wilamowski-b-m-irwin-j-d-industrial-communication-systems-2011

Communications in Medical Applications 30-13
30.6.3 Standardization
Standardization promotes the avoidance of duplicate research efforts, the improvement of technical
support, an increased volume production leading to a reduced per item cost, a broadening of the application
market, etc. To harness these benefits in healthcare environments, specific protocols addressing
interoperable bedside devices (ISO/IEEE 11073 [53]) and BANs (IEEE 802.15.6 [54]) have been proposed.
The ISO/IEEE 11073 family of standards specifies the nomenclature, the abstract data model, the
service model, and the transport for interoperable bedside devices and aims to “provide real-time plugand-play
interoperability for patient-connected medical devices and facilitate the efficient exchange of
vital signs and medical device data, acquired at the point-of-care, in all health care environments” [56].
Currently, only two transport systems have been approved: cable connected and infrared wireless.
However, an approved draft version of a set of guidelines for the use of RF wireless technology as transport
in ISO/IEEE 11073 systems is available since June 2008.
In the latter part of 2007, the IEEE 802.15 Task Group 6 (BAN) was formed to develop a communication
standard optimized for low-power devices operating in (or around) the human body (but not
limited to humans), addressing medical healthcare applications (e.g., physiological monitoring), consumer
electronics including entertainment (e.g., wireless headphone), and other applications. Besides
the unique criteria defined by Task Group 6 [58], issues regarding candidate wireless technologies have
been introduced [57]. However, a draft ready for the sponsor ballot is only scheduled for the end of 2009,
which will significantly delay the standard adoption.
Although not specifically designed envisaging healthcare environments, the IEEE 1451 [52] has the
potential to become a contender in medical monitoring applications. This standard was initially sponsored
by the IEEE Instrumentation and Measurement Society and targets industrial wired and wireless
distributed monitoring and control applications. The IEEE 1451 family of standards defines a set of open,
common, network-independent communication interfaces for connecting transducers (sensors or actuators)
to microprocessors, instrumentation systems, and control/field networks [55]. Smart transducer
interfaces for sensors (and actuators) employing wireless communication protocols (Wi-Fi, ZigBee,
Bluetooth, and LoWPAN) are standardized since 2007 and are already commercially available [59].
Despite the existence of standards specifically addressing communications among medical devices in
healthcare environments, commercial modules supporting those standards are still scarce, thus hindering
their application in real deployments. Also, standards should be designed to reduce feature redundancy
and incompatibility, which would foster interoperability.
30.6.4 timeliness
The occurrence of high delays and jitter in medical communication systems has a direct impact on
the quality of service provided by the associated equipment. For example, a varying (high) latency in
real-time patient vital sign communication can interfere with computerized and human interpretation,
increasing the probability of misdiagnosis and risking therapeutic interventions. Moreover, delays
can originate spurious alarms, such as “lead-loss” or “offline patient,” which reduce system trust and
increase complaints (and investigations) for “no-problem-found” events.
Because security and privacy are main requirements in healthcare communications, the use of standard
encryption mechanisms is highly desirable as it allows securing data and guaranteeing compatibility
and continuous improvement of the technology. However, since most medical devices embed small power
microprocessors, the delay associated with the encryption/decryption procedure can be significant.
Many of the aforementioned medical communications employed in localization, monitoring, and
automation applications have not been fully assessed, i.e., standard protocols are employed for data
communication without any experimental or theoretical evaluation of latency and jitter. This approach
is inadequate and highly censurable for medical applications with safety-critical real-time communication
requirements.
© 2011 by Taylor and Francis Group, LLC