A conceptual IoT-based early-warning architecture for remote monitoring of COVID-19 patients in wards and at home

Modifications to the National Early Warning Score 2: a Scoping Review

BACKGROUND

The National Early Warning Score 2 (NEWS2) has been adopted as the standard approach for early detection of deterioration in clinical settings in the UK, and is also used in many non-UK settings. Limitations have been identified, including a reliance on 'normal' physiological parameters without accounting for individual variation.

OBJECTIVE

This review aimed to map how the NEWS2 has been modified to improve its predictive accuracy while placing minimal additional burden on clinical teams.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) and the Population, Intervention, Comparator, Outcome, and Study (PICOS) frameworks were followed to structure the review. Six databases (CINAHL, PubMed, Embase, ScienceDirect, Cochrane Library and Web of Science) were searched for studies which reported the predictive accuracy of a modified version of NEWS2. The references were screened based on keywords using EndNote 21. Title, abstract and full-text screening were performed by 2 reviewers independently in Rayyan. Data was extracted into a pre-established form and synthesised in a descriptive analysis.

RESULTS

Twelve studies were included from 12,867 references. In 11 cases, modified versions of NEWS2 demonstrated higher predictive accuracy for at least one outcome. Modifications that incorporated demographic variables, trend data and adjustments to the weighting of the score's components were found to be particularly conducive to enhancing the predictive accuracy of NEWS2.

CONCLUSIONS

Three key modifications to NEWS2-incorporating age, nuanced treatment of FiO2 data and trend analysis-have the potential to improve predictive accuracy without adding to clinician burden. Future research should validate these modifications and explore their composite impact to enable substantial improvements to the performance of NEWS2.

The role of blockchain to secure internet of medical things

This study explores integrating blockchain technology into the Internet of Medical Things (IoMT) to address security and privacy challenges. Blockchain's transparency, confidentiality, and decentralization offer significant potential benefits in the healthcare domain. The research examines various blockchain components, layers, and protocols, highlighting their role in IoMT. It also explores IoMT applications, security challenges, and methods for integrating blockchain to enhance security. Blockchain integration can be vital in securing and managing this data while preserving patient privacy. It also opens up new possibilities in healthcare, medical research, and data management. The results provide a practical approach to handling a large amount of data from IoMT devices. This strategy makes effective use of data resource fragmentation and encryption techniques. It is essential to have well-defined standards and norms, especially in the healthcare sector, where upholding safety and protecting the confidentiality of information are critical. These results illustrate that it is essential to follow standards like HIPAA, and blockchain technology can help ensure these criteria are met. Furthermore, the study explores the potential benefits of blockchain technology for enhancing inter-system communication in the healthcare industry while maintaining patient privacy protection. The results highlight the effectiveness of blockchain's consistency and cryptographic techniques in combining identity management and healthcare data protection, protecting patient privacy and data integrity. Blockchain is an unchangeable distributed ledger system. In short, the paper provides important insights into how blockchain technology may transform the healthcare industry by effectively addressing significant challenges and generating legal, safe, and interoperable solutions. Researchers, doctors, and graduate students are the audience for our paper.

A tree-based explainable AI model for early detection of Covid-19 using physiological data

With the outbreak of COVID-19 in 2020, countries worldwide faced significant concerns and challenges. Various studies have emerged utilizing Artificial Intelligence (AI) and Data Science techniques for disease detection. Although COVID-19 cases have declined, there are still cases and deaths around the world. Therefore, early detection of COVID-19 before the onset of symptoms has become crucial in reducing its extensive impact. Fortunately, wearable devices such as smartwatches have proven to be valuable sources of physiological data, including Heart Rate (HR) and sleep quality, enabling the detection of inflammatory diseases. In this study, we utilize an already-existing dataset that includes individual step counts and heart rate data to predict the probability of COVID-19 infection before the onset of symptoms. We train three main model architectures: the Gradient Boosting classifier (GB), CatBoost trees, and TabNet classifier to analyze the physiological data and compare their respective performances. We also add an interpretability layer to our best-performing model, which clarifies prediction results and allows a detailed assessment of effectiveness. Moreover, we created a private dataset by gathering physiological data from Fitbit devices to guarantee reliability and avoid bias.The identical set of models was then applied to this private dataset using the same pre-trained models, and the results were documented. Using the CatBoost tree-based method, our best-performing model outperformed previous studies with an accuracy rate of 85% on the publicly available dataset. Furthermore, this identical pre-trained CatBoost model produced an accuracy of 81% when applied to the private dataset. You will find the source code in the link: https://github.com/OpenUAE-LAB/Covid-19-detection-using-Wearable-data.git .

A systematic review and knowledge mapping on ICT-based remote and automatic COVID-19 patient monitoring and care

BACKGROUND

e-Health has played a crucial role during the COVID-19 pandemic in primary health care. e-Health is the cost-effective and secure use of Information and Communication Technologies (ICTs) to support health and health-related fields. Various stakeholders worldwide use ICTs, including individuals, non-profit organizations, health practitioners, and governments. As a result of the COVID-19 pandemic, ICT has improved the quality of healthcare, the exchange of information, training of healthcare professionals and patients, and facilitated the relationship between patients and healthcare providers. This study systematically reviews the literature on ICT-based automatic and remote monitoring methods, as well as different ICT techniques used in the care of COVID-19-infected patients.

OBJECTIVE

The purpose of this systematic literature review is to identify the e-Health methods, associated ICTs, method implementation strategies, information collection techniques, advantages, and disadvantages of remote and automatic patient monitoring and care in COVID-19 pandemic.

METHODS

The search included primary studies that were published between January 2020 and June 2022 in scientific and electronic databases, such as EBSCOhost, Scopus, ACM, Nature, SpringerLink, IEEE Xplore, MEDLINE, Google Scholar, JMIR, Web of Science, Science Direct, and PubMed. In this review, the findings from the included publications are presented and elaborated according to the identified research questions. Evidence-based systematic reviews and meta-analyses were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Additionally, we improved the review process using the Rayyan tool and the Scale for the Assessment of Narrative Review Articles (SANRA). Among the eligibility criteria were methodological rigor, conceptual clarity, and useful implementation of ICTs in e-Health for remote and automatic monitoring of COVID-19 patients.

RESULTS

Our initial search identified 664 potential studies; 102 were assessed for eligibility in the pre-final stage and 65 articles were used in the final review with the inclusion and exclusion criteria. The review identified the following eHealth methods-Telemedicine, Mobile Health (mHealth), and Telehealth. The associated ICTs are Wearable Body Sensors, Artificial Intelligence (AI) algorithms, Internet-of-Things, or Internet-of-Medical-Things (IoT or IoMT), Biometric Monitoring Technologies (BioMeTs), and Bluetooth-enabled (BLE) home health monitoring devices. Spatial or positional data, personal and individual health, and wellness data, including vital signs, symptoms, biomedical images and signals, and lifestyle data are examples of information that is managed by ICTs. Different AI and IoT methods have opened new possibilities for automatic and remote patient monitoring with associated advantages and weaknesses. Our findings were represented in a structured manner using a semantic knowledge graph (e.g., ontology model).

CONCLUSIONS

Various e-Health methods, related remote monitoring technologies, different approaches, information categories, the adoption of ICT tools for an automatic remote patient monitoring (RPM), advantages and limitations of RMTs in the COVID-19 case are discussed in this review. The use of e-Health during the COVID-19 pandemic illustrates the constraints and possibilities of using ICTs. ICTs are not merely an external tool to achieve definite remote and automatic health monitoring goals; instead, they are embedded in contexts. Therefore, the importance of the mutual design process between ICT and society during the global health crisis has been observed from a social informatics perspective. A global health crisis can be observed as an information crisis (e.g., insufficient information, unreliable information, and inaccessible information); however, this review shows the influence of ICTs on COVID-19 patients' health monitoring and related information collection techniques.

Unlocking Insights in IoT-Based Patient Monitoring: Methods for Encompassing Large-Data Challenges

The remote monitoring of patients using the internet of things (IoT) is essential for ensuring continuous observation, improving healthcare, and decreasing the associated costs (i.e., reducing hospital admissions and emergency visits). There has been much emphasis on developing methods and approaches for remote patient monitoring using IoT. Most existing frameworks cover parts or sub-parts of the overall system but fail to provide a detailed and well-integrated model that covers different layers. The leverage of remote monitoring tools and their coupling with health services requires an architecture that handles data flow and enables significant interventions. This paper proposes a cloud-based patient monitoring model that enables IoT-generated data collection, storage, processing, and visualization. The system has three main parts: sensing (IoT-enabled data collection), network (processing functions and storage), and application (interface for health workers and caretakers). In order to handle the large IoT data, the sensing module employs filtering and variable sampling. This pre-processing helps reduce the data received from IoT devices and enables the observation of four times more patients compared to not using edge processing. We also discuss the flow of data and processing, thus enabling the deployment of data visualization services and intelligent applications.

Digital health in smart cities: Rethinking the remote health monitoring architecture on combining edge, fog, and cloud

Purpose

Smart cities that support the execution of health services are more and more in evidence today. Here, it is mainstream to use IoT-based vital sign data to serve a multi-tier architecture. The state-of-the-art proposes the combination of edge, fog, and cloud computing to support critical health applications efficiently. However, to the best of our knowledge, initiatives typically present the architectures, not bringing adaptation and execution optimizations to address health demands fully.

Methods

This article introduces the VitalSense model, which provides a hierarchical multi-tier remote health monitoring architecture in smart cities by combining edge, fog, and cloud computing.

Results

Although using a traditional composition, our contributions appear in handling each infrastructure level. We explore adaptive data compression and homomorphic encryption at the edge, a multi-tier notification mechanism, low latency health traceability with data sharding, a Serverless execution engine to support multiple fog layers, and an offloading mechanism based on service and person computing priorities.

Conclusions

This article details the rationale behind these topics, describing VitalSense use cases for disruptive healthcare services and preliminary insights regarding prototype evaluation.

COVICT: an IoT based architecture for COVID-19 detection and contact tracing

The world we live in has been taken quite surprisingly by the outbreak of a novel virus namely SARS-CoV-2. COVID-19 i.e. the disease associated with the virus, has not only shaken the world economy due to enforced lockdown but has also saturated the public health care systems of even most advanced countries due to its exponential spread. The fight against COVID-19 pandemic will continue until majority of world's population get vaccinated or herd immunity is achieved. Many researchers have exploited the Artificial intelligence (AI) knacks based IoT architecture for early detection and monitoring of potential COVID-19 cases to control the transmission of the virus. However, the main cause of the spread is that people infected with COVID-19 do not show any symptoms and are asymptomatic but can still transmit virus to the masses. Researcher have introduced contact tracing applications to automatically detect contacts that can be infected by the index case. However, these fully automated contact tracing apps have not been accepted due to issues like privacy and cross-app compatibility. In the current study, an IoT based COVID-19 detection and monitoring system with semi-automated and improved contact tracing capability namely COVICT has been presented with application of real-time data of symptoms collected from individuals and contact tracing. The deployment of COVICT, the prediction of infected persons can be made more effective and contaminated areas can be identified to mitigate the further propagation of the virus by imposing Smart Lockdown. The proposed IoT based architecture can be quite helpful for regulatory authorities for policy making to fight COVID-19.

Real-Time Learning and Monitoring System in Fighting against SARS-CoV-2 in a Private Indoor Environment

The SARS-CoV-2 virus has posed formidable challenges that must be tackled through scientific and technological investigations on each environmental scale. This research aims to learn and report about the current state of user activities, in real-time, in a specially designed private indoor environment with sensors in infection transmission control of SARS-CoV-2. Thus, a real-time learning system that evolves and updates with each incoming piece of data from the environment is developed to predict user activities categorized for remote monitoring. Accordingly, various experiments are conducted in the private indoor space. Multiple sensors, with their inputs, are analyzed through the experiments. The experiment environment, installed with microgrids and Internet of Things (IoT) devices, has provided correlating data of various sensors from that special care context during the pandemic. The data is applied to classify user activities and develop a real-time learning and monitoring system to predict the IoT data. The microgrids were operated with the real-time learning system developed by comprehensive experiments on classification learning, regression learning, Error-Correcting Output Codes (ECOC), and deep learning models. With the help of machine learning experiments, data optimization, and the multilayered-tandem organization of the developed neural networks, the efficiency of this real-time monitoring system increases in learning the activity of users and predicting their actions, which are reported as feedback on the monitoring interfaces. The developed learning system predicts the real-time IoT data, accurately, in less than 5 milliseconds and generates big data that can be deployed for different usages in larger-scale facilities, networks, and e-health services.

Remote Monitoring of COVID-19 Patients Using Multisensor Body Area Network Innovative System

As of late 2019, the COVID19 pandemic has been causing huge concern around the world. Such a pandemic posed serious threats to public safety, the well-being of healthcare workers, and the overall health of the population. If automation can be implemented in healthcare systems, patients could be better cared for and health industries could be less burdened. To combat such challenges, e-health requires apps and intelligent systems. Using WBAN sensors and networks, a doctor or medical professional can advise patients on the best course of action. Patients' fitness could be assessed using WBAN sensors without interfering with their daily activities. When designing a monitoring system, system performance reliability for competent healthcare is critical. Existing research has failed to create a large device capable of handling a large network or to improve WBAN topologies for fast transmitting and receiving patient data. As a result, in this research, we create a multisensor WBAN (MSWBAN) intelligent system for transmitting and receiving critical patient data. To gather information from all cluster nodes and send it to multisensor WBAN, a novel additive distance-threshold routing protocol (ADTRP) is proposed. In small networks where data are managed by the transmitting node and the best data route is determined, this protocol has less redundancy. An edge-cutting-based routing optimization (ES-EC-R ES-EC-RO) is used to find the best route. The Trouped blowfish MD5 (TB-MD5) algorithm is used to encrypt and decrypt data, and the encrypted data are stored in a cloud database for security. The performance metrics of our proposed model are compared to current techniques for the best results. End-to-end latency is 63 ms, packet delivery is 95%, security is 95.7%, and throughput is 9120 bps, according to the results. The purpose of this article is to encourage engineers and front-line workers to develop digital health systems for tracking and controlling virus outbreaks.

SHUBHCHINTAK: An efficient remote health monitoring approach for elderly people

With the proliferation of IoT technology, it is anticipated that healthcare services, particularly for the elderly persons, will become a major thrust area of research in the coming days. Aim of this work is to design a fit-band containing multiple sensors to provide remote healthcare services for the elderly persons. An application has been designed to capture health data from the fit-band, pre-process the data and then send them to cloud for further analysis. A wireless Bluetooth enabled connection is proposed to establish communications between sensors and the application for data transmission. In the proposed application, there are three different front-end interfaces for three different users: system administrator, patient and doctor. The data collected from the patient's fit-band are sent to a cloud data storage, where the data will be analyzed to detect anomaly (e.g., heart attack, sleep apnea, etc.). A Convolution Neural Network (CNN) model is proposed for anomaly detection. For the classification of anomaly, a Long Short Term Memory (LSTM) model is proposed. In the presence of anomaly, the system immediately connects a doctor through a phone call. A prototype system termed as Shubhchintak has been developed in Android/IOS environment and tested with a number of users. The fit-band provides data tracking with an overall accuracy of 99%; the system provides a response with 3000 requests in less than 100 ms. Also, Shubhchintak provides a real-time feedback with an accuracy of 97%. Shubhchintak is also tested by patients and doctors of a nearby hospital. Shubhchintak is shown to be a simple to use, cost effective, comfortable, and efficient system compared to the existing state of the art solutions.

Remotely Monitoring COVID-19 Patient Health Condition Using Metaheuristics Convolute Networks from IoT-Based Wearable Device Health Data

Today, COVID-19-patient health monitoring and management are major public health challenges for technologies. This research monitored COVID-19 patients by using the Internet of Things. IoT-based collected real-time GPS helps alert the patient automatically to reduce risk factors. Wearable IoT devices are attached to the human body, interconnected with edge nodes, to investigate data for making health-condition decisions. This system uses the wearable IoT sensor, cloud, and web layers to explore the patient's health condition remotely. Every layer has specific functionality in the COVID-19 symptoms' monitoring process. The first layer collects the patient health information, which is transferred to the second layer that stores that data in the cloud. The network examines health data and alerts the patients, thus helping users take immediate actions. Finally, the web layer notifies family members to take appropriate steps. This optimized deep-learning model allows for the management and monitoring for further analysis.

IoT-Based Smart Health Monitoring System for COVID-19

With the commencement of the COVID-19 pandemic, social distancing and quarantine are becoming essential practices in the world. IoT health monitoring systems prevent frequent visits to doctors and meetings between patients and medical professionals. However, many individuals require regular health monitoring and observation through medical staff. In this proposed work, we have taken advantage of the technology to make patients life easier for earlier diagnosis and treatment. A smart health monitoring system is being developed using Internet of Things (IoT) technology which is capable of monitoring blood pressure, heart rate, oxygen level, and temperature of a person. This system is helpful for rural areas or villages where nearby clinics can be in touch with city hospitals about their patient health conditions. However, if any changes occur in a patient's health based on standard values, then the IoT system will alert the physician or doctor accordingly. The maximum relative error (%ϵ r) in the measurement of heart rate, patient body temperature and SPO2 was found to be 2.89%, 3.03%, 1.05%, respectively, which was comparable to the commercials health monitoring system. This health monitoring system based on IoT helps out doctors to collect real-time data effortlessly. The availability of high-speed internet allows the system to monitor the parameters at regular intervals. Furthermore, the cloud platform allows data storage so that previous measurements could be retrieved in the near future. This system would help in identifying and early treatment of COVID-19 individual patients.

A study to introduce National Early Warning Scores (NEWS) in care homes: Influence on decision-making and referral processes

AIM

Early warning scores are commonly used in hospital settings, but little is known about their use in care homes. This study aimed to evaluate the impacts of National Early Warning Scores alongside other measures in this setting.

DESIGN

Convergent parallel design.

METHODS

Quantitative data from 276 care home residents from four care homes were used to analyse the relationship between National Early Warning Scores score, resident outcome and functional daily living (Barthel ADL (Barthel Index for Activities of Daily Living)) and Rockwood (frailty). Interviews with care home staff (N = 13) and care practitioners (N = 4) were used to provide qualitative data.

RESULTS

A statistically significant link between National Early Warning Scores (p = .000) and Barthel ADL (p = .013) score and hospital admissions was found, while links with Rockwood were insignificant (p = .551). Care home staff reported many benefits of National Early Warning Scores, including improved communication, improved decision-making and role empowerment. Although useful, due to the complexity of the resident population's existing health conditions, National Early Warning Scores alone could not act as a diagnostic tool.