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Top1. Introduction
The number of people diagnosed with chronic diseases and diabetes in particular is rising dramatically worldwide (Baker, Simpson, Lloyd, Bauman, & Singh, 2011). This situation is expected to impose an additional cost and load on the medical centers which are not always able to handle. Emphasis is therefore is being put on alternative solutions such as remote monitoring, taking into consideration that health providers are becoming more and more involved in technology to aid in their jobs. In addition, healthcare systems with remote monitoring have been shown to improve patient's quality of life and reducing costs (http://www.bosch-telehealth.com/) (McGee, 2009)
The benefits of remote data acquisition and monitoring have been widely recognized and therefore many other applications are emerging to address the demands of mobile health. A system that allows for remote monitoring of patient's vital parameters like ECG, blood pressure and oxygen saturation level can be built by having the patients equipped with ambulatory sensors that acquire these health data. The acquired data can then be transmitted to a local PC station at the patient's home via Bluetooth. The local PC runs customized software to analyze the acquired data and produces alerts according to a parameter threshold table. Other researches have been reported on wearable medical devices that measure vital signs, which are closely related to this research. These devices utilize wireless sensor networks to monitor patients’ health (Milenković, Otto, & Jovanov, 2006; Walker, Polk, Hande, & Bhatia, 2006). In other projects, wireless modules have been integrated into the medical device itself, for example a prototype was developed to send data from an ECG monitoring device to remote monitoring stations using Bluetooth and Internet connections, while storing the data in intermediate stages along the way (Lucani, Cataldo, Cruz, Villegas, & Wong, 2006). Many research papers focus on remote monitoring within the parameters of the hospital itself. One such study proposes Wireless Body Area Network (WBAN) architecture for remote monitoring using ZigBee technology. The sensor nodes pass their data to a centralized service node, which then transfers the data to a remote terminal over the Internet (Khan, Yuce, & Karami, 2008). With body area networks the sensor is expected to remain very near to the patient to measure vital signs. Prototypes have been built to send ECG signals over Bluetooth in WBANs (Yu & Yang, 2009).
Other systems developed focused on Bluetooth as the sole means of data transmission, with the data being sent from the client medical device to the server over a Bluetooth connection (Tafa & Stojanovic, 2006). One such prototype explores P2P Bluetooth networks in medical monitoring, with sensor data being sent from the patient room to a nurse, and from the nurse to the database, all using Bluetooth connections (Cho et al., 2008). The disadvantage of such systems is that the server cannot be placed at a remote location, and instead must remain within the medical device’s Bluetooth range.
Since its introduction, the m-health has become a key domain within the e-health and wireless telemedicine gathering academic research and industry disciplines worldwide (Istepanian, Jovanov, & Zhang, 2012). Mobile device-based methodologies have also been reported in literature to support wireless acquisition of patient's data using Short Message Service (SMS) text messaging (Ferrer-Roca, Cárdenas, Diaz-Cardama, & Pulido, 2004; Kim, 2007). Wireless Application Protocol (WAP) (Rami, Popow, Horn, Waldhoer, & Schober, 2006), or Bluetooth functionality (Zou, Istepanian, & Huang, 2006; Al-Taee, Jaradat, & Abu Ali, 2011) of mobile phones. In these applications, data can be entered using the numeric keypad, or mobile phones can be used as a hub to enable wireless data transfer from patient's medical devices. The acquired data are then forwarded to a central database via text messaging or mobile Internet. Another mobile phone based concept which utilizes the mobile phone camera to take photos of the medical measurements and send it to a remote monitoring center was reported in Schreier, Kollmann, Kramer, Messmer, Hochgatterer, and Kastner (2004).