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Totally Connected Healthcare with TV White Spaces
Article in Studies in Health Technology and Informatics · July 2017
DOI: 10.3233/978-1-61499-781-8-68
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Konstantinos Katzis Richard W. Jones
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Totally Connected Healthcare with
TVWS
Konstantinos KATZISa,1, Richard W. JONES b and Georgios DESPOTOU c
a
Depatment of Computer Science and Engineering, European University Cyprus, CY
b
School of Engineering, University of Warwick, U.K.
c
Institute of Digital Healthcare WMG, University of Warwick, U.K.
Abstract. Recent technological advances in electronics, wireless
communications and low cost medical sensors generated a plethora of
Wearable Medical Devices (WMDs), thus setting the stage for an entirely
new concept of always connected healthcare. 5G networks can probably
provide connectivity to WMDs but this will come at a cost to the clients
for the service provided. This contribution reviews how 5G can address
all these devices and presents a novel architecture employing White
Space Devices (WSD), IEEE 802.22 (WiFar) standard to provide
seamless connectivity taking advantage of the freely available TV White
Spaces (TVWS).
Keywords. Wearable Medical Devices, CIoT, WiFar, TVWS
1. Introduction
Future communications envisage a plethora of wireless, connected, sometimes ‘smart’
devices that will communicate in real time with each other. This is referred to as the
‘Internet of Things’. These devices are expected to be part of our daily lives,
interfacing not only with humans, but also with other devices known as machine to
machine communications [1]. IoT enabled medical devices are expected to form a
smart environment that is characterized by polymorphic requirements in terms of
latency, throughput, reliability, speed, power, security, etc. 5G is expected to provide
connectivity to such devices including a wide range of wearable medical devices
(WMD) [2]. When considering broadband connections, one might think the fastest the
better. Nevertheless, some of these devices / users might not necessarily require a
‘gigabit experience’ but lower data-rates to maintain longer battery life and reliability.
WMD requirements, are application specific but there are a common set of constraints
in size, power and functionality since they are all going to be carried by humans. The
location of the WMD, data rate, frequency and regulatory standards all influence the
design complexity and power dissipation of telemetry links. The design of antenna is
very demanding with the major challenges being miniaturization, low-power
consumption to aid the energy efficiency of the MD (especially in the case of
Implanted Medical Devices). Patch antennas are generally used because of their
flexibility in design, conformability and shape [4]. For those that they do need the high
data-rate experience, delivering higher capacities and speeds requires better cell
densification and access to new, broader carriers in new spectrum. So how can 5G
address all these devices singlehanded? For the time being and perhaps for the next few
years, part of the capacity growth can be gradually addressed by the ageing 3G/4G
based systems, but by 2020, 5G technologies will have to be operational. Nokia [4] and
Ericsson [5] introduced a number of new services and use cases that will drive the
technology such as mobile broadband, mobile media, IoT, etc. Based on these use-
cases, it has been deduced that 5G networks will be have to somehow fulfill the 5
major parameters and these are: throughput, capacity, number of devices, cost, latency
and reliability.
2.0 Wearable Medical Devices – Operation parameters and requirements
Advances in electronics, sensors and IoT technology, has inspired the design of new
medical devices, shaping the new generation of Body Area Networks (BAN) and
healthcare. Wearable Medical Devices (WMDs) and Implanted Medical Devices
(IMDs) can be considered part of the BAN and expected to generate data, communicate
it, aggregate it, and analyze it providing constant health monitoring for the patients.
This enables the healthcare system to sustain detailed long-term health records of
patients and help the doctors make the correct diagnosis. Current wireless technologies
used for connecting various medical sensors are: Bluetooth, ZigBee, WiFi, RFID, IEEE
802.15.6, etc [6]. As the number of applications increases, existing wireless
technologies will not be able to cope with the fast-evolving sensors. For example, the
data-rates supported by the current standards might not be able to cope with future
sensors which will generate larger volumes of data. Furthermore, security is already an
issue for some of the standards such as RFID and ZigBee [7],[8]. This means that great
caution must be taken when using them in a healthcare environment.
2.0 5G Networks – Providing services to Wearable Medical Devices
Remote monitoring for large numbers of patients will require high bandwidth, reliable
communication links, large coverage area and high quality of service when deploying
future mobile communication systems. Today, the main wireless cellular mobile
network technologies that can be used to provide substantial coverage and data-rates
for wireless medical devices are 3G: WCDMA, CDMA2000, EVDO and 4G: Long
Term Evolution (LTE). Nevertheless, these types of wireless networks cannot provide
connectivity to WMDs and IMDs devices since these are usually low power, high
frequency devices (usually operating in the Industrial Scientific Medical bands), plus it
will be expensive for the patient to keep all devices connected transmitting through
these networks. 5G systems will bring in paradigm shift in remote patient monitoring
and tracking but probably at a cost. As part of the future 5G networks, IoT enabled
medical devices operating within this environment are expected to have the capability
to observe, think, and understand the physical and social environments they are asked
to operate. They will be therefore equipped with Cognitive Radio characteristics [9].
More specifically, Cognitive Internet of Things (CIoT) is a new paradigm where
current IoT devices are equipped with five fundamental cognitive tasks: perception-
action cycle, massive data analytics, semantic derivation and knowledge discovery,
intelligent decision-making, and on-demand service provisioning [10]. CIoT is defined
in [10] as “a new network paradigm, where (physical/virtual) things or objects are
interconnected and behave as agents, with minimum human intervention, the things
interact with each other following a context-aware perception-action cycle, use the
methodology of understanding-by-building to learn from both the physical environment
and social networks, store the learned semantic and/or knowledge in kinds of databases,
and adapt themselves to changes or uncertainties via resource – efficient decision
making mechanism”. In [11], a cognitive management framework is presented focusing
on how to hide heterogeneity of connected objects and how to ensure resilience of a
dynamic service provisioning. It is also investigating how to instruct systems to assess
proximity between IoT applications and “useful” objects and how to use cognitive
technologies to provide intelligence while minimizing user’s intervention. To do this, it
is important to have a dynamically intelligent system managing the radio spectrum that
will employ adaptive strategies for the efficient and effective use and reuse of radio
spectrum by the large number of IoT nodes. Primary target is to offer reliable
communications whenever and wherever needed. Whether communication systems are
cellular or not, the network must be able to cope with the increased signaling of a large
number of CIoT nodes. This can be achieved by capitalizing on the spectrum holes
(temporal and spatial spectrum availability) detected by the radio-scene analyzer and
the output of transmit-power controller. Using this intelligence, the radio transceiver
will then choose the modulation strategy that adapts to the time-varying conditions of
the radio environment and the requirements of the application of the IoT sensors /
devices in reference.
3.0 TVWS for Connecting Wearable Medical Devices?
WMDs and IMDs are considered highly demanding due to the nature of the data
exchanged, depending on the mission and safety critical process control data. They
therefore require robust, low latency, reliable and highly available wireless links while
interference must be mitigated in an interference-prone radio-busy radio environment.
What we are proposing here is a network that will connect all wearable and implanted
medical devices to the healthcare system in a secure way while guaranteeing the
polymorphic requirements of each application. As part of this system, a devices will
have to be design in order to connect with the WMDs and IMDs and will provide them
with internet connectivity through the TV White Space (TVWS) spectrum employing
the IEEE 802.22 communication standard also known as WiFar (see fig.1). All data
collected from the medical sensors / devices located on the body, will use CIoT
technology to communicate with a handheld device called Body Sensor Managing
Device (BSMD). BSMD will then use the closer 802.22 base station to connect the
internet. The IEEE802.22 network, to avoid causing / receiving interference to the
incumbent devices (see fig 1), sensing-assisted spectrum databases (SASDs) are used
where they offer an efficient solution for certain scenarios, eliminating the need for
wireless network operations and management in a complex, interference-prone local or
indoor environment when used in the context of self-configuration [12]. Since
healthcare has very strict operational requirements it is imperative employ dynamic
spectrum management, relying on the information collected and managed by such
databases in order to ensure incumbent protection, co-existence and interference
management as well as fine-grained adaptation to available spectrum.
Figure 1 Proposed architecture connecting WMDs and IMDs to the internet using WiFar (IEEE 802.22)
4.0 Discussion
Medical sensors in/on human body will become vital part of our lives and in some
cases mandatory (possibly by our life insurance). In order to provide seamless
connectivity in large geographical areas, a novel type of network is proposed where all
these sensors use CIoT technology to communicate with our BSMD and all data is
transferred in real time using the freely available TVWS spectrum using IEEE802.22.
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