In this paper applications and requirements of mobile broadband multimedia healthcare services are presented, with the focus on specific research challenges. Such pervasive multimedia healthcare applications include hospital tele-consultation, health monitoring, intelligent emergency management systems, pervasive healthcare data access, and ubiquitous mobile telemedicine. After a survey of the past and undergoing research and demonstration projects in the area, recent challenges and future research directions of comprehensive wireless multimedia health monitoring are presented, including context awareness, content awareness, quality issues, security and reliability, and autonomous and adaptable operation.

Wireless broadband multimedia health services: Current status and emerging concepts

Worldwide Interoperability for Microwave Access (WiMAX) Technology is one of the most interesting solutions for broadband wireless access, that provide multimedia traffic and applications through an appropriate QoS management for fixed and mobile devices. In this regard, we attempt to introduce a new distributed model to improve the performance of QoS over fixed WiMAX with respect to parameters including throughput, delay and application response time, to enhance the services that are provided to the end users by minimizing delay, application response time and increasing throughput. A Model was developed based on the proposed new distributed model (Master-Slave), the first scenario comprised of 3 Base Stations (BS) and thirty Subscriber Station (SS) with one Master BS selected by the designed algorithm (Nearest Neighborhood Algorithms). Simulations run while increasing the number of BSs, SSs and master BSs using point-to-multipoint connection with multicast transmission based on Orthogonal Frequency Division Multiplexing (OFDM). The design has been evaluated using the simulation tool OPNET modeler 16.0. The results obtained from the three Scenarios shows significant increase in the network throughput and drastic decrease in network delay and application response time. Furthermore, with help of the distributed Master BSs, the coverage area of WiMAX has been increased. Thus greatly enhances the performance of Quality of service (QoS).

Simulation Model to Improve QoS Performance over Fixed WiMAX using OPNET

In current architectures for infrastructure networks, a single (logically centralized) network element is in charge of managing mobility. As new requirements arise from the widespread use of sophisticated end-user devices, new standard solutions are emerging that challenge the status quo and aim for an evolution toward distributed mobility management.

Mobility Management in Infrastructure Networks

Next generation wireless and wireline communication technologies for healthcare applications and services is a new and growing field to facilitate reliable, innovative, personalized, and high-quality healthcare applications and services. Advances in networking infrastructures (e.g., HSxPA/WiMax/LTE) are important in order to deliver healthcare applications and services regardless of the patient's physical location. Furthermore, continuous and personalized care solutions address the participation of patients in care and prevention processes and respond to the needs of elderly people by using sensors and advanced wireless monitoring tools. Finally, another area where the use of next generation communication technologies may foster rapid developments in healthcare is the support of the translation of cutting-edge research into clinical practice. 
 
The goal of this special issue is to report on cutting-edge research in converged communications and networking solutions for healthcare. Basic research papers were solicited, together with papers on systems integration or deployment, reflecting those aspects of research in communications for healthcare which are distinctly different from communications research in general. 
 
The call for papers for this special issue attracted numerous responses from the research community, and submissions covered diverse areas of interest. After an extensive peer review process, nine papers have been selected for inclusion in this special issue, addressing requirements for e-Health services and applications, technologies and systems for telemedicine applications, and pilot implementations of telemedical systems. Several application areas have been addressed, ranging from cardiology to neurology and chronic pulmonary diseases, besides general purpose telemedicine platforms. In the following paragraphs, we briefly introduce the papers. 
 
The article “Using exploratory focus groups to inform the development of targeted COPD self-management education DVDs for rural patients” by M. Stellefson et al. assessed the self-management learning needs, experiences, and perspectives of COPD patients treated at a Certified Federal Rural Health Clinic to inform the development of a COPD self-management DVD. Engaging rural communities in formal qualitative inquiries to describe COPD specific needs may lead to future use of educational technologies aimed at improving quality of life for rural populations. 
 
The article “e-SCP-ECG+ protocol: an expansion on SCP-ECG protocol for health telemonitoring—pilot implementation.” by G. C. Mandellos et al., extends the use of SCP-ECG protocol in order to be included in health monitoring systems by introducing new sections into SCP-ECG structure for transferring medical and comprehensive demographic data. It also considers the pilot implementation of the new protocol as a software component in a Health telemonitoring system. 
 
The article “Implementation of compressed sensing in telecardiology sensor networks,” by E. C. Pinheiro et al., presents an implementation of a compressed sensing paradigm in a wireless sensor network. The cardiovascular function monitoring was assessed and found to be very profitable. It was found that the approach between the two distant worlds of wireless sensor networks and compressed sensing is very interesting and may be further transposed to other areas of patient monitoring. 
 
The article “An empirical analysis of the current need for teleneuromedical care in German hospitals without neurology departments” by G. W. Ickenstein et al. delivers an excellent example of the high value in the use of next generation communication technologies to address the lack of highly specialized expertise in rural areas. The article describes the need for setting up teleneurology infrastructure in order to support small hospitals in rural areas when treating patients with strokes and other acute conditions or syndromes urging for neurological or neurosurgical intervention. A large study in 119 acute hospitals without neurology departments in smaller towns in Germany (less than 100,000 inhabitants) clearly shows that the introduction of teleneurology is expected to increase quality of care and dicrease the need for unnecessary patient transports among other advantages. 
 
The article “Tile-Ippokratis: the experience of an ehealth platform for the provision of health care services in the island of Chios and Cyprus” by H. Papadopoulos presents an integrated low-cost and ease-of-use ehealth platform for the provision of ehealth services for both patients with chronic diseases and patients who have been served by an intensive care unit. The platform based on the use of terrestrial and wireless communication infrastructures, supported teleconsultation and ehealth service. 
 
The article “Vascular neurology nurse practitioner provision of telemedicine consultations” by B. M. Demaerschalk et al. investigates the possibility of delivering timely consultations in cases of acute stroke patients in emergency departments of rural areas within established hub and spoke networks. The study investigated the delivery of diagnosis and treatment both in terms of quality of diagnosis and treatment as well as overall duration of the procedure, clearly indicating that there is high value in telestroke consultations. 
 
The article “Telemedical support in patients with chronic heart failure: experience from different projects in Germany” by A. Muller et al. addresses the very important application of telemedical monitoring in cases of chronic heart failure by reviewing seven related projects in Germany. The article emphasizes on the need for standardization, especially in order to be able to compare different telemonitoring solutions. Each of the projects addressed introduces a different approach in capturing and improving the situation of the affected patients, and the authors present these aspects for each one of the projects. 
 
The article “Flexible macroblock ordering for context-aware ultrasound video transmission over mobile WiMAX,” authored by M. G. Martini and C. T. E. R. Hewage, focuses on the exploitation of the characteristics of emerging network technologies and of recent coding standards for the joint design of the compression and transmission strategy in a telemedical system for real-time delivery of ultrasound video sequences. 
 
The article “Analysis of QoS requirements for e-Health services and mapping to evolved packet system QoS classes” by L. Skorin-Kapov and M. Matijasevic provides a framework for the provisioning of 3 GPP network architectures. It proposes a mapping of e-Health service types to standardized 3GPP QoS class identifiers in the evolved packet system (EPS). 
 
In summary, this special issue includes papers that span diverse areas of interest including system development and specific e-Health applications, as well as technological foundations. 
 
The first two articles address requirements for eHealth services. Two articles address telemedicine technologies and systems. Finally, a group of articles describe telemedicine pilot implementations.

Editorial: Healthcare applications and services in converged networking environments

The current growth of mobile data usage and emergence of new applications have greatly motivated the Third Generation Partnership Project (3GPP) to work on Long Term Evolution (LTE). LTE is the most recent standard in the mobile network technology to be developed based on GSM/EDGE and UMTS/HSPA network technologies with the aim of optimizing the capacity and speed of 3G mobile communication networks. In this chapter, the structures and features of fourth generation (4G) LTE are investigated at the early stages of telemedical research. The paper also provides a comparison of WiMAX and LTE standards on various aspects, as well as the potential of technology in healthcare applications. A survey on telemedicine services using traditional wireless system is presented. Finally, issues and challenges of wireless technologies in healthcare applications and services are deliberated.

3GPP Long Term Evolution and its application for healthcare services

Ubiquitous computing (UbiComp) systems rely on heterogeneous technologies and diverse protocols to enable the Anywhere, Anything, Anytime paradigm. Besides networking, the typical definition of a UbiComp system includes also soft- ware components and user interaction. The design of a UbiComp system is not an easy task, as architectural choices need to be made regarding technologies, applications and protocols to be employed. In this chapter we present a methodological framework for evaluating the support of ubiquity in mobile computing systems and protocols. This framework can be employed in different network architectures to design and evaluate protocols for future mobile networks, without incurring the overhead of prototyping, simulation or ethnographic studies. We illustrate the importance of protocol selection in UbiComp systems by presenting a case that com- pares ubiquity support in Mobile IPv6 (MIPv6) and Host Identity Protocol (HIP) protocols. The case study shows that without recurring to experts in the field (e.g. UbiComp systems experts) we can demonstrate that HIP supports ubiquity better than MIPv6.

Resource and Power Management in Mobile Computing Systems

Wireless Metropolitan Area Networks based on IEEE 802.16 standards are in the deployment phase in many countries. In fact, this technology can deliver high data rate while covering long distances, being a suitable candidate to solve the problem of digital divide and thus being able to provide connectivity in isolated and impervious areas. This paper presents the results of the EU Integrated Project WEIRD (WiMAX Extension to Isolated Researc h Data networks), in which WiMAX technology has been used to provide connectivity in impervious areas to perform volcano monitoring, fire prevention and telemedicine. In particular, we describe the advantages of the WEIRD system architecture and we show how WiMAX test­beds have been set up within the project to demonstrate the possibility to use WiMAX to extend the connectivity of the pan­European data communication network GEANT2 to stringent scenarios.

/pdf/extending-wimax-to-new-scenarios-key-results-on-system-28g0yd5kq4.pdf

Extending WiMAX to New Scenarios: Key Results on System Architecture and Test­beds of the WEIRD project

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Resource and Power Management in Mobile Computing Systems

Extending WiMAX to New Scenarios: Key Results on System Architecture and Testbeds of the WEIRD project

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Resource and Power Management in Mobile Computing Systems

Extending WiMAX to New Scenarios: Key Results on System Architecture and Test­beds of the WEIRD project

Extending WiMAX to New Scenarios: Key Results on System Architecture and Testbeds of the WEIRD project