Personal connected healthcare - How oneM2M can help develop the market?

1. Personal Connected Healthcare – How
oneM2M can help Develop the Market
oneM2M Membership
Chuck Parker, Lamprey Networks, Inc.
chuckparker@lampreynetworks.com
2015-07-01 Continua and oneM2M for Personal Connected Healthcare

2. The Opportunity
• Drivers motivating the need for change in the
manner healthcare is delivered:
– Aging populations (global trend)
– Increasing complexity of medical care - clinical
error rate
– Declining ratio of healthcare professionals to
patients (global issue)
• Current practice in the delivery of Healthcare
per capita is globally unsustainable with
respect to cost.

3. A Shift
• In US, there is currently a dramatic shift away from
Institutional and episodic care to Personal
monitoring and continual care
– US Healthcare market is $2.7 trillion
– Remote care and home monitoring is now $1.7 billion
– Desire is to move market to a 30% shift to new models
– This would increase size of home care to nearly $100 billion by current
projections (2025)
• And, personal self care is also shifting to self-funded (i.e. I buy my sensors
for me or my family)
• LNI is targeting 10% of this Sensor and Connectivity market with tools and
services ($100 million)

4. http://www.healthit.gov/providers-professionals/how-attain-meaningful-use
http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/Beginners_Guide.pdf
The US (Medicare/Medicaid) fosters innovation via incentives based on
meaningful achievements. Healthcare providers have objectives they must
achieve to get incentive payments.
US Model Through Incentives

5. LNI Vision
To enable a higher quality
of life through
continuous collection,
distribution, and
application of health
Information

6. Vision Enablement
• Monitoring – To integrate new sensor technology into systems
that collect health data as unobtrusively as possible
• Distributing – To make the collected data as usable as possible
through proper representation and sharing for both human
and machine consumption
• Understanding – To aggregate health information and apply
analytics to identify issues and propose interventions
• Intervening – To support complex and divergent communities
of people in creating effective viable workflows for patient
care.

7. Application Areas
• Reduce the impact
on care givers
helping people live
at home
• Improve the
quality of life for
those battling
chronic conditions
• Consumer
Empowerment
• Pharma trials
• Post operative care transition
• Disaster management
• Field based health data capture

8. Continua
Continua is a non-profit, open industry organization of healthcare
and technology companies joining together in collaboration to
improve the quality of personal healthcare. In February 2014,
Continua, HIMSS and mHealth Summit created the Personal
Connected Health Alliance (PCHA).
Continua is dedicated to providing chronic disease patients with
interoperable, unobtrusive devices that can be used at home, at
work, or on the move, allow them to regularly track and share
their health status. It also enables care givers to make necessary
interventions and family members to play a greater role.
ITU adopted Continua guidelines in December 2013.
(recommendation ITU-T H.810)

9. Continua Unique Value Proposition
The only organization in Connected Health at home to focus
on interoperability from the patients to the caregivers, with
clear, detailed, and ready-to-use guidelines based on existing
standards such as IEEE, HL7, or SNOMED CT.
Continua is to the Connected health at home what IHE is to
the hospital environment (definition of profiles).
It also provides certification, assistance, and extensive source
code library.
“We do not see any alternative to
Continua” wrote Roald Bergstrom, the
Principal Advisor to the National Health
Authority in Norway.

10. Continua - Latest on Adoption
ITU endorsed the Continua guidelines in Dec. 2013 (ITU-T H.810).
In December 2014, Norway announced the adoption of Continua
following Denmark. Other Nordic countries (Finland, Sweden,
Iceland) should follow.
The Continua guidelines are stated in the European Commission’s
eHealth Interoperability Framework (2013) and their refinement are
proposed in the Antilope project (2014).
In the US, ONC is requesting Continua to support DIRECT and
FHIR and the FDA has initiated works with Continua to create a
quality framework for implementation and testing with Continua.
Singapore promotes Continua.
In China, as local governments build their healthcare systems to
care for a growing population, and as they look to promote Chinese
manufactured medical devices, interest in Continua is growing.

11. The Antilope project has refined the European eHealth
interoperability framework to advise and guide national and
regional health administrations on promoting interoperability
locally. Continua and IHE are both core partners.
The European Interoperability Framework

12. • Pulse oximeter
• Blood pressure monitor
• Thermometer
• Weighing-scales
• Glucose meter
• Cardiovascular fitness
• Step counter
• Strength fitness
• Activity hub
• Adherence monitor
• Peak flow meter
• Fall sensor
• Motion sensor
• Enuresis sensor
• Contact closure sensor
• Switch sensor
• Dosage sensor
• Water sensor
• Smoke sensor
• Property exit sensor
2015 Guidelines - Continua Profiles
• Temperature sensor
• Usage sensor
• PERS sensor (Personal Emergency Response Sensor)
• CO sensor (Carbon Monoxide)
• Gas sensor
• Heart-rate sensor
• Basic 1-3 lead ECG sensor (ElectroCardioGram)
• Body composition analyzer
• INR meter
• Sleep Apnea Breathing Therapy Equipment (SABTE)
MoU Continua / Bluetooth SIG
Bluetooth Smart (BLE) Continua profiles:
HTP - Health Thermometer Profile
HRP - Heart Rate Profile
BLP - Blood Pressure Profile
GLP - Glucose Level Profile
WSP - Weighing Scale Profile
BCS - Body Comp Analyzer Service
3 IEEE domains: Disease Management, Health and Fitness,
and Independent Living (Aging Independently)

13. Continua - Beyond Connected Health
3 IEEE domains: Disease Management, Health and Fitness,
and Independent Living (Aging Independently)
Connected Health data systematically sent to caregivers
 Disease Management
Beyond Connected Health data occasionally sent to caregivers
 Health and Fitness
 Independent Living (Aging Independently)
 Smart home

14. Health
Record
Network
(HRN)
Interface
Personal Device
Weight Scale
Pulse Oximeter
Independent
Living Activity
Cardio / Strength
Medication
Adherence
Glucose Meter
Pulse /
Blood Pressure
Thermometer
Physical Activity
Peak Flow
Electrocardiogram
Insulin Pump
Aggregation
Manager
Personal
Area
Network
(PAN)
Interface
Wide
Area
Network
(WAN)
Interface
Telehealth
Service
Center
Health
Records/
Networks
EHR
PHR
NHIN
HIE
WiFi, 2G, 3G & 4G
Continua utilizes standards

15. What Happens Without Continua
Homes city 1
Hospital
medical
system
EHRs
Big data
?
Chronic care
(coordination)
Acute care
(hospitalization)
Homes city 2
MANY
INTERFACES
Telemedicine
provider
Medical
provider
Patients
& devices
Gateways

16. With Continua
UNIVERSAL
CONTINUA
INTERFACE
Homes city 1
Hospital
medical
system
EHRs
Big data
Patient
Primary care
Hospital care
Physiotherapist
Social care
Specialist
Nurse
HCP
Relatives
Chronic care
(coordination)
Acute care
(hospitalization
)
Telemedicine
provider
Medical
provider
Patients
& devices
Gateways
Homes city 2

17. With Continua and oneM2M
UNIVERSAL
CONTINUA
INTERFACE
Homes city 1
Hospital
medical
system
EHRs
Big data
Patient
Primary care
Hospital care
Physiotherapist
Social care
Specialist
Nurse
HCP
Relatives
Chronic care
(coordination)
Acute care
(hospitalization)
Telemedicine
provider
Medical
provider
Patients
& devices
Gateways
Homes city 2
Ecosystem
Care givers
Family
members
Insurance
Specialists
Pharmacy
Emergency
Home
automation
Infotainment

18. Without Continua
• integration
• maintenance
• rollout
• cost
• security
• reliability
several devices = several interfaces
several interfaces = several data models

19. With Continua
several devices = one interface
one interface = one data model
one data model = one application
one application = one portal
• integration
• maintenance
• rollout
• cost
• security
• reliability
• care coordination
• pooled resources
• EHRs

20. With Continua and oneM2M
one application = one portal
one portal = one data stream
one data stream = one ecosystem
one ecosystem = multiple users
• integration
• shared data
• enterprise class
• economies of scale
• ecosystem enabler
• service platform
• data independence

21. oneM2M Application

22. Continua/oneM2M Remote Healthcare Monitoring Solution
Home
Bluetooth
Patient
Continua
Scale
Continua Blood
Glucose/Pressure Meter
Continua/oneM2M
IoT Gateway
Patient uses Continua certified health devices to
measure weight, blood pressure and glucose levels
Health observations are uploaded to
IoT Gateway via Continua Standardized
messaging and services.
1 2 3 4 5 6 7 8

23. Continua/oneM2M
Home
Bluetooth
Patient
Continua
Scale
Continua Blood
Glucose/Pressure Meter
Continua/oneM2M
IoT Gateway
Health Observation Upload
Application
Continua
PAN-IF
Continua WAN-IF
oneM2M AE API
oneM2M ASN-CSE
HTTP/CoAP
TCP/UDP/IP
Wi-Fi Ethernet
IEEE
11073
Bluetooth
Health observations
are uploaded to Cloud
using Continua and
oneM2M standardized
messaging and
services
1 2 3 4 5 6 7 8

24. Continua/oneM2M
HealthLink Exchange
Continua
WAN-IF
Continua
HRN-IF
HL7 v3
HTTP/CoAP
TCP/UDP/IP
IHE XDS.b
oneM2M AE API
Cellular/Ethernet
oneM2M IN-CSE
Health ObservationUpload
Application
Continua
PAN-IF
Continua WAN-IF
oneM2M AE API
oneM2M ASN-CSE
HTTP/CoAP
TCP/UDP/IP
Wi-Fi Ethernet
IEEE
11073
Bluetooth
Home
Cloud
1 2 3 4 5 6 7 8
Health observations are uploaded to
Cloud using Continua and oneM2M
standardized messaging and services
Health observations are delivered to
Independent Living Service using
Continua representation and
oneM2M messaging and services
Bluetooth
Patient
Continua
Scale
Continua Blood
Glucose/Pressure
Meter
Continua/oneM2M
IoT Gateway

25. Bluetooth
Patient
Continua Scale
Continua Blood
Glucose/Pressure Meter
Continua/oneM2
M
IoT Gateway
Continua/oneM2M
HealthLink Exchange
Continua
WAN-IF
Continua
HRN-IF
HL7 v3
HTTP
TCP/IP
IHE
XDS.b
oneM2M AE
API
Cellular/Ethernet
oneM2M IN-CSE
HealthLink Independent Living App
HTTP
TCP/IP
Cellular/Ethernet
HealthLink Exchange
CloudHome
Health Observation Upload
Application
Continua
PAN-IF
Continua WAN-IF
oneM2M AE API
oneM2M ASN-CSE
HTTP/CoAP
TCP/UDP/IP
Wi-Fi Ethernet
IEEE
11073
Bluetooth
Independent Living Service
HealthLink
Independent Living App
1 2 3 4 5 6 7 8
Independent Living Service processes health
observations & detects condition that requires
intervention. A call is placed to EMS to have
ambulance dispatched to patient’s home.

26. Continua/oneM2M
Ambulance
Home
Bluetooth
Mobile Gateway
Continua
Wireless Finger
Pulse Oximeter
Continua
Wireless Blood
Pressure Monitor
Patient connected to
medical devices in ambulance
Patient transferred
to Ambulance
Ambulance arrives at Home
Health observations are uploaded
to ambulance’s IoT Gateway via
Continua Standardized messaging
and services.
1 2 3 4 5 6 7 8

27. Continua/oneM2M
Ambulance
Bluetooth
Mobile
Gateway
Continua
Wireless
Finger Pulse
Oximeter
Continua
Wireless Blood
Pressure Monitor
Health Observation Upload
Application
Continua
PAN-IF
Continua WAN-IF
oneM2M AE API
oneM2M ASN-CSE
HTTP/CoAP
TCP/UDP/IP
Cellular
IEEE
11073
Bluetooth
Health observations are
uploaded to Cloud using
Continua and oneM2M
standardized messaging
and services over a
Cellular Connection
1 2 3 4 5 6 7 8

28. Continua/oneM2M
HealthLink Exchange
Continua
WAN-IF
Continua
HRN-IF
HL7 v3
HTTP/CoAP
TCP/UDP/IP
IHE XDS.b
oneM2M AE API
Cellular/Ethernet
oneM2M IN-CSE
Health Observation Upload
Application
Continua
PAN-IF
Continua WAN-IF
oneM2M AE API
oneM2M ASN-CSE
HTTP/CoAP
TCP/UDP/IP
Cellular
IEEE
11073
Bluetooth
Ambulance
Bluetooth
Cellular
LTE Core Network
Emulator
eNodeB Platform
Phone
Bluetooth Wireless Finger
Pulse Oximeter
Bluetooth Wireless Blood
Pressure Monitor
Cloud
1 2 3 4 5 6 7 8
Health observations are uploaded to
Cloud using Continua and oneM2M
standardized messaging and services
over a Cellular Connection
Health observations are delivered to
Hospital via Continua standardized
messaging and services

29. Continua/
oneM2M
HealthLink Exchange
Continua
WAN-IF
Continua
HRN-IF
HL7 v3
HTTP/CoAP
TCP/UDP/IP
IHE XDS.b
oneM2M AE
API
Cellular/Ethernet
oneM2M IN-CSE
Health Observation Upload
Application
Continua
PAN-IF
Continua WAN-IF
oneM2M AE API
oneM2M ASN-CSE
HTTP/CoAP
TCP/UDP/IP
Cellular
IEEE
11073
Bluetooth
Hospital Emergency Arrival App
HTTP
TCP/IP
Ethernet/Wi-Fi
HL7 v3 / IHE XDS.b
HealthLink Exchange
Ambulance
Bluetooth
Phone
Bluetooth Wireless Finger
Pulse Oximeter
Bluetooth Wireless Blood
Pressure Monitor
Cellular
Cloud
Hospital
Hospital Emergency
Arrival System
LTE Core Network
Emulator
eNodeB Platform
Hospital Emergency Arrival
app processes observations
and monitors patient’s vitals
while travels to hospital
1 2 3 4 5 6 7 8

30. Continua/PCHA Architecture
© 2014 oneM2M Partners
30
Facility-Office-Home-Mobile Backend
HRN INterface
WAN
Interface
LAN InterfacePAN Interface
Physician EMRs
EHRs
PHRs
Application Hosting Device
PAN Device LAN Device
WAN Device
HRN Device
WAN Observation
Receiver
WAN Observation
Server

31. Facility-Office-Home-Mobile Backend
HRN INterface
WAN
Interface
LAN InterfacePAN Interface
Physician EMRs
EHRs
PHRs
Application Hosting Device
PAN Device LAN Device
WAN Device
HRN Device
WAN Observation
Receiver
WAN Observation
Server
Longer Term Picture
© 2014 oneM2M Partners
31
Source: Continua/PCHA
Lightweight
Management of
AHD and LAN/PAN
Devices
Store-and-Forward
Message Delivery
Between AHD and
WAN Device
Triggering of AHD
by WAN Device
Cross Vertical
Semantics

32. Near term  oneM2M over WAN I/F
© 2014 oneM2M Partners
32
WAN-IFApplication
Hosting Device
WAN Device
Gateway/Phone/Etc. Backend/Cloud Server
oneM2M
HTTP/CoAP/MQTT
TLS/DTLS
TCP/UDPoneM2M
Service Layer
(ASN-CSE)
oneM2M
Service Layer
(IN-CSE)
Examples of value-add oneM2M features currently leveraged:
Efficient RESTful oneM2M Interfaces and APIs:
- oneM2M resources
- AE, remoteCSE, container, contentInstance, and subscription
- oneM2M primitives/procedures
- AE and CSE registration - Persistent Session between AHD and WAN Device
- Container/ContentInstance CRUD operations
- Subscription/Notifications
- pointOfAccess proxying between ASN-CSE and IN-CSE over Mcc reference point
Mca
Mcc
Mcc
HL7/IEEE 11073
Mca
PAN
Device
PAN-IF
LAN
Device
LAN-IF
TAN
Device
TAN-IF

33. E.g. Persistent Session between
AHD and WAN Device
© 2014 oneM2M Partners
33
WAN-IFApplication
Hosting Device
WAN
Device
Gateway/Phone/Etc. Backend/Cloud Server
oneM2M
Service Layer
(ASN-CSE)
oneM2M
Service Layer
(IN-CSE)
Mca
Mcc
Mca
PAN
Device
PAN-IF
LAN
Device
LAN-IF
TAN
Device
TAN-IF
Persistent oneM2M Service Layer Session
Non-Persistent Transport Session (e.g. TCP)
oneM2M Service layer hosted on AHD registers to service layer hosted on
WAN Device. This registration persists independently of underlying
transport session being setup and torn-down.
Mcc

34. Thank You
Chuck Parker
VP, Business Development, LNI
chuckparker@lampreynetworks.com

35. Backup

36. LNI: End-to-end Architecture
Health@Home Spectrum
H@H apps and hub H@H exchange
H@H
Analytics
Provides data
visualization and
real-time reporting
on sensor
measurements for
teleheath service
centers or physician
offices

37. Device Support - Health
HealthDevices
Questionnaires
Medication Dispensing
Vital Signs
Blood Pressure
Weight
Temperature
Heart Rate
Blood Glucose
Pulse Ox
Activity
Fall
Pedometer

38. Device Support - HA
HomeAutomation
Presence
Control Bed System
Consumer
Electronics
Lighting
Locking
Environment
Thermometer
Thermostat

39. Health@Home Hubs
Applications Chronic Disease
Management
Aging Independently Emergency Response
User
Experience
Take measurement
only engagement
model
Unified
Communications –
reminders on “best
interface”
Voice controlled via
Google
voice/Amazon echo
Workflow integration
with a Community or
Care using common
interfaces
Remote
Control
Anytime access to
Hub from Cloud
Remote provisioning
Remote diagnostics,
user support and
software upgrades
Remote device
control
Clinical Measurement Data
in clinical form
Biometric
identification of
patient
Continua WAN
time consistency
HIPAA and FDA
Compliant
Technology Continua
Supports Bluetooth,
Bluetooth Smart,
IEEE 802.15.4, IEEE
802.11 (g/n/ah)
radios
oneM2M interface to
AHD resources and
observations
ISO/IEEE 11073,
ZigBee, Threads,
LWOMA

40. Health@Home Exchange
Features
Low bandwidth Near
real time observation
delivery
Observation
translation using
XDS.b/DIRECT
Observation
translation to
multiple private
formats
Application Support
via RESTful FHIR API
User
Experience
Simple Web API for
small business
individual consumer
Diagnostic interface
to isolate problems
Simplified AHD
management/Distrib
ution for LNI AHDs
Remote
Control
Private AHD
management
model using
Continua APS
oneM2m based
AND
management
Provide Device
Status
General
Diagnostics
Clinical
Translation to
PHMR for
delivery to IHE
repository
Consent based
enforcement of
documents
Time
management
and validation
HIPAA and FDA
Compliant
Security
and Privacy
oAUth Support
including self
authentication
Audit record
STS-1 server
support

41. H@H InSight
Features
Core collection of
observation from
devices
Presence tracking
and CE mangement
Real time monitoring
including alert
management
Sleep support
User
Experience
Transparent to the
person receiving care
Web/device
interface for care
providers
Distributed Points of
access using
DLNA/WiFi
Direct/Home
Automation
Workflow
Support
Prescription
adherence
Dementia Sleep
Diverse
Community of
Care
Clinical Alerting to
clinical care
Proper
generation of
clinical
documents
Distributed
workflow
management
FDA Compliant
Security
and Privacy
Consent
Enforcement
DIRECT support HIPAA compliant

42. Engineering standards
hardware
Technology
PAN/LAN DEVICES
Leader in Health Remote
Monitoring System
Standards Based Plug and Play
Healthcare Data Networks
Custom services and
coding for interoperability
Interoperability leader with
oneM2M, Continua, and DLNA
Plug & Play
Standards Based
Interoperability
E2E Data
Connectivity

43. Health@home - Freedom to
Scale
Clinically acceptable,
Plug and Play
Healthcare Data
Networks
PLUG & PLAY
Seamless
interoperability
between PAN Devices
and HRN System
INTEROPERABILITY
End-to-End Data
Connectivity
E2E CONNECTIVITY
Custom solutions to
bring interoperability
to legacy systems
ENGINEERING
Health@home Solution