Mobile Healthcare: More on TeleHealth

There are some major developments going on in the field of Mobile/Wireless healthcare. Sometime back I happen to attend a lecture organised by IET Berkshire where Prof. Lionel Tarassenko gave an overview of what developments are going on in this area. Unfortunately I could not get hold of the presentation but there is enough info on the web about it.

Vodafone has been field-testing neurosurgical telemedicine applications using third generation (3G) technology in Germany. Scientists in Denmark have successfully used text messaging to collect diary data from asthma patients in a pilot study to determine whether increased remote support improves clinical outcomes. Previous studies using home PCs to send the same diary information proved disappointing, with users rejecting the application after a short while.

Researchers from the Norwegian Centre for Telemedicine in Tromso studied parent-child interaction using a mobile and wireless system for blood glucose monitoring, and concluded that, whether or not the health outcome is improved as a result, the peace of mind provided by such a system may make it a commercial proposition.

In Finland, Medixine has been promoting home care by integrating diagnostics and patient diaries before sending results via a PC based web-link to health professionals. The company is now offering the same functionality using hand-held mobile PCs.

Researchers in the UK have, however stolen a march. When scientists from Oxford University set out to determine whether a system based on automated transfer of data, real time analysis and immediate feedback to the patient could improve glycaemic control for young adults with type 1 diabetes, they adopted the mobile approach.

The substantive difference between their work and others cited in the literature is that, with the help of funding from the charitable Vodafone Foundation, professors Andrew Neil and Lionel Tarassenko were able to conduct randomised clinical trials.

For the first time, the use of mobile telephone technology was proved to have a significantly beneficial effect and resulted in demonstrably improved clinical outcomes.

The system involved in the trials, which has subsequently been made commercially available under the “t+ diabetes” brand, uses a glucose meter linked by Bluetooth to a GPRS-enabled mobile telephone. (GPRS allows a handset to communicate with a remote server without the user having to dial in manually.)

After the patient has taken a reading in accordance with the advice he or she has been given by a GP or practice nurse, they spend around 10 seconds adding essential diary information about diet, exercise and general health via the telephone’s keypad. The system is intuitive and easy to use.

The information, together with the reading, is sent by the handset to a central computer which responds within seconds, providing patients with personalised feedback in easy-to-read graphical format delivered to their mobile’s display.

The number crunching done by the remote computer uses sophisticated algorithms to help negate the effects of occasional rogue readings and deliver a consistently meaningful result to the patient’s mobile.

This presentation here gives the motivation for the need to have a mobile based healthcare system.

• In the UK there are 17.5 million people with a long-term condition (mainly diabetes, hypertension, asthma or Chronic Obstructive Pulmonary Disease).
• Diabetes is the fastest growing disease in the Western world as a result of poor diet and obesity.
• £5.8 billion is spent per year by the NHS on diabetes and its related complications (2002 figures).
• Asthma affects 3.7 million adults and 1.5 million children in the UK (70,000 hospital admissions for asthmain 2002).
• 80% of primary care consultations relate to long-term conditions and patients with such conditions or their complications use over 60% of hospital days.

The key to minimising long-term complications is to empower patients to take more responsibility for the management of their condition.

The economic driver is reduction in unplanned hospital admissions.

Lot of time of healthcare professionals and bed space in the hospitals are wasted for the routine procedures that can be avoided by remote monitoring of the patients

Why Mobile Phones?

• Equality of care – 90% of UK population owns a mobile phone
• Real-time feedback, with two-way information flow
• Communication with remote carer based on shared data
• Economic model based on reduction in unplanned hospital admissions makes mobile phone solution a financially viable proposition
• Interactive tool to promote self-managementRegular support from remote nurse (based on real-time data)

What kinds of problems are being looked at:

• Asthma: 3 published clinical studies, 1 recruiting for Asthma UK
• COPD: 1 trial at Bristol Royal Infirmary published in Thorax
• Diabetes Type 1: 1 RCT at OCDEM published in Diabetes Care 4 trials in progress in Dundee, Eire, Dubai and Oxford 2 studies pending with UK NHS and Singhealth in Singapore
• Diabetes Type 2: 1 published clinical study for Lloyds Pharmacy
• Cystic Fibrosis: 1 published clinical trial (data submitted to NICE)
• Cancer: 1 study at Churchill Hospital published in Annals of Oncology
• Drug Titration: 1 study at Corbeilles-Essonepresented at Alfadiem and 1 trial recruiting in Oxfordshire GP Practices
• Hypertension: 1 trial recruiting in Oxfordshire GP Practices

You can read more about the tools and applications being developed here and here.

There is also a very good and detailed study of Asthama that can be seen here. There is a diary at the end that shows how readings are entered in the phone, etc.

Speaking at the LTE World Summit 2009

I am going to be speaking in the LTE World Summit 2009 being held in Berlin, Germany from the 18th till the 20th May.

I am speaking at the Breakfast Briefing Session on the 20th morning at 8am. The topic of my speech is "Killer Devices or Killer Apps: Whats the key to success".

If you have any ideas or suggestions that you would like to share with me on the topic then I will be grateful. You can either email me directly (my first name dot my last name at yahoo dot com) or post in the comments section.

If you are coming to the event please feel free to drop an email. I have half a day on Sunday afternoon that I will probably spend looking around in Berlin. Any places in particular I should definitely see?

If you are interested in the details of the conference then you can check the brochure here.

Hoping to hear from many of you.

Forum Oxford Conference 2009

The Forum Oxford Conference 2009 was held on 24th of April. Unfortunately I was unable to attend to report in detail what happened. This conference is close to my heart as its a hotbed for new and innovative ideas.

Here is a collection of blogs, etc. that cover this conference in detail. I will be adding more blogs when I find them:

• Martin Sauter's thoughts on the conference.
• Twitter feed for the conference.

Presentations from the conference:

• Evolution of Mobile Networks - Martin Sauter

Newspaper Articles:

• If Africa can cut out banks, why can't we? - Victor Keegan, Guardian, UK

Simplified RRC in LTE as compared to UMTS

RRC states in LTE have been simplified. In case of UMTS there was a possibility of four states with complicated movements between them but in case of LTE, there is 'RRC Idle' and 'RRC Connected'.

Figure Source: Freescale White Paper

As in case of UMTS, in 'RRC_Idle' the main task of the RRC would be monitoring and cell/plmn selection. Everything else falls in 'RRC_Connected' state. The figure above shows RRC functions in both these states.

RRC Specs for LTE is 3GPP TS 36.331

SAE design targets

With SAE implementation in full swing around the world i thought it would be good idea to discuss some of the design targest for the SAE.

Following are the main targets for SAE design:

• High-level user and operational aspects,
• Basic capabilities,
• Multi-access and seamless mobility,
• Man–machine interface aspects,
• Performance requirements for the evolved 3GPP system,
• Security and privacy, and
• Charging aspects.

Although the SAE requirements are many and split into the subgroups above, but as seen from the above points the SAE requirements are mainly non-radio access related.

The SAE system should be able to operate with more than the LTE radio access network and there should be mobility functions allowing a mobile terminal to move between the different radio-access systems. In fact, the requirements do not limit the mobility between radio access networks, but opens up for mobility to fixed-access network. The access networks need not to be developed by 3GPP, other non-3GPP access networks should also be considered. Thus the implementation for SAE should cover classes or functions for each handovers where the functions can be called as mobility functions.

The SAE requirements also list performance as an essential requirement but do not go into the same level of details as the LTE requirements. Different traffic scenarios and usage are envisioned, for example user to user and user to group communication. Furthermore, resource efficiency is required, especially radio resource efficiency (spectrum efficiency requirement for LTE). The SAE resource efficiency requirement is not as elaborated as the LTE requirement.
Thus it is the LTE requirement that is the design requirement.

Of course, the SAE requirements address the service aspects and require that the traditional services such as voice, video, messaging, and data file exchange should be supported, and in addition multicast and broadcast services. In fact, with the requirement to support IPv4 and IPv6 connectivity, including mobility between access networks supporting different IP versions as well as communication between terminals using different versions, any service based on IP will be supported

There is quality of service requirement of SAE is SAE system should for example, provide no perceptible deterioration of audio quality of a voice call during and following handover between dissimilar circuit switched and packet-switched access networks. Furthermore, the SAE should ensure that there is no loss of data as a result of a handover between dissimilar fixed and mobile access systems. A particular important requirement for the SAE QoS concept is that the SAE QoS concept should be backwards compatible with the pre- SAE QoS concepts of 3GPP. This is to ensure smooth mobility between different 3GPP accesses (LTE, WCDMA/HSPA and GSM).

The SAE system should provide advanced security mechanisms that are equivalent to or better than 3GPP security for WCDMA/HSPA and GSM. This means that protection against threats and attacks including those present on the Internet should be part of SAE. Furthermore, the SAE system should provide information authenticity between the mobile terminal and the network, but at the same time enable lawful interception of the traffic.

The SAE system has strong requirements on user privacy. Several levels of user privacy should be provided, for example communication confidentiality, location privacy, and identity protection. Thus, SAE -based systems will hide the identity of the users from unauthorized third parties, protect the content, origin and destination of a particular communication from unauthorized parties, and protect the location of the user from unauthorized parties. Authorized parties are normally government agencies, but the user may give certain parties the right to know about the location of the mobile terminal. One example hereof is fleet management for truck dispatchers.

Several charging models, including calling party pays, flat rate, and charging based on QoS is required to be supported in SAE. Charging aspects are sometimes visible in the radio access networks, especially those charging models that are based on delivered QoS or delivered data volumes. However, most charging schemes are only looking at information available in the core network.

Have phone, will talk!

Nice Collection of Photos on rediff with people on phones. Have a look here.

AT&T to do HSPA+ enhancement before adopting LTE

Before AT&T implements LTE, it plans another HSPA upgrade that will bring 3G capacity up to 7.2 Mb/s, says Telephony Magazine, using software enhancements to squeeze one last boost in bandwidth from its current high-speed packet access (HSPA) network. That will boost speeds from 3.6 megabits per second to 7.2 Mb/s, said Scott McElroy, AT&T Mobility vice president of technology.

In March AT&T announced plans to invest between US$17 billion and US$18 billion this year to, “extend and enhance wireless and wired broadband networks to provide more coverage, speed and capacity.”

AT&T currently has the enhanced networks running in two test markets but plans to extend those capabilities to its entire network, according to Telephony. Later this year, AT&T plans to start migrating its 3G networks to evolved-HSPA (or HSPA+), which would triple peak speeds.

AT&T, previously known as Cingular, launched its HSDPA network in 2005, supporting 1.8 Mb/s, but boosted that capacity to 3.6 Mb/s by 2008. Most of the laptop cards and smartphones AT&T sells, including the iPhone, have the silicon necessary to access that additional capacity. AT&T is now in the process of field certifying 7.2-Mb/s devices on its two test networks, McElroy said.

AT&T will most likely skip the final HSPA iteration of 14.4 Mbps, said McElroy, since HSPA+ is now ready for prime time. Evolved High-Speed Packet Access (also known as: HSPA Evolution, HSPA+, I-HSPA or Internet HSPA) is a wireless broadband standard defined in 3GPP release 7.

That could enable AT&T to go straight to 21 Mb/s. HSPA+ actually encompasses a bevy of upgrades, including evolving to a flat IP core and the introduction of smart antenna technology, but AT&T is focusing on upgrades to the baseband, which will dramatically increase capacity without having to fiddle with the elements on the tower or in the core.

Via: Daily Wireless

Innovative Designs and UI is the key to survival for Handset manufacturers

The smartphone segment of the market is poised for growth, just as a range of players are poised to release new smartphone devices in the months ahead. Among the most anticipated are new handsets based on Google's Android operating system, the next iteration of the iPhone, and the Palm Pre.

But as the number of smartphone makers proliferates, the need to create a differentiated product also increases. Much of that differentiation likely will come from the phone's user interface. Unfortunately for those in the market, it's difficult to deliver a phone with a compelling user interface that doesn't mimic all the other devices on the market.

The user interface has to be more than just a pretty face. It has to add value and ease of use for consumers. "It has to be a distinction that consumers value," said Avi Greengart, an analyst for Current Analysis. "Having a prettier set of animated weather cards isn't going to be enough."

Driving innovation may be too difficult a task for OEMs to accomplish in-house, according to John Jackson, vice president of research for CCS Insight. However, there are notable exceptions to this-HTC designed its TouchFlo3D UI in-house, and Samsung has latched onto its proprietary TouchWiz UI as the building block for its smartphones. Nevertheless, many handset makers are turning to outside firms to stay ahead of the innovation curve.

Companies such as TAT and Handmark have built their businesses around working with handset makers and operators on the user interface. TAT CEO Charlotta Falvin claims that her company's offerings sit on 10 percent of all mobile phones out on the market. Falvin said TAT's role in the design of UI is to bridge gaps between the desires and strategies of vendors and operators, a tricky proposition since operators, vendors and independent service providers all want a piece of real estate on the phone--and in consumers' minds.

"Nokia wants it to be a Nokia experience, Vodafone wants it to be a Vodafone experience and Facebook wants it to be a Facebook experience," she said. Success in creating a differentiated UI, however, will not be based around who is the first to market, or who makes the best partnerships, Falvin said, but on "who makes the best experience."

Handmark tries a similar approach. One of its main products is Pocket Express, a cross platform application that gives users access to news, sports, weather, stocks, travel and entertainment applications via a single interface. Wugofski said that the service has 2 million active users.

On the other hand, Daily Wireless argues that innovative designs and thinking out of the box may be key to success for the handsent manufacturers. There are lots of innovation happening around the 'fourth screen'.

OpenPeak has created a ‘fourth screen’ (after tv, computer and cell) for the home. It’s a hub that combines features of the telephone, TV, PC and cell phone into a compact, communications center.

The intuitive navigation menu on the 7? touchscreen makes it easy to make calls, play music, share photos, and organize your household. The device, powered by an Intel Atom processor, features 1GB of built-in storage, WiFi connectivity, an ethernet port, an audio out jack, and USB socket. It runs a cellular-branded version of the OpenFrame software, which appears to be based on Ubuntu linux. It is a wired device (no battery operation).

O2, a large cellular carrier in the UK is offering it to subscribers for £149.99 or free if taken instead of a handset when upgrading or signing a new 18 or 24 month contract. Its being marketed by the name Joggler.

The Verizon Hub is a home phone with an internet-connected base that offers users access to V Cast entertainment services, messaging, and email among other features. It will link up to an Application Store.

GiiNii plans to ship its Android-based portable media player and picture frame in October and January, respectively, according to a spokesperson. Archos announced an Android portable media player for mobile telephony.

Intel is now pushing Moblin V2 Core Alpha for Netbooks which should arrive in beta in May. It will now (apparently) take precedence over Moblin for MIDs, says Linux Devices, which is now postponed until 2010.

The UMPC Portal blog opines that MIDs based on Moblin 1.0, such as the BenQ S6 are being overwhelmed by the popularity of netbooks so abandoned MID developers might instead move to Android or even, gulp, Windows XP.

And ofcourse there are many other devices not mentioned here but please feel free to add them in the comments.

High speed Bluetooth officially announced

From its annual All Hands Meeting in Tokyo this week, the Bluetooth SIG formally adopted Bluetooth Core Specification Version 3.0 High Speed (HS), or Bluetooth 3.0. This latest iteration of the popular short-range wireless technology fulfills the consumers’ need for speed while providing the same wireless Bluetooth experience – faster. Manufacturers of consumer electronics and home entertainment devices can now build their products to send large amounts of video, music and photos between devices wirelessly at speeds consumers expect.

Bluetooth 3.0 gets its speed from the 802.11 radio protocol. The inclusion of the 802.11 Protocol Adaptation Layer (PAL) provides increased throughput of data transfers at the approximate rate of 24 Mbps. In addition, mobile devices including Bluetooth 3.0 will realize increased power savings due to enhanced power control built in.

On March 16, 2009, the WiMedia Alliance announced it is it will transfer all current and future specifications to Bluetooth, and the Wireless USB Forums. After completion of the technology transfer, the WiMedia Alliance will cease operations.

More than eight new Bluetooth enabled products are qualified every working day and more than 19 million Bluetooth units are shipping per week, says the Bluetooth SIG, with over two billion Bluetooth devices in the marketplace.

The Bluetooth SIG includes Promoter group companies Ericsson, Intel, Lenovo, Microsoft, Motorola, Nokia and Toshiba, along with over 11,000 Associate and Adopter member companies. The Bluetooth SIG, Inc. headquarters are located in Bellevue, Washington.

The next-generation Bluetooth is said to operate at similar distances (around 30 feet, best case) to today’s Bluetooth 2.0 but is a lot faster, capable of wireless transfers at a rate of 480Mbps. That’s the amazing 60MB per second, fast enough for high definition videoconferencing or moving files around at a fairly rapid clip.

That kind of speed blows the doors off Bluetooth 2.0, which pokes along at a mere 2.1 Mbps. The new Bluetooth gets its exponentially faster speed by teaming up with ultra wideband technology (UWB). But there are other contenders using similar tech such as Wireless USB (also 480Mbps), and it’s hard to tell how these various protocols will compete with each other, but for sure it is gonna be good for the consumers like us.

Applications

With the availability of Bluetooth version 3.0 HS, consumers can expect to move large data files of videos, music and photos between their own devices and the trusted devices of others, without the need for cables and wires. Some applications consumers will experience include:

• Wirelessly bulk synchronize music libraries between PC and music player or phone
• Bulk download photos to a printer or PC
• Send video files from camera or phone to computer or television

Temporary Identities in LTE/SAE - 1

An MS may be allocated three TMSIs, one for services provided through the MSC (TMSI), one for services provided through the SGSN (P-TMSI for short) and one for the services provided via the MME (M-TMSI part GUTI for short).

The purpose of the GUTI is to provide an unambiguous identification of the UE that does not reveal the UE or the user's permanent identity in the Evolved Packet System (EPS). It also allows the identification of the MME and network. It can be used by the network and the UE to establish the UE's identity during signalling between them in the EPS.

The GUTI has two main components:

• one that uniquely identifies the MME which allocated the GUTI; and
• one that uniquely identifies the UE within the MME that allocated the GUTI.

Within the MME, the mobile shall be identified by the M-TMSI.

The Globally Unique MME Identifier (GUMMEI) shall be constructed from the MCC, MNC and MME Identifier (MMEI).

The MMEI shall be constructed from an MME Group ID (MMEGI) and an MME Code (MMEC).

The GUTI shall be constructed from the GUMMEI and the M-TMSI.

For paging purposes, the mobile is paged with the S-TMSI. The S-TMSI shall be constructed from the MMEC and the M-TMSI.
S-TMSI = MMEC + M-TMSI

The operator shall need to ensure that the MMEC is unique within the MME pool area and, if overlapping pool areas are in use, unique within the area of overlapping MME pools.

The GUTI shall be used to support subscriber identity confidentiality, and, in the shortened S-TMSI form, to enable more efficient radio signalling procedures (e.g. paging and Service Request).


The format and size of the GUTI is therefore the following:
GUTI = GUMMEI + M-TMSI, where
GUMMEI = MCC + MNC + MME Identifier and
MME Identifier = MME Group ID + MME Code
MCC and MNC shall have the same field size as in earlier 3GPP systems.
M-TMSI shall be of 32 bits length.
MME Group ID shall be of 16 bits length.
MME Code shall be of 8 bits length.

During Handover to GERAN/UTRAN
RAI = MCC + MNC + LAC + RAC
E UTRAN "MCC" maps to GERAN/UTRAN "MCC"
E UTRAN "MNC" maps to GERAN/UTRAN "MNC"
E UTRAN "MME Group ID" maps to GERAN/UTRAN "LAC"
E UTRAN "MME Code" maps to GERAN/UTRAN "RAC" and is also copied into the 8 most significant bits of the NRI field within the P TMSI;

"P-TMSI" includes the mapped NRI
P TMSI shall be of 32 bits length where the two topmost bits are reserved and always set to 11.

E UTRAN "M-TMSI" maps as follows:
6 bits of the E UTRAN "M-TMSI" starting at bit 29 and down to bit 24 are mapped into bit 29 and down to bit 24 of the GERAN/UTRAN "P TMSI";
16 bits of the E UTRAN "M-TMSI" starting at bit 15 and down to bit 0 are mapped into bit 15 and down to bit 0 of the GERAN/UTRAN "P TMSI";
and the remaining 8 bits of the E UTRAN "M-TMSI" are mapped into the 8 MBS bits of the "P-TMSI signature" field.

Abbreviations Summary:
GUTI - Globally Unique Temporary UE Identity
GUMMEI - Globally Unique MME Identifier
MMEGI - MME Group ID
MMEC - MME Code
S-TMSI = SAE Temporary Mobile Subscriber Identity
M-TMSI = MME Temporary Mobile Subscriber Identity

Reference: 3GPP TS 23.003: Technical Specification Group Core Network and Terminals; Numbering, addressing and identification (Release 8) - Section 2.8