Della Mea Vincenzo, Popescu Mihai Horia, Gonano Dario, Petaros Tomaž, Emili Ivo, Fattori Maria Grazia
Department of Mathematics, Computer Science and Physics, University of Udine, Udine, Italy.
Cimtech Srl, Reana del Rojale, Italy.
JMIR Med Inform. 2020 Feb 25;8(2):e14583. doi: 10.2196/14583.
Increasing life expectancy and reducing birth rates indicate that the world population is becoming older, with many challenges related to quality of life for old and fragile people, as well as their informal caregivers. In the last few years, novel information and communication technology techniques generally known as the Internet of Things (IoT) have been developed, and they are centered around the provision of computation and communication capabilities to objects. The IoT may provide older people with devices that enable their functional independence in daily life by either extending their own capacity or facilitating the efforts of their caregivers. LoRa is a proprietary wireless transmission protocol optimized for long-range, low-power, low-data-rate applications. LoRaWAN is an open stack built upon LoRa.
This paper describes an infrastructure designed and experimentally developed to support IoT deployment in a health care setup, and the management of patients with Alzheimer's disease and dementia has been chosen for a proof-of-concept study. The peculiarity of the proposed approach is that it is based on the LoRaWAN protocol stack, which exploits unlicensed frequencies and allows for the use of very low-power radio devices, making it a rational choice for IoT communication.
A complete LoRaWAN-based infrastructure was designed, with features partly decided in agreement with caregivers, including outdoor patient tracking to control wandering; fall recognition; and capability of collecting data for further clinical studies. Further features suggested by caregivers were night motion surveillance and indoor tracking for large residential structures. Implementation involved a prototype node with tracking and fall recognition capabilities, a middle layer based on an existing network server, and a Web application for overall management of patients and caregivers. Tests were performed to investigate indoor and outdoor capabilities in a real-world setting and study the applicability of LoRaWAN in health and social care scenarios.
Three experiments were carried out. One aimed to test the technical functionality of the infrastructure, another assessed indoor features, and the last assessed outdoor features. The only critical issue was fall recognition, because a slip was not always easy to recognize.
The project allowed the identification of some advantages and restrictions of the LoRaWAN technology when applied to the health and social care sectors. Free installation allows the development of services that reach ranges comparable to those available with cellular telephony, but without running costs like telephony fees. However, there are technological limitations, which restrict the scenarios in which LoRaWAN is applicable, although there is room for many applications. We believe that setting up low-weight infrastructure and carefully determining whether applications can be concretely implemented within LoRaWAN limits might help in optimizing community care activities while not adding much burden and cost in information technology management.
预期寿命的增加和出生率的降低表明世界人口正在老龄化，这给老年人、体弱多病者及其非正式照料者的生活质量带来了诸多挑战。在过去几年中，人们开发了通常被称为物联网（IoT）的新型信息通信技术，这些技术围绕为物体提供计算和通信能力展开。物联网可以为老年人提供设备，通过扩展他们自身的能力或减轻其照料者的负担，使其在日常生活中实现功能独立。LoRa是一种针对远程、低功耗、低数据速率应用进行优化的专有无线传输协议。LoRaWAN是基于LoRa构建的开放堆栈。
本文描述了一种为支持医疗保健环境中的物联网部署而设计并通过实验开发的基础设施，并选择了阿尔茨海默病和痴呆症患者的管理进行概念验证研究。所提出方法的独特之处在于它基于LoRaWAN协议栈，该协议栈利用未授权频段并允许使用极低功耗的无线电设备，使其成为物联网通信的合理选择。
设计了一个完整的基于LoRaWAN的基础设施，其部分功能在与照料者协商后确定，包括用于控制游荡的户外患者跟踪；跌倒识别；以及收集数据以进行进一步临床研究的能力。照料者提出的其他功能包括夜间运动监测和大型住宅建筑的室内跟踪。实施过程涉及一个具有跟踪和跌倒识别功能的原型节点、一个基于现有网络服务器的中间层以及一个用于患者和照料者全面管理的Web应用程序。进行了测试以研究在实际环境中的室内和室外功能，并研究LoRaWAN在健康和社会护理场景中的适用性。
进行了三项实验。一项旨在测试基础设施的技术功能，另一项评估室内功能，最后一项评估室外功能。唯一的关键问题是跌倒识别，因为滑倒并不总是容易识别。
该项目确定了LoRaWAN技术应用于健康和社会护理领域时的一些优点和限制。免费安装使得能够开发出覆盖范围与蜂窝电话相当的服务，但没有电话费用等运营成本。然而，存在技术限制，这限制了LoRaWAN适用的场景，尽管仍有许多应用空间。我们认为，建立轻量级基础设施并仔细确定应用是否能够在LoRaWAN限制范围内具体实施，可能有助于优化社区护理活动，同时不会在信息技术管理方面增加太多负担和成本。
