Wireless Connectivity for Personalized Healthcare Applications Emerging Technologies, Regulation and Standards 1st AMA-IEEE Conference
Dave Cavalcanti, Dong Wang, Monisha Gosh Philips Research North America March 22, 2010
Ubiquitous Cableless Monitoring
Philips Research North America, March 22, 2010
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Medical Body Area Network (MBAN) - A wireless network of sensors around a patient • Clinical benefits Extension of monitoring into care areas that are currently unmonitored Improve healthcare workflow efficiency, safety and clinical outcome. Patient mobility, comfort, infection control Monitoring flexibility and scalability Reduced overall monitoring costs
Philips Research North America, March 22, 2010
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Ubiquitous Cableless Monitoring System Architecture Patient worn sensor devices
… SpO2
ECG
Blood Pressure
MBAN
Bed side Monitor
Wired network
Patient worn hub device
Wi-Fi, WMTS or other long-rang radios
Remote central station
Medical body area network is a key enabling technology to achieve ubiquitous cableless monitoring Philips Research North America, March 22, 2010
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Healthcare & Business Relevance of MBANs • MBAN will have a significant impact on Patient Monitoring (PM) and home healthcare business. • Enable continuous growth in the high acuity PM market. 5,747 acute care hospitals in US (based on 2008 statistics) 879,105 staffed beds, 56% are monitored (492,298 beds) MBAN would simplify patient care and reduce costs 44% are unmonitored (386,806 beds)
• New oppurtunities to explore fast-growing markets Low & Medium acuity cableless PM, and PM in general wards 1500+ Rapid Response Teams Reduction in unplanned ICU admissions Reduction in healthcare costs Remote patient monitoring for Home healthcare Philips Research North America, March 22, 2010
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Overview of 2.4 GHz spectrum and wireless technologies 2.4 GHz ISM band Spectrum Allocation
•The 2.4 GHz ISM band is used by many wireless technologies (e.g. Wi-Fi, Bluetooth, ZigBee/802.15.4, DECT, etc) in hospitals and homes. • There is a need for clean spectrum to foster future MBAN applications FCC is in the process of considering to open 2360-2400 MHz spectrum for MBAN applications Philips Research North America, March 22, 2010
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Rationale of 2360-2400 MHz Selection • The 2360-2400 MHz band is adjacent to the 2.4GHz ISM band and it would allows 2.4 GHz off-the-shelf low-power short-range radios to be leveraged and permits small, efficient antennas. • The 2360-2400 MHz band is very sparsely utilized over USA geography, time, and frequency. – Mostly clean spectrum and less interference sources. • Primary users in the 2360-2400 MHz band – High-power, long-range AMT (Aeronautical Mobile Telemetry) and Amateur primary users are good coexistence candidates for opportunistic low-power, short-range MBANS devices (secondary users). • A Contiguous 40 MHz spectrum allocation would provide flexibility for future MBAN innovations. – Support opportunistic secondary operations, even in highest usage density hospital settings – Flexibility to support future high-rate applications and ultra low power applications – Provide medical-grade performance Philips Research North America, March 22, 2010
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FCC MBAN Regulation Status FCC MBAN Progress Dec. 27, 2007, GEHC proposed MBAN in its ex parte comments in response to a NOI in the MedRadio Proceeding
May. 27, 2008, FCC issued MBAN NOI
Jun. 29, 2009, FCC published MBAN NPRM
Oct. 5, 2009, FCC MBAN NPRM comments stage finished
Nov. 4, 2009, FCC MBAN NPRM reply comments stage finished
• The process is going well and a positive outcome is expected
Current stage, Interested parties make Ex Parte presentations to FCC
The FCC is likely to publish rules in 2010 for public comment
Philips Research North America, March 22, 2010
Next stage, FCC drafts order and publish it for public comments
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Options for MBAN Spectrum Regulations Eligibility & Permissible Communications – Limited to transmission of data (no voice) used for monitoring, diagnosing or treating patients. – Licenses by rules, operations by authorized health care professionals and by any other person, if such use is prescribed by a health care professional.
Frequencies & Authorized Locations – –
2360-2390 MHz MBANS operations limited to health care facilities (in-hospital use only), which are outside exclusion zones (areas of potential overlap with primary users). 2390-2400 MHz MBANS operations permitted anywhere (all hospitals, in-home, mobile ambulances)
MBAN spectrum allocation suggested by Philips in comments to FCC (Oct. 2009)
Additional Technical Requirements – All stations must employ contention-based protocol. – Transmit power (EIRP) and out-of-band emission restrictions – Use cognitive radio technology to protect primary users Philips Research North America, March 22, 2010
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Cognitive Radio Technology Enables Coexistence Cognitive radio =
Flexible
+
“quickly adapts transmission characteristics”
Detect channel availability and dynamically selects channels based on spectrum usage policies
smart “aware of spectrum usage in vicinity, makes intelligent decisions, and reacts according to spectrum usage policies”
• CR technology can be used to “Detect and Avoid” interference to primary users • Through geographical databases and spectrum sensing, devices can identify potential interference conditions • Through dynamic channel selection, devices can adaptively move to a clean channel as needed to avoid interference. Philips Research North America, March 22, 2010
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Exclusion Zones and E-Key for Primary User Protection (Proposed by Philips in the Oct. 2009 comments to FCC) • An exclusion zone is defined for each active AMT site in which hospitals are not allowed to use the MBAN spectrum. The zone size is selected to guarantee sufficient geographical separation between hospitals and AMT sites to avoid interference to AMT receivers.
• An access e-Key authorizes devices to transmit in a given location/channel The e-key could be managed through a coordinator, such as ASHE (the WMTS band coordinator). To get an access e-key, a hospital needs to register with the coordinator The coordinator would maintain a registration database (as it does for WMTS), AMI site locations and exclusion zone coordinates. Hospitals that are located outside the exclusion zone would be provided with an access e-key.
Philips Research North America, March 22, 2010
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Related Standardization • IEEE 802.15.6 Developing radio standard for diverse body area network applications (in-body, onbody) in consumer electronics, lifestyle, well-being and healthcare domains. Many frequency bands considered: MICT (in-body), 2.4 GHz, new MBAN spectrum, UWB, … MBAN spectrum has been considered there for medical applications
• IEEE 802.15.4 A new study group (approved March 19 2010) will study the prospects of an amendment to extend the use of the 15.4 family of standards to MBAN spectrum. o 15.4 is widely available - annual sales of several million devices o It has a well established eco-system (chips, modules, support) o There are already many healthcare applications using 15.4 o Existing 2.4 GHz 15.4 based systems can be extended into the 2.36 GHz band o Allow for a quick deployment complementing 802.15.6 as a strategic development o15.4 amendment will ensure coexistence between 15.4 and 15.6 in the MBAN spectrum Cognitive radio techniques will enable such coexistence
Philips Research North America, March 22, 2010
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Conclusion • Medical body area network is a key enabling technology to achieve ubiquitous cableless monitoring • FCC is considering to open 2360-2400 MHz spectrum for MBAN applications – The FCC is expected to publish rules in 2010 for public comment
• Allocating the full 40 MHz of spectrum (2360-2400 MHz) will reduce interference risks and promote MBAN innovation – Much cleaner spectrum – Reusing the mature 2.4GHz radios to minimize development costs – Flexibility to foster new MBAN applications
• Cognitive radio techniques are key to enable protection of primary uesrs and coexistence in the MBAN spectrum while improving spectrum usage efficiency. • MBAN standardization activities are undergoing in the IEEE 802.15.
Philips Research North America, March 22, 2010
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Philips Research North America, March 22, 2010
Current Wireless Technologies used for wireless body/personal area networks Technology Spectrum Modulation Channels Data Rate Operating space
•
Peak power
nJ/bit Topology Join time
Bluetooth classic
2.4 GHz ISM
GFSK
79
1-3 Mbps
1-10m on-body only
[email protected]
50
Scatternet
~3s
Bluetooth Low Energy
2.4 GHz ISM
GFSK
3
1 Mbps
1-10m on-body only
[email protected]
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Piconet Star
