Friday, 14 September 2012

Why don't we have interoperability of telecare devices... yet?



One of the old chestnuts within the telecare arena is the idea of interoperability.  Interoperability simply means that technologies can work together, thus a product by one manufacturer can be used with another manufacturers kit. A simple analogy would be that a Microsoft Word document could be edited on on a PC as well as a Mac computer.

In telecare terms this would mean that I could buy a fall detector from one manufacturer and it should still be configurable with another manufacturer's alarm system. In reality, this can usually be simply done through the purchase of a bridging device, but interoperability should mean that this device is no longer required.

I am mindful of the recent courtroom battle between Apple and Samsung which upheld Apple in the US but nowhere else in the world as the designers of the iPhone and iPad appearance and software. It is interesting to me as I am writing this on a netbook with Windows XP installed, whilst having an Apple device flash emails arriving to me.  I also have an Android smartphone and and Android tablet on this same desk providing further alerts and noises.  I know I will never miss any critical information with all this technology, but the time spent sifting through the rubbish to find the golden nugget is considerable. It is questionable whether this venture  is actually worth the effort.

I stray to illustrate that today we have a range of technological options open to us and we have to decide how we progress down the technological route.  For computers to write type on  I prefer Microsoft products but I also have a  keyboard for the tablet computer  and occasionally use that to edit things on.  The tablet has its own excellent touchpad keyboard as does the smartphone so I can actually edit documents and other things without the need for an external keyboard.

I use the cloud providers of free storage to store current active documents so they can be accessed anywhere on any of my wireless device. I also use the cloud to share documents with other people I work with, so they can edit them or review them. Thus if I am in McDonald's I can still access my email and edit a paper whilst sipping my Coke.

So what does this say about interoperability? Well it is interesting, to me, that although the devices are not per se interoperable, certain things on them are.

One source of interoperability is Bluetooth, which enables all my devices to link together or link to portable devices such as keyboards, mice etc.

A second interoperable source is the cloud providers allowing access to all my stored files on any device, as long as the operating system is compatible with the cloud software.

I have similar software on all my devices and Skype is a great example of a cross platform software that operates on almost all platforms.

So I am thinking to myself, I have a mobile phone that can communicate with everything else, I have an Apple product that does this as well and a netbook that also does this, and a Nokia Symbian smartphone that also does this, that I no longer use,so why can simple telecare devices not make use of the advances in technology to allow proper interoperability?

I am fully aware of the Continua group and think what they are doing is great, but it is no longer rocket science.  Devices can communicate through Bluetooth or Zigbee, or infra red or wirelessly. Software can be made to be cross platform so each operating system can use it, so why can I not use the fall detector I think is best with the dispersed alarm unit I think is best and add the best peripherals to this?  Why are we still faced with no choice? we are committed to buying a system from one manufacturer and then we must purchase on their peripherals with the limitations that they have.

The customer is left with little or no choice.

I am staggered that the mobile product market is rapidly expanding but the telecare marketplace appears stagnating in comparison.

How can we reverse this state of affairs?


How can we make telecare interoperable and usable?










8 comments:

Roger Downey said...

When we entered the telehealth (what we call telemedicine in the States) space, we decided that interoperability was essential. So all of our products are USB and PC-based. We build systems that work within legacy networks like Cisco, Polycom and LifeSize. Late this year, we expect to receive FDA registration for a cloud service that preserves medical images in DICOM format to a highly encrypted server. Once saved, the application will notify a physician that images from his patient are available for viewing. Using his smartphone, an iPad, an Android tablet or computer, he can sign on to the secure server from anywhere and view the images. This works for both visible light images like digital photos and invisible light images like xrays, CT-scans, MRIs, ultrasounds, etc. The physician can write a temporary report that he will finish later, or a final report that is saved with the images. Since he is only "viewing" the images, they are never resident on his device.
You might want to visit our Web site. www.globalmed.com
Roger Downey

Malcolm Clarke said...

I suggest to look on the products page of ZigBee.org and Continua Alliance to see the products being released that are interoperable across telecare and telehealth

Stephen Pattenden said...

Guy, I fully agree.
However, the roblem is far worse because the home especialy is potentially going to be full of devices that do things for systems in various sectors such as energy management, smart metering, security, home systems and assisted living systems. By and large they are all likely to be doing similar things or similar services for the same people in the same houses.
But they, almost without exception will have their own systems using their own profiles or specific protocols.
In terms of resources this is wasteful, in terms of operation by providers and consumers this is very confusing and in terms of technology, it will only be a matter of time before one system "kills" another with potential dangers for the consumer or patient.
This is a general Internet of Things issue and includes the Future Internet and the Cloud in its scope.
In TAHI (The Application Home Initiative) we developed an Interoperability Framework Requirements Specification (IFRS) which looked very hard at this issue and is being standardised by CENELEC. (CWA50560:2010 IFRS)
In particular it requires that any object, device, application, network, and a whole lot more, all have to:
1. Be Discoverable,
2. Have an unique ID
3. Have a description which will include access and management rights, what system, protocol or owner they have. Thus any object can specify what can be done with it and by whom.
This leads on to the concept of an Interoperability Ecosystem where objects and systems can be linked by apps, drivers or connectors.
The Ecosystem needs to describe how the apps can be found, invoked and where they can be downloaded from and at what cost. It also needs to describe what happens when a specific app is not available and how it can be specified and created abd by whom. It need to specify the monetisation of the ecosystem so all the stakeholders are rewarded and users pay a fair price.
TAHI is becoming the Smart Homes & Building Association and will be looking closely at the Interoperability Ecosystem but also at all the issues around applications and products in homes and buildings from multiple points of view.
The point of all of this is that the issue is not just a telehealth issue. It covers everyone at home and about and unless tackled holistically will not provide lasting and generic solutions.
Stephen Pattenden
Secretariat of SH&BA
See our LinkedIn Groups and website at www.shaba.eu

Andy Mackie said...

How about also the output being to a standard format so that it can be integrated with other devices, reported on and monitored automatically.

MelvinReynolds said...

@ Andy Mackie: ... which is precisely what IEEE 11073, HL7, IHE and SNOMED do (as a content-representation elements of a progression along a communications path) - and taken together constitute a large part of the Continua guidance - which adds, but retains some separation from, the ever-evolving delivery technologies.
Trouble is, it's not simple, and you only have to look at Guy's favoured office software, to realise that achieving full interoperability across all the components remains a challenge after >25 years. And that in a single organisation that could impose integration.
'Legacy' product is therefore both an advantage in terms of experience and a disadvantage in terms of freedom of manoeuvre to achieve interoperability.
Additionally, to Stephen P's point, the challenge coming rapidly over the horizon is the need for convergence of many disparate technologies if 'assisted living' is to be assistive rather than obstructive...

paul_tanner said...

I'm afraid that Interoperability is going to be a long time coming in this sector. If you look at the history in other ICTs I think you can predict what will happen here.

It's great that initiatives such as TAHI and others are pushing this forward. However, the real movement will come when those standards are adopted by suppliers. I contend that will only happen when buyers demand it and are prepared, if, necessary, to pay a premium for it.

Without this pull from buyers (and those system integrators who represent their interests) we will see continuing vendor behaviour that produces lock-in around proprietary technologies.

They don't do this for the hell of it. It's (arguably) just good business practice.

Paul Tanner

paul_tanner said...

I'm afraid that Interoperability is going to be a long time coming in this sector. If you look at the history in other ICTs I think you can predict what will happen here.

It's great that initiatives such as TAHI and others are pushing this forward. However, the real movement will come when those standards are adopted by suppliers. I contend that will only happen when buyers demand it and are prepared, if, necessary, to pay a premium for it.

Without this pull from buyers (and those system integrators who represent their interests) we will see continuing vendor behaviour that produces lock-in around proprietary technologies.

They don't do this for the hell of it. It's (arguably) just good business practice.

Paul Tanner

amaan raisel said...

Nowadays, there are many tools available in market. These tools used for analyzing traditional IP networks is Wireshark. Zigbee is an open source, textual protocol analyzer supporting many IP and non IP protocols.