are availability of the study, coverage of indexed articles which belongs to journals or magazines or various reviews and usability for their selection. Selection of
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search engine is given in Table 1. Table 1: Selection of search engine Search engine
Source address
IEEE Xplore
http://ieeexplore.ieee.org/
ACM
http://dl.acm.org/
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ACCEPTED MANUSCRIPT Springer
http://link.springer.com/
Elsevier
http://www.elsevier.com/
This review examines the various IoT based healthcare researches and addresses various healthcare technologies, networks and taxonomy through IoT innovations. In this regard, this
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review contributes to
Modeling an existing method in IoT healthcare network and presenting summary of each for better understanding.
Model a detailed analysis of recent state-of-the-art IoT healthcare methods with their
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objectives, metrics, classification, strength and future scope.
A broad survey of IoT healthcare services and its applications.
Developing a core healthcare systems and healthcare networks, that can reshape
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healthcare technologies based on the IoT.
Modeling a current real-world application to support all researchers and policymakers
Finally, the intention is to overcome the challenges and the open issues to make the
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in integrating the IoT innovation into healthcare technologies in practice.
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IoT-based healthcare technologies robust.
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ACCEPTED MANUSCRIPT Sec. 1 Introduction Sec. 2 Enabling Methods of IoT
Sec 2.1 People-centric IoT Sec 2.2 Human Bond Communication Sec 2.3 Social IoT Sec. 3 Related Works Sec. 4 IoT in Healthcare Applications
Sec 4.2 Remote Monitoring Sec 4.3 Context-Awareness Sec. 5 IoT Healthcare Networks
Sec. 5.1 IoT Network Topology Sec. 5.2 IoT Network Platform Sec. 5.3 IoT Network Architecture
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Sec 4.1 Clinical Care
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Sec. 5.3.1 IoT Architecture Based on WBAN for Healthcare Applications Sec. 6 WBAN Based IoT Healthcare Technologies Sec. 6.1 Security
Sec. 6.1.1 Information Security
Sec. 6.1.2 System Privacy and Confidentiality
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Sec. 6.2 Energy
Sec. 6.2.1 Power
Sec. 6.3 Ubiquitous Healthcare
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Sec. 6.4 Resource Management Sec. 6.5 Quality of Services
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Sec. 6.6 Real Time Wireless Health Monitoring
Sec. 7 IoT Healthcare Services and Applications
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Sec. 7.1 IoT Healthcare Services
Sec. 7.2 IoT Healthcare Applications
Sec. 8 Challenges and Open Issues of IoT Healthcare System Sec. 8.1 Scalability Sec. 8.2 IoT Healthcare Security Sec. 8.3 Low Power in IoT Healthcare Device
Sec. 8.4 Network Architecture Sec. 8.5 Cost Analysis of IoT Healthcare System Sec. 8.6 The app development process Sec. 8.7 Quality of Services Sec. 8.8 Continuous Monitoring for Healthcare Purpose Sec. 9 Conclusions
Figure 2: Overview of the paper 8
ACCEPTED MANUSCRIPT The rest of the survey paper is organized and demonstrated in the Fig. 2. The remaining segments are structured as follows: Section 2 introduces enabling technologies of IoT, Section 3 presents the related work, Section 4 introduces the IoT in healthcare applications, Section 5 explains the IoT healthcare networks, Section 6 explains the WBAN based on IoT healthcare technologies followed by IoT healthcare services and applications in Section 7, the
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Section 8 presents some IoT healthcare challenges, and open issues, and finally Section 9 concludes the overall survey. This work ends with some future research directions. 2 Enabling Methods of IoT
The IoT should be capable of interconnecting billions or trillions of heterogeneous
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objects through the Internet. Such an evolution is enabled by the latest developments in smart sensors, communication technologies, and Internet protocols. A critical need for flexible methods emerged. In such a situation, an IoT can be realized with three important enabling
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methods, which include: People-Centric IoT, HBC, and SIoT. Some of them are based on the
2.1 People-centric IoT
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IoT healthcare system, as explained in the following.
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The People-IoT makes the design establishments for Future IoT network. It is a relevant application to a wide variety of needs and the innovative technologies. In this setting,
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an engineering reference displays the interoperability of IoT frameworks which concentrates on other mechanical issues, such as adaptability, versatility, administration, unwavering
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quality, security and protection [13]. People-centric IoT structures are used for displaying the Internet of People and the things they interface. The wearables are used for measuring the heart rates, calories, speed, temperature etc [14]. Therefore, the main focus of wearables on IoT applications is based on people-IoT services. This system is mainly used for the safety purpose such as biometric, tracking etc. 2.2 Human Bond Communication
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ACCEPTED MANUSCRIPT The HBC is mainly related to the WBAN healthcare system. The Knowledge Home is an important criterion in HBC. Also, it can be used in many applications, but mainly in the healthcare sector. Besides, the important knowledge home has healthcare issues such as predicting or preventing certain harms like heart attack, cardiac problem, etc. HBC is introduced as another hypothesis of transmitting five senses that mankind detects. It
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incorporates the accomplished Knowledge from the HBC transmission with the capacity of transmission of various human emotions and makes Knowledge Home [15]. The five faculties are specific, optic, sound-related, olfactory, gustatory and material. A wearable device is required for the digitalization of this new kind of information. The device will have
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the capability of revealing, transforming the information in digital form and sending the same through a communication channel. So conceptually, humans need to carry a so called BAN for detection and transmission of information. Usually information is sent using wireless link
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due to mobility issues. Moving personal health data has close similarity with HBC data security issues. Since privacy is important to both of the data, it must not be modified or
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accessed by any un-authorized persons.
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2.3 Social IoT
The Social IoT (SIoT) is a late embraced term for the coordination of individuals and
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gadgets into the informal organization worldview [16]. A definitive objective of SIoT is to advance human life via flawlessly coordinating their gadgets into their quotidian schedule.
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We add SIoT with a suggestion that merges the Web, "things" and clients under a semantic approach. This union rises up out of acquiring person to person communication elements and the estimations of intelligence, proposal, separation and benefits creation and recommending a widespread structure to consolidate clients, gadgets and administrations and the connections among them [17]. Smart Buddy idea is created to break down huge information produced by smart city communities to characterize human elements. Smart Buddy is bolstered by a
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ACCEPTED MANUSCRIPT framework design that investigates the surge of approaching information and comprehends human practices progressively, at long last impacting their practices through the ceaseless input [18]. To build up a framework for characterizing human elements, the SIoT-based shrewd city idea is utilized where a few remote and wired sensors, observation cameras, body zone systems are used for restorative applications. Facebook, Twitter, and other fixed gadgets
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convey about healthcare systems [19-20]. Smart Buddy takes the data from social networking applications but shrewd city metropolitan framework is keen in stopping the acquisition of data. 3 Related Works
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Some of the surveys based on the WBAN by means of IoT healthcare applications are documented below
Castillejo et al. presented the integration of wearable devices based on WSN for an e-
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health application where it was based on the WSN for IoT [21]. They mainly focused on the feasible e-health application by means of IoT. They introduced these sensors mainly for the
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usage of fireman and women than to the sportspersons. According to the functionalities, if a
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person reaches the hazardous level, an alarm alerts the user to stop doing the exercise. Thus, it is a real-time monitoring system, where it transmits the alerted message to the users. Their
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proposed system is fully tested and implemented, as it provides efficient real-time applications. Even though it has many advantages for various applications, it has some open
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issues such as accuracy and efficiency. He et al. introduced anonymous authentication for WBAN with provable security
[22]. The wireless networks, integrated circuits and the embedded systems are the emerging technologies in the BAN. Nowadays, the IoT plays an important role with WBAN in modern medical systems, because it has a capacity to collect the real-time medical data through the medical sensor from the patient's body. Even though the BAN was used for many
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ACCEPTED MANUSCRIPT applications, it has a major challenge in keeping the patient data confidential and private. Many schemes are introduced for these challenges, but it still remains a challenging one. Therefore, the proposed system reduced the security weakness on the client side. Zhang et al. produced the interference mitigation for cyber-physical WBAN system using social networks [23]. The WBAN was a key element for real-time monitoring in the
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ubiquitous healthcare applications. The WBAN could operate under dense environments, like hospitals, high mutual communication scenarios etc. These sensor networks depleted the energy more quickly and became unreliable in the collection of healthcare data. It increased the reliability of the system and reduced the power consumption. Many enabling technologies
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were introduced to regulate the overall system, but it remained as an open issue. Therefore, the authors introduced power game-based approach, to mitigate the modeling of interference, developing the social interaction and developing power control while minimizing the power
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consumption of the WBAN. Thus, this system produced the effectiveness in power management.
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Tokognon and Gao explained about the WBAN based on IoT for the healthcare
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applications as it communicated with the individual to individual and the individual to things [24]. According to the author, the IoT was made to be a part of the overall Internet of the
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future and several technologies were used in the IoT such as communication solutions, tracking technology, wired and wireless sensor identification etc. A new current trend IP
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(Internet Protocol) address was introduced, so that it could reach any other node of the network. Another paradigm was introduced called squared, which is a web2.0 evaluation grating web and sensing technologies to enrich this concept. In IoT the squared was an important application on an Internet. The current traditional technology is not fit for IoT, so the squared can be used for further researches. Scalability and efficiency were some of the challenges faced by the research community for efficient applications.
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ACCEPTED MANUSCRIPT Catarinucci et al. modeled a smart healthcare system based on IoT aware architecture [25]. The authors introduced the IoT aware architecture for automatic monitoring and tracking of patient’s biomedical information. They also proposed smart hospital system, with enabling technologies, especially for wireless networks and smart mobile to enable network infrastructure. The wireless Personal Area Network (PAN) with integrating technologies
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sensed the biomedical data and served the clients. Thus, it provided highly efficient real-time monitoring of patient's biomedical information. Furthermore, privacy was an open issue in this system.
Jara et al. described the interconnection framework for m-healthcare application
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based on IoT [26]. The process of communication and the information access process had a personalized health end to end framework. The personalized data was complex and was found to be in an incomplete manner. So, the authors introduced interconnection framework
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for m-healthcare applications based on IoT. It made continuous and real-time vital sign monitoring system which introduced technological innovations for the health monitoring of
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patient's devices by means of Internet system. In addition to this the data aggregation was
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determined by the round-trip delay time with the impact of security. Thus, it provided highly secure communication. Although profitability and scalability were also open issues in this
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framework.
Chen introduced the group mobility protocol for low power PAN based system by
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means of WBAN [27]. The proposed system provided low handoff delay and the signaling cost improved with the help of group mobility and the group based BAN. The packet loss ratio and the overhead criteria of the healthcare systems were reduced by the proposed method. Even though it had many applications, it possesses security challenges in this system. Thus, it acted as an open issue in the proposed system.
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ACCEPTED MANUSCRIPT Rohokale et al. explained the cooperative IoT system for the rural healthcare control and monitoring [28]. The authors mainly focused on the healthcare applications, as the information objects were tagged in persons by browsing with an IoT. In addition, the quality of services was an important paradigm in this work, as the authors developed the proposed IoT for the quality of services. This system was mainly introduced for the monitoring of poor
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people's health parameters, such as Hemoglobin, Abnormal cellular growth, Blood pressure etc. Furthermore, the authentication and the authorization was still an open issue in this system. The scope of the survey paper was to provide suitable research direction to the readers on how to choose the most appropriate IoT healthcare system for their network.
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4 IoT in Healthcare Applications
In the healthcare, IoT plays a very important role in various applications. This criterion is divided into three phases, such as clinical care, remote monitoring and context
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awareness. During data collection, the risks of human error are reduced by means of automatic medical data collection method. This will improve the quality of the diagnosis and
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reduce the risk of human errors, who are involved in the collection or transmission of false
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information which is dangerous for the patients' health. 4.1 Clinical Care
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In the hospitals, the patients, especially those who are in the intensive care, need continuous monitoring and close attention so as to react to the possible crisis and save lives.
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These monitoring systems employ sensors to collect physiological information which is analyzed and stored on the cloud and then it is sent to the Internet caregivers (patient’s family members, nurse) for further analysis [29]. Many health professionals collaborate together and then examine the patients according to each one’s specialty, by analyzing the flow of data collected by the sensors. Then the identification of the emergency condition for risky patients (Urgent or emergent surgery patient, cardiac patients etc) will be an easy task.
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ACCEPTED MANUSCRIPT 4.2 Remote Monitoring Remote monitoring is an important paradigm for many real-world applications. Nowadays, all over the world, there are many people whose health might suffer due to lack of effective healthcare monitoring [30]. Elderly, children or chronically ill people needed to be examined almost daily. The possibility of a remote monitoring system will help to avoid
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making rounds of the hospital for checkup illustrated in Fig. 3. Because of their critical status, sometimes their health goes unnoticed until the diseases develop into a crisis stage. Remote access sensor helps the caregivers to have pre-diagnosis and earlier intervention before things
WBAN 1st tier
Data aggregation 2nd tier
EKG Sensor
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Medical server
Medical doctor
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Motion sensor
WLAN (WiFi) WWAN (3G)
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Spo2 bp sensor.
Communicat ion 3rd tier
Internet
PDA
EMG sensor
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go wrong.
Emergency
Nurse
Figure 3: Real time remote monitoring system
Thus, the people-centric IoT is used for different units of cognitive and the physical infirmities will be enabled to have more autonomous and easy life [31]. As the sensor is attached to the skin at specific locations it can be used for diagnosing the heart condition and the influence of the drug on its activities. Many patients who suffer from chronic illnesses such as cardiopulmonary disease, Asthma, and Heart failure are located far away from the 15
ACCEPTED MANUSCRIPT medical care facilities. The real-time monitoring of such patients through wireless monitoring systems is the most promising application. Some of the real-time healthcare monitoring systems is remote patient tracking and monitoring system, remote monitoring of cardiac patients and heart beat monitoring system. The real-time monitoring system consists of remote medical monitoring unit and the monitoring center. It analyses the information from
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the sensor based on real-time analysis and a warning sign will emerge for emergency and diagnosis. The signals from the body sensor are taken to the corresponding medical center through Wireless Local Area Network (WLAN) system. As a result, this real time monitoring system provides information about patient’s health conditions, and it may also reduce more
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complications and provide treatment at the earliest. Thus, it provides accurate and real-time monitoring system in the healthcare sector. It also helps for faster detection of input sensor and save life.
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4.3 Context-Awareness
Context-awareness is a major criterion in the healthcare IoT applications. As it has the
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ability to find the patient's condition and the environment where the patient was located it
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will greatly assist the healthcare professionals to understand the variations that can influence the health status of these patients. In addition to, the change of physical state of the patient
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may increase the percentage of its vulnerabilities to diseases and be a cause for his/her health deterioration [32]. The use of several types of specialized Sensor capturing various
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information about the patient’s physical condition such as his walking, running, sleeping etc. or the environment where the patient is, such as wet, cold, hot etc., and the collaboration between them to collect the meaningful information, will provide a better understanding of the patient’s conditions, while they are hospitalized, at home or anywhere. Furthermore, it will provide help in emergency cases to locate the patients and be aware of the type of emergency intervention that can be taken.
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ACCEPTED MANUSCRIPT 5 IoT Healthcare Networks Several devices and systems must work together in the context of the IoT, which contributes to the operation and the improvement of the overall healthcare system [33]. The IoT healthcare network is one of the vital elements of the WBAN in the healthcare applications. The transmission and the reception of healthcare data achieve efficient
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communication based on the WBAN network system [34]. The IoT healthcare networks
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Topology: Application framework, physical configuration Architecture: Hierarchical model and software organization
Management
IoT Healthcare Networks
Security
consist of network topology, architecture and the platform as illustrated in Fig. 4.
Platform: Substructure and library network
5.1 IoT Network Topology
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Figure 4: Types of IoT healthcare networks
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The IoT network topology is denoted by the collection of different elements of the
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role of IoT healthcare system and it specifies different characteristic scenarios of the continuous healthcare environments [35]. The IoT in WBAN system can be monitored by the
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wearable devices based on the remote monitoring. The on body sensor and the portable medical devices attached to the patient’s body helps to collect the correct details of patient’s
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health profile. After that, the information are analyzed and stored in a particular database and this information is useful for the aggregations. Based on this process, the caregivers will be able to monitor the patient from any locations or place and also they can respond accordingly [36]. The Fig. 5 represents the streaming of healthcare data by means of an interconnected network with WiMAX, the Internet protocol network and access service networks. Similar conceptual structures are found in fig. 5 [37]. 17
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Tiny OS
6LOWPAN border router
Network
On body sensor Hospital
IP network HSDP A RNC
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Support node
IP
GSM/WIMAX network
Network
Network
ASN gateway
Access service network
Distributed system
Mobile patient
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Figure 5: IoT network topology on remote healthcare monitoring
The IoT network topology shows the role of gateway systems. The Fig. 5 also represents the iMedpack, which is known to be IoT devices that manage the problem in the pharmaceutical
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compliance, as it avoids the medicine misuse [38]. Moreover, various sensors and the interfaces of multiple wireless network topologies provide important gateway for healthcare
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applications [39]. Also the IoT healthcare system enables the diagnosis and analysis by connecting various wearable devices and IoT devices to the health care gateway.
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Furthermore, in the gateway, it can analyze, store, investigate and then present the collected
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data. Therefore, all IoT network topologies are found and integrated clinical devices are coupled with a lot of IoT healthcare infrastructure. In the IoT network topologies, the
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fundamental factor provides associated activities and roles of medical system and it is mainly for the perception of healthcare service providers. Such activities are used for the emergency medical services [40]. Thus the topology includes medical system in the semantic medical monitoring system. 5.2 IoT Network Platform
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ACCEPTED MANUSCRIPT The IoT healthcare network platform model and the IoT cloud computing healthcare platform model are the two important platform models in the IoT system. Besides, the services platform model mainly focuses on the resident health information as represented in Fig. 6. The IoT network platform structure shows the classified healthcare model of how the agents can access different database from the foremost application layer according to the
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healthcare support layer [41]. This can ensure the associated interoperability and the automatic design methodology platform introduced for the IoT network is mainly for the rehabilitation method which is presented in it. As explained above, the framework includes accessing layer, data persistent layer, business implementation layer and the support layer
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[42]. In order to handle multiple users with multiple sensors, an enabling method is needed for IoT gateway.
IoT platform for healthcare service model
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Community health center Hospital Personal device
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Data persistent later
Health record database User information database Privilege database
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User applications
Personal healthcare record Diagnosis HL7/XML encode
Business layer
Management
Support layer
Analytics
Healthcare records Basic information system Privilege system
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Accessing layer
Figure 6: A functional framework of IoT platform model for health information service model
The method enables the IoT system to handle multiple users by means of multiple sensors during the collection of healthcare data. The IoT database is used in the multi-tenant database and the resource layer is mainly responsible for data sharing of healthcare system and
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ACCEPTED MANUSCRIPT interpolation of healthcare data by means of resource control mechanism. Therefore, the given systematic framework provides user environments and the semantic capabilities of IoT in the healthcare sector. 5.3 IoT Network Architecture The IoT healthcare architecture is referred to as the outline of the specification of
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IoThNet functional organization, physical elements, techniques and its working principles [43]. Some of the key issues that have been identified for this architecture: the interoperability of the IoT gateway and the WLAN, multimedia streaming, and secure communications between IoT gateways and caregivers [44]. Due to the IoThNet system, the
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wearables and the sensors are used for the data transmission over the specified protocols. In the framework of the network data transmission the data is replied back to the sensor nodes by means of user datagram protocol [45]. Thus, it provides seamless connectivity of sensor
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nodes for patients and the medical teams.
5.3.1 IoT Architecture Based on WBAN for Healthcare Applications
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The IoT architecture based on WBAN system design consists of three tiers. Fig. 7
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illustrates the representation of various sensor nodes and small patches positioned in the human body. Those sensors are known to be wearable sensors or the body sensors, which are
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implanted in the skin and can operate by means of wireless networks. Besides, these sensors capture the correct signals and then transmit the vital signs such as temperature, humidity,
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blood pressure, heart activity and the sugar level. The capabilities and the functionalities of the nodes can be preceded on tag or low-level handling system for communications. Then, the collected data from the body sensor is transmitted to the central controller system or primarily communicated controller and then communicated by means of the nearby PWS. Thus, it can be used for emergency alert or as medical database by providing that information to the medical group for real-time processing by means of WLAN system. The registered
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ACCEPTED MANUSCRIPT patient details from the electronic medical records are collected and stored on the medical server. It provides various services to the desired users, medical personals, and informal caregivers. The medical server has the responsibility for authenticating users, format and insert this session, health monitoring, analyze and recognize health analysis, physicians suggested
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exercises etc. The medical server can examine the uploaded data and then introduce alerts in the form of potential medical conditions. In the same way, the organization might be considered contributing to observing and studying of various therapeutic effects.
In the second tier system, the PWS interfaces and the graphical interfaces of the WBAN
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sensor nodes communicates with the other services by means of HBC knowledge home system. The sensor nodes of PWS are connected to the mobile device that can run on the Personal Computer (PC) [46]. It is mainly used for monitoring the elderly people. The
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network coordinator is a main criteria used for WBAN PWS interface. The network configuration consists of initialization, sensor node registration customization and the secure
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communications. If the WBAN is configured, then the PWS manages all the processing fields
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such as network, time, data retrieval, time synchronization, data retrieval etc. Therefore, the PWS application determines the user state and their health status by using the healthcare
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information from different sensors and it also provides feedback over the user interface.
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Distributed data access
Central server Healthcare staff
Patient with sensor
Database
IP network IP
Network Access point or base station
Distributed system
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Network
Network
User
Ward or house
Local server
Tier 1 for data generation, storage and distributed access
Tier 3 for data storage and access
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Tier 2 for data processing, aggregation and storage
Figure 7: Framework of IoT based WBAN for healthcare applications The PWS keeps the patient's authentication information with the server IP address. In addition to, if the medical server is available in the communication channel, the PWS creates
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a secure communication between the medical servers and then it sends the reports into the user's medical record. When medical server and PWS is not available in the communication
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link, then the PWS stores data locally in a particular database and sends that data when the
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link is available. Consequently, this system provides full mobility system with high secure communication and the real-time monitoring and finally the information is uploaded. The
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functionalities of IoT based WBAN are given below. (i) WBAN Sensor Nodes
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The WBAN sensor nodes consist of high communication and computing capabilities,
a small sized minute battery with limited power. Some of the components of sensor nodes are: 1.sensor: for sensing the vital medical signs from the body of the patient by enclosing the embedded chip. 2. Microcontroller: It controls the function of the other components and accomplishes local data processing including data compression. 3. Memory: It temporally stores the sensed information which is obtained from the sensor nodes. 4. Radio Transceiver: 22
ACCEPTED MANUSCRIPT communicates the nodes and then it provides physiological data to wirelessly send/received. 5. Power supply: It is used to supply the sensor nodes with the required power supplied by the batteries. 6. Signal conditioning: It amplifies and filters the physiological sensed data to suitable levels for digitalization. 7. Analog to Digital Converter (ADC): It produces digital signals from the analogue ones to allow further required processes.
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(ii) Personal Web Server
The PWS is a set of core technologies that enables a user to interact with their personal data and applications, which are stored on a personal mobile device, through the public infrastructures. It is also defined as the body gateway, which connects the smartphone
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to the wireless node by means of communication protocols such as Bluetooth, Zigbee etc. It is mainly bounded for the healthcare services that can be arranged by medical server with the IP address. The PWS processes the dynamic signs from the sensor nodes and it provides the
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transmission priority for critical signs and sends it to the healthcare server. Therefore, the PWS application determines the user state and their health status by using the healthcare
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(iii) Medical Server
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information from different sensor and it also provides feedback over the user interface.
The processing, analyzing and the storing of the medical data are the main process of
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medical server. It consists of storing, processing and analyzing software to delivering the healthcare system services. The user’s authentication is a vital measure for the medical
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server. The healthcare data is obtained from the sensors based on IoT medical server for testing. After testing, if any deviation is found from the expected healthcare records of a patient, the medical unit will be notified about it. Therefore, the patient authentication, security, privacy etc., is an outstanding issue and the requirements are addressed in all tiers in the healthcare system. Thus, the limited range of wireless communication provides security issues in the overall communications.
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ACCEPTED MANUSCRIPT 6 WBAN Based IoT Healthcare Technologies Let us condense the key requirements, technologies and design consideration of wireless communication technologies, which have the potential to apply in WBAN based IoT healthcare system applications. These requirements can be characterized into six main subjects: security, energy consumption, U-healthcare, resource management, quality of
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services and real-time monitoring as illustrated in Fig. 8. They are explained below: Internet of things
Security
Energy
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WBAN
U-healthcare
Information security
Resource management
Power
Privacy & confidentiality
QOS
Real time wireless health monitoring
Figure 8: Technologies for WBAN based IoT healthcare system
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6.1 Security
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Nowadays, the smart systems are mainly used for various applications. The advancements in the information and communication technologies facilitate the researchers
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and engineers to realize that the system is authenticated for all applications. In fact, by considering the confidentiality and sensitivity of medical data, a healthcare system must
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fulfill advanced access control procedures with strict security and data quality requirements [47]. Smart healthcare application system is the most significant applications for the
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physician to monitor the condition of corresponding patients remotely through WBAN, based on IoT healthcare environment. Nevertheless, for IoT environment, the most significant characteristic is the security and the privacy of the system, but it is still questionable in various IoT architectures. BSN (Body Sensor Network)-Care: Gope and Hwang [48] proposed the body sensor network system for healthcare applications. They introduced the BSN-Care method to 24
ACCEPTED MANUSCRIPT provide security to the patient information management in the healthcare system. The authors divided the overall security framework into two parts as, network security and the data security. The network security comprises secure localization, authentication and anonymity. The data security consists of data privacy, data integrity and the freshness of the data. Therefore, the system achieves high data security and the network security for further
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requirements. Thus, the proposed method provides mutual authentication property, anonymity property, secure patient information management, defeat forgery attacks and reduce computation overhead.
Content-Centric Networking: Lal and Kumar [49] introduced the Content-Centric
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Networking (CCN) method for WBAN based on the IoT healthcare system. The main objective of this system is to provide security and seamless connectivity to access the patient's data transmission in healthcare systems. The authors focused on the suitability of the
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healthcare communications by means of low cost and low power devices that enhanced the quality of people's lives who were suffering from diseases and emergency problems.
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Therefore, the proposed system provided seamless connectivity, security, high data rate, low
collision.
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latency and very faster, even though, it faced a problem in network connectivity during signal
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Novel Trust Evaluation Model: Boukerche and Ren [50] described the novel trust evaluation model to provide security properties and to prevent the malicious nodes during
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data transmission. It was mainly used for the security assets for the multicast arrangement and then evaluated the overall performance of the system. Their proposed method protects patient's medical records. Then, it provided high security to ensure the data confidentiality and user privacy. 6.1.1 Information Security
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ACCEPTED MANUSCRIPT According to overall performance, it was very crucial for the healthcare providers to obtain reliable information, robust and secure service. These strategies not only provided protection to the healthcare data, but also prevented the offensive conflicts because of the nature of healthcare data and the information security risks in the system. When comparing the cost reduction of the system, protecting the personal information was important and a
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challenging one. So, it needs an information security strategy to safeguard the patient’s healthcare information. Therefore, a good data security service provide efficient inventory and monitor the healthcare information.
Novel authentication and the key agreement protocol: Iqbal and Bayoumi [51] described
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the new authentication and the key agreement protocol for information security and privacy. It was important to secure communication channel, medical sensors or devices and the remote servers. To achieve those requirements the authors introduced the authentication and the key
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agreement protocol, which was a lightweight resource constrain sensor and it is suitable to protect sensitive health-related data. Therefore, the proposed system provides, more secure
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small enough in size.
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communication, protected the sensitive health-related data and the devices are cheap and
Novel Anonymous Authentication:
Wu et al. [52] introduced the novel anonymous
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authentication system for a security problem in healthcare applications. It solved security problems and reduced the communication cost and computation time. The authors compared
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the Wang et al. proposed system for achieving security for the system. Therefore, the proposed system possessed secure authentication, reduced security problems, and reduced computation cost to 31.58%. Thus, it achieved high security and performance analysis than the existing methods. 6.1.2 System Privacy and Confidentiality
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ACCEPTED MANUSCRIPT The overall system privacy and confidentiality are generally interchangeable. The privacy represents the right control access and it includes physical privacy. The privacy handles the personal information through privacy principles as well as, the confidentiality obliges the healthcare physicians to keep their patient’s inappropriate personal health information.
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SPPDA: Ara et al. [53] projected the secure privacy-preserving data aggregation method. The WBAN used the medical sensor for continuously monitoring and collecting the patient's health data and then to send them to the remote medical server by means of portable digital assistants. Power, storage, privacy etc. are the computational complexities of the system.
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Also the data aggregation technique was introduced to reduce the complexities and communication overhead. Therefore, the system possessed improved efficiency, data privacy and secures real-time data transmission. Thus, the performance analysis provided the system
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which was secured by means of decisional bilinear assumption.
Secure sensor association and key management protocol: Shen et al. [54] introduced a
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new sensor association and a key management protocol to satisfy the patient's requirements
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as for confidentiality and integrity of healthcare system. The new sensor system with elliptic curve cryptography and the hash function was used for the authentication procedure and the
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key generation. Their proposed technique achieved patient's requirements such as security, privacy and confidentiality in the healthcare system. It was easy to implement and was
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efficient. Also, it reduced the computation and the communication cost. 6.2 Energy
The IoT healthcare system is a small healthcare device with limited power approach.
This device conserves more energy through switching the power-saving mode. During switching of devices, no essential reading of sensor is to be reported. The energy utilization and the network life time had a great link between them. The quality of monitoring the
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ACCEPTED MANUSCRIPT patients based on WBAN is a challenging one. In order to reduce this challenge, the energy consumption in the coordinator node has to be reduced to increase the quality of the system. In contrast, the main role of coordinator node is data packaging and transmitting them to the Base Station (BS) and also aggregation of sensory data to the BS. If the patients miss to recharge the battery, it would be dangerous for the patients, so recharging the battery of the
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coordinator node in short intervals can increase the lifetime of the system. Therefore, an energy-aware security solution is used for finding the energy constraint property of the IoT health devices. Autonomous WBAN:
Wu et al. [55] introduced the efficient autonomous WBAN
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implementation method in IoT based WBAN healthcare applications. To achieve the objective of the work, they focused on the extent of lifetime of the wearable body sensor node and flexible solar energy harvesting to power the sensor node. Therefore, the proposed
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system achieved a 24hrs lifetime of the wearable system, extended the lifetime of nodes, and long-term continuous medical monitoring.
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ANT+ protocol: Mehmood and Culmone [56] introduced the ANT+ protocol for low energy
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consumption of WBAN. The proposed method strengthens the goals of IoT healthcare system. The authors introduced the software architecture which flexibly integrated ANT+
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protocol to deliver the healthcare services. Therefore, the proposed system achieved continuous real-time monitoring system, high energy storage and extended the lifetime of
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devices and reduced the frequent battery replacement. Energy efficient medium access protocol: It was based on the energy classification. Omeni et al. [57] introduced the energy efficient medium access protocol method to reduce energy consumption and reduce the collision in the nearby mode. It avoids collisions using clear channel assessment algorithm based on listen-before-transmit standard. In order to hold those time slot intersections, the wakeup fallback time was introduced. Therefore, their proposed
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ACCEPTED MANUSCRIPT system provides less energy consumption, reduce collision, reduce complexity, and pervasive healthcare applications. Thermal energy harvesting: It was mainly based on the energy classification. Hoang et al. [58], described the thermal harvesting from human warmth for WBAN in healthcare applications. The reliability of the WBAN mainly depended on the lifespan gateway. The
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authors explained the residual energy of the sensor nodes by the system gateway and also the lifetime of the WBAN increased by changing the gateway by thermal energy harvesting system. Therefore, the extension of the wearable devices reduced the complexity, power consumption, and the reliability of the system.
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6.2.1 Power
Power was a vital concept in the healthcare system. In the IoT healthcare system, many devices are made to be a heterogeneous function in terms of transmit, sleep, composite,
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receive mode etc. In addition to, power requirements based on service availability pose additional challenge to each communication layer.
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Hybrid data compression scheme: This scheme is mainly meant for the classification of
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power based on energy requirements. Heng et al. [59] explained the hybrid data compression technique for reduction of power in WSN based on the IoT healthcare applications. It was
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mainly focused on the power reduction in the IoT technologies. The author focused on the data compression with loss and the lossless method; subsequently it enabled the hybrid
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transmission mode with support data rate selection and then saves power in wireless transmission mode. Thus, the proposed method possesses an enabled hybrid transmission mode, enabling power aware transmission, optimizing utilization of local storage, increased error tolerance etc. Ultra-low power and traffic adaptive MAC (Medium Access Control) rules: It was mainly intended for the power classification in energy requirements. Ullah and Kwak [60]
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ACCEPTED MANUSCRIPT proposed the traffic MAC and ultra-low power control protocol for WBAN. It was mainly applicable for the low power consumption and to reduce traffic problems as idle listening and over-hearing problems. Consequently, the proposed technique provided low cost, low power consumption, and reliable energy transmission. 6.3 Ubiquitous Healthcare
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Nowadays, people have become highly health conscious and views about better health management are getting top priority. Besides, the Ubiquitous Healthcare (U-health) had a great potential in U-telemedicine and mobile application which was integrated with WBAN for efficient healthcare monitoring. It was a combination of medical, telecommunications and
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information technology, which provides medical services for diagnosis and treatment without restricted time or distance.
Smart e-healthcare gateway: It is mainly based on the U-healthcare system. Rahmani et al.
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[61] introduced the smart e-healthcare gateway that brought intelligence to IoT based ubiquitous healthcare system. It provided several higher-level services including embedded
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data mining, local storage, monitoring of real-time applications etc. Their proposed system
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provided reduced data ambiguity, robustness, and reliability, extended coverage in time or space, and further increased the quality of data. Furthermore, for the gateway management,
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the expansion of command set made a complete data. Also, the listing of different transport layer protocol sockets capable of generic library was for easy interoperability of a variety of
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nodes with different priorities. Sensor Network Tasking: It was mainly based on the U-healthcare system. Wang et al. [62] described the sensor network tasking for an efficient U-healthcare system for gathering patient’s information. The authors focused on the U-healthcare, based on WBAN system to provide information based probability and the relational model between the key indicators for data gathering and precedence in WBAN. Therefore, the proposed system provided
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ACCEPTED MANUSCRIPT sequenced data gathering, better priority consideration, high utility gain, reduce energy loss etc. Ubiquitous-healthcare using ECG: Chung et al. [63] projected the ECG system based on the ubiquitous healthcare. It provided a system to transmit all measured data from sensor nodes to the server without the packet loss and for monitoring the physiological data.
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Though, the proposed system possessed small size and was of low power consumption, it was compactable and the sensing and monitoring of communication was more accurate. 6.4 Resource Management
Resource management is an important aspect in the healthcare sector. Proper
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resource management is critical for providing high-quality healthcare. The focus on resource management of healthcare needs more research development and new policies. The resource management strategies need better outcome to access the healthcare around the world.
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Temporal informative analysis: Bhatia and Sood [64] proposed the m-healthcare perspective for smart-ICU (Intensive Care Unit) monitoring based on temporal informative
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analysis method. It also provided real-time monitoring as efficient monitoring of various
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events. Their proposed criteria obtained Real-time healthcare monitoring, accurate monitoring and reduced mortality rate. The novel work had some major challenges such as
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continuous data transmission and network load efficiency etc. IoT vehicle healthcare service model: Jeong and Shin [65] introduced the implantable
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devices for vehicle based on IoT healthcare service model. Its main focus was to provide healthcare services in a vehicle installed with IoT devices. Consequently, the proposed system worked automatically and stopped the vehicle when dangerous situation occurred and it took the patient to the nearest safe place and automatically called the emergency services.
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ACCEPTED MANUSCRIPT WSN for monitoring and alarming: Aubidy et al. [66] used the WSN system for patient health monitoring and real-time alarming system based on GUI (Graphical User Interface) monitoring method. The author introduced this system for the patients, particularly for the patients suffering from harmful diseases. Therefore, the new system achieves clear monitoring, scanning the data with reliable communications and was cheap and intelligent in
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decision making. 6.5 Quality of Services
The Quality of Services (QoS) is an important parameter used in the healthcare services which is a highly time-sensitive system. Numerous challenges exist to meet the
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quality requirements of IoT-based applications in terms of energy efficiency, sensing data quality, network resource consumption, and latency. The quality of body sensors determines the accuracy and sensitivity measurements provided by a sensor. Some of the parameters
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for the quality of a body sensor network are determined by the quality of data provided in response to a query. Delay and Delay Variation: It refers to delay and delay variation in data
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collection from nodes. Bandwidth, Capacity and Throughput: It indicates the capacity of a
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sensor network to send data over a link within a given time. Accuracy: Depending on the accuracy of the sensor observations, a particular sensor may have less value to the target
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query. Trustworthiness: The data for certain observations may be overlapping, when two or more sensors provide it for the same area. Decisions on determining an optimal subset of
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sensors which has to be kept active in order to meet subscription requirements may be made based on parameters such as sensor accuracy, level of trustworthiness, and available battery level. In contrast, each parameter in the IoT network framework is useful for quantitative measurement of the healthcare data. We consider these parameters in the survey because it provides accurate and robust health care application. There are lots of parameters to ensure the IoT system but these
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ACCEPTED MANUSCRIPT applied parameters provide better results than others. Similarly, it attains better reliability and life time, improve the quality of signals, ensure security and data privacy in the communications etc. Distributed Beamforming: Kisseleff et al. [67] introduced the distributed beamforming for magnetic induction based body area sensor network. The system was used to increase the
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quality of services, data rate and to reduce the vulnerabilities against attenuation and distortion in the signal. Their proposed criteria improved the quality of signals data rate and reduced the signal to noise ratio. Quality-aware ECG monitoring system:
Satija et al. [68] introduced an IoT-based
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healthcare real-time signal quality monitoring method known as ECG telemetry system. It automatically classified the acquired ECG signal, to provide design and development of a light-weight ECG signal quality aware method in IoT healthcare system, even though, the
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battery life of IoT-enabled devices was increased by light-weight ECG signal. Thus, the proposed system achieved better reliability and life time more than the existing method.
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6.6 Real-Time Wireless Health Monitoring
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The real-time wireless healthcare monitoring system is an important research field. This monitoring system may help the doctor or caregiver to monitor the patients in time.
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Automation healthcare system: Velrani and Geetha [69] described the Automation Healthcare System (AHS) to investigate advanced home healthcare services and to provide
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security and real-time monitoring system. They mainly focused on the WBAN based on the IoT healthcare application system. Moreover, one of the models was used for the real-time monitoring of patients as the wearable tags were used for automatic monitoring by means of IoT frameworks. Therefore, the proposed technique possessed reduction in healthcare cost, managed the shortage of nursing staff, high security, and compact size and was easy to
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ACCEPTED MANUSCRIPT handle. Thus, the system used P2P paradigm to ensure security and data privacy in the communications. Hand hygienic monitoring based on IoT: Bal and Abrishambaf [70] introduced the sensor based healthcare information system. Nowadays, the healthcare system lacks security and accurate real-time monitoring. The system is required to detect hand hygiene events in real-
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time, and help to measure the hand hygiene compliance at large-scale health-care facilities where it is deployed. Therefore, the proposed system was scalable and easy to install. It also provided proper use of healthcare facilities than existing techniques.
Wireless structural health monitoring: Si et al. [71] proposed the authentication
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algorithm and real-time damage detection by wireless healthcare monitoring system. It was mainly used for the identification of potential change in the structural system by authentication algorithm. Consequently, the proposed method held attractive functional
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point, efficient real-time monitoring and had high damage detection.
Table 2: Relevant literature on various classification technologies of IoT based WBAN Name of Classification Methods author with year
1
Si et al. (2009) [71]
PT
ED
Sl. No
AC
CE
RWHM
2
Bal and RWHM Abrisham baf (2017) [70]
Advantages
Future scope
Need improvement in functional point, efficient real time monitoring and high damage detection. Scalable, Performance easy to testing required install, for the better use healthcare in ease. facilities.
Metrics
Authentic Real-time ation measurement, algorithm strong potential
Acceleration , time, magnitude, and frequency.
HHM
-
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ACCEPTED MANUSCRIPT AHS
Reducing cost, manage shortage of nursing staff, high security, compact size and easy to handle.
Further Accuracy, improvement in node significant impact number. on healthcare field.
Satija et QoS al. (2017)[6 8]
LRSQ
5
kisseleff et al.(2016) [67]
DB
Improve quality of ECG signals and improved lifetime Improves the quality of signals data rate, reduce SNR.
Improvement for resource utilization, ambulatory physical activity. Unlikely and undesirable for the future BASNs and IoT.
6
Aubidy et RM al. (2016) [66]
7
Jeong RM and Shin (2016) [65]
QoS
GUI AM
& Accurate in scanning, clear in monitoring, reliable in communicati on, intelligent in decision making, and cheap.
Number of ECG segments, time, and amplitude. Number of sensor nodes, sum rate, distance.
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4
RWHM
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Velrani and Geetha (2016) [69]
Further Oscillation, development and pressure possibility of sensor. marketing in the near future.
ED
M
3
It automatically stops the vehicle when any dangerous situation occurs, takes the patient to nearest safe place call the emergency services.
Improves the overall system and analyzes network condition values at the beginning.
Communicat ion strength, communicati on overhead, and network efficiency.
TAG
accurate monitoring, reduce mortality rate etc.
Improves the overall system and analyze network condition values.
Delay time, mean absolute sift, temperature and frequency.
AC
CE
PT
AHP
8
Bhatia RM and Sood (2016) [64]
35
ACCEPTED MANUSCRIPT 9
Chung et UH al. (2008) [63]
ECG and Small in size, SpO2 low power consumption, compactable, sensing, and monitoring
Further Time, ECG improvement in data, SpO2 the real time data, and monitoring acceleromete process. r data.
10
Wang et UH al. (2010) [62]
IT
Sequenced data gathering, better priority consideration , high gain, reduce energy loss etc.
Promote the confidentiality and robustness of the system.
11
Rahmani UH et al. (2015) [61]
LZO LZ4
& Reduce data ambiguity, robustness, extended coverage in space and time, and increased quality of data.
Enable a generic library for easy interoperability of variety of nodes with different protocols.
Number of nodes, compression time.
12
Ullah and Power Kwak (2012) [60]
FDC
Low cost, low power consumption and reliable energy transmission.
Improvement required in the system to enable traffic control and power efficiency.
Wakeup period and packet interarrival time.
13
Heng et Power al. (2017) [59]
LL
Enable hybrid transmission mode, power aware, optimizing utilization of local storage etc.
Further improvement in the power consumption and efficiency.
Frequency, power, amplitude, PRD, CR, time.
TEG
Reduce complexity, power consumption, extend the lifespan, reliability
Promotes Energy, robustness and rounds, efficiency of the number of system. nodes, output power load resistance.
Hoang et Energy al. (2009) [58]
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ED
PT
CE
AC 14
Time, energy consumption , and latency.
36
ACCEPTED MANUSCRIPT Omeni et Energy al. (2008) [57]
CCA
Decrease the energy consumption, reduce collision, reduce complexity, etc.
Further improvement for power consumption in the MAC protocol.
16
Mehmoo Energy d and Culmone (2015) [56]
ANT+
High energy storage, extend the life time, reduce the frequent battery replacement.
Improvement Time, required for distance. connectivity and life time of battery.
17
Wu et al. Energy (2017) [55]
MPPT
It possesses 24hrs lifetime wearable system, extend the life time
It needed more signal detections to cover many areas of WBAN.
18
Shen et Privacy, ECC al. confidentiality (2015) [54]
Security, privacy, easy to implement, efficient, reduce computation, communicati on cost.
Promotes the Overhead, confidentiality and key robustness of the derivation. system.
19
Ara et al. Privacy, SPPDA (2017) confidentiality [53]
Improved efficiency, data privacy and secure real time data transmission.
Required decrease in computational overhead and increase in efficiency.
CPU time, number of exponentiati on.
Secure authenticatio n, reduce security problems, and reduce computation cost.
Promote the confidentiality and robustness of the system.
Communicat ion cost, computation cost.
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ED PT
CE
AC 20
Wu et al. Security (2016) [52]
AA
Sleep time, number of retransmissi on, and power.
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15
Voltage, current, Power and time.
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ACCEPTED MANUSCRIPT 21
Iqbal and IS Bayoumi (2016) [51]
KAP AM
22
Boukerch Security e and Ren (2009) [50]
TE
23
Lal and Security Kumar (2017) [49]
CCN
24
Gope and Security Hwang (2016) [48]
BSN-C
& More secure communicati on, protect the sensitive health related data, cheap and small enough in size etc.
Development Processor needed in full cycle and BAN system for CPU cycles. healthcare application in IoT.
the Security overhead, Percentage of malicious nodes.
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Protects Promote patient’s robustness. medical records, to ensure the data confidentialit y and user privacy.
PT
ED
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Provides Improvement seamless required connectivity, connectivity. security, high data rate, low latency, QoS Mutual authenticatio n property, reduce computation overhead etc.
Cache size in and percentage of handover performance.
Little effect Alarm net should be required and BSNon the whole care. network.
AC
CE
RWHM- Real time wireless health monitoring, QoS- Quality of Service, RM- Resource management, UH-Ubiquitous-healthcare, IS- information security, HHM- Hand hygienic monitoring, DB- Distributed beamforming, LRSQ- light-weight real-time signal quality assessment, GUI & AM- monitoring and alarming method, AHP- Analytic hierarchy process technique, TAG-Temporal Associative Granulation method, IT- information-based tasking algorithm, FDC- flexible duty cycling technique, LL-Lossy and lossless techniques, TEGthermoelectric generator method, CCA- clear channel assessment algorithm, MPPT- maximum power point tracking technique, AA- Anonymous authentication approach, KAP & AM- key agreement protocol and authentication method, TE- Trust evaluation technique, CCN- ContentCentric networking protocol.
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ACCEPTED MANUSCRIPT Table 2 given above represents the relevant literature on various classification technologies of IoT based WBAN. It described the overview of technologies used, its advantages, metrics, future scope etc. Table 3: Standard, specification and latest release on various classification technologies of
Author name
Standard
Specifications
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IoT based WBAN Latest releases
Iqbal and 6LoWPAN Bayoumi [51]
1.580 m energy X.509 certificate consumption, 80 byte to 48 byte
Wu et al. [52] Ara et al. [53]
512, 160, 1024 bits 2 GB memory, 64 Oracle VM virtual Box bits Manager
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IEEE 802.15.6 Wi-Fi
Wi-Fi 160, 1024 bits Bluetooth, Wi-Fi 13 V & 2.5 V, (4G) 12.5F superconductor, 5 V Mehmood and Zigbee, 2.4 GHz, 1 MHz Culmone [56] Bluetooth, Wi-Fi Omeni et al. 802.11 or Zigbee 50 kbps, 10 bits, [57] 50–500 Hz
MPPT circuit
Hoang et al. IEEE 802.15.6, 200 bit, 16 kΩ, [58] Bluetooth 952.4 µJ Heng et al. [59] Bluetooth 8-channels 12-bits, 5-bits MSB Ullah and Kwak IEEE 802.15.4 2.4 GHz [60]
HT12D, HT12E
Rahmani et al. Zigbee, [61] 6LoWPAN, Bluetooth, Wi-Fi
-
UT-GATE
Wang et al. [62] IEEE 802.15.4
1 kbit/s to 1 Mbit/s
-
Chung [63]
300 (24.8 dB), 0.05 Accelerometer, ~ 123 Hz, 12 bits, converter, 200 Hz, 2.4 GHz~ transceiver 2.485 GHz, 95 dBm, 250 kbps, 18.8 mA, 17.4 mA,
AC
CE
PT
ED
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Shen et al. [54] Wu et al. [55]
et
al. IEEE 802.15.4
ANT branded LBT, WBASN ASIC, in a 0.13 m CMOS process
0.35 μm CMOS, MIT/BIH TaMAC with IEEE 802.15.4 MAC, WiseMAC, and SMAC protocols
A/D Wireless
39
ACCEPTED MANUSCRIPT 1 µA, 3.3 V
Jeong and Shin Bluetooth [65] Aubidy et al. IEEE 802.15.4 [66] Satija et al. [68]
Bluetooth, Wi-Fi
Velrani and Bluetooth, RFID Geetha [69]
-
IBM SPSS
9600 bits per second 13.56 MHz, 14 kHz, 1 mm, 25 nodes 360 samples/second and 11 bits, 1.2 GHz
GUI, Honeywell 015PDAA5 ISO 14443/15693
-
ASDX
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and RFID
MITABIHA, Lollipop 5.0 android version, 410 MSM8916 processor and 2 GB RAM PIC16F877A Microcontroller, LM35 Temperature Sensor
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Bhatia Sood [64]
ED
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Bal and Zigbee, (UHF)- Raspberry Pi platform, Abrishambaf RFID Python application [70] Si et al. [71] IEEE 802.15.4 0.72 cm by 1.35 AFX model cm, 9XCite wireless modem, 2.87, 8.82, 13.75, 17.68, and 21.06 Hz, 1.3 m/s2
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Table 3 represents the specifications, standard and the latest release on various technologies of IoT healthcare system. It explains all the relevant technologies on IoT healthcare system
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that we consider in this survey.
7 IoT Healthcare Services and Applications
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IoT has numerous developed and developing services and applications such as
wearables, smart city, smart grids, connected car, connected health and smart home. However, research indicates the potential of IoT in healthcare system and hence enhances the quality of life in our societies. On behalf of better understanding, this section is generally classified into two sub-sections such as services and applications [72]. The applications of
40
ACCEPTED MANUSCRIPT IoT health care are sub-divided as single-condition and clustered-condition in fig 9. Therefore, the services and the applications of IoT based on healthcare are explained below.
IoT Healthcare Services and Applications AAL M-IoT ADR CH CHI WDA SMA IEH EGC ECP
Single condition
Glucose level sensing Electrocardiogram monitoring Blood pressure monitoring Body temperature monitoring Oxygen saturation monitoring
Clustered conditions
Management
Security
Rehabilitation system Medication management Wheelchair management Imminent healthcare solutions Healthcare solutions by smartphones
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IoT healthcare applications
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IoT healthcare services
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Figure 9: IoT healthcare services and applications 7.1 IoT Healthcare Services
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The IoT healthcare services consist of general IoT services and the protocols that are
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required for the IoT structure that might be required for small alterations for the accurate functioning of the healthcare system. For a better understanding of the topic, the reader can refer the literature. Hence, the following subdivisions are given below: A) Ambient Assisted Living The WBAN based IoT healthcare service is mainly offered to elderly people. The IoT platform by artificial intelligence can help the healthcare for ageing and the incapacitated individuals [73]. The main aim of Ambient Assisted Living (AAL) services is 41
ACCEPTED MANUSCRIPT to provide an independent life for elderly people and keep them safe and content. A modular architecture of IoT healthcare provides security, control, and communication. RFID and NFC are used in AAL for flexible monitoring, and provides security for elderly individuals [68]. Therefore, it possesses some limitations such as QoS’s, data storage and feasibility. B) The Internet of m-health things
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The Internet of m-health things (m-IoT) is known as mobile IoT, which includes mobile computing, communication technology and medical sensor, for healthcare services. The IoT share the information with 4G networks for future Internet based on m-health system [74]. Besides, it is used for real-time monitoring system. The context-aware issues
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and the m-IoT are the two main challenges that occur in the services. Introduction of a system for message-exchange-based mobility was done, but it lacks in verification of low network power consumption.
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C) Adverse Drug Reaction
The Adverse Drug Reaction (ADR) happens by taking over dosage of medication.
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The ADR is mainly caused due to the single dosage of drug or continued administration or
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significant medication of combination of more drugs [75]. So, if ADR based IoT is used, it can identify the drug through barcode/NFC device. This will check the drug with electronic
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health record. Hence the iMed pack was introduced in ADR by making use of RFID and
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controlled material technology. D) Community Healthcare The Community Healthcare (CH) information is an important healthcare service.
The CH mainly monitors the area around a local community. Besides, it’s an IoT based network, which monitors around the municipal hospital, a residential area, or a rural community [76]. The specialized CH provides authentication and authorization mechanism to the cooperative network. 42
ACCEPTED MANUSCRIPT E) Children Health Information The Children Health Information (CHI) is mainly used for the awareness around children’s health and their behavioral, emotional or mental health problems. Besides, the pediatric ward offers CHI services for educating, empowering, and amusing the children [77]. The IoT based m-IoT healthcare services encourage the children to inculcate good nutritional
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habits in collaboration with their teachers and parents. Thus it encourages the children to acquire good habits. F) Wearable Device Access
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Various sensors are used for the healthcare applications, particularly WSN for IoT healthcare application. A wearable device monitors the people accurately and calculates their glucose level, pulse etc. by the sensor [78]. According to the concept of S-IoT devices, it includes smart watches and smart phones which are based on Wearable Device Access
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G) Semantic Medical Access
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(WDA) prototype system with numerous healthcare applications.
The Semantic Medical Access (SMA) use large area of medical applications. It shares
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the medical information in between semantics and ontologies. Besides, a separate service needed to transfer information is known to be SMA [79]. Also, the SMA with IoT is applied
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for information retrieval from massive cloud. The SMA data processing method can be used
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to obtain interoperate and incorporate IoT data for emergency medical services. H) Indirect Emergency Healthcare The Indirect Emergency Healthcare (IEH) is an important criterion used for the
major functionality of the healthcare system. Various emergency situations arise when the healthcare is heavily involved in adverse weather conditions, earthen sites collapse, transport accidents and fire. [80]. IEH provides dedicated service to a lot of solutions for the above mentioned problems. 43
ACCEPTED MANUSCRIPT I) Embedded Gateway Configuration The Embedded Gateway Configuration (EGC) is based on the service architectural method that can connect the patient's networks directly to the Internet. The gateway of EGC is formed by IoT which is based on mobile computing device. The real-time ubiquitous healthcare system is an accurate example of EGC system [81]. It provides intelligent and
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automatic real-time monitoring. Therefore, a personal gateway was introduced for the sensor network of IoT healthcare system. 7.2 IoT Healthcare Applications
IoT applications have a close relation with IoT technologies. These applications are
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applied directly to user and patients. Therefore, the services are known to be developercentric and the applications need to be user-centric. Furthermore, the services and the applications in this section has gadgets, wearables etc. Then, the next subdivision provides
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several IoT healthcare applications including clustered-condition and single-condition. They
a) Glucose level sensing
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are as follows.
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Glucose level sensing is a vital monitoring and sensing system for elderly and diabetic patients. The glucose level monitoring is a real-time sensing method. It will give
CE
accurate results of glucose level. Besides, it helps in planning the medicines, activities, medication times etc. [82]. Consequently, the utility models in the transmission devices
AC
collect the somatic data of blood glucose by means of IoT networks. Furthermore, monitoring of glucose level in diabetic patients can be accomplished by a generic IoT based medical acquisition detector. b) Electrocardiogram Monitoring For monitoring the activity of heart electrocardiogram is used. It is an electrical activity which can measure the simple heart rate and determine the rhythm, myocardial,
44
ACCEPTED MANUSCRIPT ischemia etc. The IoT based ECG provides maximum information about the cardiac system. The ECG monitoring consists of wireless acquisition transmitter and the receiver [83]. The system integrates the search automation about the normal and cardiac abnormal functions based on real time monitoring. c) Blood Pressure Monitoring
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The Blood Pressure (BP) monitoring is mainly used for monitoring the blood pressure level. The blood pressure KIT and the mobile phone enabled kit becomes the fragment of BP monitoring based on IoT [84]. Further, the device composed is based on the apparatus of the body and the communication module, while the location is tracked by the intelligent terminal
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based on IoT network. Thus, it’s an accurate and effective monitoring technique. d) Body Temperature Monitoring
Body temperature monitoring is an essential part of health care applications [85]. In
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the m-IoT concept, the maintenance of homeostasis is varied according to the body
ED
temperature. The body sensor monitoring is embedded with the TelosBmote and it gives accurate, efficient and successful results during processing. The body temperature monitoring
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is based on the home gateway over the IoT technologies. It also helps in infrared detection
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and RFID module for the monitoring of the body temperature. e) Oxygen Saturation Monitoring
AC
The nonstop monitoring of the blood oxygen saturation is mainly accomplished by pulse oximetry method. The IoT based oxygen saturation is intended for various wearable pulse oximetry method [86]. The healthcare device profile based on Bluetooth system is used to transmit the information from the sensor. The IoT optimized sensor with low power/ lowcost pulse is used for monitoring. Thus it helps for accurate oxygen saturation monitoring. f) Rehabilitation System
45
ACCEPTED MANUSCRIPT The rehabilitation system and physical medicine can bring back the efficient ability and the quality of human life with some physical disabilities that represents the vital outlet of medicine [87]. The IoT has an ability to enrich the rehabilitation system by means of justifying difficulties that are allied to the elderly individuals besides the shortage of health specialists. The design of rehabilitation system has demonstrated that the IoT is effective for
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all real-time information applications. It helps all effective remote consultations in the comprehensive rehabilitation. g) Medication Management based IoT
The medication management problem is mainly caused due to the packaging problem.
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Besides, it causes serious hazards to public health and it may cause a huge financial wastage. To overcome these issues IoT addresses some solutions. An intelligent packaging method for medicine boxes is based on IoT such as I2pack and Imed box [88]. The e-health services
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designed based on AAL solutions.
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architecture of tags are used for the medication control system and this system is especially
h) IoT Wheelchair management
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Wheelchair management is an essential method for real-time application. Many research developers worked to introduce full automation for disabled persons as well as it had
CE
an ability to speed up the work. The design of the monitoring system with various sensors was implemented [89]. This smart wheelchair detects and vibrates in unison with the
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sensation of the disabled person. Another method is the design of a wheelchair with Intel’s IoT department. This wheelchair could monitor the vitals of the individuals in chair and then accumulate the data based on user’s environments and permitting for assessment of locations. i) Imminent Healthcare Solutions No explicit demonstration of the integration of medical devices into IoT networks is exhibited even though numerous portable medical devices are available. That is, it was only 46
ACCEPTED MANUSCRIPT a matter of time before these devices became embedded with IoT functions. Growing demand for IoT-based services around the world has given rise to a number of medical devices, healthcare applications and several cases [90]. Some healthcare areas of integration with the IoT appears imminent healthcare which include skin infection, peak expiratory flow, abnormal cellular growth, hemoglobin detection, cancer treatment, eye disorder, and
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remote surgery. Today most of the diagnostic devices are portable having conventional connectivity. j) IoT Healthcare by Smart Phones
The efficient IoT healthcare paradigm is a combination of electronic devices and
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smartphones. This combination mainly highlights one, the IoT technologies (i.e.) S-IoT. Various hardware and the software systems are embedded in the healthcare devices [91]. Fig 10 represents some of the healthcare apps used for accurate monitoring of patients; they are
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chronic care management app, healthcare and fitness app, medical apps, personal health record apps, android Telehealth Chiron app, medication management apps, inpatient care
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CE
PT
ED
mobile app and heart rate tracking apps. They are explained as,
47
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Chronic Care Management App Healthcare And Fitness App Medical Apps Personal Health Record Apps Android Telehealth Chiron App Medication Management Apps Inpatient Care Mobile App Heart Rate Tracking Apps
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ACCEPTED MANUSCRIPT
IoT HEALTHCARE APPS
Figure 10: Few Healthcare Apps
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The chronic care management apps are based on m-healthcare system. It is mainly used for managing cancer, diabetes, mental health etc. The healthcare and fitness app is mainly used
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for managing the diet, nutrition’s, weight loss etc. The Medisafe is the app used for medication management application. This app stores the list of pills, its intake details, and
PT
dosages of the medicines; also it differentiates the pills by color. Then, the android
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Telehealth Chiron app allows the doctors to link with the corresponding patient for followup appointments through video conferencing. The inpatient care mobile app is used to
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progress patient communication, literacy and entertainment with the families or caregivers. The heart rate tracking apps can be provided to different sporting organizations and also to healthcare organizations. Besides, military forces with superior information and research on the population’s physical well-being supports the effective training techniques. 8 Challenges and Open Issues of IoT Healthcare System
48
ACCEPTED MANUSCRIPT Various research works are made to design and implement the IoT healthcare systems. In contrast, there are several open issues and challenges that are needed to be carefully addressed. Besides, this section explains about various issues in the IoT healthcare services. 8.1 Scalability
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Scalability is a significant criteria needed in healthcare system. It is the ability of a device to adapt the changes in the environment and meet the changing needs in the future. The IoT healthcare systems are less scalable because the IoT healthcare system connects a huge amount of sensors, actuators, and other devices to share information and applications via the
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internet. The lack of uniformity among the connected medical devices reduces the scalability of devices, and these must be managed, maintained, operated and supported using appropriate addressing conventions, protocols, and power. Existing approaches to these
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challenges may be inadequate and fail to scale for the anticipated huge number and range of IoT objects.
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The main goal is to make the wearable device scalable to meet changing needs. The
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importance of scalability is that it helps the system to work gracefully without any delay and unproductive resource consumption and makes a good use of the available resources. Hence
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it is important to make a healthcare device with higher scalability to make it more efficient
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for the present and the future use. 8.2 IoT Healthcare Security
The data privacy and security are the significant open issues in IoT based healthcare applications. Security can be defined as managing credentials and controlling access to applications and patient’s confidential information. Data privacy is very crucial in the context of IoT-based healthcare. Healthcare applications are designed and developed based on acquiring data from IoT devices. The massive data that 49
ACCEPTED MANUSCRIPT is being transferred and stored on a regular basis can be hacked and used against the patient and the doctor. These hackers can also create fake IDs to buy drugs and medicines only to misuse them further. These challenges remain questionable in various applications because the architecture of IoT in healthcare is not well defined and it fails to provide the
8.3 Low Power in IoT Healthcare Device
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information about how to preserve the privacy and security of the data.
A typical IoT healthcare network includes small health devices of limited battery power. Such devices conserve energy by switching on the power-saving mode when no sensor reading needs to be reported. Because of many service requirements, the device faces power
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shortage even though switching on to the power-saving mode. The power consumption of long-term monitoring applications are sufficiently low and allows minimal interaction by the device wearer. Low power device should be designed to reduce the risk of patients being
8.4 Network Architecture
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offline.
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The network architecture of IoT must provide authentication and authorization for the users
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in the healthcare system. There are different types of network architectures have been proposed by researchers. The three layer architecture cannot fulfill the requirements of
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healthcare applications. The recent five layer IoT architecture have lower capacities in storage and energy. Health care devices are low cost and light weight devices that can save
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only few bytes of messages. The network architecture of IoT in healthcare is still considered as an issue, because it fails to fulfill the requirements of IoT regarding storage, security and privacy.
8.5 Cost Analysis of IoT Healthcare System Nowadays, the cost of healthcare devices dominates the healthcare IoT system more than ever before. According to the author’s knowledge, there is no comparative study has been 50
ACCEPTED MANUSCRIPT done based on the cost analysis of IoT healthcare system. Thus, we consider the cost analysis as an open issue in IoT healthcare system. The high cost of monitoring equipment in IoT health care system is a major issue even in developed countries. The IoT has not made the healthcare facilitates affordable to the common man yet. The boom in the healthcare device costs is a worrying sign for everybody.
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8.6 The App Development Process
The mobile app developers are facing challenges in security, privacy and database technology. Numerous devices can be controlled, monitored or maintained through the app.
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The security and privacy is a major concern to preserve patient or user information from leakage and ensure sharing of data to others with the consent of the patient. In addition, the mobile app collects patient’s health related data for every minute in regular basis, so to manage the big data and getting useful insights from it is a challenge. The healthcare mobile
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apps are mostly recommended for patients to get their daily regimes and to enable this; the
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8.7 Quality of Services
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app should be powered with artificial intelligence that provides real-time suggestions.
Nowadays, IoT is mainly used for real-time applications. QoS is directly related to the quality
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and the timeliness of the IoT data that can be used for decision support. It requires data generated from the health care sensors to be collected, transmitted, processed, analyzed, and
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used in a timely manner. But, in some cases the IoT devices fails to provide the necessary data on time. It can be considered as a challenge for the IoT healthcare system on regarding QoS. Also, the IoT devices generate large scale of real-time data in terms of volume, velocity, and variety and make a big data problem. It became a big challenge in combining and analyzing such data with historical patient data to obtain meaningful diagnoses suggestions within acceptable time frames (considering QoS). As the medical wearable 51
ACCEPTED MANUSCRIPT systems deal with real-time and life-critical applications, they require a strict guarantee of QoS. This remains a significant gap in the areas of heterogeneous data collection, real-time patient monitoring, and automated decision support based on QoS. Thus, it is necessary to overcome these challenges based on QoS.
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8.8 Continuous Monitoring for Healthcare Purpose Many patients required long-term monitoring mainly, the elderly people and patients with chronic diseases. In this context, constant monitoring and logging is very critical. For continuous monitoring, it is compulsory that smart devices and sensors send data to the
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required destination on time. However, it faces some limitations which can be a hurdle in continuous monitoring as if patient’s devices start malfunctioning or its battery is about to die then remote data sharing cannot be achieved. Hence, continuous monitoring will be adversely
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affected. 9 Conclusions
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WSN for healthcare applications is becoming an interesting field in the medical
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industry. The researchers throughout the world had started to discover several techniques to increase the healthcare endowment in the way of services by means of mobilizing the
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potential of IoT. This review which has mainly focused on the WBN through IoT healthcare system also offers different network architectures and healthcare platforms that in turn
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support the enabling of healthcare data transmission and data reception. In addition to, this paper provides information of research activities and how they can access the disease supervision, fitness management, pediatric, private health and elderly care management. However, the IoT healthcare sector is resourceful and the most important aspect is security, privacy, authentication, energy, power, resource management, quality of services and the real-time wireless health monitoring, which remains problematic in various IoT framework 52
ACCEPTED MANUSCRIPT since, no well-defined architectures are formed in IoT healthcare framework. This review gives a brief outlook of application of IoT architecture, services technologies etc. For better understanding of WBAN based IoT healthcare system, the paper considers various enabling technologies of IoT and the network system types in IoT healthcare system. Discussion of various technologies of WBAN based IoT healthcare applications and important challenges
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and open issues are described. Furthermore, this review is useful for several engineers, researchers, policymakers, health professionals, and healthcare technologies domain.
In the upcoming eras, the use of WBAN based on IoT healthcare will increase more
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and more. Because of its widespread adoption, the IoT in healthcare is considered as the effective patient session technology. Besides, the IoT devices support the medication, delivering home health, monitoring etc. Moreover, if the size and the prices of the IoT enabling devices are reduced, the scaling of raid technologies will increase. Thus, the IoT has
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a great future and will witness an ever increasing research work in the years to come.
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Biography:-
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Mrinai Maneetkumar Dhanvijay is currently pursuing PhD at Department of Technology, Savitribai Phule Pune University, India. She is working as Assistant Professor in Department of Electronics and Telecommunication at Modern Education Society’s College of Engineering, Pune, India. She has received her post graduate from Pune University, Pune, in 2012, after completing her B.E. from Nagpur University, Nagpur in 1999. She has published paper in IEEE explore, ACM digital Library, IJCA. Her research interests include IOT, HBC
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Dr. Shailaja C. Patil is currently working as professor in Department of Electronics and Telecommunication at Rajarshi Shahu College of Engineering, Pune, India. She has 25 years of teaching experience. The Doctorate of Philosophy in Computer Engineering has been conferred upon her by Saradar Vallabhbhai Patel Natioal Institute of Technology, Surat in April 2013. She has authored a book on Feedback Control System, Satya Prakashan, Delhi, India. She has more than 60 publications in National and International, Journals and Conferences. She is a regular reviewer of peer reviewed journals. Many International Conference and Journal articles have been reviewed by her. She has served as Session chair in several International Conferences. She has fetched funding worth 8 Lacs from BCUDSPPU and AICTE for Research and Faculty developement programs. She is a Fellow of Institution of Engineers and member of various professional bodies, IEEE, ISTE, GISFI, ISA, ACM. Her research domains Wireless Sensor Network, Image Processing and Internet of Things.
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