MedSecurance Project: Advanced Security-for-Safety Assurance for Medical Device IoT (IoMT).

The MedSecurance project focus on identifying new challenges in cyber security with focus on hardware and software medical devices in the context of emerging healthcare architectures. In addition, the project will review best practice and identify gaps in the guidance, particularly the guidance stipulated by the medical device regulation and directives. Finally, the project will develop comprehensive methodology and tooling for the engineering of trustworthy networks of inter-operating medical devices, that shall have security-for-safety by design, with a strategy for device certification and certifiable dynamic network composition, ensuring that patient safety is safeguarded from malicious cyber actors and technology "accidents".

A Hand Motion Tracker Supporting Home-Based Rehabilitation for People with Hemiplegia due to Stroke.

Modern Wearable Medical Devices (WMDs), implement capabilities that have contributed significantly to patient outcomes, as well as quality of life. Using such devices can be beneficial for many patients, especially during the time of the pandemic where everyone had to isolate at home. This paper presents a proof of concept of a new low-cost technology-based approach to support home-based rehabilitation for people with hemiplegia aiming to assess the effectiveness of their home-based exercises thus making telerehabilitation sessions more effective.

Breaking Barriers in Emerging Biomedical Applications.

The recent global COVID-19 pandemic has revealed that the current healthcare system in modern society can hardly cope with the increased number of patients. Part of the load can be alleviated by incorporating smart healthcare infrastructure in the current system to enable patient's remote monitoring and personalized treatment. Technological advances in communications and sensing devices have enabled the development of new, portable, and more power-efficient biomedical sensors, as well as innovative healthcare applications. Nevertheless, such applications require reliable, resilient, and secure networks. This paper aims to identify the communication requirements for mass deployment of such smart healthcare sensors by providing the overview of underlying Internet of Things (IoT) technologies. Moreover, it highlights the importance of information theory in understanding the limits and barriers in this emerging field. With this motivation, the paper indicates how data compression and entropy used in security algorithms may pave the way towards mass deployment of such IoT healthcare devices. Future medical practices and paradigms are also discussed.

Emerging Wireless Sensor Networks and Internet of Things Technologies-Foundations of Smart Healthcare.

Future smart healthcare systems - often referred to as Internet of Medical Things (IoMT) - will combine a plethora of wireless devices and applications that use wireless communication technologies to enable the exchange of healthcare data. Smart healthcare requires sufficient bandwidth, reliable and secure communication links, energy-efficient operations, and Quality of Service (QoS) support. The integration of Internet of Things (IoT) solutions into healthcare systems can significantly increase intelligence, flexibility, and interoperability. This work provides an extensive survey on emerging IoT communication standards and technologies suitable for smart healthcare applications. A particular emphasis has been given to low-power wireless technologies as a key enabler for energy-efficient IoT-based healthcare systems. Major challenges in privacy and security are also discussed. A particular attention is devoted to crowdsourcing/crowdsensing, envisaged as tools for the rapid collection of massive quantities of medical data. Finally, open research challenges and future perspectives of IoMT are presented.

A Mobile Crowd Sensing Application for Hypertensive Patients.

Mobile crowd sensing (MCS) is an application that collects data from a network of conscientious volunteers and implements it for the common or personal benefit. This contribution proposes an implementation that collects the data from hypertensive patients, thus creating an experimental database using the cloud service Platform as a Service (PaaS). The challenge is to perform the analysis without the main diagnostic feature for hypertension-the blood pressure. The other problems consider the data reliability in an environment full of artifacts and with limited bandwidth and battery resources. In order to motivate the MCS volunteers, a feedback about the patient's current status is created, provided by the means of machine-learning (ML) techniques. Two techniques are investigated and the Random Forest algorithm yielded the best results. The proposed platform, with slight modifications, can be adapted to the patients with other cardiovascular problems.

Home-Based Training Support for Stroke Patients Using the Leap Motion and StandInExercise Stand.

Rehabilitation aims at brain rewiring through intensive practice following brain injury. This paper presents a new supportive mechanism that will be used to isolate wrist movement and in combination to the use of serious games, to act as a motivational tool to improve adherence during home-based practice. The paper describes the proposed methodology employed to carry out the home-based programme while leap motion is used to monitor and evaluate these exercises.

UMOD: A Device for Monitoring Postoperative Urination.

A Urine Monitoring Device (UMOD) has been designed and implemented for monitoring postoperative urination. This device has been created primarily to assist nurses and doctors monitor patients during their postoperative and recovery period. Furthermore, to reduce the burden of the nursing staff required to regularly monitor and empty the urine bags saving them precious time. The device consists of a stand and a load cell where the urine bag is attached. The stand is light and can easily move shall the patient require to move. An ESP Wi-Fi microprocessor module is used to calculate the rate of flow of urine in real time, identify and ignore any false readings due to accidental movements of the urine bag using an accelerometer and transmit the readings to a server / cloud through the local Wi-Fi.

The Artificial Pancreas: Reducing Safety Risk via Intra-Peritoneal Insulin Delivery.

The Artificial Pancreas is a medical device, currently in development, that aims to provide automatic regulation of blood glucose (BG) levels in ambulatory type 1 diabetes mellitus sufferers. The most popular approach utilises subcutaneous (SC) continuous glucose monitoring (CGM) combined with SC insulin injection controlled by a Model Predictive Control (MPC) algorithm. From a safety risk perspective problematic elements include the performance robustness of the CGM and the need for a pre-meal insulin bolus to provide satisfactory post prandial BG regulation. This contribution presents preliminary in silico studies which indicate that the use of an alternative approach to insulin delivery - intra-peritoneal (IP) infusion - could provide a similar level of BG regulation (as obtained with SC delivery), without the need for the pre-meal bolus. This simplified control architecture would remove the patient safety risk related to the administration (or not) of pre-meal bolus.

Totally Connected Healthcare with TV White Spaces.

Recent technological advances in electronics, wireless communications and low cost medical sensors generated a plethora of Wearable Medical Devices (WMDs), which are capable of generating considerably large amounts of new, unstructured real-time data. This contribution outlines how this data can be propagated to a healthcare system through the internet, using long distance Radio Access Networks (RANs) and proposes a novel communication system architecture employing White Space Devices (WSD) to provide seamless connectivity to its users. Initial findings indicate that the proposed communication system can facilitate broadband services over a large geographical area taking advantage of the freely available TV White Spaces (TVWS).

Cybersecurity and the Medical Device Product Development Lifecycle.

Protecting connected medical devices from evolving cyber related threats, requires a continuous lifecycle approach whereby cybersecurity is integrated within the product development lifecycle and both complements and re-enforces the safety risk management processes therein. This contribution reviews the guidance relating to medical device cybersecurity within the product development lifecycle.

Creating XML/PHP Interface for BAN Interoperability.

Recent advances in medical and electronic technologies have introduced the use of Body Area Networks as a part of e-health, for constant and accurate monitoring of patients and the transmission as well as processing of the data to develop a holistic Electronic Health Record. The rising global population, different BAN manufacturers and a variety of medical systems pose the issue of interoperability between BANs and systems as well as the proper way to propagate medical data in an organized and efficient manner. In this paper, we describe BANs and propose the use of certain web technologies to address this issue.

Implications and Modelling of Data Quality on Confidence of Clinical Decision Support: A Conceptual Framework.

Integrated care paradigms depend on multiple sources of data. The quality of data used in decision-making will ultimately affect the delivered care to the patient. Quality includes several dimensions, which may affect the result. This paper presents how data quality dimensions may affect the delivered service, and propose a conceptual framework for the classification of confidence in data used in clinical decision-making for integrated care.

The Challenges of Balancing Safety and Security in Implantable Medical Devices.

Modern Implantable Medical Devices (IMDs), implement capabilities that have contributed significantly to patient outcomes, as well as quality of life. The ever increasing connectivity of IMD's does raise security concerns though there are instances where implemented security measures might impact on patient safety. The paper discusses challenges of addressing both of these attributes in parallel.