A wireless medical sensor application and the problems it poses

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1 A wireless medical sensor application and the problems it poses Odd Nordland SINTEF ICT Trondheim Norway 1

2 The scenario 2

3 The scenario Diabetes patient Needs regular medical attention But does not need stationary care Is not able to perform all medically necessary actions himself Has sensors on and/or in his body to collect diagnostic data and possibly actuators to perform therapeutic actions e.g. providing insulin when necessary The sensors can communicate wirelessly With each other and/or with a local base station The base station can communicate with processing platform in a hospital or doctor's practice Medical staff can trigger activators or contact the patient if necessary via the processing platform's link to the base station 3

4 Example Patient The patient is an elderly person with diabetes i.e. not into using all kinds of latest, new fangled technology Not yet retired, so needs to be reasonably mobile Lives alone in a village about 25 Km from the local hospital The patient has sensors implanted in his body To measure blood sugar To release insulin if necessary The patient has sensors on his body To measure blood pressure, temperature, pulse rate 4

5 Example sensor network Blood sugar implanted sensor that measures blood sugar once a minute Insulin depot implanted device that can release a controlled amount of insulin when actuated Blood pressure Records data (blood pressure, time and date) for later processing Temperature External sensor that measures the body temperature once a minute Pulse External sensor that measures the pulse rate once a minute Base station Receives data from sensors and processing platform Sends information to the processing platform, commands to the sensors 5

6 Example communications Blood sugar sensor can trigger insulin depot to release insulin if a threshold value is exceeded Insulin depot sends acknowledgement signal to blood sugar sensor Or an alarm if it is empty Blood sugar sensor and insulin depot transmit data to a base station for storage and processing they have no memory of their own for storing data External sensors transmit their data to the base station for storage and processing Base station transmits data to hospital for storage and processing Limited local memory Base station can transmit data to e.g. reset data in sensors Base station can receive data/commands from hospital 6

7 Example processing platform A computer system that can communicate with several base stations Receives data from a base station Processes the data in order to determine how to react Display corresponding messages to health personnel Send appropriate messages to the base station Communicates via a "global" network to be selected depending on the location of the base station Internet Mobile phone network Dedicated cable network Subject to normal maintenance (hardware & software) Down-times have to be short 7

8 What can go wrong? Human errors Patient makes mistakes Health staff makes mistakes Maintenance personnel makes mistakes Hardware errors Sensors break down Base station or processing platform error Network errors Network is down Wireless interference Transmission errors Right data, wrong patient (or vice versa) Hacking 8

9 Human errors Patient Cannot handle equipment properly Forgets limitations of base station (e.g. range) Medical staff Misunderstand messages from processing platform Maintenance staff Create breakdown through wrong maintenance procedure 9

10 Hardware errors Sensors malfunction Overheating Vibrations Loss of power Base station malfunctions Power failure Physical damage dropped water Processing platform malfunctions Power failure Physical damage 10

11 Network errors Network overload Data cannot be transferred in time Configuration error Data takes too long Data gets rerouted Data packets wrongly synchronised Network breakdown Data transmission impossible 11

12 Transmission errors Data gets falsified Erroneous data leads to erroneous diagnosis which results in wrong treatment Data is incomplete Diagnosis/treatment impossible Transmission too slow Diagnosis/treatment gets delayed Data gets hacked Wrong person gets sensitive information 12

13 Assurance requirements Evidence must be presented for the system's Suitability of use Safety Security Typically first at component level Then at system level 13

14 Suitability for intended use Who defines the intended use? The patient? The doctor? The hospital? The equipment suppliers? The health authorities? Who produces the system? And demonstrates that it is suitable for its intended use 14

15 Safety of the system Safety = System cannot do harm to life health the environment But "harm" might be medically necessary e.g. chemical therapy Protection against High voltages High temperatures Microwaves 15

16 Security of the system Security = protection of the system against effects that can compromise safety functionality Network security = data protection against falsification loss theft The patient must trust the system 16

17 Problems Conflicts between safety and security Know where the patient is at all times => safety Keep his location secret => security Patient moves Goes to work, shopping Goes on holiday Who is responsible for what? Patient's responsibilities? Service providers' and equipment suppliers' responsibilities Doctors' and hospitals' responsibilities Authorities' responsibilities 17

18 Answers 18

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