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Applications of Wireless Sensor Networks in Healthcare

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DOI: 10.4018/978-1-5225-9004-0.ch002

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Chapter 2
Applications of Wireless
Sensor Networks in Healthcare
Ramgopal Kashyap
https://orcid.org/0000-0002-5352-1286
Amity University Chhattisgarh, India

ABSTRACT
Health is the key capability humans require to perceive, feel, and act effectively,
and as such, it represents a primary element in the development of the
individual and the environment humans belong to. It is necessary to provide
adequate ways and means to ensure the appropriate healthcare delivery based
on parameter monitoring and directly providing medical assistance. Wireless
sensor networks (WSNs), commonly known as the internet of things (IoT),
enable a global approach to the healthcare system infrastructure development.
This leads to an e-health system that, in real time, supplies a valuable set
of information relevant to all of the stakeholders regardless of their current
location. Economic systems in this area usually do not meet the general
patient needs, and those that do are usually economically unacceptable due
to the high operational and development costs. This chapter shows how recent
advances in wireless networks and electronics have led to the emergence of
WSNs in healthcare.

DOI: 10.4018/978-1-5225-9004-0.ch002

Copyright © 2020, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited.
Applications of Wireless Sensor Networks in Healthcare

INTRODUCTION

WSNs consist of spatially distributed autonomous devices to cooperatively

monitor real-world physical or environmental conditions, such as temperature,
sound, vibration, pressure, motion, pollution and location. This technology
is also widely used by military applications, such as battlefield surveillance,
transportation monitoring, and sensing of nuclear, biological and chemical
agents. Recently, this technology has developed and been widely used in
daily life as WSNs are low cost, low power, rapid deployment, have self-
organizing capability and cooperative data processing, including applications
for habitat monitoring, intelligent agriculture and home automation. The major
components of a normal WSN sensor node are a microcontroller, memory,
transceiver, power source and one or more sensors to detect the physical
phenomena. The structure of the sensor node is generally divided into four
major parts: sensing unit, processing unit, communication unit and power unit
(Hejlová & Voženílek, 2013). A sensor node sends the measurement of the
physical phenomenon to the sink which has bigger memory and processing
power. Depending on the application scenario, sometimes extra hardware is
added in the sensor nodes and a deployment strategy is devised. Normally, in
applications for WSNs the environment is unpredictable such as hostile, with
remote harsh fields or disaster areas, sometimes called toxic environments.
Hence, no standard deployment strategy existed the deployment usually
involves scattering or by possibly carrying out the application scenario (Brinis
& Saidane, 2016). Despite their quick deployment and significant advantages
over traditional methods, WSNs have to face various security problems because
of their nature and the possibility of the presence of one or more faulty or
malicious nodes in the existing network. There are many technically interesting
research discussions involving WSNs, such as development of models and
tools for the design of better WSNs architecture and elaboration of standard
protocols in WSN adapted to work robustly on certain scenarios. However,
one of the most important issues that remain subject to debate is security. The
emphasis in this chapter focuses on security in WSNs. More precisely, the
work focuses on investigating models preventing internal attacks on WSNs.

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 Applications of Wireless Sensor Networks in Healthcare

Internet of Things

The ability of everyday devices to communicate with each other and/or with
humans is becoming more prevalent and often is referred to as the Internet
of Things (IoT). It is a highly dynamic and radically distributed networked
system, composed of a very large number of smart objects. Three main
system-level characteristics of IoT are: Anything communicates; anything
is identified; and anything interacts. The basic and most important smart
object of IoT is a sensor node, or more precisely, Sensor Web (SW), which
can be defined as a web of interconnected heterogeneous sensors that are
interoperable, intelligent, dynamic, scalable and flexible (Zhang, Nagarajan
& Nevat, 2017). These smart objects are envisaged to provide smart metering,
e-health logistics, building and home automation and many new uses not yet
defined. The human health today presents the primary focus of an increasing
number of case studies and projects whose goal is healthcare improvements
and achieving the foundations for a global health system. Such systems should
provide information to the patients and their doctors, regardless of the location
where they are located. This is known as e-health, and today is closely related
to the Internet including and applying IoT concepts to such defined global
system, the possibility of its application for saving lives becomes unlimited.
Various e-health scenarios are enabled by rapid advancements in information
and communications (IC) technologies and with the increasing number of
smart things (portable devices and sensors). IoT powered e-health solutions
provide a great wealth of information that can be used to make actionable
decisions. By connecting information, people, devices, processes and context,
IoT powered e-health creates a lot of opportunities to improve outcomes
(Li, Jin, Yuan & Zhang, 2018). Some of the most promising use cases of
connected e-health include preventive health, proactive monitoring, follow-up
care and chronic care disease management. It can be stated that the IoT is a
disruptive innovation, which bridges interoperability challenges to radically
change the way in which healthcare will be delivered, driving better outcomes,
increasing efficiency, and making healthcare affordable. In order to track and
record personal data it is necessary to use sensors or tools which are readily
available to the general public. Such sensors are usually wearable devices and
the tools are digitally available through mobile device applications. These
self-monitoring devices are created for the purpose of allowing personal data
to be instantly available to the individual to be analyzed. The biggest benefit
of self-monitoring devices is the elimination of the necessity for third-party

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Applications of Wireless Sensor Networks in Healthcare

hospitals to run tests, which are both expensive and lengthy. These devices
are an important advancement in the field of personal health management.
Currently, self-monitoring healthcare devices exist in many forms this chapter
presents the creation of such system which will include everything user would
expect from a commercial system. In other words, by using inexpensive
hardware and open source software, it is possible to create a DIY (Do-It-
Yourself) system in such a way that own solution providing techniques to
end-users and the possibility to shape products according to their needs is
beneficial for both users and product developers. WSN for health care systems
transmit a large volume of data collected from several bodily sensors. Given
that the information regarding the health of an individual is highly sensitive
and critical, it must be kept private and secure. Consequently, it is important
to equip the system with mechanisms that would prevent unauthorized agents
from acquiring or tampering sensitive data that is transmitted over the network
and stored in dedicated repositories.
The aim of this chapter is to provide an Internet of Things based healthcare
information system intended for indoor and outdoor use where a methodological
approach to the design process is in focus. A distinguishing feature of this
approach is that the contracting authority’s and future users’ perspectives
and needs are included in most stages of the design process. Moreover, in
the approach, the designer from the beginning has to think comprehensively
to merge human and technical constraints and requirements. The user-driven
Design Methodology (DM) is used to solve the problems of the real-life
scenario of supporting seniors living alone, especially those with limited
abilities to manage their daily lives (Watanabe, Fukuda & Nishimura, 2015).
The conducted design process results in a system proposal that meets the
required assumptions. The conducted case studies verified that the designed
system, consisting of the Inertial Measurement Unit (IMU) with a built-in
three-axis accelerometer, gyroscope, magnetometer and altimeter, together
with Wi-Fi and heart rate modules and applying thresholding, Pedestrian
Dead Reckoning (PDR) and decision trees algorithms, works properly in the
tested real environment (Kuang, Niu & Chen, 2018). The achieved person’s
localization accuracy within one meter fits the required four room-zone
level localization accuracy in an apartment environment. The developed fall
detection algorithm proved effectiveness of 98%, and other required activities
were recognized with 95% compliance. Moreover, the behavior classification
algorithm is able to distinguish normal behaviors from suspicious and
dangerous ones, working properly in almost 100% of cases.

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 Applications of Wireless Sensor Networks in Healthcare

Motivation

Wireless communication is the transfer of information between two or more

points that are not connected by electrical conductors. Most of the wireless
communication technology uses radio waves in order to transfer information
between the points which are known as nodes. One application domain of
wireless communication is wireless sensor networks. WSN is a distributed
system, containing resource or constrained nodes that work in an ad hoc
manner using multi-hop communication. WSNs and Internet are integrated as
a new application area called IoT, covering almost every area in current daily
life (Xu, Collier & O’Hare, 2017). IoT encourages several novel and existing
applications such as environment monitoring, infrastructure management,
public safety, medical and health care, home and office security, transportation,
and military applications. Figure 1 shows the complexity of wireless sensor
networks, which translate sensing and identification activities into services
using WSNs with WSN middleware and access networking. It can use: (i)
different communication platforms such as WiFi, wireless LAN, 3G and 4G;
(ii) different devices which are based on different processors such as various
types of PDA, smartphones and laptops and (iii) all these platforms and
devices being built on different architectures such as centralized, distributed
or peer-to-peer. WSNs provide unprecedented ability to identify, observe
and understand large-scale, real-world phenomena at a fine spatial-temporal
resolution. The applications range from military to daily life. For example,
in community services WSNs can (1) provide early warnings for natural
disasters such as floods, hurricanes, droughts, earthquakes, epidemics; (2)
disseminate surveillance information for cities in parks, hotels, forests, to
support municipality service delivery; and (3) provide enjoyment of the city
by citizens and tourists through public services support such as monitoring
of water quality to ensure that citizens always have clean water or providing
free environmental information on the main tourist destinations. In general,
the network consists of a data acquisition network and a data distribution
network, monitored and controlled by a management centre. Security is an
inevitable need both in wired and wireless communication networks. The
ultimate security aim in both networks is to provide confidentiality, integrity,
authenticity, and availability of all messages in the presence of resourceful
adversaries (Aminzade, 2018). Every eligible receiver should receive all
messages intended for the message recipient and be able to verify the integrity

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Applications of Wireless Sensor Networks in Healthcare

Figure 1. The complexity of wireless sensor network

of every message as well as the identity of the sender. Adversaries should

not be able to infer the contents of any message.
In the wireless paradigm wireless sensor networks continue to grow
because of their application scenarios and cost effectiveness. A major benefit
of these systems is that they perform in-network processing to reduce large
streams of raw data into useful aggregated information. Protecting information
is critical. The traditional computer network security goal is to deliver the
message to the end user in a reliable way. The leading traffic pattern in the
conventional computer network is end to end communication. The message
content is not important beyond the necessary header (Monika & Upadhyaya,
2015). In this process the message authenticity, integrity and confidentiality
are usually achieved by an end to end security mechanism such as Secure
Socket Layer (SSL).

WIRELESS SENSOR NETWORKS

Wireless sensor networks have emerged as a feasible technology for a

myriad of applications, including many different health care applications.
WSN technology can be adapted for the design of practical Health Care
WSNs (HCWSNs) that support the key system architecture requirements
of reliable communication, node mobility support, multicast technology,

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 Applications of Wireless Sensor Networks in Healthcare

energy efficiency, and the timely delivery of data. The application of the
Wireless Sensor Networks in healthcare systems can be divided into three
categories: 1. monitoring of patients in clinical settings 2. Home & elderly
care center monitoring for chronic and elderly patients 3. Collection of long-
term databases of clinical data. Monitoring of Patients in Clinical Settings
Wireless medical sensor networks are becoming increasingly important for
monitoring patients in the clinical setting (Wang & Zhang, 2015). There
exists an overwhelming need for continuous and benign monitoring of more
and more physiological functions in a hospital setting. Sensors today are
effective for single measurements, however, are not integrated into a “complete
body area network”, where many sensors are working simultaneously on an
individual patient. Mobility is desired, but in many cases sensors have not
yet become wireless. This creates the need for the implementation of new
biomedical personal wireless networks with a common architecture and the
capacity to handle multiple sensors, monitoring different body signals, with
different requirements. The type and number of sensors must be configured
according to monitoring needs related to different diseases, treatment, and
the patient treatment life cycle. WMSNs systems have several advantages
over traditional wired systems such as ease of use, reduced risk of infections,
reduced risk of failures, reduced user discomfort, enhanced mobility, increasing
the efficiency of treatment at hospital, and lower cost of delivery.

Internet of Everything

Internet of Everything (IoE) contacts various parts of life, just a few cases
fuse related homes and urban zones, related automobiles and roads, or devices
that track a man’s lead and use the data accumulated for “push” organizations.
Different cases consolidate therapeutic sensors that enable tweaked e-Health,
and sensors that screen current equipment to increase use in collecting. Uses
of IOE run from the gimmicky to the beguilement changing, from advanced
cell empowered ease back cookers to trackers which prepared authorities when
anchored forests tumble to unlawful logging. Regardless, the significance of
IOE, generally called the web of things or the advanced web, is more than
singular things. It is the canny relationship of people, methodology, data,
and things. IOE incorporates three parts: the physical thing itself, sharp
fragments, for instance, sensors and programming, and accessibility with
a more broad structure, either between singular things, among things and
a central framework between various things and outside data sources. The

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Applications of Wireless Sensor Networks in Healthcare

blend is more than the entire of its parts; structures, for example, combine
commitments from control customers in homes and work environments with
commitments from control providers in plants and twist ranches to choose when
and where imperativeness is used, changing cost to reflect ask for and finally
decreasing general essentialness use. The fast improvement in data creation
and transmission, in any case, only a little bit of every single physical inquiry
on the planet are starting at now connected with IP frameworks (Snyder &
Byrd, 2017). Cisco assesses that under 1 percent of physical things are related
with IP arranges however the IoE is reaching out as more contraptions and
customers are interfacing with IP sorts out every day, driving more trades
and techniques on the web. For individuals, the impacts of the IoE are felt
step by step. Sensors embedded in shoes, for example, track the divisions
that wellbeing aficionados run and subsequently exchange information to
web-based systems administration profiles to rapidly differentiate athletic
achievements and those of sidekicks. Web engaged wake-up clocks amass data
on atmosphere and development, uniting that information with a customer’s
logbook, choosing the perfect time to wake neighborhood occupants. In
addition, applications on cutting edge cell phones can control home electronic
devices, changing warming and cooling levels and furthermore preparing
security settings remotely (Papers, 2018). At a cutting edge level, applications
using sensor headways are getting gigantic measures of data to improve
fundamental initiative. Sensors introduced in plant fields screen temperature
and soddenness levels, controlling water framework systems. Contraptions
in oil fields moreover, significant well mechanical assemblies track all
parts of infiltrating and fuel movement, growing age efficiency. Moreover,
sensors in vehicles can screen usage, lighting up decisions around refueling
and repair and furthermore vehicle plot. For governments, IoE and gigantic
data applications are checking pandemics and common conditions improve
open prosperity and security, and augmentation viability in the transport of
open organizations, for example, common development structures that wire
steady remote checking to streamline movement streams.

Solid Pillars of IoE

There are four mainstays of IoE: People, Process, Data and Things extended
accessibility can enhance each bit of the IoE star gathering, from work process
efficiencies to quiet satisfaction and results.

15
 Applications of Wireless Sensor Networks in Healthcare

Individuals: The accessibility given by IoE improves the idea of solution

for everyone included. Patients are spared from giving monotonous data at
different reasons for area. Their recuperating office encounter is enhanced
through chronicles that illuminate more about their affliction or condition,
expanding their base of data. Test outcomes are more provoke. Their
prosperity history is accessible to each boss in their line of care, empowering
correspondence and composed exertion. Basic information is passed on to
the patient through various reasons for relationship from wearables, tablets
or propelled cells. Undoubtedly, even seemingly insignificant details, like the
ability to ask for sustenance direct from the dietician, improve the patient’s
contribution and satisfaction scores as shown in figure 2.
Process: New development is basically especially to address the issue of
waste in therapeutic work process. Testing gives an average representation.
Consistently test occurs remain new until the point that the therapeutic guardian
or pro has space plan astute to check their fax or inbox. Information can be
examined at the Internet edge, sorted out by alert level and sent clearly to a
parental figure to make a move as required (Papers, 2018). A broad number
of assignments are holding up to be automated endeavors that will save time,
diminish expenses and improve calm outcomes. As patients are diverted to
more appropriate personality settings, weight on the triage staff is remarkably

Figure 2. Strong pillars of internet of everything

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Applications of Wireless Sensor Networks in Healthcare

diminished. Turning away silly certifications maintains a strategic distance

from misuse, while it redesigns staff time for those most in require.
Data: This area of IoE holds the best assurance for setting up upgraded
methodologies for social protection movement. Over 78% of prosperity
providers nitty gritty they were gathering electronic data, despite the way
that the information has a tendency to sit away unexploited. A conventional
social protection head has distinctive applications that assemble and extra
information anyway little is done to change over that data into critical
encounters for a pro, sustain or other provider (Kashyap and Gautam, 2017).
Endeavoring to vanquish these obstructions, Cisco is making it possible to
securely facilitate and sever down data without exchanging tolerant protection.
Information imperative to providers as appeared in figure 3, it can be a tick a
long way from aiding in a care decision. Think about the vitality of promptly
differentiating a patient’s history and those in equivalent conditions. In a
moment acknowledge what worked, what didn’t.
Think about it from a patient’s perspective, especially in the occasion that
they’ve changed starting with one specialist then onto the next rather than sit
tight for a patient to recuperate printed duplicates of X-beams or diverse films,
imagine that they are open instantly through the Internet. Cisco’s ensured
affiliations are lessening downtime as they strengthen remedial fundamental
administration limits.

Figure 3. Challenges in the future

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 Applications of Wireless Sensor Networks in Healthcare

Things: In the Internet of Everything (IoE) things, are motivations behind

affiliation. In the space of medicine these range from cutting edge cell phones
and PCs to wearables and other complex helpful devices. The building that
offers learning to these things is the Cisco compose information is made
by requesting calm information, recognizing issues, and advised parental
assumes that healing movement is required.

Eventual Fate of IoE for Society

As billions and even trillions of sensors are set the world over and in our
atmosphere, we will get the ability to really hear our existence’s “heartbeat.”
Indeed, we will know when our planet is strong or wiped out. With this
suggests understanding, we can begin to execute a portion of our for the
most part pressing difficulties, including hunger and ensuring the openness
of drinkable water. Craving: By appreciation and envisioning whole deal
atmosphere outlines, agriculturists will have the ability to plant trims that
have the absolute best for accomplishment (Condon, 2018).
Likewise, once the fields are harvested, more powerful (and, as needs be,
more reasonable) transportation structures will think about the allocation
and movement of sustenance from places where there is riches to spots
where there is lack. Drinkable Water: While IoE will be notable make water
where it is required most, it will have the capacity to settle a robust part of

Table 1. Organizations benefit by five core drivers of IoE value

S.N. Industry Benefits Role of IoE Example

Enhanced capital capability cost of
Asset benefit and cost Shrewd structures, splendid
1 items diminishments and improved
diminishments creation lines
business plan execution
Possible destiny of work,
Enhanced work profitability less or
2. Delegate productivity bring your own specific
more gainful individual hours
contraption”, Versatility
Creation system and Enhanced process profitability Savvy arrange essentialness
3.
coordination’s adequacy lessened creation organize waste capability
Enhanced research, headway, and
Higher nature of things and
4. Improvement building, speed, New designs of
organizations
activity and wellsprings of salary
Related advancing and
Enhanced customer lifetime regard publicizing, related guideline
5. Customer Satisfaction
extra bit of the pie (more customers) Effects of the change of the
Internet of Everything

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Applications of Wireless Sensor Networks in Healthcare

the issues that reduce our perfect water supply, for instance, mechanical
waste, unsustainable agribusiness, and poor urban organizing. For example,
splendid sensors arranged all through a city’s water system will recognize
when there is an opening and normally divert water to avoid pointless waste.
A comparable sensor will prepared utility personnel with the goal that the
issue can be settled when resources are open. Associations benefit by five
fundamental drivers of IoE Value is appeared in table 1.

Business Strategies

The move from thing provoked organizations drove affiliations is one of the
movements this move in business method has group recommendations for an
open or private-division affiliation. Open and private fragment affiliations
have started getting device driven game plans or Internet of everything
answers for drive business handle efficiencies. Affiliations get these IoE
courses of action whether clear sensors to screen fabricating plant rigging or
applications to screen task force vehicles to help control working or capital
costs (Papers, 2018). We trust affiliations that start using IoE answers for cost
control will expand and overhaul their responses for support progression. This
advancement will drive thing driven relationship to expand their portfolios
to join more organizations. The IoE is one of the enabling advances in the
improvement of the IoE world, and by abusing; it will help relationship of
grouped sorts to see the broader plan of chances IoE affiliations make possible
that is appeared in figure 4, how internet will change the lives.

Human Interaction With Technology

IoE courses of action increase levels of correspondence amongst individuals

and advancement this extension in participation gets from the way IoE
development is used. There is an exponentially extending estimation of IoE
game plans as the human-to-advancement commitment exhibits increases
and the explanation behind the IoE course of action gives more opportunities
to one-way and two-course collaboration amongst things and people. See
Figure 4. Underneath we depict four sorts of advanced courses of action and
demonstrate the impact on human-to-development association.

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 Applications of Wireless Sensor Networks in Healthcare

Figure 4. Internet of Everything’s

(Kashyap R, and Pearson A., 2018a)

Development Adoption

The change of the IoE affect influences advancement, Systems/Connectivity

IoE courses of action will rely upon hybrid frameworks and system. Various
open and private-fragment affiliations will pass on game plans that adventure
of frameworks with expanded SLAs, security and extension characteristics
that fit the necessities of the IoE game plan. Most related device courses of
action today rely upon either settled or flexible frameworks for accessibility
with little ability to pick the best framework over a given working period. This
nonattendance of versatility brings about an answer with bring down general
quality. IoE courses of action will misuse cream frameworks organization

20
Applications of Wireless Sensor Networks in Healthcare

approaches that fuse 3G/4G/5G remote, Ethernet, diverse short-go arrange

contributions, satellite correspondences and others.

Why IoE Is Important to You

The IoE raises your remedial I.Q. by giving you the right information, at
the perfect time and in the advantageous place. In any case, it engages
you to streamline your work procedure. Clear things, for instance, wiping
out time spent get-together monotonous calm information can in a general
sense cut down your cost of organization, free staff to perform distinctive
commitments and give greater quality patient/master time. Redesigned calm
outcomes and high patient satisfaction scores would increment be able to
wage by raising your level of outcast portions course of action advancement
is changing things. Once made only out of mechanical and electrical parts,
things have ended up being capricious systems that unite gear, sensors, data
storing, microchips, programming, and accessibility in load ways. These
“keen, related things” rolled out possible by tremendous improvements in
getting ready power and device downsizing and by the framework points of
interest of inescapable remote accessibility have released some other time of
competition (Condon, 2018). The changing method for things is furthermore
disquieting quality chains, convincing associations to reexamine and retool
all that they do inside. These new sorts of things change industry structure
and the method for competition, introducing associations to new forceful
open entryways and perils. They are reshaping industry breaking points and
making absolutely new endeavors. In numerous associations, astute, related
things will oblige the fundamental inquiry, “What business am I in?” related
things raise another course of action of indispensable choices related to how
regard is made and gotten, how the gigantic measure of new data they make
is utilized and regulated, how relationship with ordinary business assistants,
for instance, channels are rethought, and what part associations should play
as industry limits are broadened. The articulation “Web of Everything’s” has
risen to reflect the creating number of splendid, related things and feature the
new open entryways they can address (Ghoneim & Hussain, 2015). Anyway
this articulation isn’t astoundingly strong in understanding the wonder or its
recommendations. The web, paying little mind to in the case of including
people or things, is essentially a framework for transmitting information. What
makes sagacious, related things basically unprecedented isn’t the web, but
instead the changing method for the “things.” It is the expanded capacities of

21
 Applications of Wireless Sensor Networks in Healthcare

splendid, related things and the data they deliver that are presenting another
time of competition. Associations must look past the progressions themselves
to the engaged change happening. This structure engages remarkable new
thing capacities. In the first place, things can screen and give their own one
of a kind record condition and condition, making in advance difficult to
reach bits of information into their execution and use. Second, complex thing
activities can be controlled by the customers, through different remote get
to decisions that gives customers the exceptional ability to alter the limit,
execution, and interface of things and to work them in hazardous or hard to
accomplish conditions. Third, the blend of checking data and remote-control
limit makes new open entryways for upgrade. Figurings can liberally improve
thing execution, utilize, and uptime, and how things work with related things
in more broad systems, for instance, splendid structures and canny farms
(Kashyap, Gautam & Tiwari, 2018). Fourth, the blend of checking data,
remote control, and streamlining computations licenses independence. Things
can learn, change in accordance with nature and to customer tendencies,
advantage themselves, and work isolated.

THE IOT AND E-HEALTH

To improve human health and well-being is the ultimate goal of any economic,
technological and social development. The concept of the IoT entails the

Figure 5. Confluence brought by the IoT

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Applications of Wireless Sensor Networks in Healthcare

use of electronic devices that capture or monitor data and are connected to a
private or public cloud, enabling them to automatically trigger certain field
of healthcare. McKinsey Global Institute in its report presents predictions
and economic feasibility of IoT powered healthcare, which states that by
2025 the largest percentage of the IoT incomes will go to healthcare as shown
in Figure 5. Internet-connected devices, introduced to patients in various
forms, enable tracking health information what is vital for some patients
(Kashyap & Tiwari, 2018). This creates an opening for smarter devices to
deliver more valuable data, lessening the need for direct patient-healthcare
professional interaction (Ghoneim & Hussain, 2015). With faster, better
insights, providers can improve patient care, chronic disease management,
hospital administration and supply chain efficiencies, and provide medical
services to more people at reduced costs. The IoT has already brought in
significant changes in many areas of healthcare. It is rapidly changing the
healthcare scenario by focusing on the way people; devices and applications
are connected and interact with each other (Figure 5). Hence, it can be
concluded that the emerging technology breakthrough of the IoT will offer
promising solutions for healthcare, creating a more revolutionary archetype
for healthcare industry developed on a privacy/security model.
Typically, IoT powered e-health solution includes the following functions:
Tracking and monitoring (e.g. patient monitoring, chronic disease self-care,
elderly persons monitoring or wellness and preventive care); Remote service;
Information management; Cross-organization integration (Abdelwahab,
Hamdaoui, Guizani & Rayes, 2014). The requirements of IoT communication
framework in e-health applications are: Interoperability is needed to enable
different things to cooperate in order to provide the desired service. Bounded
latency and reliability are needed to be granted when dealing with emergency
situations in order for the intervention to be effective. Authentication, privacy,
and integrity are mandatory when sensitive data are exchanged across the
network. A different technologies and architectures of IoT for healthcare can
be found but next building elements are common for all of them: Sensors
that collect data (medical sensors attached with the patient to measure vital
parameters, and the environmental sensors which monitor the surroundings of
the patient); Microcontrollers that process, analyze and wirelessly communicate
the data; Microprocessors that enable rich graphical user interfaces; and
Healthcare-specific gateways through which sensor data is further analyzed
and sent to the cloud. In the next chapter a cheap solution for building IoT
healthcare sensing devices will be presented.

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 Applications of Wireless Sensor Networks in Healthcare

Self-Monitoring Device

The main application domain of body sensor network (BSN) a network of

sensors attached to the human bodies is continuous health monitoring and
logging vital parameters of patients. In other words, these networked systems
continuously monitor patients’ physiological and physical conditions, and
transmit sensed data in real time via either wired or wireless technology to a
centralized location where the data can be monitored and processed by trained
medical personnel. Medical devices must use a variety of design techniques
to protect the underlying design as well as protect the sensitive data stored
within or transmitted to/from the device. Many personal health monitoring
devices must also be portable, so they need to be small, lightweight, and
low-power (Peng, 2015). In order to build own health monitoring device with
aforementioned characteristics, this chapter proposes a usage of ultra-cheap-
yet-serviceable, small and powerful computer board - Raspberry Pi (RPi). A
RPi has built in support for a large number of input and output peripherals
and network communication, and it is the perfect platform for interfacing
with many different devices and using in a wide range of applications. An
intelligent home monitoring system based on ZigBee wireless sensors to
assist and monitor the elderly people. The performance of their developed
system was evaluated by running the system at four different elderly houses
and recording the data and simultaneously performing the activity recognition
in real time. The houses were equipped with the wireless sensor network with
the fabricated sensor units attached to various house-hold appliances (Chen,
2016). Six electrical sensors are connected to appliances Microwave, Toaster,
Water Kettle, Room Heater, TV and Audio. Four force sensors are connected
to Bed, Couch, Dining chair and Toilet. One contact sensor is connected to
grooming table and one temperature and humidity sensor to monitor the
ambient environment readings. A laptop was installed with the developed
intelligent software connected with ZigBee module acted as the coordinator
associated with WSN to collect and monitor the elder’s behavior. Growth of
the elder population has given rise to the increasing demand for long-term
elder-care facilities. The majority of elders living in such facilities are suffering
from multiple chronic illnesses. Due to these illnesses, the elderly physical
and mental health is slowly declining. In order to detect these declines early,
continuous tracking of the elders’ daily activity is required and integrated a
45-node WSN-based location system in NTUH-BH to automatically track the
elder’s daily mobility (Chao & Hsiao, 2014). They collected location traces

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Applications of Wireless Sensor Networks in Healthcare

and investigated the daily and long-term mobility of four volunteering elders
for eight months. Following are the findings of their study: “Each elder’s
daily mobility shows a reoccurring pattern. The pattern, however, differs
from individual to individual. The mobility level, the total distance the elder
moves in the facility per day, shows a stronger variability. Not all elders show
reoccurring patterns in mobility levels. Some of them are spontaneous moving
from event to event.” From these observations, it was concluded that long term
location tracking, not just the mere quantity of mobility, allows discovery of
the moving patterns and in turn making early detection of the elders’ physical
or mental problems possible. The web-based system was responsible for
inferring high-order information about the activities of the condo’s occupant
and supporting the visualization in 2D Geographic Information System
(GIS) and a 3D virtual world. They believe that one of the most innovative
aspects of their project is the use of virtual world, a virtual world platform,
for visualizing the activities of the condo tenant through an avatar. Only 9%
of physicians work in rural areas, however, almost 20% of the population of
the US lives in rural areas. There is a big shortage of physicians and specialist
in the rural areas. Wireless Medical Sensor Networks technology has the
potential to alleviate problematic patient access issues. At-home care can
provide many advantages in terms of financial benefits, improved quality of
life for patients, and more effective fall detection prevention or monitoring
of many long-term chronic diseases (Domingo, 2014). Collection of Long-
Term Databases of Clinical Data Sensors links the physical with digital
world by capturing and revealing real-world phenomena and converting these
into a form that can be processed, stored, and acted upon. The data that is
gathered by the sensors in a WMSN can be used in two ways: 1. Healthcare
applications that leverage wireless sensor networks analyze the data gathered
by sensors to infer and make decisions about the state of a patient’s health and
wellbeing by improvement in monitoring consistency, continuous monitoring
enhances data quality and precision for decision support leading to better
titration of therapeutic interventions. 2. The continuous gathered data can be
analyzed utilizing computational intelligence techniques to find solutions to
the unsolved problems in the healthcare system.

Security and Privacy Concerns of IoT Powered E-Health

The realization of the IoT generally requires dramatic changes in systems,

architectures and communications which should be flexible, adaptive,

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 Applications of Wireless Sensor Networks in Healthcare

Figure 6. Security challenges in IoT

secure, and pervasive without being intrusive. The experts anticipate that the
technologies of the IoT will bring forward critical developments in the areas
of ethics, data protection, technical architecture, standards, identification
of networked objects and governance. In other words, as more intelligent
devices are connected to the Internet, the potential privacy implications and
general false sense of security associated with weak key management and
data compromise becomes critical (Scott & Mars, 2013). Thus, security
(protection of data and privacy) represents a critical component for enabling
the widespread adoption of IoT technologies and applications (Figure 6).

WSN Health Care System

Research group in Jönköping University has been research on the WSN health
care system field for several years and has made remarkable achievement and
great contribution on it. This group has established a relatively comprehensive
WSN Health Care System theory and has developed a prototype to do
experiment on it. Our gateway designs as part of Health care system base on
the existing WSN Health Care System prototype in Jönköping University.
See figure 7. This prototype consists of three parts.
The first part is monitoring sensor networks. It consisted of body sensor
networks and home sensor network (HSN). BSN are sensor nodes attached on
old people’s body and provide the on body sensing information of him or her.

26
Applications of Wireless Sensor Networks in Healthcare

Figure 7. Component setup of the wireless health care system

HSN are group of location-fixed sensor nodes with multiple sensors providing
temperature, relative humidity, light sensors, microphone, and so on. HSN is
distributed in living room, bedroom, kitchen, bathroom and corridor hiding
in the sofa, bed or chairs. The second part is the access devices, which mean
gateway. This gateway is usually a base station of the home sensor networks,
which provide an interconnection between the monitoring sensor networks
and central server system via Public Communication Network (PCN). It has to
handle the connection problem between multi network communications. The
third part is central server. It can be divided into four sub-parts: a conceptual
database, a decision mechanism, a smart application gateway and a service
management platform. The conceptual database is used to store the profiles
information of the elders, the normal data collected by the sensor systems, the
detection result, and report or alarm logs. Decision mechanism use Hidden
Markov Model to detect the elder’s coming action and health state. Once the
dangerous situation is detected, the decision mechanism will drive the smart
gateway to issue an alarm to the relatives to report the emergency situation
(Morain, Kass & Grossmann, 2016). The service management platform is an
interface of the whole system. The smart application gateway can establish
communication with the caregivers to report the situation of the elders.

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 Applications of Wireless Sensor Networks in Healthcare

Gateway

A gateway may contain devices such as protocol translators, impedance

matching devices, rate converters, or signal translators as necessary to provide
system interoperability. In the health care system, central server in HCC,
which is “far away”, cannot send requests or receives any data directly from
WSN. That is because central server is not within the coverage of WSN, It
can only access services of a WSN through PCN but sensors nodes in WSN
do not have the necessary protocol component at its disposal to communicate
with PCN and thus requiring the assistance of a gateway. Gateway acts as a
proxy for the set of sensor nodes in WSN. It represents all WSN to answer
the requests from HCC (Pesko et al., 2014). In this way, on one side, sensor
node does not have to know the existence of HCC and can dispense with all
mechanisms connect to PCN. On the other side, central server in HCC does
not have to handle multi-hop routes in the sensor network anymore to find
the exactly node with the rapid development of embedded system hardware,
gateway becomes more and more powerful due to better and better resources
e.g. faster control unit and bigger memory. These make it possible that some
tasks which originally belong to the central server can be transferred to the
gateway. In this way, we can move the processing intelligence closer to the
sensing device.

System Overview

Base on the system development research method, it is important to investigate

the functionality and requirements of the smart gateway at the beginning.
On one hand, the requirements analysis takes the system specification and
project planning as a basic starting point of activities analysis, and performs
inspection and adjustment from the software point of view; on the other
hand, the requirements specification is the main basis of software design,
implementation, testing and maintenance. The WSN health care system
architecture is illustrated in figure 8. The whole system consists of four parts.
The first part is the monitoring object; means elder’s home where sensor nodes
are probed to get multiple data of old people likes behave, activity, health
state, and living environment information. Health care system has many old
people, so this monitoring object is a plural. The second part is the monitor
healthcare center, main job of healthcare center is to monitor health state
of all old people in this system and make sure the normal operation of the

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Applications of Wireless Sensor Networks in Healthcare

Figure 8. WSN health care system architecture

entire system (Dogan, 2016). Center server is located there to save necessary
information of the elderly and provides variety of monitoring methods to
indicate the current situation of the elder. Third part is care-givers including
doctors or nurses in the hospital and the old people’s relatives. They are
responsible for dealing with the report message (normal or alarm message,
from internet or SMS) that sent to them. They can also check the elder’s current
state through webpage which provide by Healthcare care. The fourth part is
PCN including Internet, GSM/GPRS, Ethernet, and WI-FI. PCN connects
all the other three parts together.
From this figure, we can see that gateway belong to part one (monitoring
object), and it acts as bridge between WSN and PCN, offering multi
communication ways to make sure required message can be transmit to desire
destination. Detail requirements of smart gateway design are as follow: 1)
Providing a mechanism to connect the WSN base station (sink) and received
sensor collection data from it or send command to WSN. 2) Providing DB to
save sensor data. 3) According to the current input sensor data and data stored
in DB, determine the current health status of the elderly. 4) Sending notify to

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 Applications of Wireless Sensor Networks in Healthcare

HCC periodically through internet if the old people’s state is normal. Send
urgent notify to HCC through Internet and SMS to caregivers through GSM
network. 5) Providing WLAN connection for short distance wireless devices
like PDA and laptop so that they can access to the DB and receive notify.
6) Receiving and execute commands from HCC. 7) Providing management
software to control the working flow of all the requirements that mention
above. 8) Providing fast enough processor, big enough memory and adequate
external ports for these system requirements.

Hardware Structure

In the previous section, we have mentioned the requirements of smart gateway.

First thing to do is, base on these requirements, consider the whole smart
gateway as a black box so that we can see the external interface of it clearly.
For hardware design, these requirements can be grouped into three different
categories. This can be reflected in figure 9.
Combining this figure with the above-mentioned requirements, the design
of the gateway can be divided into three parts. WSN connection mechanism,
interconnection section and center control unit. See figure 3-5 the first part
is WSN connection mechanism, smart gateway has to receive data from
sensor nodes and gives commands to them. To achieve this goal, smart

Figure 9. Smart gateway architecture

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Applications of Wireless Sensor Networks in Healthcare

Figure 10. Intelligent model architecture

gateway has to provide mechanism to join into the WSN. Through this part,
smart gateway provides connection to WSN in both hardware and software
ways. At hardware way, smart gateway has to handle interface compatible
and signal translation and rate conversion. For software, it has to translate
the protocol using in WSN and extract the valuable data which can be used
by the program using in smart gateway (Serdaroglu & Baydere, 2015). In
simple model, gateway acts only as a protocol translator and data transmitter.
Architecture of simple mode is shown in figure 10. It just connects to the
WSN on one side and HCC on the other, and transmits data packets between
these two sides without storing them. Elderly health status monitoring, data
storing, mote status monitoring, and send alarm and question message to
hospital and relative works are pass to the central server.
Intelligent model is on the contrary to it. Smart gateway becomes the central
part of the whole system. It takes responsible for most of the data processing
works, like data analysis and storage, elderly status, mote status and WSN
status monitor works are distributed to it. In normal situation in intelligent
model, gateway sent health status report to HCC regularly (Allegretti, 2014).

31
 Applications of Wireless Sensor Networks in Healthcare

Alarm and question messages will also be sending to hospital and relatives
by smart gateway when those situations are detected. Furthermore, gateway
in intelligent model also provide WLAN access capabilities to facilitate the
use of system maintainers and elder’s relatives to check the operation status
of the smart gateway by laptop or PDA when they are closed to the smart
gateway. Architecture of WSN Healthcare System in intelligent model is
shown in figure 10.

HEALTHCARE IOT INFRASTRUCTURE ARCHITECTURE

The components of the healthcare IoT consists of an Information perception

layer that is responsible for collecting physiological parametric data such
as temperature, blood pressure, oxygen saturation, heartbeat rate, etc. of
patients. The data collection is by sensors or actuators that are connected to
medical wearables or implantable devices fixed into the human body. This
collected data is transmitted via wireless sensor network technologies like
infrared, Bluetooth, NFC, etc. to a dedicated device such as a mobile phone,
dedicated monitor or home computer that is then used to aggregate the data.
Once the data is collected and aggregated (Kashyap & Piersson, 2018b),
it is transferred to the network transmission layer that is responsible for
carrying the data to the application layer that includes a remote HIS service.
Conventional internet technologies such as data networks, wired or wireless
connection are used in transmitting the data (Chachin, 2017). The collected
information is then processed at the application layer and sent back via the
same communication channel to the patient.
We see from the described communication flow that every layer of the
architecture has a potential to be exploited because they all serve as entry
points into the system. If incorrect data is sent to the application layer and if
appropriate data correlation techniques are not implemented and erroneous
data gets undetected, then there is a possibility that a patient’s life can be in
danger. Also, if the functioning of a health information system (server) that
returns a processed data to the client is tampered with, the patient still gets
exposed to danger. The communication channel that transmits data from the
patient to the remote HIS can also be an entry point to intercept the data that
is being communicated. An attacker may gain remote or physical access to
the HIS to modify the data that is being sent or better servers can be affected

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Applications of Wireless Sensor Networks in Healthcare

by a denial of service attack or even ransom ware attacks which have been a
common trend in healthcare IoT industry within the last two years.

Security Issues of Healthcare IoT Infrastructure

Wireless Sensor Network Attacks

The data collection layer in healthcare IoT is exploited such that the data that
is sent to the neighboring devices is intercepted and manipulated causing
non-integrity, or non-confidentiality of data (Diaz & Sanchez, 2016). This
layer consists of RFIDs, sensors, and actuators. Attacks can come in the form
of the following:

Sensor Jamming

This can be used to deny communication between two devices. With this, an
attacker can prevent a device from communicating with another device and
then connect a rogue device in the process in what can be a man in the middle
attack as explained. The chapter further describes how a Bluetooth enabled
mobile device was jammed so that a rogue device can then communicate with
the healthcare IoT implantable device to stage a replay attack.

Eavesdropping

An attacker can intercept communication between devices by sniffing the

packets and using the data collected to the advancement of another attack.
In the attack illustrated in, there was a need to capture the packets to know
the packet size and what and what needs to the manipulated

Spoofing

An attacker can use manipulate a device to think that it is communicating

with another authenticated pair by broadcasting a rogue device as the original
device. The researchers showed a simulation of an attack on a selected health
IoT application by spoofing a device to establish a Bluetooth connection.
Masquerading like an original device also makes the attack difficult to
detect as the communicating device thinks it is communicating with an

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 Applications of Wireless Sensor Networks in Healthcare

authenticated device, an attacker would have used other methods to generate

the authentication credentials.

Data Aggregators Vulnerabilities

The data aggregators are classified with sensor-enabled devices as part of the
BANs. Mobile smartphones, dedicated health mobile devices, and desktop
health monitors etc. all fall into this category and is a threat to the healthcare
IoT system. These devices come with dedicated software applications that are
pre-configured to match the operation of a sensor device. Misconfiguration
can lead to a device being exploited for an attack. The software can also be
exposed to malware attacks since these devices are connected to the internet. If
physical security is breached, a malicious user can physically send erroneous
data through the device also since patients will use these devices, the usability
of rigorous security mechanisms may not be convenient.

Social Engineering

Social engineering techniques can be used to gain access physically or remotely

into the system. An attacker can disguise as a sick patient to gain access into
a hospital and then use rogue means to discover how a hospital IT system
is being set-up. He can also use shoulder surfing technique to discover the
access credentials of the system. Although this may not be very realistic, a
motivated and well-coordinated attack might be successful.

DISCUSSION

This exploit semantic web technologies for several reasons firstly, semantics
enables an explicit description of the meaning of sensor data in a structured way,
so that machines could understand it. Secondly, it facilitates interoperability
for data integration since heterogeneous IoT data is converted according
to the same vocabulary. Thirdly, semantic reasoning engines can be easily
employed to deduce high-level abstractions from sensor data. Fourthly,
context-awareness could be implemented using semantic reasoning. Finally, in
theory, semantics eases the knowledge sharing and reuse of domain knowledge
expertise which should avoid the reinvention of the wheel. Indeed, each time
a new domain specific vocabulary is defined. Semantic web technologies are

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Applications of Wireless Sensor Networks in Healthcare

becoming very popular and are adopted by companies such as Google and
Yahoo. Google introduces the idea of the knowledge graph to connect and
structure the data with each other. Moreover, ’Linked data’ is more and more
popular to share and reuse data to build and enhance rich web applications
with little effort. The benefits of the ubiquitous connectivity in the Healthcare
industry cannot be over-emphasized. In-fact it outweighs the possible attacks
predicted in this chapter considering the over 2.5 million people that rely on
IMDs in the United States. However, an increasing number of users come
with increased attention from manufacturers, security researchers, attackers
and defenders. It is therefore important to understand some of the threats that
are likely in this domain. The outcome of our research shows that an attack
does not require a high sophistication to generate a physical result. Contrary
to the claims that cyber terrorism is not a near threat due to sophistication of
attacks; this chapter has helped to understand clearly that there is a possibility.
Terrorist organizations can opt for the less sophisticated attacks that will be
less expensive to carry out and require a moderate level of technical-know
how. In the United Kingdom Cyber Security Strategy document for the year
2016 – 2021, it was highlighted that the technical capabilities of terrorists
remain limited while they aim to destabilize the computer network operations
in the UK, publicity and disruption remains their cyber goal. The same
document also emphasizes that for us to measure the success of a government
in preventing terrorism, there is a need to fully understand the risk posed by
cyber terrorism and the cyber threat from terrorist actors and hostile nation
states. This can be achieved through identification and investigation of cyber
terrorism threats. This chapter is a valuable input that addresses some of the
concerns raised in the cyber security strategy document as it lays emphasis
on attacks that create physical results which is one of the goals of a terrorist
organization. The output of this chapter further proves the statement that
“terrorists will likely use any cyber capability to achieve the maximum
effect possible”. “Thus, even a moderate increase in terrorist capability may
constitute a significant threat to a state and its interest”.

CONCLUSION

The rapid development of technology and the Internet leads to growing

applications of new technological solutions at the global level. With the
appearance of the Internet of Things concept, elements, such as sensors and
sensor networks, are becoming available and applicable in all fields of human

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 Applications of Wireless Sensor Networks in Healthcare

activity, thus providing conditions for the creation of expert systems that can
operate anytime and anywhere. Following these trends, an indispensable
application of it is in healthcare where the application can be found in
health monitoring, diagnostics and treatment more personalized, timely
and convenient. All of this significantly improves health by increasing the
availability and quality of care followed with radically reduced costs. Due
to the lengthening of life expectancy, society is aging, and more and more
people live to an older age. Therefore, it is highly important to assure life
quality and safety. Existing and emerging technologies can provide tools that
can support elderly people in their everyday life, making it easy and safe.
This chapter concerns the design methodology of such tools especially for
indoor and outdoor localization, health monitoring, fall detection and behavior
recognition and classification. The authors propose the design methodology for
the IoT-based home care information system intended for indoor and outdoor
environment use. The presented DM approaches the home care problem not
only from the designer’s perspective, but also considering the contracting
authority’s and potential users’ requirements, which means that apart from
the technical requirements, the design procedure considers the multifarious
constraints, including the lifetime, energy issue, usage comfort and even the
price. The DM was verified with a case study of real-life scenarios where there
is a need for supporting elderly people, especially those of limited mobility
living alone. The desire stated by the stakeholders and future users required
the system for identifying people’s position and their vital signs, but also to
be able to recognize basic activities, especially falls, and to classify them as
normal, suspicious or dangerous. The smart gateway design prototype for
health care system using WSN in this smart gateway design, tasks like sensor
data storage, elder’s current health state detection and real-time report are
done in the low power embedded system in the intelligent model. Hardware
and software design of the gateway are presented and transmit protocol is
designed for this gateway-central system architecture. In this chapter, we focus
on the interoperability of sensor data to build promising and interoperable
domain-specific or cross-domain IoT applications.

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Applications of Wireless Sensor Networks in Healthcare

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KEY TERMS AND DEFINITIONS

IHH: In home healthcare service. Human administrations at home is a

pioneer in bringing modified and capable home therapeutic administrations
benefits in India to allow quick and accommodating recovery inside the
comfort of one’s home. A part of the key helpful organizations offered
consolidate setting up ICU at home, giving cancer care at home, nursing
care, physiotherapy organizations and widely inclusive stroke recuperation
close by giving a lot of clinical system at home along these lines passing on
pretty much 70% of each clinical organization at home.
IoT: The internet of things (IoT) is the system of physical gadgets,
vehicles, home apparatuses, and different things installed with hardware,
programming, sensors, actuators, and availability which empowers these things
to associate and trade information, making open doors for more straightforward
coordination of the physical world into pc based frameworks, bringing about
proficiency upgrades, financial advantages and lessened human intercession.

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