Paper Title (use style: paper title)

INTERNATIONAL CONFERENCE ON INFORMATION,COMMUNICATION & EMBEDDED SYSTEMS (ICICES 2017)

Title of the paper: Narrowband IoT for Healthcare

Name of the author(s): Dr Sudhir K. Routray and Sharath Anand

Name of the college & University: CMR Institute of Technology, Bangalore

Complete postal address with email id and telephone numbers:

Department of Telecommunication Engineering

CMR Institute of Technology, Bangalore

#132 AECS Layout, ITPL Main Road, Kundalahalli

Bangalore - 560037

Email: sudhirkuma[email protected]c.in / shan15dc@cmrit.ac.in

Phone: +91 8028524466

INTERNATIONAL CONFERENCE ON INFORMATION,COMMUNICATION & EMBEDDED SYSTEMS (ICICES 2017)

Narrowband IoT for Healthcare

Sudhir K. Routray

Associate Professor, Telecommunication Engineering

CMR Institute of Technology, Bangalore

India

[email protected]

Sharath Anand

Telecommunication Engineering

CMR Institute of Technology, Bangalore

India

[email protected]

Abstract—The Internet of Things (IoT) is going to have its

presence in all the essential sectors of human lives. It has the

ability to provide both mainstream as well as the value added

services in almost all the sectors. Healthcare is an important

service sector for overall development. It has far reaching

implications in the quality of living. In the modern world where

the quality of living has been degraded significantly IoT can

certainly play a constructive role in providing better services. In

healthcare, there are several occasions such as patient health

monitoring, remote observation and emergency proceedings

outside the hospital where sensors can play essential roles. The

coordinated sensor networks can provide even better services.

IoT has the ability to provide all these coordinated services.

Narrowband IoT (NBIoT) is an economical and simpler version

of IoT which can handle these tasks effectively. Due to the

widespread requirement of healthcare, NBIoT is a preferred

solution as it needs fewer amounts of resources. In this article, we

provide the main issues and difficulties of NBIoT in healthcare.

Keywords—IoT;NBIoT; IoT for healthcare; modernisation of

healthcare;NBIoT for healthcare

I. INTRODUCTION

The Internet of Things (IoT) is a sensor based technology

that can connect several objects to the Internet. This

connectivity can provide us several services which are

essential for the day to day activities. Healthcare sector is very

much important and several sensor based applications are

required in its proper decision making and pre-treatment

proceedings. In addition to that, there are several other

instances where the remote monitoring of patients is essential

for successful treatment. The resources required for wide

spread healthcare services is large. Thus a resource efficient

IoT is required for these applications. Narrowband IoT

(NBIoT) is certainly one of the resource efficient forms of

currently available IoTs. We propose, NBIoT as a potential

solution for the healthcare related applications.

IoT based solutions for healthcare have been proposed in

several works. In [1], a comprehensive survey of healthcare

IoT has been presented. It provides all the main aspects of

current initiatives for IoT based healthcare. It also provides

several potential architectures of IoT for effective healthcare

service provisioning. In [2], an energy efficient and

trustworthy healthcare IoT system is proposed which can be

remotely monitored. In this work, the authors have

emphasized on the security and energy consumption aspects of

IoT based healthcare system. In [3], a body sensor network

has been proposed for monitoring several health parameters.

Security aspects have also been considered in this work which

proposes robust security measures for healthcare IoT. A

similar approach has been proposed in [4] which take care of

the health monitoring using a group of connected sensors. It

also uses body sensor networks for this purpose. In [5], an IoT

aware healthcare system has been proposed for smart

healthcare systems. In this case, the IoT sensors take

measurement of various health related parameters and send

them to a central hub where the information is processed and

decisions are taken for further course of action. In [6], a low

power sensor design methodology has been proposed for

mobile based healthcare applications. Wide area coverage

with low power is the main aim of this IoT based work. Radio

frequency identification (RFID) based personal healthcare in

the smart homes and other smart spaces has been proposed in

[7]. It uses IoT based connected architecture for personal

health motoring. NBIoT is very popular in the low power

applications. In [8], the main standards issues of NBIoT and

its potential applications have been presented. Main attraction

of NBIoT is that it has already been standardized in LTE

Release 13. In [9], the main points of LTE Release 13 for

NBIoT are documented. It provides the physical details and

deployment options for NBIoT. In [10], the main applications

of NBIoT are presented in which healthcare is one such

potential areas. Modern healthcare systems have several

different complexities and NBIoT is found to be suitable for

this complex scenarios.

In this article, we present the suitability of NBIoT for

healthcare applications. We provide the details of NBIoT, its

physical parameters, the basic standardization issues as

presented in Release 13, and the matching characteristics with

the healthcare needs. We also analyze the potential demerits of

this technology and suggest the alternatives to overcome them.

The remaining parts of this paper are organized in five

different sections. In Section II, we present the basic features

of NBIoT and its potential applications. In Section III, we

present the utilities of IoT for healthcare. In Section IV, we

present the justification and practical utilities of NBIoT for

INTERNATIONAL CONFERENCE ON INFORMATION,COMMUNICATION & EMBEDDED SYSTEMS (ICICES 2017)

healthcare. In Section V, we present the potential difficulties

and demerits of NBIoT for this sector. In Section VI, we

conclude this article with the main points.

II. NARROWBAND IOT

NBIoT is a leaner and thinner version of IoT. It takes a

narroband of frequency for its operation. In Release 13, 180

kHz is allocated for NBIoT [8]. It can be deployed in both

cellular and noncellular forms. Noncellular forms are needed

in some ad hoc applications. Cellular forms are popular as

they are very organised and can use the cellular infrastructure

for their operations.

In Realease 13, cellular IoT for GSM and LTE networks

are standardised in terms of the operating parameters. Three

different types of depolyment has been proposed for NBIoT

[9]. The first one is the standalone deployment in which a new

band of microwave frequencies have been proposed. Right

now, the microwave frequencies in the 700 MHz and 800

MHz are popular for NBIoT standalone deployments. In the

second option the guard bands of LTE and GSM are proposed

for NBIoT operations. These guard bands are notused by LTE

and GSM operators. So, these bands can be used for NBIoT

for value added services in the cellular networks. The third

option is the in-band deployment of NBIoT. In this case, some

of the opeational bands of LTE and GSM is provided for

NBIoT operations. For this to happen in a systematic way,

appropriate frequency hopping algorithms are provided.

NBIoT will take several legacy propoerties form GSM and

LTE. Therefore, the layerwise architecture of NBIoT will have

several similar features of GSM and LTE.

NBIoT is the main attraction in several applications

because it is a low power wide area (LPWA) coverage

capabilities. For the widespread application sectors such as the

healthcare LPWA technologies are essential. NBIoT has two

different input power specifications: 20 dBm and 23dBm. It

has twotier power saving mechanisms in place [9]. It uses half

duplex communication for its operations. Binary phase shift

keying (BPSK) and quadrature phase shift keying (QPSK) are

the two main modulation schemes used in NBIoT at the

moment. Therefore, the peak downlink and uplink dat rates

possible right now is around 250 kbps. It can cover a power

strength as low as -164 dBm. This is what shows NBIoT is a

real LPWA technology.

III. IOT FOR HEALTHCARE

Main motivations for IoT in healthcare come from two

obvious reasons. The first is the pre-treatment procedures

required for an emergency when the patient is being brought

to the hospital. The availability of direct contact with the

patient and remote monitoring by the healthcare experts along

the way to the hospital can save many lives. The support staff

can take appropriate decisions and provide essential services

when they are advised by the experts. The second reason is

that several ailments need constant monitoring. It is not

possible to keep these people in the hospital as they do not

need the medical services all the time. Rather only during the

onset of the problems they need to see the doctors. In such

cases, IoT is very much desirable. It sends the health

information to the healthcare service provider regularly and

when there is an urgent need of intervention of the experts. On

the other end, the healthcare provider keeps monitoring the

information received from the IoT and takes the appropriate

steps as they are required.

In addition to the above, IoT has several advantages of

providing remote monitoring is several applications including

healthcare [1]. Remote monitoring of health is required in

several occasions in which the real-time information tracking

is advisable. As the IoT is going to be an intelligent service

provider and body area sensors are readily available IoT for

healthcare is certainly an attractive technology [3]. Of course

providing healthcare from a remote location has several

challenges. The information being transmitted in a wireless

channel has several potential threats [2]. These issues have to

be handled appropriately for safe and secure healthcare.

IV. NBIOT FOR HEALTHCARE

As we have seen in Section II, NBIoT is the attraction in

sectors which are widespread as it is a LPWA technology.

Certainly, healthcare is one such sector and it needs this

technology [10]. Connectivity among sensors paved the way

for gathering important information that has not been possible

in the past. Advancements have been made in the sensor

networks and communication with the evolved technologies,

and thereby paving way for it to be adapted to various real

time fields. Healthcare is one such field where we can use

NBIoT as an alternative and as an easy technology for

diagnosing the variations in the functioning of human body.

Blood pressure, heart rate, vital capacity and many other

parameters along with their functions can be recorded and

analyzed by installing the appropriate sensor. This allows us to

collect the patient data at regular intervals and preventive

measures can be taken. In addition to the above, NBIoT has

the compatibility with the existing cellular systems which is an

extra advantage for ubiquitous healthcare monitoring.

There are two main scenarios that have to be taken into

account, namely clinical care and remote monitoring. In

clinical care, the patients are admitted in hospital and their

physiological status has to be dealt with vital care. This can be

established with NBIoT noninvasive monitoring. This

technique employs the collection of physiological data with

the help of sensors and the data is stored in local gateways and

clouds. The stored data can then be retrieved and passed over

to the care takers. This will help to reduce the necessity of

periodic health checking of the patient by the health

professional. Proper medication can be provided on

diagnosing the vital signs and hence proper care can be

provided to the patient. This technology helps to reduce the

cost and at the same time improves the quality of services

provided.

INTERNATIONAL CONFERENCE ON INFORMATION,COMMUNICATION & EMBEDDED SYSTEMS (ICICES 2017)

Fig. 2. The basic structure of the server side NBIoT for healthcare service

provisioning.

Fig. 1. The basic structure of the device or client side NBIoT for

healthcare service provisioning.

In remote monitoring, the patient is not necessarily admitted

in the hospital, but he or she is constantly under the

surveillance of the medical device which records the vital

signs. The NBIoT device is attached to the human body and it

continuously records the different parameters. The recorded

information is then transmitted using the transmit antenna

present in the device to that of the server present in the

caretakers place, where the data will be continuously

monitored on a monitor. Hence they can keep a constant eye

on the patient and in case of variations, preventive measures

can be provided. The client side architecture for NBIoT has

been shown in Fig. 1.

The small NBIoT device is attached to that of the patient‟s

body so that wherever the patient may be, the doctors can have

complete idea about the patient‟s health cycle. The

implementation of the entire process had two sections: the

device structure, and the server structure. The main function

invokes the interface function. The interface then creates the

server program. Through the keyboard, several physical and

medium access control (MAC) layer functions are invoked.

Inputs for the configuration is provided through the keyboard,

and the configuration messages are directly sent to the device

server. An application (App) is used to perform the specific

healthcare related actions (for instance, periodic monitoring of

the vital signs of the patient). These queues are initiated by the

interfaces and after initiating the sub-processes along with the

main it goes to sleep mode. The trans-received messages are

sent through the internet from the respective ends.

Server in comparison with the device structure has main and

interfaces which normally go to sleep mode after the initiation

of the sub-process by the interface through the queues which

are present. Interface is also responsible for creating the

NBIoT server which also has got keyboard through which the

configuration messages can be sent. The information present

here is routed through the MAC layer and then it is sent to the

trans-receiver antenna. The messages then travel through the

socket and enter the communication medium and become a

part of the „Internet‟. In addition, we have database which can

be accessed by processes to store the information. The

database can be used for devices as well as users. Users can be

nurses, doctors, paramedics and other authorized healthcare

officials. The information stored after diagnosing the patient

can be viewed from the available visual platform by one or

more authorized personnel. The server side architecture for

NBIoT has been shown in Fig. 2.

Smart sensors consist of sensors and microcontrollers which

are capable of measuring the vital sign of human body

accurately. Using these sensors, we can assure that quality

service is being provided. This device can also be upgraded

according to varying specifications. The microcontrollers can

also be reprogrammed so that it is adaptable to the evolving

environment. These are also user friendly and cost effective.

With the help of these sensors, it is also possible to ensure the

amount of intake of medicine and the time of intake. In

addition to this, the doctors can ensure that regular medication

is in process through the sensor mounted on the medicine

bottle. NBIoT sensors require very small amount of power for

their operation and the battery lifetime is estimated to be

around 13-15 years.

V. POTENTIAL DEMERITS OF NBIOT BASED

HEALTHCARE SERVICES

In previous sections, we have already seen the main

features and advantages of using NBIoT for healthcare. It has

a few demerits as well. The present services provided over the

NBIoT platforms are not suitable for real-time applications.

The main reason behind this is the lack of control over the

delay. The delay tolerant methodologies have not been

incorporated in the NBIoT framework as of now. In contrast

to this, there are several applications in healthcare that

demands real-time communication and information exchange.

INTERNATIONAL CONFERENCE ON INFORMATION,COMMUNICATION & EMBEDDED SYSTEMS (ICICES 2017)

In such cases, certainly, we cannot rely on NBIoT. In addition

to this, some of the healthcare applications need higher

bandwidth for better communication and sensing. In such

cases, the bandwidth required is more than what has been

allocated to the NBIoT now. With 180 kHz these services will

not be achieved as desired with high definition images and

better quality of information being exchanged between the

clients and the server. The quality of service and quality of

experience are two important parameters in IoT related

services. At both these fronts NBIoT is not yet at par with the

best ICT services available today. Of course, the NBIoT

standards will be changed gradually to be compatible with

these new demands across several application areas.

Several other possible demerits are also there. Most of the

proposed NBIoT solutions for healthcare come as wearable

electronics. These wearable devices are not always safe and

there are also senses of uncomfortable aspects to these

devices. Different manufacturers are having different

standards as there is no unison yet for unified methods for

manufacturing of IoT devices. It complicates the scenario as

the devices used by the hospital and the patients may not

match perfectly. Doctors have to be trained according to the

IoT practices as they are not aware of these technologies. It

would cost a lot to train all the medical staff. Though NBIoT

is an economical option for the widespread deployment in the

healthcare sector several challenges are still there.

VI. CONCLUSIONS

NBIoT is one of the leaner, thinner and greener versions of

IoT, and it has great potentials in several sectors. It can

provide cost effective services which are essential for both

rural and urban areas. Healthcare is a primary service sector

and it needs smart technologies for better services. In this

article, we have shown the main utilities of NBIoT for

healthcare. We have gone through the specific functions where

it can play important roles in effective service provisioning.

We have also indicated the potential demerits due to the

current deficiencies in the technology standards. However,

these short comings will be overcome in the newer versions of

NBIoT. It is expected that NBIoT will be an integral part of

modern healthcare system.

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